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Objective: To propose a new staging system for presacral recurrence of rectal cancer and explore the factors influencing radical resection of such recurrences based on this staging system. Methods: In this retrospective observational study, clinical data of 51 patients with presacral recurrence of rectal cancer who had undergone surgical treatment in the Department of Gastrointestinal Surgery, Peking University People's Hospital between January 2008 and September 2022 were collected. Inclusion criteria were as follows: (1) primary rectal cancer without distant metastasis that had been radically resected; (2) pre-sacral recurrence of rectal cancer confirmed by multi-disciplinary team assessment based on CT, MRI, positron emission tomography, physical examination, surgical exploration, and pathological examination of biopsy tissue in some cases; and (3) complete inpatient, outpatient and follow-up data. The patients were allocated to radical resection and non-radical resection groups according to postoperative pathological findings. The study included: (1) classification of pre-sacral recurrence of rectal cancer according to its anatomical characteristics as follows: Type I: no involvement of the sacrum; Type II: involvement of the low sacrum, but no other sites; Type III: involvement of the high sacrum, but no other sites; and Type IV: involvement of the sacrum and other sites. (2) Assessment of postoperative presacral recurrence, overall survival from surgery to recurrence, and duration of disease-free survival. (3) Analysis of factors affecting radical resection of pre-sacral recurrence of rectal cancer. Non-normally distributed measures are expressed as median (range). The Mann-Whitney U test was used for comparison between groups. Results: The median follow-up was 25 (2-96) months with a 100% follow-up rate. The rate of metachronic distant metastasis was significantly lower in the radical resection than in the non-radical resection group (24.1% [7/29] vs. 54.5% [12/22], χ2=8.333, P=0.026). Postoperative disease-free survival was longer in the radical resection group (32.7 months [3.0-63.0] vs. 16.1 [1.0-41.0], Z=8.907, P=0.005). Overall survival was longer in the radical resection group (39.2 [3.0-66.0] months vs. 28.1 [1.0-52.0] months, Z=1.042, P=0.354). According to univariate analysis, age, sex, distance between the tumor and anal verge, primary tumor pT stage, and primary tumor grading were not associated with achieving R0 resection of presacral recurrences of rectal cancer (all P>0.05), whereas primary tumor pN stage, anatomic staging of presacral recurrence, and procedure for managing presacral recurrence were associated with rate of R0 resection (all P<0.05). According to multifactorial analysis, the pathological stage of the primary tumor pN1-2 (OR=3.506, 95% CI: 1.089-11.291, P=0.035), type of procedure (transabdominal resection: OR=29.250, 95% CI: 2.789 - 306.811, P=0.005; combined abdominal perineal resection: OR=26.000, 95% CI: 2.219-304.702, P=0.009), and anatomical stage of presacral recurrence (Type III: OR=16.000, 95% CI: 1.542 - 166.305, P = 0.020; type IV: OR= 36.667, 95% CI: 3.261 - 412.258, P = 0.004) were all independent risk factors for achieving radical resection of anterior sacral recurrence after rectal cancer surgery. Conclusion: Stage of presacral recurrences of rectal cancer is an independent predictor of achieving R0 resection. It is possible to predict whether radical resection can be achieved on the basis of the patient's medical history.
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Humans , Neoplasm Recurrence, Local/diagnosis , Rectal Neoplasms/therapy , Retrospective Studies , Pelvis/pathology , Recurrence , Treatment OutcomeABSTRACT
Objective:To analyze the influencing factors of the medical insurance balance of hospitalization expenses for gastric cancer surgery patients under DRG payment, for reference for promoting the reform of DRG payment in public hospitals and controlling hospitalization expenses reasonably.Methods:The gastric cancer patients enrolled in the gastroenterology department of a tertiary comprehensive hospital from January to July 2022 were selected as the research subjects. The indicators such as patient age, medical insurance balance, hospitalization expenses and their composition were extracted from the hospital information management system and the medical insurance settlement system a certain city. Descriptive analysis was conducted for all data, and stepwise multiple linear regression was used to analyze the influencing factors of patients′ medical insurance balance. Monte Carlo simulation method was used to simulate different combination scenarios of various influencing factors to analyze the probability of medical insurance balance.Results:A total of 205 patients were contained, including 117 in the medical insurance balance group and 88 in the loss group. The difference in hospitalization expenses and medical insurance balance between the two groups of patients were statistically significant ( P<0.05). The intervention of medical insurance specialists, correct DRG enrollment, parenteral nutrition preparation costs, anti infective drug costs, examination costs, and consumables costs were the influencing factors of patient medical insurance balance ( P<0.05). Through Monte Carlo simulation verification, patients with different cost parenteral nutrition preparations, or different anti infective drug schemes had the higher probability of medical insurance balance in the scenario where the medical insurance commissioner intervenes and the DRG enrollment was correct. Conclusions:The hospital adopted interventions from medical insurance specialists to ensure the correct DRG enrollment of patients, accurate use of parenteral nutrition and anti infective drugs, and reasonable control the cost of examinations and consumables, which could increase the probability of medical insurance balance for gastric cancer surgery patients. In the future, hospitals should further promote the procurement of drug consumables in bulk, reduce unnecessary examinations, develop standardized perioperative nutritional interventions and anti infection treatment pathways, ensure the accuracy of DRG enrollment, optimize clinical diagnosis and treatment pathways to improve the efficiency of medical insurance fund utilization and provide high-quality medical services for patients.
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@#Objective 聽 聽To investigate and evaluate the safety and efficacy of Bentall operation in the reoperation of patients with small aortic root or annulus. Methods 聽 聽Bentall procedure was performed in 24 patients with small aortic root or annulus in our hospital from September 2014 to December 2019. There were 18 males and 6 females with a mean age of 31-68 (45.70卤15.27) years. All patients had undergone a previous replacement of the aortic valve including 20 patients receiving valve replacement, 2 patients aortic root replacement with a valved conduit and 2 patients bioprothesis replacement. Results 聽 聽There was no early death in hospital and one death during the 30-day postoperative period. Re-thoracotomy due to bleeding was necessary in only 2 patients and no bleeding was related to the proximal anastomosis of the conduit. One patient performed pacemaker implantation for heart block after the procedure. The mean sizes of implanted aortic valve prosthesis were 22.75卤1.78 mm. A mean gradient across the aortic valve prostheses in the postoperative echocardiographic examination was 11.17卤2.24 mm Hg. Conclusion 聽 聽Bentall procedure is safe and allows a larger size of prosthesis implantation in patients with small aortic annulus or root after previous aortic valve or complete root replacement, resulting in good postoperative hemodynamic characteristics and short-term clinical results.
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The development of information technology in the medical industry is accelerating the construction of 3-level rehabilitation networks centering on community-based rehabilitation, which is based on the Internet and in combination with the Internet of things(IOT). A municipal rehabilitation hospital cooperated with the health centers of sub-district communities in the city to build a remote rehabilitation network based on IOT technology, for rehabilitation training of community stroke patients. The two sides worked out a cooperation scheme on project management, designed and built a remote community rehabilitation management model. Under the remote monitoring and equipment data IOT, the medical team of the municipal rehabilitation hospital could formulate the therapeutic plan according to the immediately obtained relevant functional evaluation data, and the medical team of the community health service center was responsible for the implementation of the plan. Fifty-three patients in the experimental group received the training of remote lower limb intelligent feedback system based on IOT together with routine rehabilitation training. After 8 weeks of treatment, the functional evaluation data of the two groups were improved in varying degrees( P< 0.05), but the improvement of the experimental group was significantly better than that of the control group( P < 0.05). Remote rehabilitation under the construction path of remote rehabilitation network based on IOT technology could significantly promote the improvement of post-functional rehabilitation of community stroke patients. This study can provide reference for the construction of three-level remote rehabilitation networks based on IOT and the implementation of home-based remote rehabilitation therapy in the future.
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@#Objective To investigate the application of computational fluid dynamics (CFD) in hemodynamic evaluation of aortic root reconstruction. Methods The clinical data of 1 patient with severe aortic valve stenosis was analyzed. Enhanced CT images were used as the original data, and professional software was used to reconstruct the three-dimensional (3D) model and fluid mechanics simulation of the aorta (including preoperative, postoperative and ideal conditions). Results The 3D reconstruction model could directly present the distribution of valve calcification and the dilatation of the ascending aorta. The remodeled sinotubular junction and sinus structure were observed in the model under postoperative and ideal conditions. The improvement of ascending aorta dilatation was evaluated statistically by the diameter distribution before and after surgery. CFD simulation showed that the area of high flow velocity, pressure intensity and wall shear stress before surgery were consistent with the expansion area of the ascending aorta, and the restricted blood flow acceleration was observed at the angle between the arch and the descending aorta. In the ideal condition, the streamline of blood at the descending aorta was more stable and flat compared with preoperative or postoperative conditions, and there was no obvious abnormal high pressure and high wall shear stress area in the ascending aorta. The cardiopulmonary bypass time was 106 min, of which the aortic cross-clamp time was 60 min. The cardiac echocardiography indicated that the aortic valve worked well, and the peak systolic blood velocity was 1.7 m/s. The length of hospital stay after surgery was 12 d, including 2 d in ICU. The ventilator use time was 11.6 h. The patient did not have any remarkable discomfort during the 1-year follow-up. Conclusion CFD can be used to evaluate anatomic and hemodynamic abnormalities before aortic root reconstruction surgery. Postoperative reconstruction simulation can be performed again to evaluate the surgical effect, and meanwhile, virtual improvement can be tried for the unresolved problems to accumulate diagnosis and treatment experience, so as to provide patients with more accurate and personalized diagnosis and treatment procedure.
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Objective:To solve the issue regarding a low correlation between visual and haptic feedback provided by the current upper-limb rehabilitation training system, this study was implemented based on the end-effector based upper-limb rehabilitation robot developed in the lab. A novel visual and haptic feedback fusion technology based on force tracking was investigated and its effect on upper-limb training was also studied. Methods:Based on the force model constructed in a virtual environment, two types of haptic feedbacks correlated to the visual feedback were designed, including the repulsive force when two objects getting close and the friction force when the object moving above medium surfaces. The haptic feedback constructed in the virtual environment was delivered to the trainees by using force tracking based on robot controlling algorithm. Eight health subjects were recruited and trained with and without feedback fusion. In the training process, the actual and expected haptic feedbacks as well as the surface electromyography (EMG) signals from anterior deltoid, posterior deltoid, biceps, and triceps were collected. The root means square error (RMSE) between the actual and expected haptic feedback was calculated under the feedback fusion training mode to characterize the force tracking-based multi-sensory feedback fusion technology. The integrated EMG values (iEMG) and EMG amplitudes per unit time (EMG/T) under two training modes were measured to explore the effect of feedback fusion technology on the upper-limb motor training. Results:Under feedback fusion training mode, the RMSE between actual and expected haptic feedback was (0.757±0.171) N. The values of iEMG from four muscles were significantly higher (|t| > 7.965, P < 0.001), and the values of EMG/T from the biceps, triceps and anterior deltoid were significantly larger under feedback fusion training mode than under the training mode without feedback fusion. Conclusion:The proposed upper-limb rehabilitation robot training system could accurately transmit the haptic feedback constructed under the virtual environment to the trainees. This system could increase the stimulation to trainees' peripheral nervous function through visual and haptic feedback fusion as well as increase the trainees' training effort. The advantages of force tracking-based visual and haptic feedback fusion technology are to freely construct the force model under the virtual environment and the haptic feedback mode is not constrained by the spatial position. Moreover, two or more types of force models can be superimposed in the same spatial position by using this technology that could improve the matching effect between haptic feedback and visual feedback under a virtual environment. The trainees' motor rehabilitation interest could be stimulated and the experience feeling of human-robot interaction could also be enhanced.
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Objective:To summarize the experience of emergency treatment of type A aortic dissection during the prevalence of COVID-19.Methods:Retrospectively analyzed the data of 29 patients undergoing emergency surgery for type A aortic dissection during the outbreak of corona virus disease-19 ( COVID-19) in Wuhan Asian Heart Hospital from January 23 to March 31, including 25 males and 4 females aged 34-72 years with mean age (49.17±9.63) years.There were 10 cases in Wuhan and 19 cases outside the city.All patients were diagnosed and indicated for emergency surgery through online consultation before transportation.After the primary exclusion of COVID-19 by pulmonary CT scanning in the emergency department, the patients were admitted to the isolation ward. Emergency surgery was performed after emergency nucleic acid testing and preoperative examing. Postoperatives were carried to a single room in the ICU for isolation until COVID-19 was excluded, nucleic acid testing and reexamination of pulmonary CT were performed if they were fever during hospitalization.All medical personnel involved in the operation and perioperative management took three levels of protection and medical observation.Results:There were 5 cases of type A1 in the aortic root, 2 cases of type A2, 22 cases of type A3, 2 cases of simple arch, 27 cases of complex type (Sun's classification).12 cases of Bentall, 2 cases of Wheats, 15 cases of ascending aorta replacement, 14 cases of aortic valve repair, 25 cases of aortic arch replacement, 23 cases of trunk stents, 2 cases of hybridization, 6 cases of concurrent coronary artery bypass grafting, and 2 cases of tricuspid valvuloplasty.In the whole group, 1 case of COVID-19 was confirmed and 1 was suspected.The time of cardiopulmonary bypass was(224.00±21.14)min, the blocking time was(146.17±18.75)min, the postoperative ventilator assisted(65.07±10.36)h, the hospitalization time was(27.03±5.64)days, there were no hospitalized deaths, 4 cases of postoperative liver function damage, 6 cases of acute renal function damage, and 7 of pulmonary infection.None of the medical staff involved in the operation and perioperative management were infected with COVID-19.Conclusion:During the period of major infectious diseases, the admission and treatment procedures of critical and severe patients should be standardized, and the control of nosocomial infection should be strengthened. Emergency surgery is an effective means to rescue type A active vein interlayer, and the safety of protecting medical staff is guaranteed.
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Objective To investigate the effects of disulfiram combined with copper (DSF /Cu) on proliferation and migration of brain metastases from lung cancer. Methods The cell were divided into blank control group, valproate group (1.0 mmol·L-1 of valproate) , DSF /Cu (1,2,3,4,5 mg /0.17 mg) . Brain metastases from lung adenocarcinoma were incubated 72 hours.The changes of proliferative ability of cancer cells were detected by CCK-8 method, the effect of DSF /Cu on the migration ability of cancer cells was detected by Transwell chamber, and the degree of apoptosis of cancer cells was detected by Annexus V-PI double staining method. Results The ability of proliferation was significantly inhibited, the ability of migration was significantly reduced,and the rate of cell apoptosis was significantly increased in each dose group of brain metastases from lung adenocarcinoma compared with the blank control group. With the increase of DSF /Cu dose, its ability to inhibit the proliferation and migration of metastases cancer cells and induce apoptosis of metastases cancer cells has increased gradually. Conclusion DSF /Cu can inhibit the proliferation and migration of brain metastases from lung adenocarcinoma and induce apoptosis. DSF is expected to be a new method of the combined treatment of brain metastases cancer.
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Objective To evaluate the clinical efficacy of "Z"type aortic sinus angioplasty in acute Stanford A aortic dissection with severe aortic valve insufficiency .Methods A total of 384 cases of acute Stanford A aortic dissection were ana-lyzed retrospectively from January 2014 to March 2018 at Wuhan Asian Heart Hospital Great Vascular Center.There were 56 cases with severe aortic valve insufficiency, with 40 males and 16 females, aged 32-72 years old, averaged(53.92 ±9.26) years old.The root treatment of the 56 patients were all simulated with the "Z"type aortic sinus angioplasty technique, with 3 cases of distal semi-aortic arch replacement and 53 cases of total aortic arch replacement(placed with "trunk"stent).Results The average cardiopulmonary bypass time of all patients was(175.0 ±43.5)min, cross-clamp time was(133.3 ±31.9)min, and circulatory arrest time was(26.9 ±2.7)min.The degree of aortic valve regurgitation was 0-Ⅰin all patients after surger-y.Patients were followed-up 3 months to 4 years, the degree of aortic valve regurgitation of 45 cases was 0, 8 cases wasⅠ, and 3 cases wasⅡ.After operation, transesophageal ultrasonography immediately examined 2 cases with residual dissection of aor-tic sinus.Followed-up 1.5 years and 2.0 years respectively, no aneurysm was formed, and the diameter of the sinus of the aor-ta was 4.2 cm and 4.5 cm, respectively.No reoperation due to aortic valve regurgitation and sinus conditions was found during the follow-up.Conclusion The "Z"type aortic sinus angioplasty technique has a good clinical effect in acute Stanford A aor-tic dissection with severe aortic valve insufficiency.The operation is simple, safe and effective, easy to grasp and develop.
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Objective To analyze the safety of laparoscopic splenectomy for traumatic splenic rupture.Methods The clinical data of 62 patients with traumatic splenic rupture treated by laparoscopic splenectomy in our hospital from Jan 2013 to Jan 2018 were retrospectively analyzed.Results All 62 patients successfully underwent laparoscopic surgery except for 1 case who was converted to open surgery.One case suffered from postoperative bleeding.There was no infection,serious pancreatic leakage and other major complications.The total amount of intraoperative bleeding was 1 600 ml on average,the average operation time was 135 min,the average splenectomy time was 55 min,and the average hospital stay was 12.5 d.Conclusion Laparoscopic splenectomy is a safe and reliable minimally invasive operation for traumatic splenic rupture.
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OBJECTIVE:To provide reference for reasonably designing package inserts of ointment for manufacturers. METH-ODS:According to items included in Management Regulation for Package Insert and Label and Specification for Chemicals and Bi-ological Products for Treatment,labeled items in package inserts of 51 kinds of ointment for external use during Jan.-Jun. 2016 in our hospital were analyzed. RESULTS:Among the 51 kinds of ointment,39 were domestic varieties and 12 were imported variet-ies. In the package inserts of 39 domestic varieties,items with lower labeling rates were overdose,pharmacokinetics,use guid-ance,pharmacology and toxicology,with labeling rates of 2.6%,5.1%,15.4%,28.2%;while the labeling rates of imported vari-eties were 16.7%,83.3%,75.0%,100%. Compared with package inserts of imported ointment,composition,dosage and usage, adverse reactions,contraindications,precautions,drug interactions,medication for special populations were not enough detailed in domestic ointments. CONCLUSIONS:It is suggested that manufacturers consult medicine experts, list all auxiliary materials through Management Regulation for Drug Description and Label,refine and improve the labeling contents of dosage and usage,ad-verse reactions,precautions,medication for special populations,pharmacology and toxicology,overdose,etc. In addition,admin-istrative departments should strengthen the regulatory approval efforts.
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Objective To evaluate the appilcation value of intraoperative transesophageal echocardiography (IOTEE) in aortic valve replacement with bovine pericardium.Methods Totally 106 patients were ready to underwent the surgery of aortic valve replacement.The parameters of the aortic valves (diameter of aortic annular,aortic sinus and aortic sinus tube,effective height [eH]) were measured before cardiopulmonary by using IOTEE and during intraoperation.Results Eight cases were removed from the study due to supplemental preoperative diagnosis and modification of operative method,the rest of the 98 cases were enrolled.The coincidence rate of initial diagnosis hy using IOTEE and intraoperative diagnosis was 100 ％;5 cases (5/98,5.10 ％) of secondary diagnosis were inconsistent with intraoperative diagnosis.The coincidence rate of the number of aortic valves with preoperative IOTEE diagnosis and intraoperative diagnosis was 100 ％,the aortic valves perforation fistulas was 80.00％,the aortic valves vegetation was 85.71％,the senile calcified valvular disease was 100％,and the rheumatic disease was 100％.Diameter of aortic annular,aortic sinus and aortic sinus tube,eH measured by preoperative IOTEE had good correlation with intraoperative measurement (all r＞0.8,all P＜0.05).Conclusion IOTEE has feasibility and guiding value in aortic valve replacement with bovine pericardium,and is also of great significance to evaluate the prognosis of surgery.
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Objective To evaluate the clinical characteristics,diagnosis and surgical repair methods of double aortic arch (DAA) associated with complex cardiac anomalies.Methods Retrospectively analyzed the clinical data of the 5 DAA associated with complex cardiac anomalies patients,4 males and 1 female,age from 41 days to 19 years old,weight 4.3-56.0 kg.Accompanied cardiac malformites including 2 cases with TOF,2 cases with DORV,and 1 case with d-TGA.4 cases were diagnosed DAA via MSCT and were surgical treated combined with cardiac malformations at same stage.1 case of DAA associated with d-TGA experienced stubborn pulmonary infection with increased airway resistance and could not tolerate ventilator weaning after aterial switch operation.Then he was diagnosed DAA with left arch atresia through MSCT.So,the patient underwent another surgery to excise the left aortic arch.Results One case worsened postoperatively by the cause of vomiting and aspiration and then died.The other four were survival and discharged with no DAA repair relating complication.Conclusion Double aortic arch can be cured by surgical repair and DAA with cardiac defects can be operated in one stage via median sternotomy.Congenital vascular ring should be considered in patients with stubborn and unexplained respiratory symptoms,who should receive timely imaging examinations for accurate diagnosis and surgical treatment at the early stage.
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Objective To compare clinical efficacy between the situ secondary spleen pedicle amputation in laparoscopic splenectomy and open splenectomy for traumatic spleen rupture.Methods From January 2013 to June 2015 a total of 70 patients with splenic rupture undergoing splenectomy were devided into laparoscopic surgery (35 cases) and open surgery (35 cases) group.Clinical data included total intraoperative blood loss,the time spent on splenic artery ligation,total operation time,postoperative drainage volume,postoperative hemoglobin,platelet and albumin levels,time of anal exsufflation,hospital stay and postoperative complications.Results The average operation time in the OS group was shorter than that in LS group (P ＜ 0.05).However,LS group was better than the OS group in splenic artery ligation time,postoperative drainage volume,anus aerofluxus time,postoperative platelet count,postoperative albumin recovery,hospital stay and postoperative complications (all P ＜ 0.05).Conclusions The laparoscopic splenectomy by the amputation of in situ secondary spleen pedicle for traumatic spleen rupture has the advantages of a rapid recovery and a low postoperative complication.
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The iatrogenic cause of bile duct stone formation is mainly due to suture materials, especially silk sutures. In recent years, Prolene and Vicryl sutures have been widely used in biliary surgery, and bile duct stone formation related to sutures are seemingly becoming rare, as there has only been one report of bile duct stone formation caused by Prolene sutures in the literature. In the last few years we have had two cases of Prolene suture-related bile duct stone formation within our unit. We therefore suggest that Vicryl sutures should be used as the first choice in biliary surgery, in order to prevent the formation of iatrogenic bile duct stones
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Aim ToexploretheeffectsofnewdrugT-006 on improving learning and memory abilities in scopolamine-induced dementia mice and its possible mechanism.Methods 72maleKunmingmicewere randomly divided into six groups:normal control group,model group,donepezil treatment group,T -006 treatment group with different doses(1,3 and 10 mg·kg-1 ).All mice were treated by intragastric ad-ministration for 14 consecutive days. Learning and memory abilities were tested by a five-day Morris water maze trial from the 1 1 th day.the first 4 days of the five-day Morris water maze,the navigation test was performed,the last day of Morris water maze is the spatial probe test.During the navigation test, mice were intraperitoneally given 2 mg · kg-1 scopolamine 20 minutes before entering the water,while normal control group mice administrated with sterile saline in-stead.Mice were not given T-006 nor scopolamine in spatial probe test.After Morris water maze,all mice were sacrificed for hippocampus and cortex.The activi-ties of AchE and SOD and the levels of GSH and MDA in hippocampus and cortex were measured after tissue harvesting.Results Comparedwithmodelgroup,T-006 could obviously improve learning and memory abil-ities in scopolamine-induced mice, significantly in-crease the levels of SOD and GSH and decrease the levelsofMDAandAchE.Conclusion T-006can significantly improve cognitive abilities in scopolamine-induced dementia mice,and its relevant mechanism may be closely related to its antioxidative effect and the ability to decrease AchE level.
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Objective To investigate the surgical technique and the curative effects of neuroendoscopic surgery via superior frontal sulcus in the treatment of hypertensive intracerebral hemorrhage. Methods The clinical data of 63 patients with hypertensive intracerebral hemorrhage were analyzed retrospectively. Thirty-one of them were treated by neuroendoscopic surgery via superior frontal sulcus(neuroendoscopic surgery group), and 32 of them were treated by mini- invasive drainage (conventional therapy group). All of them were followed up for 6 months, and were assessed by the activity of daily living (ADL) scale. Results After treatment, all patients reviewed CT. The clear rate of hematoma in neuroendoscopic surgery group was 86.0%, in conventional therapy group was 23.3%, and there was significant difference (P<0.05). There were one death case in neuroendoscopic surgery group and 2 death cases in conventional therapy group. The survival patients were followed up for 6 months .The rate of better prognosis in neuroendoscopic surgery group was 83.3%(25/30), in conventional therapy group was 53.3%(16/30), and there was significant difference (P<0.05). Conclusions The surgical technique of neuroendoscopic surgery via superior frontal sulcus in the treatment of hypertensive intracerebral hemorrhage is safe and effective.
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Objective To summarize the clinical result of patients undergoing endoscopic vein harvest (EVH) technology to collect greater saphenous vein (GSV) in coronary artery bypass graft (CABG) operation, and to assess the operation outcome of EVH. Methods A total of 862 patients underwent primary CABG, among whom saphenous vein of 482 patients were taken using EVH, and the others by open vein harvesting (OVH) based on patients' willingness. The operation risk factors and complication were compared between the two groups. The 64 multi-slice computed tomography (64-MSCTA) was used to evaluate the vein grafts patency after surgery for 1 year. The vein patency between the two groups was compared. Results There was no significant difference in risk factors of incision complication between two groups ( P>0.05). But the incidence of various incision complication was significantly lower in EVH group (10.2%,49/482) compared with that in OVH group (35.0%,133/380) ( P0.05). After 1 year's follow-up, the vein graft patency were 86.0%(404/470) and 87.1%(324/372) in EVH group and OVH group, and there was no significant difference ( P>0.05). Conclusions The decrease in incision complication of EVH is unquestionably superior to those of OVH, especially for those patients with risk factors of incision complication. The EVH vein graft has good patency in short time.
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Objective To study the differences in intestinal flora of normal and type 2 diabetic mice, the effect of alcoholic extract of Coreopsis tinctoria Nutt on mouse intestinal flora, and explore the possible relationship between alcoholic extract of Coreopsis tinctoria Nutt, intestinal flora and type 2 diabetes mellitus (T2DM) in mice.Methods Stool samples were collected from the normal control group (A), high dose (1.8 g/kg) (B) and moderate dose (1.2 g/kg) (C) alco-holic extract of Coreopsis tinctoria Nutt model groups, metformin (0.2 g/kg) treatment group (D) and blank control (E) group.16S rDNA real-time quantitative PCR assay was used to determine the levels of Clostridium coccoides and Bacteroides thetaiotaomicron in the stool samples.Pearson analysis method was used to analyze the correlation between the levels of tar-get bacterial species and the fasting blood glucose ( FBG) in the mice.Results 1.Compared with the normal control group, the levels of Clostridium coccoides and Bacteroides thetaiotaomicron in the T2DM model group were significantly low-ered (P=0.017, P=0.002).2.Compared with the model group, the levels of Clostridium coccoides and Bacteroides the-taiotaomicron of the high dose Coreopsis tinctoria Nutt alcohol extract group were significantly different ( 2 weeks: P =0.027, P=0.006;4 weeks:P=0.007, P=0.012).3.The levels of Clostridium coccoides and Bacteroides thetaiotaomi-cron were positively correlated with the FBG level in the mice.Conclusions The alcohol extract of Coreopsis tinctoria Nutt has certain effect on the intestinal flora in type 2 diabetic mice and there is certain correlation between the effect of alcohol extract of Coreopsis tinctoria Nutt and their blood glucose level.
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Objective To summarize the clinical treatment experience of blood culture-negative infective endocarditis,and to explore the surgery chance and therapeutic strategy of blood culture-negative endocarditis. Methods One hundred and sixty-six patients who were diagnosed blood culture-negative endocarditis in the Aisa Heart Hospital of Wuhan from Jul. 2008 to Dec. 2012 were recruited in the study. Broad-spectrum antibiotics including cefuroxime axetil and levofloxacin were used before the result of blood culture,and sensitive antibiotics were selected to control patient's condition when getting the result of blood culture. But broad-spectrum antibiotics were continuously used to the blood culture-negative endocarditis until stable condition. When the conditions were stable,active preparation before surgery should be carried out. Thoroughly clear the vegetation and protect the cardiorespiratory function during operating. Kata-step antibiotics were used to control patient's condition until normal temperature,as well as the number of leukocytes decreased,blood sedimentation normalized and C-reaction protein decreased. Then,the narrow-spectrum antibiotics were selected including cephalosporin until discharged from hospital,and continued treatment of antibiotics for 4 - 6 weeks. Results Five patients died after the operation,including 1 case died of low cardiac output syndrome,2 cases died of multiple organ failure,1 case died of septicemia and the 1 case died of cerebral embolism. All the other patients discharged from hospital successfully. Conclusion The patients with blood culture-negative IE should be controlled rapidly. The duration and dose of antibiotics should be enough. Active operative preparation should be taken and then surgery timely. Thus,the hospital mortality could decrease and prompt the long-term outcome.