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Objective:To compare the surgical efficacy of pericardial soft ring tricuspid valvuloplasty with DeVega and artificial valvuloplasty.Methods:227 patients undergoing tricuspid valvuloplasty due to rheumatic heart disease complicated with functional tricuspid valve insufficiency were retrospectively analyzed and divided into 3 groups according to tricuspid valvuloplasty dynamic cohort(pericardial ring group, 89 cases; the artificial flap ring group, 61 cases, and the DeVega group, 77 cases) were matched 1∶1 for propensity score(match A: pericardial ring group and artificial flap ring group; match B: pericardial ring group and DeVega group), the successful matching was included in follow-up and data collection, and cases with incomplete case data during follow-up were removed from the study cohort in pairs according to matching conditions. The results of follow-up 1 month, 6 months and 24 months after surgery were compared.Results:1 month after operation: the tricuspid valve regurgitant in all groups was significantly reduced or even disappeared compared with that before operation, and the right atrium and right ventricle were also smaller than that before operation, with statistical significance( P<0.05). 6 months after surgery: There was no statistical significance in the area of tricuspid regurgitation and right atrial/indoor diameter between all groups compared with the results one month after surgery( P>0.05), and there was no statistical significance in the recurrence rate of tricuspid regurgitation between all groups( P>0.05). 24 months after surgery: There were no significant differences in the recurrence rate of tricuspid regurgitation, area of tricuspid regurgitation and right atrial/indoor diameter between the two groups in matching A( P>0.05). There was no statistical significance in the right atrial/indoor diameter between the matched pericardial ring group and the Devega group, but the tricuspid valve regurgentation area of the Devega group at 24 months after surgery was higher than that of the Devega group at 1 month after surgery, and the difference was statistically significant( P<0.05). The regurgitation area and recurrence rate of tricuspid valve were significantly higher than those of pericardium-TVP group( P<0.05). Conclusion:Pericardial soft ring tricuspid valvuloplasty can effectively correct functional tricuspid valvuloplasty and reverse right heart remodeling, which is an effective tricuspid valvuloplasty.
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Objective To analyze the multimodal imaging findings of nonspecific granulomatous prostatitis (NSGP)and improve our understanding of the disease.Methods 1 427 patients underwent transrectal ultrasoundGguided prostate biopsies in our department,then 1 3 nodules in 11 patients were proven NSGP by pathology,of which 3 nodules were in inner gland and 10 were in outer gland.The characteristics of these nodules on MRI,transrectal ultrasound elastography (TRE)and contrastGenhanced ultrasonography (CEUS)were retrospectively analyzed. Results MRI:All of the nodules showed similar performances:hypointensity on T1 WI and T2 WI,low ADC and high signal on DWI (highGbGvalue),early enhancement and faded fast or slow,depressed citrate (Cit)and relatively elevated choline (Cho)peak.TRE:The cutGoff point of strain ratio (SR)was determined as 5.97 to diagnose prostate cancer and the SRs of 8 nodules were greater than 5.9 7.CEUS:1 1 nodules showed early enhancement and great intensity,but the rest of nodules showed same performance with normal tissue.Conclusion The multimodal imaging helps to improve the understanding of NSGP and plays a positive role in guiding targeted biopsy.Moreover,the operators could lessen the number of needle punctures properly according to the multimodal imaging findings, which would reduce the risk of puncture complications on patients.
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Objective To observe transrectal CEUS characteristics of granulomatous prostatitis (GP).Methods Ultrasonic data of 5 GP patients proved pathologically were analyzed retrospectively.The conventional ultrasound and the transrectal CEUS characteristics,as well as pathological results were observed.Results All the nodules of 5 patients were hypoechoic,locating at peripheral gland,among which 4 nodules were proved nonspecific granulomatous prostatitis (NSGP) showing great peak intensity and a short time to enhance,and 1 lesion manifesting no-enhancement area on CEUS was proved specific granulomatous prostatitis (SGP).Conclusion SGP and NSGP had no obvious specific performances on CEUS.
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"Shikuqin" [SKQ] powder consists of three Chinese herbs: Punica granatum L, Sophora flavescens Ait, and Fraxinus rhynchophylla Hance. SKQ has been used for the treatment of diarrhea. In order to provide a comprehensive understanding of toxicity, the acute and sub-chronic toxicity and safety pharmacology of SKQ were evaluated in the present study. The result of the acute toxicity revealed that the LD50 of the valve was 28,379mg/kg.b.w, which was more than 5,000 mg/kg b.w. The 30-day sub-chronic toxicity test results revealed that compared with the control group, the clinical signs, hematology parameters and body weight of rats in each group had no significant differences. The viscera coefficient and histopathological examination results revealed that the SKQ powder could cause kidney and liver damage. In the safety pharmacology test, SKQ did not exhibit any toxicity to the central nervous system, cardiovascular system and respiratory system. In conclusion, SKQ powder could be considered safe for veterinary use
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Objective To investigate the late effects induced by ionizing radiation and the rehabilitation treatment of local radiation injury by medical follow-up of the patient exposed to192 Ir at 5.7 accident in Nanjing,and to provide more experience for the treatments in the medical emergency of nuclear or radiological accident.Methods According to the history inquiry and physical examination of the patient in detail and the record of clinical symptoms and signs,the changes of the blood system,immune system,reproductive system,eyes,nervous system were systematically evaluated.The effects of rehabilitation treatment for the patient with lower limb dysfunction were also assessed.Results After the medical treatments of the patient,the hematopoietic immune system was restored,but the bone marrow aspiration still showed low bone marrow hyperplasia in right ilium.Meanwhile,the level of sex hormones was within the normal range,but semen examination showed sperm motility was 0.The radiation damage also occurred in the eye lens,retina and fundus.Howevcr,the psychological evaluation showed that the patient was stable and the right lower limb skin wound healing was well except for dysfunction and pain in some extent,which was relieved after the rehabilitation treatment.Conclusions The physiological function of the exposed victim with mild bone marrow type acute radiation sickness could be completely or partially restored after the clinical treatment in the early stage.
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Objective To investigate the effect of parents accompany comfort anesthesia technique on child anesthesia induction compliance.Methods Two hundreds and thirteen children cases undergoing elective operation under general anesthesia were selected,aged 2-12 years old,ASA grade Ⅰ-Ⅱ,developmental normal,without mental system and cognitive dysfunction,and randomly divided into the experimental group 1,2 and control group.The children cases in the experimental group 1 conducted the anesthesia induction by their parents accompany on the operation day,while those in the experimental 2 conducted the anesthesia induction on the operation day after conducting the comfort anesthesia technique guidance.The control group was performed the conventional follow up before operation,the anesthesia induction was performed by the operation nurses and anesthesia doctor accompany on the operation day.Results There were statistically significant differences between the cases of slightly large age,with surgical experience,parents non-anxiety and psychological internal control type with the control group(P<0.05).The difference between conducting the anesthesia induction guidance and non-conducting the anesthesia induction guidance was not statistically significant(P>0.05).Conclusion The parents accompany comfort anesthesia induction technique can effectively increase the compliance during the anesthesia induction period in the children patients with slightly large age,operation experience,parents non-anxiety and psychological internal control type.
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Objective To determine whether there is correlation between intracranial and extracranial arterial stenosis in patients with ischemic stroke,and to understand the difference of the main risk factors between them.Methods One hundred and sixty-eight patients with symptomatic ischemic stroke were selected in order to analyze the correlation and risk factors of intracranial arterial stenosis and extracranial arterial stenosis.Results In the 168 cases,123 patients(73.2%)were with abnormal artery(include intimal thickening)and 100 patients(59.5%)were diagnosed with artery stenosis,including 33 cases of intracranial artery stenosis,48 cases of extracranial artery stenosis and 19 cases of intracranial and extracranial stenosis.The rate of extracranial artery stenosis(39.9%)was higher than that of intracranial artery stenosis(31.0%),but there was no significant difference between them(χ2 =2.93,P=0.11).There was no definite correlation between them(χ2 =0.35,P=0.61)and there were statistically significant differences in age and arterial pressure between patients with intracranial and mean extracranial artery stenosis(t=1.98,P=0.05;t=5.42,P<0.001),but the gender,blood pressure,blood glucose and dyslipidemia rate showed no significant difference (χ2 =1.15,3.41,0.43,0.81,P>0.05).Conclusion Extracranial arterial stenosis may not predict the possibility of intracranial arterial stenosis,and extracranial arterial stenosis may be more likely to cause ischemic stroke.
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Objective To investigate the effect of parents accompany comfort anesthesia technique on child anesthesia induction compliance.Methods Two hundreds and thirteen children cases undergoing elective operation under general anesthesia were selected,aged 2-12 years old,ASA grade Ⅰ-Ⅱ,developmental normal,without mental system and cognitive dysfunction,and randomly divided into the experimental group 1,2 and control group.The children cases in the experimental group 1 conducted the anesthesia induction by their parents accompany on the operation day,while those in the experimental 2 conducted the anesthesia induction on the operation day after conducting the comfort anesthesia technique guidance.The control group was performed the conventional follow up before operation,the anesthesia induction was performed by the operation nurses and anesthesia doctor accompany on the operation day.Results There were statistically significant differences between the cases of slightly large age,with surgical experience,parents non-anxiety and psychological internal control type with the control group(P<0.05).The difference between conducting the anesthesia induction guidance and non-conducting the anesthesia induction guidance was not statistically significant(P>0.05).Conclusion The parents accompany comfort anesthesia induction technique can effectively increase the compliance during the anesthesia induction period in the children patients with slightly large age,operation experience,parents non-anxiety and psychological internal control type.
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Objective To determine whether there is correlation between intracranial and extracranial arterial stenosis in patients with ischemic stroke,and to understand the difference of the main risk factors between them.Methods One hundred and sixty-eight patients with symptomatic ischemic stroke were selected in order to analyze the correlation and risk factors of intracranial arterial stenosis and extracranial arterial stenosis.Results In the 168 cases,123 patients(73.2%)were with abnormal artery(include intimal thickening)and 100 patients(59.5%)were diagnosed with artery stenosis,including 33 cases of intracranial artery stenosis,48 cases of extracranial artery stenosis and 19 cases of intracranial and extracranial stenosis.The rate of extracranial artery stenosis(39.9%)was higher than that of intracranial artery stenosis(31.0%),but there was no significant difference between them(χ2 =2.93,P=0.11).There was no definite correlation between them(χ2 =0.35,P=0.61)and there were statistically significant differences in age and arterial pressure between patients with intracranial and mean extracranial artery stenosis(t=1.98,P=0.05;t=5.42,P<0.001),but the gender,blood pressure,blood glucose and dyslipidemia rate showed no significant difference (χ2 =1.15,3.41,0.43,0.81,P>0.05).Conclusion Extracranial arterial stenosis may not predict the possibility of intracranial arterial stenosis,and extracranial arterial stenosis may be more likely to cause ischemic stroke.
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Objective To investigate the clinical significance of thoracoscopy combined with beating-heart technique to provide a certain reference for selecting clinical operation mode.Methods Forty patients with chronic rheumatic mitral stenosis receiving thoracoscopic mitral valve replacement surgery in the cardiothoracic surgery department of our hospital from September 2012 to September 2015 were included in this study and divided into the experimental group(beating-heart group,20 cases) and control group(arrested heart group,20 cases).The operative time,CPB time,enzymology indicators,RI and operative complications were analyzed and compared between the two groups.Results One case in each group died of postoperative low cardiac output syndrome.Other cases successfully completed the operation without serious operative complications such as low cardiac output syndrome,serious cardiac arrhythmia and air embolism.Two groups had no statistically significant difference in the operation time and time of CPB (P>0.05),but the ICU staying duration had statistical difference between the two groups(P<0.05).The levels of CK-MB,cTnI,LDH,TNF-α,IL-6,IL-8 and RI were significantly increased in two groups(P<0.05),while the levels in the experimental group were significantly lower than those in the control group(P<0.05).Conclusion Thoracoscopic mitral valve replacement operation with beating-heart may have better protection effect on heart and lung than thoracoscopic arrested-heart mitral valve replacement operation.
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Liver failure is characterized by rapid progress and extremely high mortality.Glucocorticoids are currently used in the treatment of liver failure to improve the prognosis,but they have not been widely recognized.This paper reviews the advances on pathogenesis of liver failure,the timing,efficacy and adverse effects of glucocorticoids treatment,so as to increase clinician's knowledge of glucocorticoids in treatment of liver failure,in order to increase the awareness and rational administration of glucocorticoids in treatment of liver failure.
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Objective To find the safe vertical displacement for minimal infusion rate change of syringe pumps as the theoretical guidance for moving pumps. Methods The infusion volume within 1 minute after none and vertically moving 15, 25, 35, 50 cm of the pumps (microinfusion pump WZ-50C、WZ-50C2、BRAUN perfusor compact) at 10 ml/min were weighted and compared by the electronic balance. Results Significant differences of the infusion rate were detected. The difference of average infusion volume within 1 minute after vertically moving 15, 25, 35, 50 cm and non-movement were 0.004 (minimal),0.017, 0.033, 0.046ml. The lowest infusion curve of 15cm displacement stretches slightly above the horizontal plane until the inflexion in the section graph, leading to steeper in accordance with the increasing vertical displacement of the pumps,which implied the following drastic increase in infusion rate. Conclusions The minimal infusion change is obtained at 15cm, thus becomes the safe displacement height and the inflexion point of further soaring changes.