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【Objective】 To analyze the basic characteristics of whole blood donors from blood stations before and after the outbreak of COVID-19. 【Methods】 After excluding invalid data, data related to the basic characteristics of whole blood donors collected from 26 blood stations in China during 2018 to 2021 were statistically analyzed, including the trend of total whole blood donors, the number of repeated blood donors, the frequency of blood donation, the average age of donors and the recruitment of first-time blood donors. 【Results】 Affected by the epidemic, 8 out of 14 indicators were with large variations, accounting for 57%. The overall growth rate of total whole blood donors during the epidemic was higher than before the epidemic (P<0.05).The number of repeated blood donors has shown an increased trend, with a higher number during the epidemic than before (P<0.05). The frequency of blood donation was lower during the epidemic than before(P<0.05).Average ages of blood donors and female blood donors fluctuated widely during the epidemic, both higher than those before the epidemic(P<0.05).The donation rate of first-time blood donors <25 years old and ≥25 years old varied widely and irregularly during the epidemic (both P<0.05). The percentage of first-time blood donors fluctuated irregularly during the epidemic, with overall percentage lower than that before the epidemic(P<0.05). 【Conclusion】 Whole blood donors from 26 blood stations increased after the outbreak of COVID-19, and some indicators in certain areas showed significant fluctuations during the epidemic.
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Ureteral calculi after lingual mucosal ureteral reconstruction are rare. In this paper, we reported a case of a male patient who had undergone robotic-assisted laparoscopic lingual mucosal right ureteroplasty. Calculi were found in the right reconstructed ureteral segment 4 months after surgery. Then the patient underwent transurethral ureteroscopic holmium laser lithotripsy combined with a stone retrieval basket, and postoperative urological CT showed no residual calculi in the right ureter. No recurrence of right ureteral calculi or complications were observed during 20 months of follow-up.
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Objective:To investigate the clinicopathological features and prognosis of mycosis fungoides.Methods:The clinical data of 34 patients with mycosis fungoides hospitalized in Liaoning Cancer Hospital from January 1996 to December 2016 were retrospectively analyzed. The clinicopathological characteristics and prognosis of the patients were summarized. The follow-up was up to June 2021. Kaplan-Meier method was used for survival analysis, and log-rank test was used to compare the overall survival (OS) of patients among different subgroups.Results:Among the 34 patients, 22 (64.7%) were male and 12 (35.3%) were female; the median onset age was 56.5 years (25-93 years). A total of 23 cases (67.6%) presented with the rash on the whole body, and the main manifestations of the rash in the tumor stage were tumor rupture (10 cases, 29.4%) and redness (7 cases, 20.6%); 20 cases (58.8%) were misdiagnosed at initial onset. In the terms of TNMB stage, 3 cases were at stage Ⅰ (8.8%), 11 cases were at stage Ⅱ(32.4%), 3 cases were at stage Ⅲ (8.8%), and 17 cases were at stage Ⅳ (50.0%); 17 cases (50.0%) had the lesions confined to the skin and 17 cases had distant metastasis. Among the patients with distant metastasis, 7 cases had visceral organs involvement, 5 cases had lymph nodes involvement, and 5 cases had bone marrow or peripheral blood involvement. There were 32 cases treated with first-line chemotherapy alone, 9 cases with radiotherapy alone, and 7 cases in combination with radiotherapy and chemotherapy. Among the 32 patients treated with first-line chemotherapy, 14 cases had complete remission (CR), 12 cases had partial remission (PR), and response rate (RR) was 81.3% (26 cases); among the 9 patients who received radiotherapy, 3 cases had CR, 5 cases had PR, and RR was 88.9% (8 /19). The median follow-up time was 142.5 months; until the last follow-up, 20 (58.8%) cases survived, 6 (17.6%) cases died and 8 (23.5%) cases lost the follow-up. Survival analysis showed that the median OS of the whole group was not reached. Compared with patients whose lesions were confined to the skin, patients with distant metastasis had poorer OS ( P = 0.039). Among patients with distant metastasis, those with lymph node involvement had better OS, followed by those with bone marrow or peripheral blood involvement, those with visceral organ involvement had the poorest OS ( P = 0.045). Conclusions:The clinical misdiagnosis rate of early-stage mycosis fungoides is high, and the diagnosis mainly depends on clinical, histological and pathological characteristics. Radiotherapy and chemotherapy have high efficiency for early-stage disease and the prognosis of patients with distant metastasis is poor. OS in patients with lymph node involvement is better than that in patients with bone marrow or peripheral blood involvement, and OS in patients with visceral organ involvement is the worst.
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【Objective】 To study the annual financial expenditure in blood stations with different scales, and to establish the regression equation between blood collection units and total expenditure. 【Methods】 The annual total expenditure, the per capita cost of serving population, as well as the collection units of whole blood and apheresis platelet of 24 blood stations were collected. The financial expenditure required for collecting 10 000U blood was calculated.The statistical analysis was carried out with SPSS statistical software. 【Results】 From 2017 to 2020, the total annual financial expenditure of 24 blood stations showed an upward trend. The total expenditure among blood stations was different. The per capita cost of servicing population in the areas where the 24 blood stations were located had been increasing year by year. The 24 blood stations were divided into two grades according to the blood collection volume as 50 000 U, and the relationship equation between the blood collection volume and the annual total expenditure had been established. After testing, each equation was effective(P<0.05); There was no difference in the financial expenditure required for collecting 10 000U blood among blood stations with different scales. 【Conclusion】 From 2017 to 2020, the blood stations with an annual collection volume more than 50 000 U demonstrated a higher financial expenditure and the per capita cost of serving population than those <50 000 U. The blood collection volume of blood stations is significantly correlated with the annual total expenditure and the per capita cost of serving population.
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【Objective】 To understand the current situation of blood components distribution in domestic prefecture-level blood stations through analyzing the components distribution data of 24 prefecture-level blood stations in China. 【Methods】 The data of components distribution of 24 blood stations from 2017 to 2020 as well as the data of blood deployment of 24 blood stations from 2019 to 2020 were collected and analyzed. 【Results】 From 2017 to 2020, positive annual growth in red blood cells, plasma and cryoprecipitate was observed in 22, 19 and 15 out of the 24 blood stations, and the annual growth median rate of above three components was 5.24%, 3.80% and 3.25%, respectively. Among the 24 prefecture-level blood stations, 23 carried out the preparation of cryoprecipitate. 【Conclusion】 The distribution of red blood cells, cryoprecipitate and plasma in prefecture-level blood stations is increasing year by year. However, there is a overstock of plasma, and most blood stations need blood employment.
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【Objective】 To learn the production efficient of platelet components among prefecture-level blood stations in China, to provide supporting data for those blood stations to optimize the production mode of platelet components and continuously improve production efficiency and supply capacity. 【Methods】 The data from 2017 to 2020 was obtained from 24 prefecture-level blood stations who were the members of the practice comparison network for blood institutes in China. The collection units of apheresis platelets, the number of dual-collections of apheresis platelets and plasma, the average apheresis units of one platelet apheresis procedure, the discarded rate of apheresis platelets, the amount of expired apheresis platelets and the amount of apheresis platelets issued were collected. For concentrated platelets, the prepared amount of platelet concentrates and the amount of expired platelet concentrates were collected; both the quantity of qualified and issued concentrated platelets were submitted for statistical analysis.The total output and efficiency of platelet components were calculated based on the collected data. 【Results】 The average annual growth rate of apheresis platelets collection in 24 prefecture-level blood stations was 12.23%, accounting for 99.80% of the total platelet output; the average collection unit of one platelets apheresis procedure was 1.75; from 2019 to 2020, only 5 blood stations performed dual-collection of platelet and plasma during one apheresis procedure; the discarded rate of apheresis platelets was 0.28%, of which 0.007% was due to expiration. A total of 1 621.2 therapeutic units of concentrated platelets were prepared, and 13.03% of them was discarded due to the expiration. The production efficiency of platelet components was 97.56%, of which the production efficiency of apheresis platelets was 97.61% and the production efficiency of concentrated platelets was 74.43%. 【Conclusion】 There are large regional differences in the supply capacity of platelet components in prefecture-level blood stations. Apheresis platelets are the main resource of platelet components product, and the collection capacity is increasing over the years with the characteristics of high production efficiency and low expiration scrapping rate. However, the preparation of concentrated platelets are still limited with relatively low production and high expiration discarded rate.
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Urinary tract infection (UTI) is one of the most common infectious diseases. It has the characteristics of high recurrence rate and prolonged course. At present, the problem of antibiotic resistance is becoming more and more serious, the incidence of adverse reactions is high, and the disadvantages of long-term administration appear, which brings severe challenges to the treatment of recurrent urinary tract infection. The prevention and treatment of UTI recurrence has become the focus of research. Recurrent urinary tract infection is related to the immune regulation mechanism of the body. Administration of immune regulation can provide new ideas for prevention and treatment. The vaccine based on immune regulation to prevent rUTI has made some progress. It can not only reduce the frequency of recurrences, but also decrease related symptoms. At the same time, the vaccine has good tolerance, high safety and good application prospect. This paper aims to summarize the progress of immune regulation and immune vaccines in vivo and clinical research.
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Objective:To explore the clinical charateristics and prognostic factors of patients with primary systemic anaplastic large cell lymphoma (ALCL).Methods:The clinicopathological data of 31 patients with newly treated primary systemic ALCL in Liaoning Cancer Hospital from January 2010 to December 2020 were retrospectively analyzed. Kaplan-Meier method was used to make survival analysis and log-rank test was performed. Multivariate analysis of factors influencing overall survival (OS) was performed by using Cox proportional hazards model.Results:Among 31 patients, there were 19 males and 12 females, with a median age of 47 years old, ranging from 16 to 74 years old. There were 18 (58.1%) patients with B symptoms, 16 (51.6%) patients with increased platelet count, 22 (71.0%) patients with Ann Arbor stage Ⅲ-Ⅳ. Until the end of follow-up, 22 cases survived and 9 cases died; the 5-year OS rate was 70.9%, and the median OS time was not reached. The 5-year OS rate of patients receiving CHOPE chemotherapy regimen was higher than that of patients receiving CHOP and other chemotherapy regimens, and the difference was statistically significant ( P = 0.049). There were statistically significant differences in the 5-year OS rates of patients with different platelet count, international prognostic index (IPI) score, chemotherapy regimens and with or without B symptoms (all P < 0.05). Multivariate analysis indicated that IPI score was an independent factor affecting OS ( HR = 2.194, 95% CI 1.078-4.465, P = 0.030). Conclusions:Most primary systemic ALCL patients are diagnosed at advanced stage and it is more common in males. Most patients have B symptoms and high platelet count. IPI score is an important prognostic factor, and CHOPE regimen may be a good choice of the first-line chemotherapy.
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Objective:To introduce a newly modified surgical approach and explore the clinical efficacy of en bloc kidney transplantation from deceased infant donors to adults.Methods:Four cases of en bloc kidney transplantation from deceased infant donor to adult were performed with a new modified surgical approach in renal transplantation and dialysis center of the Second People's Hospital of Shanxi Province from January 2017 to September 2019. All 4 cases were cardiac death donors. There were 3 males and 1 female donors, aged (54 ± 22.69) d and weighing (5.6 ± 0.79) kg. There were 1 male and 3 female recipients, aged (41.5 ± 5.97) years and weighing (45 ± 3.56) kg. For lowering operative difficulties and preventing hemodynamic disturbances, bilateral kidneys were sutured and fixed during trimming. Then end-to-side anastomosis was performed between donor kidney abdominal aortic valve and recipient external iliac artery and between donor renal inferior vena cava valve and recipient external iliac vein.Results:All operations were successful without vascular or urinary complication. The average duration of donor kidney repair was 20 min and the average duration of transplantation 68.75 min. The functions of transplanted kidney recovered well during a follow-up period of 12 months. The long-term survivals of recipient and transplanted kidney were satisfactory.Conclusions:The newly modified surgical approach of en bloc kidney transplantation from deceased infant donor to adult has optimized operative handling. With a higher success rate, vascular complications are lowered. A wider popularization is recommended.
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【Objective】 To analyze the related factors and countermeasures of adverse reactions to whole blood donation(ARBD) for medical student donors, so as to further reduce the incidence of ARBD. 【Methods】 The demographic data of medical/non-medical student donors and those suffered from ARBD from 2016 to 2018 were retrospectively analyzed, and the relationship between ARBD and age, gender, frequency of blood donation, blood volume, blood type, pulse, ALT, blood pressure, hemoglobin, etc. was statistically analyzed. 【Results】 The incidence of ARBD in all medical student donors from 2016 to 2018 was 1.16%, lower than that of non-medical students (1.51%). The ARBD rate(2.30%) of senior medical students (> 20 years old) was significantly lower than that of non-medical students (3.93%) and higher than that of junior medical students (≤20 years old)(0.70%). The ARBD rate of novel medical student donors was 1.27%, lower than that of novel non-medical students (2.12%) (P<0.05). Male medical students(1.68%) were more likely to develop ARBD than females(0.78%), donations within 200 mL(55%) than 300mL(0.26%) and 400mL(0), Hb<120 g/L(13.04%) than Hb≥120 g / L( 1.10% ), and blood type A(1.70%) than type O (0.88%) (P<0.05). Logistic regression analysis showed that blood volume and blood type were related factors. ARBD was more likely to occur in Type A blood than type O, and was more likely to occur when blood volume was lower. ARBD occurred frequently during phlebotomy, due to mental stress(75%) and hunger(8.92%)(P<0.05), while 96.43% of ARBD could recover within 10 minutes. 【Conclusion】 Novel, male, older than 20 years, Hb<120 g / L, blood type A and donation unit ≤200 mL were main risks for ARBD in medical student donors. Popularizing the knowledge of voluntary blood donation and strengthening pre-donation communication are important measures to prevent ARBD.
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Objective:To summarize the patient profiles and therapeutic efficacies of ABO-incompatible living-related kidney transplantations at 19 domestic transplant centers and provide rationales for clinical application of ABOi-KT.Methods:Clinical cases of ABO-incompatible/compatible kidney transplantation (ABOi-KT/ABOc-KT) from December 2006 to December 2009 were collected. Then, statistical analyses were conducted from the aspects of tissue matching, perioperative managements, complications and survival rates of renal allograft or recipients.Results:Clinical data of 342 ABOi-KT and 779 ABOc-KT indicated that (1) no inter-group differences existed in age, body mass index (BMI), donor-recipient relationship or waiting time of pre-operative dialysis; (2) ABO blood type: blood type O recipients had the longest waiting list and transplantations from blood type A to blood type O accounted for the largest proportion; (3) HLA matching: no statistical significance existed in mismatch rate or positive rate of PRA I/II between two types of surgery; (4) CD20 should be properly used on the basis of different phrases; (5) hemorrhage was a common complication during an early postoperative period and microthrombosis appeared later; (6) no difference existed in postoperative incidence of complications or survival rate of renal allograft and recipients at 1/3/5/10 years between ABOi-KT and ABOc-KT. The acute rejection rate and serum creatinine levels of ABOi-KT recipients were comparable to those of ABOc-KT recipients within 1 year.Conclusions:ABOi-KT is both safe and effective so that it may be applied at all transplant centers as needed.
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Objective:To summarize the clinical experiences of 9 ABO-incompatible kidney transplantation at our center and explore its clinical application value.Methods:Methods From April 2016 to December 2019, there were 9 living kidney transplants of ABO incompatible relatives, including type A to type B (n=3), type B to type O (n=3), type B to type A (n=1) and type AB to type B (n=2). Immunosuppressant plus single membrane plasmapheresis (PE) and/or double filtration plasmapheresis (DFPP) and rituximab were employed for pretreating recipients. Adverse reactions of recipients were observed during and after pretreatment. Blood group antibody titer, complications and other related parameters were recorded before and after transplantation before and after monitoring pretreatment.Results:After pretreatment, IgM, IgG and total titer of blood group antibodies were ≤1: 4 on the day of transplantation and the titer of non-blood group antibodies rebounded within 2 weeks (≤1: 8). During preconditioning, 2 patients experienced oral numbness and involuntary dithering during plasmapheresis and there was 1 case of infusion reaction after rituximab dosing. The early recovery of renal function was all excellent. Renal biopsy was performed in 4 patients with slow elevation of serum creatinine and 1 case developed acute antibody-mediated rejection. The survival rate of all recipients at the last follow-up was 100%.Conclusions:Live kidney transplantation of ABO-incompatible relatives is both safe and feasible so that it may help alleviate some shortage of donor kidney.
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Objective@#To investigate the possibility of adipose tissue mesenchymal stem cell-derived microvesicles (ADSC-MVs) to improve the retention volume of fat transplantation.@*Methods@#Human adipose tissue was obtained from 5 healthy female patients aged from 20 to 30 years, who came to the hospital for abdominal liposuction. Adipose tissue mesenchymal stem cells (ADSCs) were acquired by collagenase enzymatic hydrolysis. ADSC-MVs were isolated from the supernatant of cultured ADSCs through ultra-centrifugation, and characterized by transmission electron microscope and PKH26 staining. Sixteen BALB/c-nu nude mice were randomly divided into 2 groups (n=8, mice/group) by random number table method. In EV group, the mice were subcutaneously injected 0.35 ml human fat, with 7 μg ADSC-EVs (final concentration is 20 μg/ml), while 0.35 ml human fat were in blank group. The mice were sacrificed and the grafts were harvested at 1 month and 3 months after transplantation. Weight and volume of transplanted fat were tested. Morphology of adipocytes, fibrosis and necrosis of fat tissue were confirmed by HE staining. Blood vessel density were accessed by CD31 staining.SPSS 13.0 was used for statistical analysis and Student-t test was applied to compare the data from two groups.@*Results@#One month after fat transplantation, the volume of fat grafts in blank group was lower than that in MV group. Besides, lipoliquefaction can be observed in fat grafts of blank group. Fat grafts in MV group had a higher volume and littler necrosis and lipolique faction. Three months after grafting, the volume of fat grafts in blank group [(0.057±0.009) ml] was significantly lower than that in MV group [(0.103±0.015) ml], t=8.117, P<0.001. MV group had an increased number of vessels (29.6±4.0/field) compared with grafts from the Blank group (23.0±2.4/field), t=2.825, P=0.022. Histological analysis revealed that the fat grafts in MV group consisted less fat necrosis and fibrosis than control group.@*Conclusions@#ADSC-MVs can improve the retention volume of fat transplantation.
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Objective@#To explore an open porous microtissue which is suitable for the growth of bone marrow mesenchymal stem cells (BMSCs) , and the optimal size of this microtissue.@*Methods@#Polymethyl methacrylate (PMMA) micro-stencil array chips with pore diameters of 1500 μm and 800 μm were constructed by laser drilling technique. The gelatin solution was chemically crosslinked and uniformly spread on the micro-stencil array chips. After freeze-drying for 16 h, the microgels in the chip were ejected by the ejector-pin array. SEM images were taken to observe the microstructure of microgels. Pore size and porosity of two kinds of microgels were calculated using Image J Pro software. The P3 BMSCs were seeded on microgels at the concentration of 5×106/ml. After 7 days culture in vitro, the microtissues were obtained. Thereafter, the viability of seeded BMSCs was assessed using live/dead cell assay. The growth of the cells on the microtissues and the secretion of ECM were observed by scanning electron microscopy (SEM).@*Results@#The SEM images showed that the open porous structured microgels were successfully fabricated using the micro-stencil array chip. The pore size and porosity of 1 500 μm microgels were about 1.5 times that of the 800 μm microgels. After 7 days culture in vitro, the number of cells 1 500 μm microgels were more compared to 800 μm microgels, in the live/dead cell assay. Fluorescent quantitative analyses showed that the viability of BMSCs on 1 500 μm microtissues was 4 times that of 800 μm microtissues. SEM images showed that the cells on 1 500 μm microtissues grew well and surrounded by ECM.@*Conclusions@#The micro-stencil array chips were successfully used to construct microgels with open porous, which could be further used to fabricate open porous microtissues. The 1 500 μm microtissues were more favorable for BMSCs, compared to 800 μm microtissues.
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Objective To explore the effect of divided injection of fat grafting and to provide a new sight for the strategy of clinical particle fat transplantation.Methods Adipose tissue was aspirated from the healthy female abdomen by liposuction.In the control group,0.5 ml of adipose tissue was subcutaneously injected into the nude mice.The experimental group was injected with 0.25 ml first,followed by 0.25 ml injection of adipose tissue on the 7th,14th and 30th days.To assess graft retention rate and effectiveness we measured the wet weight and observed the pathological sections with HE or perilipin immunofluorescence.Results The wet weight of the tissue between the experimental group and the control group had no statistical difference,the experimental group had less necrosis and empty tissue than the control group.The proportion of perilipin positive staining tissue in 7 day group had statistical difference from that of the control group.Conclusions The strategy of preinjection of part of the adipose tissue and then supplement of the residual tissue after 7 days may increase the proportion of active adipose tissue in the graft.
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Objective To evaluate the efficacy and safety of converting traditional triple immunosuppressive regimen into quadruple immunosuppressive regimen of low-dose tacrolimus plus sirolimus plus mycophenolic acid plus hormone in expanded criteria donor (ECD) renal transplant recipients .Methods A retrospective analysis was conducted for 39 patients undergoing extended standard kidney transplantation with conversion therapy from January 2015 to June 2018 .Renal function ,liver function ,blood lipid ,bone marrow suppression ,positive rate of urinary protein ,positive rate of urinary BK virus and other adverse reactions were analyzed .Results A total of 39 recipients fulfilled the inclusion criteria ,including 28 boys and 11 girls with an average age of (37 .69 ± 11 .07) years and a median postoperative conversion time of 6 months .As compared with pre-conversion therapy ,renal function and estimated glomerular filtration rate improved significantly at 1 month ,3 months ,6 months and 1 year (P<0 .05) .No significant difference existed in the level of blood lipid ,whole blood leukocyte or hemoglobin at pre and post-conversion ( P>0 .05) .No significant difference existed between AST and ALT at pre and post-conversion (P< 0 .05) . After conversion , the positive rates of urinary protein and BK virus urine declined . Subacute rejection occurred in 1 case after conversion .Addition of sirolimus was curative .No severe adverse reactions such as infection and diarrhea occurred in the remaining cases .Conclusions T he quadruple immunosuppressive regimen of low-dose tacrolimus plus sirolimus plus mycophenolic acid and hormone is both safe and effective for ECD recipients of renal transplantation .
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The strategy of vascularization using tissue engineering chamber model was introduced, and the application progress of this model in tissue regeneration was summarized. Using " tissue engineering" and " chamber" as the keywords, the PubMed database were searched for the literatures on the application of tissue engineering chamber model in recent years. The results show the tissue engineering chamber model could promote the vascularization of tissue engineering grafts and support the growth of many kinds of cells and tissues including stem cells, cardiomyocytes, hepatocytes, chondrocytes, adipose tissue, thymus tissue and so on. Tissue engineering chamber model is helpful to the survival and growth of different cells and tissues in vivo. This model is expected to solve the problem of vascularization in tissue engineering and has a great application prospect.
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[Objective]To explore the clinical experience of the treatment of coronary heart disease by Professor TANG Shuhua.[Methods]Through the clinical study with the teacher to collect and collate the relevant information and medical records, from the etiology and pathogenesis of coronary heart disease, governance and other aspects of the specific analysis and discussion on Professor TANG Shuhua treatment of this disease academic point of view and clinical experience,it summed up the rule of prescription,and to the case of evidence,through regular follow-up,observed the treatment effect. [Results]Professor TANG Shuhua believes that"Yin deficiency endogenous heat and blood stasis" is an important pathogenesis of coronary heart disease. Professor TANG in the treatment of coronary heart disease takes the pathogenesis as a guide, with the proposed nourishing liver and kidney, Qingrejiedu, invigorates the circulation of general pulse function applied to add and subtract, on the basis of Lu Huang Ke Li significantly improves the symptoms of coronary heart disease angina pectoris,delays the development of coronary heart disease progression and improves the quality of life.[Conclusion]Professor TANG Shuhua's treatment of coronary heart disease by nourishing Yin and heat and activating blood circulation is significant, which is of great significance to guiding the treatment of coronary heart disease.
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Objective To investigate the anatomical basic of extensor carpi radialis brevis (ECRB) tendon transferring to extensor pollicis longus (EPL) tendon.Methods Twelve sides of ECRB and EPL in fresh adult cadaver's forearms were collected,and the anatomical model of ECRB transferring to EPL was set up in all the forearms.The anatomical parameters of EPL were measured before and after anatomical model established.Results The effective transferring length of ECRB was (3.5±0.8)cm;the maximum circumferential of ECRB and EPL were (8.5±0.8)cm and (3.6±0.3)cm (P ＞0.05),the ratio of muscle cross-sectional area was 5.57;After the anatomical model setting up,anatomic angles of EPL was (30±7)°,which was a decrease of (20±5) ° comparing with the preoperative angel of (50±9) ° (P ＞0.05);Thumb extension angle was (50± 12) °,which was a decrease of (8±3) ° comparing with the preoperative angel of (58 ± 16) ° (P＜0.05);The dorsal extension angle of first metacarpal was (12±5)o,which was a decrease of (3± 2) o comparing with the preoperative angle (15±8)° (P＞0.05);Thumb tip lifting height was (2.3±0.9) c m,which was a decrease of (1.2±0.6)cm comparing with the preoperative height (3.5±1.2)cm (P ＞0.05).Conclusion Based on the measurement of the anatomic parameters of ECRB and EPL,the ECRB has enough length and muscle force to reconstruct the function of EPL.The thumb had a good extension appearance and accorded with the rule of biomechanics after setting up the anatomical model of ECRB transferring to EPL.This study will provide the anatomical evidence for further clinical application
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Objective To summarize the effect of en bloc kidney transplantation (EBKT) from cardiac deceased infant donors into adult recipients and to share a new simplified EBKT technique.Methods Fourteen dual kidneys from infant donors (9 males,and 5 females) were transplanted into adult recipients (3 males,and 11 females).The donor ages ranged from 17 days to 8 months,and the recipient ages ranged from 19 years to 61 years.The recipients were categorized into 2 groups in terms of the microvascular surgical techniques.Case 1 to case 9 was given traditional techniques and case 10 to case 14 simplified techniques.In detail,the dual kidneys were recovered en bloc with the aorta and inferior vena cava.After splitting the rear wall of the donor aorta and inferior vena cava,suitable size of patches were made by cutting along the vascular openings of renal arteries and renal veins.We anastomosed the aorta patch to the external iliac artery in an end-to-side fashion.The donor inferior vena cava patch was anastomosed to the external iliac vein in an end-to-side fashion.The distal ends of ureters were implanted into the bladder separately.Results In traditional group,two cases underwent peri-operative graft loss because of renal artery thrombosis,and one patient died of pneumonia 16 days post-operation.During the follow-up period,graft loss was seen in 2 patients caused by irreversible drug-induced nephrotoxicity and donor-derived malignant tumor respectively.The mean serum creatinine level was 81.7 ± 27.4 μmol/L and eGFR level was 82.5 ± 22.2 mL/min/1.73 m2 in the other EBKT recipients at 24th week post-operation.In simplified group,no vascular complications post-operation occurred.Conclusion En bloc infant kidneys could be transplanted into adult recipients successfully with excellent graft function and survival outcome while censored perioperative patient death and surgical failure.Instead of traditional EBKT technique,simplified EBKT technique could decrease the incidence of surgical vascular complications and should be applied to more recipients.