ABSTRACT
Objective To summarize the experience of one case of anastomotic leakage after simultaneous pancreas-kidney transplantation (SPK ) with enteric drainage .Methods One case of type 2 diabetes mellitus complicated with end-stage nephropathy undergoing SPK was retrospectively analyzed .Iliac venous systemic circulation was employed for pancreatic venous reflux ,transplanted pancreas exocrine via enteric drainage and side-to-side anastomosis between donor pancreaticoduodenum and recipient jejunum . Pancreatoduodenal anastomotic leakage occurred at 12 days post-operation .During re-operation ,Roux-en-Y anastomosis was established between donor pancreaticoduodenum and recipient jejunum .And the relevant domestic and foreign literatures were searched .Results The follow-up time was 3 month after a second operation .Recipient pancreas and kidney transplantation survived well . There was no onset of enteric leakage .The incidence of anastomotic leakage varies greatly between different transplantation centers both at home and abroad .The incidence ranged from 3 .6％ to 11 .3％ .And the risk of pancreatic loss was as high as 54 .6％ .Conclusions As a severe postoperative complication ,anastomotic fistula after SPK may cuase abdominal infection . Even after reparing enteric fistula , the risk of leakage remains high . Roux-en-Y anastomosis is other therapeutic option .
ABSTRACT
Objective To investigate the clinical effects of different urinary diversion regimens after minimally invasive resection of bladder cancer. Methods 127 patients with muscular infiltrating bladder cancer from January 2010 to June 2015 were enrolled in this study. According to the patients' condition, they were divided into orthotopic ileal cystectomy group (58 cases), Bricker bladder surgery group (33 cases), ureteral skin ostomy group (36 cases), then compare the clinical data, postoperative complications and quality of life of the three groups. Results There was no significant difference in the ratio of sex, the distribution of age and tumor staging among the three groups. The operation time and postoperative hospital stay in orthotopic ileal cystectomy group were longer than those in the other two groups. The operation time and postoperative hospital stay of the Bricker bladder surgery group were longer than that in ureteral skin ostomy group, the difference was statistically significant; the bleeding in orthotopic ileal cystectomy group was more than the other two groups, and in Bricker bladder surgery group was more than ureteral skin ostomy group, the difference was statistically significant. There was no significant difference in the recovery time of intestinal function among the three groups. The recovery time of intestinal function in ureteral skin ostomy group was shorter than that in the other two groups, the difference was statistically significant. There was no significant difference in the incidence of short-term complications of the three groups of patients. The incidence of long-term complications of orthotopic ileal cystectomy group was significantly higher than the other two groups, the difference was statistically significant. The social function scores, and overall health score of orthotopic ileal cystectomy group were higher than the other two groups, the difference was statistically significance. Conclusion Without external device, closer to the characteristics of physiological urination, orthotopic ileal cystectomy holds higher postoperative quality of life, and higher incidence of long-term complications. With advantages of quick recovery and less complications, ureteral skin ostomy is best for patients who can not stand for long time surgery. It should choose the appropriate surgical approach for patients according to individuals' conditions.
ABSTRACT
Objective To summarize the diagnosis and treatment experience of mucor infection in renal grafts.Methods Clinical data of two patients with mucor infection in renal grafts from the same kidney donor that finally caused renal graft and renal artery rupture were retrospectively studied,and the relevant domestic and foreign literatures were reviewed. Results and conclusions Mucor infection after renal transplantation has no specific manifestation,thus it lacks of means of early diagnosis and is easy to cause misdiagnosis and missed diagnosis.Mucor infection is easy to cause vascular rupture and the prognosis is poor.Early diagnosis, thorough debridement, timely selection of effective antifungal agent, withdrawal of immunosuppressant and correction of coagulation disorders under the monitor of thrombelastogram may improve the survival rate of such patients.
ABSTRACT
<p><b>OBJECTIVE</b>To study the effects of astragalus membranaceus injection on sperm abnormality in Cd-induced rats.</p><p><b>METHODS</b>Thirty adult male Sprague-Dawley rats were divided into 5 groups: low concentration abstragalus membranaceus group(A1), high concentration astragalus membranaceus group(A2), cyclophosphamide group (CP), cadmium chloride group (Cd) and control group (C). Astragalus membranaceus injections 5 g/(kg.d) or 10 g/(kg.d) were given intraperitoneally to the rats of the A1, A2, CP and Cd groups. After 7 days, cadmium chloride(0.2 mg Cd/kg body weight) was administrated by intraperitoneal injection stimultaneously to the A1, A2 and Cd group rats. At 22 d after cadmium chloride induction, the rats were sacrificed and the testis coefficient, testicular sperm count, daily sperm production, epididymal sperm count and percentage of sperm abnorality were observed, and the testes and epididymides were studied pathologically.</p><p><b>RESULTS</b>Testis coefficient, testicular sperm count, daily sperm production and epididymal sperm count in the A2 group [(5.68 +/- 1.19), (49.01 +/- 8.78) x 10(6)/g, (10.25 +/- 2.30) x 10(6)/(g.d), (47.51 +/- 22.51) x 10(6)/ml] increased significantly compared with those of the Cd group [(3.11 +/- 0.16), (37.59 +/- 10.63) x 10(6)/g, (5.31 +/- 0.32) x 10(6)/(g.d), (10.89 +/- 2.45) x 10(6)/ml] (P < 0.05 or P < 0.01). The percentage of sperm abnormality in the A2 group [(7.04 +/- 0.12)%] decreased significantly compared with that of the Cd group [(17.81 +/- 1.55)%] (P < 0.01).</p><p><b>CONCLUSIONS</b>As an antimutagen astragalus membranaceus has practical value in occupational protection against Cd-induced genetic damage.</p>