RESUMO
@#Objective To explore growth pattern of neo-aortic root as well as development of neo-aortic regurgitation after arterial switch operation (ASO) for Taussig-Bing anomaly. Methods From 2002 to 2017, the patients who received ASO, and were discharged alive from Shanghai Children’s Medical Center and followed up for more than 3 years were retrospectively involved in this study. Results A total of 127 patients were enrolled. There were 98 (77.2%) males, the median age at ASO was 73.0 d and the average weight was 4.7 kg. Forty-five (35.4%) children were complicated with mild or mild-to-moderate pulmonary insufficiency (PI) before ASO. The average follow-up time was 7.0 years. During the follow-up, 14 (11.0%) children presented moderate or greater neo-aortic regurgitation (neo-AR). The diameter of neo-aortic annulus and sinus of Valsalva was beyond normal range during the entire follow-up. The average diameter of neo-aortic annulus was 18.0 mm at 5 years and 20.5 mm at 10 years. The average diameter of sinus of Valsalva was 25.9 mm at 5 years and 31.1 mm at 10 years. Neo-AR continued to develop over time. The diameter of children who developed moderate or greater neo-AR was constantly larger than that of children who did not (χ2=18.3, P<0.001). Preoperative mild or mild-to-moderate PI was an independent risk factor for the development of moderate or greater neo-AR during mid-to-long term follow-up (c-HR=3.46, P=0.03). Conclusion The diameters of neo-aortic annulus and sinus of Valsalva of Taussig-Bing children who receive ASO repair continue to expand without normalization. The dilation of annulus correlates with the development of neo-AR. PI before ASO repair increases the risk of neo-AR development.
RESUMO
The latest epidemiological data suggests that the situation of adult diabetes in China is severe, and metabolic diseases have become significant chronic illnesses that have a serious impact on public health and social development. After more than six years of practice, the National Metabolic Management Center(MMC) has developed distinctive approaches to manage metabolic patients and has achieved a series of positive outcomes, continuously advancing the standardized diagnosis and treatment model. In order to further improve the efficiency, based on the first edition, the second edition guideline was composed by incorporating experience of the past six years in conjunction with the latest international and domestic guidelines.
RESUMO
@#Objective To explore the effect of LeCompte maneuver on in-hospital mortality and mid-to-long term reintervention after single-stage arterial switch operation in children with side-by-side Taussig-Bing anomaly. Methods Clinical data of patients diagnosed with side-by-side Taussig-Bing anomaly and undergoing single-stage arterial switch operation in Shanghai Children’s Medical Center from 2006 to 2017 were retrospectively analyzed. Patients were divided into two groups based on whether LeCompte maneuver was performed: a LeCompte maneuver group and a non LeCompte maneuver group. The clinical data of two groups were compared. Results Finally 92 patients were collected. LeCompte maneuver was performed in 32 out of 92 patients with a median age of 65.0 days and an average weight of 4.3 kg, among whom 24 (75.0%) were male. Fifteen (46.9%) patients received concomitant aortic arch repair while 12 (37.5%) patients were associated with coronary artery malformation. LeCompte maneuver was not performed in 60 patients with a median age of 81.0 days and an average weight of 4.8 kg, among whom 45 (75.0%) were male. Twenty-two (36.7%) patients received concomitant aortic arch repair while 35 (58.3%) patients were associated with coronary artery malformation. The average cardiopulmonary bypass duration of the LeCompte maneuver group showed no statistical difference from the non LeCompte maneuver group (179.0±60.0 min vs. 203.0±74.0 min, P=0.093). The in-hospital mortality of the two groups were 6 (18.8%) and 7 (11.7%), respectively, which also showed no statistical difference (P=0.364). The median follow-up period was 4.1 (1.6, 7.5) years for 79 patients with 8 lost to follow-up, and no death was observed. Kaplan-Meier curve and log-rank test showed no statistical difference in overall mid-to-long term reintervention rate (P=0.850) as well as right ventricular outflow tract and pulmonary artery reintervention rate (P=0.240) with or without LeCompte maneuver. Conclusion Whether or not to perform LeCompte maneuver shows no statistical impact on in-hospital mortality and mid-to-long term reintervention rate of single-stage arterial switch operation for side-by-side Taussig-Bing anomaly.
RESUMO
Objective:To compare the diagnostic value of conventional fine needle aspiration biopsy(C-FNAB) and Ultrasound-guided FNAB(USFNAB) for thyroid nodules by Meta-analysis.Methods: PubMed and CNKI database were searched for English and Chinese language articles related to FNAB diagnosis for thyroid nodules.The literatures were assessed and screened according to the Standards for Reporting of Diagnostic Accuracy(STARD).Data were pooled by Metadisc software.Results: A total of 8 810 specimens were included in conventional FANA group and the pooled sensitivity,specificity,and the AUC of weighted summary receiver operating characteristic(SROC) curve were 84.9%,76.3% and 0.919 4,respectively;2 393 specimens were included in US-FNAB group and the above numbers were 84.0%,80.8% and 0.935 6,respectively.Conclusion: FNAB has high accuracy in diagnosing thyroid nodules;the accuracy of ultrasound-guided FNAB is higher than conventional FNAB.
RESUMO
Objective: To examine whether the progression of early diabetic renal disease with normotension can be slowed by ACE inhibitors(ACEI). Methods: MEDLINE and Chinese Biological Medicine Disk were searched for randomized controlled trials about the effect of ACE inhibitors on patients with normotensive early diabetic renal disease from January, 1990 to April, 1999. According to included criteria, 10 studies were chosen at last.Data were combined by RevMan 3.1 software. Results: The pooled effect sizes of urinary microalbuminuria excretion rate, systolic blood pressure, diastolic blood pressure and mean arterial blood pressure were -77.502 mg/24 h[-100.748,-54.256], -5.002 mmHg [-9.630, -0.685 ], -2.949 mmHg[-4.005, -1.892], -4.284 mmHg[-5.444, -3.123] respectively. Regarded progression to clinical albuminuria as end point,the pooled OR(odds ratio) was 0.27[0.18,0.40]. The sub category analysis showed no differences between type 1 and type 2 diabetes.There were no significant correlations between the pooled effect of urinary microalbuminuria excretion rate and systolic blood pressure, diastolic blood pressure or mean arterial blood pressure. Conclusion: ACE inhibitors can decline urinary microalbuminuria excretion rate in patients with normotensive early diabetic renal disease and delay the progression of early diabetic renal disease to clinical albuminuria, and the effects may not depend on its blood pressure reduction effect. [
RESUMO
The specific binding capacity of androgen receptor (AR)and estrogen receptor (ER)in the peripheral lymphocytes was estimated by radioligand binding assay in 130 diabetic patients (type Ⅰ 18 cases and type Ⅱ 112 cases). Results were as follows:1)plasma estradiol (E2) of diabetic patients was significantly lower than that of the controls (P
RESUMO
The effects of cyclosporine A (CsA) on glucose metabolism and betancell functions in vivo in rats were investigated. CsA (20mg/kg, 2/d) was given to Spraguer-Dawley rats for 14d. After a 1.5g/kg body weight glucose load by gavage the plasma glucose at 1 h and the area under curve (AUC) of plasma glucose were higher in the CsA-treated group than in the control (P
RESUMO
Objective:To compare efficacy and time course of adrenocortical function recovery of oral prednisone and intrathyroidal injection of dexamethasone in patients with subacute thyroiditis. Methods: Sixty patients with subacute thyroiditis were divided randomly into 2 groups. Patients in group Dex (30 cases) were treated with intrathyroidal injection of dexamethasone (5 mg,twice per week,and then once per week.). Patients in group Pre (30 cases) were treated with prednisone. Prednisone was orally given in decreasing doses: 30 mg for the first 2 weeks, 20 mg for 2 weeks, thereafter the dose was tapered by 5 mg per week. Clinical outcomes of 2 groups were compared after 2 weeks, 4 weeks,6 weeks and 8 weeks of treatment. Rapid corticotropin stimulation test was used to assess adrenocortical function. A positive response, indicative of normal adrenocortical function,has been defined as a 30 min stimulated cortisol level of more than 552 nmol/L.The initial stimulation test was performed as a baseline study immediately following the diagnosis of subacute thyroiditis,before the initiation of glucocorticoid therapies. The tests were repeated 24 h after completion of glucocorticoid course and 2 weeks and every 4 weeks thereafter until a stimulated cortisol level of more than 552 nmol/L was achieved. Results: Curative rate of group Dex and group Pre after 8 weeks were 100% and 90% respectively. Duration of therapy was (5.7?2.0) weeks in group Dex and (8.8?1.8) weeks in group Pre respectively ( P
RESUMO
Objective:To examine whether somatostatin analogous(SSAs) have effect on Graves ophthalmopathy and to compare its effects with that of glucocorticoid.Methods: Both a computer aided search of MEDLINE and Chinese Biological Medicine disc and an intensive search by hand were conducted to identify all controlled studies assessing the effect of SSAs on Graves ophthalmopathy.Results: Five studies were finally included.Three of them found SSAs to be significantly more effective than placebo;2 of them found SSAs to be able to reduce proptosis; 2 of them found SSAs to be equally effctive as glucocorticoid.The pooled OR, pooled mean difference, pooled OR were 0.070.02,0.23],-1.47 -2.10,-0.84] and 0.95 0.25,3.59] respectively.Conclusion: This Meta analysis demonstrates that SSAs are effective in treatment of Graves ophthalmopathy and in reduction of proptosis, and it is equally effctive as glucocorticoid.