Application of 24-hour dynamic electrocardiogram combined with cardiac troponin I in evaluating radiation-induced cardiac injury / 中华放射肿瘤学杂志

Objective:To investigate the value of 24-hour dynamic electrocardiogram combined with cardiac troponin I (cTnI) in evaluating the radiation-induced heart disease (RIHD) in chest tumor radiotherapy.Methods:From 2015 to 2018, 128 patients with chest tumor who received radiation therapy with/without chemotherapy in the Third People′s Hospital of Linyi were selected to undergo routine ECG examination, 24-hour dynamic ECG examination, cTnI and cardiac color Doppler ultrasound before radiotherapy, 30Gy radiotherapy, 50Gy radiotherapy, after radiotherapy and 3 months after radiotherapy, respectively. The detection rates of 24-hour dynamic electrocardiogram, routine electrocardiogram, cTnI, cardiac color Doppler ultrasound and 24-hour dynamic electrocardiogram combined with cTnI for RIHD were statistically compared. The correlation between glucose level, hypertension and coronary heart disease, combined with chemotherapy, radiation dose and the irradiated area of the heart and the incidence of RIHD was analyzed.Results:The detection rates for RIHD did not significantly differ between 24-hour dynamic electrocardiogram and routine electrocardiogram ( P>0.05), whereas the detection rates for arrhythmia, atrioventricular block, bundle branch block and ST-T changes of 24-hour dynamic electrocardiogram were significantly higher than those of routine electrocardiogram (all P<0.05). The detection rate of 24-hour dynamic electrocardiogram combined with cTnI was significantly higher compared with that of 24-hour dynamic electrocardiogram, routine electrocardiogram, cTnI or cardiac color Doppler ultrasound alone (all P<0.05). There was a significant difference in RIHD before and after radiotherapy ( P<0.05). The incidence rate of RIHD in the radiation therapy combined with chemotherapy group was significantly higher than those in the cisplatin chemotherapy and radiotherapy alone groups, especially in the epirubicin+cyclophosphamide group (45%, all P<0.05). The incidence rate of RIHD was similar between radiotherapy alone and radiotherapy combined with cisplatin chemotherapy (both P>0.05). After radiation therapy, the grade of RIHD was elevated in 40 cases (31.2%). Diabetes mellitus, hypertension, coronary heart disease, radiotherapy combined with chemotherapy, cardiac D mean and cardiac V 40Gy were the independent factors for the occurrence of grade 1-4 RIHD (all P<0.05). Conclusion:The 24-hour dynamic electrocardiogram combined with cTnI is of great value in the detection of RIHD induced by radiotherapy for chest tumors with high detection rate, simple operation and low cost, which is worthy of application in clinical practice.

Minor liver resection for hilar cholangiocarcinoma of Bismuth-Corlette type Ⅲ and Ⅳ / 中华外科杂志

Objective@#To explore the clinical effect and safety of minor liver resection for hilar cholangiocarcinoma (HC) of Bismuth-Corlette type Ⅲ and Ⅳ.@*Methods@#From May 2007 to May 2017, the clinical data of 108 patients with Bismuth-Corlette type Ⅲ and Ⅳ HC underwent hepatectomy were collected and analyzed retrospectively.There were 56 males and 52 females, aged (57.2±5.3) years (ranged 48-76 years) .Among the 108 cases, there were 51 cases of type Ⅲa, 40 cases of type Ⅲb and 17 cases of type Ⅳ. Small-scale hepatectomy (≤3 hepatectomy) was performed in 70 cases, including 8 cases of 4b segment resection, 28 cases of 4b segment+5 segment resection, and 34 cases of partial 4 segment+partial 7 segment+partial 1 segment resection. Large-scale hepatectomy was performed in 38 cases (>3 segments) , of which 30 cases were treated with 2 segments+3 segments+4 segments+1 segment, and 8 cases were treated with 5 segments+7 segments+8 segments+1 segment. t′ test was used to analyze the data which did not conform to the normal distribution, and χ2 test was used to calculate the incidence of postoperative complications and the 1, 3, and 5-year cumulative overall survival rate.@*Results@#(1) The operation time of minor liver resection group ((180±25)minutes) was shorter than that of major liver resection group ((210±35)minutes) (t′=4.676, P<0.05) , the amount of blooding operation time of minor liver resection group ((310±80)ml) was less than that of major liver resection group ((500±110)ml)in the operation (t′=9.385, P<0.05) , and the difference was statistically significant. (2) The incidence of complications was lower in minor liver resection group and major liver resection group, and the difference was statistically significant (χ2=5.230, P<0.05) . (3) The actual 1-, 3- and 5-year survival rates were 87.1%, 58.4%, 30.0% and 84.2%, 57.9%,31.6%, respectively. There were no significant differences in survival rates in two groups in 1-, 3- and 5-year survival rates (χ2=0.177, P=0.674; χ2=0.005, P=0.946; χ2=0.029, P=0.865) .@*Conclusions@#Compared to patients with major liver resection, Minor liver resection for selected patients with HC of Bismuth-Corlette Ⅲ and Ⅳaccording to our criteria achieved better long-term outcomes. Chen′s biliojejunostomy is a simple, effective and safe method, which can be widely used when there are multiple biliary intestinal anastomosese.

Analysis of etiology and antibiotic susceptibility in acute exacerbation of bronchiectasis / 中国医师进修杂志

Objective To Analyze the etiology and antibiotic susceptibility in exacerbated bronchiectasis, and guide rational drug use in clinic. Methods Pathogenic microorganism culture and drug sensitivity of sputum samples of 496 cases were collected from 2015 to 2016 in Shengjing Affiliated Hospital, China Medical University. The Excel software was used to analyze the screening data and the SPSS 22.0 was used for statistical analysis to obtain the drug resistance of the bacteria to the commonly used antibiotics. Results In 469 patients, there were 551 pieces of sputum , with 198 strains positive bacterium. Positive rate was 35.93％(198/551), and bacterium was 171 strains (86.36％). Bacteria of top three positive rate was 86 strains of Pseudomonas aeruginosa (50.29％), 54 strains of Acinetobacter baumannii (31.58％) and 10 strains of Klebsiella pneumoniae (5.85％). The resistance rate of Acinetobacter baumannii and Pseudomonas aeruginosa was higher, and other pathogens also showed various degrees of tolerance to antibiotic. Conclusions The pathogens in patients with acute exacerbation of bronchiectasis are Gram-negative bacteria. Considering the characters of Pseudomonas aeruginosa, it is not suggested to use cephalosporin of the third and fourth generation in treating Pseudomonas aeruginosa. Clinical selection of antibiotics should combine with the disease characteristics of patients in our hospital.

Progress on blocking CD47 expression for tumor sensitization and normal tissue protection in radiotherapy / 肿瘤

Radiation therapy plays an important role in the treatment of carcinoma. Though radiation can kill tumor cells, the radioresistance of tumor cells and the side effects of radiotherapy are still problems to be solved urgently in the treatment of clinical tumors. How to enhance radiosensitivity and radioprotection is a research hotspot and difficult problem for radiologists. In recent years, it has been found that CD47, as a member of the transmembrane Ig superfamily on the cell surface and an extracellular ligand of signal-regulatory protein α (SIRPα), regulates tumorigenesis and repair function of normal tissues after radiation injury. Blocking the expression of CD47 has been found to confer radioprotection of normal tissues while enhancing tumor radiosensitivity. This paper puts forward that CD47 can be regarded as a target of radiosensitization for improving the tolerance of normal tissues to radiotherapy while enhancing the radiosensitivity of tumor tissues, so as to improve the curative effect of tumor radiotherapy.

Percataneous radio frequency ablation for complicated diffuse arteriovenous malformations: a report of 12 cases / 中华整形外科杂志

Objective@#To evaluate the efficacy and feasibility of radiofrequency ablation(RFA) for complicated diffuse arteriovenous malformations.@*Methods@#From Dec. 2014 to Dec. 2016, 12 cases with complicated diffuse arterioveneous malformations were treated by RFA in our hospital. The clinical records were retrospectively reviewed. The lesion size ranged from 10 cm×7 cm to 28 cm×30 cm. Ablation procedures with " high power and long time" technique were performed under real time color Doppler monitoring. The impedance model were used and ablation needles were punctured into core lesions with the most abundant blood flow. Power was set as 90 to 110 W for central core lesions, and 60 to 80 W for superficial or surrounding lesions. The average ablation time was from 60 to 90 min (average, 75 min). Next treatment would be performed 3 months later when neccessary. The therapeutic efficacy was evaluated on a 4-level scale.@*Results@#Hyperpyrexia occurred in 1 patients during first and second treatments. Transient postoperative hemoglobinuria occurred in 2 patient. Full thickness defects induced by tissue necrosis in the original ulcer area of cheek occurred in 1 patient, which was reconstructed with pedicle Trapezius muscle myocutaneous flap. Bleeding symptom in 7 cases stopped after only 1 treatment. After a follow-up period of 1-3 years, the efficacy was graded as Ⅳ in 8 case, as Ⅲ in 4 cases.@*Conclusions@#For complicated diffuse arteriovenous malformations, radio frequency ablation with "high power and long time" technique under real time color Doppler monitoring can completely damage the deep core soft lesions, and control the life-threatening hemorrhage effectively, which can be recommended as the alternative therapy when surgery, interventional embolizationor or sclerosant injection can not control the lesions.

Preparation and evaluation of an articular cartilage extracellular matrix/human umbilical cord Wharton gel composite scaffold / 中国组织工程研究

BACKGROUND:Soft tissue engineering mainly includes seed cells,scaffolds,cytokines and bioreactors,among which,the scaffolds are the key link in the construction of tissue-engineered cartilage.OBJECTIVE:To prepare an articular cartilage extracellular matrix/human umbilical cord Wharton gel porous scaffold,and to evaluate its physicochemical properties and biocompatibility.METHODS:The articular cartilage extracellular matrix/human umbilical cord Wharton gel porous scaffold was prepared by freeze thawing drying method using porcine articular cartilage extracellular matrix and human umbilical cord Wharton glue as raw materials.The porosity,water absorption,tissue composition and longitudinal compressive elastic modulus of the scaffold were measured and histologically stained.Rabbit chondrocytes were co-cultured with the articular cartilage extracellular matrix/human umbilical cord Wharton gel porous scaffold for 7 days.Then,scanning electron microscopy,live-dead cell staining and hematoxylin-eosin staining were performed.In addition,rabbit chondrocytes were cultured in the extract of the articular cartilage extracellular matrix/human umbilical cord Wharton gel porous scaffold and cell culture medium for 6 days,respectively;and MTT assay was used to detect cell proliferation.RESULTS AND CONCLUSION:The articular cartilage extracellular matrix/human umbilical cord Wharton gel porous scaffolds had a cross-section of uniform porous network structure and a vertical cross-section of the vertical tubular structure,and the pore wall was densely covered with cartilage fibers.The composite porous scaffold was positive for hematoxylin-eosin staining,safranin O staining and toluidine blue staining,and contained collagen and glycosaminoglycan ingredients.The water absorption,porosity and longitudinal compressive elastic modulus of the scaffolds were (17.418 8±0.909 0)％,(81.495 1±6.621 0)％ and (2.833 3±0.456 4) kPa,respectively.After 7 days of co-culture,rabbit chondrocytes adhered to the scaffold and proliferated,and further grew into the pores of the scaffold.Moreover,the scaffold was non-toxic to the rabbit chondrocytes.To conclude,the physiochemical properties and biochemical components of articular cartilage extracellular matrix/human umbilical cord Wharton gel porous scaffolds are similar to those of natural cartilage,and the scaffold has good biocompatibility.

The angiographic classification and sclerotherapy of cavernous hemangiomas of maxilloface / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To explore the factors that affect the curative effect and the best method of treatment for the patients with maxillofacial cavernous hemangiomas.</p><p><b>METHODS</b>102 cases of maxillofacial cavernous hemangiomas were performed DSA examination and taken serial photography. According to the diameter, number and draining speed of efferent veins of the tumor, the cavernous hemangiomas were classified into two types-the high efferent speed and low efferent speed type. For all of them, were randomly performed embolization of efferent veins with absolute ethanol plus bleomycin-A5 intratumor injection (group I) and bleomycin-A5 intratumor injection alone (group II).</p><p><b>RESULTS</b>The cure rate and general effective rate has significant difference (P < 0.01) between two groups in 70 patients with high efferent speed veins, while no significant difference (P > 0.05) in 32 patients with low efferent speed veins.</p><p><b>CONCLUSIONS</b>This new classification is beneficial for seeking method of treatment. The embolization of efferent veins is an effective method for cavernous hemangioma with high efferent speed veins; but for the type with low efferent speed veins, bleomycin-A5 intratumor injection alone could acquire a good results.</p>

Classification and treatment of intramuscular vascular malformations of extremities / 中国现代普通外科进展

Objective:To explore the clinical classification and ideal treatment of extremitalintramuscular vascular malformations. Methods:472 cases of extremital intramuscular vascularmalformations were enrolled from Oct. 1983-Dec. 2004;the clinical manifestations and iconography features were analysed. Thus intramuscular malformations, according to the blood dynamics, areclassified into two types-the high efferent speed of 40 casaes(AVM)and the low efferent speedof 432(VM), while classified into five types according to pathological extent-monlocalized typeof 92 cases, polylocalized 162, extensive type of 166, nerve trunk type of 38 diffuse type of 14 casses operative means: 360 patients received operation alone(82 cases with two-stage operation),10 patients received operation plus muscle shift, 34 patients received operation plusembolism of entering arteria, 58 patients received embolism of efferent veins plus intratumorallysclerotherapy, 6 patients received limbs removal. 4 abandoned all treatments. Results: 386 caseswere followed-up from 1 years to 20.Among them, 234 patients were cured(60.62%), 78 cases were valid(20.21%) , 58 cases were improved (15.03%),16 cases were invalid (4.15%) . Conclusion:the right pathological classification is based on reasonable iconography diagnostic course, the new pathological classification contributes to the treatment selection and judgment of the prognosis, comprehensive treatment in which operation taken as a chief means,is a valid way for extremital intramuscular vascular malformations.

Clinical study of combined interventional embolization for the treatment of portal hypertention / 中国普通外科杂志

0.05).(4) Free pressure of portal vein(FPP) significantly declined at post-operation in the two groups(P