It is in urgent need clinically to look for an ideal substance for the coverage of burn wounds owing to shortage of autografts or allografts. After the cadaveric skin was extracted with acetic acid, salted out with NaCl and freeze-dried to prepare a porous collagen membrane. The membrane was seeded with allo-epidermal cells and allo-fibroblasts on its two sides, respectively, and then was cultured to achieve an artificial composite allograft. The artificial composite allograft was then transplanted onto ten severly burned wounds. One-year follow-up showed satisfactory results and the histological examination confirmed that the composite allograft could improve the adherence and growth of the epidermal cells and was helpful for blood vessels and healing of non-inflammatory connective tissues in the wounds.
ObjectiveTo investigate the association between preoperative systemic immune-inflammation index (SII) and early allograft dysfunction (EAD) in liver transplant recipients. MethodsThe patients underwent liver transplantation who met the inclusion and exclusion criteria in the West China Hospital of Sichuan University from January 2015 to December 2019 were collected. The postoperative EAD was analyzed. The generalized propensity score weighting (GPSW) were used to balance the confounding factors affecting the occurrence of EAD. ResultsA total of 390 patients who met the inclusion and exclusion criteria were enrolled in this study, 93 cases of EAD occurred, the incidence of EAD was 23.8%. The recipient’s model for endstage liver disease score and Child-Pugh grade, the donor’s body mass index, age, and graft weight, and the intraoperative cold ischemia time, liver transplantation time, intraoperative blood loss, total infusion, red blood cell transfusion, autologous blood reinfusion, fresh frozen plasma transfusion, concentrated platelet transfusion, total red blood cell and autologous blood transfusions were balanced by GPSW, then the overall mean correlation coefficient of the 14 covariables and SII decreased from 0.049 to 0.039, and each covariable reached the standard of less than 0.1. The binary logistic regression analysis based on GPSW showed that there was no significant association between SII and EAD (P=0.371). ConclusionFrom preliminary result of this study, it is not found that preoperative SII of liver transplantation patients is related to occurrence of postoperative EAD.
To study the expression of CTLA4Ig gene in diabetic rat and the effect of CTLA4Ig on longterm survival of the pancreatic islet. The rat pancreatic islet cell and muscle cell transfected with the cDNA for CTLA4Ig packaged with lipofectin vector. We examined the expression level of CTLA4Ig gene, T lymphocyte reaction and observed the expression of CTLA4Ig cDNA in diabetic rat and the action of CTLA4Ig in longterm survival of pancreatic islet transplanted and the transplanted rats. Results: The T lymphocyte reaction from peripheral intravenous blood at seventh day after surgery, the difference between two group was significant (Ｐ＜0.05). Only 2 out of 10 recipients of the experiment group (A) at the seventh day after pancreatic islet allograft had any detectable levels of CTLA4Ig, their concentration was 14 ng/ml, and 31 ng/ml. The average time of maintaining blood glycose in normal levels of the group A after pancreatic islets graft, 14.8±12.3 days, was significantly longer than 3.6±5.1 days of the control group (B) (Ｐ＜0.05). The average survival time of the group A, 24.0±10.8 days (the longest time was 45 days), was significantly longer than 11.8±4.8 days (the longest time was 21 days) of the group B (Ｐ＜0.01). Conclusions: The muclse cells and pancreatic islets of the recipient rat was transfected with CTLA4IgcDNA packaged with lipofectin, and CTLA4IgcDNA was expressed in recipient tissue, its expressed product CTLA4Ig make pancreatic islets transplanted and recipient rat survive longer significantly.
Objective To examine the research status and predict trends in ME research findings from 1997-2023 on a global scale. Methods Web of Science Core Collection database was searched for original articles on ME published between 1997 and 2023, and then analyzed using CiteSpace, VOSviewer and the Online Analysis Platform of Literature Metrology to map scientific knowledge. Results A total of 748 articles were eventually included. The number of ME publications increased year by year, with the USA being the most productive country. Osteoarthritis, MRI, medial meniscus posterior root repair, biomechanical evaluation, lateral meniscus allograft transplantation, radiographic joint space narrowing are the high frequency keywords in co-occurrence cluster analysis and cocited reference cluster analysis. Medial meniscus posterior root tear and lateral meniscus allograft transplantation are current and evolving research hotspots in citation burst detection analysis. Conclusions The understanding of ME has been improved significantly during the past decades. Current research focuses on optimizing surgical repair methods and obtaining long-term follow-up outcomes for medial meniscal posterior root repair and developing methods to reduce ME after lateral meniscal allograft, as well as they are the highlights of future research on ME.
ObjectiveTo explore the effect of hepatic outflow reconstruction with allograft vascular in ex-vivo liver resection and autologous liver transplantation.MethodThe clinical data of a patient with end-stage hepatic alveolar echinococcosis admitted to the Organ Transplantation Center of Sichuan Provincial People’s Hospital in August 2019 who underwent the ex-vivo liver resection and autologous liver transplantation combined with hepatic vein reconstruction with allograft vascular were analyzed retrospectively.ResultsThe patient, a 44-year-old female, was admitted to Sichuan Provincial People’s Hospital for “pain in the right abdomen accompanied by skin and sclera yellow staining for 6+ months and aggravated for 20+ d”. When the patient was admitted, the general condition was poor, such as hyperbilirubin and hypoproteinemia. The body mass was 45 kg and the standard liver volume was 852 mL. The hydatid lesions corroded the first and second hilum of the liver, the right hepatic vein and the posterior inferior vena cava. It was difficult to reconstruct the outflow tract of the hepatic vein in vivo, and it was extremely difficult to completely remove the hydatid lesions in vivo. After admission, the patient was generally in a good condition after the PTCD treatment, then after discussion and rigorous evaluation, the ex-vivo hepatectomy combined with autologous liver transplantation was required. The operative time was 15 h and the intraoperative blood loss was approximately 2 000 mL. After the operation, the routine treatment was performed, the antiviral treatment was continued, the international standardized ratio value was monitored at 1.5–2.5, and the anti-immune rejection drugs were not needed. The patient was transferred to the general ward on the 4th day after the operation, and there were no bile leakage, bleeding, infection and other complications. the result of postoperative pathological diagnosis was the alveolar echinococcosis. The re-examination of enhanced CT on 1 week after the operation suggested that the hepatic outflow tract of allograft vascular reconstruction was unobstructed, no stenosis and no thrombosis occurred. The patient was following-up at present.ConclusionsIn treatment of end-stage hepatic alveolar echinococcosis by autologous liver transplantation, reconstruction of hepatic outflow should be individualized. Allograft venous vessels could be used as ideal materials due to their advantages of matched tube diameter and length, no anti-rejection, and low risk of infection.
Objective To study and summarize the clinical experience and significance of the skeleton reconstruction of human hand allografts. Methods From January 2001 to October 2003, human hand allografts were appliedto treat 4 cases of traumatic hand defect(6 hands) at different levels. During operation, the ulna and radius were reduced anatomically and fixed firmly with 3.5 mm AO-plates and screws according to AO internal fixation principle. The X-ray films were taken periodically andthe function recovery of hand allografts was observed and estimated. Results The 4 cases were followed up for 4-36 months postoperatively. The clinical healing of fracture in 4 cases(6 hands) was achieved after 9 weeks,and by means of comprehensive assessment including the joint function, muscle strength, sensation, appearance, sequela and the ability of work, the satisfactory effects were gained eventually. Conclusion It is significant forhuman hand allografts to reconstruct skeleton firmly.
ObjectiveTo investigate the short-term effectiveness of percutaneous pedicle fixation combined with intravertebral allograft by different methods for thoracolumbar fractures. MethodsThe clinical data of 94 patients with single segment thoracolumbar fracture who underwent percutaneous pedicle fixation combined with intravertebral allograft by different methods between October 2018 and October 2019 were retrospectively analyzed. According to the different methods of intravertebral allograft, they were divided into group A (bone grafting by Jack dilator, 40 cases) and group B (bone grafting by funnel, 54 cases). There was no significant difference between the two groups (P>0.05) in the gender, age, body mass index, cause of injury, injured segment, Wolter index, time from injury to operation, and preoperative visual analogue scale (VAS) score, injured vertebral height ratio, and Cobb angle. The operation time, fluoroscopy frequency, allograft volume, and complications were recorded and compared between the two groups. VAS score of low back pain was used to evaluate the remission of clinical symptoms before operation, at 3 days, 3 months, 12 months after operation, and at last follow-up. The injured vertebral height ratio and Cobb angle were measured before operation, at 3 days, 3 months, and 12 months after operation. ResultsThe operation time, fluoroscopy frequency, and allograft volume in group A were significantly higher than those in group B (P<0.05). No complication occurred after operation, such as loosening or fracture of internal fixation. And bone grafting in the injured vertebrae healed at last follow-up. The VAS score, injured vertebral height ratio, and Cobb angle at each postoperative time point significantly improved when compared with preoperative ones (P<0.05); compared with 3 days postoperatively, the VAS score improved further after 3 months, but the injured vertebral height ratio decreased and the Cobb angle increased, and the differences were significant (P<0.05). There was no significant difference in the VAS scores of low back pain between the two groups at each time point after operation (P>0.05); the injured vertebrae height ratio in group A was significantly higher than that in group B, and the Cobb angle was significantly lower than that in group B, all showing significant differences (P<0.05). ConclusionThe intravertebral allograft via Jack dilator can restore the height and decrease the Cobb angle of the injured vertebrae, but accompanied with higher fluoroscopy frequency and longer operation time when compared with funnel bone grafting. For patients with single level thoracolumbar fractures, intravertebral allograft via Jack dilator is recommended.
Objective?To observe the changes of force bearing area and pressures of the rabbit tibiofemoral contact area and the biomechanical reconstruction level of joint after meniscal allograft.?Methods?A total of 28 Japanese rabbits were involved, weighing 3.0-3.5 kg, male or female. Of 28 rabbits, 7 were selected as meniscus donors, the remaining 21 rabbits were randomized into group A (n=7), group B (n=7), and group C (n=7). Group A underwent single knee opening and suturing, group B underwent medial meniscus excision and suturing, and group C underwent medial meniscus allograft after medial meniscus excision and suturing. The rabbits were sacrified at 12 weeks after operation for biomechanical observation through biomechanical machine and color imaging system. The meniscus tissue specimens were harvested from groups A and C to perform histological and immunohistochemical staining.?Results?After operation, all rabbits in 3 groups survived to the end of experiment. There were significant differences in the force bearing area and pressures at 0-90° flexion between group B and groups A, C (P lt; 0.05) at 12 weeks, showing no significant difference between group A and group C (P gt; 0.05); and there were significant differences in the force bearing area and pressures at 120° flexion among 3 groups (P lt; 0.05). The histological observation showed that the number of cartilage cells and collagen fibers returned to normal in group C, and the immunohistochemical staining showed that transplanted meniscus of group C contained large amounts of collagen fibers consisting of collagen type I and collagen type II. After 12 weeks of operation, the collagen type I contents were 0.612 5 ± 0.059 8 in group A and 0.587 2 ± 0.063 9 in group C, showing no significant difference (t=0.765, P=0.465); the collagen type II contents were 0.772 4 ± 0.081 5 and 0.814 3 ± 0.051 7, respectively, showing no significant difference (t= —0.136, P=0.894).?Conclusion?The allograft of rabbit meniscus can significantly increase the force bearing area of the tibiofemoral contact area and reduce the average pressure. Therefore, biomechanically speaking, the meniscus allograft can protect the articular cartilage and reconstruct the biomechanical balance.
OBJECTIVE: To study the effect of basic fibroblast growth factor (bFGF) and hyaluronic acid gel (HAG) combined with freeze-dried bone allograft in repairing segmental bone defect and to explore their mechanism. METHODS: The 15 mm segmental bone/periosteum defects were created on bilateral radius in 50 New Zealand rabbits and were treated with four different kinds of implants on 25 radius respectively (group A: bFGF and HAG combined with freeze-dried bone; group B: bFGF combined with freeze-dried bone; group C: HAG combined with freeze-dried bone; group D: simple freeze-dried bone as a control). The repair of defect was observed radiologically and histologically and were analyzed by radionuclide bone imaging and measurement of calcium contents at different periods. RESULTS: The new bone formation, bone metabolic activity and calcium contents of defects were higher in group A than in group B (P lt; 0.05), and were higher in group B than in groups C and D (P lt; 0.05). There were no significant difference between groups C and D. The bone defects healed in the 8th week in group A, in the 10th week in group B, but did not healed in the 10th week in groups C and D. CONCLUSION: As an osteogenetic factor, bFGF promotes the new bone formation; as a slow-release carrier, HAG enhances the effectiveness of bFGF. The combination of bFGF, HAG and freeze-dried bone allograft can repair the segmental bone defect more effectively.
Objective To study the effect of vascular endothelial cell growth factor (VEGF) on repair of bone defect with cortical bone allograft. Methods Forty five New Zealand white rabbits, weighted 2.5-3.0 kg, were made bone defect model of 1.5 cm in length in the bilateral radii and then were randomly divided into 3groups. The defect was repaired with only cortical bone allograft in the control group, with the cortical bone allograft and local injection of human recombinantVEGF in the experimental group, and with the cortical bone allograft and abdominal injection of VEGF PAb3 in the antagonist group. Roentgenography, immunohistochemical staining and tetracycline labelling were carried out to evaluate the reparative results 1, 3, 5, 8 and 16 weeks after operation. Results Immunohistochemical staining results showed that a great deal of blood vessels formed in the experimental group, and the number of blood vessels increased gradually with the time and reached the highest value at the 8th week. Tetracyclinelabelling showed the same result.The best results in callus formation, ossification rate and count of microvascular density were shown in the experimental group, while those in the control group were significantly better than those in the antagonist group (Plt;0.05),but there was no significant difference between the experimental group and the control group at the 8th week and the 16th week (Pgt;0.05). Conclusion VEGF can accelerates the bone formation and angiogenesis in the bone allografts, thus it can promote the repair of bone defects.