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@#Objective To compare the clinical effects of coronary artery bypass grafting (CABG) via the left anterior small thoracotomy (LAST) versus lower-end sternal splitting (LESS) approach in the treatment of coronary heart disease. Methods The patients who underwent LAST CABG in Tianjin Chest Hospital from October 2015 to December 2020 were allocated to an observation group (LAST group), and the patients who underwent LESS CABG at the same period were allocated to a LESS group. Propensity score matching method was applied with a ratio of 1∶1. The baseline data, perioperative data and grafts data were compared between the two groups after matching. Results Before matching, there were 110 patients in the LAST group, and 206 patients in the LESS group. After matching, there were 110 patients in each group. In the LAST group, there were 83 males and 27 females with an average age of 60.6±8.3 years. In the LESS group, there were 80 males and 30 females with an average age of 61.0±9.6 years. There was no statistical difference in baseline data between the two groups after matching (P>0.05). The hospital stay time (t=2.255, P=0.025) and ventilator using time (t=−2.229, P=0.027) in the LAST group were significantly shorter than those in the LESS group. There were no statistical differences between the two groups in the postoperative hospital stay time, ICU stay time, postoperative left ventricular ejection fraction, postoperative left ventricular end-diastolic diameter, average number of grafts, secondary intubation, secondary thoracotomy, postoperative wound infection, sternal complications, postoperative atrial fibrillation, postoperative pulmonary infection or main adverse cardiovascular and cerebrovascular events (P>0.05). There was no statistical difference in the distribution of target vessels in the anterior descending branch, diagonal branch or posterior descending branch between the two groups (P>0.05). The grafts of the LAST group were significantly more than those of the LESS group in the area of obtuse marginal branch and posterior ventricular branch, and the grafts of the LESS group were significantly more than those of the LAST group in the area of right coronary artery (P<0.05). Post-operative computerized tomography angiography indicated that 1 patient in the LAST group had obtuse marginal branch vein bridge vessel occlusion, and the bridge vessels in the other patients were unobstructed. Conclusion Minimally invasive CABG via both LAST and LESS approaches is safe and effective. LAST approach can achieve complete revascularization for multi-vessel lesions, and it is safe and reliable, with the advantages of less trauma and aesthetic appearance. However, it requires a certain learning curve of surgical techniques and certain surgical indications.
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Ultrasound-guided radioactive 125I particle implantation for the treatment of advanced gallbladder cancer is susceptible to factors such as ribs, respiratory activity, and biliary reflex, which brings great inconvenience to the operation. We reported one case of gallbladder cancer patients with unclear ultrasound imaging under general anesthesia mechanical ventilation and successful transplantation after sustained inflation with general anesthesia in order to providing basis of clinical diagnosis and treatment.
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Pancreatic metastasis of small cell lung cancer is very rare in clinic. The purpose of this article is to improve the knowledge of clinical and radiologists about this disease by reporting one case.
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Objective To discuss the selection of conveyance and the temperature safeguards during the transport of blood specimens for centralized nucleic acid detection.Methods A total of five chips,which have been set every 10 minuets to record the temperature,have been placed in the Specimen box accordance with the appendix B ofblood transport requirements (WS/T 400-2012).Then,observe the temperature changes in case of ice been placed on both sides,sides and top,sides and bottom,sides and top,bottom of the specimen box respectively.Results In case of ice been placed on both sides of the specimen box,the temperatures were always higher than 10 ℃.In case of ice been placed on both sides and the top of the specimen box,the temperatures were all in range of 2-10 ℃ within 13 hours.In case of ice been placed on both sides and the bottom of the specimen box,only the temperatures of the top were always higher than 10℃.In case of ice been placed on both sides,top and bottom of the box,the temperatures of the bottom were always lower than 2 ℃.Conclusion In case of ice been placed on both sides and top of the box was the most appropriate temperature safeguards during the transport of blood specimens,while in the other cases,the temperatures were lower than 2 ℃,or higher than 10 ℃.
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Objective:To discuss the clinical effects of implantation of radioative 125I seeds by the way of percutaneous puncture and laparotomy under the guidance of ultrasound in the treatment of locally advanced pancreatic cancer, and to provide the basis for choosing surgical methods in treating advanced pancreatic cancer.Methods:The clinical materials of 73 patients with advanced pancreatic cancer were collected, including 42 patients who underwent implantation of radioactive 125I seeds by percutaneous puncture(group A) and 31 patients who underwent impantation of radioactive 125I seeds by laparotomy(group B).The pain relief, local control of tumor, postoperative survival time and complications of the patients were compared between two groups. Results:The rates of pain relief of the patients in group A and group B were 91.89% and 86.40%,and there was no significant difference(P=0.815).The local control rates of the patients in group A and group B were 71.43% and 77.42% ,and there was no significant difference(P=0.564).The medium survival time of the patients in group A and group B were 11 months and 12 months;the one-year survival rates were 36.9% and 35.8%, and there was no significant difference(P=0.664).Seven patients in group A got fever;in group B, six patients got fever, two got calf muscle venous thrombosis, one got gastric retention, one got bilioentric anastomosis, one got abdominal distension and one got intestinal obstruction in the early stage after operation.The incidence rates of complications of the patients in two groups were 16.67% and 38.71%, and there was significant difference(P=0.034).Conclusion:Percutaneous implantation of radioactive 125I particles guided by ultrasound causes less complications in the treatment of locally advanced pancreatic cancer.Moreover, the percutaneous way reaches the same effect as the intraoperative way does on the pain relief, local control of tumor and survival time prolonged.
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Objective To assess the efficacy and safety of ultrasound-guided percutaneous puncturing gastric wall implantation of 125 I seeds in advanced pancreatic carcinoma . Methods Sixty-five cases ( 65 tumors ) of advanced pancreatic carcinoma implanted 125 I seeds by ultrasound-guided percutaneous puncturing gastric wall were retrospectively analyzed . The change of length diameter of tumor and pain relief were evaluated . Results The total 65 cases were performed successfully according to the preoperative plans . In the following 3 months after the operation ,the results showed that complete remission (CR) was achieved in 19 cases ,partial remission( PR) was 33 ,stable disease( SD) was 10 and the progressive disease ( PD) was 3 . The overall response rate was 80％ . About the relief of pain ,complete relief patients were 36 , partial response patients were 11 and the invalid patients were 5 . The pain relief rate was 90 .38％ . There were no bleeding ,pancreatic fistula ,biliary fistula ,gastric perforation which need to do the surgery therapy . Two cases of pancreatic pseudocyst occurred when reviewed in the third month after the operation . Conclusions It is effective and safe to adopt ultrasound-guided percutaneous puncturing gastric wall implantation of 125 I seeds in advanced pancreatic carcinoma .
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objective To clarify the significance and puncture path of 125I radioactive seeds implantation in treatment of postoperative local recurrence and pelvic metastasis in patients with rectal cancer.Methods Clinical data of 8 rectal cancer patients with postoperative local recurrence and pelvic metastasis treated by ultrasound guided 125I radioactive seed implantation were retrospectively analyzed and the therapeutic effects were observed.Results After the treatment,the symptoms of 5 cases suffering from hematochezia and 2 cases with vaginal bleeding disappeared within 21 to 30 days.7 patients with preoperative pain relieved after treatment.There was no tumor progression from postoperative imaging examination.Conclusion 125I radioactive seed implantation can effectively improve the life quality of rectal cancer patients with postoperative local recurrence and pelvic metastasis.
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Objective To make clear the clinical safety of ultrasound guided percutaneous 125I radioactive seed interstitial implantation for treatment of pancreatic cancer.Methods 92 cases of pancreatic cancer treated with ultrasound guided percutaneous 125I radioactive seed interstitial implantation were retrospectively ana lyzed.Results All the 92 cases were performed successfully according to the preoperative plan.25 cases suffered puncture-hemorrhage and blood loss about 2 to 20 ml,and all got hemostasis successfully.2 cases had pancreatic duct injury during puncture,but no pancreatic fistula was found after conservative treatment.No case had bile duct injury.No digestive tract perforation occurred in the 55 cases whose puncture path was through the gastrointestinal tract.No serious complications occurred during the surgery.Conclusions Ultrasound guided percutaneous 125I radioactive seed interstitial implantation for treatment of pancreatic cancer is safe and reliable.
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Objective:To report one case of hilar hepatic tumor treated by ultrasound-guided percutaneous puncture 125 I radioactive seed implantation,and to review the associated literatures.Methods:One patient’s CT and ultrasonic examinations were taken,and the plan of TPS was taken.The patient was treated by ultrasound-guided percutaneous puncture 125 I radioactive seed implantation according to the plan of TPS.The needles were parallel, and the distance between the seeds were 1.0 to 1.5 cm. Results:The operation was successfully completed.No postoperative complications were encountered during 1 month follow up.The volume of tumor was obviously reduced 1 month after operation detected by ultrasound and CT. The local control effect of tumor was good.Conclusion:Ultrasound-guided percutaneous puncture 125 I radioactive seed implantation is a safe and effective method in treating hilar hepatic tumor.
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Objective To explore the ultrasound imaging characteristics of thyroid papillary carcinoma complicated cervical lymph node tuberculosis, and to elucidate the key points of ultrasound diagnosis and to distinguish with cervical lymph node metastasis of papillary thyroid carcinoma.Methods In total, 1 5 well-documented cases of papillary thyroid carcinoma diagnosed definitely were selected, and there were 6 cases of concomitant lymph node metastasis. The ultrasonography of lymph node enlargement was analyzed, and the differences of the ultrasonographic characteristics between lymph node tuberculosis and metastatic lymph node including the location, swelling, calcification, blood flow and regional nodal liquefaction. Results Thyroid papillary carcinoma complicated with cervical lymph node tuberculosis was often found in the areas of Ⅲ,Ⅳ and Ⅴ, especially in the area of Ⅴ. Variety of echo was mixed in tuberculous of lymph node, and the echo was inhomogenous. The tuberculosis of lymph node calcification was patchy inhomogeneous distribution.The echo in part of liquefaction of lymph node tuberculosis was cottony weak. The flow signal of tuberculous lymph appeared the surrounding or internal punctate distribution,and the soft tissue was echogenic and disorder around the lymph node tuberculosis. Conclusion When ultrasonography examination is performed in the patients with the thyroid papillary carcinoma complicated with cervical lymph node enlargement, the history should be considered to analyze the ultrasound characteristics to dignose by observing the lesions of the surrounding soft tissues.
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Objective To investigate the role of stromal cell-derived factor-1α(SDF-1α)/CXCR4 signal pathway in the therapeutic effects of hypoxic preconditioning endothelial progenitor cell (HEPC) transplantation on acute myocardial in-farction Methods Bone marrow endothelial progenitor cells (EPCs) were isolated from syngeneic adult male Wistar rats. EPCs were cultured under normoxic condition for 4 days and 1%O2+5%CO2+94%N2 condition for 3 days. The effect of HEP-Cs on the migration ability of 100μg/L SDF-1αwas observed. Western blot assay was used to detect the expression of CX-CR4, the solo receptor of SDF-1α on cells surface. Then, 26 syngeneic adult male Wistar rats were randomized into 3 groups:control group (n=8),EPCs group (n=9) and HEPCs group (n=9). The acute myocardium infarction animal model was established. At infarction, the rats received 5-points peri-infarct intramyocardial injections of PBS 200μL, 2×106 EPCs and 2 × 106 HEPCs. After 4 weeks, the haemodynamics parameters of cardiac function were analyzed by echocardiography. Results Compare with EPCs, the migration ability of HEPCs towards SDF-1α was increased significantly. The result of Western blot analysis showed an increased CXCR4 expression on the cell surface. After 4 weeks of transplantation, the left ventricular end systolic diameter and ejection fraction (EF%) were much improved in HEPCs group than those of EPCs group and control group (P＜0.05). Compare with control group, the left ventricular end-diastolic diameter was significantly im-proved in EPCs and HEPCs groups (P＜0.05). There was no significant difference in the improvement of the left ventricular end-diastolic diameter between HEPCs and EPCs groups (P>0.05). Conclusion SDF-1α/CXCR4 pathway was up-regu-lated by HEPCs, which showed the therapeutic effects via EPCs. The adjustment of SDF-1α/CXCR4 signaling pathway is an effective method for the treatment of ischemic heart diseases.
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Objective Subjective to identify the significance of interstitial implantation of 125Ⅰ seeds in stage Ⅳ pancreatic cancer patients.Methods Retrospectively analysis the clinical datum of 18 cases of stage Ⅳ pancreatic cancer patients treated with the 125Ⅰ seeds implantation, and observe the pain relief rate and the average survival period, then compare with the bulk of domestic statistical datum.Results The rate of easement of pain was 70.6% (12/17) , and the mean time begin to relieve was 2.9 days .The life span after the operation was be-tween 2.5 and 11.5 months , and 5.2 months on average,which is longer conspicuously than the statistics of the past.Conclusions The methods of interstitial implantation of 125Ⅰ seeds can upgrade the quality of the life and living efficiently of stage Ⅳ pancreatic cancer patients.
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Objective:To investigate the effect of decoction of Fructus Mume (DFM) on the myoelectric activity of uterine smooth muscle of unpregnancy and early pregnancy rats and study its action mechanism.Methods: A pair of bipolar electrode was implanted on the serous surface of rat uterus. The DFM was injected into abdominal and the changes of uterine myoelectrical activity were observed.Results: The higher dose of DFM could enlarge the average amplitude of slow wave of uterine smooth muscle myoelectricity as well as increase the incidence and the maximal amplitude of the outbreak plexiform myoelectric wave. On the other hand, rats during early pregnancy were more sensitive to the DFM. Conclusions: The DFM enhances the myoelectricity activity of uterine smooth muscle of unpregnancy and early pregnancy rats which may result from enhacing the start cells electric activity and speeding up the action potential depolarization. Thus the DFM can serve as an effective clinical drug for anti early pregnancy.