Application value of fixation mesh with suture anchor in the repair of parailiac hernia / 中华消化外科杂志

Objective:To investigate the application value of fixation mesh with suture anchor in the repair of parailiac hernia.Methods:The retrospective and descriptive study was conducted. The clinical data of 5 patients with parailiac hernia who were admitted to Shaoxing People′s Hospital from March 2016 to February 2019 were collected. There were 4 males and 1 female, aged from 23 to 67 years, with a median age of 49 years. Patients underwent repair of parailiac hernia, in which mesh with suture anchor was fixed on the outside of the defect to the inner side of the ilium. Observation indicators: (1) surgical and postoperative conditions; (2) follow-up. Follow-up using outpatient examination or telephone interview was conducted at postoperative 1 week, at postoperative 2 weeks, at postoperative 1, 3, 6 months, at postoperative 1 and 2 years, respectively. The follow-up was up to July 2019. During the follow-up, the conditions about drainage tube removal, incision infection, hernia recurrence, and chronic pain were observed. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were represented as M (range). Results:(1) Surgical and postoperative conditions: 5 patients underwent surgeries successfully, without blood transfusion. The volume of intraoperative blood loss was 100 mL(range, 20-300 mL). The operation time and duration of drainage tube placement were (129±13)minutes and (13.8±1.9)days. Patients were discharged from hospital, without postoperative complications during the hospital stay. The duration of hospital stay was 13 days(range, 8-19 days). (2) Follow-up: patients were followed up for 4-39 months, with a median follow-up time of 16 months. One of the 5 patients was removed drainage tube during the hospital stay and other 4 patients were removed at the outpatient after discharge from the hospital. One patient felt numbness in the surgical site at postoperative 1 month without aggravation during the follow-up, and received no specific treatment. Four patients completed computed tomography examination at postoperative 6 months, without hernia recurrence. There was no incision infection or chronic pain.Conclusions:It is safe and effective to use fixation mesh with suture anchor in the repair of parailiac hernia.

Effectiveness and safety of branch protection technique:jailed balloon protection technique after pre-dilation in branch with cutting balloon / 中国介入心脏病学杂志

Objective To explore the effectiveness and safety of branch protection technique with provisional stenting strategy in coronary bifurcation lesions by utilizing jailed balloon protection technique after pre-dilation in branch with cutting balloon. Methods 32 patients undergone jailed balloon protection technique after pre-dilation in branch with cutting balloon during January, 2015 to May, 2016 in Peking University of People's Hospital were enrolled consecutively in our study. 32 patients were involved including a total of 32 bifurcation lesions which were medina type 1,1,1 (n = 25, 78. 1% ), Medine type 0,1,1 (n =5,15. 6% ) and Medine type 1,0,1 (n = 2, 6. 3% ). For side branch diameter ≥2. 5 mm, the diameter ratio of cutting balloon to side branch was 1: 1. The angiography success rate after using branch protection during main branch stent implantation, perioperative complications and major adverse cardiac events were observed. Results ( 1 ) The angiography success rate of branch protection was 100% . ( 2 ) No perioperative complications and major adverse cardiac events were observed. Conclusions Side branches were effectively protected in provisional stenting strategy by applying jailed balloon protection technique after pre-dilation using branch cutting balloon.

Application Safety for Off-label Using of Rotational Atherectomy / 中国循环杂志

Objective: To explore the application safety for off-label using of rotational atherectomy. Methods: A total of 112 patients received rotational atherectomy in our hospital from 2010-01 to 2015-12 were enrolled in this study. There were 9 off-label indications for using of rotational atherectomy which included vein grafts, massive thrombotic burden, unprotected left main coronary artery disease, culprit lesions of acute myocardial infarction, severe coronary dissection, signiifcant impaired left ventricular function (LVEF0.05.②Off-label group had 1 patient with stuck of rotablator (1.5% vs 0%) and 1 cardiac death (1.5% vs 0%), both P>0.05; On-label group had 1 patient with acute in-stent thrombosis (2.2% vs 0%),P>0.05. Conclusion: Off-label using of rotational atherectomy did not increase the incidence of slow lfow/no lfow in relevant patients, other severe complications and in-hospital MACE occurrence were also rare.

Predictive Value of NVDA Score on Minimum Lumen Area in Patients With Coronary Artery Intermediate Lesions / 中国循环杂志

Objective: Based on scores by number of vessels diseased and age (NVDA), the minimum lumen area (MLA) of left anterior descending (LAD) proximal or middle intermediate lesions were examined by intravascular ultrasound (IVUS) to analyze the clinical characteristics, to ifnd the factors affecting lumen area and to establish a scoring system for predicting MLA in relevant patients. Methods: A total of 90 patients were enrolled including 58 male and 32 female with the age of (41-77) years. The demographic information, medical history and laboratory results were studied by simple linear regression analysis to screen relevant factors affecting MLA; multi regression analysis was conducted to establish a regression equation for predicting MLA and to calculate the risk factor coefifcient for obtaining relevant scoring system. Results: NVDA score≤4 was deifned as negative result with speculated MLA≥3.0mm2, while NVDA score>4 was deifned as positive result with speculated MLA Conclusion: NVDA scoring system had the better accuracy, sensitivity and speciifcity for predicting MLA in coronary artery intermediate lesions, it had certain value for guiding coronary interventional therapy in relevant patients.

Short-term outcome of rotational atherectomy followed by drug-eluting stenting in heavily calcified ;coronary long lesions / 中国介入心脏病学杂志

Objective To investigate the safety and short-term outcome of rotational atherectomy followed by drug-eluting stenting in heavily calcified coronary long lesions. Methods From Jan 1, 2011 to May 31, 2016, 109 cases with 114 heavily calcified coronary lesions which were treated with rotational atherectomy followed by drug-eluting stenting in Peking University People's Hospital were included. They were divided into diffuse lesion group ( lesion ≥25 mm, 68 cases, 72 lesions ) and focal lesion group (lesion ﹤25 mm,41 cases, 42 lesions). All patients were followed up in hospital. Procedure parameters, procedural complications ( dissection, perforation, slow flow/no flow and procedural related myocardial infarction),procedural success and major adverse cardiovascular events (cardiac death, non-fatal myocardial infarction and stent thrombosis) were analyzed. Results The procedural success rate was 98. 5%(67/68) in diffuse lesion group and 100% ( 41/41 ) in focal lesion group ( P=0. 453 ) . Complication rates did not differ between the two groups (41. 2% and 34. 1%, P=0. 673). Major adverse cardiovascular events rates were 41. 2% and 31. 7%, P =0. 484. Conclusions Treating coronary lesions ≥25 mm in length with rotational atherectomy followed by drug-eluting stenting does not impact the short-term outcome when treating carefully and correctly . Procedural success rate and in-hospital outcome is satisfactory.

Integrated intravascular ultrasound and fractional flow reserve to guide single-stent crossover ;technique for left main and bifurcation lesions / 中国介入心脏病学杂志

Objective To investigate the relationship between the Minimum Lumen Area (MLA) and plaque burden(PB) of the left circumlfex (LCX) ostial and the occurrence of myocardial ischemia after a single stent crossover for the treatment of left main (LM) bifurcated lesions. Methods Intravascular ultrasound (IVUS) assessment was performed on 5 patients, each where coronary angiography showed left main bifurcated lesions, and to measure the MLA and PB of the LCX. Following a single stent crossover fractional lfow reserve (FFR) evaluation were performed in all 5 patients to investigate the relationship between the MLA and PB of the LCX ostium and the occurrence of myocardial ischemia. Results The mean MLA of the left main coronary of the 5 patients was (4.99±2.3) mm2 with the minimum lumen diameter (MLD) being (2.26±2.8) mm. The average MLA of the left anterior descending (LAD) ostial or proximal was (4.01±2.0) mm2, mean plaque burden (PB) at the LAD ostial or proximal was (68.15±10.1)%. Average MLA of LCX was (4.94±0.4) mm2 with a plaque burden of (66.00±6.0)%. Single stent crossover technique was used to treat the bifurcated lesions. Among the 5 patients, only 1 of them was treated with a double stent deployment where the LCX ostial FFR was0.75. Conclusions Integrated IVUS and FFR would achieve threshold measurements of MLA at LCX’s ostium which could predict ischemia after one stent strategy.

Tension-free repair in the preperitoneal space using modified surgical mesh for inguinal hernia: a prospective randomized study / 中华普通外科杂志

Objective To summarize the experience of tension-free repair for inguinal hernia in the preperitoneal space using modified surgical mesh. Methods From Dec 2008 to May 2010, 134 cases with 138 reducible primary inguinal hernia were randomly divided into two groups. Sixty-seven patients (70 hernias) in the study group underwent tension-free repair in the preperitoneal space by modified surgical mesh, while the control group (67 cases, 68 hernias) underwent Rutkow's herniorrhaphy by surgical mesh.Results Postoperatively 127 cases (95%) were followed up from 2 to 18 months with an average of 9. 2months[64 cases of the test group were followed up with an average of(9 ±4) months, 63 cases of the control group followed up with an average of (9 ± 5 ) months]. There was no recurrence. No significant differences were found between the two groups in the operation time (P = 0. 697), blood loss (P = 0. 318 ),hospital stay (P = 0. 116) and total postoperative complications (P = 0. 080). The visual analogue scale of the study group was lower than the scale of the control group ( P = 0. 048 ). Conclusions Modified surgical mesh is more comfortable in the treatment of inguinal hernia with tension-free repair in the preperitoneal space with a comparative result to Rutkow's herniorrhaphy by surgical mesh.