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1.
Article in Chinese | WPRIM | ID: wpr-884629

ABSTRACT

Objective:To compare the histological differences between magnetic anastomosis and traditional suture in canine portal vein (PV) .Methods:Eighteen healthy Chinese garden dogs, either gender, 8-12 months and weighing 13.5-18.9 kg, were randomly divided into magnetic compressive anastomats (MCA) group ( n=9) and hand-sewing (HS) group ( n=9) for PV reconstruction. The time of PV anastomosis was compared between the two groups. HE and Masson staining were performed immediately and at 4, 8, 12 and 24 weeks after operation. The ultrastructure of the anastomosis was observed using scanning and transmission electron microscopy. Results:All dogs survived. The PV anastomosis time was significantly shorter in MCA group (3.58±2.75) min than that HS group (12.89±3.12) min, P<0.01. In MCA group, the vascular wall of anastomotic stoma was well aligned immediately after operation, and the shrinkage was obvious in HS group by gross eyes. At 24 weeks, electron microscope scanning showed the re-endothelialization was smooth and endothelial cells arranged regularly at the anastomotic site of the MCA group, whereas different-sized and irregularly aligned endothelial cells and large collagenous fibers arranged in disorder were present at the HS anastomotic stoma. Representative HE and Masson staining confirmed that the magnetic device was associated with decreased infiltration of inflammatory cells and deposition of fibrotic collagen at 24 weeks explanted anastomotic stomas compared with the HS group. Conclusions:Compared with the HS, MCA produced shorter anastomosis time, smooth anastomotic intima, light fibrous tissue hyperplasia, no foreign body residue, mild inflammatory reaction and reliable technique for canines PV anastomosis.

2.
Organ Transplantation ; (6): 191-2021.
Article in Chinese | WPRIM | ID: wpr-873729

ABSTRACT

Objective To explore the feasibility of rapid and sutureless anastomosis of artificial vascular replacement of abdominal aorta in dog models using magnetic compression anastomosis (MCA) technique. Methods Twelve healthy adult crossbred dogs were evenly divided into the MCA and hand suturing (HS) groups according to the anastomosis method between abdominal aorta and artificial blood vessels. The intraoperative duration of abdominal aorta occlusion, intraoperative condition of anastomotic stoma and postoperative imaging examination of anastomotic stoma were compared between two groups. Results The intraoperative duration of abdominal aorta occlusion in the MCA group was significantly shorter than that in the HS group [(5.2±2.3) min vs. (24.4±4.3) min, P < 0.001]. No anastomotic leakage of blood or anastomotic stenosis occurred in the MCA group during the operation. Intraoperative anastomotic leakage of blood occurred in all of the 6 dogs in the HS group. Among them, 1 dog died of excessive blood loss, and 2 dogs experienced mild anastomotic stenosis due to repeated repair. Postoperative color Doppler ultrasound and angiography showed smooth blood flow at the anastomotic stoma without stenosis or thrombosis in the MCA group. In the HS group, 4 dogs presented with anastomotic stenosis on angiography at postoperative 4 weeks. Conclusions MCA technique may achieve rapid and sutureless anastomosis of artificial vascular replacement of abdominal aorta in dog models, which reduces the incidence of anastomotic complications and accelerates postoperative recovery.

3.
Article in Chinese | WPRIM | ID: wpr-752985

ABSTRACT

Objective To investigate the clinical efficacy of magnetic compression anastomosis for congenital esophageal atresia and stenosis.Methods The retrospective and descriptive study was conducted.The clinical data of 4 children who underwent magnetic compression anastomosis for congenital esophageal atresia and stenosis in the Northwest Women and Children's Hospital from December 2017 and February 2019 were collected.There were 2 males and 2 females.The children were aged 11 days,7 days,5 days,and 3 years,respectively.The children underwent magnetic compression anastomosis.Observation indicators:(1) surgical and postoperative situations;(2) follow-up.Follow-up using outpatient examination and telephone interview was performed to detect food intake and complications of children up to May 2019.Measurement data with normal distribution were represented as Mean±SD,and measurement data with skewed distribution were represented as M (range).Results (1) Surgical and postoperative situations:four children underwent magnetic compression anastomosis successfully.Of the 4 children,3 with esophageal atresia underwent open tracheoesophageal fistula repair and endoscopeassisted magnetic compression anastomosis,and 1 with congenital esophageal stenosis underwent endoscopic gastrostomy combined with magnetic compression anastomosis.The operation time of 4 children was (2.3±0.9) hours.The length of esophageal blind ending in the 3 children with esophageal atresia and length of esophageal stenosis were in the children with esophageal stenosis 30-35 mm and 8 mm.Four children has good magnet apposition,and time of postoperative magnet removal was (29± 10)days.Three children with esophageal atresia had oral removal of magnet,and 1 with esophageal stenosis had magnet removed by gastrostomy.One child complicated with postoperative fistula and anastomotic stenosis was cured by unobstructed drainage and nutritional support treatment.The duration of postoperative hospital stay was (39± 10)days.(2) Follow-up:4 patients were followed up for 3-17 months,with a median time of 10 months,and restored to oral intake after oral removal of magnet and removal of magnet by gastrostomy on the days 14-36 postoperatively.One child was detected anastomotic stenosis by esophagography at the postoperative 3 months,and was improved after esophageal dilatation.The other 3 children recovered to normal connectivity of esophagus postoperatively and maintain unobstructed.Four children had normal eating,without dysphagia or other serious complications.Conclusion Magnetic compression anastomosis is safe and feasible for congenital esophageal atresia and stenosis,with good short-term efficacy.

4.
Article in Chinese | WPRIM | ID: wpr-503112

ABSTRACT

Objective To discuss the effects of different drying methods on composition and antioxidative activities of the volatile oil fromCymbopogon citrates; To optimize the best drying method for Cymbopogon citrates. MethodsCymbopogon citrates was dried by drying in the sun, drying in the shade and oven drying at 40℃. Volatile oil was extracted by steam distillation. Chemical constituents in the volatile oil were analyzed by GC-MS and the antioxidative activities were determined by ferric reducing antioxidant power (FRAP method).Results Extraction rate of the volatile oil fromCymbopogon citratesunder the environment of freshness, sun drying, shade drying and oven drying at 40℃ were 0.25%, 1.21%, 1.19% and 1.17%, respectively; after dried by different methods, main constituents and antioxidative activities of the volatile oil fromCymbopogon citrates were basically same. Conclusion Different drying methods have little influence on composition and antioxidative activities of the volatile oil fromCymbopogon citrates. Oven drying at 40℃ was the best way to dryCymbopogon citrates.

5.
Article in Chinese | WPRIM | ID: wpr-481040

ABSTRACT

Objective To invent a set of novel veno-venous bypass (VVB) device based on magnetic anastomosis technique which can be used in ex situ liver resection, and verify its clinical value and performance in animal models.Methods Each VVB device was constructed using three magnetic rings and an inverted Y-shaped tube with magnetic rings on each end.The magnetic ring was made of NdFeB with electrode cutting, and the tube was made of polyvinyl chloride (PVC) and preconditioned with heparin coating on the surface of the lumen.Ten dogs underwent the ex situ liver resection, and VVB was established via magnetic anastomosis technique with the novel VVB device during the operation.The time for completing VVB was recorded, and the hemodynamic indexes including the venous flow velocity, carotid pressure, central venous pressure and portal pressure was detected.The changes of intestinal lumen and kidney were also observed.Results It only took 6 ~ 10 minutes to establish VVB by the novel VVB device in the operation,and the hemodynamics stability was maintained smoothly during the anheptic phase.The shunt index of inferior vena cava and portal vein was 76.2% and 75.5%, respectively.The congestion of intestinal canal and kidney were also alleviated during the anheptic phase.Conclusions It could reduce the time to establish VVB with magnetic anastomosis technique in ex situ liver resection.This study showed that utilizing the novel VVB device for intraabdominal VVB during the anheptic phase could be helpful to maintain the hemodynamics stability.

6.
International Journal of Surgery ; (12): 342-346, 2012.
Article in Chinese | WPRIM | ID: wpr-418752

ABSTRACT

Caudal-type homeoboxgene transcription factor 2 is one member of the caudal- related homeobox family,is a transeription factors important in intestinal epithelial development and in the differentiation and maintenance of the intestinal phenotype.In adulthood,these two proteins are strictly confined to the gut and are predominantly expressed by the epithelium of the small intestine and colon,but not by the normal epithelium of the oesophagus and stomach.In intestinal metaplasia,caudal-type homeohoxgene transcription factor 2 upregulation can be a direct effect of injurious agents on epithelial cells and/or can be due to the inflammatory environment of EpM,exposure to acid and/or bile acids may activate caudal-type homeoboxgene transcription factor 2 expression in human esophageal epithelial cells through promoter demethylation,and ectopie caudal-type homeoboxgene transcription factor 2 expression in esophageal squamous epithelia.It has been suggested to play an important role with retinoic acid,MUC2,p63 gene,BMP4 and many other factors working together to promote the development of this process in intestinal metaplasia and cancers.

7.
Article in Chinese | WPRIM | ID: wpr-421124

ABSTRACT

Magnetic compression anastomosis (MCA)involves the use of two rare-earth magnets that attract to each other transmurally between two internal organs, resulting in compression and subsequent fistula formation to create a nonsurgical enteric, vascular, or biliary anastomosis with therapeutic aims. The magnetic vascular coupler allows a sutureless anastomoses between arteries and veins by using interventional radiological techniques. The MCA technique significantly reduces ischemic time during anastomosis, and has the advantages of low invasiveness and simplicity. It is a rather effective method for recanalizing between various hollow viscera, creating anastomosis such as gastrojejunostomy, choledochojejunostomy, or choledochoduodenostomy.Furthermore, this novel technique is considered to be a feasible and alternative reconstructive method for patients who develop significant bile duct complications following hepaticojejunostomy and living donor liver transplantation. MCA is a promising and novel technique in the further development of minimal invasive surgery.

8.
Article in Chinese | WPRIM | ID: wpr-416665

ABSTRACT

Caudal-related homeobox transcription factor (CDX-2) is selectively localized in the fetal and adult mu-cosal epithelial nuclei of normal small and large intestines.CDX2 plays an important role in the regulation of cell proliferation and differentiation of the intestinal epithelium. Ec-topic expression of CDX-2 in the stomach, esophagus and other hollow organs might be a cause of intestinal metaplasia and adenocarcinoma. CDX-2 is expressed in both cultured and primary gallbladder carcinoma cells, and dysplasia.CDX2 is not detected in normal gallbladder and biliary tract mucosa. Ectopic CDX2 expression is an early event in gallbladder carcinogenesis. The frequency of CDX-2 expression is significantly higher in well-differentiated type than in the moderately and poorly differentiated tumors. The present study clearly showed that MUC2 expression in intestinal differentiation was dependent on the nuclear expression of CDX-2 in intraductal papillary neoplasia of the liver (IPNL)and mucinous intrahepatic cholangiocarcinoma (ICC) in the same manner as in the gastric mucosa and Barrett s esophagus. CDX-2 may also be a key factor in gallbladder carcinogenesis with intestinal differentiation and is a useful immuno-histochemical marker of intestinal differentiation in intestinal metaplasia of the gallbladder. CDX2-dependent regulation of cell proliferation may be an important factor in defining prognosis of patients with BTC.

9.
Article in Chinese | WPRIM | ID: wpr-384392

ABSTRACT

Objective To explore a new method for one-stage repair of the intestinal leakage based on the principle of magnetic compression anastomosis. Methods Twenty-four dogs were randomly divided into experimental group (n = 12) and control group (n = 12) according to random number table. The model of upper and multiple intestinal leakages was established by making transverse incisions of 1 cm in length on the jejunum wall about 50 cm and 100 cm away from the Treitz ligament. Forty-eight hours later, two NdFeB magnetic rings with the magnetic flux of 2500 G were put into the intestine from the leak sites. The leak sites were pressed between the two rings. The ventages in the control group were sutured. The condition of the dogs was observed after the repair of the leakage. The excreting time was recorded, and the leakage pressures of the anastomotic stoma were detected.The positions of the magnetic rings in the experimental group were detected by X ray. Tissues of the anastomotic stoma were processed by hematoxylin eosin and Masson staining. All data were analyzed using the two-sample t test. Results Severe abdominal infection occurred 48 hours after the establishment of the model. All the intestinal leakages in the experimental group were successfully repaired and the dogs survived for a long time. The magnetic rings were excreted six or seven days after the repair. Eight dogs of the control group survived. The leakage pressure of the anastomotic stoma seven days after the repair was (134 ±23)mm Hg (1 mm Hg =0. 133 kPa) in the experimental group and (91 ± 18)mm Hg in the control group, respectively, with a significant difference between the two groups (t = 3.225, P < 0.05). The leakage pressure of the anastomotic stoma 14 days after the repair was (281 ±7)mm Hg in the experimental group and (271 ±21) mm Hg in the control group, respectively, with no significant difference between the two groups (t =0. 988, P > 0.05). Histological observation showed that after the magnetic compression anastomosis, the intestinal muscle and mucosa recovered well, inflammatory reaction was slight and less collagen fiber and scar was formed. Conclusions Application of magnetic ring with the magnetic flux of 2500 G in one-stage repair of the intestinal leakage in the state of severe abdominal infection is safe and reliable.

10.
Article in Chinese | WPRIM | ID: wpr-384387

ABSTRACT

Cdx2 plays an important role in the proliferation and differentiation of normal intestinal cells. It has been suggested that Cdx2 is a master regulator of the intestinal differentiation program and is therefore not usually expressed outside the intestinal organs. Loss of Cdx2 expression leads to focal gastric differentiation in the colon, whereas aberrant expression of Cdx2 in the upper digestive tract may induce the initial trans-differentiation to intestinal metaplasia. The detection of a strong nuclear immunoreactivity for Cdx2 in metaplastic cells suggests that the protein is a major transcription factor in the development of intestinal metaplasia.Abnormal expression of Cdx2 is also correlated with early stage of adenocarcinoma in different organs, indicating that the protein may play an anti-oncogenic role in cancer development. The Inflammation-metaplasia-cancer'sequence is a frequent event in the lower esophagus, stomach, uterine cervix and the bladder. In all these specific anatomical sites, the noxious stimuli leading to metaplasia may have direct and/or indirect carcinogenic effects on chronically injured cells and Cdx2 plays a key role in the cascade process. Detection of Cdx2 expression in adenocarcinoma may be useful in the evaluation of malignancy and prognosis.

11.
Article in Chinese | WPRIM | ID: wpr-400065

ABSTRACT

Objective To study the expression of LI-cadherin in gastric cancer, gastric stromal tumor, chronic gastritis and intestinal metaplasia. Methods Two hundred and forty four specimens were collected, including normal epithelia (n=28), chronic superficial gastritis (n=30), chronic atrophic gastritis(n=42), intestinal metaplasia (n=58), gastric adenocarcinoma (n=46), paracancerous gastric tissues (n=30), gastric stromal tumor (n=10). The expression of LI-cadherin was detected by S-P immunohischemistry with purified goat polyclonal antibody. Results The expression of LI-cadherin in normal epithelia and chronic gastritis are all negative, the positive rates of LI-cadherin expression in intestinal metaplasia and gastric adenocarcinoma is 83% (48/58) and 65% (30/46) respectively. By Laurien classification, the positive rate of LI-cadherin expression in intestinal type was higher(78% ) than those in the diffuse type (35%) (P<0.05). LI-cadherin was in positive correlation with lymph node metastasis and staging. Paracancerous tissues and gastric stromal tumor did not express LI-cadherin. Conclusions The abnormal expression of LI-cadherin was correlated with intestinal metaplasia and gastric adenocarcinoma. GCs with high LI-cadherin index have more lymph node metastasis. High expression rate of LI-cadherin in gastric cancer tissues may predict poor prognosis.

12.
Article in Chinese | WPRIM | ID: wpr-594832

ABSTRACT

Objective To explore the feasibility of laparoscopic surgery for esophageal hiatus hernia and reflux esophagitis complicated with cholecystolithiasis.Methods Five trocars were used for the patients to perform laparoscopic hiatal hernia repair,followed by fundoplication(Nissen fundoplication in 21 cases and Toupet fundoplication in 6),and then LC.Results The procedures were completed in all of the 27 cases.The postoperative mean esophageal pressure of the patients was significantly higher than that before the operations [(19.32?4.11) mm Hg vs(7.30?1.36) mm Hg,t=-16.407,P=0.000],while the 24-hour pH value were decreased markedly(9.20?2.15 vs 160.16?50.30,t=16.387,P=0.000).No hemorrhage,intra-abdominal infection,biliary leakage occurred in this series.The patients were followed up for 1 to 24 months(1-6 months in 7 cases,and 7-24 months in 20 cases),during which no esophageal stenosis or incisional hernia were detected.Conclusions It is feasible to perform primary laparoscopic surgery for patients suffering from esophageal hiatus hernia and reflux esophagitis complicated with simultaneous cholecystolithiasis,if no contraindications.

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