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Objective:To explore the impact of donor cold ischemia time(CIT)on early recovery after liver transplantation(LT).Methods:From January 2016 to December 2020, the relevant clinical data were retrospectively reviewed for 456 LT recipients.According to the value of CIT of donor liver, they were assigned into two groups of CIT >5 h and CIT≤5 h. T, Mann-Whitney U or Chi square test was employed for statistical processing.Intraoperative findings and liver function(LF)parameters of two groups were compared, including operative duration, intraoperative volume of hemorrhage, erythrocyte transfusion and anhepatic phase.LF parameters included alanine aminotransferase(ALT), aspartate aminotransferase(AST)and total bilirubin(TB)within Day 1-7 post-LT.Postoperative recovery was evaluated by postoperative stay of intensive care unit(ICU), normalization time of liver function recovery, length of postoperative hospitalization and incidence of postoperative complications.Results:Among them, 407(89.3%)patients underwent classic orthotopic LT.Median CIT of donor liver was 309 min.In CIT≤5 h and CIT >5 h groups, operative duration was[(446.3+ 76.8)vs.(526.0+ 98.1)min], anhepatic phase time[(51.9+ 13.3)vs.(62.6+ 18.9)min]and intraoperative volume of erythrocyte transfusion[(7.3+ 5.8)vs.(10.0+ 6.87)U]. And the differences were statistically significant( P<0.001, 0.001 & 0.001). Postoperative hospitalization stay was longer[(29.1±15.9)vs.(27.1±13.0)]day.And the incidence of postoperative complications was higher in CIT >5 h group[22.7%(54/238)vs.12.4%(27/218)]. And the difference was statistically significant( P=0.045 & 0.004). As compared with CIT≤5 h group, ALT, AST & TB spiked in CIT >5 h group at Day 1 post-operation and the differences were statistically significant( P=0.002, P<0.001, P=0.001). In CIT >5 h group, ALT rose at Day 2/5/6/7 post-LT( P=0.026, 0.026, 0.015 & 0.011), AST jumped from Days 2-6( P=0.002, 0.004, 0.035, 0.029 and 0.019)and TB increased from Days 2-7 post-LT and the differences were statistically significant( P=0.003, 0.014, 0.030, 0.039, 0.027 & 0.009). LF recovered at CIT≤5 h and CIT>5 h group[(10.0±3.2)vs.(10.7±3.3)day]. There were significantly statistical differences( P=0.044). Conclusions:Non-conducive to patient recovery, prolonged cold ischemic time aggravates early LF injury post-LT.
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Objective:To compare and analyse the clinical outcome, advantages and disadvantages of submental artery island flap (SAIF) and free anterolateral thigh flap (ALTF) in the repair and reconstruction of tongue after radical surgery of tongue cancer.Methods:From January, 2016 to December, 2018, a total of 40 patients received tongue repair and reconstruction with either SAIF or ALTF after radical resection of tongue cancer. There were 28 males and 12 females, with an average age of 51 years old. Eighteen patients received tongue repair and reconstruction with SAIF and 22 with ALTF. Postoperative follow-up were carried out and the clinical data were collected. Swallowing, speech and softness of the tongue between the 2 repair methods were compared and statistically analysed. P<0.05 indicated a significant statistical difference between 2 groups. Results:All flaps survived. One ALTF had a venous vascular crisis. The flap survived after the removal of thrombus at the anastomotic site. Functional recovery of tongue was analysed after the follow-up of 12-48 months. It was found that there was no significant difference in speech function between the 2 groups (SAIF vs ALTF: 13 vs 15, P=0.206). The swallowing dysfunction in SAIF group was significantly higher than that of the ALTF group (SAIF vs ALTF: 15 vs 7, P=0.014). Moreover, the average time of surgery in SAIF group (3.5 h) was significantly less than that of the ALTF group (6.8 h), which had statistically significance ( P<0.05). Conclusion:The SAIF and ALTF are ideal flaps for repairing the tongue defect caused by tongue cancer surgery. SAIF features a simple surgical procedure and a short time for flap taking. ALTF provides sufficient amount of tissue to cover the scars left by the surgery, reduce donor site complications, and benefit the recovery of swallowing and speech functions.
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Objective To summarize the experience of diagnosis,treatment and clinical effects of Ni-Ti shape memory alloy embracing fixator for severe chest trauma complicated with multiple rib frac-tures.Methods From January 2009 to June 2013,the clinical data of 148 cases with embracing fixator and 47 cases with non-internal fixation were retrospectively analyzed and compared.Results Internal fix-ation was superior to non-internal fixation in hospital stay,pain perception,mechanical ventilation time, pulmonary function recovery and complications(P<0.05).Conclusion Ni-Ti shape memory alloy em-bracing fixator is better than other conservative therapies in the treatment of multiple rib fractures and it's worthy of spreading.
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Phosphatases play a key role not only in cell physiological functions of an organism, but also in host-pathogen interactions. Many studies demonstrated that some Gram-negative pathogenic bacteria could evade host immunity and promote pathogenicity by injecting phosphatases into host cells through type III secretion system. However, there were few reports about pathogenic fungi evading the immunity of hosts. Our researches indicated that the entomogenic fungus Metarhizium anisopliae could dephosphorylate the signal transduction substance of locust humoral immunity specifically in vitro by secreting extracellular protein tyrosine phosphatase, which implied that the fungus might interfere with the immune defense of locust. To provide reference for further studies of the functions of phosphatases, we reviewed the types of phosphatases and their roles in pathogen infection.
Subject(s)
Animals , Fungal Proteins , Metabolism , Fungi , Physiology , Gram-Negative Bacteria , Physiology , Grasshoppers , Allergy and Immunology , Microbiology , Host-Pathogen Interactions , Metarhizium , Phosphoric Monoester Hydrolases , Classification , Physiology , Bodily SecretionsABSTRACT
Objective To study comprehensive nursing meassures for small area of diabetic foot ulcer. Methods A total of 58 patients with small area of diabetic foot ulcer in our department were divided into two groups.The comprehensive nursing group (CN group,30 cases) adopted comprehensive nursing and treatment as follows, surgical dcbridement, infrared radiation of wound surface,sprinkling of growth factors(bFGF and rhEGF),covered by hydrocolloid dressing(Algoplaque).The control group(28cases) received hydropathic compress with 0.5% povidone iodine or 5% furacillin solution.Wound heal-ing progreasion,average healing time and the positive rate of wound germiculture of the two groups were observed. Results The average healing time of the CN group was (29.6±9.4)d,which was shorter than that of the control group,( 39.2±13.5 )d, P < 0.05. Statistical difference existed in the positive rate of wound germiculture at the 7th day and the 14th day between the two groups (P < 0.05). Conclusions Routine medical treatment and general nursing measures plus surgical debridement,infrared radiation of wound sur-face,sprinkling of growth factors and hydrocolloid dressing possess facilitative healing effect for small area of diabetic foot ulcer.
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BACKGROUND: Stable reliable experimental animal models are needed urgently in scar research.OBJECTIVE: Scar animal models of nude mice are evaluated with histological method to define optimal opportunity for using.DESIGN: Randomizly controlled and repetitively measured design.SETTING: Department of Burn, First Affiliated Hospital, Sun Yat-sen University.MATERIALS: The experiment was conducted at the Center for Animal Experiment, Medical College, Sun Yat-sen University between January 2004 and March 2004. Fifteen nude mice aged 4-6 weeks were provided by Center for Animal Experiment, Medical College, Sun Yat-sen University (of either gender with body mass of 15-25 g). Hyperplastic scar was gained from samples of exairesis in patients with burn after healing which is hyperplastic scar for half a year.METHODS: Human hyperplastic scar was grafted at dorsa of nude mice to establish scar animal models. After graft for four weeks, 5 experimental animals were killed every week, and grafts were gained. 100 g/L formalin was used to fix samples for 3 weeks. Picric-sirius red polarized light method was used to detect the graft and clinical materials, and histological feature was observed.MAIN OUTCOME MEASURES: ①Results of film reading of picric-sirius red polarized light method. ②Analytic result of computer image.RESULTS: ①Results of film reading of picric-sirius red polarized light method: The grafts showed the same feature of diffused distribution of mainly yellow and red thick fiber with thin-mesh green fiber under polarized light in every time segment group. ②Analytic result of computer image: In clinicopathological hyperplastic scar, type Ⅰ collagen was about 74%; type Ⅲ collagen accounted for about 26%. In the graft from 4-6 weeks, the contents of type Ⅰ collagen were (74.52 ±0.47)% , (74.43 ±0.53)% ,(74.69±0.63)%, respectively; The contents of type Ⅲ were (25.48±0.47)%, (25.57±0.53)%, (25.31±0.63)%, respectively, which had insignificant difference (P > 0.05 ).CONCLUSION: In the time segment designed by experiment, the feature of graft and clinical material is coincident, which is accorded with the characteristics of hyperplastic scar. The detection of collagen of scar tissue with picric-sirius red polarized light method is a simple effective method for assessing the tissue of hyperplastic scar. Establishing scar models with nude mice is effective and stable.