The application of descending branch of lateral circumflex femoral artery in coronary artery bypass grafting / 中华胸心血管外科杂志

In some countries and regions,descending branch of lateral circumflex femoral artery(DBLCFA) has been successfully applied to CABG.It is feasible,easy and safe to harvest and apply DBLCFA to CABG.We review the origin,distribution and anatomical features of DBLCFA.And introduce its application,relevant techniques and strategies in CABG.

Comparison of two surgical approaches for chronic subdural hematoma / 中国基层医药

Objective To compare the advantages and disadvantages of non-irrigation and irrigation in the surgical approach of chronic subdural hematoma (CSDH),thus to provide reference for clinical treatment of CSDH.Methods Clinical data of 102 patients with CSDH were retrospectively analyzed.According to the different operation methods,the patients were divided into the non-irrigation group(52 cases) and the irrigation group(50 cases).The blood loss during the procedure,operative time,length of stay and postoperative complication rate between the two groups were compared,and the causes of postoperative complications were analyzed.Results The blood loss during the procedure,operative time and length of stay in the non-irrigation group were (6.73 ± 1.17) mL,(15.06 ± 2.64) min and (10.74 ± 2.20) d,respectively,which in the irrigation group were (19.52 ± 3.18) mL,(38.54 ± 6.95) min and (10.44 ± 2.07)d,respectively,there were statistically significant differences between the two groups in the blood loss during the procedure and the operative time (t =-27.11,-22.72,all P ＜ 0.05),there was no statistically significant difference between the two groups in the length of stay (t =0.70,P ＞ 0.05).The incidence rates of postoperative complication in the non-irrigation group and irrigation group were 8.00％ and 7.69％,respectively,there was no significant difference between the two groups (x2 =0.003,P ＞ 0.05).Conclusion Each of the two methods has its own advantages and disadvantages in the treatment of CSDH.Compared with burr hole irrigation,burr hole non irrigation has the advantages of less blood loss and shorter operative time.However,burr hole non-irrigation is more likely to suffer serious complication.We should select suitable surgical approach by the specific circumstances of the patients.The causes of postoperative complications of CSDH are varied.In particular,there is an important relationship between the non-standard operation and postoperative complications.

Complete revascularization for multi-vessel coronary diseases through lower ministernotomy on beating heart off-pump surgery / 中华外科杂志

Objective@#To discuss a novel method of complete revascularization for multi-vessel coronary diseases on beating heart off-pump surgery through lower ministernotomy.@*Methods@#Clinical data of 79 patients underwent ministernotomy off-pump coronary artery bypass from January 2015 to May 2016 at Department of Cardiac Surgery, Heart Center, Beijing Friendship Hospital, Capital Medical University were analyzed retrospectively. There were 62 male and 17 female patients, with an average age of (65±9) years. All the patients were multi-vessel coronary diseases and planned to receive coronary artery bypass grafting. Left internal mammary artery, radial artery and great saphenous veins were harvested and prepared, respectively. The perioperative clinical data was observed and collected. Postoperative ventilator-assisted time, intensive care time, and 24-hour thoracic mediastinal drainage volume were recorded. Postoperative cardiac function was evaluated by echocardiography. The data were compared between pre- and post-operative using paired t test.@*Results@#Cardiopulmonary bypass was used in 2 patients during operation because of unstable hemodynamic status, but the incision was not needed to extend for those 2 patients. The lower ministernotomy was converted to traditional full sternotomy in 2 patients due to limited space for proximal anastomosis. In total, 79 patients had an average of (2.8±0.6) grafts. One proximal anastomosis was performed in 75 patients and 2 anastomoses in 4 patients. Distal target vessels consisted of left descending arteries for 79 patients, posterior descending artery for 60 patients, obtuse marginal branch and intermediate branch for 56 patients and diagonal branches for 25 patients, respectively. Average postoperative ventilation time was (19.0±2.2) hours and ICU stay was (60±20) hours. One patient developed postoperative myocardial infarction and needed temporary intra-aortic balloon pump support. One patient was subjected to incision infection. None of patient died in this study. There were no significant differences in left ventricular end-diastolic diameter and left ventricular end-systolic diameter between pre- and post-operative. The post-operative ejection fraction was significantly higher than that pre-operative (66.5%±1.6% vs. 61.2%±2.3%, t=4.30, P=0.00).@*Conclusion@#With lower ministernotomy, the various sites of distal target vessels could be reached and complete revascularization could be achieved for selected patients with triple vessel diseases, although the procedure is technical demanding.

Clinical diagnosis and treatment of inflammatory granuloma in central nervous system / 中国基层医药

Objective To discuss the diagnosis and treatment of inflammatory granuloma in central nervous system(CNS)to provide reference for clinic.Methods Retrospective data included 8 patients with CNS inflammatory granuloma in Department of Neurosurgery,Shanxi People's Hospital,2012 -2015.We analyzed the imaging features, postoperative symptoms,blood and cerebrospinal fluid changes and prognosis.Results 8 cases all received surgical treatment.All the symptoms were improved,and the CT showed that the lesions were disappeared.All the patients had recovered to normal life and work.Conclusion The diagnosis of CNS inflammatory granuloma is difficult.Clinical manifestations are lack of specificity.The blood and cerebrospinal fluid laboratory examination have no abnormal changes.CT and MRI are the main diagnostic methods.Postoperative pathology is the gold standard for diagnosis.The large lesion,frequent episodes of epilepsy,severe neurological deficits and possibility of brain tumor all should be treated by surgery.

The expression of the tryptase in the plasma of the brain traumatic patients / 中国基层医药

Objective To detect the expression of the tryptase in the plasma,and study the meaning in brain traumatic patients.Methods There were two groups:the brain traumatic group(40 patients)and the control group (20 health people).The content of plasma tryptase was determined by fluorescence enzyme immunoassay..Results The level of plasma tryptase had no statistical significance in control group(2.97 ±1.05)μg/L compared with the brain traumatic group(3.03 ±1.39)μg/L,however there had statistical significance comparing with sever brain traumatic patients(3.84 ±0.52μg/L)(t =3.32,P <0.05).4 cases of death in patients with severe head injury group content of tryptase (5.85 ±1.05)μg/L,which was significantly higher than the group of 16 cases of injury in severe head injury after 2 months still alive with the content of serum tryptase (2.49 ±0.52)μg/L,the difference was statistically significant (t =8.13,P <0.01).Conclusion The plasma tryptase level in sever brain traumatic patients increased significantly,and might be of importance for treatment strategies and prognosis.

Experimental study on inhibitory effect ofβ-elemene on ECV-304 cells'proliferation / 中国医师杂志

Objective To investigate the growth inhibition of β-elemene in ECV-304 cells,and study it's meaning to anti-angiogenesis in tumors.Methods The IC50 value of β-elemene in ECV-304 cells were got through MTT assay.Under treatment of β-elemene in ECV-304 cell,flow cytometry(FCM)was used to investigated the changing of cell cycle,electron microscope was used to show the morphological al-terations,agarose gel electrophoresis was used to detect effection on cells'DNA.Results The proliferation of ECV-304 cells was significantly inhibited by β-elemene,the IC50 value was (58.3 ±8.1)μg/ml.By FCM,we observed Cell cycle was significantly arrested in G0 /G1 phase under 60μg/ml treatment(P <0.05),apoptotic cells increased with the increase of drug concentrations.Typical apoptotic morphological alterations were found under electron microscope.Characteristic DNA-ladder standing for apoptosis was showed in agarose gel electrophoresis.Conclusions β-elemene can significantly inhibit ECV-304 cells'pro-liferation By inducing apoptosis.

Surgical treatment of functional glioma by neuronavigation with intraoperative ultrasound / 中国基层医药

Objective To investigate the operation process,extent of resection,protection function,the tumor recurrence and clicical value of neuronavigation with intraoperative ultrasound for treating functional glioma;signifi-cance of intraoperative ultrasound for correcting brain shift.Methods We analyzed the cliclical materical of 24 case of functional gliomas which were resected by neuronavigation with intraoperative ultrasound.Results The accuracy of localization of functional glioma was 100%.The distance of brain shift was 2 to 10mm,with an average 4.7mm.After 24 hours MRI confirmed that total removal of function glioma was achieved in 21 cases,subtotal in 3 cases.After oper-ation function improve was 20 cases,invalid of 2 cases,hemiplegia happened in 2 cases and no death in all the patients.Conclusion Neuronavigation with intraoperative ultrasound can correct brain shift and improve the accuracy of localization of functional glioma,to improve extent of function glioma and decrease dysfunction.Neuronavigation with intraoperative ultrasound is important to functional glioma.

Analysis of the risk factors acute kidney injury after off-pump coronary artery bypass surgery / 国际外科学杂志

Objective Univariate analysis and multivariate risk factors of early acute kidney injury on off-pump coronary artery bypass grafting are performed.Methods Analyzed retrospectively the clinical date of 261 patients who underwent off-pump coronary artery bypass surgery between Jan 2011 to Dec 2013.According to the clinical diagnostic ctriteria,261 patients were divided into AKI group (n =29) and NAKI group(n =232).There were 22 males and 7 females with an age of (68.74 ± 10.27) years in the AKI group,there were 179 males and 53 females with an age of (66.26 ± 9.82) years in the NAKI group.we summarize the clinical date,including blood pressure,left ventricular ejecting fraction,diameter of the left ventricle and serum creatinine before operation,and observed postoperative complications etc.Evaluated the factors for AKI Using Logistics regression analysis statistical methods.Results Among all the patients,the incidence of AKI was 11.11％ (29/261),1 patients died in all the patients for AKI.The statistical analysis revealed that the serum creatinine after operation,anesthesia time,and perioperative blood transfusion were the risk factors for acute injury after off-pump coronary artery bypass surgery.Conclusion AKI is the most common complication of off-pump coronary artery bypass surgery.we should carefully evaluate risk factors and enhance protection of the renal function and reduce the risk of AKI occurred.

Research on the measuring scope of skull base midline structure tumors in the mothod of single-nostril microscopy combined with neural endoscopy / 肿瘤研究与临床

Objective By combined application of endoscopic and microscopic vivisection-pronged approach,forms a three-dimensional morphological observation through focusing on an observation of structure of various signs, imaging features, morphology and measuring in vivo data, which are concerned with expansion of transsphenoidal approach. This will provide expansion of transsphenoidal approach with an intuitive morphological imagines,detailed anatomical parameters,accurate imaging data,viviperception and data measurement. Methods 80 patients were recruited for investigation, preoperative measurement of the size of the patient' s nose,height of nasal columella,the plane angle among bridge of nose,inner canthal of eyes and nose columella,and the length of bridge of nose.in the operation,measure the distance from nasal columella to aperture of sphenoidal sinus; observe the shape of aperture of sphenoidal sinus; measure the longest and the shortest distance between aperture of sphenoidal sinus; observe the shape of septum of sphenoidal sinus,three uplift and the relationship among them,as well as the color and texture of the tumor.Measure sphenoid sinus wall,screening room,sellar floor,extent of slope resection,operating space,as well as observation & study of selection and repairing of skull base reconstruction materials. Results The shape according to the discretion of the column is divided into butterfly saddle nose, normal nose, eagle nose and acromegaly hypertrophy nose.The nostrils shape is kidney form,ball form,snow humanoid formand triangle form.The butterfly saddle biggest digging distance:between the cavernous sinus is( 18.9±2.51 ) mm,from saddle nodules to slope is(19.2 ±2.67) mm.After tumor resection,the transsphenoidal observation space is forward to former group of ethmoid sinus,back to the slope. Conclusion The measurement data might be benefit for selecting of speculum, evalution of placing depth on speculum and operation position and sellar floor opening range. It would also make it possible for a safer, minimally invasive and effective surgery by avoid damage to the internal carotid artery,cavernous sinus or cranial nerve.

Analysis of scatterer microstructure feature based on Chirp-Z transform cepstrum / 生物医学工程学杂志

The fundamental research field of medical ultrasound has been the characterization of tissue scatterers. The signal processing method is widely used in this research field. A new method of Chirp-Z Transform Cepstrum for mean spacing estimation of tissue scatterers using ultrasonic scattered signals has been developed. By using this method together with conventional AR cepstrum method, we processed the backscattered signals of mimic tissue and pig liver in vitro. The results illustrated that the Chirp-Z Transform Cepstrum method is effective for signal analysis of ultrasonic scattering and characterization of tissue scatterers, and it can improve the resolution for mean spacing estimation of tissue scatterers.