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OBJECTIVE:To explore the effect of Buchang naoxintong capsule on the myocardial perfusion and platelet activation function in patients with acute myocardial infarction (AMI) after PCI. METHODS:100 AMI patients were randomly divided into control group and observation group by parallel random sampling,50 cases in each group. Control group was given conventional PCI, preoperatively chewing 300 mg aspirin+300 mg clopidogrel,postoperatively taking 100 mg/d aspirin+75 mg/d clopidogrel. Observation group was additionally treated 2-4 with Buchang naoxintong capsules(after bracket release),3 times a day,the treatment course for both groups was 7 d,observation period was 1 month. Infarct-related artery myocardial perfusion grade(TMPG)in 2 groups,platelet activation function indexes [CD62P,CD63 and monocyte platelet aggregation (MPA) positive expression rates] before and after treatment,the incidences of adverse cardiac events (MACE) and complications were observed and compared 15 min after PCI. Meanwhile,the incidence of adverse reactions was recorded. RESULTS:After treatment,the cases of TMPG perfusion grade 3 in observation group were significantly higher than control group,the incidence of MACE was significantly lower than control group, with statistical significance(P0.05). Before treatment,there was no obvious difference in CD62P,CD63,MPA positive expression rates in 2 groups;after treatment,CD62P,CD63,MPA positive expression rates in 2 group were significantly lower than before,and observation group was lower than control group,with significant differences(P<0.05). CONCLUSIONS:In PCI treatment of AMI patients,Buchang naoxintong capsule can rapidly improve platelet activation functions,TMPG perfusion,reduce the incidence of MACE,with good safety and no increase of complications.
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Objective To investigate the therapeutic effect of bilateral combined flap transfer in reconstruction and repairation of thumb and finger defects.Methods A partial fibular side wrap-around flap was harvested from both big toes.The flaps were tailored and designed based on measurements taken from the finger of the intact side.These two flaps were combined to reconstruct the defects of the finger.From March,2008 to December,2015,a total of 9 fingers (9 cases) which had defect degrees range from Ⅰ ° to Ⅲ° underwent reconstruction surgeries in this way.Appearance,sensation and function of the thumb and foot flap were followed-up.Simultaneously how to improve the outcoming and success rate were explored and investigated.Results All 9 thumbs and fingers in 9 cases with these procedures were survived.No vascular crisis happened.All patients were followed up from 3 to 24 months.The reconstructed thumbs and fingers were all with abundant blood supply,having similar shape to the normal thumbs and fingers,good pain and temperature sensation,with two-point discrimination of 4-8 mm.All patients were satisfied with the thumb and finger shape,regained life and work ability as before.The donor sites had no obvious discomfort,and walking and weight-bearing function remained normal.Judged by the tentative evalution standard of function of upper limb,which was made by Chinese Medical Association for Surgery of the Hand.The results were excellent in 6,good in 2,fair in 1.Conclusion There is less damage on foot and most hand function recovery using bilateral combined flap transplantation to repair multiple fingers defect.
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Objective:To study the relevance ofEGFR gene mutation with pathological features and prognosis in patients with non-small-cell lung carcinoma.Methods: A total of 297 patients from July 2009 to May 2013 were chosen as objects.EGFRgene mutation were detected with fluorescence quantitative PCR. Relevance ofEGFR gene mutation with clinical and pathological features was analyzed, and the prognosis of EGFR- mutant-patients and that of EGFR- wide type-patients was compared.Results:In 297 patients, 136 (45.79%) showed EGFR gene mutation.EGFR gene mutation had no significant relevance with age, gender, smoking history, family history of cancer and clinical stage (P>0.05); there was significant relevance betweenEGFR gene mutation and blood type, pathologic types, differentiation and diameter of cancer (P<0.05). The difference between prognosis of EGFR- mutant-patients and that of EGFR- wide type-patients was statistical significance (P<0.05).Conclusions:EGFR gene mutation has significant relevance with pathological features, the prognosis of EGFR- mutant-patients is better than that of EGFR- wide type-patients.
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Objective To evaluate the feasibility and efficacy of tumor resection combined with lung volume reduction surgery (LVRS) in pulmonary and esophageal patients.Methods 45 patients with lung tumor and 37 patients with esophageal tumor were di- vided into group A(tumor resection plus LVRS) and group B(tumor resection only) randomly.Group A patients underwent tumor re- section combined with LVRS.The target area was determined according to chest computed tomography and ventilation-perfusion scan- ning.The removed pulmonary tissues made up about 20%～30% of the unilateral lung parenchyma.All patients were followed up for 6～12 months.The pulmonary function,blood gas,dyspnea index and 6-min walk distance were compared.Results There were no death during perioperative period.Forced vital capacity in 1 second,PaO_2,PaCO_2,dyspnea index and 6-min walk distance of the group A were all better than preoperative ones,while group B patients had no statistical difference or slight decrease.Conclusion For some tumor patients with emphysema,simultaneous LVRS might provide better opportunity for surgical treatment,but also im- proved the post-operative quality of life.It widens the operative indication for tumor patients.