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31 December 2013, Volume 17 Issue 53 Previous Issue    Next Issue

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Retrograde sural neurovascular flap transplantation for chronic calcaneal osteomyelitis Cai Xing-jian, Zhou Jian-guo, Qian Rui, Xiao Shi-liang 2013, 17 (53):  9101-9106.  doi: 10.3969/j.issn.2095-4344.2013.53.001 Abstract ( 194 )   PDF (1942KB) ( 580 )   Save BACKGROUND: Calcaneal osteomyelitis treatment is necessary that not only eliminates foci of osteomyelitis, seals the wound, repairs soft tissue defects, but also restores normal body shape and protects weight-bearing foot function as much as possible. Sural neurovascular flaps cannot damage major blood vessels of the lower limbs and appears to have the large arc of rotation, constant and reliable blood supply, which are suitable for repair of chronic calcaneal osteomyelitis. OBJECTIVE: To study the operating method and clinical results of repairing chronic calcaneal osteomyelitis using retrograde sural neurovascular island flaps. METHODS: Totally 28 patients with chronic calcaneal osteomyeliti were treated with the distally-based sural musculocutaneous flap in the Department of Orthopedics, People’s Hospital of Ganzhou, from May 2008 to June 2012. The donor defects were closed primarily in 23 patients and were resurfaced with the split-thickness skin graft in five patients. RESULTS AND CONCLUSION: All the musculocutaneous flaps survived completely in 28 cases, four of which got some distal necrosis of the skin flap, and cured by dressing. All the flaps had good shapes and well-function, and exhibited no recurrence of osteomyelitis. All patients were able to walk normally. These findings indicate that the retrograde sural neurovascular flap transplantation is effective and feasible for treatment of chronic calcaneal osteomyelitis. 中国组织工程研究杂志出版内容重点：肾移植；肝移植；移植；心脏移植；组织移植；皮肤移植；皮瓣移植；血管移植；器官移植；组织工程 全文链接： Figures and Tables | References | Related Articles | Metrics

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Natural hirudin hydrogel improves the survival rate of random pattern flaps Wei Shu-yi, Yin Guo-qian, Han Zhi-qiang, Pan Xin-yuan, Lin Bo-jie 2013, 17 (53):  9107-9112.  doi: 10.3969/j.issn.2095-4344.2013.53.002 Abstract ( 279 )   PDF (2093KB) ( 504 )   Save BACKGROUND: A random pattern flap is prone to resulting in blood stasis and even ischemic necrosis. Clinical and animal experiments have proved that hirudin can improve the survival rate of the pattern flap. OBJECTIVE: To discuss the effects of natural hirudin hydrogel on the survival of rat random pattern flaps. METHODS: Natural hirudin hydrogel was prepared for percutaneous permeation experiment using modified Franz diffusion cell. Markwardt method was used to detect hirudin activity. Random pattern flaps from the back of Wistar rats, 9 cm × 3 cm, were used for flap preparation. The flaps were randomized into three groups, normal saline group, hirudin group and blank gel matrix group. Postoperative gross, histopathological, and morphological observations were conducted, and the survival rate of the flaps was calculated at day 7. RESULTS AND CONCLUSION: In vitro experiments: The active ingredient of the natural hirudin hydrogel passed through the skin, but there was no active ingredient in the blank gel group. In vivo experiments: After 7 days, the length of necrotic flaps in the hirudin group was significantly longer than that in the normal saline and blank gel matrix groups (P < 0.05). After 3 days, the phenomenon of red blood cell stasis in dermal capillaries and venules was significantly reduced in the hirudin group as compared with the normal saline and blank gel matrix groups; after 7 days, subcutaneous collagen and granulation tissue hyperplasia was more obvious in the hirudin group than in the normal saline and blank gel groups; after 7 days, the survival rate of flaps in the hirudin group was significantly higher than that in the normal saline and blank gel matrix groups (P < 0.05). Natural hirudin permeate the intact skin tissue, and local application of natural hirudin hydrogel can improve blood stasis after flap transplantation and be conducive to the formation of new blood vessels. 中国组织工程研究杂志出版内容重点：肾移植；肝移植；移植；心脏移植；组织移植；皮肤移植；皮瓣移植；血管移植；器官移植；组织工程 全文链接： Figures and Tables | References | Related Articles | Metrics

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Factors critical for creeping substitution of intracorporeal grafting following thoracolumbar fractures Shen Jun, Zou Tian-ming, Miao Ye, Wang Ye-feng, Xu Zheng-quan, Wang Dong-lai 2013, 17 (53):  9113-9118.  doi: 10.3969/j.issn.2095-4344.2013.53.003 Abstract ( 236 )   PDF (850KB) ( 550 )   Save BACKGROUND: The occurrence of “eggshell” change after the pedicular screw reduction                           is the main cause of reduction lose and kyphosis. Theoretically intracorporeal grafting in the juried vertebra could enhance the anterior supporting, but the clinical effects vary obviously and the specific cause is unclear. OBJECTIVE: To understand the effect of defect size and the amount of bone grafting on the osteogenesis and to explore the histological factors concerning osteogenesis of intracorporeal grafting following thoracolumbar fractures. METHODS: The two-different sizes bone defect models (1 cm3 and 2 cm3 defect groups) in the lumbar vertebras of 12 sheep were made, and each group included six sheep. Different amount of autologous iliac bone was randomly grafted into the L1, 3, 5 vertebral segments according to grafting/bone defect ratios of 0.5, 0.75, 1.0, respectively. The grafting area of operated vertebra was separated for the imaging and histological analysis to understand the osteogenesis process. RESULTS AND CONCLUSION: The bone histomorphometry and histological results of different grafting ratio in different size defects demonstrated excellent creeping substitution and osteogenesis in the grafting/cavity ratio larger than 0.75, and the grafting bone was substituted by fibrous tissue if the ratio was less than 0.75. Trabecular  number, percent of trabecular area and mean trabecular plate height increased and trabecular separation decreased with the increment of grafting/cavity ratio. There was no significant difference between the grafting ratio 0.75 and 1.0, but they had obvious difference from ratio 0.5 subgroup. The sufficient grafting amount is critical for intracorpereal grafting, and the ratio of grafting/bone defect larger than 0.75 could produce satisfactory osteogenesis. 中国组织工程研究杂志出版内容重点：肾移植；肝移植；移植；心脏移植；组织移植；皮肤移植；皮瓣移植；血管移植；器官移植；组织工程 全文链接： Figures and Tables | References | Related Articles | Metrics

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Four-point fixation contributes to decreased astigmatism after deep lamellar keratoplasty Wang Xin, Wang Ke, Wu Yan-chao, Ma Li-xiao, Guo Xiu-jin 2013, 17 (53):  9119-9124.  doi: 10.3969/j.issn.2095-4344.2013.53.004 Abstract ( 489 )   PDF (744KB) ( 722 )   Save BACKGROUND: Deep lamellar keratoplasty has been widely used in the surgical treatment of keratoconus, which can increase the visual acuity similar to penetrating keratoplasty and has a low incidence of graft rejection. OBJECTIVE: To explore whether four-point fixation can effectively reduce postoperative astigmatism after deep lamellar keratoplasty. METHODS: A retrospective analysis was performed in 50 patients (50 eyes) with keratoconus who received deep lamellar keratoplasty. Intraoperative four-point fixation was performed in 25 cases (25 eyes) and direct cutting of the planting bed in another 25 cases (25 eyes). Postoperative astigmatism and simulated keratoscopy reading were compared between two groups. RESULTS AND CONCLUSION: All the patients were followed up for 6-12 months, an average of 8.3 months. There were no corneal graft rejections, infections, and secondary glaucoma in the two groups postoperatively. Postoperative astigmatism and simulated keratoscopy reading were better in patients undergoing the four-point fixation. These findings indicate that the four-point fixation technique is shown to effectively reduce postoperative astigmatism caused by eye deformation, bed distortion, and decreased intraocular pressure in deep lamellar keratoplasty. 中国组织工程研究杂志出版内容重点：肾移植；肝移植；移植；心脏移植；组织移植；皮肤移植；皮瓣移植；血管移植；器官移植；组织工程 全文链接： Figures and Tables | References | Related Articles | Metrics

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Influence of different cryopreservation schemes on human ovarian tissue activity Li Yun-xiu, Sun Ying-pu, Tang Li, Ma Yan-ping 2013, 17 (53):  9125-9131.  doi: 10.3969/j.issn.2095-4344.2013.53.005 Abstract ( 382 )   PDF (2128KB) ( 472 )   Save BACKGROUND:Ovarian tissue cryopreservation is considered to be a safe and effective method to save female reproductive endocrine function, but there is no uniform scheme identified. OBJECTIVE:To explore the effects of three freezing schemes on human ovarian tissue and the influence on follicle activity. METHODS: Twenty specimens of human ovarian tissue were frozen by propanediol slow freezing method, dimethyl sulfoxide vitrification method, and direct liquid nitrogen method, respectively. After cell resuscitation, the number of activated cells was counted using the live/dead fluorescence analysis, and estradiol level and follicles at different development stages were measured and counted respectively after cultured in vitro to evaluate the influence of three freezing schemes on human ovarian tissue activity . RESULTS AND CONCLUSION: The activated oocyte rates of three frozen-thawed ovarian tissue groups were lower than that of the fresh ovarian tissue group (P < 0.05). Among the three frozen-thawed groups, the activated  oocyte rate of the dimethyl sulfoxide group was the lowest, and there was no significant difference between the other two groups. After in vitro culture, the estradiol level of the dimethyl sulfoxide group was lower than that in the propanediol and liquid nitrogen groups at 4 days (P < 0.05), and the estradiol levels showed no differences between the fresh ovarian tissue group and three frozen-thawed groups at 8 days. After 14 days of culture, the ratio of growing follicles was increased, but primordial follicles were still in the lead. The total number of normal occytes in the fresh ovarian tissue was higher than that in the three frozen-thawed groups (P < 0.05), and the number of normal occytes in dimethyl sulfoxide group was lower than that in the other two frozen-thawed groups (P < 0.05). These findings indicate that the cryopreservation can cause damage to ovarian tissue follicles but still can save most primordium follicle activity. The primordium follicle cultured in vitro can further develop to have secretion function. The dimethyl sulfoxide vitrification method is superior to the propanediol slow freezing method and direct liquid nitrogen method, but the direct liquid nitrogen method is simple and convenient with stable cryopreservation effects. 中国组织工程研究杂志出版内容重点：肾移植；肝移植；移植；心脏移植；组织移植；皮肤移植；皮瓣移植；血管移植；器官移植；组织工程 全文链接： Figures and Tables | References | Related Articles | Metrics

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Intrasplenic delivery of xenogeneic hepatic progenitor cells ameliorates acute liver injury in rats Wan Zhen1, 2, Zhang Xiao-gang1, 2, Zheng Xing-long1, 2, Ma Feng1, 2, Ma Jia1, 2, Xiang Jun-xi1, 2, Wang Hao-hua1, 2, Lü Yi1, 2 2013, 17 (53):  9132-9138.  doi: 10.3969/j.issn.2095-4344.2013.53.006 Abstract ( 113 )   PDF (2343KB) ( 531 )   Save BACKGROUND: Adult hepatic progenitor cells transplanted into the liver can engraft and differentiate into hepatocytes. However, little evidence was available concerning whether heterogeneic hepatic progenitor cells can promote the restoration of acute liver damage and whether the microenvironment of spleen can promote the graft survival and differentiation into hepatocytes. OBJECTIVE: To evaluate the effect of hepatic progenitor cell transplantation on acute liver injury and monitor the engraftment and hepatocytic differentiation of transplanted hepatic progenitor cells in the splenic parenchyma. METHODS: Adult mouse derived progenitor cell line liver epithelial progenitor cells were cultured in vitro for long term. The acute liver injury model was established by intraperitoneal injection of CCl4 in combination with 2/3 partial hepatectomy, for transplantation of liver epithelial progenitor cells. The liver pathological changes were observed by hematoxylin-eosin staining at 1, 5, 14 and 21 days after hepatectomy. Serum transaminase levels were monitored using automatic biochemistry analyzer. The Sry sequence in the spleens was tested by PCR.Immunohistochemistry staining against CK-19 and Alb was performed to analyze the engraftment and hepatocytic differentiation of transplanted hepatic progenitor cells in the splenic parenchyma. RESULTS AND CONCLUSION: Liver epithelial progenitor cells maintained normal proliferation and bipotential differentiation capacity after long-term culture in vitro. Compared with model group, hepatocyte edema was alleviated significantly, and serum alanine aminotransferase and aspartic transaminase levels were decreased remarkably after cell transplantation group. The Sry sequence was tested in spleen DNAs at 1, 5, 14 and 21 days post-transplantation. CK-19 positive cells existed in the splenic parenchyma throughout the study period. Alb-positive cells emerged at 5 days post-transplantation and the number of Alb-positive cells was gradually increased over time. Results show that hepatic progenitor cells engraft and differentiate into hepatocytes in rat splenic parenchyma successfully, and the transplantation can promote the recovery process from CCl4/partial hepatectomy induced acute liver injury. 中国组织工程研究杂志出版内容重点：肾移植；肝移植；移植；心脏移植；组织移植；皮肤移植；皮瓣移植；血管移植；器官移植；组织工程 全文链接： Figures and Tables | References | Related Articles | Metrics

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Transplantation of fetal liver FLK-1+ cells in treatment of acute liver injury Li Na, Ding Wei-rong, Wu Bo-qing, Liu Ting-ting, Cheng Hong-bo, Jin Cheng-hao 2013, 17 (53):  9139-9144.  doi: 10.3969/j.issn.2095-4344.2013.53.007 Abstract ( 215 )   PDF (1631KB) ( 419 )   Save BACKGROUND: Previous studies of our research group have shown that FLK-1+ cells existed in the mouse fetal liver at embryonic 17-19 days, and they expressed embryonic stem cells and presented multi-differentiation potentials. OBJECTIVE: To evaluate the therapeutic effect of the transplantation of FLK-1+ cells derived from mouse fetal liver on acute liver injury in mice. METHODS: The FLK-1+ fraction were enriched from the fetal liver with immunomagnetic beads method and detected by flow cytometry. The Oct-3/4 and Rex-1 genes in FLK-1+ cells were detected by reverse transcription-polymerase chain reaction. The FLK-1+ cells were induced to differentiate into liver cells by hepatocyte growth factor and epidermal growth factor. The model of acute liver injury in mice was established by intraperitoneally injecting carbon tetrachloride 4, and was randomly divided into two groups. In the control group, mouse models with acute liver injury were infused normal saline via tail vein; in the experimental group, mouse models with acute liver injury were infused induced FLK-1+ cells (1×106) via tail vein. The blood was collected at 16 hours and liver functions were detected. The mortality of mice was observed at 64 hours. RESULTS AND CONCLUSION: The fetal liver FLK-1+ cells highly expressed Oct-3/4 and Rex-1 mRNA, and albumin expressing rate in FLK-1+ cells was 0.6%. After induced by hepatocyte growth factor for 3 days, FLK-1 did not express. After induced by hepatocyte growth factor and epidermal growth factor for 3 days, Oct-3/4 and Rex-1 mRNA expression was significantly reduced or disappeared in FLK-1+ cells, and 96.38% FLK-1+ cells expressed albumin. After FLK-1+ cells induced for 3 days were transplanted to mouse models with acute liver injury for 16 hours, the serum glutamic-oxalacetic transaminease and glutamic-pyruvic transaminase were significantly lower (P < 0.05), but serum albumin was significantly higher than the control group (P < 0.05). However, serum total bilirubin and fibrinogen showed no significant differences between two groups (P > 0.05). The mortality rate in the control group was 80% and the mortality rate in the experimental group was 61.5% at 64 hours, with no significant difference between two groups (P > 0.05). Experimental findings indicate that, transplanting fetal liver FLK-1+ cells induced by hepatocyte growth factor and epidermal growth factor for 3 days can improve liver cells function in mice with acute liver damage. 中国组织工程研究杂志出版内容重点：肾移植；肝移植；移植；心脏移植；组织移植；皮肤移植；皮瓣移植；血管移植；器官移植；组织工程 全文链接： Figures and Tables | References | Related Articles | Metrics

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In-hospital mortality factor analysis at early stage after heart valve surgery Chen Jing-wei, Yan Fei, Huo Qiang, Zhu Tao, Liu Zheng 2013, 17 (53):  9145-9150.  doi: 10.3969/j.issn.2095-4344.2013.53.008 Abstract ( 624 )   PDF (684KB) ( 659 )   Save BACKGROUND: Actively strengthening the perioperative management in high-risk patients undergoing heart valve replacement can reduce early mortality after heart valve replacement. OBJECTIVE: To analyze the early postoperative risk factors for in-hospital mortality in patients with valvular heart diseases, and to improve surgical cure rate. METHODS: A total of 488 patients with rheumatic valvular heart disease who had received heart valve replacement were retrospectively analyzed. The study was completed until early hospital death after heart valve replacement. Univariate and multivariate logistic regression analysis of postoperative risk factors for early death was performed. RESULTS AND CONCLUSION: Among 488 cases with heart valve surgery, early postoperative deaths occurred in 27 cases, with the total mortality of 5.5%. The main causes of death were low cardiac output syndrome, malignant arrhythmia, and multi-organ failure. Univariate analysis showed that: Age ≥ 60 years, class Ⅳ heart function, valve surgery combined with concomitant coronary artery bypass grafting over the same period, left ventricular ejection fraction ≤ 50%, left ventricular end-diastolic diameter ≥ 70 mm, cardiopulmonary bypass time ≥ 120 minutes, aortic clamping time ≥ 60 minutes were related to the occurrence of death after heart valve replacement (P < 0.05). Multivariate logistic regression analysis showed that: Age ≥ 60 years, class Ⅳ heart function, valve surgery combined with concomitant coronary artery bypass grafting, cardiopulmonary bypass time ≥ 120 minutes, left ventricular ejection fraction ≤ 50%, left ventricular end-diastolic diameter ≥ 70 mm were independent risk factors for early death after heart valve surgery were independent risk factors for early death. Emphasis on perioperative management, a reasonable grasp of these factors for surgical indications, selection of the appropriate surgical approach and myocardial protection can further reduce surgical complications and mortality in these patients. 中国组织工程研究杂志出版内容重点：肾移植；肝移植；移植；心脏移植；组织移植；皮肤移植；皮瓣移植；血管移植；器官移植；组织工程 全文链接： Figures and Tables | References | Related Articles | Metrics

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Dialysis time and influencing factor in chronic renal allograft dysfunction patients Zuo Fu-jie, Feng Xiao-fang, Min Min, Zhou Mei-sheng, Wang Li-ming 2013, 17 (53):  9151-9156.  doi: 10.3969/j.issn.2095-4344.2013.53.009 Abstract ( 510 )   PDF (750KB) ( 512 )   Save BACKGROUND: Patients with chronic renal allograft dysfunction need dialysis to maintain their survivals and even re-transplantation. However, there is little evidence addressing the time for the initiation of dialysis in patients with chronic renal allograft dysfunction. OBJECTIVE: To discuss the timing of beginning dialysis and the factors that might contribute to dialysis in chronic renal allograft dysfunction patients. METHODS: A retrospective study was performed in clinical data of 98 chronic renal allograft dysfunction patients which were recruited from Shanghai Changzheng Hospital from July 2005 to December 2012. The clinical data included creatinine clearance, serum creatinine concentration, symptoms of uremia and comorbidity. Factors that might affect the timing of dialysis were further analyzed. RESULTS AND CONCLUSION: 86.73% of the patients experienced nausea or vomiting before dialysis, 77.55% occurred with cardiac morbidity and/or neuropathy, and 31.63% needed urgent hemodialysis. Among the 98 patients, the mean creatinine clearance at the time for initiation of hemodialysis was (5.94±063) mL/min, the initial mean creatinine clearance was > 10 mL/min in 9 patients, 5-10 mL/min in 51 patients, and < 5 mL/min in 38 patients. Hepatitis C virus infection patients had higher initial creatinine clearance than non-infected patients(P < 0.05). Experimental findings suggest that, chronic renal allograft dysfunction patients have obvious uremia complications at the beginning of dialysis, the timing for dialysis is late, especially in hepatitis C virus infection patients. Health education and medical care of chronic kidney disease are key factors that affect the timing of dialysis. 中国组织工程研究杂志出版内容重点：肾移植；肝移植；移植；心脏移植；组织移植；皮肤移植；皮瓣移植；血管移植；器官移植；组织工程 全文链接： Figures and Tables | References | Related Articles | Metrics

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Human amniotic epithelial cell transplantation for repair of brachial plexus injury in rabbits Zhang Yang, Liu Chun-xia, Wang Liang, Zhang Li, Liu Wei, Zhao Wei, Li Zhi 2013, 17 (53):  9157-9163.  doi: 10.3969/j.issn.2095-4344.2013.53.010 Abstract ( 420 )   PDF (2395KB) ( 499 )   Save BACKGROUND: A great deal of attention has been given to stem cell transplantation for repair of spinal cord injury, while there are few studies concerning stem cell transplantation for repair of peripheral nerve injuries, especially transplantation of human amniotic epithelial cells used to repair peripheral nerve injuries. OBJECTIVE: To discuss the effects of human amniotic epithelial cells in brachial plexus nerve repairing. METHODS: We established rabbit models of brachial plexus injuries and extracted human amniotic epithelial cells for expanding culture followed by ultrastructural observation of human amniotic membrane tissue and amniotic epithelial cells under a scanning electron microscope. Then, human amniotic epithelial cells were transfected with green fluorescent protein markers and injected into the injury site. Hematoxylin-eosin staining and fluorescence microscope were employed to observe the effects of human amniotic epithelial cells in the repair of brachial plexus injuries in rabbits. RESULTS AND CONCLUSION: (1) Successfully isolated human amniotic epithelial cells expressed cytokeratin 19 rather than vimentin, and also expressed CD29 and CD73 to different extent. Scanning electron microscope observation showed human amniotic epithelial cells had filled cell bodies and were closed interconnected in good condition. (2) After 18 weeks of successful modeling, human amniotic epithelial cells labeled with green fluorescent protein were visible in the injury site under the fluorescence microscope. (3) In the experimental group, functional recovery of the rabbit forelegs was found at postoperative 6 weeks and dramatically improved at 12 and 18 weeks after surgery. Functional scores were also significantly increased in the experimental group. However, there was no improvement in the control group. These findings indicate that human amniotic epithelial cells are involved in the repair of brachial plexus injury. 中国组织工程研究杂志出版内容重点：肾移植；肝移植；移植；心脏移植；组织移植；皮肤移植；皮瓣移植；血管移植；器官移植；组织工程 全文链接： Figures and Tables | References | Related Articles | Metrics

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Sirolimus alternative for calcineurin inhibitor in treatment of nephrotoxicity and chronic allograft nephropathy Wang Zhi-gang, Feng Gui-wen, Li Jin-feng, Shang Wen-jun, Pang Xin-lu, Cui Zhi-li, Liu Lei, Xie Hong-chang, Feng Yong-hua, Guo Zhan 2013, 17 (53):  9164-9171.  doi: 10.3969/j.issn.2095-4344.2013.53.011 Abstract ( 319 )   PDF (2834KB) ( 456 )   Save BACKGROUND: Sirolimus alternative for calcineurin inhibitor therapy is used for calcineurin inhibitor nephrotoxicity and chronic allograft nephropathy after renal transplantation. Conversion object selection and timing are essential. OBJECTIVE: To observe the clinical effects of sirolimus alternative calcineurin inhibitor in the treatment of renal transplant patients with calcineurin inhibitor nephrotoxicity and chronic allograft nephropathy under different serum creatinine levels. METHODS: Chronic calcineurin inhibitor nephrotoxicity and chronic allograft nephropathy patients, who were diagnosed after renal transplantation, were enrolled. In accordance with serum creatinine ≤ 220 μmol/L and serum creatinine > 220 μmol/L before transition, they were divided into calcineurin inhibitor nephrotoxicity group, chronic allograft nephropathy group and calcineurin inhibitor maintenance group. In the former two groups, calcineurin inhibitor was converted into sirolimus (conversion group, n=53). Calcineurin inhibitor maintenance patients served as control group (n=28). Follow-up was done for 3 years. Serum creatinine levels and the incidence of adverse events were dynamically observed in each group at different follow-up time points. Nine cases underwent the transplanted kidney biopsy at the end of the follow-up. RESULTS AND CONCLUSION: Before conversion, under serum creatinine ≤ 220 μmol/L, serum creatinine levels were significantly lower at 24 and 36 months after follow-up in the calcineurin inhibitor nephrotoxicity group and chronic allograft nephropathy group (P < 0.05). Serum creatinine levels were higher in the calcineurin inhibitor maintenance group than that in the chronic allograft nephropathy group and calcineurin inhibitor nephrotoxicity group (P < 0.05). Under serum creatinine > 220 μmol/L, serum creatinine levels were significantly reduced in the calcineurin inhibitor nephrotoxicity group after conversion (P < 0.05). Serum creatinine levels were increased in the chronic allograft nephropathy group and calcineurin inhibitor maintenance group after conversion (P < 0.05). After conversion, major adverse events included mild anemia (30.2%), hyperlipidemia (35.8%), and leukopenia (22.6%). After renal transplantation, a significant effect was detected in elevated serum creatinine crawling conversion sirolimus program. Pre-conversion biopsy diagnosed calcineurin inhibitor nephrotoxicity or chronic allograft nephropathy. In combination of serum creatinine levels, we comprehensively judged whether sirolimus conversion therapy was performed or not. Blood lipid levels were monitored. The conversion should be conducted before severe damage occurred in transplanted kidney, i.e., early conversion. The patients will benefit more. 中国组织工程研究杂志出版内容重点：肾移植；肝移植；移植；心脏移植；组织移植；皮肤移植；皮瓣移植；血管移植；器官移植；组织工程 全文链接： Figures and Tables | References | Related Articles | Metrics

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Staging treatment for severe pulmonary infection after kidney transplantation Xue Qing, Liu Ke-pu, Ma Shuai-jun, Li Zhi-bin, Zhang Geng, Yang Xiao-jian, Yuan Jian-lin 2013, 17 (53):  9172-9175.  doi: 10.3969/j.issn.2095-4344.2013.53.012 Abstract ( 1248 )   PDF (1961KB) ( 562 )   Save BACKGROUND: About 8%-16% pulmonary infection after kidney transplantation will develop into severe pneumonia with high incidence of acute respiratory distress syndrome and high mortality rate, and it is the difficulty for the prevention and the treatment.   OBJECTIVE: To retrospectively analyze the reason, clinical characteristics and therapy experiences of severe pulmonary infection after kidney transplantation. METHODS: Thirty patients with severe pulmonary infection after kidney transplantation were collected from Department of Urology, Xijing Hospital, the Fourth Military Medical University, and the clinical data of the patients were summarized. Pulmonary infections often occurred at 6 months after kidney transplantation, which were treated with anti-infection treatment after reducing dosage or stopping immunosuppressive. RESULTS AND CONCLUSION: Among the 30 patients, 10 patients died. Upper gastrointestinal bleeding was found in six cases, heart failure was in five cases, kidney failure occurred in three cases, and three cases gave up treatment. One case discharged after treatment with mechanical ventilation for 14 days. Severe pulmonary infections after kidney transplantation were mostly mixed infections. The course was divided into three stages according to the clinical features, characterized as rapid development and high mortality rate. Regular follow-up and review, developing awareness of self-protection in patients, early detection and early treatment can prevent pulmonary infections effectively. Timely adjustment of the immunosuppressant dosage and usage, and administration of antibiotics, anti-fungal anti-virus and antituberculosis medicine empirically are the keys for healing. Early application of mechanical ventilation for breathing according to the pathogenetic condition can effectively improve patient’s symptoms. 中国组织工程研究杂志出版内容重点：肾移植；肝移植；移植；心脏移植；组织移植；皮肤移植；皮瓣移植；血管移植；器官移植；组织工程 全文链接： Figures and Tables | References | Related Articles | Metrics

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Conversion from tacrolimus to cyclosporine A improves new-onset diabetes mellitus after transplantation Feng Xiao-fang, Min Min, Zuo Fu-jie, Zhou Mei-sheng, Wang Li-ming 2013, 17 (53):  9176-9181.  doi: 10.3969/j.issn.2095-4344.2013.53.013 Abstract ( 233 )   PDF (760KB) ( 486 )   Save BACKGROUND: The pathogenesis of new-onset diabetes mellitus after transplantation remains unclear. It is generally recognized that the onset is associated with patient’s ethnics, age, body weight, familial history, hepatitis C virus and immunosuppressant scheme. OBJECTIVE: To discuss the efficiency and safety of conversion from tacrolimus to cyclosporine A in renal transplant recipients with new-onset diabetes mellitus after transplantation. METHODS: Forty-two renal transplant recipients, who met the inclusion criteria, were divided into two groups randomly: conversion group (n=20; tacrolimus was converted to cyclosporine A) and control group (n=22; tacrolimus was given contrinuously). All the involved patients were followed up for 1 year after the diagnosis of new-onset diabetes mellitus after transplantation in control group and conversion from tacrolimus to cyclosporine A conversion group. The blood glucose levels of patients were dynamically monitored. Meanwhile body mass index, serum creatinine, urea nitrogen, serum uric acid, liver function, blood lipid, the dose and concentration range of immunosuppressants, urinary albumin, the incidence of acute rejection, infection rate of hepatitis C virus,  the survival rate of patients and renal graft were all recorded. RESULTS AND CONCLUSION: With the time going, fasting blood glucose and glycosylated hemoglobin were improved gradually in conversion group and the number of cases needing glucose-lowering treatment was gradually decreased. Eleven cases (55%) presented a complete remission after one year and needed no glucose-lowering treatment. In the control group, the cases needing glucose-lowering treatment were increased gradually, and all cases still needed glucose-lowering treatment after one year. Fasting blood glucose and glycosylated hemoglobin levels were higher than those in conversion group. Meanwhile, serum creatinine, alanine aminotransferase, triacylglycerol, cholesterol and serum uric acid showed no differences between two groups, but urinary albumin level in control group was higher than conversion group at 6 months. The incidence of acute rejection, the rate of infection, the survival rate of patient and renal graft also showed no differences between the two groups. Our findings indicate that, conversion from tacrolimus to cyclosporine A is an effective and safe strategy to improve new-onset diabetes mellitus after transplantation within a short time (less than one year). 中国组织工程研究杂志出版内容重点：肾移植；肝移植；移植；心脏移植；组织移植；皮肤移植；皮瓣移植；血管移植；器官移植；组织工程 全文链接： Figures and Tables | References | Related Articles | Metrics

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Toll-like receptor 3 and Toll-like receptor 4 signal transduction pathways in the peripheral blood mononuclear cells of purpura nephritis patients Fu Yuan, Liu Xiu-qin, Cheng Na, Zhang Shou-qing, Chang Hong, Zhang Qiu-ye, Chen Xiu-xia, Gao Xing-juan 2013, 17 (53):  9182-9188.  doi: 10.3969/j.issn.2095-4344.2013.53.014 Abstract ( 241 )   PDF (798KB) ( 444 )   Save Figures and Tables | References | Related Articles | Metrics

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Dexmedetomidine inhibits renal ischemia/reperfusion-induced inflammatory reaction Chen Ke-yan, Zhang Yi-nan, Diao Yu-gang, Zhou Jin, Zhang Tie-zheng 2013, 17 (53):  9189-9195.  doi: 10.3969/j.issn.2095-4344.2013.53.015 Abstract ( 471 )   PDF (2092KB) ( 652 )   Save BACKGROUND: Previous studies addressing the prevention and treatment of ischemia/reperfusion kidney damage show that, some drugs could activate or inhibit the body to protect kidney tissue, which is of great significance in renal transplantation and graft functional recovery. OBJECTIVE: To explore the influence of dexmedetomidine on expressions of inflammatory factors and C-X-C chemokine receptor type 4 in rat with renal ischemia/reperfusion. METHODS: Forty rats were randomly divided into four equal groups: sham group, ischemia/reperfusion group, dexmedetomidine preconditioning group and dexmedetomidine post-treatment group. Except the sham group, the right kidney was removed and the left kidney was subject to ischemia for 45 minutes and reperfusion for 60 minutes, thus establishing renal ischemia/reperfusion models in other three groups. As for preconditioning group, the rat femoral vein was punctured and transfused with 1 μg/kg dexmedetomidine for 10 minutes, followed by infusing 0.5 μg/kg dexmedetomidine for 30 minutes until ischemia occurred. As for posttreatment group, the rats were infused with 0.5 μg/kg dexmedetomidine for 30 minutes after reperfusion. RESULTS AND CONCLUSION: Serious kidney injury, obvious inflammation, tubular dilatation, and glomerulonephritis were found in rats with renal ischemia/reperfusion. The serum interleukin-1β and tumor necrosis factor-α levels in ischemia/reperfusion, dexmedetomidine preconditioning and dexmedetomidine post-treatment groups were increased significantly (P < 0.05). The expression of serum and renal C-X-C chemokine receptor type 4 was also increased (P < 0.05). Dexmedetomidine preconditioning or post-treatment significantly decreased serum interleukin-1β and tumor necrosis factor-α levels in rats with renal ischemia/reperfusion (P < 0.05). The same decline was observed in content of serum and renal C-X-C chemokine receptor type 4 (P < 0.05). Experimental findings indicate that renal ischemia/reperfusion can cause renal injury which is characterized by inflammatory reaction. Dexmedetomidine can reduce inflammatory reactions and attenuate C-X-C chemokine receptor type 4 expression to protect the kidney. 中国组织工程研究杂志出版内容重点：肾移植；肝移植；移植；心脏移植；组织移植；皮肤移植；皮瓣移植；血管移植；器官移植；组织工程 全文链接： Figures and Tables | References | Related Articles | Metrics

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Regeneration and structural changes of mouse cirrhotic liver after partial hepatectomy Zheng Xiao-jun, Luo Qian-xin, Chen Qian-qi, Xiong Xi-feng, Liu Yu-rong, Ma Ning-fang 2013, 17 (53):  9196-9202.  doi: 10.3969/j.issn.2095-4344.2013.53.016 Abstract ( 1284 )   PDF (2083KB) ( 514 )   Save BACKGROUND: Liver possesses a powerful regenerative capacity. It is reported that the most patients suffering from hepatocelluler carcinoma are accompanied with liver cirrhosis. The liver weight can be gradually restored after tumor resection, which indicated a regenerative potential of cirrhosis liver. OBJECTIVE:To try to use partial hepatectomy to induce proliferation of cells with regeneration capacity in cirrhotic liver of mice, and to observe the structural changes of regenerated liver. METHODS: The liver cirrhosis model of mouse was produced by injecting CCl4 liquid subcutaneously. The mice with liver cirrhosis were subjected to partial hepatectomy. The residual liver was dissected and weighted at 1, 3, 5, 7, 10, 14 and 21 days after partial hepatectomy. The structural changes of regenerating livers were compared after partial hepatectomy at various time points. Liver regeneration rate was evaluated. Immunohistochemical method was used to analyze desmin and alpha-smooth muscle actin expression in the hepatic satellite cells. The 5-bromo-2-deoxyuridine incorporation labeling method was used to exhibit and localize the regenerating cells. RESULTS AND CONCLUSION:The liver regeneration rates of the mice with liver cirrhosis at the 1, 3, 5, 7, 14, 21 days after the partial hepatectomy were 6.58%, 22.03%, 21.39%, 29.05%, 45.22%, and 50.98% respectively. The results of hematoxylin-eosin staining as well as Masson staining showed the pathological early cirrhosis features of the liver after CCl4 treatment for 8 weeks and the structure of residual livers improved gradually after partial hepatectomy. Immunohistochemical results demonstrated that the expression of desmin in regenerating liver was decreased at 1 day after partial hepatectomy, but showed an uptrend from 3 to 14 days and decreased at 21 days. The expression of alpha-smooth muscle actin decreased gradually at every time point after partialhepatectomy. The 5-bromo-2- deoxyuridine-positive nucleus localized in hepatocytes at 1-7 days and mainly localized in hepatic sinusoid endothelium and intracavity at 14-21 days after partial hepatectomy. The regenerative reaction of mouse cirrhotic liver appeared at 3 days after partial hepatectomy and the structure of normal regenerating liver will be improved and restored gradually. 中国组织工程研究杂志出版内容重点：肾移植；肝移植；移植；心脏移植；组织移植；皮肤移植；皮瓣移植；血管移植；器官移植；组织工程 全文链接： Figures and Tables | References | Related Articles | Metrics

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Erythropoietin effects on expression of stem cell factor and its receptor in acute renal injury Wang Qing-xia, Li Hong-jie, Liu Xue-mei, Xu Yan 2013, 17 (53):  9203-9208.  doi: 10.3969/j.issn.2095-4344.2013.53.017 Abstract ( 84 )   PDF (1733KB) ( 401 )   Save BACKGROUND: The effects of cytokines on lessening ischemia/reperfusion injury to the kidney have been paid attention increasingly. Stem cell factor has protective effects on organs except hematopoietic system. OBJECTIVE: To study the expression of stem cell factor and its receptor c-Kit in acute kidney injury model of rat, and the effect of erythropoietin on the expression of stem cell factor and c-Kit. METHODS: A total of 34 adult male Wistar rats were selected to induce ischemia/reperfusion models by occluding bilateral renal pedicle (ischemia for 45 minutes and reperfusion for 24 hours). The animals were randomly divided into sham-operation group (n=10), ischemia/reperfusion group (n=12) and erythropoietin group (n=12). In the erythropoietin group, 5 000 U/kg recombinant human erythropoietin was injected once via the tail vein at 2 hours before modeling. The expression of stem cell factor and c-Kit was detected by immunohistochemistry and image analysis technique in each group. The serum concentrations of creatinine and blood urea nitrogen were measured. Meanwhile, renal pathologic changes were observed by hematoxylin-eosin staining, and renal tubule injury integral was calculated. RESULTS AND CONCLUSION: Stem cell factor and c-Kit were detected only in the renal tubule section. The expression of stem cell factor and c-Kit in the ischemia/reperfusion group and erythropoietin group was higher  than sham-operation group (P < 0.05). The expression of stem cell factor was higher in the erythropoietin group than that in the ischemia/reperfusion group (P < 0.01). However, no significant difference in c-Kit was detected between the two groups (P > 0.05). Serum creatinine and urea nitrogen levels were significantly lower in the erythropoietin group than that in the ischemia/reperfusion group (P < 0.05), but higher than that in the sham-operation group (P < 0.05). Compared with the ischemia/reperfusion group, pathological changes in nephridial tissue were more lessened in the erythropoietin group. These results suggested that stem cell factor and c-Kit expression increased when ischemia/reperfusion led to acute renal injury. The protective effect of erythropoietin on acute renal injury possibly associated with the upregulation of stem cell factor and c-Kit expression. 中国组织工程研究杂志出版内容重点：肾移植；肝移植；移植；心脏移植；组织移植；皮肤移植；皮瓣移植；血管移植；器官移植；组织工程 全文链接： Figures and Tables | References | Related Articles | Metrics

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Occupational construction of China’s organ donation coordinators Wei Lin-shan, Huang Hai, Huo Feng 2013, 17 (53):  9209-9214.  doi: 10.3969/j.issn.2095-4344.2013.53.018 Abstract ( 490 )   PDF (717KB) ( 656 )   Save BACKGROUND: The organ donation coordinator is the backbone to carry out organ donation work and an important guarantee for improving China’s organ donation rate, but achieving the professionalism is the key problem to strengthen the team construction of organ donation coordinators. OBJECTIVE: This paper tried to explore a tentative probe into the construction of organ donation coordinator occupation on four aspects, namely the importance and connotation of this occupation, current situation and measures. METHODS: Articles about organ donation and organ transplantation were retrieved from CQVIP, CNKI, Wanfang, Pubmed, Medline, Highwire databases and Foreign Journals Integration System from January 2003 to August 2013 with the key words of organ donation or organ transplantation or coordinator or profession or occupation, body donation, cardiac death in both Chinese and English. After secondary manual retrieval of organ donation coordinator, literature were included if they involved organ donation coordinator and organ donation and transplantation related policies and regulations. Clinical and basic researches were excluded. This paper put forward countermeasures for the construction of organ donation coordinator occupation based on the literature induction, summary and analysis of the current status of China’s organ donation coordinators. RESULTS AND CONCLUSION: This paper described the profound connotation, professional requirement and social position of organ donation coordinators, systematically analyzed the existing problems for organ donation coordinator team construction in China, constructed the basic framework of occupational construction of China’sorgan donation coordinator, and summarized the measures for the occupational construction of organ donation coordinators. 中国组织工程研究杂志出版内容重点：肾移植；肝移植；移植；心脏移植；组织移植；皮肤移植；皮瓣移植；血管移植；器官移植；组织工程 全文链接： Figures and Tables | References | Related Articles | Metrics

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Single-center experience of donation after cardiac death and its inspirations Zhu Guang-ying, Yu Shan-shan, Wang Hai-feng, Li Hong-yan 2013, 17 (53):  9215-9220.  doi: 10.3969/j.issn.2095-4344.2013.53.019 Abstract ( 235 )   PDF (771KB) ( 562 )   Save BACKGROUND: Donation after cardiac death is a scientific strategy for solving organ source in modern China. Numerous studies focused on the relevant indexes of transplant organ recipients and their family members in China and outside China, and donation attitude, influencing factor investigation and relevant ethical problems. Few studies addressed the donors for donation after cardiac death and their family members. OBJECTIVE: To retrospectively analyze experience, summarize the information of donor and their family members, check our work and find out the shortcomings we should correct since the First Hospital of Jilin University was appointed as the second pilot organization of Donation of Cardiac Death by Ministry of Public Health of China and Red Cross Society of China in 2011. METHODS: On the basis of experience of single center pilot, statistical treatment was done in combination with general data, social nature, and recognition of donation after cardiac death of donors and their family members. RESULTS AND CONCLUSION: The donation after cardiac death in the First Hospital of Jilin University has been gradually regularized and obtained a certain outcome, and some existing problems and common errors are summarized to guide further work. Improvements are as follows: (1) precise measures are used to overcome conventional idea, mental stress and ethical problems of donor’s family members. (2) Try to make vigorous expansion of communication and cooperation with local hospitals. (3) Cannot ignore ethical evaluation and approval. (4) Seriously, accurately, promptly upload donor’s information, and renew recipient’s data in information database at any time. (5) For special cases, group discussion is needed, and the successful or failed experiences of individual cases are explored. (6) It is necessary to train the literacy of team members. 中国组织工程研究杂志出版内容重点：肾移植；肝移植；移植；心脏移植；组织移植；皮肤移植；皮瓣移植；血管移植；器官移植；组织工程 全文链接： Figures and Tables | References | Related Articles | Metrics

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Multiple effects of ultrasoundcardiogram on monitoring of heart transplantation Li Jian-feng, Qu Hong, Zheng Chang-hong, Tang Hong-tao, Xing Chun-sheng 2013, 17 (53):  9221-9226.  doi: 10.3969/j.issn.2095-4344.2013.53.020 Abstract ( 232 )   PDF (669KB) ( 550 )   Save  BACKGROUND: Acute rejection is a key factor for long survival of transplanted heart. Therefore, discovering and controlling acute rejections in time is very important in clinical practice. OBJECTIVE: To investigate the clinical significance of ultrasoundcardiogram after heart transplantation. METHODS: Recently published articles concerning clinical and animal research on ultrasoundcardiogram following heart transplantation were searched. Then, we analyzed the features of ultrasoundcardiogram of transplanted heart, structural and functional changes of donor hearts in the recipients. Relevant markers were measured and compared to evaluate the effect of ultrasoundcardiogram against acute rejections after heart transplantation. RESULTS AND CONCLUSION: Ultrasoundcardiogram can invasively monitor acute rejections after heart transplantation in time, and also can provide important references for pre-transplantation recipient evaluation, intra-transplantation monitoring, and post-transplantation follow-up. However, lack of cases and post-transplantation monitoring in different periods may impact our findings. Post-transplantation monitoring in the same period can improve the comparativeness and accuracy of the study. 中国组织工程研究杂志出版内容重点：肾移植；肝移植；移植；心脏移植；组织移植；皮肤移植；皮瓣移植；血管移植；器官移植；组织工程 全文链接： Figures and Tables | References | Related Articles | Metrics

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Management of brain death donors for heart transplantation and myocardial protection Chen Zhao-hui, Meng Wei-hong, Zhou Li-juan 2013, 17 (53):  9227-9232.  doi: 10.3969/j.issn.2095-4344.2013.53.021 Abstract ( 410 )   PDF (936KB) ( 653 )   Save BACKGROUND: Heart transplantation is an effective way to treat end-stage heart failure patients who can have a long-term survival. OBJECTIVE: To investigate the management of brain death donors for heart transplantation and myocardial protection. METHODS: A computer-based search of databases was performed for analysis of management and choice of brain death donors as well as myocardial protection. A qualified donor organ is critical for implementation of heart transplantation. The management and selection of donors is the first step, and the second is to protect and maintain myocardial function and to reduce ischemia-reperfusion injury to the donor heart. RESULTS AND CONCLUSION: The Ministry of Health and the relevant departments have developed several standards and norms for the management of brain death donors for heart transplantation, making organ transplantation more open, standardized and legalized. Improving the protection of heart function can prolong the preservation time of donor hearts. During the entire process of heart transplantation, cold cardioplegia is widely used, and cold-maceration method is often introduced for myocardial protection during donor heart transportation. With the development of the relevant provisions such as brain death criteria, in-depth research for donor heart protection and expansion of donor range will increase the number of donor bodies for organ transplantation. 中国组织工程研究杂志出版内容重点：肾移植；肝移植；移植；心脏移植；组织移植；皮肤移植；皮瓣移植；血管移植；器官移植；组织工程 全文链接： Figures and Tables | References | Related Articles | Metrics

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Variable and invariable risk factors for diabetes mellitus after kidney transplantation Li Xiao-ling, Zhu Lü-yun 2013, 17 (53):  9233-9238.  doi: 10.3969/j.issn.2095-4344.2013.53.022 Abstract ( 912 )   PDF (575KB) ( 728 )   Save BACKGROUND: Diabetes mellitus is one of the main complications after kidney transplantation. Understanding risk factors for diabetes can improve the survival rate of patients undergoing kidney transplantation. OBJECTIVE: To explore the high-risk factors for diabetes mellitus after kidney transplantation. METHODS: A literature search was performed for relevant articles concerning risk factors for diabetes mellitus after kidney transplantation. Literatures that met the study criteria were selected for in-depth data analysis. Fasting blood glucose, 2-hour postprandial blood glucose, glycosylated hemoglobin, liver function, and valley concentration values of other immunosuppressants were measured in patients receiving kidney transplantation, based on which we analyzed whether the occurrence of diabetes mellitus after kidney transplantation is associated with sex, age, body mass index, family history of diabetes, diabetes onset time after kidney transplantation, liver function, and administration of immunosuppressive drugs and hormones. RESULTS AND CONCLUSION: Patients with post-transplantation diabetes exhibited atypical symptoms of diabetes, early onset, islet dysfunction, and abnormal liver function. Age, body mass index, family history of diabetes, impaired glucose tolerance, abnormal liver function, and administration of immunosuppressive drugs are risk factors for diabetes after kidney transplantation, whereas there is no obvious association between gender and diabetes mellitus after kidney transplantation. Understanding risk factors for diabetes mellitus after kidney transplantation contributes to improving the survival rate of patients with renal transplantation. 中国组织工程研究杂志出版内容重点：肾移植；肝移植；移植；心脏移植；组织移植；皮肤移植；皮瓣移植；血管移植；器官移植；组织工程 全文链接： Figures and Tables | References | Related Articles | Metrics

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Nucleus pulposus cell transplantation inhibits intervertebral disk degeneration Wang Chun-sheng, Zhang Wei-bin 2013, 17 (53):  9239-9244.  doi: 10.3969/j.issn.2095-4344.2013.53.023 Abstract ( 532 )   PDF (892KB) ( 679 )   Save BACKGROUND: In recent years, cell transplantation and intervertebral disk grafting for intervertebral disk degeneration have been greatly developed. OBJECTIVE: To investigate the in vitro culture methods of nucleus pulposus cells and effects of nucleus pulposus cell transplantation on intervertebral disk degeneration. METHODS: A computer-based search of databases was performed to explore the effects of nucleus pulposus cell transplantation on intervertebral disk degeneration. The main function of the nucleus pulposus cells is to produce collagen and proteoglycans. Through improvement of culture methods, the number of nucleus pulposus cells increased, and matrix synthesis and secretion also increased. Therefore, the nucleus pulposus cell transplantation was able to repair the degenerated intervertebral disk. RESULTS AND CONCLUSION: The three-dimensional aggregation culture method and three-dimensional microcarrier rotation method elicit the increase in the number of nucleus pulposus cells, and hepatocyte growth factor also can produce a catalytic role in the proliferation of nucleus pulposus cells. Nucleus pulposus cell transplantation can restore degenerative disc height, and promote the biosynthesis and secretion of proteoglycans and type Ⅱ collagen in the degenerated intervertebral disk. With the deepening of intervertebral disk research, nucleus pulposus cell transplantation may become an important therapeutic tool for intervertebral disk degeneration. 中国组织工程研究杂志出版内容重点：肾移植；肝移植；移植；心脏移植；组织移植；皮肤移植；皮瓣移植；血管移植；器官移植；组织工程 全文链接： Figures and Tables | References | Related Articles | Metrics

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A meta-analysis of clinical efficacy of fresh embryo transfer versus frozen embryo transfer in in vitro fertilization cycles Zhang Meng-yuan, Chen Ke-yi, La Xiao-lin, Deekshya Shrestha 2013, 17 (53):  9245-9250.  doi: 10.3969/j.issn.2095-4344.2013.53.024 Abstract ( 579 )   PDF (702KB) ( 658 )   Save null Figures and Tables | References | Related Articles | Metrics

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Meta analysis of 2-μm laser in the treatment of non-muscle-invasive bladder tumor Yu Jie, Wang Yu-jie, Liu Yu, Ma Qi, Zhang Li-dong 2013, 17 (53):  9251-9260.  doi: 10.3969/j.issn.2095-4344.2013.53.025 Abstract ( 319 )   PDF (907KB) ( 658 )   Save  BACKGROUND: 2-μm laser is a novel intracavity technique for treating non-muscle-invasive bladder tumor, but the efficacy and safety in comparison with transurethral resection of bladder tumor are poorly understood. OBJECTIVE: To evaluate the difference of curative effect between 2-μm laser and transurethral resection of bladder tumor in treatment of non-muscle-invasive bladder tumor, and to provide medicine-based evidence for clinical application. METHODS: An online retrieval of PubMed, Ovid, Medline, Embase, Cochrane Library, CBM, CNKI, Wanfang database, Weipu database and Superstar database was performed. We also supplemented by manual and other retrieval. The retrieval time arranged from inception until September 30, 2013. Randomized controlled trials of  2-μm laser and transurethral resection of bladder tumor in treatment of non-muscle invasive bladder tumor were searched. Meta analysis was performed using RevMan5.2 software after the data were abstracted and the quality was evaluated. RESULTS AND CONCLUSION: Four randomized controlled trials involving 310 patients were included, 161 cases in 2-μm laser group and 149 cases in transurethral resection of bladder tumor group. The results of Meta analysis showed that compared with transurethral resection of bladder tumor group, postoperative bladder irrigation time (SMD=-3.61, 95%CI [-4.41, -3.13]) and period of catheterization (MD=-1.47, 95%CI [-2.32, -0.62]) were shorter in 2-μm laser group, with less incidence of obturator nerve reflex (RR=0.07, 95%CI[0.01, 0.34]), bladder irritation (RR=0.30, 95%CI [0.19, 0.47]) and bladder perforation (RR=0.09, 95%CI [0.02, 0.45] ). There were no significant differences in operation time, period of hospitalization, postoperative urethral stricture incidence and bladder tumor recurrence rate in short-term between the two groups. Experimental findings indicate that, 2-μm laser is similar to transurethral resection of bladder tumor in treatment of non-muscle invasive bladder tumor. But the incidence of obturator nerve reflex, bladder irrigation and bladder perforation is lower, postoperative bladder irrigation time and period of catheterization were shorter than transurethral resection of bladder tumor. So 2-μm laser is a minimally invasive technique with definite effect and relatively high safety. Due to the quality of the included studies and possible publication bias, the above conclusions still need more high-quality randomized controlled trials to validate. 中国组织工程研究杂志出版内容重点：肾移植；肝移植；移植；心脏移植；组织移植；皮肤移植；皮瓣移植；血管移植；器官移植；组织工程 全文链接： Figures and Tables | References | Related Articles | Metrics