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Objective:To investigate the effects of Xueshuan Xinmaining tablet combined with metoprolol on creatine kinase-MB and troponin in patients with coronary heart disease after percutaneous coronary intervention. Methods:A total of 104 patients with coronary heart disease who received percutaneous coronary intervention in Zhoushan Hospital from March 2020 to March 2021 were included in this study. They were randomly divided into observation and control groups ( n = 52/group). The control group was give metoprolol (oral, 25 mg once,3 times/day). The observation group was given Xueshuan Xinmaining tablet (2 tablets once, 3 times per day) based on medication given in the control group. Two groups were treated for 1 month. Clinical efficacy, changes in vascular endothelial function and serum inflammatory factors post-treatment relative to those before treatment, and the incidence of adverse reactions were compared between the two groups. Results:Total response rate in the observation group was significantly higher than that in the control group [86.54% (45/52) vs. 67.31% (35/52), χ2 = 4.99, P < 0.05]. After treatment, nitric oxide in the observation group was significantly higher than that in the control group [(67.23 ± 9.52) μmol/L vs. (60.49 ± 9.71) μmol/L, t = 3.57, P < 0.001]. Endothelin in the observation group was significantly lower than that in the control group [(53.12 ± 7.28) ng/L vs. (61.25 ± 8.36) ng/L, t = 5.28, P < 0.001]. Tumor necrosis factor α, C-reactive protein and interleukin-6 in the observation group were (39.51 ± 6.37) μg/L, (4.13 ± 1.02) mg/L, and (19.43 ± 2.57) μg/L, respectively, which were significantly lower than (51.37 ± 7.28) μg/L, (5.62 ± 1.15) mg/L, (26.16 ± 3.19) μg/L in the control group ( t = 8.84, 6.99, 11.84, all P < 0.05). Creatine kinase-MB and troponin in the observation group were (30.18 ± 5.89) U/L and (7.32 ± 1.12) ng/L, respectively, which were significantly lower than (41.74 ± 6.76) U/L and (9.63 ± 1.45) ng/L in the control group, respectively ( t = 9.29, 9.09, both P < 0.05). No serious adverse reactions occurred during the treatment period in each group. Conclusion:Xueshuan Xinmaining tablet combined with metoprolol exhibit remarkable therapeutic effects on patients with coronary heart disease subjected to percutaneous coronary intervention. The combined therapy can greatly reduce inflammatory reaction and decrease creatine kinase-MB level and improve vascular endothelial function.
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Objective@#To investigate the clinical value of independently-designed three-demensional printed navigation templates for hepatectomy in hepatic surgical oncology.@*Methods@#A retrospective study was conducted on 45 patients (including 36 males and 9 females, aged from 40 to 70 years) with hepatocelluar carcinoma treated by hepatoctomy from Department of Hepatobiliary and Intestinal Surgery of Hunan Cancer Hospital from June 2016 to June 2018. These patients were divided into observation group (patients conducted with the 3D navigation-template-aided operation, n=25) and control group (patients conducted with regular operation, n=20) according to operation approach. Virtual liver resection volume and actual liver resection volume were calculated in the observation group, and the correlationship between the volume of virtual liver resection and actual liver resection was analyzed by Pearson correlation analysis. The operative time, intraoperative blood loss, intraoperative intrahepatic duct injury and postoperative hospital stay were compared between the two groups.@*Results@#In the observation group, 3D modeling was successfully completed and intrahepatic and extrahepatic duct reconstruction was successful, surgical simulation. There were no statistically significant difference between the virtual and actual resected liver volume in the observation group (P>0.05). The virtual resected liver volume was positively correlated with the actual resected liver volume (r=0.991, P<0.05). Volume of intraoperative blood loss in the observation group was lower than that in the control group [(245.1±22.3) ml vs. (308.6±19.9) ml], and the length of hospital stay was shorter than that in the control group [(7.4±0.2) d vs. (8.6±0.4) d], the difference was statistically significant (P<0.05). There was no accidental injury of intrahepatic duct in the observation group, 1 case of accidental injury of middle hepatic vein and 1 case of accidental injury of secondary branch of right hepatic vein in the control group. The AST of the observation group was significantly reduced compared with that of the control group on the 4 th and 7th days after the operation, and the difference was statistically significant (P<0.05).@*Conclusions@#3D reconstruction of liver based on high quality MR images, can facilitate restoring the adjoint relationship between hepatic duct system and liver tumor. 3D printed navigation templates effectively guide certain kinds of hepatectomy, ensure that the cutting edge at the same time protect the rest of the liver tissue, reduce bleeding and accidental damage, realize accurate tumor resection.
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Objective To investigate the clinical value of independently-designed three-demensional printed navigation templates for hepatectomy in hepatic surgical oncology.Methods A retrospective study was conducted on 45 patients (including 36 males and 9 females,aged from 40 to 70 years) with hepatocelluar carcinoma treated by hepatoctomy from Department of Hepatobiliary and Intestinal Surgery of Hunan Cancer Hospital from June 2016 to June 2018.These patients were divided into observation group (patients conducted with the 3D navigation-template-aided operation,n =25) and control group (patients conducted with regular operation,n =20) according to operation approach.Virtual liver resection volume and actual liver resection volume were calculated in the observation group,and the correlationship between the volume of virtual liver resection and actual liver resection was analyzed by Pearson correlation analysis.The operative time,intraoperative blood loss,intraoperative intrahepatic duct injury and postoperative hospital stay were compared between the two groups.Results In the observation group,3D modeling was successfully completed and intrahepatic and extrahepatic duct reconstruction was successful,surgical simulation.There were no statistically significant difference between the virtual and actual resected liver volume in the observation group (P ＞ 0.05).The virtual resected liver volume was positively correlated with the actual resected liver volume (r =0.991,P ＜ 0.05).Volume of intraoperative blood loss in the observation group was lower than that in the control group [(245.1 ±22.3) ml vs.(308.6 ± 19.9) ml],and the length of hospital stay was shorter than that in the control group [(7.4 ±0.2) d vs.(8.6 ±0.4) d],the difference was statistically significant (P ＜ 0.05).There was no accidental injury of intrahepatic duct in the observation group,1 case of accidental injury of middle hepatic vein and 1 case of accidental injury of secondary branch of right hepatic vein in the control group.The AST of the observation group was significantly reduced compared with that of the control group on the 4 th and 7th days after the operation,and the difference was statistically significant (P ＜ 0.05).Conclusions 3D reconstruction of liver based on high quality MR images,can facilitate restoring the adjoint relationship between hepatic duct system and liver tumor.3D printed navigation templates effectively guide certain kinds of hepatectomy,ensure that the cutting edge at the same time protect the rest of the liver tissue,reduce bleeding and accidental damage,realize accurate tumor resection.
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Objective@#To analyze the prevalence of severe fever with thrombocytopenia syndrome virus(SFTSV)infection in Zhoushan island of Zhejiang province and the duration of serum positive IgG antibody in patients infected with SFTSV.@*Methods@#One thousand one hundred and twenty-two healthy people from Zhoushan island of Zhejiang province were recruited for cross-sectional study in August 2019, including 641 from non-epidemic areas and 481 from epidemic areas. The serum SFTSV-IgG antibody was detected by enzyme-linked immunosorbent assay (ELISA), and the positive rates of SFTSV-IgG antibody were compared between people from the epidemic areas and non epidemic areas. Meanwhile, the antibody titer of SFTSV-IgG in 19 patients confirmed between July 2011 and June 2018 was detected by indirect ELISA. SPSS 17.0 software was used to analyze data.@*Results@#The positive rate of SFTSV-IgG antibody was 1.5% (7/481) in the epidemic area, which was higher than that in the non-epidemic area (0/641) (χ2=7.187, P<0.01). The positive rates of SFTSV-IgG antibody in 2019 were lower than those in the epidemic area (11.7%) and non-epidemic area (2.5%) in 2013 (χ2=22.556 and 10.352, both P<0.01). The serum SFTSV-IgG antibody of 18 patients with previous infection was still positive, and the longest one lasted for 8 years.@*Conclusions@#There is a SFTSV latent infection in population from epidemic area of Zhoushan island. The SFTSV-IgG antibody can last for a long time in patients with SFTS and it may have certain protective effect.
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Objective:To establish the preoperative three dimensional (3D) model of liver cancer,and to precisely match the preoperative planning with the target organs during the operation.Methods:The 3D model reconstruction based on magnetic resonance data,which was combined with virtual reality technology via HoloLens glasses,was applied in the operation of liver cancer to achieve preoperative 3D modeling and surgical planning,and to directly match it with the operative target organs during operation.Results:The 3D model reconstruction of liver cancer based on magnetic resonance data was completed.The exact match with the target organ was performed during the operation via HoloLens glasses leaded by the 3D model.Conclusion:Magnetic resonance data can be used for the 3D model reconstruction to improve preoperative assessment and accurate match during the operation.
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Objective To investigate the approaches for diagnosis and treatment of intrahepatic cholangiocarcinoma(ICC)and asgess its prognosis factors.Methods The clinical data of 86 patients with ICC in our hospital from January 1995 to December2005 were retrospeetively analyzed.All patients were divided into two groups according to the treatment method,including hepatectomy and lymphatic clearance group(Group A,n=42)and hepateetomy group(Group B,n=44),and their clinicopathological variables were analyzed.Resuits The 1-,3-and 5-year survival rates were 77.81%and 35.21%,20.93%and 19.82%,2.31%and 0%respectively between group A and group B.There was significantly difference between these two groups(P＜0.01).The analysis showed that resection and lymphatic clearance were correlated to prognosis.The 1-,3-and 5-year survival rates were 59.21%,26.21%,and 20.11% respectively in 47 patients who were found no lymph node metastasis,and the 1-,3-and 5-year survival rates were 19.82%,2.31%and 0% respectively in 39 patients who were found lymph node metastasis.There was significantly difference in survival rate between group A and group B(P＜0.01).Condusions Reseetability and lymphatic clearance are two significant factors correlated to survival of the patients with ICC.Aggresgive treatment of lymph node metastasis in hepatoduodenal ligament is an important strategy to improve survival rates and strengthen patient's life quality.
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Objective To evaluate the blond-saving effect of low central venous pressure(CVP) combined with acute hypervolemic hemedilution(AHHD)in patients undergoing hepatic lobectomy.Methods sixty ASA I orⅡpatients of both sexes aged 32-48 yr weighing 47-72 kg undergoing hepatic lobectomy for primary malignant hepatonm under epidural combined with general anesthesia were randomly divided into 3 groups(n=20 each);group I control(C);group 1I AHHD and group Ⅲ low CVP+AHHD.Group C received crystalloid and coloid in a ratio of 1.5:1 during operation.In groupⅡ4% suecinylated gelatin was infused at 50 ml·kg-1·h-1 for 30 min after tracheal intubation (AHHD);while inⅢ group low CVP was induced and maintained by epidural administration of a mixture of 1.5% lidnoaine +O.2% bupivacaine 6-8 ml combined with intravenous infmion of propofol at 6 mg·kg-1·h-1 until 10 min after hepatic lobectomy was completed.then 4% succinylated gelatin was infused at 50 ml·kg-1·h-1 for 30 min.Blood glucose,Hb,Hct, WBC count,blood coagulation (PT,AVIT,Fib),shtmic-pyruvic transaminase (GPT) and renal function (BUN,Cr) were determined before operation (baseline),immediately before skin incision,immediately before and 10 min after liver lobe was removed,at the end of operation and 7 d after operation.Urine output,intraoperative blood loss and blood transfusion and complications were recorded.Results The glood glucose concentration.WBC count and GPT levd were significantly lower;the amount of fluid infused and urinary output before hepatic lobe resection and the percentage of the patients with allogeneic blood transfusion during operation were less;Hb,Hct and the amounl of fluid infused and urinary output after hepatic lobe resection were uigher in grolp Ⅲ than in group I and ⅡⅡⅡ.There were no significant differences in blood coagulation,renal function,the total amount of fluid infused and urine output among the 3 groups.No patient developed any complication.Conclusion The low CVP hefor combined with AHHD after hepatic resection can decrease intraoperative blood loss and allogeneic blood transfusior and is safe.
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Objective To investigate the feasibility and significance of the re-operation for patients with recurrent primary liver cancer.Methods The clinical data of 58 patients with post-operative recurrence after initial operation for primary liver cancer in our hospital from January 2003 to December 2008 were analyzed.They were divided into re-operation group and the other treatment group,and the 1-and 3-year survival rates were compared.Results The 23 cases of re-operation group were all treated by local radical resection plus hepatic arterial chemotherapy pump implantation,and postoperative chemotherapy was given via hepatic artery chemoembolization pump line.The 35 patients of the other treatment group underwent radiofrequency ablation plus transcatheter hepatic arterial chemoembolization via femoral artery.The 1-and 3-year survival rates in re-operation group was 100% and 82.6% respectively,which was significantly higher than that of the other treatment group(82.9% and 45.7% respectively).Conclusions Re-operation is the treatment of choice for patients with tumor recrrrencr after radical resection of primary liver cancer,provided that the conditions are suitable and the timing of operation is appropriate.
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Objective To study the diagnosis and radical resection of hilar cholangiocarcinoma. Methods Retrospective analysis was made on the clinical feature and the effect of radical resection on 38 cases of hilar cholangiocarcinomas.Results Diagnosis was made in all of the patients preoperatively.The radical resection was perfomed on 38 patients.Of them, 3(7.9%) died after operation.After operation, 5 cases (13.2%) developed bile leakage,and 2 of the 5 cases developed subphrenic abscess,which were cured by drainage; 4(10.5%) had right hydrothorax that was cured by conservative therapy; and 3(7.9%)had incision split that was cured by resuture. Among the 35 postoperative survivors,34 (97.1%) were followed up, the 1- and 3-year survival rates were 91.9% and 35.2%.None of the patients survived for 5 years. Conclusions It′s still difficult to make early diagnosis in hilar cholangiocarcinoma.The diagnosis mainly depends on the combination of imaging examinations. Nowadays the radical resection rate of hilar cholangiocarunoma is still low, the recurrence and metastasis are common after operation, and few patients can survive for a long time. It suggests that even in radical operation for hilar cholangiocarcinoma, the regions of resection and sweep are not enough,and the operative procedure needs to improve further.
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Objective To evaluate the diagnosis and surgical treatment of hilar cholangiocarcinoma(H-CC). Methods Retrospective analysis was made on the clinical feature, surgical treatment and the effect on 73 patients with H-CC. Results Diagnosis was made in all of the patients preoperatively and the correct diagnostic rate of BUS was 69.9%. In the treatment, radical resection was performed on 15 patients with good results in a short-term period. Of the 43 patients who underwent biliary tract internal drainage or exterrnal drainage, 37 patients had good results in a short-term period, while 6 died after operation. Laparotomy or hepatic artery cannulization with chemotherapy was performed on 15 patients and no change occurred in a short-term period after operation. In 15 cases subjected to radical resection, 11 cases were followed up. The 1,3-year survival rates was 90.9%, 20.0% respectively, but none of the patients survived for over 5 years. In patients undergoing other operations, none survived more than 9 months. Conclusions It's still difficult to mak early diagnosis of H-CC, which mainly depends on imaging technics. The BUS should be choiced first. Radical resection rate is still low nowadays. The lobus quadratus resection is helpful to select the operation.
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Objective To assess the clinical significance of the expression of p53, p21 protein in breast cancer (BC). Method The expression levels of p53, p21 proteins were examined by immunohistochemical (IHC) SP techniques in 69 BC specimen and 20 paracancinoma breast tissue. Result p53 and p21 proteins were failed to be observed in the paracancer tissue. p53 protein was found in 47.8% of BC, while p21 protein in 43.5% of BC. Along with the declined of BC cell differentiation degree, p53 expression increased significantly and p21 expression declined obviously. Expression of p21 was lower in patients with lymph node metastasis than that in patients without lymph node metastasis (P
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Objective To investigate the effect of surgical treatment and the influence factors of treatment effect in patieats with hepatocellular carcinoma (HCC). Methods The clinical materials of 408 cases of HCC who underwent surgical intervention in recent 8 years were retrospectively analyzed. Results The 408 patients accounted for 43.9% of patients with HCC admitted during the same time. Of the 408 patients, large HCC accounted for 81.9% of patients, 8.5% of cases complicated by portal vein thrombus (PVT) ,and 4.8% of cases complicated by bile duct thrombus (BDT). In this series, 118 cases received left external lobectomy, 97 cases received left hemihepatectomy, 112 cases received right hemihepatectomy, 73 cases received right segmentectomy , 8 cases received left and righ segmentectomy ,35 cases received hepatectomy combining with removal of PVT , 20 cases received hepatectomy combined with thrombectomy of BDT; 48 cases received hepatectomy combined with implanment of drug delivery system (DDS) (35 patients with portal vein thrombus received DDS through portal vein). Three hundred and two cases had postoperative complications, including subdiaphragm abscesses,lung infection. upper digestive tract bleeding,pleural effusion ,ascites,wound spliting etc. Mortalily was 2.7%; cancer residual rate was 18.4%;postoperative recurrence and/or metastasis was 73.0%.The 1,3and 5-year survival rate was 73.9%,51.3%, 35.5 % respectively. Conclusions This results show that most of the patients with HCC received surgical operation treatment are in advanced stage, postoperative recurrence and/or metastasis are the main influence factors of treatment effect.
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In this experiment, the acute hemorragic necrotic pancretitis(AHNP) animal was pretreated by abdominal cavity injection of recombinant human tumor necrosis factor (rhTNF) or by selective decontamination of digestive tract (SDD) with the use of tybrarmycine, amphotericinum Band polymyxine B orally plus a small dose of polymyxine B by hypodermic injection. The results showed that using exogenous TNF to treat AHNP can reduce mortality of AHNP rats. The mechanism may be that exogenous TNF can induce the tolerance of the host organ(s) to endogenous TNF. SDD plus a small dose of polymyxine B by hypodermic injection can suppress G baeteria grouth and reduce the production of endotoxin in the gut ; and polymyxine B can directly antagonize to the endotoxin of blood, reducing blood endotoxin and TNF level. The results suggest that SDD can be used to treat AHNP.