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Objective:To explore the factors that promote and hinder exercise adherence in long dialysis duration hemodialysis patients, and to provide a reference for improving their exercise levels.Methods:From March to May 2023, a qualitative research method using phenomenon approach was conducted and 15 patients with peritoneal dialysis for at least 10 years at the People′s Liberation Army Central Command Headquarters Hospital (Hankou Hospital) were selected for in-depth interviews using purposive sampling method. The data were analyzed using Colaizzi 7-step method and the main themes were extracted.Results:Among the 15 interviewers, there were 5 males and 10 females, aged 39-76 years old.Conclusions:The exercise level of long dialysis duration hemodialysis patients is influenced by multiple factors. Medical staff should correct their cognitive biases and change their behavioral attitudes, strengthen external supportive environments and reduce subjective normative pressures, gradually provide more objective support, thereby promoting the exercise training of long dialysis duration hemodialysis patients.
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Objective To establish a lncRNA prognostic risk model for gastrointestinal tumors based on the TCGA database and evaluate the prognosis of patients. Methods We collected the data of patients with esophageal cancer, gastric cancer, colon cancer and rectal cancer in the TCGA database. Univariate Cox analysis, Lasso and multivariate Cox analysis were performed to construct the prognostic risk scoring model. The model was validated and tested for independence. Time-dependent ROC curve analysis was performed to evaluate the clinical application value of the model. Results We established a prognostic risk model based on 13 lncRNAs. The three-year AUC of the training set and the validation set were 0.746 and 0.704, respectively. The pan-cancer data set was divided into high- and low-risk groups for survival analysis. The 5-year survival rate of the low-risk group was significantly higher than that of the high-risk group; among all cancer types, the five-year survival rates of the low-risk group were higher than those of the high-risk group. Multivariate Cox analysis showed that the risk score could be an independent indicator of prognosis. Conclusion The 13-gene prognostic risk score model is constructed successfully. The risk score obtained by this model can be used as an independent prognostic predictor of the patients with gastrointestinal cancer.
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Psoriasis is characterized by abnormal proliferation of keratinocytes, as well as infiltration of immune cells into the dermis and epidermis, causing itchy, scaly and erythematous plaques of skin. The understanding of this chronic inflammatory skin disease remains unclear and all available treatments have their limitations currently. Here, we showed that IMMH002, a novel orally active S1P modulator, desensitized peripheral pathogenic lymphocytes to egress signal from secondary lymphoid organs and thymus. Using different psoriasis animal models, we demonstrated that IMMH002 could significantly relieve skin damage as revealed by PASI score and pathological injure evaluation. Mechanistically, IMMH002 regulated CD3 T lymphocytes re-distribution by inducing lymphocytes' homing, thus decreased T lymphocytes allocation in the peripheral blood and skin but increased in the thymus. Our results suggest that the novel S1P agonist, IMMH002, exert extraordinary capacity to rapidly modulate T lymphocytes distribution, representing a promising drug candidate for psoriasis treatment.
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FTY720 and IMMH002, prodrugs for sphingosine-1-phosphate receptor 1 (S1P) agonists, show inadequate and inconsistent levels of phosphorylation in humans compared to that in rats. In this study, FTY720 or IMMH002 analogues (-) were designed and synthesized with modified head pieces to improve the biotransformation of the prodrugs to the active phosphorylated forms. Target compounds were synthesized a convergent route using the key and optically pure building block , which was first synthesized asymmetrically catalyzed amination. The phosphorylation rates of these analogues in rat or human blood were compared. The new methyl-substituted analogue compound showed higher phosphorylation rates in both rats and humans than the parent compound, whereas compound showed improvements in rats, but not in humans. In pharmacokinetics studies of rats, compounds and both had higher levels of phosphorylation than FTY720 and IMMH002. Thus, our study not only yielded new compounds with therapeutic potential, but also showed species differences between rats and humans in response to the structural modifications, which might be useful for predicting the biotransformation behavior and efficacy of this class of prodrugs in the clinic.
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Objective To investigate the effects of bamboo leaf extract on the malignant growth of human breast cancer MCF-7 cells under hypoxic microenvironment and the molecular mechanism .Methods Cultured human breast cancer MCF-7 cells were randomized into six groups :control group , hypoxia group ,0 .2 μg/mL bamboo leaf extract group ,0 .4μg/mL bamboo leaf extract group ,0 .8μg/mL bamboo leaf extract group and 0 .8μg/mL bamboo leaf extract group treated with IGF-1 .The cell proliferation activity in each group was determined using cell counting Kit-8 (CCK-8) assay .The expressions of proliferation markers PCNA ,Ki-67 and CCK-8 MCM2 in MCF-7 cells were detected by RT-PCR and Western blot .Flow cytometer was used to analyze the cell cycle arrest and cell apoptosis .The protein expressions of Bax ,Bcl-2 ,caspase-3 and survivin were measured by Western blot . Furthermore ,the effect of Akt/HIF-1αpathway underlying bamboo leaf extract-mediated inhibition on cancer cell growth was also explored .Results After treatment with bamboo leaf extract ,cell proliferation activity and the expressions of PCNA ,Ki-67 and MCM2 under hypoxia were obviously inhibited in a dose-dependent manner ( P<0 .01) . The proportion of MCF-7 cells upon hypoxia in the G2/M phase of the cell cycle was increased after treatment with bamboo leaf extract (P<0 .01) .The apoptosis rate of MCF-7 cells was enhanced after bamboo leaf extract stimulation ,accompanied with an increased protein levels of Bax and caspase-3 ,and decreased expressions of Bcl-2 and survivin (both P< 0 .01) .Moreover ,bamboo leaf extract down-regulated the expressions of p-Akt and HIF-1αin MCF-7 cells under hypoxia .IGF-1 ,an Akt/HIF-1α pathway agonist ,reversed the inhibiting effect of bamboo leaf extract on the malignant growth of MCF-7 cells under hypoxia .Conclusion Bamboo leaf extract inhibits the malignant growth of human breast cancer MCF-7 cells by suppressing the Akt/HIF-1αsignaling pathway under hypoxic microenvironment .
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Objective To investigate the current situation of medical instrument cleaning in Central Sterile Supply Departments(CSSD),in order to identify problems and provide references for further improvements of equipment cleaning.Methods Questionnaire survey was adopted,data of 127 CSSDs in five coastal provinces or cities in China in 2017 were collected,and status of each link of medical instrument cleaning was analyzed.Results The allocation rate of ultrasonic cleaner and spray cleaner were 96.6% and 78.7%,respectively;62.2% of hospitals used tap water to pre-rinse,and 10.2% used normal saline or sterile water to pre-rinse,11.0% used tap water for finial rinsing;78.7% of hospitals did not perform continuous humidification in transit,and 18.1% of hospitals did not perform continuous humidification and their time of transit was more than 2 hours;66.9% of CSSDs only used multi-enzyme detergent.More than half of the hospitals did not record time for manual rinsing/manual final rinsing.Conclusion The configuration of medical instrument cleaning equipment of 127 CSSDs is good.However,it is necessary to pay more attention to cleaning details.Specifications for instrument cleaning water should be established;continuous humidification during transportation of medical instruments should be promoted;cleaning methods and cleaning detergents should be selected reasonably;standardized rinsing should be enhanced to ensure quality of medical instrument cleaning.
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BACKGROUND:Insufficient oral soft tissues in the implant zone may have a negative effect on the wound healing and the aesthetic restoration in the late stage. Platelet-rich fibrin can promote the wound healing of soft tissue defects. But there is stil a lack of in-depth studies on the promotion of oral soft tissue defects in animal experiments. OBJECTIVE: To compare the repairing effects of platelet-rich fibrin and colagen membrane on soft tissue defects of the hard palate in New Zealand rabbits. METHODS:Fifty-four New Zealand rabbits were randomly divided into three groups (n=14 per group): platelet-rich fibrin group, colagen membrane group and blank control group. A 5 mm-diameter circular ful-thickness soft tissue defect was made in the front of the hard palate, 2 mm distant to the rear maxilary incisors and mucosal edge of the bilateral hard palates. Autologous platelet-rich fibrin membrane or colagen membrane were implanted into the defect in the platelet-rich fibrin group and colagen membrane group, respectively. No treatment was given in the blank control group. General observation of the wound and wound healing analysis were performed at days 3, 7, 14, 21, 28, 56 post operation. Hematoxylin-eosin staining, CD31 immunohistochemical staining and Masson staining were used to observe inflammatory reaction, angiogenesis and colagen formation in the surgical site. RESULTS AND CONCLUSION:The wound healing rate was fastest in the platelet-rich fibrin group, and no obvious scar formed. At 3 days post operation, there was no difference in the wound healing rates among the three groups; at 7 days, the wound healing rate in the platelet-rich fibrin group was significantly higher than that in the colagen membrane group and blank control group (P < 0.05). At 3 and 7 days after operation, the inflammatory reaction in the platelet-rich fibrin group was less than that in the colagen membrane and blank control groups (P < 0.05); at 14, 21, 28 and 56 days, there was no significant difference between the three groups. At 7, 14, 21 days after operation, the average absorbance value of CD31 in the platelet-rich fibrin group was significantly higher than that in the colagen membrane and blank control groups (P < 0.05). The average absorbance value of colagen formation in the platelet-rich fibrin group was significantly higher than that in the colagen membrane and blank control groups at 7 days after operation (P < 0.05), significantly higher than that in the blank control group at 14 days (P < 0.05), but lower than that in the colagen membrane and blank control groups at 21, 28 and 56 days after operation (P < 0.05). These findings show that platelet-rich fibrin can reduce inflammatory reactions in the process of wound healing, accelerate the angiogenesis, regulate the metabolism of colagen, reduce the formation of scar and improve the quality of wound healing, thereby promoting the repair of oral soft tissue defects.
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BACKGROUND:In previous experiments, we have confirmed that platelet rich fibrin has the ability of osteoinduction, and have conducted a preliminary study on its microstructure and biomechanics. However, little is reported on its histology research. OBJECTIVE:To compare the histological changes after implanting platelet-rich fibrin, Bio-Oss and autologous bone and to analyze the pros and cons of platelet-rich fibrin implantation for repair of bone defects. METHODS: As previously reported, animal models of critical bone defects were established respectively on the bilateral femoral condyles of 12 beagle dogs. Then, platelet-rich fibrin, Bio-Oss+colagen membrane (Bio-Oss group) and autologous bone (autologous bone group)+colagen membrane were respectively implanted. At 3, 6, 8 and 12 months, one experimental dog from each group was kiled, respectively, and histological observation was performed. Another beagle dog as blank control was enroled to establish the animal model of critical bone defects, with no implantation. RESULTS AND CONCLUSION:At 3, 6, 8 and 12 months after implantation, there were significant differences in the new bone formation speed and amount between the platelet-rich fibrin group, Bio-Oss group and autologous bone group. These three kinds of bone grafts al had osteoinductive ability to different extents. In the platelet-rich fibrin group, the osteogenic effects were better at 3 and 6 months, and the new bone was similar to natural one; in the autologuos bone group, bone necrosis was noticeable at 3 and 6 months, but the osteogenic effects became better at 8 months, and the new bone was similar to natural one at 12 months; in the Bio-oss group, the osteogenic effects were similar to those in the platelet-rich fibrin group, but the residual of Bio-oss was visible at 12 months; in the blank control group, no bone formed at 3 months, indicating the animal model of critical bone defects was made successfuly. In brief, the platelet-rich fibrin has good osteoinductive ability, with shorter time and better quality.
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BACKGROUND: In clinical, the research on the method and the material of the soft tissue defect of the operation area has been in depth. It wil have a positive impact on our exploration and research in this field through the establishment of reliable experimental animal oral soft tissue defect model. OBJECTIVE: To establish a rabbit model of oral soft tissue defects for oral treatment of soft tissue defects in-depth study. METHODS: Eighteen 3-month-old male New Zealand rabbits were enrol ed. A tissue ring cutting dril of 5 mm diameter was used to prepare round ful -thickness soft tissue defects in the front part of the hard palate and, respectively, from the back of the maxil ary incisors, about 2 mm from the hard palate mucosal edge. Morphology and histology were observed at 3, 7, 14, 21, 28 and 56 days after model establishment. RESULTS AND CONCLUSION: (1) Morphological observation: After 3 and 7 days, the wound’s inflammatory reaction was obvious. As the time goes, the inflammatory response subsided, the wound gradual y healed. Scar formation was observed at 21, 28 and 56 days after surgery. (2) Histological observation: 3 and 7 days after injury, many inflammatory cel s were infiltrating, and tissue necrosis area was larger. At 7 days after surgery, with the extensive formation of connective tissue proliferation and new blood capil aries, the wound gradual y shaping completely. (3) Results indicated that a rabbit model of oral soft tissue defects was successful y established, which was in line with the physical laws of wound healing and the characteristics of human oral soft tissue defects healing.
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A rapid and sensitive liquid chromatography-tandem mass spectrometry (LC-MS/MS) method was developed and validated for the simultaneous determination of H002 and its phosphorylated metabolite, H002-P and hydroxylated metabolite H002-M, in rat blood. H001, an analogue of H002, was used as the internal standard. Blood samples were prepared by simple protein precipitation. The analytes and internal standard were separated on a Zorbax SB-C18 column with a gradient mobile phase consisting of methanol and water containing 0.1% formic acid at a flow rate of 0.2 mL/min with an operating temperature of 20 °C. The detection was performed on a triple quadrupole tandem mass spectrometer with positive electrospray ionization in multiple-reaction monitoring mode. Linear detection responses were obtained from 0.2-100 ng/mL for H002 and H002-M, while 0.5-100 ng/mL for H002-P. The intra- and inter-day precision (RSD%) was within 11.76%, with the accuracy (RE%) ranging from -9.84% to 9.12%. The analytes were shown to be stable during sample storage, preparation and analytic procedures. The method was applied to determine the pharmacokinetics of H002 in rats, and a preliminary study showed that the pharmacokinetics of H002 correlated with its biological effect on peripheral blood lymphocytes.
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BACKGROUND:Previous studies have found that platelet-rich fibrin has a good ability to induce gingival soft tissue repair and regeneration. OBJECTIVE:To observe the effects of platelet-rich fibrinversus colagen membrane on gingival soft tissue healing, and to evaluate the ability of platelet-rich fibrin to repair gingival defects. METHODS:Twenty-two patients (2 premolar teeth and 20 molars) scheduled for premolar or molar removal or ridge preservation due to various reasons were selected and randomized into two groups. Bio-Oss was implanted into the extraction socket folowed by covering with platelet-rich fibrin or colagen membrane. Healing time and healing rate of gingival defects were detected to evaluate the ability of platelet-rich fibrin to promote gingival tissue healing at 1-2 weeks after Bio-Oss implantation. RESULTS AND CONCLUSION:The healing time was (12.17±2.25) days in the platelet-rich fibrin group and (17.30±2.58) days in the colagen group. The healing rate of the platelet-rich fibrin group was notably higher than that in the colagen membrane group at 1 and 2 weeks after Bio-Oss implantation. These findings indicate that platelet-rich fibrin is better than colagen membrane to improve the healing of gingival soft tissues with a shorter healing time.
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@#It has been reported that buagarofuran(AF-5)as an anxiolytic drug. It possesses a structural feature including α-agarofuran and the n-butyl side chain. Recently, there is a new metabolite found in clinical study, which is hypothesized that the n-butyl side chain has been oxidized to carboxylic acid. In order to confirm its structure, the target compound was prepared from(4aR, 7R, 8aR)-8a-hydroxy-7-(2-hydroxypropan-2-yl)-4a-methyloctahydronaphthalen-2(1H)-one in a six-step reaction with an overall yield of 16. 7%. The structure is confirmed by NMR and MS.
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A novel series of fingolimod analogues containing diphenyl ether moiety were designed and synthesized based on the modification of immunosuppressive agent fingolimod used in the treatment of multiple sclerosis. Compounds were evaluated in vivo for lymphopenic activity and heart rate affection. Most compounds showed moderate lymphopenic activity. It is worth noting that compounds 6c, 6d and 14c-14e showed considerable immunosuppressive activities comparable to fingolimod. And compound 14e had no effect on heart rate.
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A novel series of fingolimod analogues containing diphenyl ether moiety were designed and synthesized based on the modification of immunosuppressive agent fingolimod used in the treatment of multiple sclerosis. Compounds were evaluated in vivo for lymphopenic activity and heart rate affection. Most compounds showed moderate lymphopenic activity. It is worth noting that compounds 6c, 6d and 14c-14e showed considerable immunosuppressive activities comparable to fingolimod. And compound 14e had no effect on heart rate.
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Animals , Fingolimod Hydrochloride , Pharmacology , Heart Rate , Immunosuppressive Agents , Chemistry , Lymphopenia , Pathology , Phenyl Ethers , Chemistry , Structure-Activity RelationshipABSTRACT
<p><b>BACKGROUND</b>Endometriosis affects natural fertility through various approaches, and in vitro fertilization (IVF) is a good treatment. But the IVF result of endometriosis patients is still under debate. We investigated the effect of endometriosis on IVF by analyzing the data from a single reproductive center.</p><p><b>METHODS</b>A retrospective, database-searched cohort study was performed. Relevant information was collected from the electronic records of women who underwent IVF/intracytoplasmic sperm injection between January 2006 and December 2010 in the Assisted Reproductive Unit of Sir Run Run Shaw Hospital. Patients with endometriosis were enrolled the study group. The rest of the women formed the control group. The main outcome was the clinical pregnancy rate. Secondary outcomes were oocytes retrieved number, fertilization rate, high-quality embryo rate, number of high-quality embryo for embryo transplantation, and implantation embryo/high-quality embryo ratio (IE/HQE ratio). Comparisons were performed by the c(2)-test and independent t-test.</p><p><b>RESULTS</b>The endometriosis group (n = 177) had a markedly lower oocytes retrieved number, fertilization rate, implantation rate, and clinical pregnancy rate (7.6 ± 5.1, 63.6%, 27.7%, and 45.2%, respectively) compared with the non-endometriosis group (n = 4267; 11.8 ± 7.3, 68.4%, 36.2%, and 55.2%, respectively). Stratified analysis showed that this difference was found in the subgroup younger than 35-years old, while only fertilization rate and implantation rate were different in the elder subgroup. The ratio of high-quality embryos transferred is lower in endometriosis group (53.7% vs. 71.8%, P < 0.05), but there is no difference in IE/HQE ratio between two groups. There is no significant difference in fertilization rate, implantation rate, and clinical pregnancy rate between mild and severe endometriosis patients.</p><p><b>CONCLUSIONS</b>Endometriosis patients suffer a decreasing IVF pregnancy rates mainly caused by reducing oocytes number and fertilization rate, regardless of the severity of the disease. Appropriate intracytoplasmic sperm injection manipulation might improve the outcomes of IVF.</p>
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Female , Humans , Pregnancy , Endometriosis , Fertilization in Vitro , Infertility, Female , Therapeutics , Pregnancy Rate , Retrospective StudiesABSTRACT
Objective To study the feasibility of TNF-α promoting migration of rat mesenchymal stem cells (MSCs) to local damaged tissues. Methods The MSCs was exposed to TNF-α at different concentrations and the expression rate of surface adheslon molecules and specific markers as well as their adhesion to endothelial cells were detected.Based on the above steps,the MSCs stimulated with the optimal concentration of TNF-α were obtained and were injected intravenously to the rats whose hindlimbs experienced ischemia damage.The rats were executed for achieving the muscle samples in the ischemic area,which were made into frozen section to count the number of MSCs. Results ( 1 ) Twenty-four hours after the TNF-o stimulation,the expression of adhesion molecule (VCAM-1) of MSCs increased in a concentration-dependent manner,while the expression of adhesion molecules (ICAM-1,L-Selectin and VLA4) of MSCs showed no significant changes.Besides,the expression rate of specific markers of MSCs was also obscure.(2) Exposed to 10 ng/ml TNF-o,MSCs presented an obviously increased ability in adhesion to the endothelial cells.(3) MSCs stimulated with 10 ng/ml TNF-α showed a larger number in the ischemia-damaged tissue of rat hindlimbs than that in the control group. Conclusion TNF-α at concentration of 10 ng/ml is effective within a short term in increasing VCAM-1 expression in rat MSCs and promoting the adhesion of MSCs to endothelial cells without affecting their character.
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<p><b>OBJECTIVE</b>To summarize the experiences and results of ventricular septal myectomy concomitant mitral valve replacement (MVR) for obstructive hypertrophic cardiomyopathy (OHCM).</p><p><b>METHODS</b>From January 2000 to June 2007, 22 patients of OHCM with moderate or severe mitral regurgitation underwent concomitant ventricular septal myectomy concomitant MVR. There were 20 male and 2 female patients. The age ranged from 28 to 51 years old with a mean of (36 + or - 5) years old. The left ventricular out tract gradient pressure (LVOTGP) was 55 to 120 mm Hg (1 mm Hg = 0.133 kPa), with a mean of (88.0 + or - 15.8) mm Hg. The manifestation of pre-operative UCG, intra-operative transesophageal echocardiography (TEE) and post-operative UCG in 10 d, 6 months and 1 year were compared and analyzed.</p><p><b>RESULTS</b>One patient died in hospital due to serious ventricular arrhythmias. The intra-operative TEE showed that the phenomenon of systolic anterior motion (SAM) of mitral valve disappeared in all patients. Twenty-one cases were followed-up. The intra-operative TEE and post-operative UCG in every period of all 21 cases survived indicated that the mean LVOTGP and interventricular septal thickness (IVST) decreased obviously (P < 0.01).</p><p><b>CONCLUSION</b>Concomitant ventricular septal myectomy concomitant MVR is an effective and safe treatment for OHCM with moderate or severe mitral regurgitation, the short and mid-term outcome is excellent.</p>
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Adult , Female , Humans , Male , Middle Aged , Cardiomyopathy, Hypertrophic , General Surgery , Heart Valve Prosthesis Implantation , Mitral Valve , General Surgery , Mitral Valve Insufficiency , General Surgery , Retrospective Studies , Treatment Outcome , Ventricular Septum , General SurgeryABSTRACT
<p><b>BACKGROUND</b>Patients presenting with severe left ventricular dysfunction (SLVD) undergoing conventional coronary artery bypass grafting (CCABG) are at an increased risk of perioperative mortality and morbidity. The aim of this study was to assess the risk factors responsible for mortality and morbidity among patients with SLVD by comparing CCABG and off-pump coronary artery bypass surgery (OPCAB).</p><p><b>METHODS</b>We retrospectively evaluated 186 consecutive patients with SLVD who underwent coronary artery bypass grafting (CABG), including 102 by CCABG and 84 by OPCAB. Registry database, medical notes, and charts were studied for preoperative and postoperative data of the patients. Different variables and risk factors (preoperative, intraoperative, and postoperative) were evaluated and compared. The morbidity and mortality outcomes were compared in the two groups. The follow-up results and quality of life were assessed after surgery.</p><p><b>RESULTS</b>The two groups had similar percentage of patients with preoperative high-risk profiles and no significant differences were found between groups in baseline variables such as age or comorbidities. There was a significant difference in the number of grafts used between the two groups. CCABG patients received (3.6 +/- 0.5) grafts per patient, while OPCAB patients had (2.7 +/- 0.6) grafts (P < 0.05). Completeness of revascularization was also significantly different between the two groups (CCABG 91.1% vs OPCAB 73.8%, P < 0.05). The hospital mortality was similar in the two groups (4.8% in OPCAB vs 5.9% in CCABG). The risk-adjusted mortality, according to the calculated propensity score, did not reach statistical significance in the two groups. In this study, OPCAB seemed to have a beneficial effect on reducing reoperation for bleeding, blood transfusion requirement, and the length of stay at ICU. But the incidence of perioperative myocardial infarction was more common in the off-pump group (P < 0.05). The degree of improvement in angina and quality of life did not differ significantly between the two groups.</p><p><b>CONCLUSIONS</b>Using cardiopulmonary bypass is not an independent predictor of mortality and morbidity in patients with SLVD. Isolated CABG can be safely performed in SLVD patients with acceptable postoperative morbidity and mortality in addition to encouraging home discharge rates and higher quality of life. Therefore, CCABG remains a viable option in selected patients with SLVD.</p>
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Aged , Female , Humans , Male , Middle Aged , Cardiopulmonary Bypass , China , Epidemiology , Coronary Artery Bypass , Follow-Up Studies , Morbidity , Retrospective Studies , Survival Rate , Treatment Outcome , Ventricular Dysfunction, Left , Epidemiology , Mortality , General SurgeryABSTRACT
Objective To investigate the method and value of adjustable interatrial fistulization in the operation of congenital heart disease(CHD) accompany with severe pulmonary arterial hypertension(PH).Methods Twenty-seven patients(19 male,8 females) accompany with severe PH were entered the study,age ranged from 4 to 14 years old,weight from 13.7 to 42.0 kilogram.The enrolled diseases included 11 cases of atrial septal defect(ASD),10 cases of ventricular septal defect(VSD),4 cases of patent ductus arteriosus(PDA),and 2 cases of Ebstein syndrome accompany with severe tricuspid insufficiency.All patients were diagnosed as CHD accompany with severe PH(bidirectional shunt)which was the contraindications for routine operation before operation through chest X-ray,electrocardiography,ultrasonic cardiography,cardiac catheteri-zation and cardiac angiography.Results With adjustable interatrial fistulization and treatment to the abnormalities,14 fistulaes were closed immediately after operation,7 fistulaes were closed 2 days after operation,3 fistulaes were closed 3 days and 1 fistulae was closed 4 days after operation and accompanied with empyema discharged initiatively.One fistula was never closed,1 case died from low cardiac output symptom.The effective rate was 92.6%,closed to that of routine operations.Conclusion Adjustable interatrial fistulization is an easy procedure,and it can decrease the danger of PH post-operation effectively and provide operation opportunity for those patients with CHD approaching terminal stage.
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Objective To explore the efficacy of excision of pterygium combined with fresh amniotic membrane transplantation for treatment of recurrent pterygium.Methods Pteryga of 27 patients(32 eyes) were excised and transplanted with fresh amniotic membrane.Patients were followed up for 6~36 months.Results Pterygium recurred in only 2 eyes during the period of follow-up.The curative rate of the operation for recurrent pterygium was 93.75%,and the recurrence rate was 6.25%.Conclusion Excision of pterygium combined with fresh amniotic membrane transplantation is an effective therapeutic method for recurrent pterygium.