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Objective To explore the clinical significance of serum Golgi protein 73 (GP73) in liver cirrhosis and its association with radiological parameters. Methods We included 177 patients with liver cirrhosis and 61 patients with chronic hepatitis admitted to The First Hospital of Jilin University from January 2016 to December 2018, with 70 healthy subjects who underwent physical examination during the same period as the control. We compared GP73, alanine transaminase (ALT), aspartate transaminase (AST), albumin (ALB), total bilirubin (TBIL), prothrombin time (PT), and main portal vein diameter between the patients with liver cirrhosis, patients with chronic hepatitis, and healthy subjects. The GP73 level was further compared between liver cirrhosis subgroups by various classification methods. The correlation between GP73 and ALT, AST, ALB, TBIL, PT, and main portal vein diameter was analyzed. Results The GP73 level was significantly higher in the liver cirrhosis group than in the chronic hepatitis group and the healthy control group (P < 0.001). Patients with decompensated cirrhosis had a significantly higher serum GP73 level than those with compensated cirrhosis (P < 0.001). The serum GP73 levels in the Child-Pugh B and C cirrhosis subgroups were significantly higher than that in the Child-Pugh A cirrhosis subgroup (P < 0.05). In the liver cirrhosis group, the GP73 level was positively correlated with AST, ALT, TBIL, PT, and main portal vein diameter, while negatively correlated with ALB. Conclusion Serum GP73 is significantly increased in patients with liver cirrhosis, which is closely related to liver injury indicators. Serum GP73 shows important clinical value for the early diagnosis and prognosis assessment of liver cirrhosis.
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Objective:To summarize single-center experience and short-term outcomes of surgical treatment of pediatric cardiac fibromas.Methods:There was a retrospective study of 10 patients who underwent surgical treatment of cardiac fibromas between January 2018 and October 2021. Fibromas were located in the left ventricle in 7 cases, and in the right ventricle in 3 cases. Mean tumor diameter was(5.6±2.0) cm.Results:Median age at surgery was 3.1 years old(5 months-9 years old). Nine patients received complete resection, and the other one received partial resection. One patient with giant left ventricular fibroma required extracorporeal membrane oxygenation support for ventricular fibrillation after weaning from cardiopulmonary bypass, and was successfully weaned on the third postoperative day. There was no early mortality. Median follow-up time was 6 months(1 month-3 years). No tumor recurrence nor ventricular arrhythmia was documented during the follow-up period.Conclusion:Pediatric cardiac fibromas can be usually treated by complete resection, with relief of cardiac dysfunction and ventricular arrythmia after surgery, and with satisfactory results.
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Objective:To summarize the experience and effect of mitral valvuloplasty in the treatment of mitral valve disease in infants.Methods:The clinical data of 140 infants with mitral valve disease from June 2010 to June 2020 were retrospectively analyzed. There were 62 males and 78 females, with body weight of(6.4±1.4)kg and age of(196.6±80.1)days. Among them, 131 cases were moderately or above mitral insufficiency, and 9 cases were mitral stenosis. The perioperative and follow-up clinical data were recorded, and the therapeutic effect and prognostic factors of mitral valve plastic surgery were analyzed.Results:All 140 children were received surgery of mitral valve repair under cardiopulmonary bypass. Cardiopulmonary bypass time was(79.1±41.9)min, aortic cross clamp time was(46.8±20.0)min, 7(5%)early death. Mechanical ventilation time was(74.2±149.8)h. After surgery, mild mitral regurgitation was found in 48 cases, mild-moderate regurgitation in 53 cases, moderate regurgitation in 32 cases, moderate-severe regurgitation in 6 cases, severe regurgitation in 1 case, with no mitral stenosis. During the follow-up period of 6-126 months, 3 cases died in the long term, and 11 cases were reoperated. Freedom from >moderate mitral regurgitation at 5 years after surgery was 81.2%. Longer cardiopulmonary bypass time and postoperative mitral regurgitation were risk factors for death and moderate or above regurgitation at the follow-up.Conclusion:Mitral valvuloplasty can effectively treat the mitral regurgitation and stenosis in infants. The prognosis of children with short cardiopulmonary bypass time and good valve plastic effect is better. For infants with Carpentier type I, good shaping effect can be achieved by mitral annuloplasty alone, while for type Ⅱ and type Ⅲ, treatment should be tailored to deal with the problems at all levels of the valve, and additional annuloplasty should be performed.
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Objective:To study the surgical results of Yasui procedure for interruption of aortic arch and ventricular septal defect(IAA/VSD) associated with aortic stenosis(AS) or aortic atresia(AA).Methods:A retrospective study was performed on all 4 children with IAA/VSD/AS(AA) that underwent a Yasui procedure from Dec 2014 to Dec 2019. Three patients had AS, and 1 patient had AA. The age was from 10 days to 25 months and the weight was from 2.7 kg to 10 kg. The type of IAA was type A in 1 and type B in 3. The diameter and Z value of the aortic annulus were 1.9-4.3 mm and -6.7--3.6. The diameter and Z value of the ascending aorta were 2.6-5.8 mm and -5.4--2.6. The mean Z value of LVEDD and LVEDS was 3.6±2.6 and 3.6±2.9 resparately.Results:All 4 patients survived after the Yasui procedure. Three patients underwent primary repair and 1 patient underwent staged repair. CPB time was 128-283 min and aortic cross-clamping time was 98-171 min. Ventilation time was 93-296 h, and ICU and hospital length of stay was 7-25 days and 18-39 days. Follow-up was complete in all patients from 8 to 92 months, and there was no late death. All the patients were in good biventricular function with NYHA grade Ⅰ in 3 and NYHA grade Ⅱ in 2 patients. No residual left ventricular outflow tract obstruction was detected.Conclusion:The Yasui procedure can be an option for patients with IAA/VSD/AS(AA) and good developed left ventricle and can achieve good early surgical results.
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Objective:To study the surgical results of Ross procedure in pediatric patients. We report our early outcomes of the Ross procedure for congenital aortic valve disease.Methods:Retrospective analysis was performed on all 16 children with congenital aortic valve disease that underwent a Ross procedure from May 2018 to December 2019. Three patients had aortic stenosis(AS), 5 had aortic regurgitation(AR), and 8 patients had AS/AR. Two patients had endocarditis. Nine patients had prior aortic valve surgeries or interventions, 7 had percutaneous balloon aortic valvuloplasty, 1 had surgical valvotomy and 1 had aortic valve repair by cusp extension. Six patients had bicuspid and 1 had quadricuspid aortic valves.Results:There was no early death. Mean CPB time was (193.8±66.9) min (range 123~359 min), mean aortic cross-clamping time was (125.9±29.7) (range 82-186 min). Mean ventilation time was (58.0±42.4) h (range 22.7-163.0 h), and mean ICU and hospital length of stay was (5.4±3.4) d (range 2-16 d) and (25.9±18.7) d (range 7-77d). Six patients developed low cardiac output syndrome and 2 patient had hepatic dysfunction, which all improved after treatment. Follow-up was complete in all patients from 3 to 23 months, and there was no late death. Thirteen patients were in NYHA grade Ⅰ, and 3 in grade Ⅱ. The peak gradients through the aortic valve and pulmonary valve were (8.3±5.5)mmHg (3.7-26.6mmHg) and (20.5±16.4) mmHg (6.8-62.1 mmHg), respectively. The aortic regurgitation was negative in 3 patients, trivial in 1 patient and mild in 12 patients. The pulmonary regurgitation was trivial in 4 patients, mild in 9 patients and moderate in 3 patients.Conclusion:Ross procedure is a safe, effective surgical operation for congenital aortic valve disease in children >1-year of age.
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Objective:To summarize the surgical outcomes of interrupted aortic arch with ventricular septal defect (IAA/VSD) in neonates and infants.Methods:This was a retrospective review of clinical data of 123 neonates and infants who received surgery for IAA/VSD from Jan 2009 to Jan 2019. Median age at repair was 48 days. Forty-four patients (36%) were neonates. One-hundred-and-twenty-two patients (99%) underwent standard aortic arch reconstruction with VSD closure, and one neonate (1%) underwent staged Yasui operation. Risk factors for early mortality was analyzed by decision tree model.Results:Early mortality after surgery was 13%. Duration of cardiopulmonary bypass longer than 135 min, surgery received during neonatal period and before 2016 was identified as higher risk group for mortality. Median follow-up time was 3.5 years (range, 1-10 years). Freedom from aortic arch obstruction at 6 months, 1 year, 5 years after surgery was 75%, 72% and 72% respectively. Freedom from left ventricular outflow tract (LVOT) obstruction at 6 months, 1 year, 5 years after surgery was 91%, 83% and 73% respectively. A total of 17 patients received 21 reoperations. The patient who received Yasui operation experienced no residual obstruction during the follow-up.Conclusion:Early outcomes after surgery for IAA/VSD in neonates and infants are satisfactory. However, patients with standard aortic arch reconstruction have a higher risk for aortic and LVOT obstruction, and require multiple reoperations.
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@#Objective To explore the early results of Ozaki operation in children with aortic regurgitation. Methods We retrospectively analyzed the clinical data of 15 patients with aortic regurgitation who received the Ozaki operation in our hospital from April 2017 to July 2019. There were 11 males and 4 females with an average operation age of 10.7±3.7 years. Besides preoperative evaluation, aortic regurgitation and cardiac function were evaluated on 1 day, 1 week, 1 month, 3 months, and 6-12 months after surgery. Results In 14 (93.3%) patients , the aortic valve leaflets functioned well on 1 day, 1 month, 3 months, and 6-12 months, and the regurgitation grade was Ⅰ-Ⅱ, which was improved than before (P=0.001). The cardiac function of children recovered quickly after operation. There was no statistical difference in ejection fraction on 1 day, 1 month, 3 months, and 6-12 months after operation (P>0.05). No children died, and no other clinical event was found. Conclusion The Ozaki technique of reconstructing a tricuspid aortic valve leaflet for the treatment of severe aortic regurgitation in children is effective in short term, and the persistence of its valve function remains to be determined in the long-term follow-up.
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To analyze the outcomes of early Fontan failure after Fontan takedown. Methods A retrospective study of early Fontan Failure(EFF) children undergoing Fontan takedown from November 2013 to December 2017 was performed. Fontan takedown was defined as takedown back to an intermediate circulation, superior cavopulmonary connection. Fontan takedown was performed in 14 patients. There were 9 boys and 5 girls. Children were on average aged(4. 3 ± 1. 4) years when they had Fontan procedure. The mean weight was(14. 3 ±2. 7)kg. Operative procedure was extra-cardiac Fontan in 5 children, 9 had intra-cardiac Fontan. Fenestration was used in 11/14 patients. The outcomes were summarized with statistics, and risk factors for mortality after Fontan takedown were identified. Results The mortality after Fontan takedown was 4/ 14(28. 6％). In two patients(14. 3％), ECMO was followed after takedown, one of them died after two days. The time of ICU stay and hospital stay was relatively long(17. 0 ±11. 2)days and(33. 8 ±19. 4)days. The interval time between the Fontan procedure and the takedown operation is the risk fact after Fontan takedown. Conclusion Fontan takedown can be used as an effective management for the early Fontan failure, still with a high risk of mortality. Early diagnosis and takedown is recommended for EFF.
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Objective Mitral valve regurgitation often leads to cardiac insufficiency or even heart failure .Methods We tried a mitral valve annuloplasty with a ring to improve the effect of mitral valvuloplasty , 5 males and 6 females; aged(8.0 ± 4.5)years;weight(26.1 ±13.9)kg.From February 2015 to December 2017, 11 children underwent mitral valve annuloplasty with an mitral valve ring in our hospital.Immediately after surgery, the degree of mitral valve regurgitation was significant im-proved from moderate-severe to mild-moderate(P<0.05).Results 1 case of early death, 1 case had a mitral valve replace-ment because of early hemolysis.The rest of the children were discharged smoothly.The follow-up of 3 months of mitral valve regurgitation was not aggravated comparing with that immediately after surgery(P>0.05).There was no worsening of cardiac function at follow-up(P>0.05), and no other adverse events.Therefore, artificial mitral annuloplasty with a ring is effective in treating mitral regurgitation in children .The annulus had potential growth characteristics and did not require lifelong oral an-ticoagulant.Conclusion For some patients with difficulty, this method of mitral valvuloplasty can enlarge the surgical indica-tion and improve the quality of life of children.The treatment effect is good.
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Objective To investigate the therapeutic effect of the transcatheter closure of antegrade pulmonary blood flow with high-risk Fontan operations.Methods Retrospective analysis of 6 Fontan surgical patients, 4 males and 2 females, who received surgical treatment in the cardiothoracic surgery of Shanghai Children's Medical Center from May 2016 to August 2018;Age(5.7 ±2.9) years;(19.8 ±5.5) kg weight.All 6 patients were treated with primary pulmonary artery banding operation and secondary bilateral Glenn operation(BDG) and re-PAB.Before Fontan surgery, cardiac catheterization was performed in the department of cardiology to close the antegrade pulmonary blood flow .Results These six patients received interventional therapy in the department of cardiology.The mean pulmonary artery pressure(Pp) before occlusion was(17.0 ±0.8) mmHg (1 mmHg=0.133 kPa), the ventricular diastolic pressure(VEDP) was (11.2 ±0.9) mmHg, and the mean pulmonary artery pressure after occlusion was effectively decreased to(14.2 ±0.7) mmHg and VEDP to(9.7 ±0.7) mmHg.Fontan surgery was performed 6 to 12 months after the occlusion.No death was found after the operation, and all the clinical indicators were normal after the operation.Follow-up was conducted for 2-24 months, and the cardiac function and the function of each organ recov-ered well.Conclusion For some patients with high risk Fontan before operation , this method can safely and effectively reduce the average pulmonary artery pressure and reduce the ventricular and pulmonary vascular load , which is of positive help for the successful Fontan operation.
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Objective The purpose of this manuscript was to compare the outcomes of different surgical methods of Berry syndrome and to figure out the occurrence of postoperative morbidity.Methods From January 2003 through December 2017,nineteen infants with Berry syndrome underwent one-stage repair at Shanghai Children's Medical Center.There were 12 male and 7 female.Among them,six patients were neonates.The IAA morphology was type A in 17 patients and type B in 2 patients.The APW morphology was type Ⅰ a in 6 patients,type Ⅱ b in 11 patients,and type Ⅲ in 2 patients.Preoperative mechanical ventilation was required in 4 patients.Three different surgical correction techniques were employed to repair the APW and AORPA,including intra-aortic baffle in 8 patients,right pulmonary artery (RPA) detachment in 6 patients,and RPA angioplasty with aortic cuff in 5 patients.The descending aorta was then anastomosed to the aortic arch by an end-to-side anastomosis with a patch augmentation in the anterior wall.Results The mean CPB and aortic cross-clamp time was (146.7 ± 63.5)minutes (range,79 to 260 minutes) and (74.3 ± 27.4)minutes(range,46 to 147 minutes),respectively.There were 3 deaths.One patient died of severe pneumonia and multiorgan dysfunction on postoperative day 26.One patient suffered severe low cardiac output syndrome after surgery and died on postoperative day 1.One patient died of congestive heart failure at 2 months after discharge.Reoperations were required in 3 patients during the follow-up period.RPA arterioplasty with bovine pericardial patch augmentation was performed in 2 patients for RPA restenosis.Lecompte maneuverer was performed in 1 patient to release the compression of the RPA from the ascending aorta.Conclusion The mortality of one-stage repair of Berry syndrome was high.Surgical correction should be performed as soon as diagnosed.An intra-aortic baffle patch is suitable for type Ⅱ a APW defect patients beyond the neonatal period.Pulmonary hypertension crisis is important after surgery.RPA restenosis is the main reason for reoperation.
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Objective A retrospective study of patients in the past ten years who underwent surgeries because of secondary subaortic stenosis(SSS) after previous repair of congenital heart disease(CHD) was performed.The anatomy,indication,and surgical outcomes were studied.Methods Between January 2004 and October 2013,forty-eight patients underwent surgeries because of SSS.Thirty-five patients were males,and 13 were females.The mean age was(54.0 ± 34.9) months (12-156 months).The mean weight was(16.1 ±6.2)kg(6.0-37.5 kg).And the mean interval between the first and second surgery was(39.6 ±25.0) months(11-115 months).The primary diagnosis of CHD included ventricular septal defect,double outlet of right ventricle,corctation,interruption of aortic arch,patent trucus arteriosus,atrio-ventricular defect,tetralogy of fallot,transposition of great arteries,and univentricle.Results Twenty-five patients were discrete subaortic stenosis,and had the fibromuscular ridge resected.Twenty-three patients were diffuse type of subaortic stenosis.Myectomy,reconstruction of the intraventricular baffle,and modified Konno procedure were done in 8,5,and 10 patients separately.One patient died of cardiac failure postoperatively.One developed complete left bundle branch block,and another one developed complete atrioventricular block.The pressure gradients dropped from(76.8 ±20.4)mmHg to(12.4 ±8.4)mmHg,P ＜0.001.One patient was lost in follow-up and the left 46 patients had been followed up for 27 ～ 144 months [mean (59.6 ± 28.3) months] with no late death.The recent echocardiography results showed that the pressure gradients were(16.3 ± 15.2) mmHg.Five patients required reoperations due to recurrence of stenosis and the freedom from reoperation was 82.8％ at 10 years.Conclusion Earlier diagnosis and intervention is recommended for SSS,and excellent relief can be achieved.
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Objective A retrospective study of patients in the past ten years who underwent surgeries because of secondary subaortic stenosis(SSS) after previous repair of congenital heart disease(CHD) was performed.The anatomy,indication,and surgical outcomes were studied.Methods Between January 2004 and October 2013,forty-eight patients underwent surgeries because of SSS.Thirty-five patients were males,and 13 were females.The mean age was(54.0 ± 34.9) months (12-156 months).The mean weight was(16.1 ±6.2)kg(6.0-37.5 kg).And the mean interval between the first and second surgery was(39.6 ±25.0) months(11-115 months).The primary diagnosis of CHD included ventricular septal defect,double outlet of right ventricle,corctation,interruption of aortic arch,patent trucus arteriosus,atrio-ventricular defect,tetralogy of fallot,transposition of great arteries,and univentricle.Results Twenty-five patients were discrete subaortic stenosis,and had the fibromuscular ridge resected.Twenty-three patients were diffuse type of subaortic stenosis.Myectomy,reconstruction of the intraventricular baffle,and modified Konno procedure were done in 8,5,and 10 patients separately.One patient died of cardiac failure postoperatively.One developed complete left bundle branch block,and another one developed complete atrioventricular block.The pressure gradients dropped from(76.8 ±20.4)mmHg to(12.4 ±8.4)mmHg,P ＜0.001.One patient was lost in follow-up and the left 46 patients had been followed up for 27 ～ 144 months [mean (59.6 ± 28.3) months] with no late death.The recent echocardiography results showed that the pressure gradients were(16.3 ± 15.2) mmHg.Five patients required reoperations due to recurrence of stenosis and the freedom from reoperation was 82.8％ at 10 years.Conclusion Earlier diagnosis and intervention is recommended for SSS,and excellent relief can be achieved.
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Objective To investigate the clinical value of re-using ultrafiltrated and concentrated ascites fluid for refractory ascites in patients with hepatitis B cirrhosis. Methods A retrospective study was conducted, one hundred and thirteen patients with intractable ascites (all patients received intraperitoneal reinfusion of ultrafiltrated and concentrated ascites fluid therapy) admitted to the Department of Gastroenterology of No.254 Hospital of the Chinese People's Liberation Army from December 2013 to November 2016 were enrolled and assigned as the study group, fifty-two patients with intractable ascites admitted in the same period as above group in this hospital without undergoing above ascites fluid reinsfusion were served as the control group. Both groups were given conventional therapies, including measures for hepatoprotection, increase of plasma osmotic pressure, correction of hypoproteinemia (intravenous injection albumin 10 g, 3 times a week), reduction of portal venous pressure (octreotide 0.2 mg, q8 h), improvement of microcirculation, correction of water and electrolyte balance disorders, diuresis (furosemide 100 mg/d), etc. On the basis of the above conventional treatment, the system with ascites ultrafiltration, concentration and reinfusion into abdominal cavity was applied to carry out the concentrated ascites fluid reinfusion therapy in the study group. The relieve of abdominal bloating, conscious, blood pressure, 24-hour urine output, endogenous creatinine clearance rate (CCr), serum potassium ion (K+), serum sodium ion (Na+), ascites albumin quantity, serum albumin levels before treatment and after treatment for 1 week, abdominal infection situation after treatment for 1 week were observed in the study group. The difference in incidence of abdominal infection between the study group and control group (at the end of 12 weeks after treatment) was compared. Results In the study group, after treatment, the patients with abdominal bloating had different degrees of relief, 24-hour urine output was increased compared with that before treatment (mL: 1291.3±123.4 vs. 1265.0±61.5, P = 0.051), no cases with conscious changes, blood pressure instable. There were no statistical significant difference in blood K+ and Na+ (P > 0.05). And ascites albumin concentration was increased compared with before treatment (g/L: 19.1±2.9 vs. 17.2±4.1, P = 0.000); 1 week after treatment, CCr was significantly higher than that before treatment (μmol/L: 71.2±8.7 vs. 56.1±5.4, P = 0.000); serum albumin was increased after 3 times of treatment in 1 week (g/L: 25.7±4.4 vs. 24.6±3.0), but the difference was not statistically significant (P = 0.054). No abdominal infection occurred within 1 week after treatment were observed in patients of study group. There was no statistical significant difference in the incidence of abdominal infection between the study group and control group in 12 weeks after treatment [9.7% (11/113) vs. 13.6% (7/52), P = 0.476]. Conclusions The re-using of ultrafiltrated and concentrated ascites fluid can effectively relieve the abdominal bloating symptom, improve CCr, be beneficial to the re-use of ascites albumin, and does not increase the incidence of abdominal infection within 12 weeks after the therapy, therefore the treatment has relatively high therapeutic value for intractable ascites in patients with hepatitis B cirrhosis.
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Objective To investigate the clinical value of re-using ultrafiltrated and concentrated ascites fluid for refractory ascites in patients with hepatitis B cirrhosis. Methods A retrospective study was conducted, one hundred and thirteen patients with intractable ascites (all patients received intraperitoneal reinfusion of ultrafiltrated and concentrated ascites fluid therapy) admitted to the Department of Gastroenterology of No.254 Hospital of the Chinese People's Liberation Army from December 2013 to November 2016 were enrolled and assigned as the study group, fifty-two patients with intractable ascites admitted in the same period as above group in this hospital without undergoing above ascites fluid reinsfusion were served as the control group. Both groups were given conventional therapies, including measures for hepatoprotection, increase of plasma osmotic pressure, correction of hypoproteinemia (intravenous injection albumin 10 g, 3 times a week), reduction of portal venous pressure (octreotide 0.2 mg, q8 h), improvement of microcirculation, correction of water and electrolyte balance disorders, diuresis (furosemide 100 mg/d), etc. On the basis of the above conventional treatment, the system with ascites ultrafiltration, concentration and reinfusion into abdominal cavity was applied to carry out the concentrated ascites fluid reinfusion therapy in the study group. The relieve of abdominal bloating, conscious, blood pressure, 24-hour urine output, endogenous creatinine clearance rate (CCr), serum potassium ion (K+), serum sodium ion (Na+), ascites albumin quantity, serum albumin levels before treatment and after treatment for 1 week, abdominal infection situation after treatment for 1 week were observed in the study group. The difference in incidence of abdominal infection between the study group and control group (at the end of 12 weeks after treatment) was compared. Results In the study group, after treatment, the patients with abdominal bloating had different degrees of relief, 24-hour urine output was increased compared with that before treatment (mL: 1291.3±123.4 vs. 1265.0±61.5, P = 0.051), no cases with conscious changes, blood pressure instable. There were no statistical significant difference in blood K+ and Na+ (P > 0.05). And ascites albumin concentration was increased compared with before treatment (g/L: 19.1±2.9 vs. 17.2±4.1, P = 0.000); 1 week after treatment, CCr was significantly higher than that before treatment (μmol/L: 71.2±8.7 vs. 56.1±5.4, P = 0.000); serum albumin was increased after 3 times of treatment in 1 week (g/L: 25.7±4.4 vs. 24.6±3.0), but the difference was not statistically significant (P = 0.054). No abdominal infection occurred within 1 week after treatment were observed in patients of study group. There was no statistical significant difference in the incidence of abdominal infection between the study group and control group in 12 weeks after treatment [9.7% (11/113) vs. 13.6% (7/52), P = 0.476]. Conclusions The re-using of ultrafiltrated and concentrated ascites fluid can effectively relieve the abdominal bloating symptom, improve CCr, be beneficial to the re-use of ascites albumin, and does not increase the incidence of abdominal infection within 12 weeks after the therapy, therefore the treatment has relatively high therapeutic value for intractable ascites in patients with hepatitis B cirrhosis.
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Objective:To study therapeutic effect of Guanxintongluo (GXTL ) capsule combined dual antiplatelet drugs on prevention and treatment of in -stent restenosis after percutaneous coronary intervention (PCI) .Methods :A total of 82 patients with coronary heart disease undergoing stent implantation treated in our hospital were select‐ed .All patients were numbered ,and they were divided into dual antiplatelet group (n=40) and combined treatment group (n=42 ,received GXTL capsule based on dual antiplatelet group ) according to odd and even number method . Therapeutic effect was compared between two groups .Results:Compared with dual antiplatelet group after treat‐ment ,there were significant rise in total effective rates of in -stent restenosis (77.5% vs .95.2% ) ,angina pectoris (80.0% vs .95.2% ) ,ECG (77.5% vs .92.9% ) and syndrome of traditional Chinese medicine (72.5% vs .90.5% ) in combined treatment group , P0.05. Conclusion:Guanxintongluo capsule combined dual antiplatelet drugs can effectively reduce incidence rate of restenosis , improve syndrome of traditional Chinese medicine ,ECG chan‐ges ,reduce pain degree of angina pectoris in patients with coronary heart disease after PCI , which is worth extending .
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ObjectiveTo observe the effect of estrogenic-like effects ofWujia-Shenghua capsule and effective medication site.MethodsThrough D-101 macroporous resin column methods,Wujia-Shenghua capsule with 60% ethanol extraction was separated for water elution part, 20% ethanol elution part, 40% ethanol elution part, 60% ethanol elution part. Then each elution part was respectively mixed into concentration of 10mg/ml,1mg/ml, 0.1mg/ml, 0.01 mg/ml and acted on the MCF-7 cell to have, MTT test and rate of PR calculation.Results Compared with the blank control group(100%), when the concentration was 0.1 mg/ml, water elution part, 20% ethanol elution part and 60% ethanol elution part(98.10%, 101.06%, 106.04%)had no effect on the proliferation of MCF-7 cells, there was not statistically significant(P>0.05), while the 40% ethanol elution part(108.22%)can promote the proliferation of MCF-7 cells,there was a statistically significant(P<0.05). When the concentration was 1 mg/ml, 20%, 40% and 60% ethanol elution part(111.72%, 122.48%, 115.35%)can distinctly promote the proliferation of MCF-7 cells, there was a significant difference between four groups(P<0.01).ConclusionThe 40% ethanol elution part ofWujia-shenghua capsule has the strongest estrogen activity on plant.
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Effects of six kinds of Chinese herb extracts, including Folium Crataegi extract, Herba Epimedii extract, Folium Acanthopanacis Senticosi extract, Trifolium pratense L. extract, Folium Ginkgo extract and Radix Puerariae extract, on the activities of CYP450 isozymes (CYP1A2, CYP2C, CYP2E1, CYP2D, CYP3A) in rat hepatic microsomals were studied by using a UPLC-MS/MS (MRM) and cocktail probe substrates method. The results showed that effects of six kinds of Chinese herb extracts on each CYP450 isozyme activity were inhibitory. The IC50 of Folium Crataegi extract for the inhibition of rat microsomal CYP2D activity was only for 4.04 microg x mL(-1), which showed the highest inhibition; Trifolium pratense L. extract had strong inhibitory action to CYP2D, the IC50 value was 5.73 microg x mL(-1); Folium Crataegi extract also had strong inhibitory action on CYP2E1, the IC50 value was 10.91 microg x mL(-1). Furthermore, the IC50 of Folium Ginkgo extract for the inhibition of rat microsomal CYP3A, 2D, 2E1 activities were 45.12, 35.45 and 22.41 microg x mL(-1), respectively, and the IC50 of Folium Acanthopanacis Senticosi extract on the inhibition of rat microsomal CYP2E1 activity was 32.89 microg x mL(-1). In addition, mechanism of inhibition experimental results showed that the inhibiting abilities of Folium Crataegi extract and Radix Puerariae extract on each CYP450 isozyme increased with the increasing of the preincubation time, therefore, the inhibitory effects were a mechanism-based inhibition.
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Objective To review and summarize the experiences of mitral valve replacement in the children aged less than five years.Methods Twelve patients with moderate to severe mitral valve regurgitation (MR) or/and severe mitral valve stenosis (MS) were retrospectively study from January 2008 to December 2011,all of them suffered from severe heart failure and underwent mechanical mitral valve replacement.There were 9 males and 3 females.They aged from 4 to 58 months [mean (26.2 ± 18.1) months] and weighted from 5.6 to 13.0 kg [mean (9.6 ± 3.8) kg].Three patients underwent unsuccessful mitral valve repair before mitral valve replacement.17 to 23 mm aortic bileaflet mechanical prosthesis were reverse directional implanted in nine patients and 25 to 27 mm mitral bileaflet mechanical prosthesis were implanted in three patients.Results One patient died,the operative mortality rate was 8.3％.2 patients were complicated by cardiac arrhythmia and 2 patients complicated by mild hemolysis,all recovered after symptomatic treatment.The heart function of servived 11 patients improved significantly,none of them were complicated by haemorrhage or thromboembolic.Conclusion Severe mitral valve lesion injure heart function significantly for the young children and timely surgical intervention is the only option.Mitral valve replacement is the ultimate option for the patients failed in mitral valve annuloplasty.The introduction of aortic bileaflet mechanical prosthesis which smaller size is available and reverse directional implantation resolve the difficulty of prosthesis-patient mismatch essentially,most children with a small prosthesis has to redo mitral valve replacement with a larger size prosthesis.The compliance of permanent anticoagulation of young children is favourable and more intensively follow-up is essential to avoid the incidence of bleeding and thromboembolic.
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Objective To discuss the reasons of death in the in-patients with percutaneous coronary intervention(PCI).Methods Retrospective analysis was done in 33 cases who died in or after the procedures among 3 252 in-patients with PCI.Results 4 patients died in procedures and the others died after procedures.The major reasons of death in order were:cardiogenic shock,ventricular fibrillation,acute left heart failure,multiple organ failure,heart rupture and acute renal failure.The in-hospital mortality rate was 1.01%.Conclusion The major reasons of death of patients with PCI are cardiogenic shock,ventricular fibrillation and acute left heart failure.Taking some measures will reduce the in-hospital mortality rate.