Application of radial artery in total arterial coronary revascularization in elderly patients / 中华危重病急救医学

OBJECTIVE@#To summarize the application experience and clinical effect of radial artery in total arterial coronary revascularization (TAR) in elderly patients.@*METHODS@#Retrospectively analyzed the clinical data of patients who underwent TAR at the University of Hong Kong Shenzhen Hospital from July 1, 2020 to May 30, 2022. Patients were divided into ≥ 65-year-old group and < 65-year-old group according to age. The radial artery blood flow, diameter, intimal integrity and Allen test were evaluated by ultrasound before operation. The distal ends of radial artery were collected for pathological examination during operation. Coronary artery CT angiography (CTA) was examined postoperatively and follow up. The safety and reliability of ultrasonic assessment of radial artery and application of radial artery in elderly patients with TAR were summarized and analyzed.@*RESULTS@#A total of 101 patients received TAR, including 35 cases aged ≥ 65 years old, 66 cases aged < 65 years old; 78 cases used bilateral radial arteries, and 23 cases used unilateral radial arteries. 4 cases of bilateral internal mammary arteries. All the proximal ends of the radial artery were anastomosed to the proximal end of the ascending aorta, 34 cases were performed of "Y" grafts, and 4 cases were sequential anastomoses. There was no in-hospital death and perioperative cardiovascular events. Perioperative cerebral infarction occurred in 3 patients. 1 patients was reoperated for bleeding. Intra-aortic balloon pump (IABP) assistance was used in 21 patients. Poor wound healing occurred in 2 cases and healed well after debridement. Follow-up of 2 to 20 months after discharge showed no internal mammary artery occlusion and 4 radial artery occlusions; no major adverse cardiovascular and cerebrovascular event (MACCE) occurred, and the survival rate was 100%. There was no significant difference in the above perioperative complications and follow-up endpoints between the two age groups.@*CONCLUSIONS@#By adjusting the order of bypass anastomosis and optimizing the preoperative evaluation method, radial artery combined with internal mammary artery can obtain better outcome early in TAR, and can be safely and reliably applied to elderly patients.

Morphological features of normal aortic arch / 天津医药

Objective To retrospective study the morphological features of normal aortic arch in population of Tianjin area by computed tomography angiography (CTA). Methods From Jan 2016 to Dec 2016, 142 volunteers undergoing thoracic aorta CTA in our institution were retrospectively reviewed. In each patient, 10 measurements were made in GE AW4.6 workstation, including diameters, distances, and angles of branch vessels of aortic arch. SPSS statistical software was used to analyze data. Results The diameter of the origin of brachiocephalic trunk (BCT) D1 was (15.2 ± 3.0) mm, left common carotid artery (LCCA) D2 was (11.8±2.2) mm and left subclavian artery (LSA) D3 was (13.6±1.9) mm. The distance between the BCT and the LCCA (E1) was (4.0±2.5) mm, between the LCCA and the LSA (E2) was (8.2±3.7) mm. The angle between the BCT and arch (α) was 29.5°±14.4°, between the LCCA and arch (β) was 40.3°±17.5°, between the LSA and archγwas 57.9°±21.6°. The angle formed by BCT, LCCA, and LSA(Φ) was 144.1°±10.1°. The distance between center of LCCA ostia and line between center of ostia of BCT and LSA (L) was (4.5±1.2 )mm. Values of D2 and D3 were larger in male than that in female. In the three age groups of 19-40 y, 41-60 y and ≥61 y, values of D1 increased gradually, while α and γdecreased gradually. When in the two age groups of 41-60 y and≥61 y, values of D2, D3, E2 and L were significantly larger than those in the age group of 19-40 y, whileΦwas smaller (P<0.05). Conclusion The data obtained by this study on the diameter and angle of branching vessels arising from the normal aortic arch may provide support for various studies of endovascular repair of aortic arch.

Associations of JAK1 gene polymorphisms with allergic rhinitis in Chinese Han populations / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#The aim of this study was to investigate the association of JAK1 polymorphisms with allergic rhinitis in China Han population.@*METHOD@#A total of 450 patients with AR and 615 healthy subjects as control were genotyped for the presence of three single nucleotide polymorphisms using polymerase chain reaction restriction fragment length polymorphism (PGR-RFLP) analysis of DNA extracted from blood samples.@*RESULT@#All control subjects were in Hardy-Weinberg equilibrium, but high frequencies of JAK1 the homozygous rs310241 CC genotype were observed in AR patients compared to controls (P < 0.05). The results also revealed that there was no association between the rest of two investigated SNPs and AR.@*CONCLUSION@#Our results suggested that JAK1 gene rs310241 CC genotype was associated with patients with AR.

The expression and significance of VIP and its receptor in the cochlea of different degrees of chronic alcoholism rats / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To determine whether chronic alcoholism alters the expression levels of Vasoactive intestinal polypeptide (VIP) and its receptor (VIPR1) in the cochlea of chronic alcoholism rats.@*METHOD@#We measured their expression levels in 30 SD rats, in which we created models of different degrees of chronic alcoholism. We investigated the presence of the mRNA of VIP in the cochlea of chronic alcoholism rats and controls by reverse transcription-polymerase chain reaction (RT-PCR) method. We investigated the presence of proteins of VIPR1 in poisoned rats and controls by western blot. We also evaluated the local distribution of VIP cells by immunohistochemistry.@*RESULT@#We found that the levels of VIP and VIPR1 were downregulated in the chronic alcoholism groups compared to the controls group. The differences in some expression levels were significant different between chronic alcoholism rats and control rats. Moreover, at different degrees of alcohol poisoning in rats, the contents of VIP and VIPR1 differed. Decreased levels of VIP and VIPR1 were detected in the deep chronic alcoholism group compared to the group with low-degree poisoning (P 0.05).@*CONCLUSION@#These results suggest that VIP and VIPR1 play an important role in the auditory function in rats with chronic alcoholism. Chronic alcoholism may cause a peptide hormone secretion imbalance in the auditory system, eventually leading to hearing loss.

A case of the nasal septum pyogenic granuloma and literature / 临床耳鼻咽喉头颈外科杂志

A 56-year-old male had presented with left nasal bleeding repeatedly for 4 days. The pathological examination after resection showed pyogenic granuloma. Its etiology and pathogenesis, clinical features, pathological features and treatments were reviewed.

Diagnosis and treatment of laryngopharyngeal reflux disease / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the diagnosis and treatment of laryngopharyngeal reflux disease.@*METHOD@#Patients suspect of laryngopharyngeal reflux disease in our out-patient department from Jan 2008 to Jan 2009 were included in this study. All patients were assessed using the reflux symptom index(RSI) and the reflux finding score(RFS). The positive criteria of RSI was score > 13 and that of RFS was score > 7. Fifty-eight double positive patients accepted omeprazole oral administration. After continuous oral administration for three months, all patients received RSI and RFS assessment again.@*RESULT@#After treatment, the symptoms of 41 patients were significantly alleviated. In addition, RSI were positive in 41 cases and RFS were positive in 37 cases. Thirty-seven cases were double positive.@*CONCLUSION@#The RSI and RFS could serve as an effective assessment method and could accurately document treatment efficacy in patients with LPR. Proton pump inhibitor such as omeprazole is an effective treatment for patients with LPR.

Cholesteatoma of external auditory canal among 18 cases / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To improve the diagnosis and treatment of the external auditory canal cholesteatoma (EACC).@*METHOD@#The data of 18 patients caused by EACC were analysed retrospectively.@*RESULT@#In all cases, the cholesteatomas were found in the external auditory canal and the mastoid cavity. CT scanning was using for definition the ranging of lesions and the timm management surgery was completed. There was no recurrence in 10-40 months follow-up.@*CONCLUSION@#EACC is easily misdiagnosed as keratosis obturans (KO). The disease can progress to extensive mastoid destruction. CT of temporal bone and detailed history is necessary in the diagnosis. Early complete surgical treatment is the best method.

Improvement of patients' walking ability with orthosis and functional training / 中国康复理论与实践

@#Objective To observe the influence of the orthosis combined with functional training on patients' walking ability. Methods In different rehabilitation training stages, 36 patients, 11 cases of lumbar enlargement spinal cord injury (SCI), 25 cases of cerebrovascular accident (CVA) and head injury (HI), received strengthened training with ankle-food orthoses (AFO) for 6 weeks. And then, scores of ASIA, FMA and walking function in limited time (including 6 minute walking measures and 10 meters walking time measures) were evaluated respectively at admision, before and after applying AFO for 6 weeks. Results There was a significant difference in patients' walking function scores between before and after AFO training (P<0.01). However, SCI patients' ASIA scores have no significant changes after applying AFO for 6 weeks (P>0.05). In additional, HI patients' walking function scores after applying AFO for 6 weeks were more different from the scores at admision (P<0.01), and before AFO training (P<0.05). Conclusion AFO combined with functional training can obviously recover lumbar enlargement SCI and HI patients' walking ability.

The therapeutic effect of systematic rehabilitation intervention patients with upper limb dysfunction caused by fracture and soft tissue injury / 中华物理医学与康复杂志

Objective To observe the therapeutic effects of systematic rehabilitation treatments on patients with upper limb dysfunction caused by fracture and soft tissue injury. Methods This study observed 45 cases of industrial injuries, with a involvement of 25 shoulder joints, 20 elbow and 23 wrist joints. All the patients were intervened with comprehensive rehabilitation treatments for 2.2?0.9 months, which included physiotherapy( joint mobilization, stretch technique, strength exercise, CPM, physical agent therapy and hydrotherapy), occupational therapy and orthosis. ROM, pain, the muscle strength of main muscle groups and ADL were assessed before and 2 months after treatment, respectively. Results There was significant difference with regard to ROM of the involved joints except for shoulder abduction after treatment when compared with those before the treatment (P

Sequence and analysis of Cyt b gene of Agkistrodon and its adulterants sold in market / 中草药

Objective To differentiate the sequences of Cyt b gene Agkistrodon from its adulterants sold in the market in order to provide molecular evidence for identification of Agkistrodon. Methods Cyt b gene was used to sequence and analyze Agkistrodon and its adulterants sold in the market. Results There was a mixed phenomenon in Agkistrodon species. The differences of Cyt b gene sequence between Agkistrodon and its adulterants sold in the market are significant: the difference rates among the species of Agkistrodon are 0%—0.91%, the difference rates between Agkistrodon and its adulterants are 18.57%—23.78%. Conclusion The characteristics of Cyt b gene sequence can be used as a better molecular marker for authenticating Agkistrodon from its adulterants.