The bone marrow mononuclear cell(BMMNC) subset comprises mesenchymal stem cells, hematopoietic stem cells, endothelial progenitor cells. These cells can differentiate into cardiomyocytes, vascular endothelial cells and smooth muscle cells, and they can also release a wide array of cytokines that exert their effects on surrounding cells, including inducing neovascularization, preventing apoptosis of home cells and homing of endogenous systemic repairing cells. Many trials have been developed to evaluate the effect of bone marrow mononuclear cell transplantation in treating ischemia heart diseases in this country and others. Several routes have been used to deliver these cells to human myocardium or to the coronary circulation in these trials, such as intracoronary injection, intravenous infusion, direct injection into the ventricular wall, or transepicardial/transendocardial infusions,and the cells are constructed into fragmented cell sheets to improve cell retention, or some cytokines are used to enhance therapeutic effect. Although the results of the recent clinical trials in this area are rather conflicting, these therapeutic approaches seem to be promising forthe treatment of ischemic heart disease. In this review, many aspects of bone marrow mononuclear cell transplantation in myocardial infarction are summarized such as the mechanism, delivery routes, retaining of cells, homing, survival and future development, etc.
Esophageal cancer is a common gastrointestinal cancer,and the incidence in China is the highest in the world. Esophagectomy represents the gold standard for patients with resectable esophageal cancer,but postoperative morbidity and mortality rates remain high. In recent years,there have been many reports on the pathogenesis of morbidity and mortality after esophagectomy without reaching any concrete conclusion. This review focuses on the pathogenesis,prophylaxis and therapeuticsof pulmonary infection after esophageal cancer resection.
目的 探讨经皮椎体成形术(percutaneous vertebroplasty,PVP)后新发椎体骨折的发生率及危险因素。 方法 回顾分析2004年1月-2009年1月行经PVP治疗的80例骨质疏松伴椎体压缩骨折的患者的临床资料,随访7~54个月,了解患者的疗效和预后。 结果 术后80例中14例(17.5%)30个椎体新发椎体骨折,其中相邻椎体占46.7%(14/30)。有无新发椎体骨折两组间及相邻和非相邻椎体骨折两组间,体重指数(body mass index,BMI)比较差异均统计学意义(Plt;0.05),而年龄、性别、骨折椎体个数、PVP手术椎体个数、骨水泥注射剂量、身高下降比较差异无统计学意义(Pgt;0.05)。经logistic回归分析发现低体重指数(BMI≤18.5 kg/m2)是PVP术后新发椎体骨折的独立危险因素。术后患者均给予抗骨质疏松药物治疗,58.8%(47/80)的患者能坚持抗骨质疏松药物治疗1年以上。采用KaplanMeier法计算术后第1年新发椎体压缩骨折的发生率为8.6%。低新发椎体骨折发生率与患者术后坚持抗骨质疏松治疗相关。 结论 低体重指数是PVP术后新发椎体骨折的独立危险因素,与PVP手术本身无关。术后坚持抗骨质疏松药物治疗能够降低新发椎体骨折的发生。
Objective To understand status of technical realization, present development, faced problems, and application prospects of reduced-port laparoscopic surgery for rectal cancer, and to analyze safety and feasibility so as to provide theoretical and practical basis for clinical application and promotion. Method By searching the databases such as Medline, Embase, and Wanfang, etc., the relevant literatures about reduced-port laparoscopic surgery for rectal cancer were collected and reviewed. Results At present, the most common reduced-port laparoscopic surgery was the 1-port laparoscopic surgery, 2-port laparoscopic surgery, and 3-port laparoscopic surgery. The 1-port laparoscopic surgery had the effects of minimal invasiveness and cosmesis, but it was difficult to perform. The 2-port laparoscopic surgery for rectal cancer preserved as far as possible the effect of minimal invasiveness, the difficulty of procedure was reduced greatly, which was easy to be learnt and promoted. The experience of the 3-port laparoscopic surgery for rectal cancer contributed to the technical development of the 1-port laparoscopic surgery, with no need for the assisted incision for intraoperative specimen. The reduced-port laparoscopic surgery for rectal cancer was technically feasible and safe, which possessed the equal or better short-term outcomes as compared with the conventional 5-port laparoscopic or open surgery beside the radical resection for rectal cancer. However, the stringent technique for the laparoscopic surgery was necessary and it needed to overcome the learning curve. Conclusions Reduced-port laparoscopic surgery has some obvious advantages in minimal invasiveness, cosmesis, and enhanced recovery. More large-sample, multi-center, randomized controlled trials are eager to further confirm safety, effectiveness, and feasibility of reduced-port laparoscopic surgery for rectal cancer.