Clinical study on diagnosis of myocardial fibrosis by soluble suppression of tumorigenicity 2, galectin-3 combined with magnetic resonance multimodality / 中国医师进修杂志

Objective:To explore the application value of soluble tumor suppressor 2 (SST2), galectin-3 combined with magnetic resonance multimodality in the diagnosis of myocardial fibrosis.Methods:The clinical data of 88 patients with cardiomyopathy from January 2017 to December 2019 in Handan Central Hospital of Hebei Province were retrospectively analyzed as the experimental group, and 100 healthy people in the same period were selected as the control group. According to the results of cardiac magnetic resonance imaging (CMRI)-late gadolinium enhanced (LGE), the patients with cardiomyopathy were divided into LGE positive and LGE negative. The arrhythmia rate was evaluated by ambulatory electrocardiogram. The New York Heart Association (NYHA) cardiac function grade was recorded. The left ventricular ejection fraction (LVEF) and left ventricular end diastolic diameter (LVEDD) were detected by echocardiography. The SST2, galectin-3 and N-terminal pro-brain natriuretic peptide (NT-proBNP) were detected by enzyme-linked immunosorbent assay (ELISA). The receiver operating characteristic (ROC) curve was drawn to analyze the efficacy of SST2 and Galectin-3 in predicting myocardial fibrosis in patients with cardiomyopathy.Results:CMRI-LGE results of 88 patients with cardiomyopathy showed that LGE was positive in 42 cases and negative in 46 cases. The arrhythmia rate, LVEDD, SST2 and galectin-3 in experimental group were significantly higher than those in control group: 67.05% (59/88) vs. 2.00% (2/100), (46.55 ± 5.99) mm vs. (27.92 ± 2.05) mm, (61.83 ± 10.57) μg/L vs. (24.99 ± 7.69) μg/L and (18.65 ± 3.39) μg/L vs. (7.12 ± 1.33) μg/L, the LVEF was significantly lower than that in control group: (55.11 ± 8.36)% vs. (68.83 ± 9.45)%, and there were statistical differences ( P<0.01). The arrhythmia rate, NYHA cardiac function grade, LVEDD, SST2 and galectin-3 in patients with LGE positive were significantly higher than those in patients with LGE negative: 88.10% (37/42) vs. 47.83% (22/46), (3.10 ± 0.53) grade vs. (2.11 ± 0.61) grade, (48.88 ± 5.95) mm vs. (44.41 ± 5.24) mm, (65.58 ± 11.73) μg/L vs. (58.40 ± 8.10) μg/L and (21.00 ± 2.72) μg/L vs. (16.51 ± 2.39) μg/L, the LVEF was significantly lower than that in patients with LGE negative: (52.15 ± 8.23)% vs. (57.82 ± 7.60)%, and there were statistical differences ( P<0.01). ROC curve analysis result showed that the optimal critical values of serum SST2 and galectin-3 for predicting myocardial fibrosis in patients with cardiomyopathy were 65.07 μg/L and 18.46 μg/L, the area under the curve was 0.714 (95% CI 0.604 to 0.825, P = 0.001) and 0.894 (95% CI 0.828 to 0.960, P = 0.001), the sensitivity was 61.9% and 85.7%, and the specificity was 80.4% and 82.6%. Conclusions:Magnetic resonance multimodality has a good ability in detecting myocardial fibrosis, and serum SST2 and galectin-3 have good predictive value for myocardial fibrosis. SST2 and galectin-3 combined with magnetic resonance multimodality has important clinical significance in the diagnosis of myocardial fibrosis.

Comparison of laparoscopic assisted small incision in the neck surgery and traditional open surgical treatment of benign thyroid / 中国基层医药

Objective To compare the neck incision laparoscopic assisted surgery and conventional open surgical treatment of thyroid benign clinical efficacy,and explore the small incision endoscopic assisted neck safety and effectiveness.Methods According to a random number table,100 patients with benign thyroid were randomly divided into the control group and observation group,50 cases in each group.The patients in the observation group were underwent endoscopic assisted small incision neck surgery,and the patients in the control group of traditional open surgery.The efficacy of postoperative of the two groups was observed and compared.Results The operative time,hospitalization time,blood loss,drainage,drainage time of the observation group was (57.4 ±11.7)min,(3.2 ± 1.0)d,(9.4 ±5.2)mL,(21.4 ±13.5)mL,(1.7 ±0.8)d,which were better than those of the control group(t=8.577,6.352,17.563,12.970,6.273,all P<0.05);The overall incidence of complications in the observation group after the treatment was 8%,which was significantly lower than 30% in the control group(χ2 =7.86,P<0.05). Conclusion Endoscopic surgery assisted small incision in the neck benign thyroid is superior to traditional open sur-gery,and is a simple,effective and safe surgical approach.Compared to traditional open surgery,it has better cosmetic results,which is worthy of clinical application.

Application of laparoscopic-assisted radical gastrectomy in elderly patients / 中国基层医药

Objective To study the application value of laparoscopic-assisted radical gastrectomy in elderly patients.Methods 114 elderly patients with gastric cancer were randomly divided into observation group and control group.55 patients in the observation group received laparoscopic-assisted radical gastrectomy ,59 patients in the con-trol group received traditional open radical gastrectomy .The operation time,blood loss,postoperative ambulation time, postoperative hospital stay and other information were compared .Results The operative time ,blood loss and postop-erative ambulation ,postoperative hospital stay in the observation group were significantly better than those in the con -trol group(t=12.195,8.562,8.072,10.252,all P0.05).Conclusion The efficacy of laparoscopic-assisted radical gastrectomy is similar with traditional open radical gastrectomy ,and laparoscopic-assisted radicalgastrectomy has ad-vantages of minimally invasive ,faster recovery ,especially suitable for elderly patients with gastric cancer .

Clinical multi-factor analysis of 80 cases with deep vein thrombosis / 中国基层医药

Objective To analyze the deep venous thrombosis incentives.Methods The pathogenic factors of 80 cases with deep vein thrombosis were retrospectively analyzed,and risk factors for deep vein thrombosis were explored.Results The incidence of women over the age of 40-70 years old,male age over 60-80 years of age,the incidence rate in women under the age of 50 males,50 females over the age of incidence than men.The incidence of deep venous thrombosis in patients with parts of the left lower limb 55 cases,28 cases of right lower extremity,lower extremity seven cases.80 patients incentives can be found in 76 cases,35 cases of surgery-induced,accounting 43.75％,of which 19 cases of trauma,tumor surgery in 5 cases,10 cases of other diseases surgery;trauma induced 21 cases,accounting for 26.27％ ; higher BP 9 patients,accounting for 11.25 ％ ;4 patients had a history of previous thrombotic,accounting for 5.00％ ;3 cases of infectious diseases,accounting for 3.75 ％ ;4 cases of diabetes,accounting for 5％.There were 4 cases of unexplained,accounting for 5.00％.Conclusion Surgery,trauma,cancer,hypertension,diabetes,infectious diseases and past history of thrombosis are the important risk factors of deep vein thrombosis.Surgery and trauma patients in case of wound healing is not affected,getting out of bed is needed as soon as possible.

Clinical efficacy and safety analysis of left colon and intestinal surgery phase I and phase II / 中国基层医药

Objective To analyze clinical efficacy and safety of left colon and bowel obstruction .Methods 80 cases of left colon and bowel obstruction were divided into the observation group and control group,40 cases in each group.The observation group was given a surgery,and the control group received two surgical treatment,the two groups were taken the statistical analysis of clinical data to compare the clinical efficacy and safety of operation. Results The operative time,hospital stay and surgical blood loss in the observation group was (42.9 ±13.8) min, (9.3 ±2.8)d,(45.9 ±11.7)mL,which in the control group were (58.6 ±17.6)min,(6.8 ±1.5)d,(151.4 ± 19.4)mL,there were statistically significant difference between the two groups(t=25.358,16.128,29.475,all P<0.05);The abdominal abscess,lung infections and wound infection incidence of adverse reactions in the observation group was 7.5 %,10.0%,20.0 %,which in the control group was 17.5 %,2.5%,10.0%,there were statistically significant difference between the two groups (t=4.512,4.336,4.762,all P<0.05).Conclusion The clinical treatment of left colon and bowel obstruction shall promptly conduct a surgery,the role of hospitalization in patients with shorter length to enhance tumor resection rate,and actively improve the quality of life of patients.

Use of cutting balloons in coronary interventions / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To study the efficacy and safety of cutting balloons in coronary interventions.</p><p><b>METHODS</b>Twenty-two patients with 23 narrowed coronary arteries and 25 lesions enrolled the study, 17 of whom had 18 diseased coronary arteries and 18 lesions were in-stent restenosis. The average time from previous stenting was 7.60 +/- 3.53 months. The lesions were dilated with cutting balloons.</p><p><b>RESULTS</b>All of the lesions were dilated successfully by 5.16 +/- 2.30 inflations of a cutting balloon. The mean total duration of balloon inflation was 233.96 +/- 94.83 seconds at pressures up to 9.40 +/- 1.96 bars. The severity of vascular stenosis was lessened substantially (89.64 +/- 8.65% vs 17.60 +/- 17.15%, P = 0.000) without severe complications. Three restenotic lesions were further dilated with conventional balloons, another one was stented again because of a dissection distal to the previous stent. Three primary lesions were stented for dissection or residual stenosis. Angina pectoris reoccurred in two patients in a mean follow-up period of 7.42 +/- 6.87 (range 0.5-20) months.</p><p><b>CONCLUSION</b>Cutting balloon dilation is an effective and safe choice in interventions for coronary disease especially for in-stent restenosis.</p>

The new choice of pericardiocentesis route for percutaneous indwelling catheter drainage in patients with pericardial effusion / 中国介入心脏病学杂志

Objective To investigate the efficacy and safety of percutaneous pericardial drainage with indwelling catheter via the puncturing route of left sternal broader in the third or fourth interspace Methods In the 38 patients with moderate to large pericardial effusion, the pericardial echo free space and the forecasted puncturing distance were measured with two dimensinal echocardiolgraphy (2DE) prior to pericardiocentesis in the three sites: subxiphoid, cardiac apex and the left sternal broader in the third or fourth interspace Under the guidance of 2DE, pigtail catheters were percutaneously indwelled for pericardial drainage via the location of left sternal broader in the third or fourth interspace Results Among the three sites, there were no difference of echo free space measured by 2DE, and the forecasted distance of advancing needle examined in left sternal broader was the smallest The procedures of indwelling catheter drainage for pericardial effusion were successfully performed in all the 38 patients Catheters lying in posterior pericardium were found in 94 8% of the patients (36/38) There were no cases with puncturing related complications, effusion leaking into pleurum or subcutaneous tissue Only 1 case was complicated with neural mediated syncope on the third day after indwelling catheter Conclusion Pericardiocentesis using left sternal broader route is a safe and simple approach for indwelling catheter drainage in patients with pericardial effusion This route may be a promising option for clinical use widely