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1.
Environ Sci Technol ; 46(7): 4207-14, 2012 Apr 03.
Artigo em Inglês | MEDLINE | ID: mdl-22380753

RESUMO

Published emission factors (EFs) often vary significantly, leading to high uncertainties in emission estimations. There are few reliable EFs from field measurements of residential wood combustion in China. In this study, 17 wood fuels and one bamboo were combusted in a typical residential stove in rural China to measure realistic EFs of particulate matter (PM), organic carbon (OC), and elemental carbon (EC), as well as to investigate the influence of fuel properties and combustion conditions on the EFs. Measured EFs of PM, OC, and EC (EF(PM), EF(OC), and EF(EC), respectively) were in the range of 0.38-6.4, 0.024-3.0, and 0.039-3.9 g/kg (dry basis), with means and standard derivation of 2.2 ± 1.2, 0.62 ± 0.64, and 0.83 ± 0.69 g/kg, respectively. Shrubby biomass combustion produced higher EFs than tree woods, and both species had lower EFs than those of indoor crop residue burning (p < 0.05). Significant correlations between EF(PM), EF(OC), and EF(EC) were expected. By using a nine-stage cascade impactor, it was shown that size distributions of PM emitted from tree biomass combustions were unimodal with peaks at a diameter less than 0.4 µm (PM(0.4)), much finer than the PM from indoor crop residue burning. Approximately 79.4% of the total PM from tree wood combustion was PM with a diameter less than 2.1 µm (PM(2.1)). PM size distributions for shrubby biomasses were slightly different from those for tree fuels. On the basis of the measured EFs, total emissions of PM, OC, and EC from residential wood combustion in rural China in 2007 were estimated at about 303, 75.7, and 92.0 Gg.


Assuntos
Poluentes Atmosféricos/análise , Carbono/análise , Incêndios , Utensílios Domésticos , Tamanho da Partícula , Material Particulado/análise , Madeira/química , China , Geografia , Umidade , Compostos Orgânicos/análise , População Rural , Volatilização
2.
Artigo em Chinês | WPRIM | ID: wpr-1021335

RESUMO

BACKGROUND:The mechanism,manifestation,prevention and treatment of ischemia-reperfusion injury have been reported in the past.However,there are few studies on the ischemia-reperfusion injury of lower limb skeletal muscle caused by total knee arthroplasty.This article focuses on the pathogenesis,clinical impact,prevention and treatment of the ischemia-reperfusion injury of lower limb caused by total knee arthroplasty. OBJECTIVE:To summarize the related literature of lower limb ischemia-reperfusion injury caused by total knee arthroplasty,analyze the mechanism and significance,and give hints for further research on skeletal muscle ischemia-reperfusion injury. METHODS:The relevant articles on PubMed,CNKI,WanFang and VIP databases published from January 1,2000 to April 30,2022 were searched by computer with the Chinese and English search terms of"ischemia-reperfusion injury,total knee arthroplasty,tourniquet,mechanism,pathophysiology,skeletal muscle,treatment".After excluding repetitive research and some basic articles with low correlation,68 articles were finally selected for review. RESULTS AND CONCLUSION:(1)The pathogenesis of ischemia-reperfusion injury is related to oxygen free radicals,intracellular calcium overload,neutrophil activation,as well as high concentration of nitric oxide,no reflow phenomenon,apoptosis and other mechanisms.More detailed mechanism research can provide basis for future prevention and treatment.(2)Ischemia-reperfusion injury of lower limbs will cause local skeletal muscle injury,which may be caused by the trauma of the operation itself or the role of ischemia-reperfusion injury.More targeted research is needed to distinguish the relationship between the two.(3)Ischemia-reperfusion injury of lower limbs may even affect the distal organs,causing kidney and lung damage.It also affects local and systemic circulation.(4)To clarify the effect of ischemia-reperfusion injury can point out the direction for future prevention and treatment.The current prevention and treatment measures mainly include ischemic preconditioning,anesthetic,antioxidant and other drug prevention.(5)The detailed review of ischemia-reperfusion injury of lower limb skeletal muscle caused by total knee arthroplasty can provide basis for future diagnosis and treatment decisions.

3.
Artigo em Chinês | WPRIM | ID: wpr-1021415

RESUMO

BACKGROUND:Dexmedetomidine has the effect of anti-ischemia-reperfusion injury,but the comprehensive and systematic review of its signaling pathway is less. OBJECTIVE:To focus on the review of dexmedetomidine's signaling pathway in the mechanisms of antioxidant stress,inhibition of inflammation,anti-apoptosis,autophagy,and so on. METHODS:The relevant articles on PubMed,CNKI,WanFang,and VIP databases were searched by computer with the key words"ischemia-reperfusion inquiry;dexmedetomidine;signal path;oxidative stress;inflammation;apoptosis"in Chinese and English.After excluding repetitive research and some basic articles with low correlation,57 articles were finally included for review. RESULTS AND CONCLUSION:(1)Dexmedetomidine plays an important role in organ protection through many mechanisms,such as anti-oxidative stress injury,anti-inflammation,anti-apoptosis and autophagy.This involves many pathways,including Nrf2 and its downstream protein antioxidant stress pathway,Toll-like receptor 4 family and nuclear factor-κB-related anti-inflammatory pathway,JAK2/STAT3-related anti-inflammatory pathway,and cholinergic anti-inflammatory pathway,and the cholinergic pathway is the upstream mechanism of many nuclear factor-κB signaling pathways.(2)PI3K/Akt pathway plays different roles according to its activated downstream signals,inhibiting the activation of NLRP3 inflammatory body,activating signal molecules endothelial nitric oxide synthase,mammalian target of rapamycin,and hypoxia-inducible factor 1α to play an anti-inflammatory role,and activate Bad or Bax residues to play an anti-apoptotic role,and PI3K/Akt activates glycogen synthetase kinase-3β.It can also play an anti-inflammatory and anti-apoptotic role.(3)Dexmedetomidine activates SIRT3 to mediate anti-apoptosis and inhibit endoplasmic reticulum stress to produce anti-apoptosis.(4)The detailed review of the anti-ischemia-reperfusion injury signaling pathway of dexmedetomidine can provide a basis for future mechanism research and diagnosis and treatment decisions.

4.
Journal of Chinese Physician ; (12): 618-621, 2023.
Artigo em Chinês | WPRIM | ID: wpr-992345

RESUMO

The first robotic heart surgery was performed more than two decades ago. Less invasive cardiac surgical techniques have become increasingly popular in recent years. The integration of emerging materials, computers and engineering technologies has provided the conditions for the application of robotic surgery in various cardiac procedures. Coronary artery bypass grafting (CABG), mitral valvuloplasty/valvuloplasty and radiofrequency/cryoablation for atrial fibrillation are some of the most common surgical procedures. Currently, only a few international cardiac centers have teams specializing in total endoscopic coronary artery bypass grafting. Although some studies have shown good results in robot-assisted heart surgery, questions remain about its safety, cost-benefit ratio, and long-term clinical outcomes. Robotic heart surgery poses higher challenges to myocardial protection and precise anastomosis. The role of stabilizers is to provide a relatively stable field of vision for heart surgery, which is the basis of all non-stop heart surgery. Because of their importance, researchers around the world are constantly exploring how to develop new, more sophisticated stabilizers. This review focuses on the research and development status and development trend of the stabilizer, summarizes the advantages and disadvantages of the current commonly used stabilizer, closely follows the clinic, makes in-depth analysis, and puts forward the key points of the future development of the stabilizer in coronary artery bypass surgery.

5.
Tumor ; (12): 692-700, 2023.
Artigo em Chinês | WPRIM | ID: wpr-1030320

RESUMO

Radiomics is a non-invasive method to extract valuable features from computed tomography(CT)images to characterize the correlation between tumor phenotype and clinical treatment outcomes,which is of great significance in the evaluation of the efficacy of non-small cell lung cancer(NSCLC).This paper reviews the research methods of CT Radiomics in the evaluation of curative effect of NSCLC.Firstly,the research content of CT radiomics in NSCLC is summarized.Then,from the perspective of different treatment methods,such as namely radiotherapy and chemotherapy,targeted therapy and immunotherapy,the research methods of CT radiomics in the evaluation of NSCLC efficacy were summarized,and the CT radiomics was compared with other commonly used efficacy evaluation systems.Finally,the development trend and improvement of the application of CT radiomics in the evaluation of NSCLC curative effect were summarized and prospected.

6.
Artigo em Chinês | WPRIM | ID: wpr-910511

RESUMO

Objective:To establish a local effect model (LEM)-based rectal dose volume histogram (DVH) prediction model in prostate cancer patients treated with carbon ion therapy based on Japanese experience, aiming to provide reference for clinically reducing the incidence of rectal adverse reactions.Methods:The planning CT data of 76 patients with prostate cancer were collected. The microdosimetric kinetic model (MKM) was used for initial planning, and the LEM was selected to recalculate the biological dose based on the same fields to MKM. Then, the geometric features and DVH of the rectum were extracted from the LEM plans. The planning data of 61 cases were used to establish the prediction model with linear regression and the other 15 cases were used for validation.Results:The ratio of the overlapped volume between the rectum and the region of interest (ROI) expended from planning target volume by 1 cm along the left and right directions of the rectum could be proved to be the characteristic parameters for linear regression. The mean goodness-of-fit R2 of predicted and LEM plan-based DVH of 15 cases was 0.964. The results of predicted rectal adverse reactions based on predicted DVH were consistent with those of LEM plan-based DVH. Conclusions:The linear regression method used in this study can establish an accurate prediction model of rectal DVH, which may provide certain reference for reducing the incidence of rectal adverse reactions. Nevertheless, the findings remain to be further verified by clinical trials with larger sample size.

7.
Artigo em Chinês | WPRIM | ID: wpr-888240

RESUMO

Clinically, non-contrastive computed tomography (NCCT) is used to quickly diagnose the type and area of ​​stroke, and the Alberta stroke program early computer tomography score (ASPECTS) is used to guide the next treatment. However, in the early stage of acute ischemic stroke (AIS), it's difficult to distinguish the mild cerebral infarction on NCCT with the naked eye, and there is no obvious boundary between brain regions, which makes clinical ASPECTS difficult to conduct. The method based on machine learning and deep learning can help physicians quickly and accurately identify cerebral infarction areas, segment brain areas, and operate ASPECTS quantitative scoring, which is of great significance for improving the inconsistency in clinical ASPECTS. This article describes current challenges in the field of AIS ASPECTS, and then summarizes the application of computer-aided technology in ASPECTS from two aspects including machine learning and deep learning. Finally, this article summarizes and prospects the research direction of AIS-assisted assessment, and proposes that the computer-aided system based on multi-modal images is of great value to improve the comprehensiveness and accuracy of AIS assessment, which has the potential to open up a new research field for AIS-assisted assessment.


Assuntos
Humanos , Alberta , Isquemia Encefálica/diagnóstico por imagem , AVC Isquêmico , Acidente Vascular Cerebral/diagnóstico por imagem , Tomografia Computadorizada por Raios X
8.
Journal of Biomedical Engineering ; (6): 1089-1094, 2020.
Artigo em Chinês | WPRIM | ID: wpr-879240

RESUMO

Hemispheric asymmetry is a fundamental organizing principle of the human brain. Answering the genetic effects of the asymmetry is a prerequisite for elucidating developmental mechanisms of brain asymmetries. Multi-modal magnetic resonance imaging (MRI) has provided an important tool for comprehensively interpreting human brain asymmetry and its genetic mechanism. By combining MRI data, individual differences in brain structural asymmetry have been investigated with quantitative genetic brain mapping using gene-heritability. Twins provide a useful natural model for studying the effects of genetics and environment on the brain. Studies based on MRI have found that the asymmetry of human brain structure has a genetic basis. From the perspective of quantitative genetic analysis, this article reviews recent findings on the genetic effects of asymmetry and genetic covariance between hemispheres from three aspects: the asymmetry of heritability, the heritability of asymmetry and the genetic correlation. At last, the article shows the limitations and future research directions in this field. The purpose of this systematic review is to quickly guide researchers to understand the origins and genetic mechanism of interhemispheric differences, and provide a genetic basis for further understanding and exploring individual differences in laterized cognitive behavior.


Assuntos
Humanos , Encéfalo/diagnóstico por imagem , Mapeamento Encefálico , Imageamento por Ressonância Magnética , Gêmeos/genética
9.
Artigo em Chinês | WPRIM | ID: wpr-813003

RESUMO

To study the methods and principles for simultaneous treatment in the children with pectus excavatum (PE) combined with congenital cardiothoracic diseases.
 Methods: The medical records of all children, who underwent simultaneous repair of PE combined with congenital cardiothoracic diseases, were retrospectively reviewed in Hunan Children's Hospital from January 2007 to September 2018. The patients were divided into a PE combined with congenital heart disease (CHD) group (n=17) and a PE combined with thoracic disease group (n=10). The repair with a custom-made sternal lifting device, a Nuss repair, were performed in the treatment of PE, and the correction of the CHD was performed by heart open surgery using cardiopulmonary bypass (through sternotomy or right infra-axillary thoracotomy) or by transcatheter closure under echocardiography or X-ray-guided percutaneous intervention in the PE combined with CHD group. The children in the PE combined with thoracic disease group underwent thoracic surgery plus Nuss procedure concurrently.
 Results: All 27 pediatric patients underwent simultaneous repair of the PE combined with congenital cardiothoracic diseases. In the PE combined with CHD group, the duration of hospital stay ranged from 8.0 to 25.0 (13.2±4.8) days. Two patients had delayed healing of the surgical wound and 1 patient developed a small left pleural effusion postoperatively. In the PE combined with thoracic disease group, the duration of hospital stay ranged from 10.0 to 34.0 (19.9±7.5) days. One patient was complicated with chylothorax and 2 patients were complicated with pleural effusionin. The treatment for the patients in the 2 groups was satisfactory. No severe complications like surgical death, severe bleeding, chest organ injuries, and implant rejections were observed.
 Conclusion: According to the characteristics of patients, individualized programs should be selected in order to correct children's PE combined with congenital cardiothoracic diseases in the same period, which are safe, effective and can avoid the risk of multiple operations and anesthesia, and can reduce the financial burden of family.


Assuntos
Criança , Humanos , Procedimentos Cirúrgicos Cardíacos , Tórax em Funil , Cirurgia Geral , Cardiopatias Congênitas , Procedimentos Cirúrgicos Minimamente Invasivos , Estudos Retrospectivos , Esternotomia , Resultado do Tratamento
10.
Artigo em Chinês | WPRIM | ID: wpr-813062

RESUMO

To explore the effects of KIAA0196 gene on cardiac development and the establishment of zebrafish strain.
 Methods: Peripheral blood and gDNA from patients were extracted. Copy number variation analysis and target sequencing were conducted to screen candidate genes. The KIAA0196 knockout zebrafish was generated by CRISPR/Cas9 to detect whether KIAA0196 deficiency could affect cardiac development. Finally, the wild-type and mutant zebrafish were anatomized and histologically stained to observe the phenotype of heart defects.
 Results: The KIAA0196 knockout zebrafish strain was successfully constructed using CRISPR/Cas9 technology. After 60 hours fertilization, microscopic examination of KIAA0196 knockout zebrafish (heterozygote + homozygote) showed pericardial effusion, cardiac compression and severely curly tail. Compared with wild-type zebrafish, the hearts of mutant KIAA0196 zebrafish had cardiac defects including smaller atrium and larger ventricle, and the myocardial cells were looser.
 Conclusion: KIAA0196 gene plays an important regulatory role in the development of heart. It might be a candidate gene for congenital heart disease.


Assuntos
Animais , Humanos , Variações do Número de Cópias de DNA , Coração , Cardiopatias Congênitas , Genética , Miócitos Cardíacos , Fenótipo , Proteínas , Peixe-Zebra , Genética , Proteínas de Peixe-Zebra , Genética
11.
Artigo em Chinês | WPRIM | ID: wpr-687962

RESUMO

<p><b>OBJECTIVE</b>To explore the genetic basis for a patient with oculodentodigital dysplasia.</p><p><b>METHODS</b>Genomic DNA was extracted from peripheral blood samples from the patient and his parents. Whole-exome sequencing was carried out for the trio family. Suspected mutation was verified by Sanger sequencing.</p><p><b>RESULTS</b>A de novo c.412G>A mutation of the GJA1 gene was identified in the patient, which was validated by Sanger sequencing.</p><p><b>CONCLUSION</b>The c.412G>A mutation of the GJA1 gene probably underlies the disease in the patient.</p>


Assuntos
Adulto , Humanos , Masculino , Conexina 43 , Genética , Anormalidades Craniofaciais , Genética , Exoma , Anormalidades do Olho , Genética , Deformidades Congênitas do Pé , Genética , Mutação , Análise de Sequência de DNA , Sindactilia , Genética , Anormalidades Dentárias , Genética
12.
Artigo em Chinês | WPRIM | ID: wpr-693859

RESUMO

Objective:To evaluate the feasibility and safety of device closure of patent ductus arteriosus (PDA)using only venous access under echocardiography guidance alone.Methods:A total of 102 consecutive pediatric patients underwent transcatheter PDA closure without arterial access,under the guidance of only echocardiography.The patients were followed up by clinical examination,electrocardiogram,and echocardiogram at 1,3,6 12,and 24 months.Results:Transvenous PDA closure under echocardiographic guidance was successful in 99 (97.1%)patients.There were no acute procedural complications or severe adverse events.The duration ranged from 10 to 65 minutes (median,21 minutes).Immediate complete closure of PDA was achieved in 87 patients (87.9%),and 100% of the patients were completely closed after 24 h.There were no severe adverse events in the period of 1-24 months (median,12 months) follow up.Conclusion:Transvenous PDA closure without fluoroscopy avoids radiation exposure,contrast agent usage and potential arterial complications.It can be used as an alternative procedure,especially for children.

13.
Artigo em Chinês | WPRIM | ID: wpr-615333

RESUMO

Objective:To investigate the role of thoracic echocardiography in diagnosis and differential diagnosis of the right ventricular outflow tract into the right aorta with right ventricular aneurysm rupture.Methods:A total of 19 patients with sinus rupture caused by ventricular septal defect in the right ventricular outflow road were reviewed.These patients were diagnosed as aortic right coronary sinus by preoperative transthoracic echocardiography from February 2010 to September 2016 in Xiangya Second Hospital and Xiangya Medical College Affiliated Haikou Hospital.The clinical symptoms,echocardiography and intraoperative lesions were compared and analyzed among the patients.Results:The intraoperative lesions were consistent with the preoperative echocardiographic diagnosis in 16 patients.Among them,11 cases could be heard the continuous sound of the machine with systolic murmur and no tremor in left sternal rib 2-3 auscultation.The color Doppler imaging of right ventricular systolic indicated the based continuous Doppler spectrum.The preoperative echocardiography and intraoperative lesions testified the ventricular septal defect size and the right ventricular outflow tract into the right aorta with right ventricular aneurysm rupture.Among them,3 cases were complicated with other heart diseases.Other 3 cases were not accorded with the preoperative diagnosis.There were auscultation smell and noise but no tremor.The preoperative echocardiography and lesions indicated the right ruptured aneurysm of the sinus of big and long mouth,1 case with aortic valve stenosis and regurgitation,congenital aortic valve two valve malformation,1 case with aortic valve-severe reflux,1 case with pulmonary infection,and 3 cases with no intraoperative lesions in the ventricular septal defect.Conclusion:Preoperative transthoracic echocardiography is the preferred preoperative,quick and noninvasive method for ruptured aneurysm.Each stage of observation procedure and method can observe the ruptured aneurysm of aortic sinus,the location,size and adjacent ofventricular septal defect.Meanwhile,the flow spectrum characteristics of the ventricular septal defect in the right outflow tract of the right sinus aneurysm can be found by Doppler ultrasound imaging.

14.
Journal of Chinese Physician ; (12): 1350-1352,1357, 2017.
Artigo em Chinês | WPRIM | ID: wpr-660561

RESUMO

Objective To summarize the methods and experiences of one-stage repair of aortic coarctation.Methods During January 2009 and September 2016,31 patients underwent surgery for coarctation of aorta (COA) in our department.Of them,fifteen patients were accompanied by patent ductus arteriosus (PDA),five associated with ventricular septal defect (VSD),five with VSD and PDA,and six patients were single COA.All patients accepted one-stage repair and follow-up.The surgical strategies and follow-up results were retrospectively reviewed.Results Excision of coarctation and anastomoses was performed in 24 patients,a bypass with artificial graft was performed in 3 patients,longitudinally section transverse suture was performed in 2 patients,and aortoplasty with patch graft was used in 2 patients.Accompanied intracardiac malformations were repaired simutaneously.One patient died of low cardiac output syndrome 1 d after operation.Other patients recovered smoothly.Thirty patients were followed up from 6 months to 7 years.The anastomotic systolic pressure difference disappeared in 21 patients.Eight patients still suffered from systolic pressure difference (5-20 mmHg),but had no need of reoperation.One patient suffered from anastomotic recoarctation 2 years and 3 months after operation and the pressure difference was 48 mmHg.After exerting balloon dilatation,the pressure difference reduced to 17 mmHg.Conclusions Surgery is an effective method of COA treatment.The surgical strategies should be selected according to the characters of coarctation lesions,intracardiac malformations,and the age of patient.

15.
Journal of Chinese Physician ; (12): 1350-1352,1357, 2017.
Artigo em Chinês | WPRIM | ID: wpr-662699

RESUMO

Objective To summarize the methods and experiences of one-stage repair of aortic coarctation.Methods During January 2009 and September 2016,31 patients underwent surgery for coarctation of aorta (COA) in our department.Of them,fifteen patients were accompanied by patent ductus arteriosus (PDA),five associated with ventricular septal defect (VSD),five with VSD and PDA,and six patients were single COA.All patients accepted one-stage repair and follow-up.The surgical strategies and follow-up results were retrospectively reviewed.Results Excision of coarctation and anastomoses was performed in 24 patients,a bypass with artificial graft was performed in 3 patients,longitudinally section transverse suture was performed in 2 patients,and aortoplasty with patch graft was used in 2 patients.Accompanied intracardiac malformations were repaired simutaneously.One patient died of low cardiac output syndrome 1 d after operation.Other patients recovered smoothly.Thirty patients were followed up from 6 months to 7 years.The anastomotic systolic pressure difference disappeared in 21 patients.Eight patients still suffered from systolic pressure difference (5-20 mmHg),but had no need of reoperation.One patient suffered from anastomotic recoarctation 2 years and 3 months after operation and the pressure difference was 48 mmHg.After exerting balloon dilatation,the pressure difference reduced to 17 mmHg.Conclusions Surgery is an effective method of COA treatment.The surgical strategies should be selected according to the characters of coarctation lesions,intracardiac malformations,and the age of patient.

16.
Artigo em Chinês | WPRIM | ID: wpr-815143

RESUMO

The clinical data for a patient with sick sinus syndrome was retrospectively analyzed. The patient was treated because of his heart palpitations and the increased chest pain. The patient admitted to the hospital under consideration for the left atrial tumor dependent on the echocardiography findings. After the CT scan and the dynamic ECG examination, the patient successfully underwent the left atrial tumor resection, atrial septal repair and cardiac pacing lead installation. The postoperative pathological diagnosis showed that the infective endocarditis and left atrial thrombus in left atrium was cured. The patient was discharged after postoperative anti-inflammatory therapy. By analyzing the reasons for misdignosis before or during surgery, the possible mechanisms for left atrial subendocardial thrombus have been found. This study suggests that it is necessary to combine imaging diagnosis and clinical observations to distinguish tumor from excrescence.


Assuntos
Humanos , Masculino , Anti-Inflamatórios , Usos Terapêuticos , Arritmias Cardíacas , Cirurgia Geral , Septo Interatrial , Cirurgia Geral , Angiografia por Tomografia Computadorizada , Diagnóstico Diferencial , Erros de Diagnóstico , Ecocardiografia , Endocardite , Diagnóstico , Terapêutica , Átrios do Coração , Diagnóstico por Imagem , Cirurgia Geral , Cardiopatias , Cirurgia Geral , Neoplasias Cardíacas , Diagnóstico por Imagem , Cirurgia Geral , Marca-Passo Artificial , Estudos Retrospectivos , Síndrome do Nó Sinusal , Cirurgia Geral , Trombose , Cirurgia Geral
17.
Journal of Chinese Physician ; (12): 1152-1155, 2016.
Artigo em Chinês | WPRIM | ID: wpr-502247

RESUMO

Objective To investigate the early surgical outcomes of 86 patients with complete atrioventricular septal defect.Methods Between January 2007 and December 2014,consecutive 86 cases received surgical repair in our department.There were 44 male patients,and 42 female patients.Two-patch repair was performed in 69 cases,and modified single-patch repair in 17 cases.The mean age,height,and weight at the time of operation were (32.3 ± 46.5)months with a range from 1 month to 17 years,(82.1 ±27.6) cm with a range from 53 to 165 cm,and (10.8 ± 8.7) kg with a range from 4.1 to 43 kg,respectively.Rastelli A type was found in 67 cases,B type in 15 cases,and C type in 4 cases.Down's syndrome was complicated in 6 cases.Preoperative mild regurgitation of common atrioventricular valve was shown in 32 cases,moderate regurgitation in 38 cases,and moderate to severe regurgitation in 16 cases.Mild pulmonary hypertension was observed in 15 cases,moderate in 54 cases,and severe in 17 cases.Results After operation,all patients were sent into intensive care units (ICU).The mean duration mechanical ventilation,ICU stay,and hospitalization were (30.9 ± 47.7) h with a range from 2.5 to 244 h,(87.7 ± 76.8) h with a range from 14 to 306 h,and (16.4 ±9.2)d with a a range from 6 to 50 d,respectively.We encountered 4 operatively mortalities (4.7%),including 3 in two-patch repair group,and 1 in modified single-patch repair group.The cause of death was mitral regurgitation.Conclusions Modified single-patch and two-patch technique have a satisfied early outcomes.

18.
Artigo em Chinês | WPRIM | ID: wpr-814978

RESUMO

OBJECTIVE@#To investigate the outcomes of hybrid procedure in treating 10 infants/children with pulmonary stenosis under transesophageal echocardiographic guidance.
@*METHODS@#Between September, 2009 and December, 2015, 10 infants/children underwent hybrid procedure of transthoracic balloon pulmonary valvuloplasty for pulmonary stenosis in the Second Xiangya Hospital, Central South University. The age, height and weight at the time of admission were 0.7-42 (14.8±15.8) months, 53-97 (74.8±16.3) cm, and 4-15.5 (9.3±4.1) kg, respectively. Atrial septal defect, patent foramen ovale, patent ductus arteriosus, muscular ventricular septal defect, persistent left superior vena cava and tricuspid regurgitation were found in 2, 6, 1, 2, 1 and 5 cases, respectively.
@*RESULTS@#After the operation, all patients were sent into ICU. The mean duration mechanical ventilation, ICU stay and hospitalization were 0.5-41(6.8±12.3) h, 2-85 (31.1±22.8) h, and 6-20 (11.4±5.1) d, respectively. Postoperative transvalvular pressure gradient reduced to 16-45 (31.1±9.8) mmHg, which was decreased significantly compared with that in preoperative (P<0.001). There was no death during hospitalization and follow-up.
@*CONCLUSION@#Hybrid procedure of transthoracic balloon pulmonary valvuloplasty for pulmonary stenosis under transesophageal echocardiographic guidance is a safe and effective treatment.


Assuntos
Criança , Humanos , Lactente , Ecocardiografia Transesofagiana , Comunicação Interatrial , Comunicação Interventricular , Estenose da Valva Pulmonar , Resultado do Tratamento
19.
Journal of Chinese Physician ; (12): 1524-1527,1531, 2015.
Artigo em Chinês | WPRIM | ID: wpr-603001

RESUMO

Objective To investigate physiological changes in peri extracorporeal circulation period of patients who underwent cardiac valve replacement surgeries with crystalloid solution mixed with colloidal solutions and pure crystal solution as extracorporeal circulation priming solution, and explore the clinical value and practicability of crystalloid solution as the sole extracorporeal circulation priming solution.Methods A retrospective analysis was performed in 130 patients who underwent cardiac valve replacement surgeries.Pure lactated Ringer's solution liquid and Lactated Ringer's solution mixed with Voluven as the extracorporeal circulation priming solution were used.We respectively compared hematocrit at different time points, postoperative blood routine, liver and kidney function, blood coagulation index, duration of intensive care and trachea cannula in two groups.Results There were no significant differences in ages, preoperative blood routine, kidney function, blood coagulation function, duration of operation, clamping time, bypass time, intensive care, postoperative blood routine, kidney function, blood coagulation function and hematocrit at different time points in two groups (P >0.05).However, the hospital day of group which used crystalloid solution as extracorporeal circulation priming solution was significant shorter compared to group which used lactated Ringer's solution mixed with Voluven (P < 0.05).Alanine aminotransferase of group which used crystalloid solution as extracorporeal circulation priming solution was significant higher compared to group which used lactated Ringer's solution mixed with Voluven (P <0.01).Conclusions Crystalloid solution as extracorporeal circulation priming solution is safe and economy in cardiopulmonary bypass.Pure crystalloid solution as the sole extracorporeal circulation priming solution can be safely used on patients (New York Heart Association class Ⅱ-Ⅲ) who have normal liver and kidney function before the operation of adult heart valve replacement with cardiopulmonary bypass.

20.
Journal of Chinese Physician ; (12): 1015-1017, 2014.
Artigo em Chinês | WPRIM | ID: wpr-454038

RESUMO

Objective To achieve the best chance and optimize the method of operation,the clinical outcomes of 76 cases with complete atrioventricular septal defect (CAVSD) were summarized.Methods According to the Rastelli classification,there were 57 cases of type A,6 type B,and 13 type C.The repaired procedures included the two-patch technique for atrioventricular septal defect (65 cases),direct closure of ventricular septal defect (7 cases),and the Glenn bidirection shunt (4 cases).Results Two patients died.Of them,one was concomitant with double outlet right ventricle (DORV) and total anomalous pulmonary venous connection (TAPVC),died of low cardiac output syndrome; another was complicated with severe pulmonary hypertension,and the death reason was hypoxaemia and respiratory function failure.The survived patients were followed up,and the follow-up period was varied from one to ten years,mitral valve regurgitation was found in 12 cases,3 were middle and 9 were mild.Conclusions In order to prevent deteriorated condition of these patients and improve the survival rate,CAVSD should be operated as soon as the diagnosis is certain,and the co-exist malformation also should be corrected.

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