Effect of video games training on the gross motor skills of children with cerebral palsy: systematic review and meta-analysis / Efecto del entrenamiento con videojuegos en la motricidad gruesa de niños con parálisis cerebral: revisión sistemática y meta-análisis

Abstract The purpose of this work was to systematically evaluate the intervention effects of video games training (VGT) on the gross motor skills (GMS) development of children with cerebral palsy (CP). Seven Chinese and English databases (PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure, Wanfang, EBSCO) were searched. Data were retrieved from randomized controlled trials on the GMS among individuals with CP. The retrieval was from the inception of each database to March 16, 2021. The included studies were evaluated quantitatively using the PEDro Scale. Then, relevant data were inputted and analyzed in Review Manager 5.4. Thirteen papers were included: seven written in English and six in Chinese. In the three subordinate concept of GMS, VGT could significantly improve locomotor skills (LS) (standardized mean difference = 0.80, 95% confidence interval 0.55-105, P<0.00001), and non-locomotor skills (NLS) (standardized mean difference = 0.83, 95% confidence interval 0.38-1.28, P=0.0003) in CP. However, there was no significant difference in object control skills (OCS), when compared with the control group (standardized mean difference = 0.55, 95% confidence interval -0.01-0.72, P=0.05). VGT can improve LS and NLS in CP, but the effect on OCS is uncertain; therefore, it is recommended that additional high-quality literature be included in the future. In general, VGT has been proven an effective intervention tool on the GMS development in CP.

Resumen Este artículo intentó evaluar sistemáticamente el efecto de la intervención del entrenamiento con videojuegos (VGT) en el desarrollo de las habilidades motoras gruesas (GMS) de niños con parálisis cerebral (CP), basándose en un cuerpo de datos logrado de las conclusiones de pruebas controladas aleatorias sobre las habilidades motoras gruesas de niños con CP, obtenidos de la búsqueda sistemática en siete bases de datos chinos y extranjeros, tales como PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure, Wanfang y EBSCO. El lapso de búsqueda fue desde la fecha de establecimiento de cada base de datos hasta el 16 de marzo del 2021. Se aplicó la escala PEDro para realizar un estudio cuantitativo y después, se analizaron los datos relevantes con Review Manager 5.4. Se incluyeron 13 publicaciones, 7 artículos escritos en inglés y 6 en chino. En el marco del concepto de los tres subordinados de GMS, la VGT podría mejorar significativamente la habilidad locomotora (LS) (diferencia de medias estandarizada = 0.80, intervalo de confianza del 95%: 0.55-105, P<0.00001), y las habilidades no locomotoras (NLS) (diferencia de medias estandarizada = 0.83, intervalo de confianza del 95%: 0.38-1.28, P= 0,0003) en PC; pero no hubo una diferencia significativa en las habilidades de control de objetos (OCS), cuando se compararon con el grupo control (diferencia de medias estandarizada= 0,55, intervalo de confianza del 95% -0,01-0,72, P= 0,05). En conclusión, el VGT puede mejorar las LS y NLS en CP, pero el efecto sobre OCS es incierto; por lo que se recomienda la inclusión de literatura adicional de alta calidad en el futuro. De este modo se pudo demostrar que el VGT es una herramienta de intervención eficaz en el desarrollo de las GMS en niños con CP.

Study on chemical constituents from Mastic (Pistacia lentiscus) / 中国中药杂志

Phytochemical investigation on the methanolic extract of Mastic by using various chromatographic techniques led to the isolation of 9 compounds. Based on the analysis of spectroscopic data(NMR and MS) and/or comparisons with the data reported in the literature, their structures were elucidated as 3β,8α,13-trihydroxypolypoda-14-methoxy-14-methyl-17,21-diene(1), 4-hydroxymyrtenal(2),3-methyl-6-(prop-1-en-2-yl)cyclohex-3-ene-1, 2-diol(3), 2-oxo-Δ~3-4,5,5-trimethylcyclopentynyl acidic acid(4),(1S,2R,3R,5R)-6,6-dimethyl-4-methylidenebicyclo[3.1.1]-heptane-2,3-diol(5),(4R)-1-methyl-4-(1-hydroxyisopropyl)cyclohexene-6-one(6), 6,6-dimethyl-4-hydroxy[3.1.1]hept-2-ene-2-carboxylic acid(7), 6,6-dimethyl[3.1.1]hept-2-ene-2-carboxylic acid(8), 6,6-dimethyl-4-oxobicyclo[3.1.1]hept-2-ene-2-carboxylic acid(9). Compound 1 is a new compound and 2-9 were isolated from this species for the first time. In vitro cytotoxicity assay results indicated that compounds 1, 6 and 7 showed significant inhibitory effects against human lung cancer cell line A549 with IC_(50) values of 20.4, 25.1 and 22.5 μmoL·L~(-1).

The safety and efficacy of tPA intravenous thrombolysis for treating acute ischemic stroke patients with a history of cerebral hemorrhage

Alteplase (tPA) intravenous thrombolysis is an effective treatment for acute ischemic stroke (AIS) when administered within 4.5 h of initial stroke symptoms. Here, its safety and efficacy were evaluated among AIS patients with a previous history of cerebral hemorrhage. Patients who arrived at the hospital within 4.5 h of initial stroke symptoms and who were treated with tPA intravenous thrombolysis or conventional therapies were analyzed. The 90-day modified Rankin scale (90-d mRS) was used alongside mortality and incidence of symptomatic intracerebral hemorrhage (SICH) rates to evaluate the curative effect of these therapies. Among 1,694 AIS patients, 805 patients were treated with intravenous thrombolysis, including patients with (n=793) or without (n=12) a history of cerebral hemorrhage, and the rate of incidence of SICH significantly differed between them (8.3 vs 4.3%, P=0.039). No significant difference was found in 90-d mRS measurements (41.7 vs 43.6%, P=0.530) and 90-d mortality rates (8.3 vs 6.5%, P=0.946). A total of 76 AIS patients with a history of cerebral hemorrhage received tPA thrombolytic therapy (n=12) or conventional therapy (n=64), and a significant difference was noted in the 90-d mRS scores between the two groups (41.7 vs 23.4%, P=0.029), while no significant difference was found in SICH measurements (8.3 vs 4.6%, P=0.610) and 90-d mortality rates (8.3 vs 9.4%, P=0.227). A history of cerebral hemorrhage is not an absolute contraindication for thrombolytic therapy; tPA intravenous thrombolysis does not increase SICH measurements and mortality rates in patients with a history of cerebral hemorrhage, and they may benefit from thrombolytic therapy.

Early application of the antibiotic-laden bone cement (ALBC) combined with the external fixation support in treating the open fractures of lower limbs complicated with bone defect / 中国骨伤

<p><b>OBJECTIVE</b>To discuss the curative effect of the early application of the antibiotic-laden bone cement (ALBC) combined with the external fixation support in treating the open fractures of lower limbs complicated with bone defect.</p><p><b>METHODS</b>From December 2013 to January 2015, 36 cases of lower limb open comminuted fractures complicated with bone defects were treated by the vancomycin ALBC combined with the external fixation support, including 26 males and 10 females with an average age of 38.0 years old ranging from 19 to 65 years old. The included cases were all open fractures of lower limbs complicated with bone defects with different degree of soft tissue injuries. Among them, 25 cases were tibial fractures, 11 cases were femoral fractures. The radiographs indicated a presence of bone defects, which ranged from 3.0 to 6.1 cm with an average of 4.0 cm. The Gustilo classification of open fractures:24 cases were type IIIA, 12 cases were typr IIIB. The percentage of wound infection, bone grafting time, fracture healing time and postoperative joint function of lower limb were observed. The function of injured limbs was evaluated at 1 month after the clinical healing of fracture based on Paley evaluation criterion.</p><p><b>RESULTS</b>All cases were followed up for 3 to 24 months with an average of (6.0±3.0) months. The wound surface was healed well, neither bone infections nor unhealed bone defects were presented. The reoperation of bone grafting was done at 6 weeks after the patients received an early treatment with ALBC, some of them were postponed to 8 weeks till the approximate healing of fractures, the treatment course lasted for 4 to 8 months with an average of(5.5±1.5) months. According to Paley and other grading evaluations of bone and function, there were 27 cases as excellent, 5 cases as good, 3 cases as ordinary.</p><p><b>CONCLUSIONS</b>The ALBC combined with external fixation support was an effective method for early treatment to treat the traumatic lower limb open fractures complicated with bone defects. This method was typified with the advantages such as easy operation, short operation time, overwhelming superiority in controlling infection and provision of good bone grafting bed, a good bone healing can be realized by the use of membrane induction technology for bone grafting.</p>

Analysis of clinical effects of iliolumbar fixation in treating sacrum fracture of Denis type II / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate the clinical effects of iliolumbar fixation for the sacrum fractures of Denis type II.</p><p><b>METHODS</b>The clinical data of 86 patients with sacrum fracture of Denis type II treated by iliolumbar fixation from January 2008 to January 2012 were retrospectively analyzed. There were 55 males and 31 females, aged from 17 to 55 years old with an average of 39.1 years. Among them, 73 cases complicated with pelvis fracture and 13 cases with acetabular fracture; 37 cases with sacral neurological symptoms and 49 cases without sacral neurological symptoms. Fracture healing time, nerve function, clinical function and complications were observed in the patients.</p><p><b>RESULTS</b>In 86 cases, 6 cases were out of followed-up and 80 cases were followed up from 24 to 71 months with an average of 36 months. The mean fracture healing time was 13 weeks (ranged, 10 to 38 weeks). According to Gibbons scoring to evaluate the neurological function, preoperative nerve rehabilitation, lower limbs feeling, lower limbs activity,bladder and rectum function,total score respectively were 0.62 +/- 0.04, 1.54 +/- 0.35, 1.12 +/- 0.18, 0.23 +/- 0.01, 3.46 +/- 0.47 and postoperative respectively were 0.82 +/- 0.12, 0.36 +/- 0.04, 0.05 +/- 0.01, 0.03 +/- 0.01, 1.25 +/- 0.22, there were statistically significant differences between preoperative and postoperative (P < 0.05). According to Majeed scoring to evaluate the clinical function, postoperative pain, standing, sitting, sexual life, work ability, total score respectively were 22.54 +/- 4.02, 27.93 +/- 5.46, 8.47 +/- 3.61, 2.54 +/- 1.33, 16.46 +/- 4.34, 81.32 +/- 8.73, 60 cases got excellent results, 17 good, 3 fair. The main complications including fracture nonunion of 5 cases,deep incision infection of 1 case, and screw prominence resulting uncomfortable of 8 cases.</p><p><b>CONCLUSION</b>Iliolumbar fixation has the advantages of stable fixation, satisfactory functional rehabilitation, less complications, and is a good method in treating sacrum fracture of Denis type II.</p>

Glucagon-like peptide 1 improves learning and memory abilities of rats with type 2 diabetes / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the effect of glucagon-like peptide 1 (GLP-1) on cognitive dysfunction in diabetic rats.</p><p><b>METHODS</b>Male SD rats were randomly divided into normal control group, diabetes mellitus (DM) group, and GLP-1 treatment group. Rat models of type 2 diabetes were established by high-sugar and high-fat feeding and streptozotocin (STZ) injection, and 25 days after the onset of diabetes, GLP-1 was infused in GLP-1 treatment group at the rate of 30 pmol·kg·minvia a subcutaneous osmotic pump for 7 days. The learning and cognitive ability of the rats was assessed with Morris water maze test, and the expression of cognition-related genes in the hippocampus tissue was detected with real-time PCR, Western blotting and immunohistochemical staining.</p><p><b>RESULTS</b>Compared with the normal control group, the diabetic rats showed significantly decreased learning and memory abilities (P<0.05) with increased hippocampal expressions of APP, BACE1, Arc, ERK1/2, PKA, and PKC mRNAs (P<0.05) and Arc protein. Compared with diabetic rats, GLP-1-treated rats showed significantly improvements in the learning and memory function (P<0.05) with decreased expressions of APP, BACE1, Arc, ERK1/2, and PKA mRNAs (P<0.05) and Arc protein.</p><p><b>CONCLUSION</b>GLP-1 can improve cognitive dysfunctions in diabetic rats possibly by regulating the PKC, PKA, and ERK1/2 pathways and inhibiting Arc expression in the hippocampus.</p>

In vitro percutaneous penetration studies of Jinhuang Gel based on principal component analysis / 中草药

Objective: To comprehensively evaluate the in vitro percutaneous penetration and provide the experimental basis of in vitro kinetics for new drug development of Jinhuang Gel. Methods: The skin penetration of Jinhuang Gel was investigated through in vitro excised rat skin using the improved Franz diffusion cell. HPLC fingerprint of receptive solution and skin retention was established and analyzed using principal component analysis (PCA). The common peaks of HPLC fingerprint between Jinhuang Gel and Jinhuang Ointment were selected and each area was calculated to obtain the PCA biplot. Paeoniflorin as a representative of common peaks was used to investigate the in vitro permeation kinetics. Results: The results showed that the PCA biplot based on common peaks areas displayed that the global in vitro transdermal absorption effects of Jinhuang Gel were significantly better than those of Jinhuang Ointment. The in vitro transdermal absorption of paeoniflorin followed zero kinetics, and the cumulative permeation amount, permeation rate, and skin retention of paeoniflorin from Jinhuang Gel were superior to those from Jinhuang Ointment. Conclusion: Jinhuang Gel could improve the overall effects of in vitro percutaneous absorption. PCA is an effective means for investigating in vitro percutaneous absorption experiments of Chinese materia medica for transdermal administration.

Reduction of atrial fibrillation in remotely monitored pacemaker patients: results from a Chinese multicentre registry / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Many recipients of implantable cardiac electronic devices have atrial fibrillation (AF) occurrences after device implantation, even if there is no previous history of AF, and some of the episodes are asymptomatic. The purpose of this study was to evaluate trends in AF burden following early AF detection in patients treated with pacemakers equipped with automatic, daily Home Monitoring function.</p><p><b>METHODS</b>Between February 2009 and December 2010, the registry recruited 701 pacemaker patients (628 dual-chamber, 73 biventricular devices) at 97 clinical centers in China. Daily Home Monitoring data transmissions were analyzed to screen for the AF burden. In-office follow-ups were scheduled for 3 and 6 months after implantation. Upon first AF (i.e., mode-switch) detection in a patient, screening of AF burden by Home Monitoring was extended for the next 180 days.</p><p><b>RESULTS</b>At least one episode of AF was observed in 22.9% of patients with dual-chamber pacemakers and in 28.8% of patients with biventricular pacemakers. The first AF detection in a patient occurred, on average, about 2 months before scheduled follow-up visits. In both pacemaker groups, mean AF burden decreased significantly (P < 0.05) over 180 days following first AF detection: from 12.0% to 2.5% in dual-chamber and from 12.2% to 0.5% in biventricular pacemaker recipients. The number of patients with an AF burden >10% per month was significantly reduced over 6 months of implantation in both dual chamber (38 patients in the first month vs. 21 patients in month 6, P < 0.05) and biventricular (7 patients in the first month vs. 0 patient in months 4-6, P < 0.05) pacemaker recipients.</p><p><b>CONCLUSIONS</b>Automatic, daily Home Monitoring of patients treated with cardiac pacemakers allows early detection of AF, and there is a gradual and significant decrease in AF burden.</p>

Application of enhanced recovery program after surgery(ERAS) in patients undergoing radical resection for colorectal cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To compare the enhanced recovery program after surgery (ERAS) with conventional perioperative management in patients undergoing radical resection for colorectal cancer.</p><p><b>METHODS</b>The ERAS protocol included a combination of evidence-based and consensus methodology. A total of 597 consecutive patients undergoing elective colorectal resection were randomized to either the ERAS(n=299) or the control group(n=298). Outcomes related to nutrition and metabolism index, stress index, and recovery index were measured and recorded.</p><p><b>RESULTS</b>Demographics and operative parameters were similar between the two groups(P>0.05). The nutritional status of patients in the ERAS group was improved after surgery compared with that of the control group. On postoperative day (POD) 1, the HOMA-IR in the ERAS group was significantly lower than that in the control group(P<0.01). The cortisol level in the control group was elevated on both POD 1(P<0.01) and POD 5(P<0.01) compared to the preoperative level. However, the cortisol level was not increased until POD 5(P<0.01) in the ERAS group. The levels of TNF-α, IL-1β, IL-6, and IFN-γ were reduced in the ERAS group, indicating less postoperative stress responses compared with the control group. In addition, ERAS group was associated with accelerated recovery of gastrointestinal function. The postoperative length of stay [(5.7±1.6) d vs. (6.6±2.4) d, P<0.01] and expense[(15 998±2655) RMB vs. (17 763±3059) RMB, P<0.01] were reduced in the ERAS group. Twenty-eight patients(9.4%) in the control group and 29(9.7%) in the ERAS group developed complications, while the difference was not statistically significant(P>0.05).</p><p><b>CONCLUSION</b>ERAS protocol alleviates surgical stress response and accelerates postoperative recovery without compromising patient safety.</p>

Predictive value of N-terminal pro-brain natriuretic peptide in combination with the sequential organ failure assessment score in sepsis / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The prognostic power of n-terminal pro-brain natriuretic peptide (NT-proBNP) in sepsis is disputable and unstable among different models. We attempt to evaluate the prognostic potential of NT-proBNP in combination with the sequential organ failure assessment (SOFA) score in sepsis.</p><p><b>METHODS</b>In this retrospective study, 100 consecutive sepsis patients were enrolled. Clinical data such as admission SOFA, the Acute Physiologic and Chronic Health Evaluation score, shock prevalence, use of lung protective ventilation, vasopressors, and glucocorticoids were recorded. Additionally, serum creatinine (Scr1 and Scr3) and NT-proBNP (NT-proBNP1 and NT-proBNP3) were assayed and evaluated at admission and on day 3 respectively.</p><p><b>RESULTS</b>DNT-proBNP (NT-proBNP3 minus NT-proBNP1) (P < 0.001, Hazard ratio (HR) = 1.245, 95% confidence interval (CI), 1.137 - 1.362) and admission SOFA (P < 0.001, HR = 1.197, 95%CI, 1.106 - 1.295) were independently related to in-hospital mortality. Their combination was a more robust predictor for in-hospital mortality than either of them individually. Patients with high DNT-proBNP and SOFA had the poorest prognosis.</p><p><b>CONCLUSIONS</b>In our study, both DNT-proBNP and SOFA were independent predictors of septic patients' prognosis. Moreover, the combination of DNT-proBNP and admission SOFA provided a novel strategy that contained information regarding both the response to treatment and sepsis severity.</p>

Apoptosis of hypertrophic scar fibroblasts induced by HMME-PDT / 中华医学美学美容杂志

Objective To investigate the apoptotic effects of hypertrophic scar fibroblast (HSF) induced by HMME-PDT.Methods Fibroblasts were cultured from nontreated hypertrophic scars,and cells at passages 4-6 were used for the experiments (photosensitizer dose 4 μg/ml,λ630 nm,pow er density 10 mw/cm2,energy fluence 2.5 J/cm2).Morphological and biochemical changes in fibroblasts were assessed by Hoechst 33258 staining and fluorescence microscopy.The rate of apoptotic or necrotic cells was detected by flow cytometry (FCM) through double staining of Annexin V -FITC and popodium iodide (PI),respectively.Results Marked morphological features of cell apoptosis were viewed under the fluorescent microscope through Hoechst 33258 staining.The analysis of FCM indica ted that the apoptotic rate was significantly increased after HMME PDT [(34.82 ± I.42) ％ vs (3.12±0.28) ％,P＜0.05],and apoptotic rate was higher than necrosis rate [(14.65±1.02) ％ vs (34.82±1.42) ％,P＜0.05].Conclusions Low level exposure to 630 nm PDT mediated by HMME appears to induce fibroblast apoptosis.

Development and characterization of a stable cell line expressing respiratory syncytial virus non-structural protein NS1 / 病毒学报

To develop a stable cell line that could express the RSV NS1, the full-length RSV NS1 gene was generated by RT-PCR amplification from respiratory syncytial virus. NS1 gene was ligated with pBABE-puro to construct the recombinant retroviral expression plasmid pBABE-NS1, which was cotransfected into 293FT packaging cells with PIK packaging plasmid by calcium phosphate co-precipitation. The supernatant of 293FT was collected to infect HEp-2 cells, the resulting cell clones stably expressing NS1 were screened by puromycin. Using QPCR, CPE staining method and indirect immunofluorescence assay, the expression of NS1 at both gene and protein levels was identified. The recombinant plasmid pBABE-NS1 was identified by EcoRI and BamHI endonuclease digestion and the sequence analysis. QPCR results showed that the NS1 gene amplification in HEp-2-NS1 cells was 8483 fold higher than that in HEp-2 cells. Although the exogenous interferon was added, all cells were destroyed after 48 hours post infection using CPE staining method, showing that HEp-2-NS1 cells remained sensitive to the VSV virus. The results of RT-PCR and indirect immunofluorescence assay showed that the NS1 gene in HEp-2 cells could not only transcribe mRNA, but also express NS1 protein steadily. We had successfully established HEp-2-NS1 cell lines with stable expression of respiratory syncytial virus non-structural protein NS1.

Analysis of risk factors for valve replacements in 5,128 cases from a single heart center in China / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Numerous studies have developed a "severity score" or "risk index" for short-term mortality associated with coronary artery bypass grafting (CABG). Due to the different distribution of disease types, the number of valve surgeries in the US and Europe is relatively small. Thus, a risk-scoring system for valve surgeries was developed later and used less than that for the CABG surgery. We retrospectively reviewed 5128 cases of heart valve replacement, to quantitatively assess the risk factors for hospital mortality, and establish risk models for the hospital mortality of cardiac valve replacement patients.</p><p><b>METHODS</b>A total of 1549 cases of aortic valve replacement, 2460 cases of mitral valve replacement, and 1119 cases of combined aortic valve and mitral valve replacement that were recorded from January 2005 to December 2009 in the cardiac surgery database at Beijing Anzhen Hospital were selected for this study. The cases were randomly assigned to a model group (n = 3657) and a validation group (n = 1471) with a ratio of 7:3. Thirty-two pre- and intra-operative clinical indicators were selected as possible influencing factors for hospital mortality. Single-factor analysis was performed to screen these factors, and then multi-factor analysis was used to determine the risk factors for hospital mortality in the three surgeries and to establish risk models.</p><p><b>RESULTS</b>In the multi-factor analysis, age, body surface area, etiology, cardiopulmonary bypass time, preoperative cardiothoracic ratio, cardiac functional classification, and preoperative creatinine were risk factors for aortic valve replacement. Etiology, preoperative history of heart failure, cardiopulmonary bypass time, preoperative cardiothoracic ratio, and preoperative left ventricular end systolic diameter were risk factors for mitral valve replacement. Age, body mass index, cardiopulmonary bypass time, and cardiac function classification were risk factors for combined aortic valve and mitral valve replacement. The risk models showed good predictive ability (Hosmer-Lemeshow test: P = 0.981 in the model for aortic valve replacement, P = 0.503 in the model for mitral valve replacement, and P = 0.154 in the model for combined aortic valve and mitral valve replacement). The area under the ROC curve of the validation group was 0.958 (95%CI: 0.936 - 0.975) for the aortic valve replacement model, 0.876 (95%CI: 0.805 - 0.948) for the mitral valve replacement model, and 0.845 (95%CI: 0.753 - 0.939) for the combined aortic valve and mitral valve replacement, indicating that the risk models were good in predicting hospital mortality for surgeries.</p><p><b>CONCLUSION</b>The three risk models can quantitatively assess the hospital mortality risk in the patients treated with cardiac valve replacement.</p>

Histological and ultrastructural study on the medial canthal ligament of blepharophimosis, ptosis and epicanthus inversus syndrome / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Blepharophimosis ptosis epicanthus inversus syndrome (BPES) is a rare congenital ophthalmic disorder, characterized by congenital eyelid malformation including bilateral ptosis, shortening of the horizontal eyelid fissure, epicanthus inversus, and increased distance between the inner canthi. In this research, we studied the histological structure and ultrastructure of medial canthal ligament of patients with BPES.</p><p><b>METHODS</b>Thirty patients with BPES who received plastic surgery at the Zhongshan Ophthalmic Center from March 2006 to January 2008 were studied. There were 17 males and 13 females with an average age of (8.73 +/- 3.37) years (3 - 31 years). The medial canthal ligaments of patients were collected during the plastic surgery to analyze the histological structure by hematoxylin and eosin (HE), Congo red, van Gieson's (VG), Masson trichrome and aldehyde-fuchsin staining. The ultrastructures of the medial canthal ligaments were also analyzed by scanning electron microscopy (SEM) and transmission electron microscopy (TEM). Fifteen samples of medial canthal ligament from healthy persons with an average age of (9.02 +/- 3.12) years (6 - 30 years) were collected as a control group.</p><p><b>RESULTS</b>Morphological and histological study showed that the medial canthal ligaments of BPES patients were composed of collagen fibers, a few elastic fibers and striated muscles. The collagen fibers assemblies were disorganized and the fibrous connective tissues were undergoing hyaline degeneration. The karyopycnosis of fibroblasts was located among the collagen fibrils and the numbers of fibroblasts were decreased. Ultrastructural study with SEM showed that the collagen fibers were larger than normal, irregular and loose. Parts of the collagen fibers were broken and had a coarse surface. Ultrastructural study with TEM showed that the fibroblasts had less cytoplasm, fewer organelles and the nucleus displayed pyknosis.</p><p><b>CONCLUSIONS</b>The medial canthal ligament in BPES patients is composed chiefly of collagen fibers. The collagen fibers of medial canthal ligaments in BPES patients are disorganized and hyaline degeneration is present. The study revealed that the medial canthal ligament of BPES patients might have congenital dysplasia.</p>

Study on preoperative low dose amiodarone administration for prevention of atrial fibrillation after off-pump coronary artery bypass grafting / 中华老年医学杂志

Objective To assess the safety, tolerability and efficacy of preoperative low dose intravenous amiodarone in the prevention of atrial fibrillation (AF) after off-pump coronary artery bypass grafting (OPCAB). Methods Two hundred patients with coronary atheroselerotic heart disease underwent selected OPCAB and were randomly divided into two groups: control group (100 cases) and experimental group (100 cases). Patients in control group were given conventional medicines and placebo, and patients in experimental group were treated with low dose intravenous amiodarone daily for 4 days before surgery. They were given conventional medicines after surgery. Results After the off-pump coronary artery bypass grafting, the incidence of AF, ventricular rate and the duration of AF in the experimental group were lower than those in control group [15% vs. 41%, χ2=16.766, P=0.000; (126.0±20.8) times/ min vs. (150.0±25.6) times/ min, t=0.478, P =0. 017; (8. 0±8. 6) h vs. (12.0±9.6) h, t=0. 439, P=0. 019]. No significant difference were found in the incidence of side effect between low close amiodarone group and the control group. Conclusions Prophylactic application of low dose intravenous arniodarone before off-pump coronary artery bypass grafting can safely and effectively reduce the postoperative ventricular rate and the incidence of AF, shorten the duration of AF, promote the rehabilitation and slightly improve the clinical symptoms.

Surgical treatment for degenerative lumbar scoliosis associated with spinal stenosis / 中国骨伤

<p><b>OBJECTIVE</b>To study surgical techniques for degenerative lumbar scoliosis associated with lumbar stenosis and evaluate their clinical significane.</p><p><b>METHODS</b>Thirty-two patients with degenerative lumbar scoliosis associated with spinal stenosis were treated by techniques of posterior lumbar interbody fusion or posterolateral fusion and pedicle screws. There were 18 male and 14 female with 56.8 years old on the average (ranging from 49 to 75 years). There were no evident change of lumberlordosis in 15 cases, and lumber lordosis were obvious loss associated with lumbar subluxation in 17 cases. The correcting, the improvement of back and leg pain, complications and followed-up results were analyzed retrospectively.</p><p><b>RESULTS</b>Thirty-two cases were followed-up for 6 to 39 months (the average time of 13 months). The average correction rate of scoliosis was 58.0% and the rate of pain relief was (80.2 +/- 5.8)%. There were two cases of dura sac laceration, two cases of nerve roots injury and a case of pseudoarthritis. During followed-up, correction rate and height of disc spaces were not lost. Shift of interbody cages were no displaced; all the internal fixation got well fusion and the rate of fusion for the bone graft was 96.9%.</p><p><b>CONCLUSION</b>Posterior pedicle screws combined with interbody fusion or posterolateral fusion is a safe and effective surgical treatment for degenerative lumbar scoliosis associated with lumbar stenosis.</p>

Radiofrequency catheter ablation of idiopathic ventricular tachycardia and symptomatic premature ventricular contraction originating from valve annulus / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Radiofrequency catheter ablation (RFCA) has been established as an effective and curative therapy for ventricular tachycardia (VT) and severely symptomatic premature ventricular contraction (PVC) from the outflow tract in structurally normal hearts. This study aimed to investigate electrophysiologic characteristics and effects of RFCA for patients with idiopathic VT and symptomatic PVC originating from the valve annulus.</p><p><b>METHODS</b>Characteristics of body surface electrocardiogram (ECG) and endocardiogram in a successful RFCA target were analyzed in 16 patients with idiopathic VT and symptomatic PVC originating from the valve annulus. Additionally, the ECG characteristics of VT or PVC were compared with those of manifest Wolff-Parkinson-White (WPW) syndrome originating from the same site of origin in 15 patients.</p><p><b>RESULTS</b>Thirteen patients were successful, 2 recurrent and 1 failed. The recurrent cases underwent successful ablation the second time guided by the Ensite 3000 mapping system. In all patients with the WPW syndrome, the characteristics of QRS morphology were well matched with those of the VT and PVC that originated from corresponding sites of origin.</p><p><b>CONCLUSIONS</b>RFCA is an effective curative therapy for VT and symptomatic PVC originating from the valve annulus. There are specific characteristics in ECG and the ablation site could be located by means of the WPW syndrome accessory pathway's algorithm.</p>

Prognosis of patients with chronic thromboembolic pulmonary hypertension receiving conservative or operative treatments according to a new clinical classification scheme / 中华心血管病杂志

<p><b>OBJECTIVE</b>To compare the efficacy of conservative or pulmonary thromboendarterectomy (PTE) therapy for chronic thromboembolic pulmonary hypertension (CTEPH) patients according to a new clinical classification scheme.</p><p><b>METHODS</b>This retrospective study analyzed 63 cases of CTEPH admitted to our hospital from February 1995 to October 2007 and 45 cases were treated surgically (Group A) and 18 cases received conservative therapy (Group B). Results were analyzed using Fisher exact test and t test according to San Diego medical center quartering classification scheme and Anzhen Hospital modified bifurcate classification scheme.</p><p><b>RESULTS</b>There were 6 operational deaths in Group A and 2 deaths during hospital stay in Group B. During follow-ups (mean 3.6 +/- 2.5 years), there were 4 deaths in Group A and 9 deaths in Group B. the totality survival rate is significantly higher in Group A than that in Group B (P < 0.05). For patients with San Diego Type I CTEPH, survival rate was significantly higher in Group A compared with Group B (P = 0.009) and was similar for patients with type II and III and IV CTEPH between the two groups (P = 0.338, 0.455, 0.800). Survival rate was significantly higher in Group A than that in Group B for patients with Anzhen central type CTEPH (P = 0.009), but was similar between the two groups for patients with Anzhen peripheral type CTEPH (P = 0.125). The Kaplan-Meier survival curve 5 years survival rate in the Group A was (91.7 +/- 8.0)% for Anzhen central type and (76.0 +/- 8.5)% for Anzhen peripheral type (P = 0.04), and the 5 years Kaplan-Meier survival rate in the Group B was (42.9 +/- 18.7)% for Anzhen central type and (56.2 +/- 10.8)% for Anzhen peripheral type (P = 0.851).</p><p><b>CONCLUSION</b>Anzhen Hospital modified bifurcate classification scheme is a simple and effective classification to predict the prognosis and choose treatment method of CTEPH.</p>

The clinical analysis of 54 cases for the surgical treatment of pulmonary embolism / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the results of surgical procedures for pulmonary embolism.</p><p><b>METHODS</b>Fifty-four patients of pulmonary embolism received surgical treatment from October 1994 to June 2007, of which 9 were acute pulmonary embolism underwent pulmonary embolectomy and 45 patients were chronic thromboembolic pulmonary hypertension (CTEPH) underwent pulmonary thromboendarterectomy.</p><p><b>RESULTS</b>The mortality rate was 44.4% in acute pulmonary embolism group and 13.3% in CTEPH group (P < 0. 05). Thirteen patients had residual pulmonary hypertension and 23 patients had severe pulmonary reperfusion injury postoperatively. The pulmonary artery systolic pressure changed from (89.4 +/- 36.3) mm Hg (1 mm Hg =0.133 kPa) preoperative to (55.6 +/- 22.4) mm Hg postoperative. The pulmonary vascular resistance changed from (89. 7 +/- 56.7) kPa L(-1) S(-1) preoperative to (38.9 +/- 31.1) kPa L(-1) S(-1) postoperative. The arterial partial pressure of oxygen changed from (52. 3 +/- 6.7 ) mm Hg preoperative to (87.6 +/- 6.5) mm Hg postoperative. The arterial oxygen saturation changed from (88.9 +/- 4.5)% preoperative to (95.3 +/- 2.8 )% postoperative (P < 0.05). With the follow-up of (41.8 +/- 36.4) months, there were 4 patients died. According to NYHA, there were 28 patients for class I , 10 patients for class II and 2 patients for class III. According to Kaplan-Meier survival curve, the 3-year, 4-year, 5-year and 8-year survival rate were (97.1 +/- 2.8 )%, (94.0 +/- 4.1)%, (90.8 +/- 5.2)% and (85.0 +/- 7.3)% respectively. Linear rate of bleeding and thromboembolic related to anticoagulation were 0. 63% patient-years and 0. 62% patient-years respectively.</p><p><b>CONCLUSIONS</b>The operational mortality of acute pulmonary embolism is significantly higher than CTEPH, and the mid-long term survival rate is agreeable and the complication rate related to anticoagulation is relatively low.</p>

Application of the protocol of enhanced recovery after surgery in colorectal surgery / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To evaluate enhanced recovery after surgery(ERAS) protocol in colorectal surgery.</p><p><b>METHODS</b>From september 2006 to February 2007, 74 patients with colorectal cancer were randomly assigned to ERAS group and control group. The stress index, nutrition and metabolism index, intraoperative index and postoperative index were evaluated.</p><p><b>RESULTS</b>Six patients were excluded, 3 in ERAS group (2 cases received hepatectomy concomitantly and 1 case received partial ileum resection), and 3 in control group (1 case received hepatectomy and 1 case received colorectomy concomitantly, another presented asthma paroxysm). So there were 34 cases in ERAS group and 34 cases in control, with no statistical differences in sex, age, BMI index and operation types. Deviation of HOMA-IR index of ERAS was lower than the control (P>0.05), the same as plasma cortisol at the 1st day after operation (P<0.05), but plasma glucagons in the operation of ERAS group was higher than that of control (P<0.05). Plasma glucose 1st day after operation of ERAS group was lower than control (P<0.05), while plasma triglyceride intraoperation, at 1st day, 2nd day after operation of ERAS was higher than control (P<0.05). Nitrogen negative balance of ERAS group was higher than control at 2nd day after surgery, but is lower intraoperation and at 6th day after operation (P<0.05). The time of exhaust gas and stool, time to eat fluidity and semi-fluidity, out-of-bed time and exercise time per-day, residual time and complication rate in ERAS group were better than those of control (P<0.05). Post-operative expenses of ERAS was lower than that of control (P<0.05).</p><p><b>CONCLUSION</b>ERAS can decrease surgical stress, increase functional recovery and reduce complication rate.</p>