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Objective To analyze the clinical effect through 20 adult atrial septal defect repair cases with totally thoracoscopic and summarize the experience of totally thoracoscopic cardiac surgeries.Methods From March 2014 to August 2016, 20 adult atrial septal defect cases repaired by totally thoracoscopic were enrolled in the study. Extracorporeal circulation was established by inserting artery pump tubes into the right femoral artery and vein tubes in to the right femoral vein, cold blood cardioplegia was perfused ante gradely through the aortic root in order to protect the myocardium, then atrial septal defect repair cardiac surgeries were implemented by perforating 3 holes through the right chest wall. Analyze the operation time, aortic cross clamping time, CPB time, amount of drainage, hospital stay, postoperative complications and so on.Results The operation time was 3.5~5.0 h, and the average level was (3.8 ± 0.5) h. The blocking duration of the ascending aorta ranged from 28 to 46 min, and the average level was (29.8 ± 8.2) min. The duration of extracorporeal circulation ranged from 86 to 108 min, and the average level was (80.6 ± 11.5) min. Ventilation time ranged from 5 to 8h, and the average level was (6.0 ± 0.8) h. The amount of thoracic drainage ranged from 100 to 260 ml, and the average level was (150.0 ± 35.0) ml. Hospital stay ranged from 6 to 9 days, and the average level was (6.5 ± 1.2) days. All the operations were completed successfully. There were no in-hospital death or serious post-operative complications. UCG performed 3~5 days after the operation revealed surgical results were satisfactory. Follow up to 1~28 months were available in all cases. During the period, the heart function was conifrmed asⅠ level.Conclusion Adult atrial septal defect repair surgeries with totally thoracoscope is safe and reliable and have advantages of less injury, rapid discovery, light pain, and less postoperative drainage.
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Objective To investigate the clinical significance of combined detection of human papillomavirus (HPV) L1 capsid protein,thinprep cytoligic test (TCT) and HPV genotyping on the early diagnosis of cervical cancer.Methods A total of 1 260 patients with sexual life history and cervical lesions were detected of HPV genotyping and TCT,then one or both in the two indicators was tested by biopsy.Meanwhile the expression of HPV L1 capsid protein was detected in patients with abnormal TCT.Contrasted TCT,HPV genotyping,HPV L1 capsid protein and histopathological diagnosis.Results The positive rate of cervical intraepithelial neoplasia (CIN) and more gradually of no definitive diagnosis significance of atypical squamous cells (ASCUS),low-grade squamous epithelial cell lesions (LSIL),the height of squamousintraepithelial lesion (HSIL),squamous cell carcinoma (SCC) was respectively 19.0％ (11/58),63.4％ (26/41),84.6％ (22/26) and 7/7,which increased with TCT-level rise,and there was significant difference (P ＜ 0.01).Low risk HPV-positive were mainly seen in low-grade lesions,with the TCT-level rise,high risk HPV-positive rate was significantly higher,which was respectively 36.2％ (21/58),56.1％ (23/41),73.1％(19/26) and 7/7,and there was significant difference (P＜0.05).The rate ofinflammation,CIN Ⅰ in HPV L1 capsid protein-positive was higher than HPV L1 capsid protein-negative [59.2％ (42/71) vs.39.3％ (24/61),29.6％(21/71) vs.14.8％(9/61)],pathological diagnosis of SCC were negative in HPV L1 capsid protein expression.With the increased level of pathology,the positive rate of HPV L1 capsid protein decreased.Conclusions That TCT liquid-based cytology and HPV genotyping can significantly reduce high-risk groups and significantly improve the detection rate of cervical cancer,and to detect HPV L1 capsid protein of HPV infection may provide the basis for the status and prognosis.Combination of the three indicators can provide the basis for early diagnosis of cervical cancer.
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BACKGROUND: Appropriate anastomosis materials can improve success rate of trachea and bronchus reconstruction.Common domestic suture materials include silk suture, dacron and synthesized absorbable suture. However, the suture with best effects in preventing and lightening scar granulation hyperplasia and luminal stenosis remains Uncertain.OBJECTIVE: To compare the influence of three kinds of suture materials on histopathological changes of anastomotic stoma and transforming growth factor-β_1 (TGF-β_1) expression in rabbits following tracheotomy.DESIGN, TIME AND SETTING: A randomized, controlled animal experiment and histopathological observation were performed at the Animal Experimental Department, Nanhua University from September 2005 to October 2006.MATERIALS: Artificial absorbable suture was purchased from Brazil Johnson & Johnson Professional Products; silk suture and dacron were purchased from Hangzhou Fuyang Medical Suture Factory and Hangzhou Huawei Medical Products Co., Ltd.METHODS: A total of 36 New Zealand healthy adult rabbits, regardless of gender, weighing 1.6-2.0 kg, were randomly divided into silk, dacron and artificial absorbable suture groups with 12 animals in each group. The end-to-end anastomosis following tracheotomy was performed using silk, dacron and artificial absorbable suture, respectively.MAIN OUTCOME MEASURES: The pathological changes and TGF-β_1 level around the sutures 1, 2, 4 weeks post operation were observed.RESULTS: A total of 36 rats were included in final analysis. There were no difference in anastomotic healing between three groups 1 and 2 weeks postoperatively, with a great amount of inflammatory cell infiltration, mainly neutrophil, around the sutures.Moreover, bleeding in the focus and foreign body grannuloma were found. At 4 weeks postoperatively, foreign body grannuloma formed accompanied with obvious firboplasia in silk and dacron groups, and the sutures in the artificial absorbable suture group were absorbed. Compared with 1 and 2 weeks postoperatively, the expression of TGF-β_1 was slightly decreased in silk and dacron groups at 4 weeks (P > 0.05), but the absorbable suture group significantly decreased (P < 0.05).CONCLUSION: Of three kinds of suture materials, artificial absorbable suture exhibited good histocompatibility, effectively reducing inflammatory reaction and benefiting the prevention and lightening of formation of pathological scar after tracheal surgery.
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Objective: To observe the effects of electroacupuncture on withdrawal anxiety in heroin-dependent patients. Methods: Sixty heroin-withdrawal subjects with negative urine morphine were digitally randomized into two groups: acupuncture group in which 30 cases were treated by electroacupuncture and control group in which 30 cases were given no treatment. The patients were assessed by Hamilton anxiety scale before treatment and one week, two weeks and three weeks after treatment. Results: After treatment, the anxiety symptoms of heroin-dependent patients were improved more significantly in the acupuncture group than in the control group (P<0.01). Conclusion: Electroacupuncture has good effects on anxiety symptoms and emotions of heroin-dependent patients.