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Objective:To study the clinical value of left ventricle Tei index in evaluating hemodynamics after interventional therapy of patent ductus arteriosus (PDA).Methods:From May 2017 to May 2019, 50 children with PDA who underwent interventional therapy (PDA group) and 27 healthy children (healthy control group) in Anhui Provincial Children’s Hospital were selected. The left ventricle Tei index, plasma brain natriuretic peptides (BNP), left ventricular end-diastolic dimension (LVDD), left ventricular ejection fraction (LVEF) were compared between 2 groups.Results:The left ventricle Tei index was not correlated with heart rate and age in 2 groups ( P>0.05). The left ventricle Tei index before operation in PDA group was significantly lower than that in healthy control group: 0.20(0.16, 0.25) vs. 0.27(0.20, 0.30), and there was statistical difference ( P<0.05). In PDA group, the left ventricle Tei index immediately, 3 d, 1 month and 3 months after operation was significantly higher than before operation: 0.38(0.29, 0.47), 0.32(0.26, 0.40), 0.30(0.27, 0.35) and 0.32(0.26, 0.37) vs. 0.20(0.16, 0.25), and there was statistical difference ( P<0.05); the plasma BNP immediately after operation was significantly lower than before operation: 288 (126, 433) ng/L vs. 582 (303, 1 675) ng/L, and there was statistical difference ( P<0.05); the LVDD 3 months after operation was significantly lower than before operation: (3.03 ± 0.54) cm vs. (3.38 ± 0.51) cm, and there was statistical difference ( P<0.05); the LVEF immediately after operation was significantly lower than before operation: (54.24 ± 6.09)% vs. (59.45 ± 5.93)%, the LVEF 1 and 3 months after operation was significantly higher than that immediately after operation: (63.18 ± 4.71)% and (65.46 ± 4.78)% vs. (54.24 ± 6.09)%, and there were statistical differences ( P<0.05). The left ventricle Tei index before operation was negatively correlated with inner diameter of PDA and plasma BNP ( r = -0.362 and -0.388, P = 0.013 and 0.009), and there was no correlation between LVDD and LVEF ( r = -0.192 and -0.283, P = 0.229 and 0.053); the differences of Tei index before operation and immediately after operation (ΔTei) was positively correlated with inner diameter of PDA ( r = 0.325, P = 0.030), and there was no correlation with BNP, LVDD and LVEF ( r = 0.234, 0.283 and -0.039, P = 0.126, 0.076 and 0.798). Conclusions:The left ventricle Tei index can quickly and accurately assess the change of hemodynamics after interventional therapy of PDA.
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Objective To study the clinical characteristics, respond of treatment and prognosis in infants with atrial tachycardia (AT). Methods The clinical data of 23 infants with AT from August 2014 to November 2016 were retrospectively analyzed. The respond of treatment and prognosis were observed. Results Of all the 23 infants with AT, incessant AT was in 5 cases, and paroxysmal AT was in 18 cases. There were 13 infants diagnosed with AT combined with cardiac insufficiency, and among them, 5 cases were combined with tachycardia induced cardiomyopathy (TIC). Echocardiography showed that atrial septal defect in 3 cases, patent foramen oval in 6 cases, ventricular septal defect in 1 case, ventricular septal defect combined with patent foramen oval in 2 cases, ventricular septal defect combined with atrial septal defect in 1 case, and ventricular septal defect combined with coarctation of the aorta in 1 case. The curative effect was excellent in 11 cases, effective in 8 cases, and ineffective in 4 cases at discharge. There was no statistical difference in curative effect between patients with normal cardiac function and cardiac insufficiency at discharge (P＞0.05). The infants were followed up for 12 months, AT disappeared in 19 cases, 1 case progressed to sick sinus syndrome, and 3 cases were lost in follow-up. Conclusions AT can be insidious in infants, but with a favorable prognosis if treated with cardiotonic drugs and antiarrhythmic drugs during the short and mid-term follow-up. Long-term follow-up should be taken to learn more about the prognosis.
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Objective To compare the surgical effects between minimally invasive anterior ondontoid screw fixation assisted by our self-designed odontoid guider and open anterior ondontoid screw fixation in the treatment of odontoid fractures of Anderson-D'Alonzo type Ⅱ.Methods From July 2011 to July 2016,28 adults with odontoid fracture of Anderson-D'Alonzo type Ⅱ were treated at Department Ⅱ of Spinal Surgery,Hospital of 89 Army Group of Chinese PLA.Of them,15 were treated by minimally invasive anterior ondontoid screw fixation assisted by our self-designed odontoid guider (guider group) while the other 13 by open anterior ondontoid screw fixation (open group).All the patients were male,aged from 31 to 59 years (average,42.7 years).The 2 groups were compared in terms of incision length,operation time,intraoperative bleeding,intraoperative fluoroscopic frequency and hospital stay.Results There were no significant differences between the 2 groups of patients in their preoperative general data,indicating they were compatible (P ＞ 0.05).All the patients were followed up for 12 to 45 months (average,22.1 months).The internal fixation was in good place and clinical union achieved in all the 28 patients.The incision length (2.2 ± 0.1 cm),operation time (45.0 ± 3.1 min),intraoperative bleeding (29.0 ± 2.3 mL) and intraoperative fluoroscopic frequency (15.5 ± 1.9 times) for the guider group were all significantly less than those (2.9 ±0.7 cm,61.6±3.8 min,51.6±3.9 mL and 21.7±3.2 times,respectively) for the open group (P ＜0.05),but there was no significant difference between the 2 groups in hospital stay (6.5 ± 0.5 d versus 6.5 ± 0.6 d) (P ＞ 0.05).Conclusion In the treatment of odontoid fractures of Anderson-D'Alonzo type Ⅱ,compared with open anterior ondontoid screw fixation,the minimally invasive anterior ondontoid screw fixation assisted by our self-designed odontoid guider may lead to a smaller incision,shorter operation time,less blood loss and a lower fluoroscopic frequency.
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Objective To discuss the sensitization effect of celecoxib in the radiotherapy and chemotherapy of patients with esophageal cancer,and its clinical application value.Methods According to the digital table,60 patients with esophageal cancer were randomly divided into observation group and control group,30 cases in ecah group.The control group was given conventional radiation and chemotherapy,the observation group received combination with celecoxib for radiotherapy sensitization.The clinical effect was compared between the two groups.Results The total effective rate of the observation group was 46.67％ (14/30),which was higher than 20.00％ (6/30) of the control group,the difference between the two groups was statistically significant (x2 =4.343,P ＜ 0.05).In the observation group,radioactive pneumonia occurred in 1 case,radioactive esophagitis in 2 cases,radioactive myocarditis in 1 case.In the control group,radioactive pneumonia occurred in 2 cases,radioactive esophagitis in 1 case,radioactive myocarditis in 2 cases,the differences between the two groups were statistically significant (x2 =0.350,0.350,0.350,all P ＞0.05).In the observation group,7 cases occurred nausea and vomiting,diarrhea in 1 case,bone marrow suppression in 5 cases,renal toxicity in 2 cases.In the control group,8 cases had nausea and vomiting,diarrhea happened in 2 cases,bone marrow suppression in 3 cases,renal toxicity in 1 case,there were no statistically significant differences between the two groups (x2 =0.088,0.350,0.576,0.350,all P ＞ 0.05).Conclusion Application of celecoxib in patients with esophageal cancer during the process of radiation and chemotherapy has sensitization effect,it can promote the esophageal cancer treatment effect,without increase in adverse reactions,it is worthy of popularization and application in clinic.
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Objectives To study the early effect of treating teenagers with tibial insertion avulsion fracture of anterior cruciate ligament using the single-tibal tunnel,double Endobutton miniature steel plate combined with twin high-strength Ultrabraid Suture suspension fixation under an anthroscopy.Methods Retrospective analysis was conducted on 21 teenagers with tibial insertion avulsion fracture of anterior cruciate ligament treated between May 2012 and June 2015.They were treated using the single-tibal tunnel,double Endonbutton plate combined with twin Ultrabraid Suture suspension system fixation.The X-ray was taken postoperatively at 1 week,1 month,3 months and every 6 months.Anterior drawer and Lachman tests were used to evaluate the postoperative stability of knee joints,while the Lysholm score was recorded to assess the postoperative recovery.Results The average total intraoperative blood loss,operation duration and follow-up time were(53.95 ± 7.10) ml (ranging from 43 to 68 ml),(38.76 ± 7.71)min(ranging between 27 and 55 min),and(21.86 ± 2.78)months,ranging from 18 to 25 months.All fractures were healed without malunion or nonunion as could be seen in the X-ray taken 3 months after the operation.Moreover,none of the patients suffered from complications such as soft tissue infections or extension lag of the knee joints caused by the femoral intercondylar notch impingement syndrome.The Lysholm score of the last follow-up(97.14 ± 1.35)was significantly higher than that before surgery (40.24 ± 5.81).Conclusion The early efficacy of the single-tibal tunnel,double Endonbutton plate combined with twin Ultrabraid Suture suspension system fixation for teenagers with tibial insertion avulsion fracture of anterior cruciate ligament under arthroscopy is satisfactory.
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Objective To investigate the clinical effect and patients of docetaxel and cisplatin combined with radiotherapy for advanced esophageal carcinoma of the safety and the effect on the immune status of patients. Methods 104 cases of advanced esophageal cancer patients admitted in Dongyang People's Hospital from January 2011 to June 2014 were divided into the control group and the observation group with 52 cases in each group. The two groups of patients were treated with three-dimensional conformal radiotherapy, total dose of 55~65gy, the course of treatment was six weeks, at the same time, the control group were treated with cisplatin (20mg/m2) combined with 5-fluorouracil (400mg/m2) chemotherapy, the observation group were treated with cisplatin (20mg/m2) combined with docetaxel (120mg/m2) chemotherapy, the course of treatment was three weeks. Compared the two groups of patients with clinical treatment effect, survival rate and the average survival time, adverse reaction rate, and detection of two groups of patients before and after the treatment of immune function index CD3+, CD4+, CD8+ and CD4+/CD8+ levels. Results The total effective rate of observation group was 86.53%, the total effective rate of control group was 69.23%, the difference was statistically significant (P< 0.05), the patients in the observation group two years survival rate and mean survival time were significantly better than the control group, the difference was statistically significant (P< 0.05), the adverse reaction rate of the observation group was 59.62%, the adverse reaction rate of the control group was 65.38%, the difference was statistically significant (P< 0.05), two patients immune function indexes of CD3+, CD4+, CD8+ and CD4+/CD8+ levels had no significant difference before treatment after treatment, patients in the observation group, CD4+, CD3+, CD8+and CD4+/CD8+were significantly better than the control group, the difference was statistically significant (P< 0.05). Conclusion Three-dimensional conformal radiotherapy based on cisplatin combined with docetaxel chemotherapy is superior to cisplatin combined with 5-fluorouracil chemotherapy, and less adverse reaction, while patients with advanced esophageal carcinoma immune function less.
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Objective To investigate the effect of cinobufacin on P53,PTEN and HIF-1αin patients with advanced lung cancer.Methods 100 cases with advanced lung cancer were divided into two groups.control group(n=50) were treated with routine treatment, experiment group(n=50) on the base of the control group with 0.3 g cinobufacin,3 times per day oral.P53, PTEN, HIF-1α,tumor marker,survival rate and mortality were compared after the treatment.Results Compared with the control group,the serum levels of P53, HIF-1αexpression level was lower(P<0.05),PTEN expression level was higher (P<0.05),CEA,NSE,CYFRA21-1,CA125 were lower(P<0.05);the survival rate was higher, the mortality was lower(P<0.05). Conclusion Cinobufacin can regulate the advanced lung cancer patients serum P53, PTEN and HIF-1αlevels and reduce the tumor markers levels, improve the survival rate.It is of great importance for clinical treatment of advanced lung cancer.
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Objective To explore the indications and curative effect of minimally invasive pedicle screw fix-ation in the treatment of thoracolumbar fractures .Methods 10 patients with thoracolumbar fractures without neuro-logical damage and the need for vertebral lamina decompression were selected .Under the C arm,the disease vertebral and adjacent vertebral arch spikes were positioned ,four 2.5cm long incisions were done ,fixation and restoration were completed within four small incisions .Results All patients restored vertebral body height and protrusion deformity after correction.The operation time was about 2h,blood loss was 100~150mL.Conclusion The minimally invasive pedicle screw fixation in the treatment of thoracolumbar fractures is suitable for simple thoracolumbar fractures without neurological damage ,the need for patients with vertebral lamina decompression ,it has advantages of small trauma ,fas-ter postoperative recovery .
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Objective To evaluate operative methods and the clinical effect for comminuted calcaneal fractures.Methods 21 cases(24 feet)of comminuted calcaneal fractures were treated by one stage bone grafting plus open reduction and internal fixation with plastic calcaneus titanium plate.The fractures were classified according to the Sanders system into Sanders Ⅱ,Ⅲ and Ⅳ subgroups.Results All cases were followed up for 9～20 months(14months in average).All cases recovered with good healing of fracture.According to Maryland score,the results were excellent in 14 feet,good in 7 feet,fair in 2 feet,and poor in 1 foot.The excellent and good rate was 87.5％.Conclusions By using the method of internal fixation with plastic calcaneus titanium plate,fracture site can be well exposed,which is helpful to recover calcaneus to its normal length,width,height,Gissane angle and Bohler angle.A reliable internal fixation is helpful for early stage functional excise after surgery,which can maximize the recovery of the ankle function.
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Anti-tyrosinase assay guided isolation of marine-derived fungus Botrytis sp.led to separation of three ?-pyrone compounds.The structures of these compounds were elucidated by various physicochemical analytical methods.The bioactivities of these ?-pyrone derivatives were evaluated in terms of anti-tyrosinase activity.By correlating the bioactivities of these compounds with their structures,it concluded that the ?-pyrone with pentyl group gives highest anti-tyrosinase activity.
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Objective To Investigate the factors affecting the post treatment fever in patients with primary liver cancer (PLC) undergone transcatheter arterial chemo embolization(TACE).Methods Seventeen clinical parameters of 102 TACE procedures were determined as independent variables, while the numbers of days running a fever after the procedure of the patients were determined as dependent variables. A multivariate stepwise regression analysis was performed to determine the factors that had affected the duration of fever. Results The factors that affected the fever after TACE were the dose of lipiodol used, ascites, using gelatin sponge(GS), serum albumin level, a history of fever, pre operative leukocyte counts and age. The volume of lipiodol used had played the most important role in affecting febrile time. Conclusions The amount of lipiodol used is the most important factor affecting the post treatment fever in patients with PLC undergone TACE with a tendency of intensification by using GS. The systemic state and the regional state of the liver before the treatments also play some parts in affecting the fever. Some frbrile cases are probably associated with potential infection. The lasting time of fever can be predicted approximately by building up a multivariate regresion equation.