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@#Objective To investigate the perioperative results and safety of minimally invasive direct coronary artery bypass grafting (MIDCAB) treatment of anterior descending artery disease through a small left thoracic incision assisted by thoracoscopy. Methods The clinical data of 92 patients who received MIDCAB in our hospital from May 2014 to October 2018 were retrospectively analyzed, including 72 (78.26%) males aged 42-78 (61.2±7.48) years, and 20 (21.74%) females aged 30-80 (61.30±12.26) years. The perioperative complications, blood product use, left heart function changes, ventilator use time, ICU stay, hospital stay and other indicators were analyzed. Results Two (2.17%) patients were transferred to thoracotomy, 5 (5.43%) patients received blood products during the operation, 2 (2.17%) were subjected to secondary thoracotomy to stop bleeding, 4 (4.34%) had postoperative hypoxemia and 1 (1.08%) was reintubated. The ventilator use time was 3-227 (22.35±35.39) hours, the ICU stay was 16-777 (78.85±108.62) hours, and the postoperative hospital stay was 2-36 (8.86±6.05) days. One (1.08%) patient died in hospital. Conclusion MIDCAB for anterior descending artery disease has good perioperative results, especially for solitary anterior descending artery disease, which can reduce the use of blood products, and shorten the time of ventilator use after operation, ICU stay and hospital stay.
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"The Expert Group on Tumor Ablation Therapy of Chinese Medical Doctor Association, The Tumor Ablation Committee of Chinese College of Interventionalists, The Society of Tumor Ablation Therapy of Chinese Anti-Cancer Association and The Ablation Expert Committee of the Chinese Society of Clinical Oncology" have organized multidisciplinary experts to formulate the consensus for thermal ablation of pulmonary subsolid nodules or ground-glass nodule (GGN). The expert consensus reviews current literatures and provides clinical practices for thermal ablation of GGN. The main contents include: (1) clinical evaluation of GGN, (2) procedures, indications, contraindications, outcomes evaluation and related complications of thermal ablation for GGN and (3) future development directions. .
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Objective To study the radiation injury of rat C6 glioma cell line by high resolution,1 H-nuclear magnetic resonance (1 H NMR) spectroscopy,and to preliminarily investigate its mechanism.Methods Metabolite concentrations in C6 cells were determined by 1 H NMR spectroscopy.Comet assay was used to evaluate DNA damage.Flow cytometry was used to determine the cell cycle and apoptosis rate.Colony-forming assay was used to measure the colony-forming rate and preliminarily investigate the mechanism of radiation injury.The resuhs were analyzed by one-way analysis of variance and Pearson correlation analysis.Results With the increase in radiation dose from 0 Gy to 1,5,10,and 15 Gy,DNA damage was enhanced in a dose-dependent manner (P=0.000-0.690);the percentage of cells in G1 phase increased (P =0.026-0.749);the apoptosis rate significantly increased (all P =0.000);the colony-forming rate significantly declined (P =0.000-0.004);the Lac/Cr ratio significantly decreased (P =0.000-0.015),which had a negative linear correlation with DNA damage parameters (tail length,r=-0.971;％DNA in the tail,r =-0.998;tail moment,r =-0.995) and apoptosis rate (r =0.978).Conclusions 1 H NMR spectroscopy reveals that the change in the Lac/Cr ratio is associated with injury and apoptosis of C6 cells after radiation.1 H NMR spectroscopy has the potential to predict radiation injury of glioma.
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Objective To examine whether the minimally invasive video-assisted thoracoscopic surgery(VATS) in atrial septal defect(ASD) closure yields better clinical outcome equivalent to those of more established procedures,such as median sternotomy,moreover,to provide our own clinical experience in ASD Closure.Methods From January 2012 to January 2013,100 ASD patients were treated,50 patients received traditional open heart surgery (OHS group),17 males and 33 females,aged(23.3 ± 7.5) years,weighted (47.5 ± 16.5) kg; 50 patients underwent video-assisted thoracoscopic surgery (VATS group),20 males and 30 females,(22.6 ± 8.2) years old and (49.6 ± 17.2) kg weight.Collected and analyzed the clinical date of intraoperation and postoperation.Results All patients survived after surgery without serious complications like death.Clinical date of both group(OHS group vs.VATS group)include:Total operating room time (121.3 ± 20.5) min vs.(105.3±17.5) min (P＜0.05); tracheal intubation time in ICU (210.0±36.5) min vs.(100.0 ±47.5) min(P＜0.05) ; volume of thoracic drainage after operation (350.3 ± 50.8) ml vs.(47.0 ± 10.9) ml (P ＜ 0.005) ; postoperative length of hospital stay (6.2 ± 1.7) days vs.(4.4 ± 1.5) days (P ＜ 0.005).Rate of return to work in 3 weeks of postoperation 0 vs.78.4％ (P ＜ 0.005).Conclusion Completed VATS in ASD closure is less invasive,accelerates recovery and maintains overall surgical efficacy,which brings good economic and social benefits.For the appropriate patients,and for the experienced and skilled surgeon,completed VATS is the best method of choice of ASD closure in our department.
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Objective To explore the role of proton MR spectroscopic imaging(1H-MRSI)and diffusion tensor imaging(DTI)in the diagnosis of adrenoleukodystrophy and to demonstrate the involvement of fibers by using the technique of DTT.Methods 1H-MRSI,DTI and routine imaging examinations were performed in 6 patients with ALD.The values of NAA,Cho,Cr,ADC,and FA were evaluated in different regions of lesion.The involved fibers were demonstrated by using the technique of DTT.Results The ratios of NAA/Cr(0.55±0.19)and NAA/Cho(0.22±0.11)were lower(F=7.693,7.751),and Cho/Cr(2.54±0.37)was higher(F=6.348)in the initial lesions,where higher ADC values(1.49±0.36,F=5.226)and the lowest FA values(0.21±0.08,F=5.139)were also observed(P＜0.05).The decreases of NAA/Cr(1.16±0.03)and NAA/Cho(0.45±0.17)in adjacent regions were more distinct than those of remote regions(t=1.769,1.842,P＜0.05).In the developing regions,the ADC values(0.89±0.03)were lower and the FA values(0.45±0.07)were the highest.There was negative correlation between NAA/Cho and ADC values(r=-0.71,P＜0.05),and there was positive correlation between NAA/Cho and FA values(r=0.31,P＜0.05).Discontinuations and fragments of fibres were observed in corpus callosum and pyramidal tract.Conclusions Combination of 1H-MRSI and DTI can offer a sensitive method for the early diagnosis and monitor the progress of white matter.DTT can be used to directly observe the involvement of fibers.
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Objective To investigate MR imaging characteristics of MELAS syndrome.Methods The clinical data and MRI features of 13 cases with MELAS syndrome were retrospectively analyzed.Results Multiple hypointense on T1WI and hyperintense on T2WI lesions were showed predominantly in the gray matter of the temporal, parietal and occipital lobes. The lesions crossed vascular boundaries. No stenosis and occlusion of main artery were displayed by MRA.Basal ganglia calcifications and cerebral atrophy with widening of ventricles were also frequent found. Increased ADC value of the leison on DWI and appearance of Lac peak on1H-MRS were useful in diagnosis.Conclusion There are some characteristics of MRI in patients with MELAS syndrome.Combined clinical informations with neuroimaging and muscle biopsy, the diagnosis of MELAS syndrome can be made correctly.
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Objective To evaluate the accuracy of fatsuppressed fast spoiled gradient echo(FSPGR) T_1WI in detection of pancreaticdisease using the receiver operating characteristic curve(ROC).Methods The pancreas were evaluated in 92 subject investigated(57normal and 35 with pancreatic disease) with fat saturation FSPGR T_1WI.The signal intensity(SI) ratio of pancreas relative to liver and spleen was quantitatively measured using regions of interest(ROIs),then qualitatively assessed by one independent observers.Results The mean values of pancreas-liver ratios and pancreas-spleen ratios between a normal and an abnormal pancreas were significantlydifferent.Thearea under ROC curve of the pancreas-liver SI ratio and the pancreas-spleen SI ratio was 0.92?0.03 and 0.91?0.04,respectively.There was no statistically significant difference between quantitative and qualitative analysis for the diagnosis of pancreatic disease when using liver as comparable standard.The sensitivity of qualitative pancreas in comparison with liver was 86.7%,while specificity was 91.2%.Conclusion When the SI ratio of pancreas-liver is used to distinguish normal from abnormal pancreas,qualitative analysis by observers is as accuracy as quantitative measurement.
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Objective To investigate the effects of thoracic epidural analgesia on postoperative rebound hypertension after ligation of patent ductus arteriosus (PDA) . Methods Forty-eight ASA Ⅰ -Ⅱpatients undergoing ligation of PDA were studied. There were 20 male and 28 female. The age ranged from 4-30 years and body weight 15-56 kg. The patients were randomly divided into two groups: general anesthesia group (group C, n= 22) and combined general-epidural anesthesia group (group TEA, n = 26). In group C combined intravenous-inhalational anesthesia was used and intermittent intramuscular pethidine 1 mg?kg-1 was given for postoperative pain relief. In TEA group epidural catheter was placed at T8-9 before induction of general anesthesia and a loading dose of 3-6 ml of a mixture of 0. 125 %-0. 15% bupivacaine + 0.0001% fentanyl + 0.005% droperidol was given 20 min before the end of surgery followed by infusion of the mixture at a rate of 2 ml?h-1. ECG, BP, HR, RR and SpO2 were monitored during and after operation. VAS pain score was evaluated and compared between the two groups. Results Better analgesia was achieved in TEA group. Postoperative blood pressure was significantly higher in group C than that in TEA group (P
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Objective To determine if in vivo detection of choline by1H-magnetic resonance spectroscopy(1H-MRS) could differentiate between benign and malignant bone and soft tissue tumors.Methods MR spectroscopy was performed in 28 cases, including 5 healthy subjects and 23 cases of extremital tumors. Examination was performed by using a point-resolved spectroscopic sequence with echo times of 35,144 and 288 ms.Results 1H-MRS spectrum was different among normal tissue, benign and malignant tumor.Conclusion Choline can be reliable detected in malignant tumor of bone and soft tissue by using1H-MRS.1H-MRS can help differentiate malignant tumor from benign tumor.