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Establishing a center of excellence in abdominal wall reconstruction

Plastic and Aesthetic Research 2020年第4期7卷 63-72页

作者： jenny shao Sharbel Elhage Eva Deerenberg Vedra Augenstein B.Todd Heniford Gastrointestinal and Minimally Invasive Surgery Department of SurgeryCarolinas Medical CenterCharlotteNC 28204USA

Building a tertiary referral center of excellence for complex abdominal wall reconstruction is a multi-step process that requires many elements to garner and promote *** the creation of such a center is important for continual improvement of abdominal wall reconstruction outcomes by decreasing complications,recurrences,length of hospital stay,hospital readmissions,and overall *** a center of excellence incorporates several key components including the surgeon's desires and expertise,institutional participation,multidisciplinary collaboration,outcomes research and innovation,and financial *** article outlines the principal elements of building a sustainable,functional,and successful center of excellence for complex abdominal wall reconstruction.

关键词： Complex abdominal wall reconstruction center of excellence

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The use of botulinum toxin A in chemical component separation: a review of techniques and outcomes

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Plastic and Aesthetic Research 2020年第4期7卷 1-9页

作者： Sharbel A.Elhage Eva B.Deerenberg jenny M.shao Vedra A.Augenstein B.Todd Heniford Department of Gastrointestinal and Minimally Invasive Surgery Carolinas Medical CenterCharlotteNC 28204USA

Fascial closure is crucial for abdominal wall reconstruction (AWR) but can be especially difficult in patients with massive ventral hernias or loss domain. Recently, botulinum toxin A (BTA) has been increasingly utilized as an adjunct in AWR to aid in fascial closure. This review aims to evaluate the current literature on the use of BTA in AWR to assess current treatment regimens, side effects, outcomes and complications. A literature search was performed, yielding 10 studies that met the inclusion criteria. There was a significant amount of heterogeneity in treatment regimens, with studies differing in BTA injection timing, dosage, concentration, and location. The majority of studies showed that injection of BTA preoperatively was able to augment abdominal wall musculature, with many showing a decrease in mean transverse defect size and high rates of successful fascial closure. No major complications were reported from BTA administration, with only mild side effects reported by some studies. The most common side effects include a weak cough or sneeze, bloating, and back pain, which generally all resolved prior to surgery. While BTA appears to be a promising adjunct for AWR, further investigation is needed to determine optimal patient selection and treatment regimens.

关键词： Hernia abdominal wall reconstruction botulinum toxin botox chemical component separation

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Higher levels of circulating monocyte-platelet aggregates are correlated with viremia and increased sCD 163 levels in HIV- 1 infection

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Cellular & Molecular Immunology 2015年第4期12卷 435-443页

作者： Hua Liang Zhaojun Duan Dan Li Dongliang Li ZhengWang Li Ren Tao Shen Yiming shao State Key Laboratory for Infectious Disease Prevention and Control National Center for AIDS/STD Control and Prevention China CDC CollaborativeInnovation Center for Diagnosis and Treatment of Infectious Diseases Beijing China Department of Microbiology School of Basic Medical SciencesPekin8 University Beijing China and 3Beijing Chaoyang District Center for Disease Control and Prevention Beijing China Correspondence: Dr T Shen Department of Microbiology Peking University Health Science Center Beijing 100191 China.

Increased levels of monocyte-platelet aggregates （MPAs） are reported to be highly correlated with cardiovascular events. In this study, the MPA levels in different monocyte subsets and the associations between MPA levels, HIV-1 viremia and monocyte activation were evaluated during HIV-1 infection. The results showed that the percentages of MPAs in all three monocyte subsets were higher in HIV-l-infected subjects than in healthy controls, and were associated with the plasma viral load in the non-classical and intermediate monocyte subsets. The plasma levels of sCD14 and sCD163 were upregulated in HIV-1 infection and were positively associated with viral loads and negatively associated with CD4 counts. P-selectin glycoprotein ligand-1 （PSGL-1） was shown to be expressed at significantly lower levels on all three monocyte subsets and was negatively correlated with the sCD163 level. The MPA level was correlated with the levels of plasma sCD163 but negatively correlated with CD163 and PSGL-1 on all three monocyte subsets. An elevated immune activation status was correlated with increased MPA formation, underlying the potential interaction between monocyte activation and MPA formation. This interaction may be related to a higher thromboembolic risk in patients infected with HIV-I.

关键词： HIV-1 immune activation monocytes platelets sCD163

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