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Objective To assess the safety and effectiveness of laparoscopic implantation of three-dimensional (3D)-printed extravascular stent for treatment of nutcracker syndrome (NCS).Methods The clinical data of NCS in our hospital were prospectively collected from August 2015 to August 2016.Doppler ultrasound and CT examination were performed before the operation of all the patients who were in line with the diagnostic criteria of NCS.The 3D model of extravascular stents with especial device to prevent migration was designed and was made by 3D metal printer with titanium alloy.The left renal vein(LRV) was exposed completely up to the inferior vena cava,then the stent was placed around the compressed LRV.Results 10 patients were enrolled in the study,including 9 males and 1 females,age (21.5 ±4.6) years.Among these patients,there were 4 cases with severe hematuria,1 case with proteinuria,5 cases with left lumbago,and 5 cases with left severe varicocele.The preoperative doppler ultrasound examination showed the diameter of the the compressed LRV was (1.57 ± 0.25) mm,and flow velocity was (164.40 ± 55.27) cm/s;the diameter of the LRV at the renal hilum was (8.7 ± 1.59) mm,and flow velocity was (10.70 ± 2.21) cm/s.The average operation time was (75 ± 11) min,and the average hospital stay after operation was 7 d.All symptoms were relieved at 3-7 d after operation.All patients were asymptomatic and all stents were stable after follow-up.At 12 months after surgery,the diameter of the LRV at the renal hilum was (8.23 ± 1.90) mm on doppler ultrasound,and there was significant decrease (P ＜ 0.01);the flow velocity was (21.20 ±3.88) cm/s,and there was significant increase (P ＜ 0.01).Conclusions Laparoscopic three-dimensional printed extravascular stent placement is a safe,effective and minimally invasive technique for treatment of NCS.
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Objective To investigate the clinical value of observing the differences of GSK‐3βprotein expression and activity lev‐el in the peripheral blood mononuclear cells between type 2 diabetes mellitus patients and healthy people .Methods Using ELISA to detect the GSK‐3βprotein expression and activity levels of people who contained 30 patients with type 2 diabetes whose blood glu‐cose were not controlled (test group 1) ,30 cases of patients with type 2 diabetes whose blood glucose were controlled (test group 2) and 30 cases of healthy human and all the data were analyzed .Results The GSK‐3βprotein content of Type 2 diabetes mellitus group was higher than the control group(P<0 .05) ,the activity level of GSK‐3βin test group 1 was higher than the control group and test group(P<0 .05) .The GSK‐3β protein content of test group 2 was higher than the control group(P< 0 .05) .The male GSK‐3βactivity level in the test group 1 was higher than the men′s in the control group(P<0 .05) .Conclusion The GSK‐3βprotein content has a high expression in the type 2 diabetes mellitus patients .After drug treatment ,the patients ,who have controlled the blood glu‐cose effectively ,still showes high expression of the GSK‐3βprotein content ,but the activity levels showes a significant decline .In male pa‐tients with type 2 diabetes blood sugar in the control group of GSK‐3βshowes significantly higher activity level .
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Objective To compare the clinical effect of laparoscopic and open appendectomy in the treat-ment of perforated appendicitis.Methods 107 patients with perforated appendicitis were selected as the research object and were divided into two groups.The observation group(54cases)received laparoscopic appendectomy while the control group (53cases)received traditional open appendectomy.The size of incision,the amount of bleeding during operation,time of operation and hospitalization and other perioperative indexes and the incidence rate of complications were compared between the two groups.Results The operation time between the two groups had no statistical significance(t =1.286,P >0.05 ).The incision size [(2.5 ±0.3)cm],the amount of intraoperative bleeding[(10.3 ±3.4)mL]and hospitalization time[(5.4 ±0.9)d]of the observation group were better than those of (4.2 ±0.4)cm,(19.4 ±4.2)mL and (6.5 ±1.1 )d in the control group,the differences were statistically significant(t =24.901,12.329,5.666,all P <0.05).The occurrence rate of complications of the observation group was 3.4%,which was lower than 15.1% of the control group,the difference was statistically significant(χ2 =3.940, P <0.05 ).Conclusion Laparoscopic appendectomy has the advantages of less trauma,faster recovery,less complications,shorter hospitalization time,etc.And its effect is better than open appendectomy and worthy of populari-zation and application.
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Objective To observe the effect of free muscle localization and ultrasound-guided injection of botulinum toxin type A (BTX-A) combined with rehabilitation training on lower limb spasm of cerebral palsy children.Methods Sixty-one cerebral palsy children with lower limb spasticity were randomly divided into a manual localizing group (31 cases) and an ultrasound-guided group (30 cases).The children of both groups underwent BTX-A injection at adductors,hamstrings and calf triceps.The former group was injected with bare hands,while the latter was injected under the guidance of ultrasound.Both groups were administered with rehabilitation training from the 3rd day onwards after injection.Before and 12 weeks after the injection,the modified Ashworth scale (MAS) and gross motor function scale (GMFM) were used to evaluate the lower limb spasticity and function in 2 groups.Results Before the injection,there was no significant difference between the 2 groups in terms of MAS and GMFM scores (P ＞ 0.05).However,12 weeks after the injection,the average MAS scores of the two groups decreased,and that of the ultrasound-guided injection group (1.43 ±0.50) was significantly lower than that of the manual localizing group (1.77 ± 0.56).After the injection,the average GMFM scores of both groups increased,and that of the ultrasound-guided injection group was significantly higher than the manual localizing group (67.10 ± 11.25).Conclusion Ultrasound-guided injection of BTX-A with intensive rehabilitation training can significantly reduce the lower limb spasticity in children with cerebral palsy,and increase their motion of joint and motor function,and improve their posture and gait.
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Objective To observe the effects of green fluorescence protein mediated by lentivirus in bladder, and to de?termine the amount of virus obtained good transfection effects. Methods lentivirus carring GFP gene was perfused using transurethral approach into bladder of guinea pigs. Samples of bladder, liver, kidney and lungs were collected for frozen sec?tions after feeding seven days. The distribution of green fluorescence was observed using laser confocal microscopy. Re?sults The titer of lentivirus was 4 × 108. GFP was found under the mucosa when the amount of lentivirus transurethral was 30μL. GFP was distributed widely in muscle layer using 40μL lentivirus. GFP was detected even stronger in muscle layer when the amount was 50μL. GFP was found in muscle layer when 25μL lentivirus was injected intravenously. GFP was not found in other tissues than in bladder via transurethral perfusion. There was higher GFP in liver, lungs and other organs than in bladder via intravenous injection. Conclusion Lentivirus can mediate GFP transfecting bladder of guinea pig successful?ly and escape the distribution of GFP all over the body intravenously, which will bring new research direction and method for clinical treatment of diseases in bladder.
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Objective To study the beneficial effect and mechanism of Alcea rosea roots in nephrolithiasis model in-duced by 1%ethylene glycol in rats. Methods We randomly divided 60 male Wistar rats into six groups,including control group, model group, Alcea rosea roots lower-dose preventive group, Alcea rosea roots high-dose preventive group, Alcea ro-sea roots lower-dose curative group, Alcea rosea roots high-dose curative group. Control group was free to access food and water;model group was given 1%ethylene glycol drinking water and was fed with normal diet, preventive group was given 1%ethylene glycol drink and Alcea rosea roots in low (250 mg/kg) or high dose (500 mg/kg) each day, curative group re-ceived 1%ethylene glycol drink each day and Alcea rosea roots in low or high dose from day 15 to day 28. At the end of the experiment, various renal functional and injury markers such as urine volume, calcium, phosphate, magnesium, urea, creati-nine, and oxalate were evaluated using urine, serum, and kidney homogenates. The kidneys were removed and prepared for histological evaluation of calcium oxalate deposits. Results In model groups, urine output, urea, creatinine, 24 h urine Ca2+, and oxalate and MDA were increased compared to those in control group(P＜0.05). GSH and SOD were increased in preventative and curative groups compared to those in the model group(P ＜ 0.05). The urea, creatinine, 24 h urine Ca2+, urine oxalate, MDA were reduced in preventive and curative groups compared to those in the model group(P＜0.05). The number and size of calcium oxalate crystal deposits were also less and smaller, and the kidney damage was less severe in pre-ventive and curative groups compared to in the model group. Conclusion The extract of Alcea rosea roots can prevent and treat calcium oxalate urinary stone formation in rats and protect renal function.
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Objective To observe the effect of ultrasound-guided injection of botulinum toxin type A (BTX-A) combined with orthosis training for the treatment of lower limb spasticity for children with cerebral palsy.Methods Fifty-four patients with spastic cerebral palsy were randomly divided into an observation group and a control group using a random number table.Patients in the control group were given conventional rehabilitation training,while those in the observation group were additionally given ultrasound-guided BTX-A injection,followed by daily knee-ankle-foot orthosis rehabilitation training 24 h after the injection.Before and 6 weeks after treatment the lower limb function of the 2 groups was evaluated using the modified Ashworth scale (MAS) and the gross motor function measure (GMFM).Adductor angles,popliteal angles and motor ranges of the ankle joint were also measured and compared.Results After 6 weeks the average MAS scores were lower than before treatment in both observation[(1.26±0.63) vs (3.07±0.68)] and control group [(2.56±0.71) vs (2.89±0.64).And in both groups the average GMFM scores,adductor angles and popliteal angles,as well as range of motion of the ankle were all much better than before treatment.The observation group,however,improved significantly more than the control group(P ＜ 0.05).Conclusion Ultrasound-guided injection of BTX-A can effectively alleviate spasticity of lower extremity for children with cerebral palsy with accurate positioning,obvious curative effect and less adverse reactions.Knee-ankle-foot orthosis rehabilitation training after the injection can further alleviate spasticity and improve the motor function of the limbs.
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Objective To explore the clinical significance of experimental index in incomplete Kawasaki disease (iKD).Methods Eighty-eight cases of KD were reviewed,including iKD 36 cases (iKD group),complete KD(cKD) 52 cases (cKD group).The 88 cases were divided into traditional criterion group (43 cases) and supplement criterion group (45 cases).The experimental indexes of supplement criterion were compared between iKD group and cKD group.Results The rate of coronary artery lesion (CAL) in iKD group was significantly higher than that in cKD group [50.00％(18/36) vs.26.92％(14/52),P ＜ 0.05].Plasma NT-proBNP and cardiac troponin Ⅰ (cTnI) in CAL children (32 cases) in early were significantly higher than those in non CAL children (56 cases) [(468 ± 141) ng/L vs.(379 ± 120) ng/L and (0.95 ±0.22) μg/L vs.(0.49 ±0.15) μg/L,P ＜0.01].The diagnosis rates of KD in the 5th,7th,9th day in supplement criterion group were significantly higher than those in traditional criterion group [64.44％(29/45)vs.25.58％(11/43),84.44％ (38/45) vs.46.51％ (20/43),93.33％(42/45) vs.58.14％ (25/43),P ＜ 0.01].There was no statistical significance between iKD group and cKD group in C reactive protein,erythrocyte sedimentation rate,albumin,alanine aminotransferase,platelet,white blood cell,NT-proBNP and cTnI etc (P ＞ 0.05).There was no statistical significance between iKD group and cKD group in the positive rate of each experimental index (P ＞ 0.05).Conclusions There are some changes of supplement experimental index in acute phase of KD,but there is no statistical significance between iKD and cKD.Plasma NT-proBNP and cTnI are significantly higher in early KD.
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Objective To determine vascular endothelial growth factor(VEGF)-460 gene polymorphism in Uyghurs and its relationship to urolithiasis in south Xinjiang. Methods Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP),gene sequencing and genetic analysis methods were used in 200 urolithiasis patients of Uyghurs, and 200 healthy Uyghurs. Results The distribution of genotype and allele had no significant difference between urolithiasis patients and normal controls (P＞0. 05). The frequencies for the CC,TT and CT genotypes in patients with urolithiasis and normal controls were 1.5 %, 29.0 %, 69.5 % and 0. 5 %, 27.5 %, 72.0 %, respectively. The frequencies for C and T allele were 36.2%,63.7% and 36.9% ,63.1%, respectively. Conclusions The results of VEGF-460 gene polymorphisms indicate no significant relationship between patients with turolithiasis and normal controls in Uyghurs in south Xinjiang,which may not be urolithiasis susceptibility genetic locus.
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Purpose To clarify the morphologic changes and significance of interstitial cells of Cajal-like cells in the bladder of diabetic guinea pig.Methods The experimental guinea pigs were induced by a single intraperitoneal injection of streptozotocin(STZ).The diabetic guinea pig model, who were made succesful for 4 weeks, were detected through the urodynamic evaluation.The distribution of ICCs-like cells in the detrusor, which were taken from these guinea pigs,were quantitatively analyzed after frozen section and indirect immunofluorescence methods and observed by electron microscopy.Results In the diabetic group, the maximum detrusor pressure was signifently lower than controls (P＜0.01), maximum bladder capacity, compliance, residual volume and leak point pressures was significently higer than controls (P＜0.05 or P＜0.01);In detrusor, compared with control, the ICCs-like cells of diabetes group showed significently decreased in quantity. In diabetic bladder, the quantity of gap junctions between ICCs-like cells and cells around,such as smoth muscle cells,terminal nerves and other ICCs-like cells,decreased significently.And more cavities and less organoids occurred in cytoplasm of diabetic ICCs-like cells. Mitochondria became swollen or even disapeared, accompanied with swollen endocytoplasmic reticulum.Conclusion The decrease and injures of ICCs-like cells in bladder may be one of the mechanisms resulting in urodynamic changes of diabetic cystopathy.
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Objective To explore the effect of different method in preventing broncho-pulmonary dysplasia(BPD) in very low birth weight infants(VLBWI) during mechanical ventilation.Methods The gestational age of 71 infants with VLBWI was (30?2) weeks and the average weight was (1235.2?160.6)g.The infants were randomly divided into three groups,they received different therapeutic regimens during mechanical ventilation:32 cases were treated with permissive hypercapnia(PHC) ventilation in group Ⅰ;20 cases were treated by intratracheal instillation of pulmonary surfactant(PS) in group Ⅱ;19 cases were treated by inhalation of becotide(beclomethasone dipropionate,BDP) in group Ⅲ.The ventilator settings,blood gas analysis,clinical symptoms and therapeutic effect were statistically analyzed and compared.Results The peak inspiratory pressure(PIP) and ventilation rate(VR) of ventilator parameter were (18.3?1.6)cmH_2O and (35?5)bpm in group Ⅰ,there was significantly lower than that in group Ⅱ and group Ⅲ(P0.05).The incidence of BPD was 16%(5/32) in group Ⅰ,5%(1/20) in group Ⅱ and 5%(1/19) in group Ⅲ;The mortality rate of PHC group(group Ⅰ) was 6%(2/32) and 5%(1/20) in group Ⅱ.Conclusion The application of permissive hypercapnia,intracheal instillation of pumlonary surfactant and inhalation of becotide all can prevent effectively the occurrence of severe broncho-pulmonary dysplasia in VLBWI during mechanical ventilation.
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Objective To investigate the effect of the general anesthesia combined with peridural anesthesia on hirschsprung's radical operation through children abdominoscope. Methods 40 children patients with hirschsperung were elective eradicative operated by using endotrachal intubation complex vein general anesthesia combined with continuons peridural anesthesia.ECG,HR,MAP,SPO 2,P ET CO 2 were monitored, and blood gas were recorded and analyzed before pneumoperitoneum,15 minutes and 40 minutes after pneumoperitoneum,1 minute after deflation,before decannulation at the operation termination.Results Compared with before pneumoperitoneum date,HR inereased obviously 40 minutes after pneumoperitoneum,and before decannulation at the operation termination,peak pressure in airway increased obviously after pneumoperitoneum,the difference was notable,SPO 2 decreased after pneumoperitoneum,the difference was also significant.pH decreased gradually with the time prolongation,there was obviously difference.The trend of P ET CO 2 and PaCO 2 changes were analogous,P ET CO 2 had much notable difference after pneumoperitoneum,PaCO 2 had notable difference at the operation termination,and before decannulation,it was decreased to the basic value.Conlusions Hirschsprung's Disease eradical operation using general anesthesia combined with peridural anesthesia under abdominoscope guide,can immobilize ill children completely,relieve pain perfectly,muscular relaxation satisfactory,the physical interference to body is little and less complication.