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@#Objective To summarize the characteristics of children diagnosed with secondary subaortic stenosis after the surgical closure for ventricular septal defect and explore its potential mechanism. Methods We retrospectively collected patients aged from 0 to 18 years, who underwent ventricular septal defect closure and developed secondary subaortic stenosis, and subsequently received surgical repair from 2008 to 2019 in Fuwai Hospital. Their surgical details, morphological features of the subaortic stenosis, and the follow-up information were analyzed. Results Six patients, including 2 females and 4 males, underwent the primary ventricular septal defect closure at the median age of 9 months (ranging from 1 month to 3 years). After the first surgery, patients were diagnosed with secondary subaortic stenosis after 2.9 years (ranging from 1 to 137 months). Among them, 2 patients underwent the second surgery immediately after diagnosis, and the other 4 patients waited 1.2 years (ranging from 6 to 45 months) for the second surgery. The most common type of the secondary subaortic stenosis after ventricular septal defect closure was discrete membrane, which located underneath the aortic valve and circles as a ring. In some patients, subaortic membrane grew along with the ventricular septal defect closure patch. During the median follow-up of 8.1 years (ranging from 7.3 to 8.9 years) after the sencond surgery, all patients recovered well without any recurrence of left ventricular outflow tract obstruction. Conclusion Regular and persistent follow-up after ventricular septal defect closure combining with or without other cardiac malformation is the best way to diagnose left ventricular outflow tract obstruction in an early stage and stop the progression of aortic valve regurgitation.
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Objective:To explore the application of mobile augmented reality (mAR) technology in the teaching of neuroanatomy, and to observe its effect on students' academic performance and cognitive load.Methods:By collecting and designing various neuroanatomy multimedia teaching resources (graphics, animations and videos), using augmented reality (AR) marker-based image recognition technology, the multimedia resources were placed at the tags in the traditional book pages to make the books interactive. And various multimedia resources were combined with traditional printed books through mobile devices. Forty students were randomized into the experimental group or the control group. The experimental group was taught with mAR multimedia materials, and the control group adopted traditional teaching methods. After a 6-hour course was completed, all students had a unified test, and the academic performance test and the PAAS(platform-as-a-service) cognitive load scale were used for data collection and analysis. The variance analyses (MANOVA and ANOVA) were used for significance testing.Results:One-way MANOVA test was used to determine the learning effect of mAR on academic performance and cognitive load. The results showed that there was a significant difference between the experimental group and the control group ( P<0.05). The univariate ANOVA test found that the experimental group students who learned neuroanatomy through mAR had better test scores than the control group students. In addition, compared with the control group students, the cognitive load of students in experimental group was significantly reduced, with statistical significance (all P<0.05). Conclusion:Through the teaching practice, we found that using mAR to learn neuroanatomy helps students improve their academic performance while reducing their cognitive load.
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@#Objective To explore the clinical effect of mitral valvuloplasty on children with Barlow disease combined with moderate to severe or severe mitral regurgitation. Methods The clinical data of 10 patients with Barlow disease combined with moderate to severe or severe mitral regurgitation in Fuwai Hospital from January 2014 to August 2019 were analyzed retrospectively, including 3 males and 7 females, with a mean age of 8.7±7.9 years. Echocardiography before and during the operation confirmed that the mitral valve leaflets were long and swinging, the valve leaflets and the opposite edge protruded into the left atrium and were higher than the level of the mitral valve rings, the mitral valve rings were dilated, the papillary muscles and tendons were long, and the pathological changes after the operation showed mucoid degenertion of the valve leaflets and tendons, and some fibrous foci hyperplasia. Mitral valve repair included implantation of artificial valve ring, implantation of artificial tendon, posterior leaflets sliding, partial resection of posterior leaflets (excluding sliding), valve leaflets folding, tendon folding, papillary muscle splitting and annular valve contraction (excluding artificial valve ring implantation). The technique of mitral valve repair, early clinical results and follow-up echocardiographic data were analyzed. Results All the patients successfully completed the mitral valve repair. The mean time of aortic occlusion was 73.2±17.4 min, and cardiopulmonary bypass time was 99.5±19.8 min. At the same time, 4 patients received tricuspid valve repair and 1 funnel chest correction. There was no reoperation in perioperative period. The 1-year and 5-year survival rates were 100.0% and 100.0%, respectively. The incidence of below moderate mitral regurgitation was 90.0% at postoperative 1 year and 72.0% at postoperative 5 years. Conclusion For the young children who have Barlow disease and mitral regurgitation, considering the characteristics of heavy lesions, small operation space, and the need to meet the growth and development of valve, it is suggested to adopt the surgical techniques different from those of older children, such as valve ring retraction and tendon folding, if necessary, to adopt "edge to edge" suture, which can shorten aortic occlusion time and achieve good early effects, and its long-term effects still need further follow-up observation. Mitral valvuloplasty technique for Barlow disease similar to that of adults can be used in older children, including implantation of artificial valve ring and implantation of artificial tendon, etc.
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Objective To explore changes in coagulation function,assessed by thromboelastography (TEG) combined with D-dimer (D-D),in patients undergoing percutaneous vertebroplasty(PVP)or percutaneous kyphoplasty(PKP).Methods A total of 52 elderly patients with osteoporosis-associated vertebral compression fractures admitted into our hospital from May 2016 to November were enrolled in this study,including 13 men aged 64-91 years,with a mean age of(74.3 ± 10.5) years,and 39 women aged 60-89 years,with a mean age of(71.4 ± 7.3) years.Patients received vertebroplasty under local anesthesia,with 29 patients undergoing PVP and 23 cases taking PKP.Thromboelastography(TEG)and D-dimer(D-D)levels were measured at 1 h before,0.5 h,1 h and 3 h after bone cement injections,in order to analyze changes in patients' coagulation function.Results Compared with the coagulation parameters in patients 1 h before bone cement injections,the values of R,K,Angle,Ma,CI,EPL,LY30 and D-D had no significant difference in patients 0.5 h after bone cement injections (P ＞ 0.05);the values of R,Angle,CI,EPL and LY30 were significantly different(P ＜0.05),but the values of K,Ma and D-D had no significant difference(P ＞0.05)in patients 1 h after bone cement injections;the values of R,K,Angle,Ma,CI,LY30 and D-D had no significant difference(P＞0.05),but the value of EPL was significantly different in patients 3 h after bone cement injections(P ＜0.05).Conclusions The blood is in a transient hypercoagulable state during the time of 0.5 h to 3 h after PVP or PKP,which reaches the peak at the time of 1 h after operation,thereby increasing the risk of thrombosis.Therefore,some interventions such as anticoagulants could be carried out during the preoperative and postoperative period.Changes in coagulation function should be closely monitored after operation.Patients should start postoperative exercise early.
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Medical assistance is an important part of China's foreign aid. At present, the literature about teaching and training of foreign medical assistance is not frequent to find. Cambodia is a friendly diplomatic country of China, and the Changzheng Hospital has undertaken medical assistance about 13 years. This paper summarized the medical training and teaching experience of Changzheng Hospital to Preah Ket Mealea Hospital of Cambodia, including Department of Anesthesiology, Neurosurgery, Cardiovascular Center, Radiology and so on in recent years, and found that teaching methods combining various teaching approaches, cooperating with multiple departments, teaching students in accordance with their aptitude, and having flexible time and space are more suitable for Cambodia. The experience of assisting Cambodia can be further used in other countries, and establish an improved teaching system which is suitable for their national conditions and educational systems according to different medical status of different countries.
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Objective To explore the treatment of unilateral blepharoptosis caused by oculomotor nerve paralysis with pseudo-Graefe phenomenon after craniocerebral trauma or operation.Methods Three patients suffered from blepharoptosis caused by oculomotor nerve paralysis with pseudo-Graefe phenomenon were collected in this study and the modified levator resection technique was applied to correct ptosis.The observation index after operation included the height of upper palpebral margin,the radian of double eyelid,the change of eye movement and the corresponding upper eyelid height,the eye closure function and the incidence of exposure keratitis.Results One case of oculomotor nerve palsy with moderate ptosis achieved an ideal height of upper eyelid after surgery,two cases of oculomotor nerve palsy with severe ptosis were undercorrection.All the three patients had smooth double eyelid radian,no obvious change of eye movement and corresponding upper eyelid height compared with preoperative.The two severe ptoses could close eyes well,but the moderate ptosis patient couldnot close eyes completely.Conclusions The technique of modified levator resection is an effective method to treat the moderate ptosis caused by oculomotor nerve paralysis with pseudo-Graefe phenomenon,but the results are unfavorable in the treatment of severe ptosis.
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Medical assistance is an important part of China's foreign aid. At present, the literature about teaching and training of foreign medical assistance is not frequent to find. Cambodia is a friendly diplomatic country of China, and the Changzheng Hospital has undertaken medical assistance about 13 years. This paper summarized the medical training and teaching experience of Changzheng Hospital to Preah Ket Mealea Hospital of Cambodia , including Department of Anesthesiology , Neurosurgery , Cardiovascular Center, Radiology and so on in recent years, and found that teaching methods combining various teaching approaches, cooperating with multiple departments, teaching students in accordance with their aptitude, and having flexible time and space are more suitable for Cambodia. The experience of assisting Cambodia can be further used in other countries, and establish an improved teaching system which is suitable for their national conditions and educational systems according to different medical status of different countries.
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Objective To detect the expression levels of cytokines in peripheral blood of patients with diffuse large B-cell lymphoma (DLBCL), and to explore their clinical significances. Methods The levels of interleukin-1β (IL-1β), IL-2R, IL-6, IL-8, tumor necrosis factor (TNF) and IL-10 in peripheral blood of 38 newly diagnosed patients with DLBCL and 20 healthy adults in Anqing Municipal Hospital from April 2013 to January 2017 were detected and analyzed by immunofluorescence method. Results The levels of IL-2R, IL-6, IL-8, TNF and IL-10 in DLBCL group were significantly higher than those in healthy control group (all P< 0.05). The levels of IL-2R and TNF in stage Ⅲ-Ⅳ group [(5985±26) U/ml and (42.2±5.8) pg/ml)] were higher than those in stageⅠ-Ⅱ group [(3672 ±28) U/ml and (30.4 ±2.6) pg/ml] (t values were 34.861 and 28.451; P values were 0.023 and 0.038 respectively). The levels of IL-2R and IL-10 in the high-risk group (IPI 4-5) [(6322±36) U/ml and (77±7) pg/ml] were higher than those in the low-risk group (IPI 0-1) [(2567± 32) U/ml and (50±5) pg/ml)] (t values were 58.327 and 24.264; P values were 0.001 and 0.041 respectively). IL-2R, IL-6 and IL-10 levels in patients with B symptom group [(6234±26) U/ml, (38.1±2.3) pg/ml, (90± 10) pg/ml] were higher than those in patients without B symptom group [(6234 ±26) U/ml, (38.1 ±2.3) pg/ml, (90±10) pg/ml) (t values were 32.263,24.321, 36.529; P values were 0.027, 0.043, 0.020). Conclusion The levels of IL-2R, IL-6, IL-8, TNF and IL-10 in DLBCL patients are higher than those in healthy controls, and the levels of cytokines are correlated with the clinical characteristics of DLBCL patients.
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Objective To evaluate the efficacy and safety of "outside-in" arthroscopic cam resection in the treatment of femoroacetabular impingement (FAI)syndrome.Methods Nine patients were treated with "outside-in" hip arthroscopy for cam or mixed type FAI syndrome between July 2015 and July 2016.All the 9 patients(11 hips)underwent osseous correction of the femoral neck and labral debridement.Before the surgery and 12 months after it,all patients were evaluated using the Harris Score and their complications were observed.Results The average postoperative Harris Score(92.5,range from 64 to 100)was significantly better compared with the preoperative one(56.4,range from 22 to 70,P＜ 0.001).One patient with blister on dorsal foot and another with fluid leakage were cured.No neurovascular injuries or cartilage injuries were found among all the patients.Conclusion "Outside-in" arthroscopic treatment of FAI with osseous correction and labral debridement is safe and effective.
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Objective: To summarize the early- and med-term outcomes of modified Fontan operation in patients with functional single ventricle and separate hepatic venous (SHV) drainage. Methods: A total of 39 patients with functional single ventricle and SHV drainage received modified Fontan operation in our hospital from 2009-01 to 2015-12 were retrospectively analyzed. There were 26 (66.7%) male, the average age was (6.98±3.62) years, body weight was (20.79±9.66) kg and pre-operative mean pulmonary artery pressure was (9.77±2.51) mmHg. Based on if SHV combining Apicocaval Juxtaposition (ACJ), the patients were divided into 2 groups: SHV group,n=29 and SHV+CAJ group,n=10. The early (3 months) - and med (5 years)-term post-operative outcomes were analyzed. Results: General clinical data was similar between 2 groups,P>0.05. There were 20/39 patients with one-stage operation, 19 with two-stage operation (18 after Glenn operation and 1 after B-T operation). Modified Fontan operation method was mainly used extracardiac conduit-common open technique (30 patients, 76.9%). 19 patients had CPB with aorta clamping, CPB time was 72-446 (189.74±84.96) min and aorta clamping time was 26-171 (89.05±43.96) min; the other 19 patients had CPB without aorta clamping, CPB time was 60-209 (109.99±98.86) min. 10 patients received re-surgery due to early post-operative complications. 3 patients died at early post-operation with the mortality at 7.7%. The average follow-up time was 3.9 (0.83-7.17) years, 1 patient had cardiac function at NYHA II and the others at NYHA I; the 5-year survival rate was 100%. Conclusion: The early- and med-term outcomes of modified Fontan operation were good in patients with functional single ventricle and SHV drainage. Selection of modified Fontan operation method should be based on the distance form inferior vena cava to SHV and presence of ACJ.
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BACKGROUND: Ilioinguinal approach and modified Stoppa approach are commonly used to treat pelvic and acetabular fractures, but which one is safer and more effective remains controversial, so a meta-analysis is necessary.OBJECTIVE: To compare the efficacy of modified Stoppa approach and ilioinguinal approach for pelvic and/or acetabular fractures.METHODS: A computer-based retrieval of Cochrane library, PubMed, Embase, OVID, CNKI, WanFang, CBM and VIP databases was performed for the randomized controlled trials concerning modified Stoppa approach and ilioinguinal approach for pelvic and/or acetabular fractures published before October 2016. Meta-analysis was performed on RevMan5.3 software.RESULTS AND CONCLUSION: (1) Finally 11 randomized controlled trials were enrolled, including 722 patients. (2) Meta-analysis showed that the operation time, intraoperative blood loss, length of incision, volume of drainage and hospitalization time in the modified Stoppa approach group were significantly less than those in the ilioinguinal approach group (P 0.05). (3) To conclude, modified Stoppa approach is safer and more effective for pelvic and/or acetabular fractures.
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Objective To evaluate the clinical value of fasting blood glucose (FBG) in the diagnosis of multiple organ dysfunction syndrome (MODS) caused by pulmonary infection in elderly patients with diabetes. Methods Patients over 65 years old with diabetic pulmonary infection admitted to Department of Cadres Ward of Bethune International Peace Hospital of PLA from July 2015 to December 2016 were enrolled. According to the patient's highest FBG level during pulmonary infection, all patients were divided in two groups. The cases whose FBG ≥8.83 mmol/L were served as suspicious multiple organ dysfunction syndrome in the elderly (MODSE) group, and those had FBG < 8.83 mmol/L were served as suspicious non-MODSE group. The incidence of MODSE in suspicious MODSE group and suspicious non-MODSE group was compared. The receiver operating characteristic curve (ROC) was drawn, and the clinical value of highest FBG in the diagnosis of MODSE caused by pulmonary infection in elderly patients with diabetes was assessed. Results 119 elderly patients with diabetes and pulmonary infection were enrolled in the analysis. All patients were male, with age of 76-105 years with an average of (89.41±4.16) years. Among 119 patients, 55 of them with suspected MODSE, 64 of them with suspected non-MODSE. The incidence of MODSE in suspicious MODSE group was significantly higher than that in suspicious non-MODSE group (78.2% vs. 12.5%), with statistically significant difference (χ2 = 52.108, P = 0.000). The area under the ROC curve of the highest FBG for diagnosis of MODSE was 0.895, and 95% confidence interval (95%CI) was 0.839-0.951 (P < 0.001). When using FBG ≥ 8.83 mmol/L to diagnose MODSE induced by pulmonary infection in elderly patients with diabetes, the sensitivity was 84.3% and the specificity was 82.4%. Conclusion FBG ≥ 8.83 mmol/L, as an indicator reflecting the changes of metabolic function, have a diagnostic value for MODSE caused by pulmonary infection in elderly patients with diabetes.
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Objective To explore the effect of R-(-)-α-methylhistamine (RAMH) on the isoflurane exposure induced neuronal apoptosis and memory impairment in the developing rats.Methods Twenty-eight 6-7 days SD rats were randomly divided into four groups:control (CON) group (intraperitoneal injection of 5％ glucose [0.1 mL/10 g],isoflurane (ISO) group (intraperitoneal injection of 5％ glucose [0.1 mL/10 g] and then exposure to 1.6％ ISO for 6 hours),RAMH group (intraperitoneal injection of RAMH [10 mg/kg],and RAMH+ISO group (after intraperitoneal injection of RAMH [10 mg/kg] for 30 min,then exposure to 1.6％ ISO for 6 hours).Morris water maze test was employed to investigate the learning and memory ability.Immunofluorescence and Western blotting were employed to determine the neuronal apoptosis and p53 expression in the hippocampus of rats,respectively.Results Morris water maze test showed that the time in the target quadrant of ISO group was significantly shorter than that of CON group (n =7,P＜0.01),while the time of RAMH+ISO group was significantly longer than the ISO group (n =7,P＜0.05).The number of apoptotic neurons in hippocampus in the ISO group was significantly increased compared with either the CON group or the RAMH+ISO group (n=5,both P＜0.01).Compared with the CON group,the expression of p53 protein in hippocampus was significantly increased in the ISO group (n =6,P＜0.01),while p53 expression in the RAMH+ISO group was significantly lower than that in the ISO group (n =6,P＜0.01).Conclusion RAMH can ameliorate ISO exposure induced neuronal apoptosis and memory impairment in the developing rat.
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Objective To explore the changes of vascular endothelial growth factor (VEGF) and high-sensitivity C-reactive protein (hs-CRP) levels in the patients with coronary heart disease (CHD), and its clinical significance.Methods Nighty cases with CHD in our hospital from January 2015 to February 2016 were selected as study group, while 30 cases healthy persons underwent physical examination were selected as control group, and the study group were divided into stable angina pectoris ( SAP) group, acute myocardial infarction ( AMI) group and unstable angina pectoris ( UAP) group.The serum VEGF and hs-CRP levels were detected by ELISA.Results The serum VEGF and hs-CRP levels in study group were higher than those in control group (P<0.05).The serum VEGF and hs-CRP levels in AMI group were higher than those in SAP group and UAP group, the serum VEGF and hs-CRP levels in UAP group were higher than SAP group (P<0.05).There was positive correlation between serum level of VEGF and hs-CRP(r=0.626,P<0.05).The ROC showed a higher diagnostic value of VEGF and hs-CRP on CHD.Conclusion The serum levels of VEGF and hs-CRP has a higher diagnostic value and accuracy on CHD, which could evaluate the patient’s condition and predict the progress of cardiovascular events.
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Objective To analyze the causes of poor compliance of elderly patients with diabetes mellitus , and put forward corresponding countermeasures to control blood glucose level and delay the occurrence of complications .Methods A total of 113 elderly patients with type 2 diabetes mellitus aged 60 years and over were recruited in endocrinology department of our hospital.The self-made questionnaire was used to investigate the compliance and the factors that affected the compliance.Results There were 48 patients (42.48%) with good compliance and 65 patients (57.52%) with poor compliance.Univariate analysis showed that the level of education, monthly income, drug types, understanding of diabetes-related knowledge and whether the elderly living alone affected compliance ( P<0.05 ) .Multivariate Logistic regression analysis showed that patients with low education level, poor monthly income, medication types and living alone were the main factors that influence the compliance of elderly patients with diabetes mellitus (P<0.05).And the level of education, monthly income level and the compliance of diabetic medication was positively correlated, medication types and living alone and diabetes compliance were negatively correlated (P<0.05).Conclusion The low level of education, poor monthly income, medication types and living alone are the main factors that affect the compliance of elderly patients with diabetes.The social and family support can effectively improve the compliance of elder patients with diabetes.
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Objective: To compare the effects of pericardium patch aortoplasty and pulmonary patch aortoplasty for treating the infants with aorticcoarctation (AC) combining hypoplastic aortic arch in order to provide a better surgical choice in clinical practice. Methods: A total of 57 patients with AC combining hypoplastic aortic arch treated in our hospital from 2009-01 to 2014-12 were retrospectively studied. The patients were divided into 2 groups: Pericardium patch aortoplasty group,n=26 and Pulmonary patch aortoplasty group,n=31. The changes of the pressure gradient at post-operation and follow-up period were compared. Results: There were 2/57 (3.5%) patients died, 1 in Pericardium patch aortoplasty group by pulmonary hypertension crisis, the other 1 in Pulmonary patch aortoplasty group by respiratory distress syndrome. No renal failure or neurological complication occurred in neither groups. The cardiopulmonary bypass time, aortic clamping time, ventilator time and ICU stay time were similar between 2 groups,P>0.05. Selective cerebral perfusion time in Pericardium patch aortoplasty group was shorter than Pulmonary patch aortoplasty group (30.5 ± 8.6) s vs (35.6 ± 10.3) s,P0.05. Follow-up study was conducted in 51 patients for (17.6 ± 16.6) months, Pericardium patch aortoplasty group had 6 patients with re-stenosis, 3 of them would receive balloon angioplasty and 3 would be continuously followed-up; Pulmonary patch aortoplasty group had 6 patients with re-stenosis, 2 of them ifnished balloon angioplasty and their pressure gradients were obviously decreased, 4 would be continuously followed-up. Kaplan-Meier curves presented that Pulmonary patch aortoplasty group was superior to Pericardium patch aortoplasty group in re-stenosis occurrence during follow-up period. Conclusion: Both pericardium patch aortoplasty and pulmonary patch aortoplasty were effective for treating the patients with AC combining hypoplastic aortic arch, the early post-operative efifcacy was similar, while the mid-term follow-up result was better in pulmonary patch aortoplasty.
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Objective To explore the protective effect of a small balloon on bifurcation lesions by applying a single stent treatment of coronary bifurcation lesions strategy. Methods Fifty patients with coronary bifurcation lesions were randomly divided into A group and B group( 25 cases for each group ). Patients in A group were treated with the pre-entry protection branch guide wire to complete the main branch balloon pre-dilation,stenting,while in B group were treated with the set aside the branches of a small balloon. The information of main branch balloon pre-dilation,stenting were recorded. The blood flow slowed down,the incidence of side branch occlusion or stent placement,and the incidence of postoperative 24 h troponin I( cTnI) levels were measured. Results Nine cases(36%)in A group occurred lower branch blood flow,which due to 4 cases(16% )with significantly narrow branch stenting,2 cases(8%)with complete occlusion. There were only 2 cases(8%)with decrease branching blood flow in B group,and the difference was significant(P=0. 041, 0. 022). The cases with higher cTnI after 24 h in A group were 11( 39%),significantly higher in group B (3(12 %);P =0. 027 ). Conclusion Compared with the traditional protection guidewire,the approach of setting aside a small balloon to protect important branch can effectively prevent important branch occlusion, branch involvement due to lower incidence of myocardial infarction.
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Objective To analyze the distribution and antibiotic resistance of pathogens isolated from sputum in early postoperative patients after esophageal surgery, and investigate the risk factors of pulmonary infections after esophageal carcinoma and reasonable application of antibiotics during perioperative period.Methods The clinical data of 414 patients with esophageal carcinoma who were admitted to the Affiliated Hospital of Binzhou Medical University from January 2012 to June 2014 were retrospectively analyzed.The second generation cephalosporins were used as preventive antibiotics for the 181 patients between January and December 2012 and the third generation cephalosporins were used for the 233 patients between January 2013 and June 2014.Sputum samples were collected and inspected before operation and in the first three days after operation for observing distribution and antibiotic resistance of pathogens.The incidence of postoperative pulmonary infection was observed in the two kinds of patients.The risk factors closely related to the occurrence of postoperative pulmonary infections were analyzed.Comparison of rate and univariate analysis were done by chi-square test.Multivariate analysis was done with logistic regression.Results The positive rate of early post-operative sputum culture was 24.64％ (102/414), 32.04％ (58/181) in patients receiving the second generation cephalosporins and 18.88％ (44/233) in patients receiving the third generation cephalosporins, respectively, with a significant difference between the two generations of cephalosporins (x2 =9.502, P ＜ 0.05).A total of 131 strains of pathogens were isolated from early postoperative sputum samples including 12 strains of gram-positive bacteria and 119 strains of gram-negative bacteria.The top three bacteria were Klebsiella pneumoniae subsp pneumoniae (33 trains), Acinetobacter baumannii (20 strains) and Pseudomonas aeruginosa (19 strains).The resistance rate of gram-negative bacteria in early postoperative sputum samples to meropenem, ciprofloxacin and levofloxacin were 5.0％-25.0％, 2.6％-15.2％, 2.6％-20.0％, respectively.Among cephalosporins, the resistance rate to ceftriaxone, cefotaxime, cefepime, ceftazidime, cefuroxime and cefazolin were 10.3％-20.0％ , 5.3％-30.0％ , 12.8％-31.6％, 15.4％-42.1％ , 21.2％-55.0％ and 15.2％-60.0％, respectively.The overall postoperative pulmonary infection rate was 18.60％ (77/414).The pulmonary infection rate of patients receiving the second generation cephalosporins was 26.52％ (48/181), which was higher than 12.45％ (29/233) of patients receiving the third generation cephalosporins (x2=13.326, P ＜ 0.05).The results of univariate analysis showed that smoking, chronic obstructive pulmonary disease, application of the second generation cephalosporins during the perioperative period and early postoperative sputum culture positive were correlated with the postoperative pulmonary infection after esophageal carcinoma surgery (x2 =5.149, 22.765, 13.326, 159.092, P ＜ 0.05).Multivariate statistical analysis with logistic regression demonstrated that application of the third generation cephalosporins during the perioperative period was independent protective factor of postoperative pulmonary infection (OR =2.582, 95％ confidence interval: 1.331-5.009, P ＜ 0.05).Conclusions The pathogens from sputum in early postoperative period after esophageal surgery are complicated with gram-negative bacteria as the main pathogens especially Klebsiella pneumoniae subsp, pneumoniae, and different levels of antibiotic resistance are ubiquitous.The third generation cephalosporins can effectively prevent the postoperative pulmonary infection after esophageal carcinoma surgery.
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Objetcvi e Inhibitor of growth TNG3 is a candidate tumor suppressor gene ,which belongs to the human ING gene family .It has been interested by scientist because of its putative roles as tumor suppressors . There is a low expression level of ING3 in a variety of tumors.However,the relationship of ING3 and the develop-ment of colorectal cancer is unclear yet .The aim of this studyis to examine the expression of ING 3 in colorectal cancer by qRT-PCR.Methods Statistical analysis was performed with the expression of ING 3 mRNA which has been evaluated in 82 matched samples comprising primary colorectal cancer and paired non -cancerous mu-cosa samples.Results In 51%colorectal cancer patients ,the expression level of ING3 was significantly lower in cancer tissue than that in normal tissue .The expression level of ING3 was closely related to pT、pM stage , and TNM stage(P<0.05).The Univariate analysis showed that the pT、pN、pM stage,TNMstage and ING3 expression levels were associated with disease -free survival(P<0.05).CRC patients with low -expression level of ING3 showed shorter disease -free survivals(P<0.05).Conclusion The expression of ING3 might contribute to the CRC development or progression .
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Background Poly(adenosine diphosphate-ribose) polymerase 1 (PARP-1) plays an important role in the pathogenesis of diabetic retinopathy (DR),and Notch1 signal pathway is one of the important signal transduction pathways in the organism which may antagonize retinal vascular diseases.However,if Notch1 signaling pathway is involved in pathogenesis of DR has not been confirmed yet.Objective This study was to investigate the expressions of Notch1,Dll4,PARP-1,Akt,nuclear factor-κB (NF-κB) and caspase-3 in the retina of diabetic mouse model and retinal vascular endothelial cells (RVECs) under the high glucose.Methods The expressions of Notch1,Dll4,PARP-1,Akt,NF-κB and caspase-3 in the retina of diabetic mouse models were investigated using immunochemistry and Western blot method after the diabetic mouse models were established.And these proteins were detected in retinal RVECs under the high glucose by Western blot.Results The expressions of Notch1,Dll4 and phosphorylated Akt (p-Akt) in retinas reduced significantly and simultaneously companied with increases of PARP-1 and caspase-3 in diabetic mice compared with normal mice (all at P＜0.05).However,no obvious change was found in the expression of NF-κB (P＞0.05).Expressions of Notch1 and p-Akt in RVECs increased with the increase of glucose concentration,but expressions of cleaved PARP-1 and caspase-3 decreased,especially in the 30 mmol/L group,showing significant differences in comparison with the normal control group (all at P＜0.05).But no altering of NF-κB expression was seen in the mice with diabetes mellitus.Conclusions The expressions of cleaved-PARP-1 and caspase-3 in the retinas is up-regulated,but the expressions of Notch1 and p-Akt are down-regulated in diabetic mice.