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1.
Zhonghua Wai Ke Za Zhi ; 57(12): 898-901, 2019 Dec 01.
Artigo em Chinês | MEDLINE | ID: mdl-31826592

RESUMO

Objective: To examine the short-term outcomes of minimally invasive reoperation for severe tricuspid regurgitation after left-sided valve surgery. Methods: From January 2015 to December 2018, a total of 89 patients with severe tricuspid regurgitation after left-sided valve surgery received reoperation in Department of Cardiovascular Surgery, Zhongshan Hospital, Fudan University were included in this study. There were 21 males and 68 females, aging of (56.4±7.9) years (range: 41 to 74 years). The interval between previous left-sided valve surgery and tricuspid reoperation was (14.1±6.1) years (range: 4 to 33 years). A combination of multiple minimally invasive techniques were adopted, including endoscopy-assist right minithoracotomy approach, peripheral cannulation strategy with the vacuum-assist single venous drainage technique, heart beating technique, and temporary percutaneous pacemaker implantation, with a concomitant enhancement in preoperative right cardiac function optimization. Results: All patients received minimally invasive isolated tricuspid valve replacement (n=81) or tricuspid valve repair (n=8). After the application of multiple minimally invasive techniques, the operative mortality rate was only 3.4% (3/89). The causes of death were progressive right heart failure with multiorgan failure (n=1) and low cardiac output associated with postoperative bleeding (n=2). Regarding to the perioperative complications, renal replacement therapy rate was 5.6% (5/89), permanent pacemaker implantation rate was 1.1% (1/89), and the incidence of stroke was 0. Mechanical ventilation time was 24(24) hours, ICU stay time was 2.5 (3.0) days (M(Q(R))). During the short-term follow-up, there were no case of severe tricuspid regurgitation, 2 cases of moderate regurgitation, 4 cases of mild-to-moderate regurgitation. Conclusions: For severe tricuspid regurgitation after left-sided valve surgery, the advanced minimally invasive techniques can significantly reduce the operative mortality and morbidity. Minimally invasive bioprosthetic tricuspid valve replacement is a reliable alternative for severe tricuspid regurgitation after left-sided valve surgery.


Assuntos
Procedimentos Cirúrgicos Cardíacos/efeitos adversos , Insuficiência da Valva Tricúspide/cirurgia , Valva Tricúspide/cirurgia , Adulto , Idoso , Feminino , Doenças das Valvas Cardíacas/cirurgia , Implante de Prótese de Valva Cardíaca/efeitos adversos , Implante de Prótese de Valva Cardíaca/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Minimamente Invasivos , Reoperação , Resultado do Tratamento , Insuficiência da Valva Tricúspide/etiologia
2.
Zhonghua Wai Ke Za Zhi ; 57(12): 947-950, 2019 Dec 01.
Artigo em Chinês | MEDLINE | ID: mdl-31826601

RESUMO

Late tricuspid regurgitation after left-sided valve surgery can negatively affect long-term prognosis. The surgical timing and strategy of tricuspid valve reoperation will have important impact on the surgical outcomes. However, there is no clear recommendations of the surgical timing for this condition in the current guidelines. Generally, tricuspid valve reoperation should be performed before irreversible right heart failure occurs. Although tricuspid valve repair is the first choice for tricuspid regurgitation, bioprosthetic tricuspid valve replacement might be a reliable alternative when tricuspid leaflets have severe rheumatic damage or right ventricle and tricuspid annulus significantly dilate. Combined minimally invasive surgical techniques, including right minithoracotomy approach, accessing the right atrium directly through the pericardium with limited dissection, peripheral cannulation strategy with the vacuum-assist single venous drainage technique and heart beating technique, can significantly decrease the operative mortality and postoperative bleeding. With development of interventional therapy, transcatheter tricuspid valve repair or replacement may become alternatives for tricuspid regurgitation after left-sided valve surgery in the future.


Assuntos
Procedimentos Cirúrgicos Cardíacos/efeitos adversos , Insuficiência da Valva Tricúspide/cirurgia , Bioprótese , Próteses Valvulares Cardíacas , Implante de Prótese de Valva Cardíaca/efeitos adversos , Humanos , Reoperação , Resultado do Tratamento , Valva Tricúspide/cirurgia , Insuficiência da Valva Tricúspide/etiologia
3.
Zhonghua Zhong Liu Za Zhi ; 41(11): 849-853, 2019 Nov 23.
Artigo em Chinês | MEDLINE | ID: mdl-31770853

RESUMO

Objective: To investigate the changes of perioperative immune index in patients with breast cancer and its clinical significance. Methods: Th1 cells, Th2 cells, Th1/Th2 ratio and regulatory T cells (Treg) were detected in peripheral blood of 103 patients with primary breast cancer and 116 patients with breast fibroma before surgery and on the 1st, 3rd and 5th day following operation. The relationship of changes in T lymphocyte subsets and clinicopathological characteristics, as well as tumor-free survival of breast cancer patients, was analyzed. Results: The levels of Th1 cells in breast cancer group on the 1st, 3rd and 5th day following operation were (12.20±0.45)%, (13.89±0.47)%, (14.04±0.49)%, which were significantly lower than those before operation [(15.82 + 0.51)%, all P<0.05 ]. Treg cells, however, with the number of (3.82±0.13)%, (3.25±0.11)%, (2.95 ±0.11)%, were remarkably higher than those before operation [(2.53 ±0.11)%, all P<0.05]. With respect to breast fibroma patients, there was no significant difference compared with those before operation of Th1 cells, Th2 cells and Treg cells (all P>0.05). The changes of Th1 cells were associated with the degree of differentiation, T stage, N stage, TNM stage, HER-2 status and Ki-67 (all P<0.05). Treg cells were related to T stage, N stage and HER-2 status (all P<0.05). Tumor-free survival in the Th1-cell-increasing group was significantly better than that in the Th1-cell-decreasing group (P=0.045), while cell-decreasing group of Treg showed the improved outcomes (P=0.012). Conclusions: The levels of Th1 cells and Treg cells are important indicators of cellular immune function in patients with breast cancer. Moreover, the perioperative changes of Th1 cells and Treg cells are associated with the size of tumors, pathological parameters, clinical stages and tumor-free survival outcomes.


Assuntos
Neoplasias da Mama/imunologia , Neoplasias da Mama/cirurgia , Linfócitos T Reguladores/imunologia , Equilíbrio Th1-Th2 , Feminino , Humanos , Imunidade Celular
4.
Eur Rev Med Pharmacol Sci ; 23(18): 8101-8108, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31599437

RESUMO

OBJECTIVE: This paper aims to investigate the expressions of Fibulin-3 and Profilin-1 in vascular remodeling and the relationship between the two factors and vascular remodeling in hypertensive rats. MATERIALS AND METHODS: 45 spontaneously hypertensive rats (SHR) and 15 healthy Wistar Kyoto (WKY) rats were collected. The 45 SHR were randomly divided into group A, group B, and group C. Group A was injected with Profilin-1 overexpression of adenoviral vector of pAd-Profilin-1-RES-EGFP; group B was injected with recombinant Fibulin3 protein solution; and group C was injected with normal saline. The rats in the control group were normally raised. All rats were anesthetized and dissected, and the thoracic aorta of rats was taken out at T0 (8 weeks old), T1 (12 weeks old), T2 (16 weeks old). The expressions of Fibulin-3 and Profilin-1 protein in the thoracic aorta were analyzed by Western blot. The overexpression of Profilin-1 and Fibulin-3 protein, blood pressure, and body weight were compared. RESULTS: The expression level and systolic blood pressure of Profilin-1 protein of rats in group A were significantly higher than those in the other two groups (p<0.05). The expression level of Fibulin-3 protein of rats in group B at T2 was significantly higher than that in the other two groups (p<0.05). The thickness of vascular wall in the control group and group C at T1 and T2 was significantly lower than that of group A and group B. The vascular wall/cavity ratio of rats in group A, B, C was significantly higher than that in the control group at T1 and T2 (p<0.001). CONCLUSIONS: The changes in Profilin-1 and Fibulin-3 levels may affect the occurrence and development of vascular remodeling in hypertension. Therefore, Profilin-1 and Fibulin-3 can be used as sensitive detection indices for hypertension vascular remodeling.

5.
Fa Yi Xue Za Zhi ; 35(4): 402-405, 2019 Aug.
Artigo em Inglês, Chinês | MEDLINE | ID: mdl-31532146

RESUMO

Abstract: Objective To research the correlation between the visual acuity ratio and pattern reversal visual evoked potential (PRVEP) P100 waveform amplitude ratio of both eyes. Methods Forty-seven volunteers were selected, and the visual chart visual acuity of both eyes was measured. The visual acuity ratio of the eye with poor vision to the eye with better vision was calculated by five grade notation method. The amplitudes of P100 waveforms of both eyes were recorded respectively by using black-and-white checkerboard PRVEP and chosing 1°, 15' stimulating visual angle, and the ratio of amplitudes between the two eyes was also calculated. SPSS 20.0 software was used to analyze the correlation between the visual acuity ratio and the ratio of P100 waveform amplitudes between the two eyes. Return test and linear regression analysis with the binocular ratio of P100 waveform amplitudes as the independent variable (x) and the binocular visual acuity ratio as the dependent variable (y) were made. Results There was a positive correlation between the binocular visual acuity ratio and the ratio of P100 waveform amplitudes under 15' stimulating visual angle (Pearson correlation coefficient was 0.62, P=0.000). The fitting linear regression equation was y=0.090 x+0.846 (F=20.954, P=0.000). There was no significant correlation between the binocular ratio of visual acuity and the binocular ratio of P100 waveform amplitudes under 1° stimulating visual angle (P>0.05). Results of return test showed that there was no statistical significance in the difference between visual acuity estimated by equation and actual detected visual acuity. Conclusion In forensic appraisal of monocular injury, fitting linear regression equation of binocular visual acuity ratio and the binocular ratio of P100 waveform amplitudes under 15' stimulating visual angle, is helpful for visual acuity level estimation of the injured eye to some extent.


Assuntos
Potenciais Evocados Visuais , Olho/fisiopatologia , Visão Ocular , Acuidade Visual , Humanos , Análise de Regressão
6.
Zhonghua Xin Xue Guan Bing Za Zhi ; 47(7): 539-543, 2019 Jul 24.
Artigo em Chinês | MEDLINE | ID: mdl-31365994

RESUMO

Objective: To investigate the risk factors of postoperative acute kidney injury (AKI) in patients aged between 40 and 50 years old undergoing cardiac valvular surgery and the impact on outcome. Methods: The clinical data of 286 patients aged between 40 and 50 years old undergoing cardiac valve surgery in Guangdong Provincial People's Hospital from January 2012 to December 2016 were analyzed retrospectively. Preoperative coronary angiography was performed in all patients. All patients enrolled were divided into AKI group and non-AKI group according to the existence or not of postoperative AKI. Patients with AKI were further divided into AKI stage 1, stage 2, and stage 3 groups according to KDIGO guideline. Demographic characteristics, preoperative clinical data including serum creatinine, estimated glomerular filtration rate, hemoglobin, uric acid, urinary protein, presence or absence of chronic kidney disease, left ventricular ejection fraction, pulmonary artery pressure, New York Heart Association (NYHA) functional classification, preoperative co-morbidity (hypertension, diabetes, anemia, cerebrovascular disease, peripheral artery disease), preoperative medication(vasoactive drugs, diuretic, renin-angiotensin system inhibitor (RASI), surgical data (contrast dosage in coronary angiography, type of cardiac valve surgery) were recorded and analyzed in this retrospective study. The risk factors for postoperative AKI and its impact on clinical outcomes (mortality, hospitalization expenses and Intensive Care Unit stay duration) were evaluated. Logistic regression analysis was used to determine the risk factors for postoperative AKI and the adjusted variables with P<0.2 were selected for the multivariate logistic regression analysis to define the independent determinants for AKI. Results: AKI was defined in 106 out of 286 enrolled patients, including 96 patients with AKI stage 1, 10 patients with AKI stage 2 and no patients with AKI stage 3. The proportion of coexisting cerebrovascular diseases was higher in AKI group than in non-AKI group (9(8.49%) and 5(2.78%), χ(2)=4.677, P=0.031), while there was no difference among other baseline data between the two groups. Multivariate logistic regression analysis showed that preoperative complications of cerebral vascular disease was an independent risk factor of postoperative AKI (OR=3.578, 95%CI 1.139-11.242, P=0.029). Five out of 106 AKI patients died during hospitalization while there was only 1 patient died among 180 patients without AKI. Patients with AKI after cardiac valve operation experienced higher mortality than patients without AKI (χ(2)=5.625, P=0.028). Further analysis showed that there was no difference in hospitalization mortality between patients with AKI stage 2 and stage (χ(2)=0.686, P=0.408) while the hospitalization mortality in patients with AKI stage 2 was higher than those without AKI (χ(2)=8.113, P=0.004). The hospitalization expenses in patients with AKI were 10.38(8.59,12.54) ×10(4) RMB, significantly higher than that in patients without AKI (9.72(8.03,11.93) ×10(4) RMB)(P=0.043). There was no difference in hospitalization expenses between patients with AKI stage 1 and without AKI (P=0.635). The hospitalization expenses in patients with AKI stage 2 was higher than those without AKI (P=0.023). Intensive Care Unit stay duration in patients with AKI was 3(1,4) days, significantly higher than those without AKI (P=0.044). There was no difference in Intensive Care Unit stay duration in patients with AKI stage 1 and without AKI (P=0.978), while Intensive Care Unit stay duration in patients with AKI stage 2 was significantly longer than those without AKI (P=0.006). Conclusions: Preoperative complications of cerebral vascular disease is an independent risk factor of postoperative AKI. Non-senile patients with AKI after cardiac valvular surgery is associated with a higher proportion of mortality, hospitalization expenses and Intensive Care Unit stay duration as compared patients without postoperative AKI.


Assuntos
Lesão Renal Aguda , Adulto , Valvas Cardíacas , Humanos , Tempo de Internação , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Estudos Retrospectivos , Fatores de Risco
7.
Br J Oral Maxillofac Surg ; 57(7): 638-643, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31174895

RESUMO

Autotransplantation of teeth requires optimisation of both occlusion and direction to ensure minimal injury to the dental crown and the alveolar bone. We describe a method that could simulate postoperative occlusion and direction of the donor tooth by using CAD and digital surgical templates, and evaluate the postoperative effect in five patients who had teeth autotransplanted. Computed tomographic data were imported into ProPlan CMF 3.0 software, the donor tooth was simulated to replace the recipient site according to the position of the occlusion and alveolar bone, and a digital template was designed to guide preparation of the socket. A computer-aided, rapid prototyped, tooth was used to match the socket and, finally, an occlusal template was designed to ensure that the donor tooth was in the simulated position. We compared the position of the tooth in the simulation with its postoperative position using ProPlan CMF 3.0 software. In this way it was possible to simulate and guide the donor tooth accurately to the recipient site. At six-month follow up all teeth had survived successfully. Given the efficiency and precision of placement and the success, we conclude that CAD can successfully help to simulate occlusion and direction in autotransplantation of teeth while simplifying the procedure.


Assuntos
Simulação por Computador , Projeto Auxiliado por Computador , Implantação Dentária/métodos , Cirurgia Assistida por Computador , Dente/transplante , Adulto , Oclusão Dentária , Humanos , Alvéolo Dental/cirurgia , Transplante Autólogo/instrumentação , Transplante Autólogo/métodos
8.
Zhonghua Bing Li Xue Za Zhi ; 48(5): 378-384, 2019 May 08.
Artigo em Chinês | MEDLINE | ID: mdl-31104678

RESUMO

Objective: To observe the histopathological features of different opportunistic infections and tumors of the intestinal mucosa in AIDS patients, and to explore the correlation between different lesions and CD4+ T lymphocyte levels. Methods: Colonic mucosal biopsy specimens of 263 patients with clinically diagnosed AIDS and abdominal pain, diarrhea, blood in the stool and other gastrointestinal symptoms were collected from Beijing Ditan Hospital from 2010 to 2018. There were 232 males and 31 females, with age range 10-81 (mean 40±13) years. HE staining, histochemical special staining, immunohistochemical staining, and in-situ hybridization were used to detect the expression of different opportunistic infection pathogens, tumors and CD4+ T lymphocytes. Peripheral blood was also taken for CD4+ T lymphocytes, CD8+ T lymphocytes, HIV viral load and routine indicators. Results: The cohort included 263 intestinal mucosal biopsy specimens. There were 175 cases (66.5%) of non-specific inflammation, and pathogens were detected in 41 cases (15.6%), including 20 cases(7.6%) of cytomegalovirus (CMV) infection, 12 cases (4.6%) of mycobacterial infection, eight cases (3.0%) of amoeba infestation, and one case (0.3%) of talaromycesmarneffei infection; there were also 41 (15.6%) neoplastic lesions including 25 cases (9.5%) of intraepithelial neoplasia, 10 cases (3.8%) of adenocarcinoma and squamous cell carcinoma, six cases (2.3%) of lymphoma; and six cases (2.3%) of ulcerative colitis. The peripheral blood CD4+T lymphocyte levels of patients with CMV, mycobacteria and talaromycesmarneffei were less than 200/µL; the peripheral blood CD4+ T lymphocyte level (P<0.01) and intestinal mucosa CD4+T lymphocytes (P<0.01) were all significantly lower than those in patients with non-specific inflammation. The peripheral red blood cells and hemoglobin levels of patients with CMV and mycobacterial infection (P<0.01), adenocarcinoma and squamous cell carcinoma (P<0.05) were significantly lower than those of non-specific inflammation patients. Conclusions: Pathologic examination of intestinal mucosa can identify specific infections and neoplastic lesions in AIDS patients; the most common lesions are non-specific inflammation, and CMV infection is the most common opportunistic infections; CMV, mycobacteria and talaromycesmarneffei infections are associated with decreased levels of CD4+ T lymphocytes in peripheral blood and intestinal mucosa; entamoeba histolytica infestation and non-HIV-related neoplastic lesions such as intraepithelial neoplasia, adenocarcinoma and squamous cell carcinoma are not associated with changes in AIDS immune function.


Assuntos
Síndrome de Imunodeficiência Adquirida , Linfócitos T CD4-Positivos , Infecções por Citomegalovirus , Síndrome de Imunodeficiência Adquirida/imunologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Feminino , Humanos , Mucosa Intestinal/imunologia , Mucosa Intestinal/virologia , Masculino , Pessoa de Meia-Idade , Adulto Jovem
9.
J Phys Condens Matter ; 31(19): 195601, 2019 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-30848247

RESUMO

X-ray absorption spectroscopy (XAS) is performed to study changes in the electronic structures of colossal magnetoresistance (CMR) and charged ordered (CO) La1-x Ca x MnO3 manganites with respect to temperature. The pre-edge features in O and Mn K-edge XAS spectra, which are highly sensitive to the local distortion of MnO6 octahedral, exhibit contrasting temperature dependence between CMR and CO samples. The seemingly counter-intuitive XAS temperature dependence can be reconciled in the context of polarons. These results help identify the most relevant orbital states associated with polarons and highlight the crucial role played by polarons in understanding the electronic structures of manganites.

10.
Artigo em Chinês | MEDLINE | ID: mdl-31914291

RESUMO

Objective:To investigate the effect of vestibular rehabilitation exercise combined with manual reduction in the treatment of benign paroxysmal positional vertigo(BPPV). Method:A total of 186 patients with benign paroxysmal positional vertigo were selected and randomly divided into experimental group and control group . The control group was treated with manual reduction, while the experimental group was treated with manual reduction combined with vestibular rehabilitation exercises. Patients with posterior semicircular canal BPPV carried out Brandt-Daroff exercises, while patients with horizontal semicircular canal BPPV carried out Cawthorne-Cooksey exercises and position restriction. To analyze the clinical curative effect, DHI score, residual dizziness and recurrence of the two groups. Result:There was no significant difference in total efficiency rate and DHI score between the two groups at the first diagnosis(P>0.05). After 1 week, 2 weeks and 1 month of follow-up, the total efficiency rate of the experimental group were 90.3%, 91.4% and 93.5% respectively, which were significantly higher than those of the control group(P<0.05). Synchronously, the scores of DHI in experimental group were respectively 14.33±5.71, 12.25±4.98 and 9.45±3.70, which were significantly lower than the control group(P<0.05). For the experimental group, in the first diagnosis, 1 week, 2 weeks and 1 month after follow-up, residual dizziness patients were 29 cases, 13 cases, 8 cases and 0 cases. The mean duration of residual dizziness was (5.86±4.71) days, which was significantly lower than that in the control group(P<0.05). One month after follow-up, the recurrence of patients in the experimental group were 5 cases, while the control group were 11 cases, significant difference between the two groups(χ²=4.704, P=0.030). Conclusion:Manual reduction combined with vestibular rehabilitation exercise can significantly improve the therapeutic effect of BPPV, ameliorate the residual dizziness symptoms and reduce the recurrence rate, meanwhile improve the balance function and quality life of patients.


Assuntos
Vertigem Posicional Paroxística Benigna , Tontura , Terapia por Exercício , Humanos , Recidiva , Canais Semicirculares
11.
Eur Rev Med Pharmacol Sci ; 22(22): 7798-7806, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30536324

RESUMO

OBJECTIVE: MiR-638 is constantly downregulated and serves as a tumor suppressor in various cancers. Its role in gliomas remains unclear. This study is designed to investigate the clinical significance and the pathogenic role of miR-638 in human gliomas. PATIENTS AND METHODS: Quantitative Real-time PCR was performed to analyze the expression of miR-638 in the tumor and adjacent tissues of 24 glioma patients. The association between the expression of miR-638 and clinical features were examined. Survival of patients was studied by Kaplan-Meier curves. The impact of miR-638 on cell growth and apoptosis was determined by CCK-8 assay, colony formation assay, cell cycle analysis and Annexin V-FITC-PI apoptosis assay. The effect of miR-638 on HOXA9 was determined by luciferase assay and Western blot. The effect of miR-638 and HOXA9 on expression of oncogenes, Cyclin D1 and C-MYC was determined by Western blot. RESULTS: MiR-638 expression was constantly downregulated in glioma tumor tissue, which is negatively correlated with the WHO grade. MiR-638 expression was associated with clinical features such as tumor size, KPS score and WHO grade. Patients with low miR-638 had a worse overall survival than those with high expression. Experimentally, miR-638 directly targeted HOXA9 to suppress its expression, leading to attenuations of cell proliferation, colony formation and cell cycle progression and enhanced basal apoptosis level. MiR-638/HOXA9 axis also suppressed the expression of Wnt/beta-catenin-regulated oncogenes, Cyclin D1 and C-MYC. CONCLUSIONS: MiR-638 is a constantly downregulated microRNA in gliomas and is associated with its prognosis. MiR-638 regulates cellular malignancy of gliomas through targeting HOXA9. Thus, miR-638/HOXA9 signaling axis may have therapeutic potential in gliomas.


Assuntos
Glioma/genética , Proteínas de Homeodomínio/metabolismo , MicroRNAs/genética , Apoptose/genética , Linhagem Celular Tumoral , Proliferação de Células/genética , Ciclina D1/metabolismo , Regulação para Baixo , Feminino , Genes Supressores de Tumor , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Transdução de Sinais , beta Catenina/metabolismo
12.
Fa Yi Xue Za Zhi ; 34(4): 359-362, 2018 Aug.
Artigo em Inglês, Chinês | MEDLINE | ID: mdl-30465398

RESUMO

OBJECTIVES: To explore the assessment method of original height of L1-2 after vertebral compression fracture and its application value in forensic clinical practice. METHODS: A total of 154 normal thoracic and lumbar X-ray films were collected, and 140 cases were used as experimental group while 14 cases as validation group. The heights of anterior (Ha) and posterior (Hp) vertebral body of T12-L3 vertebrae in each X-ray image were measured. In the experimental group, the correlation analysis between HaL1 and HaT12, HpT12, HpL1, HaL2 and HpL2 was carried out, and regression equation was established via fitting. The correlation analysis between HaL2 and HaL1, HpL1, HpL2, HaL3, HpL3 was performed, and the regression equation was also established via fitting. The difference between the predicted and measured values of HaL1 and HaL2 in validation group was compared. RESULTS: In the 140 normal subjects, HaL1 (y1) was well correlated with HaT12 (x1) and HaL2(x2), and the multiple linear regression equation was y1=2.545+0.423 x1+0.486 x2 (determining coefficient R²=0.712, P<0.05; F=169.206, P<0.05). There was no significant difference between the predicted and actual measured values of HaL1 in the validation group ( P>0.05). HaL2 (y2) was well correlated with HaL1 (x3) and HaL3 (x4), and the multiple linear regression equation was y2=4.354+0.530 x3+0.349 x4 (determining coefficient R²=0.689, P<0.05; F=151.575, P<0.05). There was no significant difference between the predicted and actual measured values of HaL2 in the validation group ( P>0.05). CONCLUSIONS: It is more appropriate to evaluate the original height of L1 or L2 single vertebrae by comparing with the height of the anterior edge of the upper and lower adjacent vertebral bodies.


Assuntos
Fraturas por Compressão , Vértebras Lombares/diagnóstico por imagem , Fraturas da Coluna Vertebral/cirurgia , Vértebras Torácicas/diagnóstico por imagem , Idoso , Humanos , Pessoa de Meia-Idade
13.
Zhonghua Wai Ke Za Zhi ; 56(12): 916-921, 2018 Dec 01.
Artigo em Chinês | MEDLINE | ID: mdl-30497119

RESUMO

Objective: To analyze the early and midterm results of surgical treatment of interrupted aortic arch (IAA) with double-ventricular procedure. Methods: The data of the 68 cases with the main diagnosis of IAA with biventricular structure from June 2009 to June 2017 at Department of Cardiac Surgery, Guangdong General Hospital was collected, including 46 cases of type A, 22 cases of type B. There was no type C case. Except for 5 cases without patent ductus arteriosus or other intracardiac malformations, the remaining 63 cases were combined with intracardiac deformity. The age of operation was 8 days to 18 years, including 28 cases(41.2%) of newborns, 32 cases(47.1%) within 1 year old, 6 cases(8.8%) from 1 to 15 years old, and 2 cases(2.9%) above 15 years old. Of the 5 patients with no intracardiac malformations, 4 patients were treated with a left-posterior thoracic lateral incision for primary surgical correction with end-to-side anastomosis, and 1 adult patient was treated with a median sternotomy incision to complete the anastomosis with the assist of extracorporeal circulation. Of the 63 patients with intracardiac malformation, 2 underwent reconstruction of the aortic arch via posterolateral left thoracic incision merely; 2 patients underwent staged surgery to correction the IAA and intracardiac malformation; the remaining 59 patients underwent the one-stage procedure of IAA and intracardiac malformation correction with deep hypothermic circulatory arrest and 43 cases of selective cerebral perfusion. A total of 55 cases of end-to-end or end-to-side anastomosis were performed in all aortic arch reconstruction. There were 6 cases of connection the arch to descending aorta with autogenous pulmonary artery conduit, and 1 case with homemade bovine pericardial conduit. And there were 5 cases of anastomosis enlargement with autogenous pulmonary artery patch, and 1 case with left subclavian artery flap patch. There were 1 case performed with D. K.S. operation for the severe hypogenetic aortic valve and ascending aorta, and 1 case with left ventricular double outlet channel operation for the severe subvalvular aortic stenosis. Results: Follow-up to 9 years, 4 deaths (5.9%) related to circulatory system diseases: 3 cases died within 30 days after surgery (1 case was neonatal, 2 cases were 1 to 12 months old); one died 8 months after surgery for low cardiac output syndrome. In the early postoperative period, 11 cases (16.2%) of residual aortic arch obstruction (pressure gradient >30 mmHg) were observed, of which 3 cases were moderate (4.4%); follow-up to 5 years after operation was residual obstruction in 3 cases and moderate in 2 cases. There were 3 cases with aortic valve and subvalvular obstruction (differential pressure >30 mmHg), 3 cases were followed up to 5 years after aortic valve and subvalvular obstruction, and 2 cases were moderate or above. To date, 5 patients have undergone 6 reoperations of the cardiovascular system: 3 cases because of pulmonary artery stenosis, 2 cases because of severe aortic arch stenosis, and 1 case because of aortic subvalvular obstruction. Conclusions: One-stage surgical repair of IAA is safe and clinically effective in the neonatal and infant. But some patients still requires reoperation for re-obstruction from subvalvular or aorta arch. For some patients, the choice of aortic arch reconstruction depends on the specific situation.


Assuntos
Aorta Torácica , Coartação Aórtica , Procedimentos Cirúrgicos Cardíacos , Adolescente , Animais , Aorta Torácica/anormalidades , Aorta Torácica/cirurgia , Coartação Aórtica/cirurgia , Bovinos , Criança , Pré-Escolar , Humanos , Lactente , Recém-Nascido , Reoperação , Resultado do Tratamento
14.
Curr Mol Med ; 18(3): 152-159, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30198434

RESUMO

BACKGROUND: Blepharophimosis syndrome (BPES) is characterized by eyelid malformation with occasional premature ovarian failure. Mutations in FOXL2 underlie a fraction of BPES cases. OBJECTIVE: We aimed to investigate the genetic basis of BPES in 26 Chinese families that included 78 patients. METHODS: We performed ophthalmological examinations on each family member. We used Sanger sequencing to screen FOXL2 exons and their flanking sequences. We also performed bioinformatics studies, structural modeling and pathogenicity evaluations on all identified variations. Literature was reviewed and genotype-phenotype correlation analysis was performed. RESULTS: The patients had typical manifestations of BPES. Ten mutations were identified in ten of the twenty-six families. Among these, seven were novel mutations. These included the six truncating mutations, p.Glu69*, p.Gly256Glyfs*14, p.Ala14Serfs*135, p.Pro333Profs*200, p.Pro290Leufs*70, and p.Pro157Profs*91, and one missense mutation, p.Tyr59Cys. The mutations were scattered within the gene, and no mutational hotspots were found. Genotype-phenotype correlation analysis showed that frameshift or nonsense mutations were correlated with type I BPES, while in-frame or missense mutations were associated with type II BPES. CONCLUSION: We report the largest BPES cohort in China thus far as well as seven novel mutations in FOXL2. The identification of novel mutations has not only expanded the mutational spectrum of the gene (which is valuable for mutation detection-based screening) but also suggests that most mutations within the Chinese population may not have been characterized yet.


Assuntos
Blefarofimose/genética , Família , Proteína Forkhead Box L2/genética , Mutação de Sentido Incorreto , Linhagem , Adulto , Substituição de Aminoácidos , Blefarofimose/patologia , Criança , Pré-Escolar , China , Feminino , Humanos , Lactente , Masculino
15.
Zhonghua Wai Ke Za Zhi ; 56(6): 410-413, 2018 Jun 01.
Artigo em Chinês | MEDLINE | ID: mdl-29886661

RESUMO

As a result of right ventricular outflow tract reconstruction, which is the important and basic step of complex cardiac surgery, the blood flow of right ventricular outflow tract is unobstructed, while pulmonary valve regurgitation and right heart dysfunction could be happened. These problems are often ignored in early days, more and more cases of right heart dysfunction need clinical intervention, which is quite difficult and less effective. How to protect effectively the right ventricular function is the focus. At present main methods to protect the right ventricular function include trying to avoid or reduce length of right ventricular incision, reserving or rebuilding the function of the pulmonary valve, using growth potential material for surgery. The protection of the right ventricular function is a systemic project, it involves many aspects, single measures is difficult to provide complete protection, only the comprehensive use of various protection strategy, can help to improve the long-term prognosis.


Assuntos
Implante de Prótese de Valva Cardíaca , Próteses Valvulares Cardíacas , Insuficiência da Valva Pulmonar , Obstrução do Fluxo Ventricular Externo , Humanos , Valva Pulmonar , Insuficiência da Valva Pulmonar/cirurgia , Resultado do Tratamento , Obstrução do Fluxo Ventricular Externo/cirurgia
16.
Phys Chem Chem Phys ; 20(17): 12084-12096, 2018 May 03.
Artigo em Inglês | MEDLINE | ID: mdl-29676425

RESUMO

The interactions of energetic ions with multi-cation compounds and their consequences in terms of changes in the local electronic structure, which may facilitate intriguing hybridization between O 2p and metal d orbitals and magnetic ordering, are the subject of debate and require a deep understanding of energy transfer processes and magnetic exchange mechanisms. In this study, nanocrystals of ZnFe2O4 were exposed to O7+ ions with an energy of 100 MeV to understand, qualitatively and quantitatively, the metal-ligand field interactions, cation migration and magnetic exchange interactions by employing X-ray absorption fine structure measurements and X-ray magnetic circular dichroism to get deeper mechanistic insights. Nanosized zinc ferrite nanoparticles (NPs) with a size of ∼16 nm synthesized in the cubic spinel phase exhibited deterioration of the crystalline phase when 100 MeV O7+ ions passed through them. However, the size of these NPs remained almost the same. The behaviour of crystal deterioration is associated with the confinement of heat in this interaction. The energy confined inside the nanoparticles promotes cation redistribution as well as the modification of the local electronic structure. Prior to this interaction, almost 42% of Zn2+ ions occupied AO4 tetrahedra; however, this value increased to 63% after the interaction. An inverse effect was observed for metal ion occupancies in BO6 octahedra. The L-edge spectra of Fe and Zn reveal that the spin and valence states of the metal ions were not affected by this interaction. This effect is also supported by K-edge measurements for Fe and Zn. The t2g/eg intensity ratio in the O K-edge spectra decreased after this interaction, which is associated with detachment of Zn2+ ions from the lattice. The extent of hybridization, as estimated from the ratio of the post-edge to the pre-edge region of the O K-edge spectra, decreased after this interaction. The metal-oxygen and metal-metal bond lengths were modified as a result of this interaction, as determined from extended X-ray absorption fine structure measurements. These measurements further support the observation of cation migration from AO4 tetrahedra to AO6 octahedra and vice versa. The Fe L-edge magnetic circular dichroism spectra indicate that Fe3+ ions occupying sites in AO4 tetrahedra and BO6 octahedra exhibited antiferromagnetic-like ordering prior to this interaction. The NPs that interacted with energetic O ions displayed a different kind of magnetic ordering.

17.
Fa Yi Xue Za Zhi ; 34(1): 67-72, 2018 Feb.
Artigo em Chinês | MEDLINE | ID: mdl-29577708

RESUMO

Binocular vision refers to a progress of analysing and integrating the binocular visual signals into a whole and three-dimensional sensory perception by higher nerve centre. In this process, the interac- tion between the two eyes results in the changes of output signal, which is called binocular interaction. Through a series of subjective and objective experiments, it can be concluded that binocular interaction can be divided into three types: facilitation, summation and suppression, and the forms of binocular interaction in different visual states are different. In general, the visual signal is processed by binocular interaction, so that there are some differences between binocular vision and monocular vision. The extent of the difference can be affected by the damage of monocular vision and then affects the binocular vision. Thus, it is necessary for forensic scientists to further study the effects of the monocular visual impairment on visual function. Based on relevant data, this paper reviews the mechanism of the monocular visual impairment in binocular vision, the research methods and the application prospect in forensic science.


Assuntos
Transtornos da Visão , Visão Binocular , Visão Monocular , Acuidade Visual , Adulto , Humanos , Visão Ocular
18.
J Phys Condens Matter ; 30(15): 155601, 2018 Apr 18.
Artigo em Inglês | MEDLINE | ID: mdl-29498360

RESUMO

We present magnetic susceptibility, heat capacity, and neutron diffraction measurements of polycrystalline Nd2Ru2O7 down to 0.4 K. Three anomalies in the magnetic susceptibility measurements at 146, 21 and 1.8 K are associated with an antiferromagnetic ordering of the Ru4+ moments, a weak ferromagnetic signal attributed to a canting of the Ru4+ and Nd3+ moments, and a long-range-ordering of the Nd3+ moments, respectively. The long-range order of the Nd3+ moments was observed in all the measurements, indicating that the ground state of the compound is not a spin glass. The magnetic entropy of Rln2 accumulated up to 5 K, suggests the Nd3+ has a doublet ground state. Lattice distortions accompany the transitions, as revealed by neutron diffraction measurements, and in agreement with earlier synchrotron x-ray studies. The magnetic moment of the Nd3+ ion at 0.4 K is estimated to be 1.54(2)µ B and the magnetic structure is all-in all-out as determined by our neutron diffraction measurements.

19.
Zhonghua Yi Xue Za Zhi ; 98(6): 454-456, 2018 Feb 06.
Artigo em Chinês | MEDLINE | ID: mdl-29429259

RESUMO

Objective: To evaluate the clinical application and effect of preseting Double-J ureteric stent in percutaneous nephrolithotripsy. Method: 74 cases of renal calculi treated with PCNL in our hospital during June 2014 to February 2017 were retrospectively analyzed. Of 74 cases, 54 was male, 20 was female. All cases were aged 27 to 78, the mean age was (49.5±12.3) years old. The diameter of the stone was 20 to 59 mm, and the mean diameter was of (29.4±4.3) mm.Our Surgical methods was first putingFr6 double J tube in abnormal ureteral in advance in lithotomy position, then indwellingthree-way Foley catheter and clipping drainage port, perfusingirrigation port with 3 000 ml saline from 60-80 cm height.Perfusingsaline through irrigation port in prone position, we produce artificial hydronephrosis, then indwelling channel Fr20 through B ultrasound guided percutaneous nephrostomy, and removing renal calculi using holmium laser lithotripsy. Results: All patients were successfully completed percutaneous nephrostomy and indwell Fr20 channel, mean channel set up time (8.0 ±2.0) min, mean operation time (79±46) min, mean decline of hemoglobin (17.0±4.0) g/L, mean serum creatinine increased(3.1±1.1) µmol/L, one-stage stone-free rates 81.1%, complication rate 8.1% (1 case injured pleura and suffered from pneumothorax, 1 case suffered from massive hemorrhage of renal arteriovenous fistula after operation, 4 cases suffered postoperative fever). Conclusion: Advance in percutaneous nephrolithotripsy indwelling double J tube is a safe and feasible method, which is advantageous to the percutaneous renal puncture and the establishment of channels, and can avoid the blindness of along the line of indwelling double J.


Assuntos
Litotripsia , Adulto , Idoso , Feminino , Humanos , Cálculos Renais , Masculino , Pessoa de Meia-Idade , Nefrostomia Percutânea , Punções , Estudos Retrospectivos
20.
Zhonghua Wai Ke Za Zhi ; 56(1): 35-40, 2018 Jan 01.
Artigo em Chinês | MEDLINE | ID: mdl-29325351

RESUMO

Objective: To evaluate risk factors for delayed gastric emptying(DGE)following pancreaticoduodenectomy(PD). Methods: There were 492 consecutive patients who underwent PD in Pancreas Center, the First Affiliated Hospital with Nanjing Medical University between January 2012 and December 2014 were identified from a prospective database.There were 315 male and 177 female patients with a median age of 60.5 years.Univariate and multivariate analyses were performed to investigate the independent risk factors for clinically relevant DGE(CR-DGE). Results: The overall incidence of DGE was 29.5%, with Grade B and C occurring at 4.3% and 5.9%, respectively.In multivariate analysis, pancreatic duct diameter less than 3 mm(OR=1.888, P=0.042), pylorus-preserving pancreaticoduodenectomy(OR=2.627, P=0.005) and clinically relevant postoperative pancreatic fistula(OR=2.740, P=0.007) were independently associated with CR-DGE.Other main complications such as postoperative pancreatic fistula, pyoperitoneum, intraabdominal infection were also associated with the severity of DGE(χ(2)=21.360, 14.422, 14.378; P=0.011, 0.002, 0.002). DGE patients had a significantly prolonged postoperative length of stay(31(24-41)d vs. 13(11-17)d) and increased medical cost((122 367.5±66 068.3)yuan vs. (78 200.7±27 043.9)yuan)(both P<0.01). Conclusions: Small pancreatic duct, underwent pylorus-preserving pancreaticoduodenectomy and suffered postoperative pancreatic fistula might indicate a high risk of CR-DGE.


Assuntos
Gastroparesia , Pancreaticoduodenectomia , Feminino , Esvaziamento Gástrico , Gastroparesia/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Estudos Prospectivos , Fatores de Risco , Resultado do Tratamento
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