Objective To review the latest progress in the major biological properties of adipose-derived stem cells (ADSCs) and ADSCs assisted autologous lipotransfer in breast repair and reconstruction. Methods Recent literature about ADSCs assisted autologous lipotransfer in breast repair and reconstruction was reviewed. Results ADSCs have multipotential differentiation capacity, and they could promote angiogenesis and regulate immune reactions. ADSCs assisted autologous lipotransfer can obtain satisfactory effectiveness in breast repair and reconstruction with few complications, but more studies are needed to confirm the long-term safety. Conclusion ADSCs assisted autologous lipotransfer has good effectiveness in breast repaired and reconstruction. But further clinical trials are needed to confirm the long-term safety.
目的 观察茵陈柴平汤治疗重度慢性乙型肝炎的疗效及不良反应。 方法 2009年3月－2010年3月，选择采用茵陈柴平汤联合常规保肝药物治疗50例重度慢性乙型肝炎患者（治疗组），并与50例仅用常规保肝药物治疗的重度慢性乙型肝炎患者（对照组）进行比较，观察治疗2、4周时的临床症状、肝功能及凝血酶原活动度等指标的变化。 结果 治疗2、4周时，治疗组在肝功能及凝血酶原活动度等指标均有显著改善，无严重不良反应；4周时，治疗组的症状缓解率（84%）明显高于对照组（66%）；其总有效率（96%）亦高于对照组（80%）。 结论 茵陈柴平汤治疗重度慢性乙型肝炎具有较好的临床疗效，且无严重不良反应。
【摘要】 目的 探讨并分析导致肺曲霉病患者误诊的原因，为早期诊断并及时正确治疗提供科学的依据。 方法 回顾性分析2010年1-4月间确诊为肺曲霉病的3例患者在诊治过程中被误诊的原因。 结果 3例患者均缺乏明显的特异性临床表现和影像学表现，最后确诊均依据病理学活检证实。 结论 肺部的曲霉菌感染缺乏特异性的临床和影像学表现，及早行纤维支气管镜检查或肺组织活检可提高早期诊断率。【Abstract】 Objective To analyze the misdiagnostic causes of pulmonary aspergillosis. Methods The clinical data of three patients with pulmonary aspergillosis from January to April 2010 were retrospectively analyzed, and the misdiagnostic causes were analyzed. Result No specific clinical and imaging findings were found in the three patients, and pulmonary aspergillosis was finally diagnosed according to the pathological biopsy. Conclusion Pulmonary aspergillus lacks specific clinical and imaging manifestations; early fiberoptic bronchoscopy or pulmonary biopsy may improve the rate of accurate diagnosis.
【摘要】 目的 比较靶控诱导后Shikani喉镜、Macintosh直接喉镜和GlideScope®视频喉镜插管时的应激反应。 方法 选取2008年12月-2009年2月期间ASA Ⅰ~Ⅱ级、拟于全身麻醉下行择期颅内占位病变切除术的患者30例，随机分为Shikani喉镜组（S组）、Macintosh直接喉镜组（M组）与GlideScope®视频喉镜组（G组）。靶控异丙酚和瑞芬太尼诱导，分别采用上述3种喉镜行经口气管插管。记录患者的心率、血压，计算心率收缩压乘积（RPP）。 结果 3组插管时间、心率、血压和RPP比较差异无统计学意义（Pgt;0.05）。S组和M组插管后心率、血压及RPP均较插管前显著升高（Plt;0.05），而G组插管后的心率、60~300 s时的收缩压、平均动脉压和RPP与插管前比较，差异无统计学意义（Pgt;0.05）。 结论 3种喉镜进行经口气管插管时具有相似的血流动力学反应，GlideScope®视频喉镜更有利于循环稳定。【Abstract】 Objective To compare the hemodynamic responses of orotracheal intubations with GlideScope® videolaryngoscope, Macintosh direct laryngoscope, and Shikani optical stylet after target-controlled-infusion (TCI). Methods Thirty patients with American Society of Anesthesiologists (ASA) physical status Ⅰ-Ⅱ, scheduled for elective intracranial mass lesion surgery under general anesthesia were randomly allocated equally to Shikani optical stylet group (group S) Macintosh laryngoscope group (group M), and GlideScope® videolaryngoscope group (group G). After the patients became unconscious by TCI induction of propofpol and remifentanil, the endotracheal intubation were carried out through above three laryngoscope. The heart rate (HR), blood pressure and rate pressure product (RPP) were recorded. Results The differences of intubation time, HR, blood pressure and RPP in three groups were not statistically significant (Pgt;0.05). After intubation, the HR, blood pressure and RPP of group S and M were obviously higher than those before intubation (Plt;0.05); while there was no obvious change on the HR, systolic pressure at 60-300 s, mean arterial pressure and RPP of group G compared before intubation (Pgt;0.05). Conclusions There are similar hemodynamic responses in the three laryngoscope. GlideScope® is more advantageous to cycle stability.
【摘要】 目的 对季也蒙念珠菌感染患者的临床及微生物学特征进行分析，为临床诊治提供参考。 方法 收集2006年1月-2008年12月病原菌培养为季也蒙念珠菌的10例住院患者资料进行回顾性分析。 结果 季也蒙念珠菌感染患者存在多种基础疾病，大多数患者（8/10）有易感因素，其中7例使用广谱抗菌药物。10例中有8例为深部真菌感染。其临床表现与感染部位有关，主要累及泌尿道、呼吸道和皮肤软组织。多数深部感染患者（6/8）在感染前存在同部位细菌感染，部分患者（3/8）在相同部位还可分离出其他真菌。全部季也蒙念珠菌菌株对两性霉素B敏感，大多数菌株（9/10）对氟康唑敏感。仅1例患者因肺部感染、呼吸衰竭死亡，其余患者经氟康唑、伊曲康唑或特比萘芬等抗真菌药物治愈。 结论 季也蒙念珠菌感染多发生于有基础疾病、存在真菌易感因素者，感染部位多为原细菌感染部位，常合并其他细菌或真菌感染。部分菌株对氟康唑和伊曲康唑中敏或耐药，治疗应根据药敏进行选择。【Abstract】 Objective To analyze the clinical and microbiologic characters of candida guilliermondii to improve the clinical diagnosis and treatment. Methods The clinical data of 10 patients with candida guilliermondii infection diagnosed in our hospital from January 2006 to December 2008 were retrospectively analyzed. Results All the patients had several underlying conditions; eight patients had predisposing factors and seven patients were prescribed with broad-spectrum antibacterials. Eight patients had deep mycoses, whose clinical manifestation was associated with the infectious sites, mainly involved in urinary tract, respiratory tract and skin-soft tissues. Most deep mycoses (6/8) had prior bacterial infection at the candida guilliermondii infection site; some patients (3/8) had other fungous infection at the same time. All the strains were sensitive to amphotericin B; most fungous strains (9/10) were sensitive to fluconazole. One patient died of pulmonary infection and respiratory failure, and the others were cured by fluconazole, itraconazole or terbinafine. Conclusion Candida guilliermondii infection mainly occurs in patients with underlying conditions and predisposing factors. The infectious sites have prior bacterial infection and bacterial infection or fungous infection at the same time. Since some candida guilliermondii strains were not sensitive to fluconazole and itraconzole, drug sensitive test should be consulted.
【摘要】 目的 探讨术中应用曲马多、芬太尼对全麻苏醒期镇痛效果的影响。 方法 2009年10月-2010年4月将80例静脉麻醉下行胃癌根治术的患者随机分为4组:Q1组曲马多1 mg/kg、F1组芬太尼1 μg/kg、Q2组曲马多2 mg/kg、F2组芬太尼2 μg/kg。各组分别于术毕前30 min静注给药。手术结束后送恢复室，比较4组的呼唤睁眼时间、拔管时间、拔管后即刻疼痛评分（VAS评分）、术前术后平均动脉压（MAP）、心率（HR）、脉搏血氧饱和度（SpO2）的变化以及不良反应的发生情况。 结果 4组患者呼唤睁眼时间差异无统计学意义（Pgt;0.05），F2组的拔管时间明显长于其他3组（Plt;0.05），Q1组和F1组的疼痛评分明显高于Q2组和F2组（Plt;0.05），在T2时点，Q2组和F2组的MAP值明显低于Q1组和F1组（Plt;0.05）。 结论 曲马多2 mg/kg与芬太尼2 μg/kg的镇痛效果的效果相当，但安全性更高，更加适合全麻苏醒期的镇痛治疗。【Abstract】 Objective To investigate the effects of tramadol and fentanyl on analgesia in the early recovery period after general anesthesia. Methods A total of 80 patients who underwent the operation of gastric cancer under general anesthesia from October 2009 to April 2010 were randomly divided into four groups: group Q1 received tramadol 1 mg/kg, group F1 received fentanyl 1 μg/kg, group Q2 received tramadol 2 mg/kg, and group F2 received fentanyl 2 μg/kg. Thirty minutes before the end of surgery, intravenous administration was performed on all of the patients. In the recovery room, the wake-up time, extubation time, pain level evaluated by Visual Analogue Scale (VAS), the mean arterial pressure (MAP), heart rate (HR) and pulse oxygen saturation (SpO2) before and after the surgery, and incidence of complications were recorded. Results No significant differences in wake-up time among the four groups were found (Pgt;0.05). The extubation time was longer in group F2 than that in the other three groups (Plt;0.05). The VAS scores in group Q1 and F1 were higher than those in group Q2 and F2. At the T2 time point, MAP in group Q2 and F2 were lower than those in group Q1 and F1 (Plt;0.05). Conclusion The analgesic efficacy of tramadol 2 mg/kg is similar to that of fentanyl 2 μg/kg, but tramadol is more suitable for analgesic treatment in recovery period after general anesthesia due to the higher security.
Objective To explore the effect of rolling compression loading bioreactor on chondrogenesis of rabbit bone marrow mesenchymal stem cells (BMSCs) with different loading parameters. Methods BMSCs were isolated from New Zealand rabbits, aged 2.5 months. BMSCs at passage 3 were used to prepare BMSCs-agarose gels (4 mm in diameter and height, respectively). Samples were divided into 8 groups: 10% (group A1), 20% (group A2), and 30% (group A3) compression groups (0.4 Hz, 3 h/ d) and 20 minutes (group B1), 3 hours (group B2), and 12 hours (group B3) rolling time groups and static culture (control groups). The living cell rate, the collagen type II and Aggrecan gene expressions, and glycosaminoglycan (GAG) content were determined, and histological staining was done at 24 hours, 7 days, 14 days, and 21 days after culture. Results At 14 and 21 days, the living cell rates of groups A1 and A2 were significantly higher than that of group A3 (P lt; 0.05), groups B1 and B2 were significantly higher than group B3 (P lt; 0.05). Collagen type II and Aggrecan gene expressions of the experimental groups at each time point were significantly higher than those of the control groups (P lt; 0.05); at 14 and 21 days, collagen type II and Aggrecan gene expressions of groups A1 and A2 were significantly higher than those of group A3, and groups B1 and B2 were also significantly higher than group B3 (P lt; 0.05). At 14 and 21 days, the GAG contents of groups A1 and A2 were significantly higher than those of group A3 (P lt; 0.05); groups B1 and B2 were also significantly higher than group B3 (P lt; 0.05). At 21 days, toluidine blue staining showed that obvious blue-staining and even cartilage lacunae were seen in groups A2 and B2, but light and quite rare blue-staining in groups A1, A3, B1, and B3. Conclusion The rolling compression loading bioreactor has great promotion effect on chondrogenesis of rabbit BMSCs with rolling parameters of 0.4 Hz, 3 hours, and 20% compression.
Objective To investigate the effect of preoperative rehabilitation on early function of joints after total hip arthroplasty by comparing with non-preoperative rehabilitation. Methods Between March 2010 and November 2011, 98 patients with hip disease were recruited in study. Of 98 patients, 49 received preoperative rehabilitation for 2 weeks in trial group, and 49 did not receive preoperative rehabilitation in control group. There was no significant difference in gender, age, disease duration, disease cause, preoperative visual analogue scale (VAS) score, and preoperative Harris score between 2 groups (P gt; 0.05). Results There was no significant difference in VAS score at each time point after operation between 2 groups (P gt; 0.05), but significant differences were found in Harris score (P lt; 0.05). At 3 days after operation, compliance evaluation results showed that 36 cases were of full compliance, and 13 cases were of partial compliance in trial group; 27 cases were of full compliance, 14 cases were of partial compliance, and 8 cases were of non-compliance in control group; there was significant difference between 2 groups (Z=2.286, P=0.002). The ambulation time was within 7 days in trial group, and was within 7 days in 47 cases and more than 7 days in 2 cases in control group; there was significant difference between 2 groups (Z=3.840, P=0.000). Conclusion Preoperative rehabilitation plays an important role in compliance, decreased bed rest time, and hip function improvement in patients after total hip arthroplasty.
ObjectiveTo compare the effectiveness of triple Endobuttons and clavicular hook plate fixation in the treatment of fresh acromioclavicular joint dislocation (Rockwood type III-V). MethodsBetween February 2008 and October 2010, 40 patients with fresh acromioclavicular joint dislocation (Rockwood type III-V) were treated with triple Endobuttons in 18 cases (trial group) and with clavicular hook plate in 22 cases (control group). There was no significant difference in gender, age, disease duration, joint dislocation classification, preoperative visual analogue scale (VAS) score and Constant-Murley score between 2 groups (P gt; 0.05). ResultsAfter operation, wound healed by first intention with no early complication of infection or neurovascular injury. The patients were followed up 12-20 months (mean, 15.8 months) in trial group and 13-24 months (mean, 17.2 months) in control group. Significant differences were found in the VAS score and Constant-Murley score at the last follow-up between 2 groups (P lt; 0.05). X-ray films showed no loosening of internal fixators or hook displacement occurred. No re-dislocation was observed. ConclusionTriple Endobuttons has less shoulder pain and better shoulder motion than clavicular hook plate, so it is an effective method of treating Rockwood type III-V fresh acromioclavicular joint dislocation.
目的 探讨针刺治疗在防治术后恶心呕吐（PONV）中的作用与疗效。 方法 通过对2012年6月收治的1例全身麻醉下行小脑血肿清除术后出现持续性恶心呕吐症状，后辅以针刺治疗好转的病例报道，就针刺治疗对PONV的穴位选择，刺激方式，介入时间等相关研究进行复习和总结。 结果 患者恶心呕吐症状在选取中脘、足三里（双）、内关（双）穴针刺治疗3次后（30 min/次）明显减少，自诉恶心程度较前缓解，连续针灸6次后呕吐现象得到有效控制。 结论 目前有关针刺治疗PONV的研究越来越多，但尚无统一的治疗标准。