A case of autologous pericardium patch in treatment of aortoesophageal fistula / 中南大学学报(医学版)

Aortoesophageal fistula (AEF) is a rare but fatal complication caused by foreign body ingestion. Aortic replacement and endovascular stent graft are the common repair surgeries. The materials to repair an aortic defect in AEF are typically homograft or allograft, but the use of an autologous pericardium patch is rarely reported. Here we reported a patient with AEF and severe mediastinal infection induced by chicken bone ingestion. In this case, the autologous pericardium patch was used as the repair material.

Effect of T4 thoracoscopic sympathectomy on plantar hyperhidrosis in patients with primary palmoplantar hyperhidrosis / 中南大学学报(医学版)

OBJECTIVE@#To evaluate the effect of video-assisted thoracoscopic sympathectomy at the T4 level on plantar hyperhidrosis in the treatment of palmoplantar hyperhidrosis.
@*METHODS@#The clinical data of 28 patients with primary palmoplantar hyperhidrosis, who were admited in our hospital from June 2009 to May 2014, was analyzed. All patients were qualified to bilateral thoracoscopic transaction of the sympathetic chain at the thoracic level T4. Patients completed a self-administered hyperhidrosis questionnaire and scoring before and after procedure. Follow-up data were obtained at 1 and 6 months after the surgery.
@*RESULTS@#Endoscopic thoracic sympathectomy at the thoracic level T4 was performed successfully for all cases. Palmar hyperhidrosis was completely alleviated after the operation and no recurrence was observed during follow-up. The ratio for initial improvement of plantar hyperhidrosis was 28.6% (8/28) at 1 month after the surgery followed by a recurrence of plantar hyperhidrosis. No case continued to show the improvement of palmoplantar hyperhidrosis at 6 months after the sympathectomy. Twenty-seven patients (96.4%) were very satisfied with the outcome of the operation, 1 patient (3.6%) satisfied and no patient regretted the surgical procedure.
@*CONCLUSION@#T4 thoracoscopic sympathectomy could initialliy alleviate plantar hyperhidrosis in some patients with palmoplantar hyperhidrosis, but the improvement was not sustained over a long period. It could not be used to treat plantar hyperhidrosis.

Effect of T4 endoscopic thoracic sympathicotomy on life quality in patients with primary palmar hyperhidrosis / 中南大学学报(医学版)

OBJECTIVE@#To assess the quality of life in patients with primary palmar hyperhidrosis before and after T4 endoscopic thoracic sympathicotomy (ETS) using the modified rating scales system for life quality.
@*METHODS@#Between June, 2009 and May, 2014, forty-eight patients with primary palmar hyperhidrosis received ETS at the thoracic level T4. Patients completed self assessment of life quality by the modified rating scales system before and after the surgery. Follow-up data including effectiveness of operation, patient satisfaction and life quality were obtained at 1 and 6 months after the surgery.
@*RESULTS@#ETS at the thoracic level T4 was performed successfully for all cases. No mortality or serious complications were observed. No one needed thoracotomy in the period of surgery. Mild or moderate compensatory sweating was appeared in 38 cases (79.1%) or 1 case (2.1%), respectively. None severe case was observed after T4 ETS. About 97.9% of the patients were very satisfied with the result of the operation and no patient regretted the surgical procedure. All patients answered the quality of life (QoL) questionnaire and showed the improvement of QoL after the procedure (F=763.67, P<0.001).
@*CONCLUSION@#Primary palmar hyperhidrosis led to the reduction of life quality. ETS at T4 level could reduce sweating production and improve QoL in patients with primary palmar hyperhidrosis.

Experimental study on novel hybrid artificial trachea transplantation / 生物医学工程学杂志

We developed and designed a new type of artificial trachea. The basic structure of the artificial trachea was polytetrafluoroethylene vascular prosthesis linked with titanium rings on both sides. Dualmesh was sutured on titanium rings. This experimentation follows the replacement of trachea in dogs with a combined artificial trachea to investigate the feasibility of this type of prosthesis. Sixteen dogs were implanted with the combined artificial trachea after resection of 5 cm of cervical trachea. The 5 cm-long trachea of dogs on the necks were resected and the reconstruction of the defect of the trachea was performed with trachea prosthesis. According to the method of trachea reconstruction, the models were divided into 2 groups, artificial trachea implantation group (the control group, n = 8) and group of artificial trachea implantation with growth factor (the experimental group, n = 8). Then computer tomography scan (CT), bronchoscope and pathologic examination were conducted periodically to observe the healing state of the hybrid artificial trachea. None of the dogs died during operation of cervical segmental trachea construction. But four dogs in the control group died of apnea in succession because artificial trachea was displaced and the lumen was obstructed, while 2 dogs died in the experimental group. In the first month there was granulation around anastomosis with slight stenosis. The rest of dogs were well alive until they were sacrificed 14 months later. The mean survival time of the experimental group was longer than that of the control group. The rate of infection, anastomotic dehiscence, severe stenosis and accidental death in the experimental group were lower than the control group (P < 0.05). Artificial trachea was encapsulated by fibrous tissue and no mucous membrane was seen in the lumen of the artificial trachea. The artificial trachea can be used to reconstruction of the defect of the trachea with long-term survival of the animals. The unique design of artificial trachea reduces stenosis around anastomosis effectively but infections and split or displacement of the artificial trachea are still major problems affecting long-term survival of the animals. Application of growth factors to a certain extent promotes tissue healing by changing the local environment.

Clinical analysis of modified technique for pectus bar removal after Nuss procedure / 中南大学学报(医学版)

OBJECTIVE@#To evaluate the safety and efficacy of modified technique for removing Nuss bar after Nuss procedure.@*METHODS@#We reviewed 186 patients undergoing bar removal after repair of pectus excavatum with Nuss procedure at our institution from December 2008 to February 2012. All patients had unilateral incision (metallic stabilizers have been used on one side in all patients). Under general anesthesia with single lumen tracheal tube or laryngeal mask, with the patient lying down in supine position, the bar was pulled out along the thoracic wall without overturning or straightening.@*RESULTS@#Totally 132 patients (71.0%) had the bar removed 2 years after the Nuss procedure, 1 (0.5%) removed within 1 year and 53 (28.5%) removed over 2 and half years. The operation time for bar removal was 9-20 (13.1 ± 3.4) min, and the operative blood loss was 3-20 (5.2 ± 2.7) mL. There was no hemorrhage. Three patients (1.6%) developed mild pneumothorax and none showed infection of incision after the operation. All patients were discharged 1 day after the surgery and followed up for 4-48 (21.4 ± 6.8) months. Recurrence was found in the one who which had the bar removed within 1 year (0.5%).@*CONCLUSION@#With modified procedures, Nuss bar can be easily and safely removed 2 years or longer after the Nuss operation. After removing the metallic stabilizer, the bar should be turned and then pulled out along the original surgical incision without bending or turning.

Non-thoracoscopic and thoracoscopic modified Nuss procedure for correction of pectus excavatum / 中南大学学报(医学版)

Objective:To summarize the curative effect, safety and experience of non-thoracoscopic modiifed Nuss procedure for correction of pectus excavatum (PE). Methods:From January 2007 to December 2011, 267 cases of PE patients were selected in our hospital. Among them 85 were treated by thoracoscopic minimally invasive modified Nuss Procedure and 182 by non-thoracoscopic procedure. The operation time, blood loss during operation, length of postoperative hospital stay and effect of treatment were compared retrospectively. Results:All the 267 patients finished the repair procedure smoothly. The non-thoracoscopic group had advantage in terms of operative time (22.5 min vs 35.1 min, P0.05). hTere were no deaths. Conclusion:Non-thoracoscopic minimally invasive modified Nuss procedure is as safe and effective as thoracoscopic Nuss procedure. With advantages of simpliifed operation procedure and shorter operation time, it is easier in practice.

Video-assisted thoracoscopic sympathictomy plus bypass fiber resection for patients with primary palmar hyperhidrosis / 中南大学学报(医学版)

OBJECTIVE@#To evaluate the efficiency of video-assisted thoracoscopic surgery for primary palm hyperhidrosis by T4 sympathicotomy plus bypass fiber resection, and to describe our experience regarding the prevention of related postoperative complications.@*METHODS@#Clinical data for 32 cases of primary palmar hyperhidrosis in patients who underwent bilateral video-assisted thoracoscopic sympathictomy plus bypass fiber resection from October 2008 to June 2011 were analyzed retrospectively.@*RESULTS@#The operation was performed successfully on all patients, and their palmar hyperhidrosis was completely alleviated after operation. No severe, surgery-related, postoperative complications occurred.@*CONCLUSION@#Video-assisted thoracoscopic sympathictomy is an effective, safe and minimally invasive procedure for primary palmar hyperhidrosis.

Determination of Sodium Content in Danshen Injection by Atomic Absorption Spectroscopy / 中国中医药信息杂志

Objective To determine the total sodium in Danshen for injection.Methods Flame atomic absorption spectroscopy was used to determine the total sodium in Danshen for injection.Results The calibration curves were linear in the range of 0.5～10 mg/L for sodium chloride.The average recovery rates of sodium chloride were 101.8%,RSD=1.60%.Conclusion This method was found to be simple,quick and accurate for simultaneous determination of sodium in Danshen for injection.

Augmentation of Neovascularization by Implantation of Autologous Bone Marrow Mononuclear Cells in a Rat Ischemic Limb Model / 中国医师杂志

Objective To investigate the effect of autologous bone marrow mononuclear cells (BM-MNCs) implantation on neovascularization in rat model of hind limb ischemia, and explore its mechanism. Methods Rat BM-MNCs were isolated from tibia and femur using density gradient centrifugation. A rat model of ischemic hind limb was made by the ligation of the right femoral artery and its branches in imbred Wistar rats. BM-MNCs were injected into 7 points of the ischemic muscles (20?l/point). The levels of VEGF, bFGF and IL-1? in the ischemic musles at the third, 7th and 14th days after ligation were measured by ELISA. Micro-vessel density (MVD) in the ischemic mulsles was evaluated at the second and 4th weeks after ligation. Results The levels of bFGF and IL-1? in the implantation group were significantly higher than those in the control group. The MVD of ischemic mulsles in the implantation group was also significantly higher than that in the control group at the second and 4th weeks after treatment. Conclusion The implantation of autologous BM-MNCs could induce neovascularization in a rat ischemic hind limb, and bFGF and IL-1? secreted by BM-MNCs might play a role in the neovascularization.

Postoperative Psychosis Following Open-Heart Surgery / 中国医师杂志

Objective To study the etiology, pathogenesis, prophylaxis and management measures for psychosis after open-heart surgery.Methods Four thousand one hundred and six cases of patients with open-heart surgery were observed. The patients with psychosis complications were diagnosed and treated by psychiatrist.Results Thirty-eight cases of the patients had psychosis complications,the incidence of which was 0 93%. Most of the patients with postcardiotomy psychosis were adults. The symptoms of postcardiotomy psychosis were manic state, compression state, schizophrenia-like state and neurosis reaction. The prognosis of the patients was good.Conclusion Postcardiotomy psychosis may be viewed as having a multivariant etiology encompassing physiologic factors, environmental factors and psychological factors. Comprehensive prevention measures should be taken.

Nuss procedure by Video-assisted thoracoscopy for the correction of recurred pectus excavatum / 重庆医科大学学报

Objective:To investigate the short-term effects of minimally invasive repair of recurred pectus excavatum.Methods:Eight patients were all treated with Nuss procedure,which were performed under general anesthesia with endotracheal intubation.A transverse incision was made in each lateral chest wall and a steel bar was passed under the sternum from the right thoracic cavity under thoracoscope,then the bar was turned over to raise the sternum to the normal position.The bar was fixed to ribs by using one stabilizing bar.Results:Eight cases all got the successful operation.The operation time ranged from 30 to 70 min(average 45 min) and the post-operative hospital stay ranged from 5 to 7 days.The post-operative pain were less than 3 days and without pneumothorax and subcutaneous emphysema.No unilateral stabilizing bar displacement and incision infection were found.Conclusion:The Nuss procedure is safe and effective for the correction of recurred pectus excavatum with good short-term results.