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Objective: To observe the impact of cardiac resynchronization therapy (CRT) on ventricular remodeling in patients with III°atrio-ventricular block (AVB) combining systolic dysfunction. Methods: A total of 49 III °AVB patients received CRT in our hospital from 2009-01 to 2014-10 were studied. Echocardiography was conducted at pre-operation and 6, 12 months post-operation to measure left ventricular ejection fraction (LVEF), left ventricular end-systolic volume (LVESV), left ventricular end-diastolic volume (LVEDV), left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD) and mitral regurgitation (MR) grade in order to observe the changes of cardiac structure and function in relevant patients. Results: Compared with pre-operative condition, at 6 months post-operation, LVEF was increased (4.92±5.24)%and at 12 months post-operation, it was further increased (5.02±6.52)%, both P Conclusion:CRT may reverse ventricular remodeling and improve cardiac function in patients with III°AVB combining systolic dysfunction.
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Objective: To analyze the predictors of left ventricular reverse remodeling in patients with III? atrio-ventricular block (AVB) combining left ventricular systolic dysfunction after cardiac re-synchronization therapy (CRT). Methods: A total of 65 III? AVB patients received CRT in our hospital from 2009-01 to 2015-05 were enrolled. Clinical information before and after the operation were recorded. Left ventricular reverse remodeling was deifned by left ventricular end systolic volume (LVESV) decreased 15% or left ventricular ejection fraction (LVEF) increased≥5% at 12 months after CRT. The patients were divided into 2 groups: Reversal group,n=36 and No reversal group,n=29. Clinical condition was compared between 2 groups, predictors for CRT reversing left ventricular remodeling were evaluated by two classiifcation Logistic regression analysis. Results: The patients' average age was (62±14) years and 36/65 (55.4%) with reverse remodeling. In Reversal group, the ratios of female (P=0.011), baseline QRS width>120ms (P=0.001), inter-ventricular mechanical delay (IVMD)≥40 ms (P=0.027) and standard deviation of time-to-minimum systolic volume of 16 segments [Tmsv16-SD (%R-R)≥8.3%, (P=0.001)] were higher than those in No reversal group. Two classiifcation Logisitic regression analysis indicated that female (OR=6.228, 95%CI 1.561-24.842, P=0.01), QRS duration>120 ms (OR=7.778, 95% CI 1.996-30.769,P=0.003) and Tmsv16-SD (%R-R)≥8.3% (OR=8.134, 95% CI 2.064-32.057,P=0.003) were the independent predictors for ventricular reverse remodeling . Conclusion: Female, QRS>120ms and Tmsv16-SD (%R-R)≥8.3% could be used as the predictors for CRT reversing left ventricular remodeling in III? AVB patients combining left ventricular systolic dysfunction.
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Objective To evaluate the effect of injecting botulinum toxin A (BTX-A) to the external urethral sphincter on detrusor wall thickness (DWT) and the bladder function of spinal cord injury patients with detrusor-sphincter dyssynergia (DSD).Methods Twenty-one adult patients with DSD due to spinal cord injury were recruited.A single 100 IU dose of botulinum toxin A was injected into their external urethral sphincters via an uhrasound-guided transperineal route.DWT,detrusor leak-point pressure (DLPP),post-void residual volume (PRV) and maximum bladder capacity(MBC) were assessed by urodynamic examination and ultrasound evaluation before and 4 and 8 weeks after the injection.Results Four weeks later a significant decrease in PRV was observed,but no significant difference in DWT,DLPP or MBC.After eight weeks the mean DWT value had decreased by 17％,a significant reduction.There were also significant improvements in DLPP,PRV and MBC at eight weeks compared with the of baseline values.Conclusions BTX-A injection to the external urethral sphincter can reduce DWT and improve bladder function in spinal cord injury patients with DSD.
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Objective To analyze characteristics of pathogenic microbiology and antimicrobial susceptibility of Vib-rio vulnificus (V.vulnificus)causing infection in patients at a hospital in Shantou City. Methods Four patients with V.vulnificus infection admitted to a hospital between June 2013 and June 2014 were analyzed retrospectively, blood specimens of patients were collected for culture,blister fluid and wound secretion were taken and inoculated on blood agar plates,MacConkey agar plates,and thiosulfate citrate bile salts sucrose (TCBS)plates,isolated strains were identified and performed antimicrobial susceptibility testing. Results Among 4 patients with V. vulnificus infection,3 died,1 was cured;patients developed primary septicemia and lower extremity infection be-cause of eating pickled crab,steamed scallop,or contacting with seafood products after trauma. Blister fluid from patients A and B,wound secretion from patient C,and blood from patient D were all isolated oxidase-positive gram-negative bacteria which produced green colonies on TCBS plate,these strains were identified as V.vulnificus, which were resistant or intermediate to cefazolin,intermediate to cefotetan,and 1 strain was resistant to cefepime. Conclusion Four patients infected with V.vulnificus have high mortality rate (3/4),positive rates of blister fluid and wound secretion are higher than blood;timely medical consultation,early antimicrobial therapy,and active de-bridement will help to cure the disease.
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Objective To study the cryoprecipitate effect of local external treatment of anal fistula surgical wound repair.Methods A total of 95 cases of low simple anal fistula patients was chosen, and was divided into three groups according to random number table method.The cryoprecipitate group (n =32 cases) began with cryoprecipitate dressing (2 layer) even to fill in a wound, once per day.The Kangfuxin group (n =32 cases) used Kangfuxin solution.The exposed burn ointment (MEBO) group (n =31 cases) used MEBO to cover the wound.The healing time, postoperative wound healing rate, the granulation tissue growth, new epithelial coverage, and adverse reactions were observed.Results The cryoprecipitate group in 14 d and 21 d had postoperative wound healing rate (60.97 ±4.20)％ and (97.69 ± 1.79)％ ,wound healing time (21.31 ±2.08)days;it had higher healing rate and shorter healing times compared to other two groups (P ＜0.05).Wound repaired more neatly;and 14d and 21d after the operation, wound granulation tissue growth rate [(61.06 ± 13.29) ％ and (97.63 ± 2.81) ％] and new epithelial coverage [(33.03 ±4.15)％ and (94.97 ±4.36)％] were more than the control groups (P ＜0.05) with less adverse reactions relative to control groups.Conclusions The cryoprecipitate contained in the composition has a strong biological activity.It can promote the wound tissue cell growth, and promote the wound repair.
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BACKGROUND:Procolagen type 1 N-terminal propeptide (P1NP) and β-colagen special sequence(β-CrossLaps) are two bone metabolic markers that are closely related to osteoporosis. Combined detection of bone metabolic markers and bone mineral density is of clinical significance for the diagnosis of osteoporosis. Bone metabolic markers are ideal indicators to predict fractures, which can compensate for the lack of bone density test. OBJECTIVE:To introduce the application of bone metabolic markers in the monitoring of drug efficacy on the treatment of osteoporosis as wel as in the prediction of fracture risks in recent 20 years and to explore the clinical values of P1NP and β-CrossLaps to assess the therapeutic efficacy on osteoporosis and risks for osteoporotic fractures. METHODS:A computer-based search of CNKI and SCI databases were performed for relevant articles published from 2000 to 2014 using the keywords of “serum bone metabolic markers; osteoporosis; bone mineral density” in Chinese and English, respectively. Finaly, 44 articles meeting the inclusive criteria were reviewed. RESULTS AND CONCLUSION:This paper analyzes the source and detection mechanisms of P1NPand β-CrossLaps and then compares their advantages in the therapeutic effect assessment of osteoporosis. Serum bone metabolic markers cannot only reflect the dynamic changes of bone metabolism, but also have earlier changes than the bone mineral density. Both P1NPand β-CrossLaps are very important for assessing the early diagnosis of osteoporosis as wel as anti-osteoporosis drug efficacy.
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Objective To understand the result coincidence of 4 hematology analyzers (LH780 ,LH750 ,XN-1000 ,and XS-1000i) .Methods 20 samples of routine blood test were selected and detected by different hematology analyzers whose within-run precision and between-run precision all met the requirements of WS/T 406 standard .LH750 was chose to be the reference instru-ment ,and its detection results were standard values .The relative deviations and coincidence rates of WBC ,RBC ,Hb ,HCT , PLT ,MCV ,MCH and MCHC of the other 3 hematology analyzers were calculated .The WBC and PLT coincidence results of 82 cases of low-WBC samples ,86 cases of low-PLT samples ,and 35 cases of platelet aggregation samples were investigated .Results The coincidence rates of all items were more than 90% between LH780 and LH750 .For XN-1000/XS-1000i ,the coincidence rate was 80% in HCT ,and which were less than 80% in MCV and MCHC ,and more than 85% in other items .After readjusting the calibration factors of HCT of XN-1000 and XS-1000i ,the coincidence rates of HCT ,MCV and MCHC were all increased to more than 85% .The coincidence rates of WBC and PLT were less than 70% in low-WBC samples (WBC<1 .0 × 109/L) and low-PLT samples (PLT<30 × 109/L) .The results of WBC and PLT could not reach the relative deviation standards in 35 platelet aggrega-tion samples .Conclusion The comparative tests should be carried out among different hematology analyzers in one laboratory .
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Objective To observe the effects of Dl-3-n-butylphthalide ( NBP) on the mitochondria infarction, size of myocardial infarction and myocardial apoptosis after acute myocardial ischemia in rats. Methods 92 male SD rats were divided into sham operation group (8 rats) , model group (21 rats) , and low-dose NBP group (21 rats) , medium-dose NBP group (21 rats) , high-dose NBP group (21 rats) . The model and NBP groups were made into MI model by ligation of the left anterior descending ( LAD) coronary artery, but not in sham-operated group. Model group and NBP group were taken heart specimens after coronary artery ligation. Cardiomyocyte apoptosis was ana-lyzed by TUNEL in each group. Size of MI was analyzed by TTC staining in sham-operated group, model group and high-dose NBP group. Electron perspective microscopy was applicated in observing mitochondria infarction in model group and high-dose NBP group after myocardial infarction. The expressions of Bcl-2 protein and Bax protein were detected by Western blot. Results Compared with model group, butylphthalide significantly increased expression of Bcl-2 protein ( P <0.05 ) and the ratio of Bcl-2/Bax ( P <0.05 ) , inhibited mitochondria infarction ( P <0.05 ) , reduced myocardial infarct size ( P<0.01 ) and cardiomyocyte apoptosis ( P<0.05 ) . Conclusion Bu-tylphthalide significantly inhibits myocardial infarction by increasing expression of Bcl-2 protein and the ratio of Bcl-2/Bax and decreasing mitochondria infarction, reducing myocardial infarct size and cardiomyocyte apoptosis in rats during the acute myocardial ischemia process.
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Objective To determine any relationship among detrusor wall thickness (DWT),bladder capacity (BC) and neurogenic lower urinary tract dysfunction (NLUTD),and to study the clinical implications of using DWT to predict the risk of renal injury after spinal cord injury (SCI).Methods Forty-eight adults with NLUTD due to SCI were recruited for the SCI group,and another 41 healthy adults formed a control group.Both groups underwent urodynamic evaluation and maximum bladder capacity (MBC) detection.The DWT of all subjects was measured by ultrasound imaging of the anterior bladder wall.Thereafter,the SCI group was divided into low and high risk subgroups based on the results of the urodynamic tests.Patients with detrusor leak point pressure ＜40 cmH2O were classified as low risk.Results At MBC,the average DWT in the SCI group was (0.97 ± 0.31)mm and (0.59 ± 0.08)mm in the control group,demonstrating a significant difference in DWT between patients with NLUTD and normal adults.The average DWT among the patients with type A detrusor sphincter dyssynergia was (1.10 ± 0.34)mm,which was significantly higher than among the patients with external urethral sphincter contraction without detrusor contraction (type C).DWT was significantly correlated with detrusor leak point pressure.A DWT of 0.87 mm (sensitivity 89.5％,specificity 58.6％) could be used as a critical point for predicting risk of renal injury in patients with NLUTD.Conclusions DWT is significantly greater among SCI patients with NLUTD and it correlates positively with detrusor leak point pressure.DWT could be used as a risk predictor for renal injury in patients with NLUTD due to SCI.
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Objective To investigate the effectiveness of botulinum toxin A (BTX-A) injection to the external urethral sphincter guided by ultrasound in the treatment of various types of lower urinary tract dysfunction.Methods Twenty-two patients with urinary retention caused by neurological dysfunction (neurogenic bladder) were recruited,of which 18 were men and 4 women.They had various types of lower urinary tract dysfunction including detrusor external sphincter dyssynergia (DESD) in 7,nonrelaxing urethral sphincters in 5,and detrusor underactivity in 10.BTX-A (100 U) was injected into the external urethral sphincter at three different points guided by ultrasound.Clinical effects and urodynamic parameters were compared at baseline and after treatment.Results After treatment the urinary function and urodynamic parameters in each group improved significantly compared with the baseline.Maximum efficacy was observed at the 4th week.In the DESD group,3 patients (43％) had an excellent result and 3 (43％) had significant improvement; in the nonrelaxing sphincter group 3 (60％) had excellent results and 2 (40％) showed significant improvement; in the detrusor underactivity group 5 (50％) had excellent results and 3 (30％) had significant improvement.There were no obvious side effects.Conclusions BTX-A injections guided by ultrasound can accurately locate the external urethral sphincter.It is a simple and repeatable method for the treatment of lower urinary tract dysfunction.
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Objective To observe the influence of hands-washing and non-hands-washing on clinical disinfection effect before surgical hands antisepsis.Methods Totally 40 surgcal staff wee divided into the handa-washing group and the non-hands-washing group.The sterilizing effect of handa at diggerent time points during operations and kinds of bacteria colony were compared between two groups.Results Bacteria colony of hands at different time points during operations showed no significant difference between two groups.Both groups were detected bacteris colony on their hands,mainly made up of coagulase negative staphylococcus,corynebacterium and eaterococcus and no difference was seen between two groups.Conchusions The non-hands-washing method can acquire the same disinfection effect as traditional hands-washing method.Its disinfection effect lasts three hours,easy to operate,little stimulation on the skin,and was worthy of clinical application.
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Objective To investigate the application effect of the fast-track surgery in rectal cancer surgery.Methods 90 patients wnderwent rectal cancer surgery were randomly divided into two groups,45 cases treated with conventional perioperative treatment were selected as the control group,45 cases with rapid rehabilitation of surgical techniques used in the perioperative treatment were seoected as the observation group.Results The first defecation time of the observation group (2.2 ± 0.5) d,for the first time the exhaust time was (1.5 ± 0.4) d,length of stay (6.2 ± 1.8) days,the cost of hospitalization (1.25 ± 0.21) million.The control group were (3.8 ± 0.6) d,(3.5 ±0.8) d,(9.2 ± 2.5) d,(1.98 ± 0.32) million,the difference were statistically significant (all P ＜ 0.05).1 patient (2.22％) had complications in the observation group,7 cases(15.56％) complications occurred in the control group,which was significantly higher than the observction group,the difference was statistically significant (P ＜0.05).Conclusion The rapid rehabilitation of surgical technique in rectal cancer can promote the rehabilitation of patients,reduce the incidence of complications,shorter hospital stay,lower medical costs.
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Objective To assess visibility of scleral spur in images of anterior chamber angle measured by the CAM model of Fourier optic coherence tomography (OCT). Methods Subjects aged 40 years or older were selected from outpatients in our opthalmologic clinic. All participants underwent standard ocular examinations, and anterior chamber angle was measured by CAM-L model of RTVue-OCT (Optovue Inc,USA) and gonioscopy. Visibility of scleral spur in OCT images and its related factor were analyzed. Results 98 subjects (98 eyes) aged (63.3±10.5)y included 62 females (63.3%) were selected in this study. There were 286 in 392 quadrants (73.0%) with visualized scleral spur, which had significant difference among local bulbar conjunctiva thickened or not (P＜0.01). Logistic multiple regression showed that the visibility of scleral spur was not associated with gender, age, gonioscope grades (P＞0.05), but significant associated with local bulbar conjunctiva thickened (OR＝0.113, P＜0.01) and quadrants (OR of superior/temporal＝0.210, OR of inferior/temporal＝0.340, P＜0.01), of which there were different scleral spur visibility in superior and inferior quadrants compared with temporal(OR＝0.210, 0.340, P＜0.01). Angle status was still identified in 80.2% quadrants on condition that scleral spur was not visualized. Conclusions Fourier optic coherence tomography has good feasibility to detect anterior chamber angle as an alternative method, and may supply helpful information to estimate the pathogenesis of angle closure glaucoma.
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Objective To study the effects of motor imagery therapy combined with electromyographic (EMG) biofeedback on upper limb function in hemiplegic patients.Methods Sixty hemiplegic stroke patients were recruited and divided into a control group (n=20),an electrical stimulation group (n=20) and a combination group (n=20).All groups received basic medication and routine rehabilitation training once daily for 4 weeks.The electrical stimulation group was also treated with EMG biofeedback,and the combination group with motor imagery therapy plus EMG biofeedback.The Fugl-Meyer assessment (FMA),the modified Barthel index (MBI) and EMG parameters were assessed before and after 2 courses of treatment.Results After 8 weeks of treatment all groups had significantly higher FMA scores and MBI scores,and better integrated EMG values,but the effects in the combination group were significantly better than those in the other two groups.Conclusions Motor imagery therapy combined with EMG biofeedback can more effectively promote recovery of upper limb function in hemiplegic stroke patients.
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Objective To investigate the extended-spectrum beta-lactamases ( ESBLs) producing clinical isolates of gram negative bacilli and their antibiotic resistance in Shantou and to provide suggestions on empirical treatment against the bacteria.Methods A total of 1 445 strains of gram negative bacilli (895 strains of Escherichia coli and 550 strains of Klebsiella pneumonia) were collected and examined for the production of ESBLs and antibacterial susceptibility test by Vitek-2.Results There were 69.4% of escherichia coli and 33.6% of klebsiella pneumonia producing ESBLs.The resistance rate of the ESBLs-producing strains to penicillins,cephalosporins and monocyclic beta-lactam antibiotics were very high.The ESBLs-producing strains were multidrug resistant and the resistance rates were higher than that of the non-ESBLs-producing strains.Both ESBLs-producing and non-ESBLs-producing strains were susceptible to Imipenem.Conclusion The incidence of ESBLs-producing strains was high in gram negative bacilli in Shantou.The resistance rates of the ESBLs-producing strains were higher than that of the non-ESBLs-producing strains and they expressed multiple drug resistance phenotypes.Imipenem was the best drug in the treatment of infections caused by ESBLs-producing strains.
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Objective To explore diagnosis capability of macular ganglion cell complex (mGCC)and peripapillary retinal nerve fiber layer(pRNFL) thickness for glancoma. Methods Adult outpatients received ocular regular examinations of glaucoma in our hospital were enrolled in this study. Parameters of pRNFL and mGCC measured by Fourier optic coherence tomography(OCT) were evaluated. Results 116 subjects ( 116 eyes) included 51 (44. 0% ) normal subjects, 30(30. 2% ) early glaucoma patients and 35 (25.9%) advanced glaucoma patients. There were significantly different pRNFL and mGCC thickness among the three groups ( F = 83.022,97. 361,27. 899,79. 585,140. 686,119. 166,116. 234, 90. 855,64. 341,133.064, P ＜0. 0l ). Area under Receive Operated Curve (AROC) of all pRNFL parameters in early glaucoma except nasal ( P ＞ 0. 05 ) and mGCC parameters had significantly diagnostic capability ( Need to be corrected by authors) ( pRNFL:0. 796 ±0. 049;mGCC:0. 748 ±0. 055, P ＜0. 05). As to the whole glaucoma, AROC of pRNFL and mGCC parameters had significantly diagnostic capability ( pRNFL:0. 889 ±0. 029; mGCC: 0. 862 ±0. 034, P ＜0. 01 ). Through AROC pairwise comparisons, the diagnosticpower of almost pRNFL and mGCC parameters had no difference ( P ＞ 0. 05) except that temporal, superior pRNFL thickness were significant higher than focal loss of volume (FLV) of mGCC ( P ＜ 0. 05 ). Conclusion The measurement of pRNFL thickness might still be used as a main method on diagnosis of glaucoma and mGCC could serve as a new beneficial complement tool for detection of glaucoma.
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Objective To investigate the effects of Shen-fu injection on pulmonary contusion rabbits. Meth-ods Sixteen rabbits were randomly divided into 2 groups: the treatment group (Shen-fu group) and the control group. The animals were induced the pulmonary contusion models. After 60min, the animals in Shen-fu group re-ceived Shen-fu injection received 5 ml/kg, and those in control group 5 ml/kg LRS. The animals were killed six hours later, the right lung tissue wet-to-dry (W/D) ratio and myeloperoxidase (MPO) activity were obtained,the pro-tein expression of nuclear factor-kappa B (NF-κB) and intercellular adhesion molecule-1 (ICAM-1) were also detec-ted. Results The lung tissue W/D, MPO, and the protein expression of NF-κB and ICAM-1 were decreased evi-dently in Shen-fu group (P<0. 01). The morphologic and ultrastructural damages in Shen-fu group were milder than in control group. Conclusion Shen-fu injection is effective on pulmonary contusion rabbits.
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Background Isoliensinine(IL) is a kind monomer alkaloid of double benzyl group quinoline separated from Plumula nelumbinis,which has been speculated to have antiarrhythmic effect,Ca~(2+) and?1-receptor blockade, and reversal the left ventricular hypertrophy(LVH).It has been reported the activity of Sarco/Endoplasmic reticulum Ca~(2+)-ATP_(ase)(SERCA) in essential hypertention(EH)/LVH patients was lower than that of healthy people. Objective To investigate the effects of Isoliensinine on left ventricular hypertrophy and activity of SERCA in 2 kidney 1 clamp(2K1C) hypertensive rats.Methods 2K1C hypertensive rats were randomly received Isoliensinine (RHR-IL,5 mg/kg per day p.o,n=16) or placebo.Blood pressure,left ventricle mass index(LVMI) and the activity of myocardial SERCA were measured after 10 weeks treatment.Six untreated SD rats were served as control. Results Isoliensinine decreased BP and LV/BM ratio(IL:136.4?14.6 vs control:189.8?4.4 mm Hg,P
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Objective The trial was designed to observe the hemodynamic circadian rhythm in serious heart failure.Methods Totally 140 cases were assigned into the trial;120 cases of serious heart failure were into the heart failure group and 20 cases without heart failure into the control group.Heart rate(HR) and stroke volume(SV)were measured per hour during hospitalization.Results Circadian rhythm existed in two groups,but the heart rates were faster and the stroke stroke volumes lower in the heart failure group.As a whole,the HR and SV were positively correlative in two groups.But the cures of heart rate and stroke volume were separate between 1:00~4:00 before dawn in the heart failure group.The heart rate descended,while stroke volume rose.Conclusion There is divergence phenomenon between heart rate and stroke volume before dawn in serious heart failure.
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OBJECTIVE To explore the factors and effective preventive method of nosocomial lower respiratory(infection) after general anesthesia through trachea intubation.METHODS Using bacterial culture and identification technique to detect the samples collected from pipe and the sides of anesthetic machine,from disposable virus/(bacteri)a respiratory filter and buccal and bronchial secretion of patients with general anesthesia through trachea(intubation.) RESULTS Eight of 15 anesthetic machines without disinfection were with positive bacterial culture.All sides of virus/bacteria respiratory filter,and buccal and bronchial secretion of patients during operation had same(bacteria.) No bacteria growth was found in anesthetic machine and disposable virus/bacteria respiratory filter used after operation.The same bacteria as from buccal secretion were isolated from anesthetic machine in patients(without) using virus/bacteris respiratory filter.CONCLUSIONS The(results) showed the anesthetic machine is more easy to be contaminated by patients,and the reuse of anesthetic machine is an important factor for nosocomial(lower) respiratory infection after general anesthesia through trachea intubation.Intensifying periodic disinfection of(anesthetic) machine and using virus/bacteria respiratory filter can prevent contamination between anesthetic(machine) and patients and decrease nosocomial lower respiratory(infection) after operation.