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Objective To investigate the effect of aquatic treadmill training on walking function in stroke patients.Methods From July, 2015 to October, 2017, 33 patients with cerebral infarction were randomly divided into control group (n = 16) and treatment group (n = 17).The control group accepted routine water exercise, while the treatment group accepted aquatic treadmill training in addition, for six weeks. They were assessed with Berg Balance Scale (BBS), Timed Up and Go Test (TUG), 2 Minute Walk Test (2MWT) and gait analysis before and after six weeks of treatment.Results All the indexes improved in both groups after treatment (t＞ 2.536, P ＜ 0.05), and the performance of BBS, TUG, 2 MWT, and gait analysis indexes of length, speed and width of steps improved more in the treatment group than in the control group (t＞ 2.057, P ＜ 0.05). The incidence of improvement was more in in the treatment group than in the control group (χ2= 33, P ＜ 0.001) Conclusion Aquatic treadmill training can improve the walking function for stroke patients.
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Objective To investigate the relationship of wall motion abnormality and myocardium viability with chronic total occlusion (CTO) lesions by cardiac magnetic resonance (CMR) imaging. Methods We identified 128 patients with CTO lesion of at least one coronary artery confirmed by coronary arteriography at Beijing Anzhen Hospital between December 2014 to November 2017. All of the patients received CMR examination after admission. We analyzed the CMR images according to the AHA/American College of Cardiology 17-segment model, and recorded the left ventricular ejection fraction (LVEF), end-systolic volume (ESV) and end-distolic volume (EDV) calculated by CMR. Results In the myocardium regions corresponding to the 149 CTO lesions, only 11.5％ presented transmural myocardial infarction. A 58.6％ of the myocardial segments showed no delayed enhancement. Patients with delayed enhancement degree over 75％ had the lowest LVEF and the largest EDV and ESV. Conclusion CMR showed that patients with CTO lesions had different degrees of myocardial infarction. Patients with transmural myocardial infarction had significant cardiac function decline and ventricular remodeling. Only a fraction of patients had transmural infarction, suggesting that a majority of the CTO patients would benefit from treatment.
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<p><b>BACKGROUND</b>Matrix metalloproteinase (MMP)-2 plays an important role in the remodeling of left ventricles (LVs) and right ventricles (RVs). We investigated the differences of MMP-2 expression between LV and RV in response to nandrolone decanoate (ND), swimming training (ST), and combined ND and ST (NS) in mice, based on their structural, functional, and biochemical characteristics.</p><p><b>METHODS</b>Totally 28 male C57B1 mice (6 weeks old; 20-23 g) were divided into four groups, including the control (n = 7), ND (n = 6), ST (n = 8), and NS (n = 7) groups. After respective treatments for 8 weeks, echocardiographic examination was used to assess the cardiac structure and function. Van Gieson stain was used to examine the fibrosis of LV and RV in response to different treatments, and Western blotting analysis was performed to explore different MMP-2 expressions between LV and RV in response to ND and/or ST. Analysis of variance was used for comparing the four groups.</p><p><b>RESULTS</b>At 8 weeks, right ventricular dimension/body weight in the ND group was larger than the other three groups (F = 7.12, P < 0.05) according to the echocardiographic examination. Fibrosis induced by ND administration was increased more in RV (2.59%) than that in LV (2.21%). MMP-2 expression of the ND group in RV was significantly greater than the control and NS groups in RV and the corresponding ND group in LV.</p><p><b>CONCLUSION</b>The experimental data support the hypothesis that ND administration induces greater MMP-2 expression increase in RV compared to LV, leading to consequent RV dilation.</p>
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Objective:To explore risk factors for high risk ventricular arrhythmias (HRVA)after emergency percuta-neous coronary intervention (PCI)in patients with ST elevation acute myocardial infarction (STEMI).Methods:The clinical data of 176 STEMI patients undergoing PCI were retrospectively analyzed.According to presence or not of HRVA after PCI,they were divided into HRVA group (n=34)and no HRVA group (n=142).Single factor and multifactor Logistic regression analysis were used to analyze risk factors for HRVA.Results:Compared with no HRVA group,there were significant rise in levels of serum creatinine [SCr,(86.43±21.26)mmol/L vs.(96.67± 20.85)mmol/L],glycosylated hemoglobin A1 [HbA1c,(6.13 ± 1.53)% vs.(6.75 ±0.74)%],white blood cell count [(10.09±3.34)109/L vs.(11.73±3.42)109/L]and percentage of Killip class VI (2.94% vs.14.7%),and significant reduction in level of low density lipoprotein cholesterol [(3.16±0.92)mmol/L vs.(2.75±0.87)mmol/L]in HRVA group,P <0.05 or <0.01;multifactor Logistic regression analysis indicated that HbA1c,white blood cell count,cardiac function Killip class and SCr were independent risk factors for HRVA after PCI in STEMI pa-tients (OR=4.012~7.145,P <0.05 or <0.01).Conclusion:Glycosylated hemoglobin A1,white blood cell count, cardiac function grading and creatinine are closely correlated with occurrence of HRVA after emergency PCI in STEMI patients.Timely treatment can reduce occurrence of HRVA.
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Objective:To explore risk factors for high risk ventricular arrhythmias (HRVA)after emergency percuta-neous coronary intervention (PCI)in patients with ST elevation acute myocardial infarction (STEMI).Methods:The clinical data of 176 STEMI patients undergoing PCI were retrospectively analyzed.According to presence or not of HRVA after PCI,they were divided into HRVA group (n=34)and no HRVA group (n=142).Single factor and multifactor Logistic regression analysis were used to analyze risk factors for HRVA.Results:Compared with no HRVA group,there were significant rise in levels of serum creatinine [SCr,(86.43±21.26)mmol/L vs.(96.67± 20.85)mmol/L],glycosylated hemoglobin A1 [HbA1c,(6.13 ± 1.53)% vs.(6.75 ±0.74)%],white blood cell count [(10.09±3.34)109/L vs.(11.73±3.42)109/L]and percentage of Killip class VI (2.94% vs.14.7%),and significant reduction in level of low density lipoprotein cholesterol [(3.16±0.92)mmol/L vs.(2.75±0.87)mmol/L]in HRVA group,P <0.05 or <0.01;multifactor Logistic regression analysis indicated that HbA1c,white blood cell count,cardiac function Killip class and SCr were independent risk factors for HRVA after PCI in STEMI pa-tients (OR=4.012~7.145,P <0.05 or <0.01).Conclusion:Glycosylated hemoglobin A1,white blood cell count, cardiac function grading and creatinine are closely correlated with occurrence of HRVA after emergency PCI in STEMI patients.Timely treatment can reduce occurrence of HRVA.
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<p><b>OBJECTIVE</b>To observe the effect of core strength training on knee joint function and postural stability after anterior cruciate ligament reconstruction (ACLR).</p><p><b>METHODS</b>A total of 80 ACLR patients were randomly allocated into conventional rehabilitation training group and core strength training group from May 2013 to May 2015 with 40 patients in each group. The patients in conventional rehabilitation training group underwent conventional ACLR rehabilitation training, in which 28 males and 12 females. The mean age was(30.5±5.2) years old(ranged, 22 to 42 years old). The mean BMI was(23.8±2.4) kg/m²(ranged, 18.2 to 25.9 kg/m²). Thirty patients had injuries on the dominant side and 10 patients had injuries on the non-dominant side. The core strength training group received conventional ACLR rehabilitation training and core strength training, in which 31 males and 9 females. The mean age was(31.1±4.8) years old(ranged, 21 to 45 years old). The mean BMI was(24.1±2.7) kg/m²(ranged, 18.5 to 26.1 kg/m²) . Twenty-seven patients had injuries on the dominant side and 13 patients had injuries on the non-dominant side. The Lysholm score, tibial anterior transition measured by KT-1000 before and after treatment, and the Star Excursion Balance Test results after treatment were compared between the two groups.</p><p><b>RESULTS</b>Six months after rehabilitation training, the tibial anterior transition of the conventional rehabilitation training group and the core strength training group were(3.4±1.0) mm and(3.3±1.2) mm respectively, which were less than(12.1±1.8) mm and(12.5±2.0) mm before treatment. But there was no significant difference in anterior tibial translation between two groups(>0.05). The Lysholm score of the conventional rehabilitation training group and the core strength training group were 91.8±4.3 and 92.1±3.9 individually, which were higher than 69.2±5.8 and 70.2±5.1 before treatment. But there was no significant difference in Lysholm score between two groups(>0.05). Six months after rehabilitation training, the results of Star Excursion Balance Test showed the reach distance with the support in the injured side and healthy side in the core strength training group were greater than that of the conventional rehabilitation training group in the eight directions(<0.05).</p><p><b>CONCLUSIONS</b>The core strength training could improve the dynamic balance of ACLR patients.</p>
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<p><b>BACKGROUND</b>Vein graft failure (VGF) is a serious complication of coronary artery bypass graft, although the mechanism remains unclear. The study aimed to investigate the effects of microRNAs (miRNAs) on the endothelial dysfunction involved in VGF.</p><p><b>METHODS</b>Human umbilical vein endothelial cells (HUVECs) were subjected to mechanical stretch stimulation to induce endothelial dysfunction. Genome-wide transcriptome profiling was performed using the Human miRNA OneArray® V4 (PhalanxBio Inc., San Diego, USA). The miRNA-messenger RNA (mRNA) network was investigated using gene ontology and Kyoto Encyclopedia of Genes and Genomes. The miR-551b-5p mimic and inhibitor were applied to regulate miR-551b-5p expression in the HUVECs. The 5-ethynyl-2'-deoxyuridine assay, polymerase chain reaction (PCR), and Western blotting (WB) were used to assess HUVECs proliferation, mRNA expression, and protein expression, respectively. The vein graft model was established in early growth response (Egr)-1 knockout (KO) mice and wide-type (WT) C57BL/6J mice for pathological and immunohistochemical analysis. Endothelial cells isolated from the veins of WT and Egr-1 KO mice were subjected to mechanical stretch stimulation; PCR and WB were conducted to confirm the regulatory effect of Egr-1 on Intercellular adhesion molecule (Icam-1). One-way analysis of variance and independent t-test were performed for data analysis.</p><p><b>RESULTS</b>Thirty-eight miRNAs were differentially expressed in HUVECs after mechanical stretch stimulation. The bioinformatics analysis revealed that Egr-1 might be involved in VGF and was a potential target gene of miR-551b-5p. The mechanical stretch stimulation increased miR-551b-5p expression by 2.93 ± 0.08 fold (t = 3.07, P < 0.05), compared with the normal HUVECs. Transfection with the miR-551b-5p mimic or inhibitor increased expression of miR-551b-5p by 793.1 ± 171.6 fold (t = 13.84, P < 0.001) or decreased by 26.3% ± 2.4% (t = 26.39, P < 0.05) in the HUVECs, respectively. HUVECs proliferation and EGR-1 mRNA expression were significantly suppressed by inhibiting miR-551b-5p expression (P < 0.05). The lumens of the vein grafts in the Egr-1 KO mice were wider than that in the WT mice. Icam-1 expression was suppressed significantly in the Egr-1 KO vein grafts (P < 0.05).</p><p><b>CONCLUSIONS</b>Increased miR-551b-5p expression leads to endothelial dysfunction by upregulating Egr-1 expression. EGR-1 KO can improve the function of a grafted vein through suppressing Icam-1.</p>
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<p><b>OBJECTIVE</b>To evaluate the safety, effectiveness, and outcomes of holmium laser enucleation of the prostate (HoLEP) for patients with symptomatic enlarged prostate after 11 years of experience.</p><p><b>METHODS</b>The 3162 evaluable patients treated with holmium laser enucleation of the prostate at our institution between August 2001 and August 2011 were retrospectively analyzed. Study variables included International Prostate Symptom Score, quality of life, maximum urinary flow rate, and incidence of complications.</p><p><b>RESULTS</b>HoLEP were performed successfully completed, not patients which occurs as electric cutting syndrome. The operation time was (60.8 ± 18.4) minutes; average resection of prostate quality was (45.4 ± 24.4) g. The hemoglobin reduce though surgery was (1.81 ± 0.93) g/L; percentage of red blood cell change was 1.24% ± 0.43%, and sodium blood drop was (1.14 ± 0.35) mmol/L. Postoperative patients of hospital stay (3.1 ± 1.1) days, average time of indwelling catheter time was (2.3 ± 0.8) days. Patients were followed up for 6-131 months time, an average of 32.4 months. Postoperative patients with international prostate symptom score progressive declined. The quality of life score was 2.2 ± 1.7, and it less than preoperative (5.7 ± 3.3, t = 2.447, P < 0.01). The time of follow-up droped further, and postoperative comparative differences have statistical significance (t = 2.179, 2.228, 2.306 and 2.365, P < 0.05). The maximum urinary flow rate also improved (P < 0.05). Postoperative complications included bladder neck contracture (4 cases), urinary tract infection (107 cases), urethral stricture (11 cases) and urinary incontinence (11 cases). The 11 patients reoperation.</p><p><b>CONCLUSIONS</b>HoLEP treatment of benign prostatic hyperplasia could achieve the advantages of open surgery the same effect. It had fewer damage, faster recovery, fewer complications, and is a good treatment option.</p>
Subject(s)
Adult , Aged , Aged, 80 and over , Humans , Male , Middle Aged , Lasers, Solid-State , Prostatic Hyperplasia , General Surgery , Retrospective Studies , Transurethral Resection of Prostate , Treatment OutcomeABSTRACT
<p><b>OBJECTIVE</b>To study the anatomy of veins of the lower lumbar spine and provide the anatomic basement for laparoscopic lumbar surgery.</p><p><b>METHODS</b>A total of 15 formaldehyde-preserved cadavers were studied with special attention to the variety and surrounding structure of ascending lumbar vein (ALV) and iliolumbar veins (ILV), and their relationship with lumbar plexus.</p><p><b>RESULTS</b>ALV and ILV can be found on every sides, which have four variants including separate entry and common entry. The ascending vein and iliolumbar vein separately enter common iliac vein in 18 cases, and as a common stem enter the common iliac vein in 12 cases. Retracting common iliac vein medially both the ascending lumbar and the iliolumbar veins are always at risk of avulsion on exposure of the disc space. The injury of obturator nerve and lumbosacral trunk of lumbar plexus should be avoided.</p><p><b>CONCLUSION</b>Awareness of these anatomic variation can prevent the hemorrhage and be helpful for the surgeon in performing a careful ligation of these veins before medial retraction of the common iliac vein. Our findings emphasize the need for proper dissection of ALV and ILV before ligature during exposure of the lower lumbar spine.</p>
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Female , Humans , Male , Cadaver , Endoscopy , Lumbar Vertebrae , Lumbosacral Region , General Surgery , Retroperitoneal Space , VeinsABSTRACT
<p><b>OBJECTIVE</b>To provide anatomic data for reducing lumbar plexus nerve injury.</p><p><b>METHODS</b>The applied anatomy of lumbar plexus was studied by 15 formaldehyde-preserved cadavers, two groups of sectional images of lumbar segment and three series of virtual chinese human dataset.</p><p><b>RESULTS</b>Arrangement of the lumbar nerve was regular. From anterior view, lumbar plexus nerve arranged from lateral to medial from L2 to L5; from lateral view, lumbar nerve arrange from ventral to dorsal from L2 to L5. The angle degree between the lumbar nerve and lumbar increased from L1 to L5. The lumbar plexus nerve was revealed to be in close contact with transverse process. By sectional anatomy, all parts of the lumbar plexus nerve were located in the dorsal third of the psoas major. The safety zone of the psoas major to prevent nerve injuries was ventrally 2/3.</p><p><b>CONCLUSIONS</b>Psoas major can be considered as surgery landmark when expose the lateral anterior of lumbar by incising the psoas muscle. Incising the psoas muscle ventral 2/3 can prevent lumbar plexus injury. Transverse process can be considered as landmark for the position of lumbar plexus in operation.</p>
Subject(s)
Female , Humans , Male , Lumbar Vertebrae , General Surgery , Lumbosacral Plexus , Lumbosacral Region , Minimally Invasive Surgical ProceduresABSTRACT
<p><b>OBJECTIVE</b>To investigate the biomechanical effect of different volume, distribution and leakage to adjacent disc of bone cement on the adjacent vertebral body by three-dimensional osteoporosis finite element model of lumbar.</p><p><b>METHODS</b>L(4)-L(5) motion segment data of the cadaver of an old man who had no abnormal findings on roentgenograms were obtained from computed tomography (CT) scans. Three-dimensional model of L(4)-L(5) was established with Mimics software, and finite element model of L(4)-L(5) functional spinal unit (FSU) was established by Ansys 7.0 software. The effect of different loading conditions and distribution of bone cement after vertebroplasty on the adjacent vertebral body was investigated.</p><p><b>RESULTS</b>This study presented a validated finite element model of L(4)-L(5) FSU with a simulated vertebroplasty augmentation to predict stresses and strains of adjacent untreated vertebral bodies. The findings from this FSU study suggested the endplate and disc stress of the adjacent vertebral body was not influenced by filling volume of bone cement but unipedicle injection and leakage to the disc of bone cement could concentrate the stress of adjacent endplate.</p><p><b>CONCLUSIONS</b>Asymmetric distributions and leakage of cement into intervertebral disc can improve the stress of endplate in adjacent vertebral body. These results suggest that optimal biomechanical configuration should have symmetric placement and avoid leakage of cement in operation.</p>