2016年青田县内榕树冻害调查研究

2016年1月,青田县遭遇50年一遇低温天气,极端低温达到-10℃,部分榕树严重受冻。通过调查青田县内榕树冻害情况,比较了不同胸径、移栽年限、小气候环境的抗冻性及冻害前后不同处理措施对榕树恢复的影响。为青田县乃至浙南地区榕树绿化引种提供一定的理论依据。

Graft-versus-host disease after liver transplantation:A comprehensive literature review

AIM： To determine the factors affecting mortality in pa- tients who developed graft-versus-host disease （GvHD） after liver transplantation （LT）. METHODS： We performed a review of studies of GvHD following LT published in the English literature and ac- cessed the PubMed, Medline, EBSCO, EMBASE, and Google Scholar databases. Using relevant search phras- es, 88 articles were identified. Of these, 62 articles con- raining most of the study parameters were considered eligible for the study. Risk factors were first examined using a univariate Kaplan-Meier model, and variables with a significant association （P 〈 0.05） were then sub- jected to multivariate analyses using a Cox proportional- hazards model. RESULTS： The 61 articles reported 87 patients, 58 male and 29 female, mean age, 40.4 ± 15.5 years （range： 8 mo to 74 years）, who met the inclusion criteria for the present study. Deaths occurred in 59 （67.8%） patients, whereas 28 （32.2%） survived after a mean follow-up period of 280.8 ± 316.2 d （range： 27-2285 d）. Among the most frequent symptoms were rash （94.2%）, fever （66.6%）, diarrhea （54%）, and pancytopenia （54%）. The average time period between LT and first symptom on- set was 60.6 ± 190.1 d （range： 2-1865 d）. The Kaplan- Meier analysis revealed that pancytopenia （42.8% vs 59.3%, P = 0.03）, diarrhea （39.2% vs 61.0%, P = 0.04）, age difference between the recipient and the donor （14.6 ± 3.1 years vs 22.6 ± 2.7 years, P 〈 0.0001）, and time From first symptom occurrence to diagnosis or treatment （13.3 ± 2.6 mo vs 15.0 ± 2.3 mo, P 〈 0.0001） were significant factors affecting mortality, whereas age, sex, presence of rash and fever, use of immunosuppressive agents, acute rejection before GvHD, etiological causes, time of onset, and donor type were not associated with mortality risk. The Cox proportional-hazards model, de- termined that an age difference between the recipient and donor was an independent risk Factor （P = 0.03; hazard ratio, 7.395, 95% confidence interval, 1.2-46.7）. CONCLUSION： This study showed that an age differ- ence between the recipient and donor is an independent risk factor for mortality in patients who develop GvHD after LT.

Coronary artery bypass grafting in the octogenarians： should we intervene, or leave them be？

Objective Coronary artery bypass grafting （CABG） is gradually increasing in the elderly population. We aimed to investigate the risk factors and the results of CABG along with the long term survival in patients at an age of 80 and older. Methods Between Januaa-y 2002 and December 201 I, a total of i01 consecutive patients at an age of S0 and older who underwent CABG in our hospital were included in the study. The patients were followed and the long-term survival was estimated. Results The mean age of the patients was 82.98 ~ 2.27 years. Sixty-four （63.4%） were males and 37 （36.6%） were females. Emergency surgery, duration of cardiopulmonary bypass, the intensive care unit （ICU） stay, inotropic support, intra aortic balloon pulsation application, amount oferythrocyte transfusion and flesh frozen plasma transfusion and ventilation period were significantly higher in the patients who died in the hospital. The duration of cardiopulmonary bypass （CPB） was found to be an inde- pendent predictor of mortality （OR： 1.18, 95% CI 1.01-1.38, P = 0.034）. The in-hospital mortality was 16.8%. Kaplan-Meier analyses revealed a survival ratio of 91.3% at one year, 82.9% at three years and 69.0% at five years. Conclusions Patients at the age of 80 and older can be candidates for the CABG procedure bearing in mind that they may have a longer ventilation period and intensive care unit stay. The morbidity and mortality of this age group is considered within an acceptable range. Approaches to minimize CPB, or the choice of off-pump surgery, may be a preventive method to lower the incidence of mortality. Hence, CABG may be performed in this age group with a satisfactory survival ratio.

Off-pump coronary artery bypass grafting using a bilateral internal mammary artery Y graft

Objective To evaluate the outcome of off-pump coronary artery bypass grafting （OPCABG） using a bilateral internal mammary artery （BIMA） Y configuration graft to achieve total arterial myocardial revascularization. Methods From October 2002 to December 2008, 208 patients （196 males and 12 females） underwent OPCABG using a BIMA Y configuration graft. The average age of the patients was 56.5 ± 11.3 years, with an age range of 33-78 years. A total of 167 （80.2%） cases had triple-vessel disease. Left main stem disease was found in 33 （15.9%） cases, and double-vessel disease was found in 8 （3.9%） cases. The semi-skeletonization technique was used to harvest the two internal mammary arteries （IMAs）, and then the free right internal mammary artery was connected end-to-side to the left internal mammary artery （LIMA） in situ to complete the Y configuration graft. Off-pump and sequential anastomosis methods were used to perform coronary artery bypass surgery in all patients. Graft patency was assessed intm-operatively with the HT311 transit time flowmeter. Results A total of 728 distal anastomoses were performed in 208 patients, with the average being 3.5± 1.3 per person. No one died or experienced recurrent angina within 30 days after the operation. Conclusions OPCABG using the BIMA Y graft was safe and effective to achieve total arterial revascularization. This method avoids surgical operation on the ascending aorta and other incisions.

Revascularization for Iliac-femoral Artery Pseudoaneurysm with Greater Saphenous Vein

Objective To investigate the role of revascularization procedures with autologous greater saphenous vein in surgical management of iliac-femoral artery pseudoaneurysm in parenteral drug abusers. Methods Twenty-one patients with iliac-femoral artery pseudoaneurysm caused by parenteral drug abuse from 2004 to 2007 were enrolled. Among them,15 patients were male and 6 were female; their average age was 31.3 years. The size of pseudoaneurysms ranged from 3.0 cm to 7.5 cm. Common femoral artery and distal external iliac artery were often involved. We performed arterial reconstruction on these patients with autologous greater saphenous vein as a graft after excising iliac-femoral artery pseudoaneurysm through a single curved inguinal incision. All patients were followed up,and the complications were recorded. Results The surgical procedures were finished without intraoperative mortality or perioperative complications. All patients were free of claudication symptoms after the surgery except one case with preoperative popliteal artery stenosis. One case of infection and wound tissue fistula was found later. One case had inguinal incisional hematoma and another complained of numbness in thigh skin. Conclusions The use of autologous greater saphenous venous grafts for arterial reconstruction after pseudoaneurysm excision in drug abusers is safe and effective. This technique offers more advantages than arterial ligation alone without revascularization. An optimal greater saphenous venous graft is a prerequisite for revascularization.

Octogenarian liver grafts:Is their use for transplant currently justified?

AIMTo analyse the impact of octogenarian donors in liver transplantation.METHODSWe present a retrospective single-center study, performed between November 1996 and March 2015, that comprises a sample of 153 liver transplants. Recipients were divided into two groups according to liver donor age: recipients of donors ≤ 65 years (group A; n = 102), and recipients of donors ≥ 80 years (group B; n = 51). A comparative analysis between the groups was performed. Quantitative variables were expressed as mean values and SD, and qualitative variables as percentages. Differences in properties between qualitative variables were assessed by χ2 test. Comparison of quantitative variables was made by t-test. Graft and patient survivals were estimated using the Kaplan-Meier method.RESULTSOne, 3 and 5-year overall patient survival was 87.3%, 84% and 75.2%, respectively, in recipients of younger grafts vs 88.2%, 84.1% and 66.4%, respectively, in recipients of octogenarian grafts (P = 0.748). One, 3 and 5-year overall graft survival was 84.3%, 83.1% and 74.2%, respectively, in recipients of younger grafts vs 84.3%, 79.4% and 64.2%, respectively, in recipients of octogenarian grafts (P = 0.524). After excluding the patients with hepatitis C virus cirrhosis (16 in group A and 10 in group B), the 1, 3 and 5-year patient (P = 0.657) and graft (P = 0.419) survivals were practically the same in both groups. Multivariate Cox regression analysis demonstrated that overall patient survival was adversely affected by cerebrovascular donor death, hepatocarcinoma, and recipient preoperative bilirubin, and overall graft survival was adversely influenced by cerebrovascular donor death, and recipient preoperative bilirubin.CONCLUSIONThe standard criteria for utilization of octogenarian liver grafts are: normal gross appearance and consistency, normal or almost normal liver tests, hemodynamic stability with use of < 10 μg/kg per minute of vasopressors before procurement, intensive care unit stay < 3 d, CIT < 9 h, absence of atherosclerosis in the hepatic and gastroduodenal arteries, and no relevant histological alterations in the pre-transplant biopsy, such as fibrosis, hepatitis, cholestasis or macrosteatosis > 30%.

Study on Effect of Age of Seedlings Transplant on the Performance of Tomato （Lycopersicon esculentum） in a Southwestern Nigeria Location

Field trials were conducted at the experimental site of the Department of Plant Science of the University of Ado Ekiti, Nigeria during the 2005 and 2006 cropping season to examine the effects of age of transplanting on the performance of tomato Lycopersieon esculentum L. Establishment count %, plant height stem girth, earliness to flower, and fruit yield were significantly affected by the ages at which the seedlings were transplanted. The 2 and 3 weeks after sowing transplants were identical in performance and gave the highest number of field establishment count, growth increase, and yield. The 4WAS transplants performed better than the 5WAS transplants. It is concluded that a delay in early transplanting of tomato seedlings after 4WAS could lead to a very high reduction in tomato yield in the study area.

Effect of maternal age on the outcomes of in vitro fertilization and embryo transfer(IVF-ET)

This is a retrospective,observational study to evaluate the effect of maternal age on the outcomes of in vitro fertilization and embryo transfer(IVF-ET).11830 IVF-ET cycles from 10268 women were included.Four groups of different maternal age periods were compared.The groups were 21 30 years old group(4549 cycles),31-35 years old group(4424 cycles),36-40 years old group(2429 cycles),and over 40 years old group(428 cycles).The mean starting dose of Gn and mean total dose of Gn in each cycle were significantly higher(P<0.01),while the mean retrieved oocyte number was significantly lower(P<0.01) in groups of higher maternal age period than those in each of the lower groups.The biochemical pregnancy rate and the clinical pregnancy rate were significantly lower(P<0.01),while the miscarriage rate was significantly higher(P<0.01) in groups of higher maternal age period than those in the lower groups.No difference was found in two-pronuclear zygotes(2PN) rate and good quality embryo rate among different groups.Birth defect rate was also comparable in the born babies in different groups.In the group with patients' age over 40 years old,the pregnancy rate was 26.87%,the clinical pregnancy rate was 19.39%,while the miscarriage rate after clinical pregnancy was 36.14%.To draw the conclusion,patients with higher maternal age had worse IVF outcomes.In women of fertile age,patients between 20 and 30 years old have the best IVF outcomes.Patients over 40 years old have poor IVF outcome and high miscarriage rate,which suggested the necessity of preimplantation genetic screening(PGS).

Nonunion of the scaphoid treated by anterior vascularized bone graft： a review of 26 cases

[Abstract] Objective： To evaluate the clinical and radiological outcome of anterior vascularized bone graft in the treatment of primitive nonunion of the scaphoid. Methods： This is a retrospective study of 26 scaphoid nonunion cases treated by this technique between 2004 and 2009. The mean age was 38 years. Nonunion was of types IIA and IIB according to the Alnot＇s classification and only one case showed a proximal pole necrosis （type IV）. The fixation was ensured by K-wire. The mean immobilization period was 9 weeks. Results： At mean 19 months follow-up, the bone union rate was 88.5%. Failure was noted in three cases. No significant complications secondary to this technique were observed. The mobility in extension and flexion had an average recovery of 18°. Nineteen patients （73%） were free of pain, and the others had occasional pain Conclusions： It is a meticulous surgical technique that provides better union rates than those of conventional scaphoid graft. This technique is first adopted in cases of failure of conventional grafts in the treatment of scaphoid nonunion but the encouraging results suggest expanding indications to primitive nonunion.