Objective To investigate the early diagnosis of lower l imb deep vein thrombosis (DVT) after major orthopedic surgeries. Methods From October 2005 to June 2009, color doppler sonography and hemorheology detection were carried out for 62 cases undergoing first total hip arthroplasty (THA), 14 cases undergoing total knee arthroplasty (TKA), and 86 cases undergoing hip fractures surgery (HFS) before operation and 1, 7, 14 days after operation. The plasma D-dimerlevels of the DVT were also examined for the THA patients before operation and 3 days after operation. Of all cases, therewere 89 males and 73 females, aged from 34 to 74 years (51.5 years on average). After operation, all the patients were treated with the regular low molecular weight heparin sodium against DVT. Results After operation, 17 cases (10.5%) developed DVT, including 8 THA cases, 1 TKA case, and 8 HFS cases. Preoperative color doppler sonography showed no abnormal echo, normal b blood flow signal, and normal periodical variation in vein blood flow without regurgitation. Postoperative examinations showed that the vascular occlusion of common femoral vein and popl iteal vein occurred in DVT patients. There were significant differences (P lt; 0.05) in whole blood viscosity between patients with DVT and without DVT after 1, 14 days and no significant difference (P gt; 0.05) before operation and 7 days after operation. There was no significant difference (P gt; 0.05) in plasma viscosity and erythrocyte aggregation index, between patients with DVT and without DVT pre- and postoperation. There was significant difference (P lt; 0.05) in erythrocyte deformation index between patients with DVT and without DVT 14 days after operation. The preoperative plasma D-dimer levels of patients with DVT and without DVT were (372.00 ± 148.62) ng/mL and (369.00 ± 141.03) ng/mL, respectively, showing no significant difference (P gt; 0.05); the 3 days postoperatively levels were (574.00 ± 217.29) ng/mL and (391.00 ± 120.16) ng/mL, respectively, showing significant difference (P lt; 0.05). Conclusion Color doppler sonography in combination of hemorheology and plasma D-dimer examination can be beneficial for the early diagnosis of DVT in major orthopedic surgeries.
ObjectiveTo reveal the true value of plasma detection of epidermal growth factor receptor (EGFR) mutation for early-stage non-small cell lung cancer (NSCLC) gene diagnosis and to predict survival prognosis. MethodsTissue samples of positive EGFR mutations by using amplification refractory mutation system (ARMS) method were surgically resected from 198 patients with stage I-IV NSCLC between February 2014 and June 2015 in Tangdu hospital. Paired blood samples were collected before surgery. And the cellfree DNA (cfDNA) in plasma was extracted, plasma EGFR mutations were detected by real-time polymerase chain reaction (PCR). Concentration of cfDNA was measured by ultraviolet spectrophotometry. Follow-up observation for stage ⅢA patients was put into force after surgery. Kaplan-Meire was used in survival analysis. ResultsThe sensitivity of EGFR mutation for the 198 paired tissues and plasma samples was 17.2%.The sensitivity was positively correlated with TNM stage and negatively correlated with tumor differentiation. The sensitivity of sage ⅢA was 33.3%, significantly higher than that of the patients at stage ⅠA (1.6%, P=0.000) and stage ⅠB (7.9%, P=0.004). The sensitivity of poor differentiation was 36.8%, significantly higher than that of high differentiation (0.0%, P=0.000) and moderate differentiation (15.7%, P=0.010). There was no correlation between plasma cfDNA concentration and patient characteristics. Survival analysis showed that plasma detection was a vital factor for predicting postoperative survival prognosis of stage ⅢA patients (P=0.014). ConclusionTissue samples cannot be replaced by plasma samples for epidermal growth factor receptor (EGFR) mutation test in early-stage NSCLC patients, currently. When the sensitivity increases dramatically in the plasma samples of stage ⅢA NSCLC and poor differentiation tumor, we recommend using plasma detection for gene diagnosis, dynamic monitoring of EGFR mutations in stage ⅢA or poorly differentiated tumors, especially in NSCLC patients whose tissue samples cannot be obtained by surgery. And plasma EGFR detection is a valuable method of forecasting survival prognosis for locally advanced NSCLC patients.
Abstract： Objective To summarize the clinical experiences of performing extracorporeal membrane oxygenation (ECMO) on patients with heart and respiratory failure, and compare the clinical outcomes of Medtronic system and Quadrox PLS system. Methods We retrospectively analyzed the clinical data of 121 heart and respiratory failure patients who underwent ECMO treatment in Fu Wai Hospital from December 2004 to December 2009. Based on the different systems used, 121 patients were divided into two groups. In group M, there were 65 patients including 41 males and 24 females, with an age of 26.6±25.9 years; and they accepted Medtronic ECMO system treatment. In group Q, there were 56 patients including 39 males and 17 females, with an age of 32.4±23.9 years and they underwent Quadrox PLS ECMO system treatment. The evaluation of the clinical outcomes of these two different systems was based on the comparison of transmembrane pressure drop (TMPD), anticoagulation, hemolysis, plasma leakage, organ function, complication and hospital mortality between the two groups. Results Compared with group M, ECMO with Quadrox PLS system was associated with lower TMPD (at the beginning of ECMO: 15.0±6.0 mm Hg vs.28.0±5.0 mm Hg, P=0.000; 24 hours later: 16.0±5.0 mm Hg vs. 30.0±7.0 mm Hg, P=0.000) and less thrombus formation(7.1% vs.23.1%, P=0.037), less plasma leakage (0.0% vs. 50.8%, P=0.000), less hemolysis (14.3% vs. 29.2%, P=0.047). There were no significant differences between the two groups in support duration, complication rate, and hospital mortality(Pgt;0.05). Conclusion Both devices have similar effects for safe clinical application, but Quadrox PLS ECMO system has a relatively high biocompatibility with lower TMPD, less plasma leakage, and thrombus formation.
Objective To discuss the relationship between motilin, vasoactive intestinal peptide and the gallstone formation. Methods The level of motilin, vasoactive intestinal peptide in plasma, bile and gallbladder tissue of 48 cases of chololithiasis before operation and the first, third, seventh day after cholecystectomy were mesured by radioimmunoassay. Results The level of motilin in plasma was markedly increased in patients with chololithiasis before cholecystectomy and the first day after cholecystectomy. The level of motilin, vasoactive intestinal peptide in bile and gallbladder tissue were significantly increased in patients and motilin was positively correlated with vasoactive intestinal peptide in the gallbladder tissue. Conclusion Motilin, vasoactive intestinal peptide might affect the gallstone formation by affecting the motility of gallbladder.
ObjectiveTo explore the concentration of the plasma homocysteine (Hcy) and the relationship with TOAST subtypes in patients with acute cerebral infarction. MethodsA total of 120 patients with acute cerebral infarction (ACI) treated from April 2012 to April 2013 were enrolled into the ACI group.They were classified with Korean TOAST classification as five subtypes:atherothrombosis (AT) type,small artery disease (SAD) type,cardioembolism (CE) type,stroke of other disease (SOD) type,and stroke of undetermined etiology (SUE) type.The plasma Hcy concentrations in each group and in 60 heathy people who were selected into the control group were measured.Furthermore,the relationship between plasma Hcy concentration and their subtypes were analyzed. ResultsThe plasma Hcy level in ACI group was significant higher than that in the control group (P<0.01).The levels of plasma Hcy were much higher in patients with AT,SAD,SOD,and CE than those in the control groups (P<0.01).In different subtypes,AT and SAD subtypes had higher homocysteine concentration than SUD and CE subtypes did.The concentration of Hcy in AT and SAD group had no significant difference. ConclusionACI is related to hyperhomocysteinemia.The plasma Hcy level varies with different TOAST subtypes of ACI,specially elevating in the subtypes of AT and SAD,which may indicate that hyperhomocysteinemia may increase stroke risk through proatherogenic effect and endothelial dysfunction.
ObjectiveObservational studies have shown that plasma lipids are associated with the development of neurodegenerative diseases (NDD), but the causal relationship is unclear. This study investigated the causal relationship between 179 liposomes and NDD using a two-sample Mendelian randomization (MR). MethodsA two-sample MR method was used to comprehensively analyze the causal relationship between liposomes and major NDD such as Alzheimer's disease (AD), Parkinson's disease (PD), amyotrophic lateral sclerosis (ALS) and multiple sclerosis (MS). The two sample software package and Phenoscanner database were used to screen for appropriate instrumental variables (TV). In this study, inverse variance weighting (IVW) was used as the primary measure of MR analysis, and various sensitivity tests were performed. ResultsMR-IVW results showed that phosphatidylethanolamine (PE) (OR=0.90, 95%CI 0.83 to 0.99, P=0.03), phosphatidylcholine (PC) (OR=0.92, 95%CI 0.85 to 0.99, P=0.02) and phosphatidylinositol (PI) (OR=0.90, 95%CI 0.83 to 0.99, P=0.03) were protective factors for AD. Sterol ester (OR=1.18, 95%CI 1.04 to 1.34, P=0.01) and cholesterol (OR=1.26, 95%CI 1.02 to 1.56, P=0.03) increased the risk of PD. PE (OR=0.79, 95%CI 0.64 to 0.98, P=0.03) and PC (OR=0.83, 95%CI 0.69 to 0.98, P=0.03) reduced the risk of PD. Diacylglycerol (DAG) (OR=1.24, 95%CI 1.01 to 1.54, P=0.04) and sphingomyelin (SM) (OR=1.13, 95%CI 1.08 to 1.58, P=0.01) were the risk factors for MS. PI (OR=0.77, 95%CI 0.62 to 0.95, P=0.02) and PC (OR=0.74, 95%CI 0.88 to 0.95, P=0.02) were protective factors for MS. PI (OR=1.02, 95%CI 1.01 to 1.04, P=0.02) and triglyceride (TG) (OR=1.03, 95%CI 1.01 to 1.05, P=0.02) increased the risk of ALS, PC (OR=0.98, 95%CI 0.97 to 0.99, P=0.03) decreased the risk of ALS. ConclusionThere is a causal relationship between sterol ester, cholesterol, PC, PE, PI, DAG, SM, TG and different NDD, which provides a theoretical basis and support for further clinical studies.
Objective To evaluate the effect of the plasma treated PLGA nerve conduits seeded BMSCs on repairing SD rat sciatic nerve defects. Methods BMSCs were acquired from 30 newborn SD rats. After ampl ified and passaged for 3 times, PLGA nerve conduits were prepared and some of them were treated with plasma. A 1-cm-length sciatic nerve defect wasmade in 30 4-week-old SD rats, then they were randomly divided into 3 groups for three different nerve defects reconstruction methods (n=10). In the experimental group, defect was repaired by plasma treatment and PGLA nerve conduits seeded with BMSCs; in the control group, by normal PLGA nerve conduits seeded with BMSCs; and in the autologous group, by autologous nerve. At 6 weeks after the surgery, the dynamic walking pattern was recorded and the sciatic function index (SFI) was calculated; the electrophysiological test was taken; the gastrocnemius wet weight recovery rate was calculated; and the image analysis of regenerated nerve was made. Results All rats survived after the surgery and l ived to the end of the experiment. At 6 weeks after the surgery, the dynamic walking pattern of the experimental group and autologous group was better than that of the control group. The SFI value of the experimental, control and autologous groups was —51.02 ± 6.54, —58.73 ± 7.87 and —48.73 ± 3.95, respectively, showing statistically significant differences among the experimental group, control group and autologous group (P lt; 0.05). The results of the motor nerve conduction velocity and wave ampl itude showed that there were statistically significant differences between the experimental group and the control group (P lt; 0.05), and between the control group and the autologous group (Plt; 0.01); but no significant difference between the experimental group and autologous group(Pgt; 0.05); The gastrocnemius wet weight recovery rate of the experimental, control and autologous groups was 56.13% ± 4.27%, 43.14% ± 6.52%, 59.47% ± 3.85%, respectively; showing statistically significant differences among experimental group, control group and autologous group (P lt; 0.05). The density, diameter of regenerated nerve fiber as well as neural sheath thickness of the experimental group were all higher than those of the control group (P lt; 0.05) and lower than those of the autologous nerve group (P lt; 0.05); there was significant difference between the control group and the autologous group (P lt; 0.01). Conclusion Plasma treated PLGA nerve conduits seeded with BMSCs can effectively repair sciatic nerve defects and provide a new strategy for the development of tissue engineered nerve to repair the peripheral nerve defects.
To explore the effects of plasma jet (PJ) and plasma activated water (PAW) on the sterilization of Streptococcus mutans (S. mutans) and compare the advantages and disadvantages of the two methods, so as to provide a basis for plasma treatment of dental caries and to enrich the treatment means of dental caries, an atmospheric pressure plasma excitation system was built, and the effects of PJ and PAW on the sterilization rate of S. mutans and the changes of temperature and pH during treatment were studied under different excitation voltage (Ue) and different excitation time (te). The results showed that in the PJ treatment, the difference in the survival rate of S. mutans between the treatment group and the control group was statistically significant (P = 0.007, d=2.66) when Ue = 7 kV and te = 60 s, and complete sterilization was achieved at Ue = 8 kV and te = 120 s in the PJ treatment. In contrast, in the PAW treatment, the difference in the survival rate of S. mutans between the treatment group and the control group was statistically significant (P = 0.029, d = 1.71) when Ue = 7 kV and te = 30 s, and complete sterilization was achieved with PAW treatment when Ue = 9 kV and te = 60 s. Results of the monitoring of temperature and pH showed that the maximum temperature rise during PJ and PAW treatment did not exceed 4.3 °C, while the pH value after PAW treatment would drop to a minimum of 3.02. In summary, the optimal sterilization parameters for PJ were Ue=8 kV and 90 s < te ≤ 120 s, while the optimal sterilization parameters for PAW were Ue = 9 kV and 30 s<te ≤ 60 s. Both treatment methods achieved non-thermal sterilization of S. mutans, where PJ required only a smaller Ue to achieve complete sterilization, while at pH < 4.7, PAW only required a shorter te to achieve complete sterilization, but its acidic environment could cause some chemical damage to the teeth. This study can provide some reference value for plasma treatment of dental caries.
【Abstract】Objective To evaluate effect of artificial liver support system (ALSS) in liver failure and liver transplantation.Methods Forty-four patients with liver failure (including 12 undergoing liver transplantation) were treated with MARS or plasma exchange. The changes of toxic substances and cytokines in blood were detected before and after treatment. Results ALSS therapy achieved a remarkable improvement in clinical symptoms and physical signs. After ALSS treatment, there was a significant decrease in total bilirubin, total bile acid, alanine aminotransferase, creatinine, urea nitrogen, blood ammonia and endotoxin levels(P＜0.05); the levels of serum NO, TNF-α, IL-4 and IL-6 were significantly decreased(P＜0.05); there was no statistical change in erythrocytes, leukocytes and platelets. The survival rate of 30 liver failure patients caused by severe hepatitis B was 60.0%(18/30). Six patients with acute liver failure were successfully performed liver transplantation. Two patients in 6 with acute liver failure after liver transplantation survived. One patient in 2 with acute liver failure after pancreatoduodenectomy survived. Conclusion ALSS plays a positive role in treatment of liver failure by removing blood toxins, NO and cytokines. ALSS also plays a substitute role for liver failure patients who are waiting for liver transplantation.
ObjectiveTo compare the clinical efficacy of transurethral plasmakinetic resection of bladder tumors (PKRBT) and holmium laser resection of bladder tumors (HOLBT), and discuss the effcacy, safety, indication, and complications of PKRBT for the treatment of bladder tumors compared with HOLBT. MethodsA hundred patients with bladder tumors were divided into two groups randomly, who were selected from patients in the Department of Urology of West China Hospital from March 2011 to March 2013. Among all the 100 cases, half of them were treated with PKRBT, and all others treated with HOBLT. The significant markers in both groups were recorded and evaluated, including the situation of before operation, during operation and after operation. The data recorded consisted of the general records of patients' medical background, concomitant disease, laboratory examination, and the position, amount, pathology of the tumor, total operative duration, the time of gross hematuria, the time of postoperative bladder irrigation and catheterization, the length of stay, postoperative complications and patients' conditions at month 3, 6, and 12 during the follow-up. ResultsAll operations were successfully performed, and there was no significant diTherences between the two groups in preoperative indexes (P>0.05). No abnormalities were detected in the postoperative laboratory examinations. The diTherences in operatative duration, time of bladder irrigation, duration of indwelling catheter, and postoperative length of stay between the two groups were not significant (P>0.05). But the mean time of gross hematuria was significantly shorter after operation in the HOLBT patients [(6.1±7.6) hours] than in those treated with PKRBT [(15.3±17.2) hours] (P<0.05). There was no significant diTherence between the two groups in the recurrence rate 3, 6, and 12 months after operation (P>0.05). ConclusionHOLBT can be used safely and effectively in treating bladder tumors, and it is easy for clinical manipulation. HOLBT is as effective and safe as PKRBT with similar adverse side-effect rate within and after operation.