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Objective To evaluate the patient-reported outcome(PRO)of patients with breast cancer who underwent autologous breast reconstruction and implant breast reconstruction.Methods Patients who underwent breast reconstruction in Shanghai Cancer Center,Fudan University from Jan 2020 to Jun 2021 were selected,including 111 patients who underwent autologous breast reconstruction and 108 patients who underwent implant breast reconstruction.Chinese version Breast-Q2.0 scale,breast cancer specificity scale QLQ-BR23 and EORTC quality of life scale QLQ-C30 were used to investigate the PRO of the two groups 18 months after operation.Results The rate of stage Ⅲ breast cancer in the self-weight construction group was higher than that in the implant reconstruction group(64.9%vs.44.4%,P<0.001).The preoperative neoadjuvant therapy and postoperative radiotherapy in the autologous reconstruction group were higher than those in the implant reconstruction group(P<0.001).Postoperative chemotherapy and endocrine therapy in the autologous reconstruction group were lower than those in the implant reconstruction group(P<0.001).The study based on Breast-Q scale showed that the breast satisfaction of autologous reconstruction group was higher than that of implant reconstruction(59.28±17.20 vs.54.94±14.48,P<0.05).The study based on QLQ-BR23 showed that the self-weight construction group was higher than the implant reconstruction group in the field of arm symptoms(20.02±20.80 vs.12.65±16.18,P<0.05).The study based on QLQ-C30 scale showed that there was no significant difference in all functional areas and symptom areas of patients.There was no significant difference in the number and time of social regression between the two groups.Conclusion Breast reconstruction can improve the PRO of breast cancer patients,and oncology factors will affect the choice of breast reconstruction.Patients with autologous breast reconstruction are more satisfied with breast appearance,but upper limb symptoms such as swelling and pain are more obvious than implant reconstruction,which is related to the higher proportion of axillary lymph node dissection in patients with autologous reconstruction.There is no significant difference in quality of life and social regression between the two groups.
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Undergraduates in colleges and universities have great academic potential. In order to cultivate undergraduate innovative scientific research talents, the key is to improve the cultivation mode of undergraduates and stimulate students' academic potential. Taking the evidence-based medicine research group of Guangdong Medical University as an example, this paper systematically analyzes the specific measures and relevant practical experiences of the research team in the cultivation of undergraduates. The research team creatively uses the methods of "student guidance system", "PBL" mode and real-time feedback mechanism, and a complete talent training system has formed to explore a group of excellent undergraduate talents. Through innovative scientific research training, these undergraduates have made many achievements in academic research. This paper hopes these strategies and experiences can provide some reference for the cultivation of undergraduates in colleges and universities all over the country.
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Objective To evaluate the safety and efficacy of intravascular lithotripsy(IVL)in the treatment of coronary artery calcification lesions.Methods A total of 53 patients who underwent endovascular imaging guided treatment of coronary artery calcified lesions with either IVL or cutting balloon(CB)at the Affiliated Hospital of Jining Medical College from January 2023 to July 2023 were retrospectively analysed(IVL:n=18,CB:n=35)were retrospectively analysed to compare the technique,clinical success rate,major adverse cardiovascular events(MACE)and readmission for cardiovascular events in patients followed during hospitalisation and 1 month after the procedure.Results Clinical success rates were identical in the IVL and CB groups(100.0%vs.100.0%,P>0.999),the minimum lumen area of lesions was similar in the VL and CB groups[(1.7±0.4)mm2 vs.(1.7±0.5 mm2),P=0.628].And there was a statistically significant difference in the overall mean lesion length between the IVL and CB groups[(28.4±9.6)mm vs.(20.9±8.6)mm,P=0.008].During the procedure,there were no complications such as aneurysm,thrombus,or emergency vessel closure.There was a statistically significant difference in the overall mean value of residual stenosis between the IVL and CB groups[(1.7±1.7)%vs.(6.9±2.0)%,P=0.049].There were no MACE in either group during hospitalisation or at the one-month follow-up(0 vs.0,P>0.999),and 3 patients in the CB group were readmitted for angina pectoris(0 vs.8.6%,P=0.543),with no significant difference in readmission rates between the two groups.Conclusions The technique of intravascular lithotripsy is safe and effective in the treatment of coronary artery calcification lesions.
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With the continuous improvement of cancer treatment, the survival of patients with spinal metastases has been significantly prolonged. Currently, the treatment of spinal metastases presents a trend of multi-mode. Clinical surgical methods include vertebral tumor resecting spinal canal decompression and internal fixation surgery, separation surgery, minimally invasive surgery and percutaneous ablation technology, etc. Radiotherapy techniques include traditional external radiation therapy, stereotactic radiotherapy and brachytherapy, etc. The risk of vertebral tumor resecting spinal canal decompression and internal fixation surgery, and the incidence of intraoperative and postoperative complications is high. The extension of postoperative recovery period may lead to delay of follow-up radiotherapy and other medical treatment, which has a serious impact on patients' survival and treatment confidence. However, the precision of traditional external radiation therapy is not high, and the limitation of tolerance of spinal cord makes it difficult to achieve the goal of controlling insensitive tumor. With the development of radiotherapy and surgical technology, stereotactic radiotherapy with higher accuracy and separation surgery with smaller surgical strike have become the focus of many clinical experts at present. This article reviews the progress of Hybrid treatment of separation surgery combined with stereotactic radiotherapy.
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Humans , Radiosurgery , Spinal Neoplasms/surgery , Spine , Decompression, Surgical , Fracture Fixation, InternalРеферат
The spine is the most common site of bone metastases from malignant tumors, with metastatic epidural spinal cord compression occurring in about 10% of patients with spinal metastases. Palliative radiotherapy and simple laminectomy and decompression have been the main treatments for metastatic spinal cord compression. The former is ineffective and delayed for radiation-insensitive tumors, and the latter often impairs spinal stability. With the continuous improvement of surgical techniques and instrumentation in recent years, the treatment model of spinal metastases has changed a lot. Decompression surgery underwent open decompression, separation surgery, minimally invasive surgery and laser interintermal thermal ablation decompression. However, no matter what kind of surgical plan is adopted, it should be assessed precisely according to the specific situation of the patient to minimize the risk of surgery as far as possible to ensure the smooth follow-up radiotherapy. This paper reviews the research progress of decompression for spinal metastases.
Тема - темы
Humans , Spinal Cord Compression/surgery , Spinal Neoplasms/secondary , Decompression, Surgical/methods , Spine/surgery , Retrospective Studies , Treatment OutcomeРеферат
Objective:To investigate the clinical efficacy of manual reduction under general anesthesia combined with anterior cervical discectomy and fusion (ACDF) in the treatment of lower cervical locked facet dislocation.Methods:Retrospectively analyzed were the data of 53 patients with traumatic single segment dislocation of lower cervical spine combined with single/bilateral facet articular lock who had been admitted to Department of Orthopaedic Spine Surgery, Xiangya Hospital, Central South University from January 2019 to December 2020. There were 36 males and 17 females, aged from 18 to 64 years (average, 45.5 years). All the patients were treated with ACDF under neuroelectrophysiological monitoring. Clinical efficacy was assessed by observing complications and comparing American Spinal Injury Association (ASIA) grading, Modified Japanese Orthopaedic Association (mJOA) scores, neck disability index (NDI) and visual analogue scale (VAS) before and after surgery.Results:All patients were followed up for 16 to 30 months (mean, 24 months). All incisions healed by primary intention with no infection after operation. There were 2 cases of delirium, 9 cases of abdominal distension, 4 cases of lower extremity venous thrombosis, and one case of central diabetes insipidus. Postoperative imaging data showed that all patients achieved sequential reduction of the cervical spine, intervertebral bony fusion, and no internal fixation loosening. The last follow-up showed that the overall improvement rate of ASIA grading of spinal cord function was 84.9% (45/53) compared with the preoperation and that the VAS score (2.0±0.5), mJOA score (13.1±3.1) and NDI index (16.6±5.9) were significantly improved compared with the preoperative values (7.5±1.5, 6.9±3.5, and 37.8±7.8) ( P< 0.05). Conclusion:On the premise of fully assessing the patient's injury status, manual reduction under general anesthesia combined with ACDF is a safe and effective treatment of single-level lower cervical fracture combined with facet dislocation.
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Objective: To explore the effects of expanded frontal-parietal pedicled flap in reconstructing cervical scar contracture deformity in children after burns. Methods: A retrospective observational study was conducted. From January 2015 to December 2020, 18 male children with cervical scar contracture deformity after burns who met the inclusion criteria were admitted to Zhengzhou First People's Hospital, aged 4 to 12 years, including 10 cases with degree Ⅱ cervical scar contracture deformity and 8 cases with degree Ⅲ scar contracture deformity, and were all reconstructed with expanded frontal-parietal pedicled flap. The surgery was performed in 3 stages. In the first stage, a cylindrical skin and soft tissue expander (hereinafter referred to as expander) with rated capacity of 300 to 500 mL was placed in the frontal-parietal region. The expansion time was 4 to 6 months with the total normal saline injection volume being 2.1 to 3.0 times of the rated capacity of expander. In the second stage, expander removal, scar excision, contracture release, and flap transfer were performed, with the flap areas of 18 cm×9 cm to 23 cm×13 cm and the secondary wound areas of 16 cm×8 cm to 21 cm×11 cm after scar excision and contracture release. After 3 to 4 weeks, in the third stage, the flap pedicle was cut off and restored. The rated volume of placed expander, total normal saline injection volume, type of vascular pedicle of flap, survival of flap and reconstruction of scar after the second stage surgery were recorded. The neck range of motion and cervico-mental angle were measured before surgery and one-year after surgery. The appearance of neck, occurrence of common complications in the donor and recipient sites of children, and satisfaction of children's families for treatment effects were followed up. Data were statistically analyzed with paired sample t test. Results: All the patients successfully completed the three stages of operation. The rated volume of implanted expander was 300 mL in 6 children, 400 mL in 9 children, and 500 mL in 3 children, with the volume of normal saline injection being 630 to 1 500 mL. The type of vascular pedicle of flap was double pedicle in 13 cases and was single pedicle in 5 cases. All the flaps in 17 children survived well, and the secondary wounds after neck scar excision and contracture release were all reconstructed in one procedure. In one case, the distal blood supply of the single pedicled flap was poor after the second stage surgery, with necrosis of about 2.5 cm in length. The distal necrotic tissue was removed on 10 days after the operation, and the wound was completely closed after the flap was repositioned. In the follow-up of 6 months to 3 years post operation, the cervical scar contracture deformity in 18 children was corrected without recurrence. The flap was not bloated, the texture was soft, and the appearances of chin and neck were good. The range of motion of cervical pre-buckling, extension, left flexion, and right flexion, and cervico-mental angle in one year after operation were improved compared with those before operation (with t values of 43.10, 22.64, 27.96, 20.59, and 88.42, respectively, P<0.01). The incision in the frontal donor site was located in the hairline, the scar was slight and concealed. No complication such as cranial depression was observed in expander placement site, and the children's families were satisfied with the result of reconstruction. Conclusions: Application of expanded frontal-parietal pedicled flap in reconstructing the cervical scar contracture deformity in children after burns can obviously improve the appearance and function of neck, with unlikely recurrence of postoperative scar contractures, thus it is an ideal method of reconstruction.
Тема - темы
Child , Humans , Male , Burns/surgery , Cicatrix/surgery , Contracture/surgery , Perforator Flap , Plastic Surgery Procedures/methods , Saline Solution , Skin Transplantation , Treatment OutcomeРеферат
Transcranial direct current stimulation (tDCS) is a non-invasive low-current brain stimulation technique, which is mainly based on the different polarity of electrode stimulation to make the activation threshold of neurons different, thereby regulating the excitability of the cerebral cortex. In this paper, healthy subjects were randomly divided into three groups: anodal stimulation group, cathodal stimulation group and sham stimulation group, with 5 subjects in each group. Then, the performance data of the three groups of subjects were recorded before and after stimulation to test their mental rotation ability, and resting state and task state electroencephalogram (EEG) data were collected. Finally, through comparative analysis of the behavioral data and EEG data of the three groups of subjects, the effect of electrical stimulation of different polarities on the three-dimensional mental rotation ability was explored. The results of the study found that the correct response time/accuracy rate and the accuracy rate performance of the anodal stimulation group were higher than those of the cathodal stimulation and sham stimulation groups, and there was a significant difference (
Тема - темы
Humans , Electric Stimulation , Electroencephalography , Frontal Lobe , Reaction Time , Transcranial Direct Current StimulationРеферат
Objective:To explore the effects and mechanism of zedoary turmeric oil and its active components on the vascular endothelial growth factor A (VEGFA), signal transducer and activator of transcription 3 (STAT3), and mechanistic target of rapamycin (mTOR) in the ovarian cancer (OC). Method:Network pharmacology technology was employed to analyze the mechanism of Curcumae Rhizoma on OC. Bioinformatics was used to analyze the expression of VEGFA, STAT3, and mTOR in OC and the effect on the prognosis of OC to explore the feasibility of zedoary turmeric oil in regulating VEGFA, STAT3, and mTOR in OC.The xenograft tumor model of nude mice was established, and the effects of zedoary turmeric oil and its active components on VEGFA, STAT3, and mTOR in OC were observed by hematoxylin-eosin (HE) staining, real-time fluorescence-based quantitative polymerase chain reaction (Real-time PCR), Western blot, and immunohistochemistry (IHC). Result:Bioinformatics analysis and literature research showed that VEGFA, STAT3, and mTOR played a special regulatory role in the occurrence and development of OC, and were potential key targets for the proliferation of OC. Network pharmacology analysis revealed that Curcumae Rhizoma could regulate multiple disease targets of OC, and mediate VEGFA, STAT3, and mTOR in OC through these multiple targets. As demonstrated by HE staining, the tumor cells in the model group were densely arranged, with no erosion on the edge and no vesicles inside. Compared with the model group, the cell density in other treatment groups was reduced, and strip-shaped erosion on the edge and small empty vesicles were observed in the tumor tissue, especially in the zedoary turmeric oil group. According to the results of Real-time PCR and IHC, zedoary turmeric oil and its active components could inhibit the mRNA and protein expression of VEGFA, STAT3, and mTOR in the OC tissue (<italic>P</italic><0.05). Conclusion:Zedoary turmeric oil and its active components could reduce the expression of VEGFA, STAT3, and mTOR in tumor tissue of nude mice, and inhibited the proliferation of OC through VEGFA, STAT3, and mTOR.
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Paeoniae Radix Alba is the dried root of Paeonia lactiflora, which was first recorded in the Shennong's Classic of Materia Medica and listed as the top grade. It is a common blood-tonifying herb, and its chemical components are mainly monoterpenes and their glycosides, triterpenes, flavonoids and so on. Modern research has demonstrated that Paeoniae Radix Alba has the activities of anti-inflammation, pain easing, liver protection, and anti-oxidation, and thus it is widely used in clinical practice and has broad development prospects. In this paper, the research progress on the chemical composition, pharmacological effects, and quality control of Paeoniae Radix Alba were summarized. On this basis, the Q-markers of Paeoniae Radix Alba were predicted from the aspects of mass transfer and traceability, chemical composition specificity, and availability and measurability of chemical components, which will provide a scientific basis for the quality evaluation of Paeoniae Radix Alba.
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Drugs, Chinese Herbal , Medicine, Chinese Traditional , Monoterpenes , Paeonia , Plant ExtractsРеферат
Sleep is a complex physiological process of great significance to physical and mental health, and its research scope involves multiple disciplines. At present, the quantitative analysis of sleep mainly relies on the "gold standard" of polysomnography (PSG). However, PSG has great interference to the human body and cannot reflect the hemodynamic status of the brain. Functional near infrared spectroscopy (fNIRS) is used in sleep research, which can not only meet the demand of low interference to human body, but also reflect the hemodynamics of brain. Therefore, this paper has collected and sorted out the related literatures about fNIRS used in sleep research, concluding sleep staging research, clinical sleep monitoring research, fatigue detection research, etc. This paper provides a theoretical reference for scholars who will use fNIRS for fatigue and sleep related research in the future. Moreover, this article concludes the limitation of existing studies and points out the possible development direction of fNIRS for sleep research, in the hope of providing reference for the study of sleep and cerebral hemodynamics.
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Humans , Brain/diagnostic imaging , Hemodynamics , Polysomnography , Sleep , Spectroscopy, Near-InfraredРеферат
Effective methods for visualizing neurovascular morphology are essential for understanding the normal spinal cord and the morphological alterations associated with diseases. However, ideal techniques for simultaneously imaging neurovascular structure in a broad region of a specimen are still lacking. In this study, we combined Golgi staining with angiography and synchrotron radiation micro-computed tomography (SRμCT) to visualize the 3D neurovascular network in the mouse spinal cord. Using our method, the 3D neurons, nerve fibers, and vasculature in a broad region could be visualized in the same image at cellular resolution without destructive sectioning. Besides, we found that the 3D morphology of neurons, nerve fiber tracts, and vasculature visualized by SRμCT were highly consistent with that visualized using the histological method. Moreover, the 3D neurovascular structure could be quantitatively evaluated by the combined methodology. The method shown here will be useful in fundamental neuroscience studies.
Тема - темы
Animals , Mice , Imaging, Three-Dimensional , Neural Networks, Computer , Spinal Cord/diagnostic imaging , Synchrotrons , X-Ray MicrotomographyРеферат
Effective methods for visualizing neurovascular morphology are essential for understanding the normal spinal cord and the morphological alterations associated with diseases. However, ideal techniques for simultaneously imaging neurovascular structure in a broad region of a specimen are still lacking. In this study, we combined Golgi staining with angiography and synchrotron radiation micro-computed tomography (SRμCT) to visualize the 3D neurovascular network in the mouse spinal cord. Using our method, the 3D neurons, nerve fibers, and vasculature in a broad region could be visualized in the same image at cellular resolution without destructive sectioning. Besides, we found that the 3D morphology of neurons, nerve fiber tracts, and vasculature visualized by SRμCT were highly consistent with that visualized using the histological method. Moreover, the 3D neurovascular structure could be quantitatively evaluated by the combined methodology. The method shown here will be useful in fundamental neuroscience studies.
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Objective:To observe the effect of 1 470nm laser anterograde enucleation on benign prostatic hypertrophy (BPH), and its influence on stress response and quality of life.Methods:From July 2018 to May 2019, 90 patients with BPH diagnosed and treated by urology department in Rizhao Central Hospital were selected in the study.According to the different treatment methods, they were divided into two groups, with 45 cases in each group.In the observation group, 1 470nm laser anterograde enucleation of prostate was used.The control group was treated with transurethral plasma resection.The operation time, bladder flushing time, indwelling catheter time and hospitalization time of the two groups were compared.The stress responses of the two groups were compared, including CK, CRP, cortisol and adrenaline levels.The differences of IPSS score, QOL score, maximum urine flow rate (Qmax) and residual urine test (PVR) between the two groups were compared after 6 months of follow-up.The incidence of complications of the two groups was compared.Results:The operation time of the observation group was significantly longer than that of the control group[(80.2±23.5)min vs.(69.5±19.2)min], and the bladder washing time[(1.4±0.3)d vs.(1.7±0.4)d], indwelling catheter time[(5.2±0.9)d vs.(6.2±1.1)d] and hospitalization time[(6.7±1.1)d vs.(8.3±1.6)d] were significantly shorter than those of the control group ( t=4.576, 4.025, 4.719, 5.528, all P<0.05). After operation, the levels of CK[(100.5±11.5)U/L vs.(86.5±9.2)U/L, (103.5±15.4)U/L vs.(87.3±9.9)U/L], CRP[(14.5±2.9)mg/L vs.(12.5±2.5)mg/L, (16.3±3.1)mg/L vs.(12.6±1.9)mg/L], cortisol[(285.2±45.6)ng/mL vs.(235.6±36.5)ng/mL, (310.2±55.6)ng/L vs.(241.6±43.2)ng/L] and adrenaline[(57.8±8.7)pg/mL vs.(51.5±7.8)pg/mL, (62.5±9.9)pg/L vs.(50.9±8.9)pg/L] in the two groups were significantly higher than those before operation ( t=6.377, 6.478, 3.504, 5.125, 5.696, 6.752, 3.617, 4.992, all P<0.05). The levels of CRP, cortisol and adrenaline in the observation group were significantly lower than those in the control group (all P<0.05). After operation, the IPSS score[(7.5±1.6)points vs.(24.2±6.8)points, (7.7±1.9)points vs.(23.8±7.6)points] and QOL score[(1.4±0.5)points vs.(5.0±0.6)points, (1.6±0.6)points vs.(4.9±0.7)points] of the two groups were significantly reduced, Qmax[(21.7±3.5)mL/s vs.(7.5±2.1)mL/s, (22.1±4.3)mL/s vs.(7.8±2.5)mL/s] were significantly increased, PVR[(28.6±7.2)mL vs.(111.2±26.5)mL, (29.3±8.1)mL vs.(114.5±32.5)mL] were significantly increased, the differences were statistically significant ( t=16.037, 14.251, 30.920, 27.528, 23.338, 22.527, 20.178, 21.852, all P<0.05), but there were no statistically significant differences between the two groups (all P>0.05). There was no significant difference in the incidence of postoperative complications between the two groups ( P>0.05). Conclusion:1 470nm laser anterograde enucleation of prostate is a reliable method for the treatment of BPH.
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Objective:To summarize the early results and follow-up of mitral valve repair for rheumatic heart disease(RHD).Methods:From January 2018 to November 2019, 48 patients with rheumatic heart disease undergoing mitral valve repair in Cardiovascular Surgery Department of GaoZhou People' s Hospital were analyzed retrospectively. Surgical methods: according to the condition of mitral valve disease, the prosthetic mitral annulus was used in rheumatic mitral valve repair by the methods of joint incision, valve thinning, calcification stripping, Chordae tendineae release and papillary muscle splitting. All patients with tricuspid regurgitation were fixed with artificial valve ring(type C ring), and with atrial fibrillation were treated with Maze-IV radiofrequency ablation. Data on extracorporeal circulation time, aortic occlusion time, mechanical ventilation time, ICU stay time, and major postoperative complications were collected. Patients were followed up to assess mitral valve, cardiac function, and cardiac rhythm.Results:According to pathological classification, type Ⅰ were 9 cases, 31 cases as type Ⅱ and 8 cases as type Ⅲ. All patients in type I and type II were repaired successfully, and type III has 1 case who was repaired failed and underwent mitral valve replacement due to moderate regurgitation. Cardiopulmonary bypass(CPB) time was(110.62±27.68) min, Cross-clamp time was(76.63±17.63) min, ICU stay was(46.16±11.37) h, mechanical ventilation was(21.60±10.89) h. All survived at 30 days, 1 case of acute renal failure, 1 case of low cardiac output syndrome, 3 cases of pulmonary infection, no complications such as stroke and malignant Arrhythmia. 47 patients were followed up for(9.86±6.78) months. There were no death, malignant Arrhythmia and reoperation during the follow-up, and the cardiac function was improved significantly( P<0.001). Conclusion:The mitral valve repair of RHD can preserve the intact mitral valve structure, maintain the heart function, and have a good survival and quality of life. On the basis of mastering the repair of heart valve, being familiar with the anatomic features of rheumatic mitral valve disease, strictly grasping the indications, fully evaluating before operation, it is feasible to carry out the repair of rheumatic mitral valve, and the early clinical effect is satisfactory, long-term results recommend long-term follow-up.
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Cognitive enhancement refers to the technology of enhancing or expanding the cognitive and emotional abilities of people without psychosis based on relevant knowledge of neurobiology. The common methods of cognitive enhancement include transcranial direct current stimulation (tDCS) and cognitive training (CT). tDCS takes effect quickly, with a short effective time, while CT takes longer to work, requiring several weeks of training, with a longer effective time. In recent years, some researchers have begun to use the method of tDCS combined with CT to regulate the cognitive function. This paper will sort out and summarize this topic from five aspects: perception, attention, working memory, decision-making and other cognitive abilities. Finally, the application prospect and challenges of technology are prospected.
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Humans , Cognition , Cognition Disorders , Memory, Short-Term , Neuropsychological Tests , Prefrontal Cortex , Transcranial Direct Current StimulationРеферат
Objective To compare the difference between transthoracic device closure of ventricular sep-tal defect and conventional thoracotomy and examine the effect and safety of transesophageal echocardiography (TEE) guided minimally invasive transthoracic device closure of ventricular septal defect. Methods Three hun-dred and sixty-eight patients underwent isolated ventricular septal defect surgery in our hospital from May 2014 to May 2016. There were 40 patients in group A underwent TEE guided minimally invasive transthoracic device clo-sure of ventricular septal defect and 328 patients in group B underwent conventional thoracotomy surgery.By using the method of propensity score matching,we selected 40 conventional thoracotomy patients as a control group in our study. Results All patients were survived after surgery without death and other serious complications. Compared with conventional thoracotomy surgery,patient with transthoracic device closure of ventricular septal defect had sta-tistical improvement in surgery time(1.97 ± 0.48 vs. 3.55 ± 1.95)h, ICU stayed time(21.15 ± 30.52 vs. 38.37 ± 10.91)h,volume of thoracic drainag(28.39 ± 32.67 vs.174.84 ± 85.36)mL,surgery incision length(2.98 ± 0.72 vs. 11.76 ± 2.89)cm.There were no significant differences in postoperative valvular regurgitation,arrhythmia and resid-ual shunt between the two groups.Conclusion TEE guided minimally invasive transthoracic device closure of ven-tricular septal defect is safe,effective,feasible,less trauma,less bleeding,faster recovery and etc.
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Objective To determine the spectrum of conjunctival flora and the antibiotic susceptibility profiles of patients scheduled for penetrating intraocular surgeries.Methods A prospective case control study was performed.A total of 192 patients (192 eyes) scheduled for penetrating intraocular surgeries at the Fourth People's Hospital of Shenyang from February to August 2015 were enrolled.Samples from the conjunctival sac were collected before instillation of any ophthalmic solutions for both aerobic and anaerobic culture.The positive rate and bacterial spectrum were observed.Bacterial isolates were tested for antibiotic susceptibility to 7 commonly used ophthalmic antibiotics using automated drug resistance analyzing system.The research was approved by the Ethics Committee of the Fourth People's Hospital of Shenyang.Results Totally 91 strains were collected from 81 conjunctival samples during aerobic culture,the positive rate was 42.19%.Staphylococcus epidermidis was the most common microorganism (64.84%),followed by Staphylococcus lentus (7.69%) and Staphylococcus aureus (3.30%).Coagulatase negtive Staphylococcus (CNS) accounted for 80.22% of the positively cultured aerobes.For anaerobic culture,a total of 28 strains were isolated from 28 conjunctival samples,the positive rate was 14.58% Propionibacterium acnes was the predominant species (71.43%),followed by Finegoldia magna (10.71%).Majority of the CNS were sensitive to gentamycin and vancomycin,with resistance rates lower than 10%,but their resistance rate to erythromycin and ceftazidime was 87.67% and 63.01%,respectively.Resistance rate of these CNS to levofloxacin,ciprofloxacin,and moxifloxacin was 42.47%,39.73% and 17.81%,respectively.Multidrug resistance to at least 3 antibiotic classes was present in 38.36% of the CNS.Conclusions Bacteria in the conjunctiva sac of preoperative patients are resistant to various ophthalmic antibiotics.To follow-up the bacterial distribution and antibiotic resistance is great meaningful in the prophylactic and treatment in ocular surgery-related infections.
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Objective To investigate the clinical value of plasma NT -proBNP and left ventricular mass index in the diagnosis of heart failure (HF) with normal left ventricular ejection fraction (LVEF) in elderly patients. Methods From August 2014 to August 2017,82 patients with congestive heart failure in the People's Hospital of Yinzhou were enrolled .According to the results of LVEF in echocardiography ,the patients were divided into HFNEF group (41 cases) and HFREF group (41 cases),another 40 patients with normal heart function were selected as the control group.The relative indicators of echocardiography were compared among the three groups .The plasma NT-proBNP levels were compared among the three groups .The ROC curve of plasma NT -proBNP was used to diagnose HFNEF,and the sensitivity and specificity of HFNEF were calculated .The ROC curve of left ventricular mass index (LVMI)was drawn and its sensitivity and specificity were calculated .The plasma NT-proBNP level was used as an indirect indicator of left ventricular filling pressure ,the correlation of LVMI and plasma NT -proBNP in the HFNEF group was compared .Results The LVMI in the control group was significantly lower than that in the HF group [(86.95 ±8.72)g/m2vs.(130.53 ±15.18)g/m2,t =20.078,P=0.000),but there was no statistically significant difference between the HFNEF group and HFREF group (P>0.05).The NT-proBNP was the lowest in the control group,followed by the HFNEF group and HFREF group ,the difference was statistically significant among the three groups [(72.56 ±7.81)ng/mL vs.(182.55 ±18.45)ng/mL vs.(653.58 ±55.95)ng/mL,F=8.254, P=0.000).The sensitivity,specificity,positive predictive value and negative predictive value of HFNEF were 0.94, 0.83,0.95 and 0.21,respectively,when NT-proBNP 131pg/mL was used as the cut -off value.The sensitivity and specificity of HFNEF were 0.62 and 0.99,respectively,when LVMI>125 g/m2was used as the standard .The corre-lation between plasma NT-proBNP and LVMI in the HFNEF group was r=0.513 (P<0.01).Conclusion Plasma NT-proBNP and LVMI in elderly patients with HFNEF are significantly higher than those in elderly patients with HFNEF,which may be useful for the diagnosis of HFNEF ,independent use of NT -proBNP or LVMI for diagnosis , there may be some defects ; if applied together,may improve the accuracy of diagnosis .
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Objective: To explore the clinical efficacy of surgical radiofrequency ablation-modified Maze procedure in treating atrial fibrillation (AF) patients with large left atrial heart valve disease. Methods: A total of 267 patients received cardiac valve replacement and radiofrequency ablation-modified Maze procedure at the same time in our hospital from 2014-01 to 2015-15 were retrospectively studied. Based on the size of left atril, patients were divided into 2 groups: Group A, patients with left atrial size<60 mm, n=182 and Group B, patients with left atrial size≥60 mm, n=85. All patients were followed-up for 6 months after operation, clinical efficacy of surgical radiofrequency ablation-modified Maze procedure in treating AF was compared between 2 groups. Results: ①All patients were successfully completed the operation, radiofrequency ablation time was similar between Group A and Group B [18-32 (24±4) min] vs [22-38 (25±6)min], P>0.05. ②The ratios for recovering to sinus rhythm at the end of operation and discharge in Group A were 156/182 (86%) and 152 (84%), in Group B were 56/85 (66%) and 54 (64%); at 3 and 6 months post-operation in Group A were 149/182 (81.6%) and 146 (80.2%), in Group B were 48/85 (56.4%) and 46 (54.1%), all P<0.05. ③No patients needed installing permanent pacemaker, no operative mortality and no ablation related complications.Conclusion: Radiofrequency ablation-modified Maze procedure was safe, simple and effective in treating heart valve disease complicated AF, the effect in patients with left atrial ≥60 mm was inferior than left atrial<60mm; it could be used in clinical practice.