Value of serum fibroblast growth factor 23 in diagnosis of hypophosphatemic rickets in children / 中国当代儿科杂志

OBJECTIVES@#To study the value of serum fibroblast growth factor 23 (FGF23) in the diagnosis of hypophosphatemic rickets in children.@*METHODS@#A total of 28 children who were diagnosed with hypophosphatemic rickets in Children's Hospital of Nanjing Medical University from January 2016 to June 2021 were included as the rickets group. Forty healthy children, matched for sex and age, who attended the Department of Child Healthcare of the hospital were included as the healthy control group. The serum level of FGF23 was compared between the two groups, and the correlations of the serum FGF23 level with clinical characteristics and laboratory test results were analyzed. The value of serum FGF23 in the diagnosis of hypophosphatemic rickets was assessed.@*RESULTS@#The rickets group had a significantly higher serum level of FGF23 than the healthy control group (P<0.05). In the rickets group, the serum FGF23 level was positively correlated with the serum alkaline phosphatase level (rs=0.38, P<0.05) and was negatively correlated with maximum renal tubular phosphorus uptake/glomerular filtration rate (rs=-0.64, P<0.05), while it was not correlated with age, height Z-score, sex, and parathyroid hormone (P>0.05). Serum FGF23 had a sensitivity of 0.821, a specificity of 0.925, an optimal cut-off value of 55.77 pg/mL, and an area under the curve of 0.874 in the diagnosis of hypophosphatemic rickets (P<0.05).@*CONCLUSIONS@#Serum FGF23 is of valuable in the diagnosis of hypophosphatemic rickets in children, which providing a theoretical basis for early diagnosis of this disease in clinical practice.

An Epidemiologic Survey and Violent Behavior Analysis of Antisocial Personality Disorder in Young Men in Chengdu / 法医学杂志

OBJECTIVES@#To investigate the epidemiological characteristics of antisocial personality disorder (ASPD) in young men in Chengdu and explore the characteristics and risks of violence.@*METHODS@#Stratified random sampling was used to conduct a self-assessment questionnaire survey in 4 108 males aged from 18 to 34 in Chengdu, including general demographic characteristics, structured clinical interview for the diagnostic and statistical manual of mental disorders-Ⅳ axis Ⅱ disorders (SCID-Ⅱ) personality disorder screen questionnaire, violence questionnaire, psychosis screening questionnaire (PSQ), Alcohol Use Disorders Identification Test (AUDIT) and drug use. χ2 test, univariate and multivariate logistic regression were used for analysis and odds ratio (OR) was calculated.@*RESULTS@#The positive rate of ASPD was 5.91%, which was associated with young age, unmarried, unemployment state, low educational level, violent behavior, psychotic symptoms, alcohol and drug use (P<0.05). Young men with ASPD also had a risk (P<0.05) of violence (OR was 8.51), multiple violence (OR was 16.57), injury (OR was 6.68), intentional violence (OR was 11.41), etc., the risk decreased after controlling for psychotic symptoms and substance abuse, but was still statistically significant.@*CONCLUSIONS@#The risk of violence, severe violence and intentional violence in young men in Chengdu is high, and psychotic symptoms and substance abuse increase the risk of ASPD violence and relate characteristics.

Paratesticular liposarcoma: the clinicopathological features of nineteen cases / 中华病理学杂志

Objective: To investigate the clinicopathological features and differential diagnoses of paratesticular liposarcoma. Methods: The cases were collected from 2012-2020, from the archives of the Department of Pathology, Peking University Third Hospital, with diagnosis confirmed by histology, immunostaining and FISH tests. Results: Totally 19 patients were enrolled (including 11 in-hospital patients and 8 consultant cases). The patients aged 37-84 years (mean 57 years). The preoperative clinical diagnoses were spermatic cord/inguinal masses (nine patients), scrotal masses (seven patients), and inguinal hernia (three patients). Six lesions recurred after local resection, including one case extending from pelvic liposarcoma. Histologically, there were 10 cases of well-differentiated liposarcoma (WDLPS) and nine cases of dedifferentiated liposarcoma (DDLPS). WDLPSs mostly showed the combined features of lipoma-like, inflammatory and sclerosing subtypes (six patients); the other four WDLPSs had pure lipoma-like subtype features. DDLPSs were low-grade (three patients) or high-grade (six patients), with the morphology resembling myxofibrosarcoma, inflammatory myofibroblastoma, spindle cell sarcoma, pleomorphic undifferentiated sarcoma and pleomorphic liposarcoma. Intense inflammatory cells infiltration was commonly observed in five WDLPSs and two DDLPSs. Ossification was observed in three tumors. Immunohistochemically, the tumors were positive for MDM2 (8/10) and CDK4 (10/10), which were expressed in lipo-differentiating cells, spindle cells in WDLPS, and in dediffferentiated components. S-100 was only expressed by lipocytes (10/10). CD34 expression was positive and diffuse in the stromal cells of WDLPSs and focal or diffuse in dedifferentiated areas (10/10). FISH tests with an MDM2 gene probe were positive (12/12). Conclusions: Paratesticular liposarcoma may be overlooked by both clinicians and pathologists. WDLPS and DDLPS predominate, showing various histologic divergences. The presence of amplification of the 12q14-q15 region (containing the MDM2 and CDK4 genes) is helpful for making the correct diagnosis.

Design of dual targeting immunomicelles loaded with bufalin and study of their anti-tumor effect on liver cancer / 中西医结合学报

OBJECTIVE@#Bufalin is an effective drug for the treatment of liver cancer. But its high toxicity, poor water-solubility, fast metabolism and short elimination half-life limit its use in tumor treatment. How to make the drug accumulate in the tumor and reduce side effects while maintaining its efficacy are urgent problems to be solved. The goal of this study is to solve these problems.@*METHODS@#A copolymer with tunable poly-N-isopropylacrylamide and polylactic acid was designed and synthesized. The corresponding dual targeting immunomicelles (DTIs) loaded with bufalin (DTIs-BF) were synthesized by copolymer self-assembly in an aqueous solution. The size and structure of DTIs-BF were determined by ZetaSizer Nano-ZS and transmission electron microscopy. Then, its temperature sensitivity, serum stability, critical micelle concentration (CMC), entrapment efficiency (EE), drug release and non-cytotoxicity of blank block copolymer micelles (BCMs) were evaluated. Next, the effects of DTIs-BF on cellular uptake, cytotoxicity, and tumor cell inhibition were evaluated. Finally, the accumulation of DTIs-fluorescein isothiocyanate (FITC) and the in vivo anti-tumor effect were observed using an interactive video information system.@*RESULTS@#DTIs-BF had a small size, spherical shape, good temperature sensitivity, high serum stability, low CMC, high EE, and slow drug release. The blank BCMs had very low cytotoxicity. Compared with free bufalin, the in vitro cellular internalization and cytotoxicity of DTIs-BF against SMMC-7721 cells were significantly enhanced, and the effects were obviously better at 40 °C than 37 °C. In addition, the therapeutic effect on SMMC-7721 cells was further enhanced by the programmed cell death specifically caused by bufalin. When DTIs-FITC were injected intravenously in BALB/c nude mice bearing liver cancer, the accumulation of FITC was significantly increased in tumors.@*CONCLUSION@#DTIs-BF is a potentially effective nano-formulation and has broad prospects in the clinical treatment of liver cancer.

Advances in the prediction and treatment of recurrent pancreatic cancer / 医学研究生学报

Patients with pancreatic adenocarcinoma who underwent surgical resection have poor prognosis, with the recurrence rate of over 80% within two years. Currently, the treatment of recurrent pancreatic cancer is still in the exploratory phase, and the efficacy is only limited to chemotherapy. In addition, there are differences in the efficacy of different chemotherapy schemes, and there is no unified chemotherapy scheme. Meanwhile, new radiotherapy and surgical treatment have been proposed for the treatment of recurrent pancreatic cancer, but its efficacy is yet to be confirmed. This paper summarizes the factors to predict postoperative recurrence, various chemotherapy schemes and new radiotherapy methods, reviews and analyzes the effectiveness of surgical treatment on recurrent pancreatic cancer.

Intra-nucleus accumbens shell injection of baclofen blocks the reconsolidation of conditioned place preference in morphine-addicted mice / 生理学报

Preclinical studies suggest that the GABA receptor is a potential target for treatment of substance use disorders. Baclofen (BLF), a prototypical GABA receptor agonist, is the only specific GABA receptor agonist available for application in clinical addiction treatment. The nucleus accumbens shell (AcbSh) is a key node in the circuit that controls reward-directed behavior. However, the relationship between GABA receptors in the AcbSh and memory reconsolidation was unclear. The aim of this study was to investigate the effect of intra-AcbSh injection of BLF on the reconsolidation of morphine reward memory. Male C57BL/6J mice were used to establish morphine conditioned place preference (CPP) model and carry out morphine reward memory retrieval and activation experiment. The effects of intra-AcbSh injection of BLF on morphine-induced CPP, reinstatement of CPP and locomotor activity were observed after environmental cues activating morphine reward memory. The results showed that intra-AcbSh injection of BLF (0.06 nmol/0.2 μL/side or 0.12 nmol/0.2 μL/side), rather than vehicle or BLF (0.01 nmol/0.2 μL/side), following morphine reward memory retrieval abolished morphine-induced CPP by disrupting its reconsolidation in mice. Moreover, this effect persisted for more than 14 days, which was not reversed by a morphine priming injection. Furthermore, intra-AcbSh injection of BLF without morphine reward memory retrieval had no effect on morphine-associated reward memory. Interestingly, administration of BLF into the AcbSh had no effect on the locomotor activity of mice during testing phase. Based on these results, we concluded that intra-AcbSh injection of BLF following morphine reward memory could erase morphine-induced CPP by disrupting its reconsolidation. Activating GABA receptor in AcbSh during drug memory reconsolidation may be a potential approach to prevent drug relapse.

Feasibility and safety of new simplified left bundle branch area pacing via nine-partition method / 中华心血管病杂志

Objective: To investigate the efficacy and safety of left bundle branch area pacing (LBBaP) with the new simplified approach (nine-partition method). Methods: A total of 118 patients with clinical indications and received pacemaker implantation from December 1, 2018 to December 31, 2019 in Beijing Anzhen Hospital were enrolled. LBBaP was performed with the nine-partition method (in the right anterior oblique 30° position, the ventriculogram was divided into nine partitions and the initial implant sites were located in the lower base 1/3 partitions). In X-ray image, the 3830 lead is located in the left bundle branch area, the unipolar pacing QRS wave is in the form of right bundle branch block, and the peak time from stimulation to left ventricular activation<90 ms is defined as successful operation. The clinical characters, such as the methods of venipuncture, electrode parameters, operation duration, fluoroscopy duration, the peak time from stimulation to left ventricular, pacemaker types, surgical success rate, complications, and immediate postoperative ECG parameters were collected. The patients were followed up after the operation, and the electrode parameters and postoperative complications were recorded. Results: This study is a retrospective study. There were 62 (52.5%) male patients in this cohort, the average age was (65.9±13.4) years old,and there were 49(41.5%) sick sinus syndrome, 6(5.1%) abnormal sinus node and atrioventricular node simultaneously, 63(53.4%) atrioventricular block, 26(22.0%) atrial fibrillation, 20(16.9%) cardiomyopathy; the baseline duration of QRS was (109.21±39.03) ms. Successful LBBaP was achieved in 109 patients with"nine-partition method"and the success rate was 92.4%; 104 patients (95.5%) were axillary vein puncture, 5 (4.6%) were subclavian vein puncture; the operation duration was (80.3±23.0) min, the fluoroscopy duration was (12.29±5.13) min; the QRS duration after LBBaP was (116.36±18.11) ms. The threshold of the left bundle branch (LBB) lead was (0.92±0.63) V, the R wave amplitude was (10.60±5.04) mV and the impedance was (798.71±194.90) Ω. In 1 V pacing, the peak time from stimulation to left ventricular activation was (67.91±12.15) ms, and in 5 V pacing was (67.52±12.45) ms; 1 case (0.9%) with a single-chamber pacemaker implanted, 106 cases (97.3%) with dual-chamber pacemaker and 2 cases (1.8%) with three-chamber pacemakers. There were no hematomas, pneumothorax, hemothorax, electrode dislocation, infection, and capsular hemorrhage and other serious surgery-related complications during the operation. A total of 97 patients (89.0%) were followed up for (6.21±2.90) months. The electrode parameters of all patients were stable and no complications observed. Conclusions: The LBBaP with nine-partition method is a simple, safe and effective physiological pacing approach. However, its long-term effect still needs to be further verified.

Design of novel micellar nano-traditional Chinese medicine formulations based on anti-tumor mechanisms of traditional composition / 第二军医大学学报

Clinically traditional Chinese medicine (TCM) has been proven to possess obvious anti-tumor effects. It is critical to further explore the effective components and the corresponding mechanism of the TCM against target cells, which also has great significance for developing novel nano-TCM formulations for clinical treatment of tumor. This paper systematically reviews the anti-tumor effects of Chinese herbal compound and the anti-tumor mechanism of single herb. We also summarized the progress in the current traditional nano-TCM preparations. Taking the shikonin in Herba Arnebiae as an example, using the nano-material self-assembly technology, we discussed the design of novel nano-macromolecule TCM formulations while considering the mechanism of single herb and the clinical obstacles.

Influence of pulmonary hypertension on patients with advanced chronic obstrnctive pulmonary disease prior to lung transplantation / 中华器官移植杂志

Objective To study the influence of pulmonary artery hypertension (PAH) on survival of patients with advanced chronic obstructive pulmonary disease (COPD) on the waiting list of lung transplantation.Methods The characteristics of 143 patients with COPD receiving lung transplantation evaluation from January 2014 to August 2016 were queried.Mild PAH was defined as mean pulmonary artery pressure (mPAP) ≥25 mmHg and severe ≥35 mrnHg by right heart catheterization measurements.The incidence of PAH was studied,and the patients were divided to different groups to determine the effect of PAH on survival prior to transplantation on the basis of different definitions of PAH.Kaplan Meier method was used to draw survival curves,and a log-rank test was used to analyze the effect of PAH on survival of COPD patients on the waiting list of pulmonary transplantation.Univariate and multivariate Cox proportional hazard models were performed to test the relationship between each main covariate and the hazard of mortality.The waiting time was tracked from wait list entry date until death or censoring,and the censoring issues were as follows:receiving lung transplantation,removing from the waiting list without transplant,and still wating for donor until the last follow-up day (2016-08-30).Results Of 143 COPD patients,there were 119 males and 24 males,with mean age of 61.73 years old;46 patients received lung transplantation,and the remaining 97 not;50 had mPAP ≥25 mmHg and 21 had mPAP ≥35 mmHg.A total of 23 cases (22.88％) died on the waiting list.Thirty-eight patients were removed from the list prior to transplantation,and 36 were still on the waiting list.Kaplan-Meier survival function showed suvival of patients with mild PAH or severe PAH was significantly shorter than that of patients without PAH (P＜0.001).Using Cox proportional hazards models,univariate analysis revealed significant differences in survival for mild PAH (HR =2.147,95％CI 1.429-3.157,P＜ 0.001) and severe PAH (HR =3.458,95 ％ CI 2.518-4.859,P＜0.001).Multivariate Cox models identified significant risk for death for mild PAH (HR=2.518,95％CI 1.728-3.364,P＜0.001) and severePAH HR=4.027,95％ CI 3.257-4.703,P＜0.001).Conclusion The incidence of PAH among COPD patients waiting for lung transplantation was high.PAH is associated with significantly increased risk of death among COPD patients waiting for lung transplantation.

Short-term efficacy and safety of low-intensity extracorporeal shock wave therapy in erectile dysfunction: a systematic review and meta-analysis

ABSTRACT Aim: The role of low-intensity extracorporeal shock wave therapy (LI-ESWT) in erectile dysfunction (ED) is not clearly determined. The purpose of this study is to investigate the short-term efficacy and safety of LI-ESWT for ED patients. Materials and Methods: Relevant studies were searched in Medline, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), WANFANG and VIP databases. Effective rate in terms of International Index of Erectile Function-Erectile Function Domain (IIEF-EF) and Erectile Hardness Score (EHS) at about 1XSmonth after LI-ESWT was extracted from eligible studies for meta-analysis to calculate risk ratio (RR) of effective treatment in ED patients treated by LI-ESWT compared to those receiving sham-treatment. Results: Overall fifteen studies were included in the review, of which four randomized controlled trials (RCTs) were for meta-analysis. Effective treatment was 8.31 [95°/o confidence interval (CI): 3.88-17.78] times more effective in the LI-ESWT group (n=176) than in the sham-treatment group (n= 101) at about 1 month after the intervention in terms of EHS, while it was 2.50 (95% CI: 0.74-8.45) times more in the treatment group (n= 121) than in the control group (n=89) in terms of IIEF-EF. Nine-week protocol with energy density of 0.09mJ/mm2 and 1500 pluses seemed to have better therapeutic effect than five-week protocol. No significant adverse event was reported. Conclusion: LI-ESWT, as a noninvasive treatment, has potential short-term therapeutic effect on patients with organic ED irrespective of sensitivity to PDE5is. Owing to the limited number and quality of the studies, more large-scale, well-designed and longterm follow-up time studies are needed to confirm our analysis.

Clinical analysis of Walit in the treatment of central serous retinopathy / 中国生化药物杂志

Objective To investigate the clinical effect of Walit on central serous retinopathy. Methods A total of 92 patients with central serous retinal retinopathy were enrolled in our hospital from January 2015 to January 2017, and were randomly divided into control group and study group (n=46). The control group, the central serous chorioretinopathy treated with laser therapy, the study group by laser combined with Walit therapy, two groups were treated for 4 weeks, the curative effect and follow-up records, the data input SPSS software. Results The two groups of central serous chorioretinopathy patients successfully completed the treatment. The study group central serous chorioretinopathy in patients with clinical therapy in the treatment of the total efficiency (91.30 %) was significantly better than the control group (76.09 %), the differences were statistically significant (P<0.05); recurrence rate of study group (0.00 %) was significantly lower than the control group (13.04 %), the differences were statistically significant (P<0.05). Conclusion The use of laser treatment for central serous chorioretinopathy combined with Wolitingke significantly improve curative effect, has the positive significance to guarantee the prognosis and quality of life.

Effects of Moxibustion at Different Temperatures on Blood Lipids and TRPV1 mRNA in Dorsal Root Ganglion with Hyperlipidemia Rats / 中国中医药信息杂志

Objective To compare the effects of moxibustion at different temperatures on blood lipid and TRPV1 in dorsal root ganglion with hyperlipidemia rats; To verify the correlation between efficacy of adjusting fat of moxibustion with activating of TRPV1. Methods The rat model of hyperlipidemia was made by high fat diet. 60 SD mice were randomly divided into four groups: control group, model control group, the 38 ℃ moxibustion group and the 45 ℃ moxibustion group, with 15 mice in each group. Acupoints Shenque and Zusanli were chosen under moxibustion for 10 minutes each time, once another day, for 4 weeks, in the 38 ℃ moxibustion group and the 45 ℃moxibustion group. Blood was taken after intervention, and blood TC, TG, LDL-C and HDL-C of the mice were detected by oxidase method; the dorsal root ganglion was taken to detect the expression of TRPV1 mRNA by real-time fluorescence quantitative PCR. Results Compared with model group, blood lipid indexes in moxibustion groups had different changes, with statistical significance compared with 45 ℃ moxibustion group (P<0.05, P<0.01), and there was statistical significance between 38 ℃ moxibustion group and 45 ℃ moxibustion group (P<0.01); there was statistical significance in TRPV1 mRNA of dorsal root ganglion among 45 ℃ moxibustion group and other three groups (P<0.01). Conclusion The correlation between efficacy of adjusting fat of moxibustion with activating of TRPV1 has been confirmed.

Clinical analysis of Walit in the treatment of central serous retinopathy / 中国生化药物杂志

Objective To investigate the clinical effect of Walit on central serous retinopathy. Methods A total of 92 patients with central serous retinal retinopathy were enrolled in our hospital from January 2015 to January 2017, and were randomly divided into control group and study group (n=46). The control group, the central serous chorioretinopathy treated with laser therapy, the study group by laser combined with Walit therapy, two groups were treated for 4 weeks, the curative effect and follow-up records, the data input SPSS software. Results The two groups of central serous chorioretinopathy patients successfully completed the treatment. The study group central serous chorioretinopathy in patients with clinical therapy in the treatment of the total efficiency (91.30 %) was significantly better than the control group (76.09 %), the differences were statistically significant (P<0.05); recurrence rate of study group (0.00 %) was significantly lower than the control group (13.04 %), the differences were statistically significant (P<0.05). Conclusion The use of laser treatment for central serous chorioretinopathy combined with Wolitingke significantly improve curative effect, has the positive significance to guarantee the prognosis and quality of life.

Effects of Moxibustion at Different Temperatures on Blood Lipids and TRPV1 mRNA in Dorsal Root Ganglion with Hyperlipidemia Rats / 中国中医药信息杂志

Objective To compare the effects of moxibustion at different temperatures on blood lipid and TRPV1 in dorsal root ganglion with hyperlipidemia rats; To verify the correlation between efficacy of adjusting fat of moxibustion with activating of TRPV1. Methods The rat model of hyperlipidemia was made by high fat diet. 60 SD mice were randomly divided into four groups: control group, model control group, the 38 ℃ moxibustion group and the 45 ℃ moxibustion group, with 15 mice in each group. Acupoints Shenque and Zusanli were chosen under moxibustion for 10 minutes each time, once another day, for 4 weeks, in the 38 ℃ moxibustion group and the 45 ℃moxibustion group. Blood was taken after intervention, and blood TC, TG, LDL-C and HDL-C of the mice were detected by oxidase method; the dorsal root ganglion was taken to detect the expression of TRPV1 mRNA by real-time fluorescence quantitative PCR. Results Compared with model group, blood lipid indexes in moxibustion groups had different changes, with statistical significance compared with 45 ℃ moxibustion group (P<0.05, P<0.01), and there was statistical significance between 38 ℃ moxibustion group and 45 ℃ moxibustion group (P<0.01); there was statistical significance in TRPV1 mRNA of dorsal root ganglion among 45 ℃ moxibustion group and other three groups (P<0.01). Conclusion The correlation between efficacy of adjusting fat of moxibustion with activating of TRPV1 has been confirmed.

The social capital and organizational performance of civil society organizations in the field of HIV/AIDS prevention and control / 中国卫生政策研究

To analyze the influence of external social capital on organizational performance of civil society organ-izations in HIV/AIDS prevention and control fields. Methods:Multi-variate stratified sampling and cluster sampling methods were used to investigate 212 civil society organizations in the field of AIDS prevention and control in eight prov-inces of China. The data were analyzed with the help of the multivariate logistic regression. Results:The findings showed that the shared vision,network will affect organizational institution performance(OR=3.23,95% CI,1.77-5.88),(OR=2.21,95% CI:1.21-4.02); Shared vision factors will affect the organization's performance of the organization's external social capital (OR=4.17,95% CI:2.23-7.78);Shared vision is closely relative to Shared vision and the organization's financial performance (OR=2.97,95% CI:1.60-5.51);Shared vision, network and support has positive correlation with organizational culture performance(OR=2.04,95% CI:1.09-3.85),(OR=2.02 ,95% CI:1.09 -3.76), (OR =3.34, 95% CI: 1.79 -6.23); Shared vision and the network will affect the organization's comprehensive performance (OR=14.56,95% CI:6.83-31.06), (OR=2.23,95% CI:1.11-4. 48). Conclusions:The external social capital of civil society organizations in the field of HIV/AIDS prevention and con-trol can affect organizational performance,and different organizations and the governments should develop the external social capital vigorously to improve organizational performance.

Lung transplantation with extracorporeal membrane oxygenation for idiopathic pulmonary arterial hypertension / 中华器官移植杂志

Objective To discuss the benefits of extracorporeal membrane oxygenation (ECMO) applied in the patients with idiopathic pulmonary arterial hypertension during the operation of bilateral sequential single lung transplantation.Methods Fifteen patients with idiopathic pulmonary arterial hypertension received lung transplantation supported with ECMO between Nov.2009 and Sep.2014.ECMO was removed after the transplantation if the oxygenation and hemodynamic were stable,otherwise,ECMO was applied continuously until the situation improved.Results All the operations of 15 patients were accomplished successfully and the ECMO was removed in 3 patients after the operation immediately,while in the other 12 patients,ECMO was applied continuously until the situation improved in ICU.ECMO was applied again in 3 patients when it was necessary.Deep venous thrombosis occurred in one patient.Three patients died after operation and the other 12 patients are alive till now.Conclusion ECMO can be applied safely and effectively in lung transplantations for idiopathic pulmonary arterial hypertension patients.

Clinical analysis of risk factors for early primary graft dysfunction after lung transplantation / 中华胸心血管外科杂志

Objective To investigate the institution of extracorporeal membrane oxygenation(ECMO) for primary graft dysfunction( PGD) after lung transplantation and analysis its clinical outcome. Methods From September 2002 to December 2013, 286 patients with end-stage lung disease underwent lung transplantation(LTx) in Wuxi People's Hospital. Among them, there were 22 patients occured grade 3 PGD in early stage after LTx. In which there were 2 cases with chronic obstructive pulmonary disease, 12 with idiopathic pulmonary fibrosis, 4 case with primary pulmonary hypertension, 1 case with lung tuber-culosis, 1 case with silicosis, 2 cases with bronchiectasis. There were 7 patients with single LTx(3 cases with ECMO support) and 15 patients with bilateral LTx(2 cases with CPB support and 6 cases with ECMO support). According to the severity levels of PGD, different treatment measures were used, such as reinforce ventilatory support, negative fluid balance, extending the treatment time of the ventilator, the use of pulmonary vasodilators, such as prostaglandin E1 and ECMO. Results Six patients were treated by adjusting low volume, high frequency and high positive end expiratory pressure ventilation( PEEP) mode, and 2 cases reversed, 4 cases died of respiratory failure. 16 cases accepted ECMO support, among them 10 cases apply venous-ve-nous mode, 6 cases venous-artery mode, the average flow time was 5. 5 days. 10 cases dismantled from ECMO successly and 6 cases died of multiple organ failure, infection and cardiac arrest. 30-day, 1-year and 5-year survival of PGD recipients post-op-eratively were 55％, 40％, 25％, respectively. Conclusion The high incidence of PGD causes high mortality peri-operative-ly after LTx. Preventing PGD can improve the survival rate of the lung transplant patients. Once PGD happens, appropriate treatment should be given as soon as possible. ECMO can effectively promote the transplanted lung function recovery, reduce the perioperative mortality. If the indications of ECMO use was reached, the institution of ECMO should as soon as possible.

Preliminary Clinical Application of a Novel Locking Stylet in Cardiac Lead Extraction / 中国循环杂志

Objective: To explore the safety and efficacy of a novel lead locking device (LLD) in the procedure of cardiac lead extraction for heart rhythm implants. Methods: A total of 6 patients using LLD for cardiac lead extraction in our hospital were retrospectively reviewed. Clinical parameters, the reason of cardiac lead extraction, lead locking stylet condition, outcome of lead extraction and operative complications were summarized. Results: There were 6 patients including 1 female with the median age at 62.5 years. LLD was used and 13 cardiac leads were extracted including 1 scrap electrode wire and 12 functional electrode wire. Among those, LLD was successfully inserted and locked on the top of 11/13 (85%) leads for whole procedure and 2 (15%) leads were not locked for whole procedure; 12 (92 %) leads were completely removed and 1 (8%) lead was partially removed. No severe complications occurred. Conclusion: The novel LLD may safely and effectively extract electrode lead which is beneficial for complete cardiac lead extraction.

Lung transplantation for end-stage pulmonary diseases using donation after death of citizens: report of 242 cases / 中华器官移植杂志

Objective To summarize the lung transplant program using donation after death of citizens (DCD).Methods Retrospective characteristics of 242 patients with end-stage lung diseases receiving lung transplantation in our hospital were reviewed between January 2015 and December 2016.The data about evaluation and collection of all donors were analyzed.The survival rate,causes of deaths,and postoperative complications were reviewed.Kaplan Meier survival curves and a logrank test of differences in survival functions were used to assess the effect of lung transplant type and extracorporeal membrane oxygenation (ECMO) on survival post transplant.Results A total of 231 patients donated their lungs,including China type three (135 cases),China type two (19 cases),and China type one (77 cases).242 lung transplantations were successfully performed.The 3-month,6-month and 1-year survival rate after lung transplantation was 80.6％,80.6％,and 77.8％,respectively.There were 47 deaths during perioperative period,including 22 cases of primary graft dysfunction,14 cases of sepsis,6 cases of multiple organ failure,3 cases of heart failure,and 2 cases of stomal leak.One hundred and thirty-two patients received bilateral lung transplantation,with 3-month,6-month,and 1-year survival rate being 78.6％,78.6％,and 75.6％ respectively.110 underwent single lung transplantation with 3-month,6-month,and 1-year survival rate being 82.7 ％,82.7 ％,and 80.1％,respectively.No significant difference in survival rate was observed between single and bilateral lung transplantation (P＞0.05).One hundred and twenty-nine cases of lung transplants were conducted under ECMO support,with the 3-month,6-month and 1-year survival rate being 72.5％,72.5％,and 70.5％ respectively,which was significantly higher in those without ECMO with the 3-month,6-month and 1-year survival rate being 90.2％,90.2％ and 86.6％ respectively (n =113) (P ＜ 0.05).Conclusion DCD may facilitate the development of lung transplantation in China with long-term survival.

Clinical research on the relationship of central retinal vein occlusion and atherosclerosis / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To explore the relationship of central retinal vein occlusion ( CRVO) and atherosclerosis ( AS) . METHODS:Fifty cases of CRVO patients were chosen as the observation group in our hospital from October 2012 to October 2014, other 50 patients with AS ( non-CRVO) as control group. In the control group, 22 cases of AS mild stenosis, moderate stenosis in 24 cases, 4 cases of severe stenosis ( 3 cases implanted stent ) . According to the severity, two grade prevention primary prevention therapy, and cerebral vascular disease treating stroke, corresponding drug treatment was undergone. Two groups of patients were performed cervical carotid artery color Doppler ultrasound examination, including assessing plaque, carotid artery intima-media thickness ( IMT) , the degree of stenosis of internal carotid artery blood flow velocity and the systolic peak ( PSV ) , end diastolic blood flow velocity ( EDV) , resistance index ( RI) values for kinetic parameters etc. All the indexes of the two groups were compared with color Doppler ultrasound examination results, to evaluate the correlation between CRVO and AS. RESULTS: In the observation group, 15 cases were detected of carotid artery with mild stenosis, 28 cases of arterial diameter reduced CONCLUSION: CRVO and AS are highly correlated, the neck of Doppler ultrasound examination can clearly reflect the central retinal vein blood supply, the standard treatment for AS disease, can reduce the risk of CRVO, with certain clinical significance.