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Objective: Through comparative analysis of the disease burden of occupational pneumoconiosis in Gansu Province from 2010 to 2020, the main influencing factors are screened, and scientific basis is provided for rational allocation of limited health resources, precise management and policy implementation. Methods: In August 2021, survey and collect information on surviving occupational pneumoconiosis patients and dead occupational pneumoconiosis patients diagnosed in Gansu Province from 2010 to 2020, and analyze and calculate indicators such as morbidity, mortality, and disability adjusted of life years (DALY). Analyzing the influencing factors of disease burden usirrg multiple linear regression. Results: From 2010 to 2020, the average annual incidence of occupational pneumoconiosis in Gansu Province was 0.9992/100000, the average annual mortality was 0.897/100000, the cumulative case fatality rate was 25.75%, and the cumulative DALY was 28932.96 person-years. The first stage of occupational pneumoconiosis was the highest among DALY loss (19920.14 person-years), and the DALY loss was positively correlated with the stage of occupational pneumoconiosis. Among occupational pneumoconiosis in Gansu Province, silicosis (13753.66 person-years) and coal worker's pneumoconiosis (13414.73 person-years) caused the highest disease burden, followed by cement pneumoconiosis and asbestos lung. Period, length of service, type of disease, and region are all influencing factors of DALY loss (P<0.05). Conclusion: From 2010 to 2020, the DALY losses caused by occupational pneumoconiosis in Gansu Province showed a fluctuating decrease, with the composition of DALY mainly changing from the loss of life years due to premature death to the loss of years due to injury and disability.
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Antracose , Amianto , Pneumoconiose , Silicose , Humanos , Pneumoconiose/epidemiologia , Silicose/epidemiologia , Antracose/epidemiologia , Efeitos Psicossociais da Doença , China/epidemiologiaRESUMO
Objective: To examine the clinical effect of minimally invasive duodenum preserving pancreatic head resection(DPPHR) for benign and pre-malignant lesions of pancreatic head. Methods: The clinical data of patients with diagnosis of benign or pre-malignant pancreatic head tumor were retrospectively collected and analyzed,all of them underwent laparoscopic or robotic DPPHR between October 2015 and September 2021 at Division of Gastrointestinal and Pancreatic surgery,Zhejiang Provincial People's Hospital. Thirty-three patients were enrolled with 10 males and 23 females. The age(M(IQR)) was 54(32) years old(range: 11 to 77 years old) and the body mass index was 21.9(2.9)kg/m2(range: 18.1 to 30.1 kg/m2). The presenting symptoms included abdominal pain(n=12), Whipple triad(n=2), and asymptomatic(n=19). There were 7 patients with hypertension and 1 patient with diabetes mellitus. There were 19 patients who were diagnosed as American Society of Anesthesiologists class â and 14 patients who were diagnosed as class â ¡. The student t test,U test, χ2 test or Fisher exact test was used to compare continuous data or categorized data,respectively. All the perioperative data and metabolic morbidity were analyzed and experiences on minimally invasive DPPHR were concluded. Results: Fourteen patients underwent laparoscopic DPPHR,while the rest of 19 patients received robotic DPPHR. Indocyanine green fluorescence imaging was used in 19 patients to guide operation. Five patients were performed pancreatico-gastrostomy and the rest 28 patients underwent pancreaticojejunostomy. Pathological outcomes confirmed 9 solid pseudo-papillary neoplasms, 9 intraductal papillary mucinous neoplasms, 7 serous cystic neoplasms, 6 pancreatic neuroendocrine tumors, 1 mucous cystic neoplasm, 1 chronic pancreatitis. The operative time was (309.4±50.3) minutes(range:180 to 420 minutes),and the blood loss was (97.9±48.3)ml(range:20 to 200 ml). Eighteen patients suffered from postoperative complications,including 3 patients experienced severe complications(Clavien-Dindo Grade ≥â ¢). Pancreatic fistula occurred in 16 patients,including 8 patients with biochemical leak,7 patients with grade B pancreatic fistula and 1 patient with grade C pancreatic fistula. No one suffered from the duodenal necrosis and none perioperative death was occurred. The length of hospital stay was 14(7) days (range:6 to 87 days). The follow-up was 22.6(24.5)months(range:2 to 74 months). None suffered from recurrence or metastasis. During the follow-up,all the patients were free of refractory cholangitis. Moreover,in the term of endocrine dysfunction,no postoperative new onset of diabetes mellitus were observed in the long-term follow-up. However,in the view of exocrine insufficiency,pancreatic exocrine insufficiency and non-alcoholic fatty liver disease (NAFLD) was complicated in 2 and 1 patient,respectively,with the supplement of pancreatic enzyme,steatorrhea and weight loss relieved,but NAFLD was awaited to be seen. Conclusions: Minimally invasive DPPHR is feasible and safe for benign or pre-malignant lesions of pancreatic head. Moreover,it is oncological equivalent to pancreaticoduodenectomy with preservation of metabolic function without refractory cholangitis.
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Pancreatectomia , Neoplasias Pancreáticas , Adolescente , Adulto , Idoso , Criança , Duodeno/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pâncreas/cirurgia , Neoplasias Pancreáticas/cirurgia , Pancreaticoduodenectomia , Complicações Pós-Operatórias , Estudos Retrospectivos , Adulto JovemRESUMO
Objective: To investigate the clinicopathological features, diagnosis, differential diagnosis, and molecular alterations of malignant gastrointestinal neuroectodermal tumor (MGNET). Methods: Four cases of MGNET were collected at Fujian Provincial Hospital, from July 2013 to January 2019. H&E and immunohistochemical staining were retrospectively evaluated, together with genetic mutation analysis of EWSR1. The relevant literature was systematically reviewed. Results: There were two male and two female patients, with an age range of 34-81 (median 57) years. Tumor sizes ranged from 5-9 (median 6.8) cm. Microscopy showed diffuse and flaky growth of tumor cells, some of which were small and round. The tumor cells were arranged in solid, flaky, nested or pseudoadenoid patterns. The tumor cells were epithelioid, oval, short spindled, or small, with round or oval nuclei. The cytoplasm was eosinophilic or clear. Osteoclast-like multinucleated giant cells were scattered focally. Mitosis was about (2-10)/10 HPF. Immunohistochemically, the tumor cells were positive for S-100 protein (4/4), SOX10 (4/4), Syn (2/4), INI1 (4/4), H3K27Me3 (4/4) and vimentin (4/4). Ki-67 index was 15%-90%. Gene mutation detection confirmed EWSR1 mutation in all four cases, and C-KIT/PDGFRα genes were not mutated in two cases. Conclusions: MGNET is a rare high grade malignant soft tissue tumor. The diagnosis is based on clinicopathological, immunophenotypic, and molecular pathology features. The primary treatment for MGNET is complete surgical excision and chemotherapy; the prognosis is poor.
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Neoplasias Gastrointestinais , Tumores Neuroectodérmicos , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores Tumorais , Feminino , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Proteínas S100RESUMO
Objective: The epidemiological characteristics of occupational pneumoconiosis in Gansu Province from 2010 to 2018 were analyzed to provide a theoretical basis for the development of prevention and control strategies for pneumoconiosis in Gansu Province. Methods: In March 2019, the data of newly diagnosed occupational pneumoconiosis in 2010-2018 and the data of occupational pneumoconiosis as of December 31, 2018 in Gansu Province were collected by the Occupational Disease and Occupational Health Information Monitoring System. The stage, type of disease, time, enterprise information of newly diagnosed pneumoconiosis and the region, type of disease, enterprise information of existed pneumoconiosis were analyzed. Results: From 2010 to 2018, a total of 1269 new cases of occupational pneumoconiosis were reported in Gansu Province, including 818 cases (64.46%) of stage I pneumoconiosis, 284 cases (22.38%) of stage II pneumoconiosis, 167 cases (13.16%) of stage III pneumoconiosis. Silicosis, coal worker's pneumoconiosis and cement pneumoconiosis ranks the top 3, accounting for 55.71% (707/1269) , 37.67% (478/1269) and 3.78% (48/1269) of the total number, respectively. The new cases of stage III pneumoconiosis were mainly distributed in private economy (58.09%, 79/136) and small-sized (59.88%, 97/162) enterprises. As of December 31, 2018, Gansu Province had reported a total of 12211 cases of occupational pneumoconiosis, of which 58.16% (7102/12211) were coal worker's pneumoconiosis and 28.15% (3438/12211) were silicosis. Mainly distributed in Baiyin city (21.63%, 2641/12211) , Lanzhou city (17.79%, 2172/12211) and Wuwei city (13.73%, 1676/12211) . The existed cases of pneumoconiosis are mainly distributed in state-owned economy (76.95%, 9396/12211) and large-sized (54.23%, 6622/12211) enterprises. Conclusion: Silicosis and coal worker's pneumoconiosis are the main type of pneumoconiosis in Gansu Province. And the number of silicosis reported is on the rise, which should be taken seriously. Pneumoconiosis in Gansu Province is mainly distributed in state-owned economy and large-sized enterprises. However, pneumoconiosis patients in private economy and small-sized enterprise is generally serious, so it should be the focus of supervision.
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Antracose , Minas de Carvão , Doenças Profissionais , Pneumoconiose , Silicose , Antracose/epidemiologia , China/epidemiologia , Cidades , Humanos , Pneumoconiose/epidemiologiaRESUMO
Based on the theories of quantum weak measurement, we built a set of linear common-path optical weak measurement systems in frequency domain for detecting chiral molecules. The polarization resolution with this system to detect the optical rotation of chirality molecules is nearly two orders of magnitude higher than that of conventional polarizers. Combined with ultraviolet spectroscopy, the purity of the proline enantiomers mixture was detected. The purity resolution can reach to 0.14%, which is comparable to the liquid chromatography. Weak measurement combined with ultraviolet spectroscopy to non-separatedly detect the purity of chiral enantiomers has great application potential in the pharmaceutical industry.
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Objective: To explore the characteristics of serum D-dimer level before and after delivery in women with advanced maternal age (VTE), and to assess the value of the characteristics for the diagnosis of venous thromboembolic disease. Methods: The objects were 785 puerperae with advanced maternal age (AMA) who experienced delivery in Women's Hospital, Zhejiang University School of Medicine during 1(st) Jan 2017 to 31(st) Dec 2017, and 327 puerperae with appropriate maternal age as controls were randomly selected from puerperae who gave birth in the same period. Their serum D-dimer levels before and after delivery were evaluated, and AMAs with high-level postnatal serum D-dimer were specially observed for the prognosis. Besides, puerperae complicated with VTE were retrieved from the medical database during 2014-2018, and their clinical characteristics and dynamic variation of serum D-dimer levels were analyzed. Result: The significant difference of D-dimer levels neither before nor after delivery was not observed between AMAs and controls (antenatal: 1.64(1.19, 2.29) mg/L vs 1.53(1.04, 2.23) mg/L, and postnatal: 2.70(1.71, 2.97) mg/L vs 2.63(1.17, 4.13) mg/L, P<0.05 for both; None of AMAs with high-level serum D-dimer after delivery were complicated with VTE, and most of their serum D-dimer levels decreasedsharply with in four postnatal days (the average decrease was 9.2(7.69,12.74) mg/L, and 96.2% of the sepuerperae's decrease was more than 50%). Eight puerperae complicated with VTE were found in the database from 2014 to 2018, among which five were AMAs. The eight puerperae all received a B ultrasound because of the discomfort of lower limbs or abnormal variation of serum D-dimer levels (a slow decrease or an increase trend), so that a diagnosis of VTE was established; besides, the diagnosis or symptoms all emerged in the 3(rd) to 5(th) day after caesarean. Conclusions: The factor of advanced maternal age has little influence on the serum D-dimer level before or after delivery among pregnant women. It is not a single detection for serum D-dimer level, but the intensive monitoring of clinical symptoms and dynamic change of serum D-dimer level, that helps early diagnosis of VTE.
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Produtos de Degradação da Fibrina e do Fibrinogênio/análise , Idade Materna , Gravidez/sangue , Tromboembolia Venosa/sangue , Estudos de Casos e Controles , Feminino , Humanos , Tromboembolia Venosa/diagnósticoRESUMO
Objective: To describe the status quo of short term quality of life after discharge in patients with colorectal cancer (CRC) following enhanced recovery after surgery (ERAS) pathway and to explore its influencing factors. Methods: Surveys of 127 CRCs following ERAS pathway were conducted. The Readiness for Hospital Discharge Scale and Quality of Life Questionnaire-Core 30 (QLQ-C30) were issued at the discharge and 1 months after the operation,respectively. Results: The score of global quality of life was 66.8±18.8. Education,surgical type,stoma,and the readiness for hospital discharge were influencing factors of global quality of life. Conclusion: CRC patients' global quality of life is at the middle level. Patients with low education,open surgery,stoma and low readiness for hospital discharge are of poor global quality of life at 1 months after the operation,which should be regarded as the focus of medical attention.
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Neoplasias Colorretais , Qualidade de Vida , Humanos , Alta do Paciente , Inquéritos e QuestionáriosRESUMO
Objective: To correlate chromosomal translocations of DUSP22 or TP63 with clinical significance in ALK-negative anaplastic large cell lymphoma (ALK(-)ALCL). Methods: Thirty-two patients with ALK(-)ALCL were selected from January 2004 to January 2014 at Fujian Provincial Hospital for the detection of chromosomal translocations of DUSP22 and TP63 by fluorescence in situ hybridization (FISH). The relationship between DUSP22 and TP63 chromosomal translocations and the clinicopathological parameters of ALK(-)ALCL was analyzed. Results: Among the 32 ALK(-)ALCL patients, 7(21.8%) had DUSP22 gene rearrangement (DUSP22(+)ALK(-)ALCL). Three patients (9.4%) had TP63 gene rearrangement (TP63(+) ALK(-)ALCL). There were 22 patients (68.8%) without rearrangement of either DUSP22 or TP63 (DUSP22(-)TP63(-)ALK(-)ALCL). The patients with DUSP22(+) ALK(-)ALCL were among the younger, and the patients with TP63(+) ALK(-)ALCL were among the elder. The mean age of patients with DUSP22(-)TP63(-)ALK(-) ALCL was between those of DUSP22(+)ALK(-)ALCL and TP63(+) ALK(-)ALCL (P<0.05). Based on Ann Arbor staging, incidence of DUSP22 gene rearrangement decreased as the clinical stage of ALK(-)ALCL increased (P<0.05). Incidence of TP63 gene rearrangement cases increases in patients at more advanced clinical stage(P<0.05). The five-year survival rate and prognosis of patients with DUSP22(+)ALK(-)ALCL were the highest. Patients with TP63(+) ALK(-)ALCL had the lower five-year survival and the worse prognosis (P<0.05). Conclusion: Presences of DUSP22 and TP63 chromosomal translocations correlate with the clinical stages and prognosis of ALK(-)ALCL and may be used for the differential diagnosis, determination of tumor aggressiveness and prognostication of ALK(-)ALCL.
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Quinase do Linfoma Anaplásico/genética , Fosfatases de Especificidade Dupla/genética , Linfoma Anaplásico de Células Grandes/genética , Fosfatases da Proteína Quinase Ativada por Mitógeno/genética , Fatores de Transcrição/genética , Translocação Genética , Proteínas Supressoras de Tumor/genética , Humanos , Hibridização in Situ FluorescenteAssuntos
Sarcoma , Neoplasias de Tecidos Moles , Neoplasias Uterinas , Feminino , Humanos , Sarcoma/genética , Sarcoma/patologia , Neoplasias Uterinas/genética , Neoplasias Uterinas/cirurgia , Neoplasias Uterinas/patologia , Receptor trkA/genética , Biomarcadores Tumorais , Proteínas de Fusão Oncogênica/genética , Rearranjo GênicoRESUMO
Objective: To analyze the epidemiological characteristics of occupational diseases in Gansu Province, China in 2010-2017, and to provide a scientific basis for the prevention and control of occupational diseases. Methods: The cluster sampling method was adopted to make statistical analysis of 1339 cases of occupational disease reported by "occupational disease and occupational health information monitoring system" in Gansu province from 2010 to 2017, to investigate the diseases, regions and industries of occupational diseases in June 2018. Results: A total of 1339 cases of occupational diseases (39 types, 8 classes) were diagnosed and reposed in 2010-2017. The three most frequent diseases were pneumoconiosis (87.53%, 1172/1339), occupational poisonings (5.83%, 78/1339), and occupational ear, nose, and throat (ENT) diseases (3.14%, 42/1339). The cases of silicosis accounted for 54.61% (640/1172) of all cases of pneumoconiosis, the second was coalworker pneumoconiosis, which accounted for 38.57% (452/1172). In the cases of occupational poisonings, 32.05% (25/78) suffered from carbon monoxide poisoning. Patients with occupational diseases were reported in 14 districts of Gansu, mostly in Lanzhou (27.52%, 347/1261), Jinchang (16.57%, 209/1261), and Baiyin (14.20%, 179/1261). The reported cases are mainly concentrated in mining (71.56%, 468/654) and manufacturing (21.87%, 143/654), the types of state-owned economy (55.63%, 692/1244) and private economy (33.68%, 419/1244), large (43.41%, 540/1244) and small enterprises (35.21%, 438/1244) in 2010-2017 in Gansu. Conclusion: The pneumoconiosis caused by silicious and coal dust and the occupational poisonings caused by carbon monoxide seem to be the main occupational hazards in Gansu province. Occupational diseases occur in all districts of Guangzhou and in various industries. The state-owned economy and private sector, large and small enterprises should be the focuses of occupational health supervision.
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Doenças Profissionais/epidemiologia , Pneumoconiose/epidemiologia , Intoxicação/epidemiologia , Intoxicação por Monóxido de Carbono/epidemiologia , China/epidemiologia , Estudos Epidemiológicos , Humanos , IncidênciaRESUMO
Objective: To investigate the effect of different cryoablation time on tracheal traumatic granulation formation and its mechanism. Methods: A total of 32 rabbits were randomly assigned into four groups (A-D). Group A underwent tracheotomy alone. Group B, C and D received intra-tracheal brush rubbing to establish airway granulation model. Group C and D underwent 30 s and 2-minute cryoablation respectively. Tracheal specimens of all groups were collected to examine pathological changes using HE staining. Levels of transforming growth factor beta 1 (TGF-ß(1)) and CD34 in tracheal granulation were evaluated using immunohistochemistry (IHC) and real-time quantitative reverse transcription polymerase chain reaction (RT-qCR). Results: Tracheal lumens of group A were smooth without granulation. While the growth of granulation and luminal stenosis were most severe in Group B, followed by Group D and C. Submucosa thickness of Group B was largest as compared with other groups (0.20±0.07, 0.77±0.28, 0.44±0.13 and 0.55±0.18 mm for Group A to D, respectively. P<0.05). And the submucosa layer of Group C was thinner than Group D (P<0.05). The expression and transcription levels of TGF-ß(1) of trachea were highest in Group B as detected by IHC and RT-qPCR (P<0.05), followed by Group D and C (IHC: 0.48±0.01 vs 0.43±0.01, P<0.05; RT-qPCR: 12.61±2.14 vs 2.38±0.10, P<0.05). Both protein and mRNA levels of CD34 were highest in Group B as detected by IHC and RT-qPCR (P<0.05). Tracheal mRNA levels of CD34 were more abundant in Group D than Group C (4.92±0.90 vs 2.09±0.10, P<0.05), while no significant difference was found between groups regarding protein levels measured by IHC. Conclusions: Cryoablation could alleviate the hyperplasia of tracheal traumatic granulation, possibly due to the inhibition of TGF-ß(1) and CD34 expression. The effect of 30 s cryoablation for tracheal traumatic granulation is better.
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Criocirurgia , Granuloma/cirurgia , Traqueia , Animais , Proliferação de Células , Coelhos , TraqueotomiaRESUMO
Objective: To explore the value of the intraoperative transesophageal echocardiography during the aortic valve reconstruction. Methods: The echocardiographic features were retrospectively summarized in 19 patients (male: 15 cases; female: 4 cases; age ranged from 12 to 65 years, mean age: 37.7 years) with aortic valve reconstruction at Beijing Anzhen Hospital between October 2014 and October 2016. Results: The findings of the neo-aortic valve on the transesophageal echocardiography included the slightly thickened and hyperechogenicity of the commission, especially the central coaptation point of the neo-valve. Trace aortic regurgitation was noted in 9 cases after operation, mild aortic regurgitation in 1 case and no aortic regurgitation in 9 cases. The velocity of the aortic valve increased significantly in 2 cases. Compared with pre-operation, the diameter of ascending aorta[(32.7±6.1) mm vs (36.4±6.3) mm, P<0.001]and the inner diameter of left ventricle[(48.3±6.1) mm vs (59.1±7.3) mm, P<0.001]decreased significantly after operation, the coaptation length of aortic valve[(6.6±1.3) mm vs (2.2±0.7) mm, P<0.001]significantly increased than that of pre-operation. The mean immediate velocity after operation (175 cm/s) was slightly higher than that (165 cm/s) of 3-month follow-up after surgery, but with no significant difference (P=0.367). Severe aortic regurgitation was found 15 days after operation in 1 case and 12 months after operation in 2 cases. Conclusion: Intraoperative transesophageal echocardiography is a useful tool to evaluate the result of the aortic valve reconstruction.
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Valva Aórtica , Ecocardiografia Transesofagiana , Adolescente , Adulto , Idoso , Insuficiência da Valva Aórtica , Criança , Ecocardiografia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto JovemAssuntos
Neoplasias Ósseas , Condrossarcoma Mesenquimal , Condrossarcoma , Humanos , Condrossarcoma Mesenquimal/cirurgia , Condrossarcoma Mesenquimal/metabolismo , Condrossarcoma Mesenquimal/patologia , Condrossarcoma/diagnóstico por imagem , Condrossarcoma/cirurgia , Músculo Esquelético/patologia , Neoplasias Ósseas/patologiaRESUMO
Objective: To investigate the reproductive health status of female workers in petrochemical industry, and to provide a reference for improving reproductive health status and developing preventive and control measures for female workers in petrochemical industry. Methods: A face-to-face questionnaire survey was performed from January to October, 2016. The Questionnaire on Women's Reproductive Health was used to investigate the reproductive health of female workers in petrochemical industry. The multivariate logistic regression model was used to identify the influencing factors for reproductive health of female workers in petrochemical industry. Results: Among the 7485 female workers, 1 268 (40.9%) had abnormal menstrual period, 1 437 (46.4%) had abnormal menstrual volume, 177 (28.5%) had hyperplasia of mammary glands, and 1 807 (24.6%) had gynecological inflammation. The reproductive system diseases in female workers in petrochemical industry were associated with the factors including age, marital status, education level, unhealthy living habits, abortion, overtime work, work shift, workload, video operation, occupational exposure, positive events, and negative events, and among these factors, negative events (odds ratio[OR]= 1.856) , unhealthy living habits (OR=1.542) , and positive events (OR=1.516) had greater impact on reproductive system diseases. Conclusion: Many chemical substances in the occupational environment of petrochemical industry can cause damage to the reproductive system, which not only affects the health of the female workers, but also poses potential threats to the health of their offspring. Occupational exposure, unhealthy living habits, overtime work, and work shift have great influence on reproductive system diseases in female workers.
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Indústria Química , Doenças Profissionais/prevenção & controle , Exposição Ocupacional , Saúde Ocupacional/normas , Petróleo/toxicidade , Saúde Reprodutiva , Feminino , Humanos , Modelos Logísticos , Inquéritos e QuestionáriosRESUMO
Objective: To investigate the surgical technique and clinical efficacy of arthroscopic treatment of the elderly patients with massive rotator cuff tear. Methods: From June 2012 to June 2015, thirty-six patients with massive rotator cuff tear were treated with arthroscopic and followed up. The visual analog scale(VAS)pain score, University of California Los Angeles (UCLA) scores, Constant scores and American Shoulder and Elbow Surgeons scale(ASES)were used before and after the arthroscopic surgery. Results: All the patients were followed up for average of 18.5 (12 to 30) months.Before arthroscopic surgery, the VAS, UCLA, Constant, ASES were (6.1±2.2), (10.6±4.3), (40.3±10.5) and (28.8±18.5) points; the average flexion of the shoulder was (76.5±42.6)°, the average abduction of the shoulder was (72.4±35.2)°, the average external rotation of the shoulder was(26.6±22.2)° and the average internal rotation of the shoulder was (20.2±6.2)° respectively.These scores were improved to (1.4±1.2), (30.4±5.2), (82.6±12.6), and (78.8±22.6) points, the average flexion of the shoulder was improved to (152.8±25.6)°, the average abduction of the shoulder was improved to (120.6±32.8)°, the average external rotation of the shoulder was improved to (42.6±16.2)° and the average internal rotation of the shoulder was improved to (38.4±5.6)° after one-year follow-up period.Improvement in these scores and range of motion(ROM) were significant difference(P<0.05). Conclusion: Arthroscopic repair can effectively treat the eldly patient with massive rotator cuff tear and obviously improve the function of shoulder joint. The surgery has a clinical application value.
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Artroscopia , Lesões do Manguito Rotador/cirurgia , Idoso , Feminino , Seguimentos , Humanos , Masculino , Amplitude de Movimento Articular , Manguito Rotador , Ombro , Articulação do Ombro , Resultado do TratamentoRESUMO
Objective: To compare the early clinical effect of septal myectomy and percutaneous transluminal septal myocardial ablation (PTMSA) on the left ventricular outflow obstruction and the rate of complication in patients with hypertrophic obstructive cardiomyopathy (HOCM). Methods: A total of 204 patients with HOCM who received septal reduction treatment were recruited. These patients were divided into two groups, surgery group (n=135) (65 patients with modified Morrow procedure, 70 patients with non-Morrow myomectomy) and PTMSA group (n=69). The baseline characteristics, disease status, other history of surgery and echocardiography parameters before and after septal reduction were collected, as well as the complication within 1 week after operation. Results: The mean age in surgery group was (46±14) years old, with 76 males (56.3%); mean age was (47±11) years old and with 51 males (73.9%) in PTMSA group. There was no significant difference in age, gender, the time of symptom and diagnosis, syncope, family history and atrial fibrillation between the two groups (all P>0.05). The proportion of mitral valve prolapse in the surgery group was higher than that in PTMSA group (75.8% vs 44.2%, P<0.05). Baseline left ventricular outflow tract (LVOT) gradient was comparable (82.7 mmHg in surgery group vs 77.7 mmHg in PTMSA group, P>0.05). The mean resting LVOT gradient after septal reduction therapy was lower (16.55 mmHg in surgery group, 26.68mmHg in PTMSA group) than that before operation, with lower gradient in surgery group (P<0.05). Compared with PTMSA group, the duration of hospitalization was longer in surgery group (P<0.05). There was similar rate of operation related complications in the two groups. Conclusions: Both septal reduction therapies can improve the LVOT obstruction, more significant in surgery group, but with longer hospital stay. The rate of operation related complication is similar in both groups.
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Cardiomiopatia Hipertrófica/cirurgia , Septos Cardíacos/cirurgia , Adulto , Ponte de Artéria Coronária , Ecocardiografia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento , Obstrução do Fluxo Ventricular ExternoRESUMO
We assessed the prevalence of bilateral discoid lateral meniscus (BDLM), as well as its subtypes, among patients with symptomatic DLM. Medline, Cochrane, EMBASE, and Google Scholar were searched until September 18, 2015. All studies evaluating patients with BDLM who underwent MRI, macroscopic observation, and/or arthroscopy for the diagnosis of discoid meniscus/menisci were included. Eight clinical studies with a total of 583 DLM patients examined including 103 cadavers. There was a male predominance and average age of BDLM patients ranged from 10.4 to 39.9 years. The reported prevalence was higher in East Asian countries (72.7 to 97%) than rest of the world (6.8 to 90%). Homotypes were much more common than heterotype, and ranged from 82.9 to 91.7% of all BDLM patients. The actual prevalence of BDLM is likely higher. The findings provide a glimpse of the wide spread this disorder potentially has in East Asia.
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Meniscos Tibiais , Lesões do Menisco Tibial , Artroscopia , Humanos , Articulação do Joelho , Imageamento por Ressonância Magnética , Masculino , PrevalênciaRESUMO
Objective: To observe the clinical outcome of intramyocardial dissecting hematoma (IDH) after acute myocardial infarction (MI). Methods: The clinical characteristics and outcomes of nine patients with IDH after acute MI in Beijing Anzhen Hospital from 2010 to 2014 were retrospectively assessed, and all the patients were followed up. Results: The mean age of nine IDH patients (7 males, 2 females) was (61±5) years. One patient was diagnosed as right ventricular IDH and died before surgery because of deteriorated cardiac and renal failure. Eight patients were diagnosed as left ventricular IDH, among whom 1 patient died of perioperative bleeding. The other 7 patients survived, among whom 5 cases were treated medically and 2 cases accepted surgical treatment. After 2-6 years of follow-up, the survived patients had no other complications. Conclusion: IDH after acute MI was a rare clinical event with a high mortality, and improvement of recognition of this rare condition may reduce its mortality, especially the right ventricular IDH.
Assuntos
Hematoma , Infarto do Miocárdio , Feminino , Ventrículos do Coração , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
OBJECTIVE: To investigate the clinical value of echocardiography combined with genetic testing in the fetal cardiac rhabdomyoma. METHODS: Thirty-three fetal cardiac rhabdomyoma cases diagnosed by fetal echocardiogram in Beijing Anzhen Hospital from Jan. 2011 to Oct. 2015 were enrolled in a retrospective analysis. The results of other examination and pregnancy outcomes of them were followed up, the genetic characteristics of cardiac rhabdomyoma were summarized on the basis of pathology and genetics examination results. RESULTS: The pregnancy outcomes: 24 cases were terminated pregnancy, 4 cases were born and 5 cases were lost. The results of ultrasound, pathology and genetic examination were detailed in 8 cases. Pathological examination: the typical characteristics of cardiac rhabdomyoma were found in the 8 cases with cardiac rhabdomyoma. The tumor tissue was composed of irregular and swelling shape of cardiomyocytes, and the cytoplasm was vacuole like, which was characteristic of " spider like cells" through microscopic observation. The geneticdetection results: 7 cases had tuberous sclerosis complex (TSC) gene mutation, TSC gene abnormalities were not detected in 1 case. Among the 7 cases with TSC gene mutations, 6 cases were with TSC2 gene mutation and the other 1 case was with TSC1 gene mutation. The family gene was investigated in the 5 cases, which including 3 cases of TSC gene mutation in mother passed on to the fetus (1 case with family of three generations of genetic) and 2 cases of spontaneous TSC gene mutation in the fetus. CONCLUSIONS: Prenatal echocardiography combined with genetic detection have important clinical significance, which not only can clear if cardiac rhabdomyomas were associated with TSC, but also can clear the TSC gene mutation source. So as to further guide the perinatal management.
Assuntos
Ecocardiografia , Doenças Fetais , Testes Genéticos/métodos , Neoplasias Cardíacas/diagnóstico por imagem , Diagnóstico Pré-Natal/métodos , Rabdomioma/diagnóstico por imagem , Feminino , Doenças Fetais/diagnóstico , Doenças Fetais/genética , Neoplasias Cardíacas/genética , Humanos , Mutação , Gravidez , Resultado da Gravidez , Estudos Retrospectivos , Rabdomioma/genética , Esclerose Tuberosa/genéticaRESUMO
The objectives of the present study were to identify additional genes that may play important roles in the regulation of skeletal muscle growth and development, and to provide fundamental information for understanding the underlying molecular mechanisms. Eighteen cDNA libraries were constructed from the longissimus muscle of Polled Dorset (PD) and Small-tailed Han (SH) fetuses. To reveal the differences between the two species, we analyzed the differences in gene expression in 60-, 90- and 120-day fetal skeletal muscle by applying Agilent ovine genome-wide microarray. In this study, we obtained 17,704 genes using a chip containing 39,242 probes. There were 88 differentially expressed genes in the 60-day group (P < 0.05), 128 genes in the 90-day group (P < 0.05), and 340 genes in the 120-day group (P < 0.05) between the two breeds. The differentially expressed genes were grouped in different GO categories and signaling pathways. These results suggested that there are many genetic differences in the muscle growth and development transcriptomes between these two breeds. This study laid the foundation for future genomic research in sheep.