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Objective To evaluate the clinical outcome of transesophageal echocardiography(TEE) in guiding and monitoring min-invasive transthoracic hybrid procedure for intracristal ventricular septal defects (VSD) using eccentric occluders.Methods 13 patients with intacristal VSD successfully underwent the min-invasive hybrid procedure using eccentric occluders were analyzed retrospectively.They were all carefully examined by transthoracic echocardiography (TTE) preoperatively and were diagnosed as intracristal VSD.There were no obvious aortic valve prolapse and no severe regurgitation.The entire process was guided and monitored by TEE.The condition of VSD occlusion was assessed by immediate postoperative TEE.Results All cases were occluded successfully.The results of postoperative TEE showed that the occluder was coincided closely with the edge of VSD,no aortic valve regurgitation worsen.2 had tiny residual left-to-right shunt (＜1.5 mm),which disappeared 1 and 3 months respectively after operation.No occluder dislocated followed-up at 6 months to 2 years postoperatively,and no major complications occurred.Conclusions The min-invasive hybrid procedure for intracristal VSD using eccentric occluders guided and monitored by TEE is easy to manipulate,which is safe,less invasive,and has excellent early-term results.
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OBJECTIVE:To observe the therapeutic effect of combined use of capreomycin in treating multiple-drug-resistant tuberculosis.METHODS:After 268 patients with multiple-drug-resistant tuberculosis had underwent intensive treatment with levofloxacin,pyrazinamide,pasiniazid,protioamide and capreomycin for 3 months,they underwent another 9 months of strengthened treatment with levofloxacin,pasiniazid,and rotioamide.RESULTS:The negative rate determined in sputum test for tuberculosis bacteria was up to 78.36%,and the closing rate of the cavity was up to 37.76%.CONCLUSION:The therapeutic effect for treatment of multiple-drug-resistant tuberculosis can be improved by carrying out the principle of whole range direct monitoring of chemotherapy and using capreomycin in combination with other drugs to increase the sensitivity to mycobacterium tuberculosis.