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Objective:We performed a meta-analysis examining outcomes of isolated tricuspid valve repair versus replacement.Methods:We searched PubMed, Embase, the Cochrane Library, Web of Science, CNKI, VIP database and WanFang database from the inception to September 30, 2021 for studies reporting outcomes of both isolated tricuspid valve repair and replacement, excluding congenital tricuspid aetiologies. Data were extracted and pooled using random-effects models and Review Manager 5.3 software.Results:A total of 18 articles were included, covering 10 023 patients, totalling 4 749 repairs and 5 274 replacements. Pooled operative mortality rates and odds ratios (95% confidence intervals) for isolated tricuspid repair and replacement surgery were 8.4% vs. 9.9%, OR=0.64(0.44, 0.93). Tricuspid repair was also associated with lower in-hospital acute renal failure 12.4% vs. 15.6%, OR=0.81(0.72, 0.92) and pacemaker implantation 7.9% vs. 26.4%, OR=0.24 (0.21, 0.30). There were no differences in rates of hospital stroke 14.4% vs. 10.3% , OR = 1.41 (0.98, 2.04) and late mortality rates 13.9% vs. 16.1%, OR=0.91(0.49, 1.69). Conclusion:Isolated tricuspid valve repair is associated with significantly reduced in-hospital mortality, renal failure and pacemaker implantation compared with replacement and is therefore recommended where feasible for isolated tricuspid valve disease.
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OBJECTIVE@#Primary mediastinal yolk sac tumor, which is also known as endodermal sinus tumor, is a rare but lethal neoplasm and its prognosis is very dismal. The current treatment for this tumor is controversial, and chemotherapy combined with resection of residual lesions is adopted sometimes. We summarized the experience of seven primary mediastinal yolk sac tumors treated with platinum-based chemotherapy and extended resection in Peking University First Hospital.@*METHODS@#Clinicopathological data of the patients with primary mediastinal yolk sac tumor who received operation in Peking University First Hospital between August 2014 and August 2018 were collected and analyzed retrospectively.@*RESULTS@#We experienced seven primary mediastinal yolk sac tumors during this period. Computed tomography scan revealed an anterior mediastinal tumor in all the patients and all of them had markedly raised alphafetoprotein (AFP) and normal β-human chorion gonadotropin (β-HCG). Five patients underwent needle core biopsy before treatment, which showed a mediastinal yolk sac tumor. All of these patients received preoperative platinum-based chemotherapy and they all presented partial response according to computed tomography. Two other patients did not receive preoperative biopsy, so they directly underwent extended resection. All of the seven patients underwent operation successfully and two of them experienced postoperative complications, including one with pneumonia and the other with atelectasis. R0 resection was achieved in six patients and R1 resection was achieved in the other patient. According to postoperative pathology, there were one microcyst subtype, one adenoid subtye, one giant capsule subtype and two hybrid subtypes. Surprisingly, there were no yolk sac tumor tissue in the other two patients after preoperative chemotherapy. All the patients received postoperative chemotherapy, excluded one patient who was unable to tolerate chemotherapy after operation. Three patients experienced postoperative pulmonary metastases within one year and two of them died soon. The other patient received chemotherapy and immunotherapy after recurrence and he was alive at the time of writing. Four other patients were alive without recurrence and metastasis.@*CONCLUSION@#Primary mediastinal yolk sac tumor is rare and its prognosis is poor. A multimodality approach including adjuvant chemotherapy and resection of residual lesions is the optimal treatment and it may lead to long-term survival.
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Humans , Male , Endodermal Sinus Tumor , Mediastinal Neoplasms , Mediastinum , Neoplasm Recurrence, Local , Retrospective StudiesABSTRACT
Objective To evaluate the feasibility of 3D thoracoscopic system in uniportal video-assisted thoracoscopic surgery (uniportal VATS) for the treatment of thoracic diseases. Methods 7 cases of thoracic diseases were accomplished with 3D thoracoscope from Nov 2015 to Dec 2015, including 3 cases of lobectomy, 2 cases of wedge resection of pulmonary tumor, 2 cases of mediastinal mass. Results All the operations were completed successfully, without conversion to open surgery. All the patient recovery successfully. The data of operative time, bleeding volume, postoperative chest tube drainage and hospital time and postoperative complications were counted. No complications and tumor recurrence or metastasis were observed during the followed 3 months. Conclusion 3D thoracoscopic system can be used in uniportal video-assisted thoracoscopic surgery (uniportal VATS) safely and provide high-definition and better sense of depth which facilitate the operation more precise and safer.
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Objective To study the clinical and pathological characteristics of early gastric cancer ( EGC) and to evaluate the value of blue laser imaging combined with magnification endoscopy ( BLI-ME) in the diagnosis of EGC. Methods A retrospective study was conducted on data of 255 patients with EGC diagnosed in Huashan Hospital from January 2014 to January 2017, including 33 cases of preoperative BLI-ME intensive examination. According to the Japanese classification of gastric carcinoma of Japanese Gastric Cancer Association, the EGCs were histopathologically divided into differentiated and undifferentiated subtypes. Clinical characteristics, endoscopic features, pathological type, lymph node metastasis, and lesion characteristics of BLI-ME were analyzed. Results Among the 255 cases of EGC, 164 cases ( 63. 31％) were male, 242 cases ( 94. 90％) were over 40 years old, 182 cases ( 71. 37％) belonged to differentiated type, 93 cases ( 36. 47％) were located in gastric antrum, 92 cases ( 36. 08％) were type 0-Ⅱc under endoscopy, and 37 cases (14. 51％) had lymph node metastasis. Comparative analysis showed that the lymph node metastasis rate was significantly lower in mucosal carcinoma compared to submucosal carcinoma[ 5. 04％(7/139) VS 25. 86％ (30/116),χ2=22. 109, P=0. 000], lower in differentiated carcinoma compared to undifferentiated carcinoma[9. 89％ (18/182) VS 26. 03％ (19/73), χ2=10. 938, P=0. 002], and lower in tumors with maximum diameter of lesion≤2. 0 cm compared to maximum diameter of lesion>2. 0 cm [ 9. 88％ ( 16/162 ) VS 22. 58％ ( 21/93 ) , χ2 =7. 687, P=0. 009 ] . Among the 33 cases undergoing BLI-ME, differentiated EGC was mainly fine-network pattern (13. 64％, 3/22), intralobular loop pattern (ILL)-1 (59. 09％, 13/22) and ILL-2 (22. 73％, 5/22), whereas undifferentiated subtype patients were characterized as ILL-2 ( 45. 45％, 5/11 ) and corkscrew pattern ( 54. 55％, 6/11 ) . Conclusion The incidence of EGC is higher in male with age over 40 years. Gastric lesions occur most frequently in the antrum, and the most common microscopic morphology is 0-Ⅱc type. Tumor>2. 0 cm or invasion of submucous layer, and undifferentiated carcinoma are prone to lymph node metastasis. The assessment of mucosal microvascular pattern and micro surface structure under BLI-ME facilitate to determine the pathological type of EGC.
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Objective To detect the SNR and geometric accuracy of MRI based on American College of Radiology (ACR)standards.Methods The SNR and geometric accuracy of Siemens Skyra 3.0T,Siemens Trio 3.0T and GE Excite HD 1.5T MRI were measured with ACR phantom,and the detection results were calculated according to the standards.Results The SNR values of Siemens Skyra 3.0T,Siemens Trio 3.0T and GE Excite HD 1.5T MRI were 589.98,438.50 and 277.12 respectively.Siemens Skyra 3.0T MRI had the values of geometric accuracy being-1.93％ at X direction,-3.20％ at Y direction and 0.68％ at Z direction,Siemens Trio 3.0T MRI had the value of geometric accuracy being-0.87％ at X direction,-2.33％ at Y direction and 1.49％ at Z direction,GE Excite HD 1.5T MRI had the values of geometric accuracy being 0.20％ at X direction,-1.53％ at Y direction and 1.69％ at Z direction.Conclusion The detection of the SNR and geometric accuracy of MRI can effectively guarantee the image quality.
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Objective To establish an efficient HPLC method for the determination of uric acid in plasma of hyperuricemia model mice,and the evaluation of uric acid lowering effect of Lesinurad.Methods The Laballiance Series Ⅲ HPLC system was adopted with Kromasil C18 column (100 mm × 4.6 mm,5 μm).The mobile phase consisted of methanol-0.5％ acetic acid (10:90) for isocratic elution with a flow rate of 0.4 mL/min.The detection wavelength was set at 283 nm.The established HPLC method was used to detect the plasma uric acid level of mice at 0.5,1.0,and 2.0 h time points after which being ip injected with 250 and 500 mg/kg uric acid.Lesinurad of 250 and 500 mg/kg was ig given to mice,0.5 h later,mice were ip injected with 500 mg/kg uric acid to establish hyperuricemia model,and 1 h later,the established HPLC method was used to detect the plasma uric acid level of mice.Results There was a good linear relationship between peak area and the concentration of plasma uric acid in the range of 7.5-150 μg/mL (r =0.997).The specificity,repeatability,precision,stability,and recovery of the established HPLC method was in accordance with the guiding rules of biological sample determination.Compared with the endogenous serum uric acid concentration of control group mice,serum uric acid concentration of 250 mg/kg dose group was significantly increased 0.5 h after ip administration with uric acid (P ＜ 0.01),and serum uric acid concentration of 500 mg/kg dose group was significantly increased 0.5,1.0,and 2.0 h after ip administration with uric acid.Compared with model group,the concentration of uric acid in plasma decreased significantly in low dosage group administered with Lesinurad (P ＜ 0.05),while decreased more significantly in high dosage group (P ＜ 0.01).Conclusion This convenient,rapid,and accurate method can be applied to the determination of uric acid in mouse plasma and the evaluation of relative drugs,which provide an efficient analysis way for establishing hyperuricemia model and screening relative drugs.
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Objective To establish evidence-based knowledge translation professional group in general hospital, and to explore its effects on clinical practice. Methods Double goals including evidence-based nursing and knowl-edge translation were built,inner organization structure of "Nursing Department-Core Group-Research Nurse-Practice Nurse" was set up,outer platform of "Evidence-Based Nursing and Knowledge Translation Center" was established,"double cycle" operation mode and "double track" management mode were developed. Results After establishment of evidence-based knowledge translation professional group,24 nurses received systematic training in evidence-based nursing knowledge translation. We successfully joined Best Practice Spotlight Organization of Canadian. Conclusion Evidence-based knowledge translation professional group in general hospital can promote the development of evi-dence-based nursing knowledge translation.
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Objective To detect the SNR and geometric accuracy of MRI based on American College of Radiology (ACR)standards.Methods The SNR and geometric accuracy of Siemens Skyra 3.0T,Siemens Trio 3.0T and GE Excite HD 1.5T MRI were measured with ACR phantom,and the detection results were calculated according to the standards.Results The SNR values of Siemens Skyra 3.0T,Siemens Trio 3.0T and GE Excite HD 1.5T MRI were 589.98,438.50 and 277.12 respectively.Siemens Skyra 3.0T MRI had the values of geometric accuracy being-1.93％ at X direction,-3.20％ at Y direction and 0.68％ at Z direction,Siemens Trio 3.0T MRI had the value of geometric accuracy being-0.87％ at X direction,-2.33％ at Y direction and 1.49％ at Z direction,GE Excite HD 1.5T MRI had the values of geometric accuracy being 0.20％ at X direction,-1.53％ at Y direction and 1.69％ at Z direction.Conclusion The detection of the SNR and geometric accuracy of MRI can effectively guarantee the image quality.
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<p><b>OBJECTIVE</b>To investigate the survival and prognostic factors in patients undergoing potentially curative resection of stage IIIA-N2 non-small cell lung cancer.</p><p><b>METHODS</b>Clinical data of eighty-nine patients, who underwent curative operation from January 2003 to April 2007 in the Peking University First Hospital and were pathologically diagnosed as stage IIIA-N2 NSCLC, were reviewed. The patients were followed up until death or the cut-off date. The overall 3-year and 5-year survival rates were calculated, and Cox proportional hazard model was used to determine the clinical and pathological risk factors and evaluate their influence on the survival.</p><p><b>RESULTS</b>The three-year and five-year survival rates were 51.7% and 31.5%, respectively. The univariate Cox regression analysis revealed five significant factors associated with prognosis: the arm of age < 55, T3 stage, lymphovascular invasion (LVI), multiple positive N2 station and the number of positive N2 nodes > 3 were found to be at increased risk of tumor-related death, and those risk factors were confirmed especially in the age ≥ 55 group. Multivariate Cox regression analysis indicated three independent prognostic factors: T3 stage, LVI and multiple positive N2 station.</p><p><b>CONCLUSIONS</b>The results of this preliminary study show that T3 stage, lymphovascular invasion and N2 level (single or multiple station) are associated with the prognosis of stage IIIA-N2 NSCLC patients after potentially curative resection, and the characteristics of age < 55 and the number of positive N2 nodes > 3 may imply worse prognosis.</p>
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Adult , Aged , Female , Humans , Male , Middle Aged , Age Factors , Antineoplastic Combined Chemotherapy Protocols , Therapeutic Uses , Carboplatin , Carcinoma, Non-Small-Cell Lung , Drug Therapy , Pathology , General Surgery , Chemotherapy, Adjuvant , Cisplatin , Follow-Up Studies , Lung Neoplasms , Drug Therapy , Pathology , General Surgery , Lymph Node Excision , Lymphatic Metastasis , Neoplasm Staging , Pneumonectomy , Methods , Proportional Hazards Models , Retrospective Studies , Survival RateABSTRACT
Objective To explore the investigation method of complicated and profound traditional Chinese herbal medicine,the potential action mechanisms of flavonoids from Scutellaria baicalensis were studied by docking calculation.Methods In total, eight flavonoids (aglycones and their glicosides) from S. baicalensis were selected as ligands.The crystalline structures of targets related to common diseases were used as the receptors for calculation. The calculations were conducted with Schr(o)dinger software package. The grading standard of selectivity was developed according to G-score between ligands and receptors. Results Twenty-six pharmacologic actions have been reported.Among all effects in literature, nine of them can be deduced from the docking calculation of aglycone. From glycosides with grade ++, 25 reported effects can be estimated by calculation. Apparently, the target selectivity of aglycones and their glycosides are different form the virtual evaluation. The virtual evaluation results of glycosides were closer to the reported effects. Conclusion Our proposed virtual evaluation method seems an effective way to investigate the complicated system of traditional Chinese herbal medicine. It suggests that aglycones may be effective as the form of glucoside in vivo, and metabolism is a very important factor for virtual evaluation.
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Objective To report the first family of cerebral autosomal recessive arteriopathy with subcortical infarcts and leukoencephalopathy(CARASIL)in China,and to explore its clinicopathological characteristics.Methods The clinical,imaging and pathological findings of the two patients were studied, and the sequence of the exons from 2 to 6 on Notch 3 in the chromosome 19 was detected.Results Two siblings were born from consanguineous parents.The ages at onset were 25 and 20 years old,respectively. Clinically,both of the patients were characterized by alopecia,acute lumbago,progressive intellectual deterioration,ataxia,pseudobulbar palsy and pyramidal tract signs.MRI demonstrated diffuse leucoencephalopathy and multiple subcortical infarcts on both hemisphere.The sural nerve biopsy on the elder sister demonstrated concentric thickening of vascular wall,narrowing of the lumen and mild fibrous proliferation of the intima.There were no amyloid,PAS granular deposition and uhrastructural granular osmiophilic material on the vascular wall.No mutation of exons from 2 to 6 on Notch 3 in the chromosome 19 was found by direct sequence.Conclusion The clinicopathological findings of the two patients fulfill the diagnostic criteria based on Fukutake.