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1.
Article in Chinese | WPRIM | ID: wpr-912313

ABSTRACT

Objective:To evaluate the clinical effect of the pulmonary rehabilitation system based on the concept of prehabilitation for patients after cardiac surgery to wean tube and avoid related complications.Methods:From January 2018 to December 2019 in a single-center(third-class hospital in cardiac surgery intensive care unit), all adult patients hospitalized for 7 days before open-heart surgery were included. They were randomly divided into pulmonary rehabilitation group(198 cases) and control group(234 cases). To compare and analyze the clinical effects, the main observations were observed including overall outcome indicators(such as early extubation rate, ICU stay, hospitalization costs, advanced oxygen therapy support after extubation) and lung outcome related indicators(such as the occurrence of pulmonary complications, chest drainage, secondary intubation, tracheotomy, lung infection and chest tube drainage).Results:There was no statistical difference between groups in basic conditions and surgical conditions. The lung rehabilitation group significantly increased the rate of early extubation, reduced the number of advanced oxygen therapy after weaning, shortened the length of ICU stay, saved hospitalization cost, significantly reduced the occurrence of postoperative respiratory complications and improved postoperative respiratory function( P<0.05). Conclusion:During cardiac perioperation, pulmonary rehabilitation significantly can increase the rate of early extubation , shorten the length of mechanical ventilation, reduce the occurrence of secondary tracheal intubation and pulmonary complications. And it can also effectively promote the recovery of lung function and the overall recovery.

2.
Article in Chinese | WPRIM | ID: wpr-911692

ABSTRACT

Objective:To explore whether hypoxia-inducible factor prolyl hydroxylase inhibitor (HIF-PHI) preconditioning can relieve inflammation, reduce cell apoptosis and alleviate renal ischemia-reperfusion injury in mice.Methods:Male C57BL/6 mice were randomly divided into three groups of sham operation (sham), ischemia reperfusion injury (IRI) and IRI+ HIF-PHI ( n=6 each). In IRI+ HIF-PHI group, mice received an intragastric dose of roxadustat (20 mg/kg) every other day one week before. After renal IRI modeling, serum creatinine (SCr) level was monitored and hematoxylin-eosin (HE) staining employed for observing the pathological changes of renal tissue and scoring injury degree. Apoptosis of renal tubular epithelial cells was assessed by terminal-deoxynucleoitidyl transferase mediated nick end labeling (TUNEL). Reverse transcription-polymerase chain reaction (RT-PCR) was utilized for detecting the mRNA expressions of HIF-1α, TNF-α and IL-1β in renal tissues. Immunofluorescence and immunohistochemistry were employed for detecting the expressions of hypoxia-inducing factor 1α (HIF-1α), inflammatory cytokines tumor necrosis factor α (TNF-α) and interleukin 1β (IL-1β). Results:As compared with IRI group, SCr level declined markedly in IRI+ HIF-PHI group ( P<0.01), renal tissue injury improved markedly, semi-quantitative score of renal tubule injury dropped ( P<0.01), apoptotic cells decreased ( P<0.01) and the expression levels of TNF-α and IL-1β declined ( P<0.05). Compared with sham group, the mRNA expression of HIF-1α was not significantly elevated in IRI group ( P>0.05). Immunofluorescence showed that the expression of HIF-1α in medulla of renal tissues was up-regulated in IRI group, but not markedly in cortex. While the mRNA expression of HIF-1α was markedly up-regulated after a pretreatment of HIF-PHI ( P<0.05), the expression spiked markedly in renal cortex, but was weaker in medulla than that in IRI group. Conclusions:HIF-PHI can boost the expression level of HIF-1α, reduce the expression of inflammatory factors, relieve the inflammatory response, reduce cell apoptosis, improve renal function and alleviate renal ischemia reperfusion injury.

3.
Article in Chinese | WPRIM | ID: wpr-911649

ABSTRACT

Objective:To evaluate the effect of unilateral pediatric kidney donation for adult kidney transplantation.Methods:Retrospective analysis was conducted on the cases of children who donated unilateral donor kidney for adult kidney transplantation recipients in our hospital, and those who were followed up for more than three years were included in this study. The body weight of the recipients in group A was ≤50 kg, and the body weight of the recipients in group B was ≤70 kg.The recipients were divided into 0-5 year old donor group (group A) and 6-17 year old donor group (B group). Clinical data, recipient/kidney survival, graft function and growth, and complications of the recipient were analyzed.Results:A total of 45 adult recipients were enrolled, including 12 in group A and 33 in group B. The renal survival rate at 3 years after operation was (100%, 96.9%)/(91.6%, 93.9%). One week after the operation, the early postoperative recovery of renal function in group B was better than that in group A, and the difference of serum creatinine was statistically significant ( P<0.05), while the difference of serum creatinine in other postoperative follow-up time points was not statistically significant ( P>0.05). Within a year, both groups of grafts continued to grow, reaching adult levels in one year. There was no statistical significance in the incidence of complications between the two groups ( P>0.05). The incidence of protein in the two groups was 33.3% and 6.1%, respectively, 1 case in each group still had proteinuria at 1 year after surgery, and only 1 case in the infant donor kidney recipient in group A had proteinuria at 3 years after surgery. Conclusions:Unilateral donor kidney transplantation from children can provide good results for adult patients with uremia by selecting suitable donors according to the weight of the recipient.

4.
Article in Chinese | WPRIM | ID: wpr-908025

ABSTRACT

Objective:To retrospectively analyze clinical data of infant donors with body weight ≤15 kg into children recipients, and to investigate the efficacy and complications under the strategy of pediatric donor to pediatric recipient (PTP) of pediatric kidney transplantation allocation.Methods:Clinical data of kidney transplantation for children with infant donors performed in the First Affiliated Hospital of Zhengzhou University from August 2010 to December 2019 were collected.Clinical data of donors and recipients, postoperative adverse events, postoperative renal recovery, and human and renal survival were analyzed.Results:A total of 50 infant donors and 93 pediatric recipients were enrolled in this study.Recipients included 89 patients with single kidney transplantation (SKT) and 4 with en-bloc kidney transplantation (EBKT). The major perioperative complications were delayed graft function (DGF) (5 cases, 5.4%) and vascular thrombosis (VT) (3 cases, 3.2%), followed by recurrence of primary nephropathy (3 cases, 3.2%), respiratory tract infection (3 cases, 3.2%), and acute rejection (AR) (2 cases, 2.2%). During the follow-up period, the main cause of death was respiratory tract infection (4 cases, 4.3%). Except for the cause of death, the main causes of graft loss were rejection (2 cases, 2.2%) and recurrence of primary kidney disease (2 cases, 2.2%). Serum creatinine decreased progressively from (824.77±150.24) μmol/L preoperatively to (90.73±47.24) μmol/L 1 month postoperatively.In SKT group, the median follow-up time was 31 months (3-74 months), and the survival rates of recipients and transplanted kidneys at 1, 3 and 5 years postoperatively were 97.5%/94.2%, 96%/88.8% and 93.1%/86.1%, respectively.In EBKT group, the median follow-up time was 50 months (13-65 months), and the survival rates of recipients and transplanted kidneys at 1, 3 and 5 years postoperatively were all 100.0%.During the fo-llow-up period, there was no significant difference in the human/kidney survival rate between groups (all P>0.05), and well acceptable transplantation outcomes were obtained. Conclusions:Single/double kidney transplantation for children and adolescent recipients from infant donors in the First Affiliated Hospital of Zhengzhou University has achieved acceptable outcomes.Adopted by the PTP strategy, the incidence of complications after kidney transplantation does not increase, indicating its safety and reliability.

5.
Article in Chinese | WPRIM | ID: wpr-885816

ABSTRACT

Objective:To summarize acute type A aortic dissection(ATAAD) is relatively uncommon in dialysis patients, and repair outcomes are not fully understood.Methods:Between January 2014 and March 2020, 20 patients with ATAAD required dialysis for preoperative end-stage renal disease(ESRD) were treated by our group. There were 11 male and 9 female patients at mean age of(47.8±11.3) years. The mean duration of dialysis therapy in the total 20 patients before the onset of ATAAD was(4.5±3.9 )years, with 90%(18 cases) of these patients undergoing hemodialysis(rather than peritoneal dialysis). 17 patients were treated emergency surgically, surgical operation were performed under deep hypothermic circulatory arrest and perfused the cerebral selective cerebral perfusion, 5 cases with ascending aorta + arch fenestrated stent, 5 cases with ascending aorta+ hemi-arch replacement(2 cases with stent elephant trunk), 4 cases with ascending aorta+ arch replacement+ stent elephant trunk(1 case with coronary artery bypass grafting for left anterior descending coronary artery), 2 cases with aortic valvuloplasty + ascending aorta+ hemi-arch replacement, 1 case with Bentall+ arch fenestrated stent.Results:2 patients were died from aortic ruptured before operation, 1 patient treated medically was alive three months after admission. Cross-clamp, cardiopulmonary bypass, and circulatory arrest times of all the surgical patients were(233.8±84.4) min, (155.5±63.6)min and(28.2±10.8)min, respectively. The following complications occurred postoperative: 3 cases died in the hospital, 1 case of tracheotomy, 2 cases of cerebral infarction, 1 case of cerebral hemorrhage, 1 case of transient paraplegia, and 1 case of surgical site infection. After a mean follow-up of(11.6±14.5) months(rang, 3-61 months). the overall survival rate at 1 year and 5 years was 53% and 27% respectively.Conclusion:Dialysis patients with ATAAD should be operated on urgently and medical treatment carries high risks of aortic rupture, although in-hospital mortality is acceptable, long-term mortality is poor.

6.
Chinese Journal of Urology ; (12): 370-374, 2021.
Article in Chinese | WPRIM | ID: wpr-885024

ABSTRACT

Objective:To compare the efficacy of single kidney transplantation for children from pediatric donors between body weight ≤15 kg and >15 kg.Methods:A retrospective review in 156 children with single donor kidney transplantation from August 2010 to December 2019 in the Kidney Transplantation Department of the First Affiliated Hospital of Zhengzhou University was conducted. The patients were classified into the small kidney group (pediatric donor body weight ≤15 kg) and the big kidney group (pediatric donor body weight >15 kg). In this study, 89 cases were concluded in the small kidney group and 67 cases were concluded in the big kidney group. The donor kidneys were obtained from 46 cases of small weight (≤15 kg) pediatric donors and 48 cases of large weight (>15 kg) pediatric donors. There were significant differences in age [1.00 (0.02 - 4.00) years vs. 10.00 (3.00-18.00) years], body weight [10.0 (3.4 - 15.0) kg vs. 35.0 (16.2- 35.0) kg], height [76 (50- 113) cm vs. 144 (67-172) cm], GFR [(31.50±7.46)ml/min vs. (36.79±7.00) ml/min], and renal length to diameter [(5.91±0.48) cm vs. (8.71±1.88) cm] between the small kidney group and the big kidney group ( P < 0.01). There was no significant difference between the two groups of donors in gender, cold/warm ischemia time and cause of death ( P>0.05). There were significant differences in age [(11.28±3.89) years vs. (13.86±3.56) years], body weight [(31.83±10.45)kg vs. (35.13±9.15) kg], and height [(130.02±28.56) cm vs. (143.97±16.59) cm] between recipients of the small kidney group and big kidney group ( P < 0.05). While there were no significant differences in preoperative serum creatinine level [(822.65 ± 135.04) μmol/L vs. (777.31 ± 165.40) μmol/L], HLA mismatch [(3.4 ± 1.4) site vs. (3.2±1.3) site], and primary disease between the two groups ( P > 0.05). The recovery of renal function, postoperative adverse events, postoperative children, and graft survival were compared between the two groups. Results:The renal function of the two groups of recipients returned to normal 3 months after operation. The perioperative complications in the small kidney group and the big kidney group mainly included renal delayed recovery [5.6% (5/89) vs. 7.5% (5/67), P=0.89], renal vascular embolization [3.4% (3/89) vs. 0, P=0.35], and acute rejection [2.2% (2/89) vs. 4.3% (3/67) , P=0.75]. The main cause of recipient death during the follow-up period was pulmonary infection [4.5% (4/89) vs. 6.0% (4/67) , P=0.68]. The postoperative small kidney group was followed up for an average of 30 (3-74) months. The survival rates of children in the small kidney group at the 1, 3 and 5 years after surgery were 96.6% (86/89), 91.0% (81/89) and 91.0%(81/89), while the transplanted renal survival rates were 92.1% (82/89), 86.5% (77/89) and 84.2% (75/89), respectively. The postoperative big kidney group was followed up for an average of 32 (4-89 ) months. The survival rates of children in the big kidney group were 95.5% (64/67), 94.0% (63/67) and 91.0%(61/67) in the first 1, 3 and 5 years postoperatively, while the graft survival rates were 92.5% (62/67), 83.6% (56/67) and 83.6% (56/67), respectively. The postoperative kidneys of two groups were fast-growing, and there was no significant difference between the small kidney group and the big kidney group in graft length to diameter [(9.63±0.31) cm vs. (9.75±0.71) cm] after 1 year ( P>0.05). Conclusions:The effect of single pediatric kidney transplantation for pediatric donor with body weight ≤15 kg is equivalent to that for pediatric donor with body weight >15 kg , which can be carried out clinically.

7.
Article in Chinese | WPRIM | ID: wpr-883259

ABSTRACT

In recent years, many researchs have found that microRNA (miRNAs) has differential expression in pancreatic tissues, pancreatic cancer cells and drug-resistant pancreatic cancer cells, and miRNAs can change the sensitivity of pancreatic cancer cells to chemotherapy drugs by acting on downstream target genes.The molecular mechanism of drug resistance in tumors is complex. In the drug-resistance of pancreatic cancer, miRNAs can mediate drug resistance in pancreatic cancer cells by affecting epithelial-mesenchymal transformation, DNA damage and repair, downstream signaling pathways, non-coding RNA, related coding genes, pancreatic cancer stem cells and other mechanisms. Therefore, the investigation of drug resistance mechanism and related miRNAs in pancreatic cancer will help to find new anti-drug resistance treatment methods. The authors summarize exosome miRNAs invloved in regulating chemoresistance in pancreatic cancer, in order to provide theoretical support for clinical treatment and find new targeted therapy of pancreatic cancer.

8.
Article in Chinese | WPRIM | ID: wpr-880460

ABSTRACT

In neurosurgery, skull repair caused by surgical approach is one of the important research contents. In this paper, a rapid reconstruction method of the skull defect with optical navigation system is proposed. This method can automatically reconstruct the structure of skull defect with the intraoperative defect edge points and preoperative medical image data. The head model experiment was used to evaluate the effect of the method, the average error of the reconstruction of the defect in the right orbit was 0.424 mm, while the average error of the reconstruction of the defect in the posterior skull base was 0.377 mm. The experimental results show that the structure of the defect is consistent with the actual defect, and the reconstruction accuracy satisfies the clinical requirements in neurosurgery.


Subject(s)
Craniotomy , Surgery, Computer-Assisted
9.
Chinese Journal of Nephrology ; (12): 675-679, 2020.
Article in Chinese | WPRIM | ID: wpr-871001

ABSTRACT

Objective:To investigate the efficiency and safety of peritoneal dialysis (PD) in pediatric patients with acute kidney injury (AKI).Method:A retrospective study of children who underwent PD for AKI in the First Affiliated Hospital of Xi’an Jiaotong University from 2003 to 2013 was performed, and the laboratory examinations, the causes, the complication, the prognosis and the risk factors were evaluated.Results:The study included 48 children, with the age of (67.6±51.7) months (ranging from 3 months to 15 years old), including 31 males (64.6%) and 34 co-infections (70.8%). Primary glomerulonephritis (27.1%) was the most common cause of AKI, followed by the hemolytic uremic syndrome (18.7%) and drug induced AKI (18.7%). Peritoneal dialysis was performed manually using percutaneous or adapted catheters. The duration of PD during hospitalization was 11(7,14) days. PD treatment was highly effective in attenuation of toxics retention and correction of electrolyte disturbances (all P<0.05). There were 3 cases of PD-related complications, including 1 case of peritonitis, 1 case of catheter outflow obstruction, 1 case of catheter exit site hematoma, and no child patient died of PD complications. Among the AKI children, 37 cases (77.1%) recovered with the PD treatment and had the catheter successfully removed till discharge, 7 cases (14.6%) needed further peritoneal dialysis and 4 cases (8.3%) died. The serum albumin level was significantly higher in patients who got recovered with PD treatment than other unrecovered cases [(32.6±6.7) g/L vs (23.2±4.3) g/L, t=-3.994, P<0.001]. Conclusions:PD can be safely and efficiently performed for the treatment of pediatric AKI. Low albumin level may be related to poor prognosis of AKI.

10.
Article in Chinese | WPRIM | ID: wpr-870550

ABSTRACT

Objective:To explore the efficacies of single-center pediatric transplantations and discuss the current problems.Methods:From July 2007 to September 2019, the clinical data of 202 children (aged ≤17 years) undergoing renal transplantation were reviewed. And their perioperative complications, transplantation outcomes and patient/kidney survival were analyzed.Results:The most common perioperative complication was delayed graft function (DGF)( n=24, 11.9%), recurrence of renopathy ( n=8, 4.0%) and acute rejection ( n=21, 10.4%). The major causes of death and graft failure were lung infection ( n=9, 4.5%) and rejection ( n=11, 5.4%). Perioperative serum creatinine decreased progressively from (816.1±303.1) μmol/L preoperatively to (62.7±20.6) μmol/L at Month 3 post-operation. The value of eGFR were (166.8±37.3), (135.1±29.0) and (109.9±31.1) ml/(min·1.73 m 2) at Year 1/3/5 post-operation respectively. The survival rates were 96.7%, 96.3%, 94.1%, 93.5%, 94.1% and 90.7% at Year 1/3/5 post-operation respectively. No difference existed in human/kidney survival rate between LD and DD groups at Year 1/3/5 post-operation ( P>0.05) and transplantation outcomes were excellent. Conclusions:Effective and successful outcomes have been achieved at our center. And further optimizations are required for resolving various problems.

11.
Article in Chinese | WPRIM | ID: wpr-799092

ABSTRACT

Objective@#To prepare a novel magnetic heating phasetransition nanoparticle contrast agent (PFH-HIONS), and to study its performance on enhancing photoacoustic imaging, magnetic resonance imaging and ultrasound imaging after phasetransition by magnetic-thermo in vitro.@*Methods@#Firstly, the superparamagnetic nano hollow iron spheres (HIONS) were prepared by a one-pot solvothermal method, and then the phasetransition liquid perfluorocarbon (PFH) was loaded on the HIONS by vacuum adsorption to obtain PFH-HIONS. After characterization of the nanoparticles, photoacoustic imaging, magnetic resonance imaging and ultrasound imaging after phasetransition with magnetic-thermo were performed in vitro, and the results were analyzed by a software.@*Results@#PFH-HIONS was successfully prepared with uniform particle size of (537.3±24.8)nm. PFH-HIONS could apparently enhance photoacoustic imaging and magnetic resonance imaging in vitro. In an alternating magnetic field, it could significantly increase the temperature, which promotes phasetransion of the PFH to produce microbubbles, thereby enhancing ultrasound imaging. Furthermore, as the concentration increased, the imaging intensity was enhanced, and the differences in imaging intensity between different concentration groups were statistically significant (P<0.05).@*Conclusions@#The PFH-HIONS can enhance the multimodal imaging including ultrasound, photoacoustic and magnetic resonance, and it also has obvious magnetic heating performance. It provides a new and efficient research platform for theranostics based on molecular imaging, therefore it has promising application prospects.

12.
Chinese Journal of Orthopaedics ; (12): 445-452, 2020.
Article in Chinese | WPRIM | ID: wpr-868991

ABSTRACT

Distal femoral fracture is one of the difficult fractures to treat due to the complex types and varies complications after operation. The concept about closed reduction to deal with fracture has been accepted widely with the innovation of surgical technology and internal fixation. Some tissue, including joint capsule, ligaments, muscles and tendons, surround femoral condyle, which indicates they may tract the fractured bone to deformity. In addition, the difficulty of reduction during operation may be increased with combined other injuries. At present, the idea of using different methods to reduce the re-injury before the closed reduction of distal femoral fracture has been recognized and popularized. A kind of appropriate reduction and internal fixation can not only reduce the difficulty of operation but also shorten the operation duration and reduce the incidence of postoperative complications. In addition to the common reduction method of manual reduction, plate can not only be taken as internal fixation, but also achieve reduction reviewing literatures about the methods of reduction in recent years. However, it is not suitable for some complex fractures. The traction table is not widely used at present due to varies complications. Distractors like AO distractor or other kinds of femoral distractors can achieve reduction by providing reverse force. However, it should be noticed that some risk factors such as vascular and nerve injury can occur during the surgery. The present study summarized different ways that were adopted during the closed reduction and internal fixation of distal femoral fractures. The appropriate method chose by surgeons to improve the efficiency and reduce risks should be used based on the need of surgery.

13.
Article in Chinese | WPRIM | ID: wpr-868049

ABSTRACT

Objective:To evaluate the right ventricular(RV) function by two-dimensional speckle tracking echocardiography(2D-STE) in heart failure patients with different left ventricle diastolic dysfunction grade.Methods:Twenty-nine healthy volunteers(control group), sixteen heart failure patients with reduced ejection fraction(HFrEF group) and eighty-six heart failure patients with preserved ejection fraction(HFpEF group) were enrolled in the Second Affiliated Hospital of Chongqing Medical University from October 2018 to September 2019. HFpEF patients were further divided into four subgroups according to recommendations of the American Society of Echocardiography in 2016: normal left ventricular diastolic function group and left ventricular diastolic dysfunction groups with grade 1, 2, 3 (LVDD1, LVDD2, LVDD3). Conventional ultrasonic parameters were obtained in apical four-chamber images, including RV basal diameter(RVD1), RV middle diameter(RVD2) and RV longitudinal diameter(RVD3), RV end diastolic area(EDA), end systolic area(ESA) and fractional area change(FAC), peak systolic velocity(S′), myocardial performance index(MPI), tricuspid annular plane systolic excursion(TAPSE). 2D-STE was performed to observe strain parameters, including basal, middle, apical and the whole longitudinal peak systolic strain of RV free wall respectively (RVLSbas, RVLSmid, RVLSapi and RVLSfw). Then 2D strain parameters were compared among these groups, and the correlation between 2D strain parameters and conventional ultrasonic parameters were analyzed.Results:①TAPSE and S′ gradually decreased in normal group, HFpEF group and HFrEF group(all P<0.05). For the four subgroups of HFpEF, compared to LVDD3, TAPSE、S′ increased significantly in normal group, LVDD1 and LVDD2(all P<0.05). ②RVLSbas, RVLSmid, RVLSfw gradually increased in control group, HFpEF group and HFrEF group(all P<0.05). The same trend appeared in group LVDD1, LVDD2 and LVDD3(all P<0.05). ③In control group, HFpEF group and HFrEF group, RVLSfw showed strong correlation with LVEF( r=0.77, P<0.01) and middle correlation with age, TAPSE, and S′( r=0.41, -0.48, -0.40, P<0.01). In the subgroups of HFpEF, RVLSfw had middle correlation with LV diastolic function( r=0.59, P<0.01), and weak correlation with age( r=0.21, P<0.01), and the same correlations with B-type natriuretic peptide(BNP), FAC, TAPSE( r=0.28, -0.29, -0.29; all P<0.01). Conclusions:2D-STE can detect the early subtle impairment of RV systolic function in HFpEF patients.

14.
Article in Chinese | WPRIM | ID: wpr-867977

ABSTRACT

Objective:To prepare a novel magnetic heating phasetransition nanoparticle contrast agent (PFH-HIONS), and to study its performance on enhancing photoacoustic imaging, magnetic resonance imaging and ultrasound imaging after phasetransition by magnetic-thermo in vitro. Methods:Firstly, the superparamagnetic nano hollow iron spheres (HIONS) were prepared by a one-pot solvothermal method, and then the phasetransition liquid perfluorocarbon (PFH) was loaded on the HIONS by vacuum adsorption to obtain PFH-HIONS. After characterization of the nanoparticles, photoacoustic imaging, magnetic resonance imaging and ultrasound imaging after phasetransition with magnetic-thermo were performed in vitro, and the results were analyzed by a software.Results:PFH-HIONS was successfully prepared with uniform particle size of (537.3±24.8)nm. PFH-HIONS could apparently enhance photoacoustic imaging and magnetic resonance imaging in vitro. In an alternating magnetic field, it could significantly increase the temperature, which promotes phasetransion of the PFH to produce microbubbles, thereby enhancing ultrasound imaging. Furthermore, as the concentration increased, the imaging intensity was enhanced, and the differences in imaging intensity between different concentration groups were statistically significant ( P<0.05). Conclusions:The PFH-HIONS can enhance the multimodal imaging including ultrasound, photoacoustic and magnetic resonance, and it also has obvious magnetic heating performance. It provides a new and efficient research platform for theranostics based on molecular imaging, therefore it has promising application prospects.

15.
Article in Chinese | WPRIM | ID: wpr-755643

ABSTRACT

Objective To evaluate the value of bedside lung ultrasound for diagnosis of acute re-spiratory distress syndrome ( ARDS) and for assessment of the severity. Methods Fifty patients of both se-xes suspected of having ARDS ( oxygenation index<300 mmHg) and required lung CT tests and Pulse Indi-cator Continuous Cardiac Output because of their condition, aged 18-80 yr, were selected. At 24 h after entering ICU, chest CT, lung ultrasound and arterial blood gas analysis were performed to record Extravas-cular Lung Water Index ( EVLWI) and the number of B lines, and lung injury ultrasound score and oxygen-ation index were calculated. The patients diagnosed with ARDS by chest CT and lung ultrasound were divid-ed into 3 groups: mild group ( 200 mmHg<oxygenation index≤300 mmHg) , moderate group ( 100 mmHg<oxygenation index≤200 mmHg) and severe group ( oxygenation index≤100 mmHg) . Kappa consistency a-nalysis was used to assess the consistency between lung ultrasound and chest CT in diagnosis of ARDS. The receiver operating characteristic curves of th number of B lines, EVLWI and lung injury ultrasound score in assessing the severity of ARDS were drawn, and the area under the curve and 95% confidence interval ( CI) , critical value, sensitivity and specificity were calculated. Results Forty-six patients were diag-nosed as having ARDS by both chest CT and lung ultrasound. There was good consistency ( Kappa value 0. 648, P<0. 01) between chest CT and lung ultrasound in diagnosis of ARDS. There was good consistency ( Kappa value 0. 788, P<0. 01) between lung ultrasound and chest CT in diagnosis of pulmonary consolida-tion. Lung ultrasound and chest CT were in good agreement ( Kappa value 0. 825, P<0. 01) with each oth-er in diagnosis of pulmonary consolidation in the posterior region. Compared with mild group, the lung inju-ry ultrasound score was significantly increased, and the number of B lines was increased in moderate group, and the lung injury ultrasound score and EVLWI were significantly increased, and the number of B lines was increased in severe group ( P<0. 05) . Compared with moderate group, the lung injury ultrasound score and EVLWI were significantly increased, and the number of B lines was increased in severe group ( P<0. 05) . The area under the curve ( 95% CI ) of the number of B lines in diagnosing severe ARDS was 0. 915 ( 0. 905-0. 935 ) , and the critical value, sensitivity and specificity were 15. 5, 78. 9% and 85. 2%, respectively. The area under the curve ( 95% CI) of lung injury ultrasound score in diagnosing severe ARDS was 0. 856 (0. 833-0. 878), and the critical value, sensitivity and specificity were 25. 5, 73. 7% and 82. 5%, respectively. The area under the curve (95% CI) of EVLWI in diagnosing severe ARDS was 0. 907 ( 0. 888-0. 933) , and the critical value, sensitivity and specificity were 15. 5, 73. 7%and 92. 6%, respectively. Conclusion Lung ultrasound can be used for diagnosis of ARDS and for evalu-ation of the severity of ARDS.

16.
Article in Chinese | WPRIM | ID: wpr-734410

ABSTRACT

Objective To investigate the effect of periosteum deficiency on the treatment of segmental bone defect of lower extremity by Ilizarov bone transport Technique.Methods From April 2009 to April 2016,data of 54 cases with lower limb segmental bone defect who were treated by Ilizarov bone transport technique were retrospectively analyzed.According to intraoperative observation of the distribution of periosteum at the osteotomy site,all cases were divided into two groups.There were 10 cases in absent periosteum group,including 6 males and 4 females,aged from 23 to 57 years old (mean,38.20±9.90 years old).There were 3 cases locating at femur,and 7 cases at tibia.4 cases had non-infective bone defect,while the other 6 had infective bone defect.Segmental bone defect ranged from 4.0 to 14.0 cm (mean,6.85±2.87 cm).There were 44 cases in normal periosteum group,including 32 males and 12 females,aged from 22 to 65 years old (mean,38.90±10.10 years old).There were 9 cases locating at femur and 35 cases at tibia.12 cases had non-infective bone defect,while 32 cases had infective bone defect.Segmental bone defect ranged from 4.0 to 9.0 cm (mean,6.09±1.54 cm).Visual analogue scale (VAS) was used to estimate the pain during bone transport.The distraction index,bone healing index,external fixator index was collected to evaluate the distraction osteogenesis and mineralization.The Paley method was utilized to appraisal the function of proximal joints in bone transport.Results All the 54 cases were followed up for 24-48 months,with an average of 28.50±5.70 months.All skin and soft tissue defects were satisfied healed.All limbs were restored to their original lengths,and bone healing was eventually achieved.There were no statistically significant differences in the distraction index,bone healing index,external fixator index,VAS between absent periosteum group (12.29± 1.04 d/cm,39.00±3.96 d/cm,51.25±3.69 d/cm,3.30± 1.77 score) and normal periosteum group (11.67±0.96 d/cm,38.07±4.22 d/cm,49.74±4.25 d/cm,3.36± 1.66 score)(P > 0.05).Paley adjacent joint function evaluation showed no statistically difference between absent periosteum group [good rate 100%(10/10)] and normal periosteum group [good rate 97.7% (43/44)] (P=0.901).The overall incidence of complications was 20.0% (2/10) in the absence of periosteum group,with 1 case of mild infection and 1 cases of tissue contracture incarcerated at the docking site.The overall incidence of complications was 27.3% (12/44) in the normal of periosteum group,with 2 cases of mild infection,3 cases of poor limb strength alignment,6 cases of tissue contracture incarcerated at the docking site and 1 case of severe foot drop deformity.There was no statistically significant difference in the overall incidence of complications between the two groups (P=0.636).Conclusion The absence of periosteum at the epiphyseal osteotomy site hasno significant effect on Ilizarov bone transport technique in the treatment of segmental bone defects of lower limbs in bone regeneration and healing,mineralization and bone remodeling,and does not increase the incidence of complications.

17.
Article in Chinese | WPRIM | ID: wpr-800790

ABSTRACT

Objective@#To investigate the clinical efficacy of minimally invasive plate oseoynthesis (MIPO) assisted by a self-designed lower limb axial tractor in the treatment of complex tibial plateau fractures.@*Methods@#The data were retrospectively analyzed of the 31 patients who had undergone surgical treatment for complex tibial plateau fractures from June 2015 to April 2018 at Department of Orthopeadics, Hospital Affiliated to Binzhou Medical College. MIPO was conducted with the assistance of the axial tractor in 17 of them. They were 12 men and 5 women with an age of 50.8±14.7 years, with 8 cases of Schatzker type Ⅴ and 9 ones of Schatzker type Ⅵ. MIPO was conducted without the assistance of the axial tractor but with the assistance of manipulation reduction in the other 14 patients. They were 9 men and 5 women with an age of 48.9±9.5 years, with 6 cases of Schatzker type Ⅴ and 8 ones of Schatzker type Ⅵ. The 2 groups were compared in terms of operation time, intraoperative bleeding, and Rasmussen scores for knee function and medial angle of the proximal tibia at the last follow-up.@*Results@#The 2 groups were comparable due to insignificant differences in the preoperative general data between them (P>0.05). The tractor and manipulation groups were followed up for a mean of 9.8 months and 10.9 months respectively. Bone healing was achieved in all patients. For the tractor and manipulation groups, respectively, the operation time was127.8±40.8 min and 174.1±66.8 min, and the intraoperative bleeding 115.6±41.7 mL and 184.3±91.4 mL, showing significant differences between them (P<0.05). In the tractor group at the last follow-up, the knee flexion was 126.1°±9.3°, the medial angle of the proximal tibial 87.8°±1.4°, the posterior inclination angle 8.7°±3.8° and the Rasmussen score 26.5±2.9 points; in the manipulation group at the final follow-up, the knee flexion was 124.7°±8.9°, the medial angle of the proximal tibial 86.9°±2.1°, the posterior inclination angle 9.8°±4.1° and the Rasmussen score 25.6±3.2 points. There were no significant differences between the 2 groups in the above items (P>0.05). Loss of force line was observed in none of the patients at the last follow-up.@*Conclusion@#Compared with conventional manipulation reduction, use of our self-designed lower limb axial tractor can shorten operation time, reduce bleeding and facilitate reduction of fracture fragments in the treatment of tibial plateau fractures of Schatzker types Ⅴ and Ⅵ.

18.
Article in Chinese | WPRIM | ID: wpr-796531

ABSTRACT

Objective@#To explore the evaluations and recipient selection methods of extended criteria donor (ECD) kidney donation in the death of citizens and analyze the transplantation outcomes.@*Methods@#From January to September 2019, the clinical data of donor-recipients were retrospectively studied. The recipients of ECD donor kidneys not evaluated for kidney zero puncture assessment from January 2014 to July 2016 were group A1 and those receiving standard donor kidney (SCD) belonged to group A2. From August 2016 to March 2019, all DCD donors were routinely evaluated for kidney zero puncture and those receiving ECD recipients fell into Group B1 and those receiving SCD belonged to Group B2. Analysis was performed for ECD/SCD donor renal zero puncture pathological features and lesion degree and utilization of ECD donor kidney; donor-recipient body surface area (BSA) ratio and lesion degree of ECD donor kidney on recipient selecting and matching. Serum creatinine value, perioperative adverse events and 1-year follow-up of human/kidney survival rate in each group were compared at 1 day, 1 week, 1 month, 3 months, 6 months and 1 year.@*Results@#A total of 108, 264, 306 and 416 recipients were recruited into A1, A2, B1 and B2 groups respectively. The ECD donor renal utilization rate was 88.5% vs 93.3% during two time periods. According to the 2016 Banff standard, glomerular sclerosis (GS), renal interstitial fibrosis (Ci) and intimal fibrosis thickening (Cv), small arterial intimal hyalinization (ah), tubular atrophy (ct) and acute tubular injury (ati) accounted for more than B1 group than B2 group (P<0.05). The severity of ECD donor kidney disease, BSA ratio <1.1 group and ≥1.1 group 1 week, 1 month, 3 months postoperative blood creatinine value was lower than the former while declining amplitude of blood creatinine was higher. A significant difference existed in the degree of moderate lesions in donor kidney (P<0.05). After 1 year, serum creatinine value of B1 group was lower than that of A1 group (P<0.05).@*Conclusions@#The quality of ECD donor kidney is obviously inferior to that of SCD donor kidney. The Banff donor kidney criterion is an effective mode of evaluating the quality of ECD donor kidney. Based upon the extent of Banff's nephropathy, the ratio of donor/recipient BSA is an important selecting method for ECD donors to receive kidneys and recipients, ultimately improving graft utilization and recipient transplantation.

19.
Article in Chinese | WPRIM | ID: wpr-791856

ABSTRACT

Objective To explore the evaluations and recipient selection methods of extended criteria donor (ECD) kidney donation in the death of citizens and analyze the transplantation outcomes .Methods From January to September 2019 ,the clinical data of donor-recipients were retrospectively studied .The recipients of ECD donor kidneys not evaluated for kidney zero puncture assessment from January 2014 to July 2016 were group A1 and those receiving standard donor kidney (SCD) belonged to group A2 .From August 2016 to March 2019 ,all DCD donors were routinely evaluated for kidney zero puncture and those receiving ECD recipients fell into Group B1 and those receiving SCD belonged to Group B2 .Analysis was performed for ECD/SCD donor renal zero puncture pathological features and lesion degree and utilization of ECD donor kidney ;donor-recipient body surface area (BSA ) ratio and lesion degree of ECD donor kidney on recipient selecting and matching . Serum creatinine value ,perioperative adverse events and 1-year follow-up of human/kidney survival rate in each group were compared at 1 day ,1 week ,1 month ,3 months ,6 months and 1 year .Results A total of 108 , 264 ,306 and 416 recipients were recruited into A1 ,A2 ,B1 and B2 groups respectively .The ECD donor renal utilization rate was 88 .5% vs 93 .3% during two time periods . According to the 2016 Banff standard , glomerular sclerosis (GS) ,renal interstitial fibrosis (Ci) and intimal fibrosis thickening (Cv ) ,small arterial intimal hyalinization (ah) ,tubular atrophy (ct) and acute tubular injury (ati) accounted for more than B1 group than B2 group (P<0 .05) .The severity of ECD donor kidney disease ,BSA ratio <1 .1 group and ≥1 .1 group 1 week ,1 month ,3 months postoperative blood creatinine value was lower than the former while declining amplitude of blood creatinine was higher .A significant difference existed in the degree of moderate lesions in donor kidney (P<0 .05) .After 1 year ,serum creatinine value of B1 group was lower than that of A1 group (P<0 .05) .Conclusions The quality of ECD donor kidney is obviously inferior to that of SCD donor kidney . The Banff donor kidney criterion is an effective mode of evaluating the quality of ECD donor kidney .Based upon the extent of Banff's nephropathy ,the ratio of donor/recipient BSA is an important selecting method for ECD donors to receive kidneys and recipients ,ultimately improving graft utilization and recipient transplantation .

20.
Article in Chinese | WPRIM | ID: wpr-824405

ABSTRACT

Objective To investigate the clinical efficacy of minimally invasive plate oseoynthesis (MIPO) assisted by a self-designed lower limb axial tractor in the treatment of complex tibial plateau fractures.Methods The data were retrospectively analyzed of the 31 patients who had undergone surgical treatment for complex tibial plateau fractures from June 2015 to April 2018 at Department of Orthopeadics,Hospital Affiliated to Binzhou Medical College.MIPO was conducted with the assistance of the axial tractor in 17 of them.They were 12 men and 5 women with an age of 50.8 ± 14.7 years,with 8 cases of Schatzker type Ⅴ and 9 ones of Schatzker type Ⅵ.MIPO was conducted without the assistance of the axial tractor but with the assistance of manipulation reduction in the other 14 patients.They were 9 men and 5 women with an age of 48.9 ± 9.5 years,with 6 cases of Schatzker type Ⅴ and 8 ones of Schatzker type Ⅵ.The 2 groups were compared in terms of operation time,intraoperative bleeding,and Rasmussen scores for knee function and medial angle of the proximal tibia at the last follow-up.Results The 2 groups were comparable due to insignificant differences in the preoperative general data between them (P > 0.05).The tractor and manipulation groups were followed up for a mean of 9.8 months and 10.9 months respectively.Bone healing was achieved in all patients.For the tractor and manipulation groups,respectively,the operation time was 127.8 ±40.8 min and 174.1 ±66.8 min,and the intraoperative bleeding 115.6 ±41.7 mL and 184.3 ± 91.4 mL,showing significant differences between them (P < 0.05).In the tractor group at the last follow-up,the knee flexion was 126.1°± 9.3°,the medial angle of the proximal tibial 87.8°± 1.4°,the posterior inclination angle 8.7° ± 3.8° and the Rasmussen score 26.5 ± 2.9 points;in the manipulation group at the final follow-up,the knee flexion was 124.7° ± 8.9°,the medial angle of the proximal tibial 86.9° ± 2.1°,the posterior inclination angle 9.8° ±4.1° and the Rasmussen score 25.6 ± 3.2 points.There were no significant differences between the 2 groups in the above items (P > 0.05).Loss of force line was observed in none of the patients at the last follow-up.Conclusion Compared with conventional manipulation reduction,use of our self-designed lower limb axial tractor can shorten operation time,reduce bleeding and facilitate reduction of fracture fragments in the treatment of tibial plateau fractures of Schatzker types Ⅴ and Ⅵ.

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