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Risk factors,surgical complications and graft survival in liver transplant recipients with early allograft dysfunction 预览
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作者 Douglas Bastos-Neves Paolo Rogerio de Oliveira Salvalaggio Marcio Dias de Almeida 《国际肝胆胰疾病杂志:英文版》 SCIE CAS CSCD 2019年第5期423-429,共7页
Background: Early allograft dysfunction (EAD) is a severe complication after liver transplantation. The associated risk factors and complications have re-gained recent interest. This study investigated risk factors, s... Background: Early allograft dysfunction (EAD) is a severe complication after liver transplantation. The associated risk factors and complications have re-gained recent interest. This study investigated risk factors, survival and complications associated with EAD in a large liver transplant center in Latin America. Methods: Retrospective, unicenter, cohort, based on data from adult patients undergoing first deceaseddonor liver transplant from January 2009 to December 2013. EAD was defined by one or more of the following:(i) bilirubin ≥10 mg/dL on postoperative day 7;(ii) international normalized ratio ≥1.6 on postoperative day 7, and (iii) alanine aminotransferase or aspartate aminotransferase > 2000 IU/L within the first seven days after transplant. Results: A total of 602 patients were included;of these 34.2% developed EAD. Donor risk factors were male ( P = 0.007), age between 50 and 59 years ( P = 0.034), overweight ( P = 0.028) or grade I obesity ( P = 0.012), sodium > 157 mmol/L ( P = 0.002) and grade IV ischemia/reperfusion injury ( P = 0.002). Cold ischemia time ≥10 h ( P = 0.008) and warm ischemia time ≥40 min ( P = 0.013) were the surgical factors. Male ( P < 0.001) was the only recipient protective factor. Compared with the non-EAD group, patients with EAD were submitted to more reoperations (24.3% vs. 13.4%, P = 0.001) and had higher graft loss rates (37.9% vs. 21.2%, P < 0.001), with similar patient survival rates ( P = 0.238). Conclusions: EAD risk factors are related to donor, surgical procedure and recipient. Donor risk factors for EAD were male, age between 50 and 59 years, donor overweight or grade Ⅰ obesity, sodium > 157 mmol/L and grade Ⅳ ischemia/reperfusion injury. Cold ischemia time ≥10 h and warm ischemia time ≥40 min were the surgical risk factors. Male was the only recipient protective factor. Patients with EAD had higher reoperations and graft loss rates. 展开更多
关键词 GRAFT SURVIVAL Liver TRANSPLANTATION Primary GRAFT DYSFUNCTION DONOR evaluation
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Liver graft preservation methods during cold ischemia phase and normothermic machine perfusion 预览
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作者 Konstantin Y Tchilikidi 《世界胃肠外科杂志:英文版(电子版)》 2019年第3期126-142,共17页
The growing demand for donor organs requires measures to expand donor pool. Those include extended criteria donors, such as elderly people, steatotic livers, donation after cardiac death, etc. Static cold storage to r... The growing demand for donor organs requires measures to expand donor pool. Those include extended criteria donors, such as elderly people, steatotic livers, donation after cardiac death, etc. Static cold storage to reduce metabolic requirements developed by Collins in late 1960s is the mainstay and the golden standard for donated organ protection. Hypothermic machine perfusion provides dynamic organ preservation at 4°C with protracted infusion of metabolic substrates to the graft during the ex vivo period. It has been used instead of static cold storage or after it as short perfusion in transplant center. Normothermic machine perfusion (NMP) delivers oxygen, and nutrition at physiological temperature mimicking regular environment in order to support cellular function. This would minimize effects of ischemia/reperfusion injury. Potentially, NMP may help to estimate graft functionality before implantation into a recipient. Clinical studies demonstrated at least its non-inferiority or better outcomes vs static cold storage. Regular grafts donated after brain death could be safely preserved with convenient static cold storage. Except for prolonged ischemia time where hypothermic machine perfusion started in transplant center could be estimated to provide possible positive reconditioning effect. Use of hypothermic machine perfusion in regular donation instead of static cold storage or in extended criteria donors requires further investigation. Multicenter randomized clinical trial supposed to be completed in December 2021. Extended criteria donors need additional measures for graft storage and assessment until its implantation. NMP is actively evaluating promising method for this purpose. Future studies are necessary for precise estimation and confirmation to issue clinical practice recommendations. 展开更多
关键词 Liver GRAFT PRESERVATION GRAFT PRESERVATION solutions Static cold storage Hypothermic MACHINE PERFUSION Normothermic MACHINE PERFUSION Ischemia-reperfusion injury Marginal GRAFTS DONATION after cardiac death Extended criteria donors Transpla complications
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Recurrent surgical site infection after anterior cruciate ligament reconstruction:A case report 预览
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作者 Don Koh Shi Ming Tan Andrew Hwee Chye Tan 《世界骨科杂志(英文版)》 2019年第6期255-261,共7页
BACKGROUND Surgical site infections following anterior cruciate ligament(ACL)reconstruction are an uncommon but potentially devastating complication.In this study,we present an unusual case of recurrent infection of t... BACKGROUND Surgical site infections following anterior cruciate ligament(ACL)reconstruction are an uncommon but potentially devastating complication.In this study,we present an unusual case of recurrent infection of the knee after an ACL reconstruction,and discuss the importance of accurate diagnosis and appropriate management,including the issue of graft preservation versus removal.CASE SUMMARY A 33-year-old gentleman underwent ACL reconstruction using a hamstring tendon autograft with suspensory Endobutton fixation to the distal femur and an interference screw fixation to the proximal tibia.Four years after ACL reconstruction,he developed an abscess over the proximal tibia and underwent incision and drainage.Remnant suture material was found at the base of the abscess and was removed.Five years later,he re-presented with a lateral distal thigh abscess that encroached the femoral tunnel.He underwent incision and drainage of the abscess which was later complicated by a chronic discharging sinus.Repeated magnetic resonance imaging revealed a fistulous communication between the lateral thigh wound extending toward the femoral tunnel with suggestion of osteomyelitis.Decision was made for a second surgery and the patient was counselled about the need for graft removal should there be intraarticular involvement.Knee arthroscopy revealed the graft to be intact with no evidence of intra-articular involvement.As such,the decision was made to retain the ACL graft.Re-debridement,excision of the sinus tract and removal of Endobutton was also performed in the same setting.Joint fluid cultures did not grow bacteria.However,tissue cultures from the femoral tunnel abscess grew Enterobacter cloacae complex,similar to what grew in tissue cultures from the tibial abscess five years earlier.In view of the recurrent and indolent nature of the infection,antibiotic therapy was escalated from Clindamycin to Ertapenem.He completed a six-week course of intravenous antibiotics and has been well for six months since surgery,with excellent 展开更多
关键词 Chronic SURGICAL SITE INFECTION Anterior CRUCIATE ligament reconstruction SURGICAL SITE INFECTION Graft preservation ENTEROBACTER CLOACAE complex Septic arthritis Case report
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嫁接技术对烤烟生长发育的影响 预览
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作者 肖德波 熊承飞 +4 位作者 王军 艾永峰 杨承 宋光龙 罗会斌 《安徽农业科学》 CAS 2019年第7期29-32,共4页
[目的]探究嫁接技术对烤烟生长发育的影响。[方法]以烤烟品种云烟87、K326为接穗,以Coker176、贵烟9号为砧木,设计4种嫁接组合开展试验,分别测量了各时期农艺性状、根系性状、干物质积累、化学成分、关键酶活等指标。[结果]选用优良砧木... [目的]探究嫁接技术对烤烟生长发育的影响。[方法]以烤烟品种云烟87、K326为接穗,以Coker176、贵烟9号为砧木,设计4种嫁接组合开展试验,分别测量了各时期农艺性状、根系性状、干物质积累、化学成分、关键酶活等指标。[结果]选用优良砧木后,嫁接烟株与自根烟株相比,烟株农艺性状、根系性状、干物质积累量等指标均有不同程度提高,化学成分变化不大,过氧化物酶、超氧化物歧化酶、几丁质酶等酶活指标均有提高。[结论]嫁接是改善烟株各项生理生化指标、增强抗逆性、促进烤烟生长发育的有效途径。 展开更多
关键词 烤烟 嫁接 生长发育 农艺性状 酶活
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髂腹股沟嵌合穿支骨皮瓣修复四肢骨和软组织缺损的临床应用
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作者 王海文 顾荣 +3 位作者 江新民 邓建林 吴霄 伍翰笙 《中华显微外科杂志》 CSCD 北大核心 2019年第1期32-36,共5页
目的探讨应用髂腹股沟嵌合穿支骨皮瓣修复四肢骨和软组织缺损的临床方法和疗效。方法2004年5月至2018年2月,对11例骨不连或骨缺损伴软组织缺损的患者,应用以吻合旋髂浅动脉为蒂的嵌合穿支骨皮瓣修复7例,应用以吻合旋髂深动脉为蒂的嵌合... 目的探讨应用髂腹股沟嵌合穿支骨皮瓣修复四肢骨和软组织缺损的临床方法和疗效。方法2004年5月至2018年2月,对11例骨不连或骨缺损伴软组织缺损的患者,应用以吻合旋髂浅动脉为蒂的嵌合穿支骨皮瓣修复7例,应用以吻合旋髂深动脉为蒂的嵌合穿支骨皮瓣修复4例。骨瓣切取大小为2.5 cm×2.0 cm×2.0 cm~6.0 cm×3.0 cm×2.0 cm,皮瓣切取大小为5.0 cm×3.0 cm~17.0 cm×13.0 cm。皮瓣供区均逐层严密直接缝合。术后对9例患者进行回院随访,观察皮瓣的外观、质地、色泽、浅感觉、骨折愈合情况、患肢功能恢复情况及供区情况。结果本组皮瓣术后全部成活。9例术后随访3~18个月,受区皮瓣外形良好,质地柔软,色泽与受区相近,骨折断端均骨性愈合,患肢功能恢复良好,掌骨缺损处掌指关节、掌腕关节活动无受限,步态正常,步行无疼痛,皮瓣供区除1例稍增生,余仅留线状瘢痕,无腹壁疝发生,大腿无麻木不适感。结论髂腹股沟嵌合穿支骨皮瓣修复四肢骨和软组织缺损,根据骨缺损大小选择切取不同血管蒂带血供的髂骨移植并修复创面,供区隐蔽、创伤小,骨折愈合快,手术体位操作方便,疗效满意。 展开更多
关键词 旋髂浅动脉 旋髂深动脉 嵌合穿支骨皮瓣 骨缺损 移植
不同茄科砧木嫁接红花大金元对烟草青枯病的防控效果研究 预览
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作者 谭玉娇 徐兴阳 +1 位作者 张俊文 吕芬 《昆明学院学报》 2019年第3期7-14,共8页
为缓解烟草青枯病对红花大金元的危害,选用8个野生茄科品种为砧木,红花大金元为接穗进行嫁接试验,并测定嫁接后其移栽成活率、农艺性状、青枯病发病情况及化学成分.结果表明:1)白花刺天茄、红茄、兰花刺天茄与红大嫁接,亲和性强,伤口愈... 为缓解烟草青枯病对红花大金元的危害,选用8个野生茄科品种为砧木,红花大金元为接穗进行嫁接试验,并测定嫁接后其移栽成活率、农艺性状、青枯病发病情况及化学成分.结果表明:1)白花刺天茄、红茄、兰花刺天茄与红大嫁接,亲和性强,伤口愈合好,移栽成活率均大于90%;2)嫁接后可提高烟株抗逆性,降低烟草青枯病发病率,且以组合T2,T4和T8的防治效果较好,成熟期病情指数显著低于对照;3)单叶质量以组合T1最大,T4次之,T8一般,但其化学成分尚待研究.综上所述,以组合T8(兰花刺天茄/红大)整体表现较好. 展开更多
关键词 红花大金元 茄科 嫁接 青枯病 防控效果
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Recalcitrant distal humeral non-union following previous Leiomyosarcoma excision treated with retainment of a radiated nonangiogenic segment augmented with 20 cm free fibula composite graft: A case report 预览
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作者 Martin Gathen Grayson Norris +1 位作者 Simon Kay Peter V Giannoudis 《世界骨科杂志(英文版)》 2019年第4期212-218,共7页
BACKGROUND Leiomyosacromas in the Extremities are rare malignant smooth muscle tumors. Adjuvant radiation therapy, in combination with wide surgical excision allows the best chance of treatment. During the follow up p... BACKGROUND Leiomyosacromas in the Extremities are rare malignant smooth muscle tumors. Adjuvant radiation therapy, in combination with wide surgical excision allows the best chance of treatment. During the follow up pathological fractures are common complications that can be accompanied by Implant failure and defect situations that are most challenging in their management. CASE SUMMARY We present a case of a 52-year-old female suffering from a pathological fracture of the humeral shaft 10 yr after resection of a Leiomyosarcoma and postoperative radiotherapy. She developed implant failure after retrograde nailing and another failure after revision to double plate fixation. In a two-stage revision, the implants were removed and the huge segmental defect created after debridement was bridged by a compound osteosynthesis with nancy nails and bone cement for formation of the induced membrane. Due to the previous radiotherapy treatment, 20 cm of the humeral shaft were declared devascularized but were left in situ as a scaffold. In the second stage, a vascularized fibula graft was used in combination with a double plate fixation and autologous spongiosa grafts for final reconstruction. CONCLUSION This combinatory treatment approach led to a successful clinical outcome and can be considered in similar challenging cases. 展开更多
关键词 Humerus FIBULAR graft Bone tumor OSSEOUS defect Implant failure LEIOMYOSARCOMA Case report
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A critical review on flocculants and flocculation 预览
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作者 Srijita Bharti 《非金属材料科学(英文)》 2019年第1期11-21,共11页
The article critically reviews the applications of biopolymers in the area of water treatment. A number of biopolymers were reported for their flocculation behavior for treating the wastewater and making it suitable f... The article critically reviews the applications of biopolymers in the area of water treatment. A number of biopolymers were reported for their flocculation behavior for treating the wastewater and making it suitable for various industrial as well as agricultural purposes via chemical alteration onto its backbone. Wastewater treatment was followed by flocculation process using standard ‘Jar test protocol’. Minute quantities of dosage were found be ideal to diminish the organic, biological and suspended loads from wastewater sample. The process of flocculation using biopolymers was also found economically suitable compared to other various processes applied in water treatment. 展开更多
关键词 Biopolymers GRAFT COPOLYMERS POLYMERIC FLOCCULANTS Standard 'jar test protocol’ Mechanism of FLOCCULATION
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改进葡聚糖接枝技术制备高性能层析介质 预览
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作者 张强 操文军 +1 位作者 夏海锋 丁重阳 《化工进展》 EI CAS CSCD 北大核心 2019年第6期2658-2664,共7页
利用改进的葡聚糖接枝技术,在以环氧氯丙烷为交联剂交联琼脂糖微球骨架的过程中加入葡聚糖溶液,在交联的同时接枝葡聚糖制得葡聚糖接枝型琼脂糖微球Rigose-Dex,再与盐酸2-氯三乙胺(DEAE)反应,获得葡聚糖接枝型高载量弱阴离子交换介质Rig... 利用改进的葡聚糖接枝技术,在以环氧氯丙烷为交联剂交联琼脂糖微球骨架的过程中加入葡聚糖溶液,在交联的同时接枝葡聚糖制得葡聚糖接枝型琼脂糖微球Rigose-Dex,再与盐酸2-氯三乙胺(DEAE)反应,获得葡聚糖接枝型高载量弱阴离子交换介质Rigose-Dex DEAE。以牛血清白蛋白(BSA)为模型蛋白,以商品化介质DEAE Sepharose 6FF为对照,系统研究了该葡聚糖接枝型Rigose-Dex DEAE的蛋白吸附性能,并进行了物理性能研究。结果表明,改进后葡聚糖接枝技术的最高接枝量为24.5mg/mL。自制Rigose-Dex DEAE可耐受700cm/h的线性流速,对BSA的动态饱和载量为127.6mg/mL,为商品介质DEAE Sepharose 6FF载量的212%;具有在高流速下快速结合蛋白的能力,上样蛋白溶液在层析柱中停留2min即可基本达到饱和动态载量;重复使用性能好,经120次在线清洗后,Rigose-Dex DEAE介质的动态载量为原始载量的90.4%。 展开更多
关键词 离子交换 葡聚糖 接枝 介质 吸附
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Low platelet count: Predictor of death and graft loss after liver transplantation 预览
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作者 Pedro Beltrame Santiago Rodriguez Ajacio Bandeira de Mello Brandao 《世界肝病学杂志:英文版(电子版)》 2019年第1期99-108,共10页
BACKGROUND The impact of platelets on liver transplantation (LT) is well recognized, but not completely understood. Platelets exert dichotomous effects on the graft and on the patient. On the one hand, they are essent... BACKGROUND The impact of platelets on liver transplantation (LT) is well recognized, but not completely understood. Platelets exert dichotomous effects on the graft and on the patient. On the one hand, they are essential for primary hemostasis and tissue repair and regeneration. On the other hand, they support ischemia/reperfusion injury and inflammatory processes. Recent evidence has shown a new role for platelet count (PC) in predicting outcomes after LT. AIM To evaluate if low PC is a predictor of short- and long-term outcomes after LT. METHODS Four hundred and eighty consecutive LT patients were retrospectively assessed. PC from the preoperative to the seventh postoperative day (POD) were considered. C-statistic analysis defined the ideal cutoff point for PC. Cox regression was performed to check whether low PC was a predictor of death, retransplantation or primary changes in graft function within one year after LT. RESULTS The highest median PC was 86 × 10^9/L [interquartile range (IQR)= 65–100 × 10^9/L] on seventh POD, and the lowest was 51 × 10^9/L (IQR = 38–71 × 10^9/L) on third POD. The C-statistic defined a PC < 70 × 10^9/L on fifth POD as the ideal cutoff point for predicting death and retransplantation. In the multivariate analysis, platelets < 70 × 10^9/L on 5POD was an independent risk factor for death at 12 mo after LT [hazard ratio (HR)= 2.01; 95% confidence interval (CI) 1.06-3.79; P = 0.031]. In the Cox regression, patients with PC < 70 × 10^9/L on 5POD had worse graft survival rates up to one year after LT (HR = 2.76; 95%CI 1.52-4.99; P = 0.001). CONCLUSION PC < 70 × 10^9/L on 5POD is an independent predictor of death in the first year after LT. These results are in agreement with other studies that indicate that low PC after LT is associated with negative outcomes. 展开更多
关键词 PREDICTIVE factors Prognosis PLATELET COUNT Liver transplantation GRAFT survival MORTALITY
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De novo malignancies after liver transplantation: The effect of immunosuppression-personal data and review of literature 预览
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作者 Tommaso Maria Manzia Roberta Angelico +8 位作者 Carlo Gazia Ilaria Lenci Martina Milana Oludamilola T Ademoyero Domiziana Pedini Luca Toti Marco Spada Giuseppe Tisone Leonardo Baiocchi 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第35期5356-5375,共20页
BACKGROUND Immunosuppression has undoubtedly raised the overall positive outcomes in the post-operative management of solid organ transplantation. However, long-term exposure to immunosuppression is associated with cr... BACKGROUND Immunosuppression has undoubtedly raised the overall positive outcomes in the post-operative management of solid organ transplantation. However, long-term exposure to immunosuppression is associated with critical systemic morbidities. De novo malignancies following orthotopic liver transplants (OLTs) are a serious threat in pediatric and adult transplant individuals. Data from different experiences were reported and compared to assess the connection between immunosuppression and de novo malignancies in liver transplant patients. AIM To study the role of immunosuppression on the incidence of de novo malignancies in liver transplant recipients. METHODS A systematic literature examination about de novo malignancies and immunosuppression weaning in adult and pediatric OLT recipients was described in the present review. Worldwide data were collected from highly qualified institutions performing OLTs. Patient follow-up, immunosuppression discontinuation and incidence of de novo malignancies were reported. Likewise, the review assesses the differences in adult and pediatric recipients by describing the adopted immunosuppression regimens and the different type of diagnosed solid and blood malignancy.RESULTS Emerging evidence suggests that the liver is an immunologically privileged organ able to support immunosuppression discontinuation in carefully selected recipients. Malignancies are often detected in liver transplant patients undergoing daily immunosuppression regimens. Post-transplant lymphoproliferative diseases and skin tumors are the most detected de novo malignancies in the pediatric and adult OLT population, respectively. To date, immunosuppression withdrawal has been achieved in up to 40% and 60% of well-selected adult and pediatric recipients, respectively. In both populations, a clear benefit of immunosuppression weaning protocols on de novo malignancies is difficult to ascertain because data have not been specified in most of the clinical experiences. CONCLUSION The selected populations of toleran 展开更多
关键词 Pediatric LIVER TRANSPLANT IMMUNOSUPPRESSION WEANING Clinical operational tolerance Adult LIVER TRANSPLANT Graft REJECTION Immune system De novo MALIGNANCIES IMMUNOSUPPRESSION minimization Cancer
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聚丙烯纤维改性及应用研究 预览
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作者 刘冶球 杨毅 +2 位作者 黄梅欢 胡希 朱奕嘉 《广东化工》 CAS 2019年第15期7-8,35共3页
采用马来酸酐接枝改性聚丙烯纤维,研究了引发剂浓度、单体用量和反应时间对接枝率的影响。改性后的聚丙烯纤维对于水泥砂浆的增强效果优于未改性的聚丙烯纤维,在一定范围内随改性纤维含量的增加,纤维改性水泥砂浆的抗折、抗压强度均持... 采用马来酸酐接枝改性聚丙烯纤维,研究了引发剂浓度、单体用量和反应时间对接枝率的影响。改性后的聚丙烯纤维对于水泥砂浆的增强效果优于未改性的聚丙烯纤维,在一定范围内随改性纤维含量的增加,纤维改性水泥砂浆的抗折、抗压强度均持续增加。 展开更多
关键词 聚丙烯纤维 接枝 水泥 强度
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两种根砧嫁接‘洛阳红’光合特性与叶绿素荧光参数的比较 预览
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作者 常毅洪 赵鹏飞 +3 位作者 王锐 栗燕 贺丹 陈军洲 《西北农林科技大学学报:自然科学版》 CSCD 北大核心 2019年第6期89-96,共8页
【目的】对2种根砧嫁接的‘洛阳红’盆栽植株叶片的光合特性与叶绿素荧光参数季节性变化进行比较,筛选更适宜盆栽的嫁接‘洛阳红’砧木。【方法】以‘洛阳红’为接穗,芍药根和凤丹根为砧木,测定2种根砧嫁接‘洛阳红’叶片的净光合速率(... 【目的】对2种根砧嫁接的‘洛阳红’盆栽植株叶片的光合特性与叶绿素荧光参数季节性变化进行比较,筛选更适宜盆栽的嫁接‘洛阳红’砧木。【方法】以‘洛阳红’为接穗,芍药根和凤丹根为砧木,测定2种根砧嫁接‘洛阳红’叶片的净光合速率(Pn)、气孔导度(Gs)、胞间CO2浓度(Ci)、蒸腾速率(Tr)、单叶瞬时水分利用效率(WUE)、羧化速率(CE)等光合特性以及初始荧光(F0)、最大荧光(Fm)、PSⅡ的最大光化学效率(Fv/Fm)、PSⅡ的有效量子产量[Y(Ⅱ)]、光化学淬灭系数(qP)、非光化学淬灭系数(qN)等叶绿素荧光参数,并分析Pn与其他参数的相关性。【结果】盛花期至夏季休眠期,芍药砧‘洛阳红’叶片的Pn始终高于凤丹砧‘洛阳红’。圆桃期至盛花期,芍药砧‘洛阳红’叶片的Pn、CE、WUE、Fm、Fv/Fm、Y(Ⅱ)分别增长了145.86%,245.10%,60.68%,33.27%,8.45%和25.00%,增长幅度较凤丹砧‘洛阳红’大。花后生长期,芍药砧‘洛阳红’叶片qN显著高于凤丹砧‘洛阳红’。相关性分析表明,芍药砧和凤丹砧‘洛阳红’叶片的Pn与CE、Tr均呈极显著正相关,芍药砧‘洛阳红’的Pn与Gs呈显著正相关,凤丹砧‘洛阳红’的Pn与Gs呈极显著正相关;芍药砧‘洛阳红’Pn与Fv/Fm呈极显著正相关,凤丹砧‘洛阳红’Pn与Fv/Fm呈显著正相关,2种根砧‘洛阳红’Pn与Y(Ⅱ)均呈正相关关系,但均未达到显著水平。【结论】 芍药砧嫁接‘洛阳红’叶片具有更高的光能利用效率,更适宜作为盆栽‘洛阳红’的砧木。 展开更多
关键词 根砧嫁接 '洛阳红’牡丹 光合参数 叶绿素荧光参数
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Blessing and a curse of outpatient management of delayed graft function 预览
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作者 Justin W Blazel Jennifer A Turk +1 位作者 Brenda L Muth Sandesh Parajuli 《世界移植杂志》 2019年第4期58-61,共4页
Delayed graft function (DGF) is a common complication occurring most often after deceased donor kidney transplant with several donor characteristics as well as immunologic factors that lead to its development post-tra... Delayed graft function (DGF) is a common complication occurring most often after deceased donor kidney transplant with several donor characteristics as well as immunologic factors that lead to its development post-transplant.These patients require dialysis and close kidney function monitoring until sufficient allograft function is achieved.This has resulted in limited options for DGF management,either prolonged hospitalization until graft function improves to the point where dialysis is no longer needed or discharge back to their home dialysis unit with periodic follow up in the transplant clinic.DGF is associated with a higher risk for acute rejection,premature graft failure,and 30-d readmission;therefore,these patients need close monitoring,immunosuppression management,and prompt allograft biopsy if prolonged DGF is observed.This may not occur if these patients are discharged back to their home dialysis unit.To address this issue,the University of Wisconsin-Madison created a clinic in 2011 specialized in outpatient DGF management.This clinic was able to successfully reduce hospital length of stay without an increase in 30-d readmission,graft loss,and patient death. 展开更多
关键词 Delayed graft function KIDNEY transplantation IMMUNOSUPPRESSION Acute rejection KIDNEY DONOR profile INDEX KIDNEY DONOR risk INDEX Dialysis
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聚偏氟乙烯树脂改性研究进展 预览
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作者 叶翠翠 俞群力 +1 位作者 沈洁清 李勇进 《化工生产与技术》 CAS 2019年第1期18-25,I0003共9页
介绍了聚偏氟乙烯(PVDF)材料改性的主要方法及其改性材料的应用领域。从物理改性方法(热处理、涂覆和共混)和化学改性方法(光引发、等离子体诱导、辐照引发和臭氧活化)等方面出发,探讨了改性方法对PVDF材料性能的影响,叙述了改性PVDF树... 介绍了聚偏氟乙烯(PVDF)材料改性的主要方法及其改性材料的应用领域。从物理改性方法(热处理、涂覆和共混)和化学改性方法(光引发、等离子体诱导、辐照引发和臭氧活化)等方面出发,探讨了改性方法对PVDF材料性能的影响,叙述了改性PVDF树脂在介电材料、压电材料以及水处理等应用领域的发展。认为在PVDF改性研究的方面应该以提高改性材料性能的稳定性、提高单体接枝率为重点,进一步开发出性能优异的PVDF功能材料,以应对在压电材料、介电材料、过滤材料等领域实际应用过程中的需求。 展开更多
关键词 聚偏氟乙烯 改性 接枝 功能化
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Comparison of nighttime and daytime operation on outcomes of kidney transplant with deceased donors: a retrospective analysis
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作者 Qi-Hang GUO Qian-Long LJu +3 位作者 Xiao-Jun HU Yang Li Jin Zheng Wu-Jun Xue 《中华医学杂志:英文版》 SCIE CAS CSCD 2019年第4期395-404,共10页
Background: Kidney transplant is always emergent operations and frequently need to be performed at nighttime to reduce cold ischemia time (CIT). Previous studies have revealed that fatigue and sleep deprivation can re... Background: Kidney transplant is always emergent operations and frequently need to be performed at nighttime to reduce cold ischemia time (CIT). Previous studies have revealed that fatigue and sleep deprivation can result in adverse consequences of medical procedures. This study aimed to evaluate whether nighttime operation has adverse impact on kidney transplant. Methods: A retrospective analysis of recipients accepted kidney transplant from deceased donors in one center from 2014 to 2016 was performed. Daytime transplant was defined as operation started after 8 AM or ended before 8 PM and nighttime operation was defined as operation ended after 8 PM or started before 8 AM. The incidences of complications such as delayed graft function, acute rejection, surgical complications and nosocomial infections were compared between 2 groups. Student’s t-test was used to analyze continuous variables such as serum creatinine (Scr) at 1-year of post-transplant. The Chi-square test was used to analyze categorical variables. Differences in recipients and graft survival were analyzed using Kaplan–Meier methodology and log-rank tests. Results: Among the 443 recipients, 233 (52.6%) were classified into the daytime group and the others 210 (47.4%) were in the nighttime group. The 1-year survival rate of recipients was similar for the recipients in the daytime and nighttime groups (95.3% vs. 95.2%, P= 0.981). Although the 1-year graft survival rate in the nighttime group was slightly superior to that in the daytime group, the difference was not significant (92.4% vs. 88.4%, P= 0.164). Furthermore, Scr and incidence of complications were also not significantly different between the 2 groups. Conclusions: Our results suggested that operation time of kidney transplant with short CIT has no significant impact on the outcome of kidney transplant. Nighttime operation of kidney transplant with short CIT could be postponed to the following day to alleviate the burden on medical staffs and avoid the potential risk. 展开更多
关键词 Kidney TRANSPLANT Delayed GRAFT function DONATION after cardiac death NIGHTTIME TRANSPLANT
嫁接对西瓜植株各部位内源激素含量的影响 预览
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作者 杨积冠 王善珍 +2 位作者 朱妍妍 俞家永 王朋成 《安徽农业科学》 CAS 2019年第13期40-42,共3页
[目的]探讨嫁接对西瓜幼苗内源激素含量的影响。[方法]以大型西瓜品种‘金绿红玲’为接穗,选用南瓜砧木“力娃”、葫芦砧木“京欣砧一号”进行嫁接,分析不同砧木嫁接西瓜对嫁接苗内源激素含量的影响。[结果]与对照相比,2种砧木嫁接西瓜... [目的]探讨嫁接对西瓜幼苗内源激素含量的影响。[方法]以大型西瓜品种‘金绿红玲’为接穗,选用南瓜砧木“力娃”、葫芦砧木“京欣砧一号”进行嫁接,分析不同砧木嫁接西瓜对嫁接苗内源激素含量的影响。[结果]与对照相比,2种砧木嫁接西瓜后,嫁接苗叶片、嫁接接口上部、嫁接接口下部内源激素含量均发生显著变化。南瓜、葫芦砧木嫁接西瓜后,嫁接苗叶片和嫁接接口上部的ABA、IAA、GA含量均上升;在南瓜砧木嫁接西瓜苗中嫁接接口下部的ABA、IAA、GA、ZR含量均下降,而在葫芦砧木嫁接西瓜苗中嫁接接口下部的ABA、IAA含量下降,GA、ZR含量上升。[结论]不同砧木嫁接西瓜可改变嫁接苗内源激素含量。 展开更多
关键词 西瓜 砧木 嫁接 内源激素
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Implantless patellar fixation in medial patellofemoral ligament reconstruction
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作者 Ashish Devgan Umesh Yadav +5 位作者 Pankaj Sharma Rajesh Rohilla Radhika Devgan Pravesh Mudgil Aman Verma Vasudha Dhupper 《中华创伤杂志:英文版》 CAS CSCD 2019年第5期281-285,共5页
Purpose:The medial patellofemoral ligament(MPFL)acts as primary restraint to lateral patellar dislocation and its rupture has been reported in almost all cases of acute patellar dislocation.Various surgical techniques... Purpose:The medial patellofemoral ligament(MPFL)acts as primary restraint to lateral patellar dislocation and its rupture has been reported in almost all cases of acute patellar dislocation.Various surgical techniques have been described for MPFL reconstruction,using many femoral and patellar fixation techniques and different grafts.This article details our technique for MPFL reconstruction using semitendinosus graft which avoids the use of implant at patellar end.Methods:Twenty patients(8 males and 12 females)with complaints regarding acute and chronic lateral patellar instability were evaluated and treated by MPFL reconstruction procedure.The mean age of patients was 21 years(range 17-34 years).MPFL reconstruction was performed using semitendinosus graft passing through two parallel,obliquely directed tunnels created in patella.Fixation of graft was done with an interference screw only at the femoral end.Mean follow-up period after intervention was 26.4 months(range 23-30 months).Results were evaluated using Kujala score.Results:All patients gained adequate patellar stability and full arc of motion.No incidence of patella fracture was noted.There were no postoperative complications related to the procedure.There was no recurrence of instability in patella at final follow-up.Conclusion:Passing the graft through the tunnels in patella without use of any implant has given excellent functional outcome and moreover has the advantages of less implant-related complications and cost-effectiveness. 展开更多
关键词 PATELLAR DISLOCATION PATELLAR instability MEDIAL PATELLOFEMORAL LIGAMENT SEMITENDINOSUS graft
Fluoroquinolones for the treatment of latent Mycobacterium tuberculosis infection in liver transplantation 预览
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作者 Jose Tiago Silva Rafael San-Juan +1 位作者 Mario Fernandez-Ruiz Jose Maria Aguado 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第26期3291-3298,共8页
Solid organ transplantation(SOT)is the best treatment option for end-stage organ disease.Newer immunosuppressive agents have reduced the incidence of graft rejection but have increased the risk of infection,particular... Solid organ transplantation(SOT)is the best treatment option for end-stage organ disease.Newer immunosuppressive agents have reduced the incidence of graft rejection but have increased the risk of infection,particularly due to the reactivation of latent infections due to opportunistic agents such as Mycobacterium tuberculosis.Active tuberculosis(TB)after SOT is a significant cause of morbidity and mortality.Most cases of posttransplant TB are secondary to reactivation of latent tuberculosis infection(LTBI)due to the effects of long-term immunosuppressive therapy.Risk minimization strategies have been developed to diagnose LTBI and initiate treatment prior to transplantation.Isoniazid with vitamin B6 supplementation is the treatment of choice.However,liver transplantation(LT)candidates and recipients have an increased risk of isoniazid-induced liver toxicity,leading to lower treatment completion rates than in other SOT populations.Fluoroquinolones(FQs)exhibit good in vitro antimycobacterial activity and a lower risk of drug-induced liver injury than isoniazid.In the present review,we highlight the disease burden posed by posttransplant TB and summarize the emerging clinical evidence supporting the use of FQs for the treatment of LTBI in LT recipients and candidates. 展开更多
关键词 FLUOROQUINOLONES MYCOBACTERIUM TUBERCULOSIS LATENT TUBERCULOSIS infection LIVER transplantation DRUG-INDUCED LIVER graft injury
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加速康复外科理念在腓骨瓣游离移植治疗长段骨缺损中的应用
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作者 王正 喻爱喜 +3 位作者 漆白文 肖卫东 赵勇 李宗焕 《中华显微外科杂志》 CSCD 北大核心 2019年第5期463-466,共4页
目的总结加速康复外科(ERAS)理念在腓骨瓣游离移植(FVFG)治疗长段骨缺损中的应用经验。方法2012年1月至2017年1月,对26例长段骨缺损行带血管蒂FVFG的患者应用ERAS理念,通过加强心理护理与营养支持、优化手术方案、强化疼痛管理、早期功... 目的总结加速康复外科(ERAS)理念在腓骨瓣游离移植(FVFG)治疗长段骨缺损中的应用经验。方法2012年1月至2017年1月,对26例长段骨缺损行带血管蒂FVFG的患者应用ERAS理念,通过加强心理护理与营养支持、优化手术方案、强化疼痛管理、早期功能锻炼等一系列综合措施,出院后门诊定期随访,记录手术时间、住院时间、患者出院满意度、术后疼痛视觉模拟量表(VAS)评分、骨缺损愈合时间、患肢功能恢复情况。结果本组平均手术时间(3.2±0.5)h,平均住院时间为(10.2±1.2)d,出院满意度超过95%,术后VAS评分小于3分。随访时间1.6~6.0年,26例腓骨瓣全部成活,骨缺损部位均骨性愈合,平均愈合时间(5.5±0.6)个月。术后1.5年,7例上肢功能恢复80.1%,19例下肢功能恢复82.5%。结论ERAS理念应用于FVFG修复长段骨缺损,术后患肢功能恢复良好,疼痛明显减轻,缩短了住院时间,促进了患者康复,患者满意度高。 展开更多
关键词 加速康复外科 腓骨瓣 移植 骨缺损 长段
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