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Objective:To compare the effects of thoracoscopic anatomical segmentectomy and thoracoscopic lobectomy on patients' respiratory function.Methods:Retrospective analysis of 326 patients who underwent thoracoscopic surgery from July 2016 to July 2019(209 patients underwent anatomical segmentectomy, 117 patients underwent lobectomy). According to variables including gender, age, tumor location, smoking history and BMI, two propensity score-matched cohorts including 89 patients respectively were constructed. The patients’ baseline data and respiratory function date of the patients pre-operation and post-operation were analyzed. The measurement data that obey the normal distribution were described by mean±standard deviation, and the t-test was used for comparison between groups; the measurement data of non-normal distribution was described by the median value( P25, P75), and the Wilcoxon rank sum test was used for the comparison between groups; The data was described by frequency, and the chi-square test or Fisher's exact probability method was used for comparison between groups. Results:At the first-month follow-up after surgery, there was no significant difference in the variation of FVC[(0.48±0.40)L vs.(0.34±0.37)L, P=0.215)and FEV1[(0.52±0.46)L vs.(0.43±0.77)L, P=0.364), and in the change rate of FVC(%)[15.23(8.74, 21.25) vs. 14.58(7.75, 19.40), P=0.122], FEV1(%)[17.25(9.56, 22.78) vs. 16.42(9.15, 20.28), P=0.154]and DLCO(%)[18.54(10.88, 25.68)vs. 17.45(9.58, 23.75) P=0.245]. Between the segmentectomy group and lobectomy group, there was a significant difference in the alteration of FVC[(0.50±0.47)L vs. (0.29±0.31)L, P=0.031] and FEV1[(0.44±0.34)L vs.(0.24±0.23)L, P<0.001], the change rate of FVC(%)[14.27(7.87, 22.32) vs. 9.95(5.56, 17.24), P=0.008]、FEV1(%)[15.23(8.36, 22.17)vs. 10.05(5.15, 18.54), P<0.001]and DLCO(%)[13.74(6.24, 19.78) vs. 4.45(-2.32, 13.75), P=0.023]in the 6th month after surgery. The lobectomy group had a higher variation of FEV1[(0.34±0.49)L vs.(0.18±0.26)L, P=0.006] and change rate of FVC(%)[9.28(2.15, 18.94) vs. 5.24(0.52, 11.45), P=0.0032] and FEV1(%)[10.45(3.15, 21.32) vs. 6.50(1.55, 14.24), P<0.001] in the first year after surgery. However, the variation of FVC[(0.29±0.36)L vs.(0.21±0.24)L, P=0.176) and the change rate of DLCO(%)[8.35(2.15, 16.45) vs. 6.23(2.12, 14.54), P=0.143] didn't show a significant difference between the two groups. Conclusion:Whether in the short or the middle postoperative period, segmentectomy can preserve postoperative respiratory function than lobectomy.
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@#Objective To assess the correlation of WHO pathological classification and Masaoka stage of thymomas with its prognosis. Methods A total of 468 patients with thymomas who received surgeries during 2009-2019 in Huashan Hospital, Fudan University, were collected. There were 234 males and 234 females with an average age of 21-83 (49.6±18.7) years. A total of 132 patients underwent video-assisted thoracic surgery (VATS) and 336 patients underwent thymectomy with median sternal incision. The follow-up time was 5.7±2.8 years. The clinical data of the patients were analyzed. Results The amount of intraoperative bleeding was 178.3±133.5 mL in the median sternal incision group, and 164.8±184.1 mL in the VATS group (P=0.537). The operative time was 3.3±0.7 h in the median sternal incision group and 3.4±1.2 h in the VATS group (P=0.376). Postoperative active bleeding, phrenic nerve injury and chylothorax complications occurred in 8 patients, 9 patients and 1 patient in the VATS group, respectively, and 37 patients, 31 patients and 7 patients in the median sternal incision group, respectively. There was no statistical difference between the two groups (P=0.102, 0.402, 0.320). The 5-year cumulative progression free survival (PFS) rates of patients with WHO type A, AB, B1, B2, B3 and C thymomas were 100.0%, 100.0%, 95.7%, 81.4%, 67.5% and 50.0%, respectively (P<0.001). The 5-year PFS rates of patients with Masaoka stageⅠ-Ⅳ thymomas were 96.1%, 89.2%, 68.6% and 19.3%, respectively (P<0.001). The 5-year PFS rate was 87.3% in patients with myasthenia gravis (MG) and 78.2% in patients without MG (P<0.001). The 5-year PFS rates of patients with different surgeries were 82.4% and 83.8%, respectively (P=0.904). Conclusion WHO pathological classification and Masaoka stage have significant clinical prognosis suggestive effect. Thymoma patients combined with MG have better prognosis, which suggests early diagnosis and treatment of thymoma are important.
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Objective@#To evaluate the effects of the blended learning applied in the course of Medical Nursing of Vocational Colleges.@*Methods@#From March to November of 2018, the Vocational Colleges nursing students of grade 2017 were selected as the research subjects. They were divided into the experimental group (n=120) and the control group (n=150). The experimental group implements the blended teaching mode based on rain classroom, while the control group adopts the traditional classroom teaching mode. This paper evaluated the effect of the blended teaching mode based on rain classroom by using the students′ autonomous learning ability scale, the teaching effect satisfaction scale and the theoretical examination papers.@*Results@#The scores of autonomous learning ability (90.6±8.8) and theoretical examination (48.8±3.5) in the blended teaching mode group based on rain classroom were higher than those in the control group (71.4±9.6,39.6±3.6), with statistical significance (t=21.125,16.942, P<0.05). Nearly 93.3% (112/120) of the students in the experimental group accepted this teaching mode.@*Conclusions@#The blended teaching model based on rain classroom can obviously improve the self-learning ability and interest of nursing Medical Nursing of Vocational Colleges, and it is worthy of being promoted.
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Objective To explore the mediating effect of anxiety in perimenopausal women between sleep disturbance and life quality. Methods A total of 516 perimenopmenopausal women in Shenyang,Lia-oning province and Jinzhou city were investigated using the Pittsburgh sleep quality index(PSQI),the self-rating anxiety scale(SAS) and the WHO quality of life( WHOQOL-BREF). Results The scores of sleep disorder,anxiety and quality of life were (14. 31±2. 75),(49. 94±9. 58) and (54. 02±4. 50) in perimeno-pausal women. There was a positive correlation between anxiety and sleep disorder (r=8. 32,P<0. 01),and a negative correlation between anxiety,sleep disorder and quality of life (r=-5. 37,-5. 62,P<0. 01). Anxiety had a mediating effect between sleep disorders and quality of life. The intermediate effect value was-0. 201, accounting for 32. 4%. Conclusion Anxiety has some mediating effects between sleep disorders and quality of life in perimenopausal women,and regulating anxiety can relieve sleep disorders and reduce their impact on quality of life.
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Motor dysfunction is the main clinical symptom and diagnosis basis of patients with Parkinson's disease (PD). A total of 30 subjects were recruited in this study, including 15 PD patients (PD group) and 15 healthy subjects (control group). Then 5 wearable inertial sensor nodes were worn on the bilateral upper limbs, lower limbs and waist of subjects. When completing the 6 paradigm tasks, the acceleration and angular velocity signals from different parts of the body were acquired and analyzed to obtain 20 quantitative parameters which contain information about the amplitude, frequency, and fatigue degree of movements to assess the motor function. The clinical data of the two groups were statistically analyzed and compared, and then Back Propagation (BP) Neural Network was used to classify the two groups and predict the clinical score. The final results showed that most of the parameters had significant difference between the two groups, ten times of 5-fold cross validation showed that the classification accuracy of the BP Neural Network for the two groups was 90%, and the predictive accuracy of Hoehn-Yahr (H-Y) staging and unified PD rating scale (UPDRS) Ⅲ score of the patients were 72.80% and 68.64%, respectively. This study shows the feasibility of quantitative assessment of motor function in PD patients using wearable sensors, and the quantitative parameters obtained in this paper may have reference value for future related research.
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Objective To evaluate the diagnostic value and safety of domestic electromagnetic navigation bronchoscopy (ENB) guided transbronchial lung biopsy (TBLB) for peripheral pulmonary lesions.Methods Sixty-four patients with peripheral pulmonary lesions shown by thoracic CT in Zhongshan Hospital,Fudan University between Jul.and Dec.,2014 were collected.The patients were randomly assigned to test group (underwent ENB in combination with X-ray guided TBLB) and control group (underwent X-ray guided TBLB).The final diagnosis was confirmed by pathologic examination of surgically removed lesions or by 24 months clinical follow-up.The operative time as well as the intraoperative and postoperative complications were also recorded.Results Sixty-four patients had 70 peripheral pulmonary lesions.There was no difference in age,sex,the lesion size or location between the two groups.Pathology results showed that the diagnostic yield of test group and control group were 88.6％ and 62.9％,respectively,with statistical significance (P =0.012).Subgroup analysis showed that if the lesion's diameter was ≤2 cm,the diagnosis yield of test group was higher than control group (66.7％ vs.20.0％,P =0.266);if the lesion was ＞2 and ≤3 cm,the diagnosis yield of test group and control group were 100 ％ and 81.8 ％,respectively (P =0.485).But if the lesion was＞3 cm,the diagnostic yield of the 2 group was significantly different (94.4 ％ in test group,63.1％ in control group,P =0.042).Mean operation duration of the 2 group was (966 ± 372)s and (1 040 ± 470) s,respectively,with no statistical difference (P =0.600).However,there was statistical difference between the 2 groups on the X-ray time needed to find the pulmonary lessions [(7.0 ± 4.8)s vs.(37.0 ± 37.5) s,P =0.008).There was no pneumothoraxes and excessive bleeding in patients undergoing ENB.Conclusions Compared with X-ray guide TBLB,ENB guided TBLB for peripheral pulmonary lesions has a certain degree of security,and has superiority in reducing the X-ray time required to find the lesion and improving diagnostic yield especially when the lesion's diameter was ＞3 cm.
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Objective@#To evaluate the clinical effect of injectable modified sodium hyaluronate gel filler in the treatment of facial profile modification and rejuvenation.@*Methods@#A total of 125 patients who received facial injection of hyaluronate gel from October 2013 to October 2015 were collected. The patients included 62 cases for rhinoplasty, 28 for chin augmentation, 20 for nasolabial fold correction and 15 for lacrimal groove correction. The post-operation results, satisfaction survey and adverse reaction were observed.@*Results@#All the injected positions improved immediately, and the instant average satisfaction score was 9.3±0.7, followed by 8.1±0.7 after 3 months, 6.9±0.8 after 6 month and 5.2±0.8 after 1 year. Thirty cases exhibited swelling, 5 cases bruised, and they all recovered within one week.@*Conclusions@#Sodium hyaluronate is effective and stable in the treatment of facial contour modification and rejuvenation.
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BACKGROUND:hIL-24, a tumor suppressor gene, can stimulate immune responses, inhibit the growth of tumor cel s, and the formation of tumor vessels, and induce cel apoptosis. OBJECTIVE:To explore the effects of hIL-24 gene on the proliferation and apoptosis of fibroblasts in the keloid and the underlying mechanisms. METHODS:Al the keloid specimens col ected from 13 patients were used for fibroblast culture and indentification. Fibroblast of the keloid was transfected with or without hlL-24 lentivirus. Subsequently, mRNA expressions of transforming growth factor-β, Smad3, proliferating cel nuclear antigen, matrix metal oproteinase-2,-9, and metal opeptidase inhibitor 1 were determined. RESULTS AND CONCLUSION:Immunofluorescent staining and flow cytometry showed that vimentin antibody was expressed positively in cytoplasma of fibroblast cultures, and the purity was more than 97.8%. Western blot assay showed that hIL-24 expression was significantly increased in the transfected fibroblasts. Quantitative PCR showed that the overexpression rate of hIL-24 in fibroblasts was 81.7%and mRNA expressions of transforming growth factor-β, Smad3, proliferating cel nuclear antigen, matrix metal oproteinase-2, and-9 were significantly decreased, while metal opeptidase inhibitor 1 mRNA expression was significantly increased in hIL-24 transfection group compared with control group (P<0.05). These findings suggest that hIL-24 gene inhibits the expressions of proliferating cel nuclear antigen, matrix metal oproteinase-2, and-9 in fibroblasts, and the underlying mechanism may involves TGF-β/Smad3 pathway.
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Objective To observe before and after surgery plasma vascular endothelial growth factor (VEGF) and transforming growth factor beta 1 (TGF-β1) content changes in the children with congenital heart disease(CHD) combined severe pulmonary arterial hypertension(PAH),and to explore the relationship with the pulmonary artery pressure.Methods Sixty cases patients with CHD in the First Hospital of Hebei Medical University from June 2014 to January 2015 were selected,including 30 cases left to right shunt CHD with severe PHD,30 cases no PHD.The content of serum VEGF,TGF-β1,parallel echocardiographic estimates pulmonary artery mean pressure(PAMP) of all children were detected with preoperative and postoperative 24 h,7 d and 30d.Results PAMP of children with severe PAH before surgery was (60.29±8.48) mmHg and (48.36±5.25)mmHg of postoperative 24 h,(28.21±3.29) mmHg of 7 d after surgery,(25.21±2.09) mmHg of 30 d after surgery,the difference was statistically significant (F within the grouP=39.86,P＜0.001),and compared with no PHD group,the difference was significant ((14.26±1.78) mmHg,(14.30±1.92) mmHg,(13.31±1.02)mmHg;F between groups=46.01,P＜0.001).The levels of VEGF and TGF-β1 in severe PHD group were (808.90±41.37) ng/L and (1156.96±83.68) ng/L of before operation,(620.21±30.30) ng/L and (906.20±65.11) ng/L of postoperative 24 h,(454.49±21.48) ng/L and (826.23±35.11) ng/L of postoperative 7 d,(454.49±21.48) ng/L and (806.49±29.48) ng/L of postoperative 30 d,the differences were significant (Fwithin the grouP=43.73,P＜0.001;F within the grouP=65.41,P＜0.001),compared with no PHD group,the differences were significant (VEGF:(379.25±20.21) ng/L,(380.05±19.98) ng/L,(380.05±19.98) ng/L,F between groups =54.09,P＜0.001;TGF-β1:(728.56±29.93) ng/L,(728.11±25.26) ng/L,(727.05±24.99) ng/L,F between groups=83.05,P＜0.001).Conclusion Plasma VEGF and TGF-β1 level has correlation with pulmonary artery pressure,the severity evaluation of pulmonary hypertension and surgical curative effect has a certain significance.After surgery,severe PAH is still exist in a certain period in children with pulmonary hypertension,sufficient attention should be paid to strengthening treatment and follow-up.
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Objective To explore the relationships among psychological empower, role stressors and job burnout in nurses.Methods From February to October of 2014, by random sampling method, 420 nurses from three hospitals of Jinzhou city of Liaoning province were selected and assessed with the psycho-logical empower questionnaires,the job burnout questionnaire,role stressors questionnaire.The data were ana-lyzed using pearson correlation analysis and logical multiple linear regression analysis.Results The average score of job burnout was (59.58±18.30) points, the average score of psychological empower was (38.87±7. 05) points.Job burnout and each dimension were negative correlated with self-determination of the psycho-logical empower ( r=-0.25--0.34, P<0.05) and self-efficacy ( r=-0.08--0.53, P<0.05).The scores of role stressors were positively correlated with the scores of emotional exhaustion( r=0.17-0.43, P<0.05) and cynicism ( r=0.07-0.46, P<0.05) .Multiple regression analysis showed that age(β=-0.104) ,education lev-el(β=-0.237),seniority(β=-0.334),self-determination(β=-0.152),self-efficacy(β=0.127),role am-biguity(β=0.284),role overload(β=0.325) were influencing factors of nursing burnout.Conclusion -Nurses role stressors and psychological empower can predict nurses’ burnout, so nurse managers can in-crease the level of authority to relieve psychological job burnout by reducing caregiver stress source.
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Objective To analyze the effect of applying KTH [knowledge-attitude-belief practice model (KABP model), transtheoretical model of behavior (TTM) and health belief model (HBM)] integrated health education into nursing of elderly patients with hypertension in institutions in poor areas. Methods KTH integrated health education was established. Before the intervention and 12 weeks after intervention, the Questionnaire of Hypertension Knowledge, the Primary Hypertension Patients′Compliance Scale and Chinese version of the World Health Organization Quality of Life Questionnaire (WHOQOL-100) were used to investigate 84 cases of elderly patients with hypertension of four pension institutions in three poverty-stricken counties of Chaoyang city. Results After 12 weeks of intervention, the awareness rate of hypertension knowledge, compliance behavior and quality of life scores were higher than those before intervention, the complete awareness rate was 100.0% (84/84) vs. 3.5% (3/84);the high level of compliance behavior was 48.8%(41/48) vs.15.5%(13/84),the difference was significant (χ2=156.41, 86.27, P<0.01). The total score of quality of life was 86.95±5.41, higher than that before the intervention (76.93±6.60), the difference was statistically significant (t=8.662, P<0.01). Conclusions KTH integrated health education is an effective way to be applied in pension institutions of poor areas.
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Objective To analyze the recent condition on medication safety of the elderly with chronic diseases in poor areas of Liaoning Province, the structural equation model(SEM) was used to investigate the influencing factors of the medication safety in order to provide the scientific basis for medication safety and the rational use of drugs. Methods The 1 690 elderly with chronic diseases in poor areas of Liaoning Province were selected by the multi-stage random sampling and investigated with the self-designed questionnaire, the database was established on SPSS17.0, the model of structural equation modeling was built by AMOS17.0. Results The four common factors, which were the knowledge,attitude, practice and adherence of medication safety, were extracted by confirmation factor analysis, and the data of the four common factors was fitted, the fitting parameters were: χ2/DF=2.254, GFI=0.913, NFI=0.909, CFI=0.925, AGFI=0.825, RMSEA=0.062, the model fitting was ideal. Conclusions The medication of the elderly with chronic diseases in poor areas of Liaoning Province exists potential security risks, the knowledge, attitude, practice and adherence of medication safety are the important factors which affect the medication safety, the health education about medication safety should be conducted in the elderly with chronic diseases in the poor areas, to develop the safety, effectiveness and economy of medication among the elderly.
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Objective To evaluate the reliability of serum catecholamine concentrations in reflecting the depth of dexmedetomidine-based general anesthesia.Methods Forty patients,aged 30-45 yr,of American Society of Anesthesiologists physical status Ⅰ-Ⅱ,undergoing elective laparoscopic hysterectomy under general anesthesia,were divided into 2 groups (n =20 each) using a random number table:dexmedetomidine-based general anesthesia group (group Ⅰ) and general anesthesia group (group Ⅱ).Dexmedetomidine was intravenously infused as a loading bolus of 1 μg/kg over 10 min before induction of anesthesia,followed by an infusion of 0.5 μg · kg-1 · h-1 until 30 min before the end of operation in group Ⅰ.The equal volume of normal saline was given instead of dexmedetomidine in group Ⅱ.Anesthesia was induced with iv midazolam 0.05 mg/kg,propofol 1 mg/kg,cisatracurium 0.15 mg/kg and sufentanil 0.4 μg/kg.Anesthesia was maintained with iv infusion of remifentanil 0.1-0.3 μg · kg-1 · min 1,1％-2％ sevoflurane inhalation and intermittent iv boluses of cisatracurium.Before administration of dexmedetomidine,at the end of administration of the loading dose,at the end of intubation,at the end of skin incision,after establishment of pneumoperitoneum and at the end of operation (T0-5),venous blood samples were taken from the peripheral vein for determination of concentrations of epinephrine (E) and norepinephrine (NE) in serum (by enzyme-linked immunosorbent assay).Results Compared with group Ⅱ],the serum NE and E concentrations were significantly decreased at T1-4 in group Ⅰ (P＜0.05).Compared with the baseline at T0,the serum NE and E concentrations were significantly decreased at T1 in group Ⅰ,and increased at T2-4 in group Ⅱ (P＜0.05).Conclusion The serum catecholamine concentration produces poor reliability in reflecting the depth of dexmedetomidine-based general anesthesia,and thus it is not a suitable monitoring index.
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Objective To investigate long-term care needs and its influencing factors among old people with chronic diseases in nursing homes in rural area of Liaoning. Methods A total of 502 elderly with chronic diseases were recruited using convenience sampling method from eight nursing homes in rural area of Liaoning, and were investigated with the general information questionnaire, Short Form 36-item Health Survey (SF-36) and long-term care needs questionnaire from March 2015 to January 2016. Results Logistic regression analyses were used to identify that age (P=0.000), old patients′ disease condition (P=0.008), marriage (P=0.013) and quality of life (P=0.000) were major factors affecting long-term care needs. The top three highest percentage services were seeing the doctor 85.26% (428/502), assisting with taking the medicine 80.28% (403/502), assisting with bathing 70.32% (353/502). Conclusions This study suggests that we should improve the quality of services of long-term care needs based on the demands of old people with chronic diseases in nursing homes in rural area.
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Objective To evaluate the myocardial protective effects of Histidine-TryptophanKetoglutarate (HTK) solution on infants with tetralogy of fallot in cardiac operation through comparison with St.Thomas Ⅱ cardioplegia(STH) and HTK cardioplegia in the operation of tetralogy of fallot.Methods Forty infants with tetralogy of fallot(TOF) were enrolled in this study.Their age ranged from 7 to 35 months,and body mass from 5.3 to 9.5 kg.The infants were randomly divided into HTK (n =20) group and STH (n =20) group who received HTK or STH solution respectively.Then 3 ml blood sample were got at 1,2,4,8,24 and 48 h after the opening of ascending aorta.The serum levels of cardiac troponin Ⅰ(cTnI),creatine kinase(CK) and creatine kinase MB(CK-MB) were measured.Results There was significant difference between two groups in terms of the level of cTnI at different time (F(inner group)=49.94,P＜0.001;F(between group) =10.23,P＜0.001;F (across group) =28.49,P＜0.001),and the level of cTnI in HTK group was lower than that of STH group at 1,2,4,8,24 and 48 h after the opening of ascending aorta (P＜0.05).There was significant difference between two groups in terms of the level of CK at different time (F(inner group) =58.85,P＜0.001;F(between group) =16.43,P＜0.001;F(across group)=18.32,P＜0.001),and the level of CK in HTK group was lower than that of STH group at 1,2,4,8,24 and 48 h after the opening of ascending aorta (P＜0.05).There was significant difference between two groups in terms of the level of CK-MB at different time (F(inner group)=34.51,P ＜0.001;F(between group)=11.03,P＜0.001;F(across group)=10.28,P＜0.001),and the level of CK-MB in HTK group was lower than that of STH group at 1,2,4,8,24 and 48 h after the opening of ascending aorta (P ＜0.05).Conclusion HTK is more valid than STK for improving the ability of anti ischemia of myocardium and cardiac function,reducing arrhythmia and ischemia reperfusion injury on infants with TOF in cardiopulmonary bypass.
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Objective To investigate the illness uncertainty state of the family members of elder patients with colostomy,explore their correlation with social support.Methods A total of 138 family members of elder patients with colostomy in two hospitals from September 2013 to November 2014 were recruited in this study.The General Information Questionnaire,Mishel Uncertainty in Illness Scale-Family Member Form (MUIS-FM) and Social Support Rating Scale (SSRS) were used to investigate the family members of elder patients with colostomy and analyse the correlation between illness uncertainty of family members and its influencing factors and social support.Results The average total score of illness uncertainty was (72.17±9.44) scores.There was significantly different of the family members of elder patients with colostomy in total uncertainty on degree of education,the relationship with patient,stoma nature and economic conditions (P＜0.05).The average total score of social support was (37.14±5.25) scores.The level of illness uncertainty was negatively associated with social support (r=-0.526,P＜0.01).Conclusions The illness uncertainty was mostly in higher levels in the family members of elder patients with colostomy and was negatively correlated with social support.Clinical practice should improve social support of family members to relieve illness uncertainty,so as to provide better services of family and promote physical and psychological rehabilitation of patients.
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Objective To integrative the effect of ulinastatin on postoperative cognitive function in elderly gastric cancer surger-y.Methods Two hundred elderly patients with gastric cancer surgery were randomly divided into observed group (100 cases)and control group (100 cases).Patients in observed group received the intravenous drip of ulinastatin before and after the surgery,while others only received the intravenous drip of physiological saline before and after the surgery.Results The urine output of observed group was (441.7±78.5)mL,which was significantly lower than that in control group as the result was (613.2±81.2)mL(P <0.05).After the treatment,the score of MMSE,visual regeneration and association learning in both observed group and control group were significantly lower than that before the treatment(P <0.05).The scores of MMSE,visual regeneration and association learning in observed group were 24.4±1.5,9.7±1.7 and 12.4±1.8,which were significantly higher than that in control group as the scores were 21.1±1.0,8.7±1.5 and 11.3±1.7 (P <0.05).The level of S100βin serum of observed group at the end of sur-gery,1 day and 3 day after the surgery were (0.099±0.024)μg/L,(0.074±0.026)μg/L and (0.061±0.022)μg/L,which were significantly lower than that in control group as the results were (0.138±0.042)μg/L,(0.110±0.034)μg/L and (0.075±0.031)μg/L (P < 0.05).Conclusion Ulinastatin can not only improve the postoperative cognitive dysfunction in elderly patients with postoperative,but can also reduce the level of S100βin serum.It provides brain protection for patients.
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Objective To share the clinical experience of tetralogy of stage Ⅰ Fallot children with little left ventricle.Methods Thirty-eight cases with stage Ⅰ Fallot with little left ventricle from March 2008 to Jun 2012 were selected as our subjects.Of them,18 were boys and 20 were girls.The age of the cases ranged from 5 to 18 months and average was (9.37 ±2.45) months.The weight ranged from 6.6 to 10.4 kg,and average was (8.33 ± 1.72) kg.All cases showed cyanosis of oral lip.They all were performed tetralogy by the breast bone median incision and then expanding interventricular septal defect.Results All cases survived.Following-up 6 -18 months showed that all cases got good recovery.Left arterial diameter at before the operation,discharge,3 months after surgery were (14.07 ± 0.79) mm,(14.37 ± 0.68) mm,(16.01 ± 0.72) mm respectively and transverse diameter of right atrium were (18.23 ± 1.07) mm,(18.74 ± 0.96) mm,(19.28 ± 0.71) mm respectively.The differences were significant (F =99.474,69.760,P =0.000).Main pulmonary artery diameter at before the operation,discharge,3 months after surgery were (7.98 ±0.92) mm,(8.16 ±0.54) mm and (9.92 ± 0.81) mm,and left ventricular end diastolic diameter were (19.27 ± 1.15) mm,(21.06 ± 1.75) mm,(23.41 ± 1.18) mm.Meanwhile,left ventricular fractional shortening rate were (35.57 ± 1.45)％,(32.61 ± 2.15) ％,(34.29 ± 2.12) ％,and main pulmonary artery systolic flow velocity were (450 ± 98.36) cm/s,(150.0 ± 9.22) cm/s,(148.0 ± 7.92) cm/s.All differences were statistically significant (F =108.620,96.410,99.485,102.914;P =0.000).Conclusion Tetralogy on Fallot children with little left ventricle can lead to cardiac remodeling,which reduce the load of right ventricle and improve left ventricular function.