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991.
Hiromu Miyake Bo Li Carol Lee Yuhki Koike Yong Chen Shogo Seo Agostino Pierro 《Journal of pediatric surgery》2018,53(5):909-913
Background
Necrotizing enterocolitis (NEC) is a disease known to cause injury to multiple organs including the liver. Liver regeneration is essential for the recovery after NEC-induced liver injury. Our aim was to investigate hepatic proliferation and progenitor cell marker expression in experimental NEC.Methods
Following ethical approval (#32238), NEC was induced in mice by hypoxia, gavage feeding of hyperosmolar formula, and lipopolysaccharide. Breastfed pups were used as control. We analyzed serum ALT level, liver inflammatory cytokines, liver proliferation markers, and progenitor cell marker expression. Comparison was made between NEC and controls.Results
Serum ALT level was higher in NEC (p < 0.05). The mRNA expression of inflammatory cytokines in the liver was also higher in NEC (IL6: p < 0.05, TNF-α: p < 0.01). Conversely, mRNA expression of proliferation markers in the liver was lower in NEC (Ki67; p < 0.01, PCNA: p < 0.01). LGR5 expression was also significantly decreased in NEC as demonstrated by mRNA (p < 0.05) and protein (p < 0.01) levels.Conclusions
Inflammatory injury was present in the liver during experimental NEC. Proliferation and LGR5 expression were impaired in the NEC liver. Modulation of progenitor cell expressing LGR5 may result in stimulation of liver regeneration in NEC-induced liver injury and improved clinical outcome.Level of evidence
Level IV. 相似文献992.
Introduction
The ability to use detailed, accurate current procedural terminology (CPT) codes is a key component of effective research. We examined the effectiveness of CPT codes to accurately reflect care in patients undergoing surgery for necrotizing enterocolitis (NEC).Methods
A multicenter retrospective analysis of operations on patients with NEC was conducted across 4 institutions between 2011 and 2016. Correlation between operative dictation and CPT coding was analyzed.Results
A total of 124 patients with NEC diagnosis undergoing exploratory abdominal operations were identified. NEC was improperly diagnosed in 25 patients, who were excluded from further analysis. Of the 99 patients reviewed, the initial exploratory abdominal operation was coded inaccurately in 58 cases (59%). Within these, 15 (26%) had multiple coding errors such that the nature of the original operation was not discernable from the applied codes. Inaccurate codes often did not describe the presence of a mucous fistula (n = 27, 44%), ostomy (n = 24, 39%), or extra segments of bowel resected (n = 9, 16%). The length of bowel resected is not currently described by any CPT codes.Conclusion
CPT coding for abdominal operations does not sufficiently reflect complexity of pediatric surgeries. This study highlights the significance of this inadequacy and its implications in future database studies in the era of electronic medical records.Level of evidence
Level IV.Type of study
Clinical research study. 相似文献993.
994.
995.
996.
997.
J.-F. Cai W. Wang W. Hao Z.-J. Sun L.-L. Su X. Li X. Zheng X.-D. Zhang 《Transplantation proceedings》2018,50(10):3411-3415
Background
Ureteral stents have been widely used in kidney transplantation to prevent postoperative ureter-related complications such as ureteral stricture, ureteral obstruction, and ureteral leakage; however, a longer indwelling ureteral stent time corresponds to a greater risk of complications such as urinary tract infections. Currently, transplantation centers have not yet reached an agreement on the time to remove ureteral stents. Several randomized controlled trials (RCTs) have evaluated the optimal removal time for ureteral stents.Objective
This meta-analysis was designed to evaluate and discuss the optimal removal time for ureteral stents after kidney transplantation.Method
We used key words to search PubMed, Embase, and Cochrane Library and retrieve published articles. A total of 568 kidney transplantation patients from 5 RCTs were included in this meta-analysis. We collected information regarding postoperative complications related to indwelling stents, such as ureteral stricture, ureteral obstruction, ureteral leakage, and urinary tract infection, and evaluated whether early removal of ureteral stents (≤7 days) was superior to late removal (≥14 days).Results
A significant difference was observed in the incidence of urinary tract infection between the early removal group and the late removal group (risk ratio [RR] = 0.43, 95% confidence interval [CI] [0.32, 0.59], P < .01). No significant between-group difference was observed in the incidence of major urological complications (MUCs) (RR = 1.87, 95% CI [0.45, 7.70], P > .05).Conclusion
Early removal of ureteral stents of transplanted kidneys after kidney transplantation (≤7 days) did not significantly increase the incidence of postoperative MUCs (ureteral stricture, ureteral obstruction, and ureteral leakage) relative to late removal (≥14 days). Early removal may significantly reduce the incidence of postoperative urinary tract infection relative to late removal. 相似文献998.
X. Chen G. Huang S. Yang J. Li Q. Fu X. Yuan W. Chen C. Wang 《Transplantation proceedings》2018,50(8):2436-2438
Four kidneys from 2 young donors suffering from rhabdomyolysis were rejected for transplantation at the time of procurement because of their severely bruised and black gross appearance. A frozen section revealed a focal tubular injury filled with granular pigmented casts which an immunohistochemistry confirmed to be myoglobin. The 4 kidneys were transplanted successfully and all recipients recovered normal renal function with no delay. These cases indicate that kidneys with patchy black gross appearance caused by myoglobin casts secondary to rhabdomyolysis is not a contraindication for transplantation. 相似文献
999.
1000.
We present the case of a 91-year-old woman who presented with a 2?day history of progressive pain and immobility of the right shoulder joint after fever of unknown etiology. Aeromonas sobria was isolated from a culture of purulent synovial fluid. The clinical condition gradually improved with the application of appropriate antibiotics and no surgical intervention was necessary. This report indicates that acute septic arthritis may result from Aeromonas veronii biotype sobria infections in healthy people. This case is contrary to the previous reports due to the absence of obvious risk factors. 相似文献