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Endothelial progenitor cells (EPCs) are the precursor of vascular endothelial cells and are involved in a variety of biological metabolic processes.This article reviews the roles of EPCs in acute ischemic stroke.
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Objective To evaluate the clinical effect of Tissue-Link combined with Cusa and Pringle in hepatectomy for primary hepatocellular carcinoma. Methods From January 2013 to January 2017,the clinical data of ninety-six primary hepatocellular carcinoma patients who had received hepatectomy were collected. 45 cases of hepatectomy (control group) were performed by Pringle. The other 51 cases (observation group) were treated with Tissue-Link combined with Cusa. The indexes and survival rates were compared between the two groups during and after operation. Results Compared with the control group, the operation time of the observation group was prolonged ((189. 2±45. 8) min vs. (151. 6±34. 7) min,t = -5. 101),the intraoperative blood loss ((273. 5±141. 6) ml vs. (371. 3±127. 2) ml,t = 7. 396),total bilirubin at seventh days after the operation (( 15. 7 ± 8. 9 ) μmol/ L vs. ( 26. 5 ± 10. 8 ) μmol/ L, t = 5. 320 ) and postoperative albumin supplementation((61. 0±9. 7) g vs. (84. 6±9. 3) g,t = 7. 698) of the observation group decreased. The tumor recurrence rate ( 0 vs. 8. 9% ( 4/ 45)), intrahepatic metastasis rate ( 7. 8% ( 4/ 51) vs. 20% ( 9/ 45)), extrahepatic metastasis rate (3. 9% (2/ 51) vs. 17. 8% (8/ 45)) (χ2 =. 031,6. 315,6. 746) decreased and the differences were statistically significant (P< 0. 05) . The 2 year and 3 year tumor free survival rate (88. 2%, 76. 5%) of the observation group was higher than those of the control group (64. 4%,44. 4%,χ2 = 5. 468, 8. 902),and the total survival rate of 3 year after operation (80. 4%) in the observation group was significantly, higher than that of the control group (51. 1%,χ2 = 4. 896),the difference was statistically significant (P<0. 05) . Conclusion Tissue-Link combined with Cusa is superior to Tissue-Link combined with Pringle in hepatectomy for primary hepatocellular carolnoma. It has less intraoperative blood loss, less damage to liver function and a lower relapse rate of ineisional margin,and the disease-free survival rate and overall survival rate are improved significantly.
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Objective To investigate the effects of two kinds of anesthesia methods on the immunological function of patients with primary liver cancer during perioperative period .Methods The clinical data of 86 cases of primary liver cancer from December 2010 to December 2015 were collected and divided into control group and study group ,43 cases in each group .The control group re-ceived sevoflurane inhalation anesthesia ,and the study group was given intravenous anesthesia with propofol ,the effects of different anesthesia methods on T lymphocyte subsets ,IL-2 ,IL-6 and TNF-α were compared .Results The levels of CD3+ ,CD4+ ,CD8+ , CD4+ /CD8+ ,IL-2 ,IL-6 and TNF-αin the two groups before anesthesia were not statistically significant (P>0 .05) ,there was no significant difference in CD3+ ,CD8+ and IL-2 between the two groups after anesthesia (P>0 .05) .Compared with T0(before anes-thasia) ,the two groups decreased significantly on CD4+ and CD4+ /CD8+ at the T1(end of anesthesia) segment(P<0 .05) ,but the control group returned to the pre anesthesia level in the T 2(24 h after surgery ) segment ,the indexes at the T1 and T2 segment in the study group were higher than those in the control group (P<0 .05) ,and the level of IL-6 at T1 and T2 segment were signifi-cantly higher than those at the T0 segment (P<0 .05) .Compared with T0 ,the control group increased gradually on TNF-α (P<0 .05) ,while the study group only increased at the T1 segment (P<0 .05) ,and the T2 segment was restored to the pre-anesthesia induction .Conclusion Propofol and sevoflurane could inhibit the immune function of primary hepatocellular carcinoma ,but the de-gree of inhibition of propofol is relatively light ,and with less stress response .
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Objective To investigate the effects of two kinds of anesthesia methods on the immunological function of patients with primary liver cancer during perioperative period .Methods The clinical data of 86 cases of primary liver cancer from December 2010 to December 2015 were collected and divided into control group and study group ,43 cases in each group .The control group re-ceived sevoflurane inhalation anesthesia ,and the study group was given intravenous anesthesia with propofol ,the effects of different anesthesia methods on T lymphocyte subsets ,IL-2 ,IL-6 and TNF-α were compared .Results The levels of CD3+ ,CD4+ ,CD8+ , CD4+ /CD8+ ,IL-2 ,IL-6 and TNF-αin the two groups before anesthesia were not statistically significant (P>0 .05) ,there was no significant difference in CD3+ ,CD8+ and IL-2 between the two groups after anesthesia (P>0 .05) .Compared with T0(before anes-thasia) ,the two groups decreased significantly on CD4+ and CD4+ /CD8+ at the T1(end of anesthesia) segment(P<0 .05) ,but the control group returned to the pre anesthesia level in the T 2(24 h after surgery ) segment ,the indexes at the T1 and T2 segment in the study group were higher than those in the control group (P<0 .05) ,and the level of IL-6 at T1 and T2 segment were signifi-cantly higher than those at the T0 segment (P<0 .05) .Compared with T0 ,the control group increased gradually on TNF-α (P<0 .05) ,while the study group only increased at the T1 segment (P<0 .05) ,and the T2 segment was restored to the pre-anesthesia induction .Conclusion Propofol and sevoflurane could inhibit the immune function of primary hepatocellular carcinoma ,but the de-gree of inhibition of propofol is relatively light ,and with less stress response .
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Objective To investigate the influence of difference ileocecal junction length on the efficacy of laparoscopic subtotal colectomy combined with antiperistaltic cecorectal anastomosis (LSCACRA) in treatment of slow transit constipation (STC). Methods Ninety- two STC patients undergoing LSCACRA were divided into 2 groups by random digits table method:10-15 cm group (10-15 cm ascending colon preserved above ileocecal junction, 46 cases) and 2-3 cm group (2-3 cm ascending colon preserved above ileocecal junction ,46 cases). All the patients were followed up for 24 months, and the Wexner incontinence score (WIS), ileocecal junction emptying time of barium enema, Wexner constipation score (WCS), abdominal pain intensity score (NRS), gastrointestinal quality of life index (GIQLI), abdominal pain frequency score and abdominal bloating frequency score were compared between 2 groups. Results All the patients successfully completed LSCACRA, with no conversion to open surgery and death occurred. There were no statistical differences in amount of bleeding, operative time, hospitalization time, exhaust time, incidences of postoperative intestinal obstruction and pulmonary infection, defecation time, WIS and abdominal bloating frequency score between 2 groups (P>0.05). The WCS, GIQLI, NRS and abdominal pain frequency scores 6, 12 and 24 months after operation in 2-3 cm group were significantly better than those in 10 - 15 cm group, WCS: (1.7 ± 1.3) scores vs. (4.2 ± 2.3) scores, (1.7 ± 1.1) scores vs. (4.1 ± 1.9) scores, (1.2 ± 0.5) scores vs. (3.9 ± 2.5) scores;GIQLI:(116.8 ± 6.2) scores vs. (98.5 ± 14.7) scores, (122.9 ± 7.5) scores vs. (104.7 ± 16.5) scores, (124.3 ± 5.9) scores vs. (108.3 ± 15.1) scores; NRS: (1.3 ± 0.5) scores vs. (2.5 ± 1.7) scores, (0.9 ± 0.3) scores vs. (2.3 ± 1.4) scores, (0.8 ± 0.3) scores vs. (2.2 ± 1.5) scores;abdominal pain frequency score:(0.9 ± 0.3) scores vs. (1.6 ± 1.2) scores, (0.7 ± 0.3) scores vs. (1.4 ± 1.1) scores, (0.7 ± 0.2) scores vs. (1.2 ± 1.0) scores, and there were statistical differences (P<0.05). The ileocecal junction emptying time of barium enema 24 months after operation in 2-3 cm group was significantly shorter than that in 10-15 cm group: (17.6 ± 8.4) h vs. (21.3 ± 10.8) h, and there was statistical difference (P<0.05). Conclusions STC patients with LSCACRA is safe and effective. The shorter length of ascending colon preserved above ileocecal junction can improve the efficacy of LSCACRA in the treatment of STC and the prognosis of patients. The 2-3 cm length of ascending colon preserved above the ileocecal junction should be recommended.
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Objective To explore the effect of pathogenesis,diagnosis,therapy and prevention of portal vein thrombosis(PVT) after devascularization.Methods Data of 86 patients who underwent devascularization because of cirrhotic portal hypertension between January 2009 and December 2014 were retrospectively analyzed.Patients were divided into preventive anticoagulant treatment group (46 cases) and nonpreventive anticoagulant treatment group (40 cases) according to whether or not to receive prophylactic anticoagulant therapy.Compared the causes of PVT and clinical characters.Results The occurrence of PVT was 10.9％ (5/ 46) in preventive anticoagulant treatment group,PVT Ⅰ , Ⅱ, Ⅲ, Ⅳdegree were 2,3,0,0 cases,and that was 32.5％ (13/40) in nonpreventive anticoagulant treatment group, PVT Ⅰ , Ⅱ , Ⅲ, Ⅳ degree were 4,7,2,0 cases, the incidence rate of treatment group was lower than control group (x2 =9.735, P ＜ 0.05).There was no relationship in PVT with sex, age, and intraoperative ligation of splenic artery beforehand (P＞0.05).There were apparent correlation in PVT with centrifugal-flow of portal vein and peak value of platelet count(P＜0.05).All patients discharged uneventfully after anticoagulant treatment, including 2 cases of thrombolytic and 4 cases of blood supply recanalization, no case died from PVT.Conclusion The definite cause of PVT after devascularization is centrifugal-flow of portal vein and the peak value of platelet count (300-499) × 109/L is a pivotal risk factor.The key point of therapy is early diagnosis and early anticoagulant treatment.
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Objective To discuss the safety and effectiveness of laparoendoscopic single -site surgery (LESS)in cholecystectomy.Methods LESS and conventional laparoscopic(LC)effect were compared and analyzed in cholecystectomy.48 cases were divided into the two groups,24 cases(group LESS)were cheated by laparoendo-scopic single-site surgery;24 cases(group LC)were cheated by laparoscopic cholecystectomy.Contrasted in their operation time,intraoperative amount of bleeding,intraoperative laparotomy rate,body temperature after operation, complications,intestinal recovery time (postoperative exhaust),hospitalization time after operation,postoperative pain index,cosmetic effect,white blood cell (WBC),serum cortisol (Cortisol,Cor),immunoglobulin A (IgA)and comple-ment (C3 ).Results All cases were successful,no cases converted to laparotomy,no postoperative complications.The operation time of group LESS and group LC were (110.2 ±29.3)min and (77.8 ±31.2)min,respectively,the differ-ence was ststictically significant (t=5.07,P<0.05).The intestinal recovery time and hospitalization time after oper-ation in group LESS were less than that in gruoup LC (P<0.05 ).The cosmetic effect in group LESS (3.5 ± 0.5)was higher than that in group LC(2.1 ±0.5)(P<0.05).Cor and C3 in group LESS were higher than those in group LC(P<0.05 ).Conclusion Laparoendoscopic single -site surgery in cholecystectomy is safe and feasible, compared with traditional laparoscopic operation,operation time in LESS is long,but arapid postoperative recovery, beauty effect is obvious.
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Objective To study the clinical effectiveness of low cut and five dissector thyroidectomy to treat hyperthyroidism.Methods 337 cases of hyperthyroidism were randomly divided into study group(low cut and five dissector technique,223 cases) and control group(traditional technique,114 cases) according to the ratio of two:operating time,bleeding,complications,recur were compared between these two groups.Results The operating time of the study group and control group were(66.33?25.11)min and(121.27?42.35)min(t=12.75,P0.05).The rate of recurrence was marked(P
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Objective To discuss the way and effect of washing intestine and pelvic cavity to prevent the fistula of lo place close entrance's in carcinoma of rectum. Methods Cut the rectum and lymph node,used the tip large intestine to connect with washing machine tube. cut vermiform appendix and put urine tube enter ileocecal them use 500ml N.S to wash large intestine for sustained.After se the recturn and large intestine.Use two tube(0.8～1cm) pelvic cavity about 1～6 days. Results The improvement group(38 cases) had not occur leak of lo place cclose entrance, classical group (18 cases) had occur 2 cases (11.1%)leak of lo place close entrance, usestatistics to deal with, P