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With the continuous in-depth study of minimally invasive cardiac surgery(MICS), minimally invasive cardiac surgery in children has also been developed in this period, but there is still a certain gap compared with adults. Because of the large difference in body size and the low tolerance of surgery in children, minimally invasive cardiac surgery in children still has a short board on complex cardiac diseases. This article reviews several commonly used minimally invasive techniques: (1) small incision cardiac surgery; (2) thoracoscopic and robot-assisted cardiac surgery; (3) minimally invasive cardiopulmonary bypass(MiECC) and cardiac surgery to avoid cardiopulmonary bypass; (4) hybrid surgery and enhanced cardiac rehabilitation surgery(ERACS) in pediatric cardiac surgery and their application and research progress.
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Objective:To systematically evaluate the efficacy and safety of tissue adhesive combined with lauromacrogol (modified Sandwich method) for gastric varices.Methods:Literature in the Cochrane Library, PubMed, EMbase, CNKI, VIP and Wanfang were searched by two independent researchers from the establishment of the databases to June 30, 2020, and qualified data from the eligible literature were extracted. Revman 5.3 was used to analyze outcomes including hemostatic efficiency, incidence of postoperative fever, chest and abdominal pain, ulcer, ectopic embolism and complications, and postoperative re-bleeding rate (Mantel-Haenszel method).Results:A total of 8 randomized controlled trials including 898 patients were included in this meta-analysis. The results showed that compared with the classic Sandwich method, the modified version had a better hemostatic effect ( P=0.01, OR=2.07, 95% CI: 1.17-3.68) and a lower incidence of postoperative ectopic embolism ( P=0.001, OR=0.06, 95% CI: 0.01-0.34). There were no significant differences in the incidences of postoperative fever ( P=0.58, OR=0.86, 95% CI: 0.52-1.44), chest and abdominal pain ( P=0.83, OR=0.95, 95% CI: 0.58-1.56), local ulcer ( P=0.31, OR=0.66, 95% CI: 0.30-1.47) , re-bleeding ( P=0.14, OR=0.76, 95% CI: 0.53-1.09) or overall incidence of adverse reactions ( P=0.24, OR=0.66, 95% CI: 0.33-1.32). Conclusion:The modified Sandwich method of tissue adhesive combined with lauromacrogol is an effective and safe method in the treatment of gastric varices.
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Objective To investigate the difference in the clinical efficacy by thoracoscopy or thoracotomy for treating esophageal atresia.Methods Thirty-one cases of type-Ⅲ esophageal atresia undergoing surgical treatment from February 2015 to May 2018 at the Department of Pediatric Surgery of Fujian Provincial Maternity and Children's Hospital were included,and according to the different surgical methods they were divided into thoracoscopic group (15 cases) and thoracotomy group (16 cases).The operation duration,blood loss,postoperative chest drainage time,postoperative hospital stay and postoperative complications were analyzed between 2 groups.Results The mean time of operation was (181.33 ± 13.86) min in the thoracoscopic surgery group and (139.06 ± 10.98) min in the thoracotomy group,the thoracoscopie group had longer operation duration than thoracotomy group,and there was a significant difference in operation duration between two groups (t =9.44,P =0.000);mean blood loss was (3.07 ± 0.96) mL in the thoracoscopic surgery group and (5.06 ± 1.12) mL in the thoracotomy group,the thoracoscopic group had less amount of blood loss than thoracotomy group,and there was a significant difference in blood loss between two groups(t =-5.29,P =0.000);mean postoperative chest drainage time was (11.67 ± 1.34) d in the thoracoscopic group and (12.25 ± 1.06) d in the thoracotomy group,and there was no significant difference in postoperative chest drainage time between two groups (t =-1.34,P =0.19);mean time of postoperative hospitalization time was (15.20 ± 0.94) d in the thoracoscopic group and (16.00 ±0.96) d in the thoracotomy group,and there was a significant difference in the postoperative hospitalization time between two groups (t =-2.33,P =0.027);the anastomotic leak rates were 33.33％ (5 cases) versus 25.00％ (4 cases) with closed or open approaches,respectively;anastomotic stricture rates were 40.00％ (6 cases) versus 31.25％ (5 cases) with closed or open approaches,respectively.There was no significant difference in postoperative incidence of anastomotic fistula and anastomotic stenosis between two groups.Conclusions Compared with thoracotomy in the treatment of esophageal atresia,thoracoscopic approach has smaller incision and less bleeding,less chest deformity,short hospital stay postoperatively,so it is safe and effective.However,the surgeon must have experience in doing thoracoscopie operation.
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BACKGROUND: Intra-articular injection of sodium hyaluronate can safely and effectively treat knee osteoarthritis and obviously improves the pain and function of knee joint. The efficacy of extracorporeal shock wave therapy for early-and middle-term knee osteoarthritis still remains controversial. OBJECTIVE: To compare the effects of extracorporeal shock wave therapy and intra-articular injection of sodium hyaluronate for early-and middle-term knee osteoarthritis. METHODS: According to the inclusion criteria, a total of 77 patients with knee osteoarthritis were enrolled, and randomly divided into extracorporeal shock wave therapy group and sodium hyaluronate therapy group. The extracorporeal shock wave therapy group underwent 5 sessions of 2 000 shockwave pulses performed on the affected knee with the dosage adjusted to 0.2 mJ/mm2 energy. The sodium hyaluronate group was administered intra-articularly sodium hyaluronate once per week for 5 weeks. The results were assessed with the Visual Analogue Scale, Lequesne index and Western Ontario and McMaster Universities Osteoarthritis Index. RESULTS AND CONCLUSION:① After 5 weeks of treatment, the Visual Analogue Scale, Western Ontario and McMaster Universities Osteoarthritis Index and Lequesne index in the two groups were significantly decreased compared with the baseline (P ＜ 0.05). All above indexes in the extracorporeal shock wave therapy group were significantly lower than those in the sodium hyaluronate therapy group (P ＜ 0.05).② These results indicate that the extracorporeal shock wave therapy and sodium hyaluronate therapy are effective for early-and middle-term knee osteoarthritis, and the former is more significant.
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Objective@#To investigate the difference in the clinical efficacy by thoracoscopy or thoracotomy for treating esophageal atresia.@*Methods@#Thirty-one cases of type-Ⅲ esophageal atresia undergoing surgical treatment from February 2015 to May 2018 at the Department of Pediatric Surgery of Fujian Provincial Maternity and Children′s Hospital were included, and according to the different surgical methods they were divided into thoracoscopic group (15 cases) and thoracotomy group (16 cases). The operation duration, blood loss, postoperative chest drainage time, posto-perative hospital stay and postoperative complications were analyzed between 2 groups.@*Results@#The mean time of operation was (181.33±13.86) min in the thoracoscopic surgery group and (139.06±10.98) min in the thoracotomy group, the thoracoscopic group had longer operation duration than thoracotomy group, and there was a significant difference in operation duration between two groups (t=9.44, P=0.000); mean blood loss was (3.07±0.96) mL in the thoracoscopic surgery group and (5.06±1.12) mL in the thoracotomy group, the thoracoscopic group had less amount of blood loss than thoracotomy group, and there was a significant difference in blood loss between two groups(t=-5.29, P=0.000); mean postoperative chest drainage time was(11.67±1.34) d in the thoracoscopic group and (12.25±1.06) d in the thoracotomy group, and there was no significant difference in postoperative chest drainage time between two groups(t=-1.34, P=0.19); mean time of postoperative hospitalization time was(15.20±0.94) d in the thoracoscopic group and (16.00±0.96) d in the thoracotomy group, and there was a significant difference in the postoperative hospitalization time between two groups (t=-2.33, P=0.027); the anastomotic leak rates were 33.33% (5 cases) versus 25.00% (4 cases) with closed or open approaches, respectively; anastomotic stricture rates were 40.00%(6 cases) versus 31.25% (5 cases) with closed or open approaches, respectively.There was no significant difference in postoperative incidence of anastomotic fistula and anastomotic stenosis between two groups.@*Conclusions@#Compared with thoracotomy in the treatment of esophageal atresia, thoracoscopic approach has smaller incision and less bleeding, less chest deformity, short hospital stay postoperatively, so it is safe and effective.However, the surgeon must have experience in doing thoracoscopic operation.
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BACKGROUND:In recent years, the number of cases of anterior cruciate ligament reconstruction with remnant preservation is increased year by year, but its clinical results, especialy effects on improving proprioceptive recovery after reconstruction, are stil controversial. OBJECTIVE: To compare the clinical effects of arthroscopic anterior cruciate ligament reconstruction with or without remnant preservation. METHODS:Totaly 146 patients undergoing arthroscopic anterior cruciate ligament reconstruction were randomly divided into two groups; preserving-remnant group and removing-remnant group. Autologous hamstring tendons were selected. Evaluation of knee mobility, Lysholm score, IKDC scores and knee stability was performed before and 6, 12 months after reconstruction. Proprioception was recorded before and 3, 6 and 12 months after reconstruction. The comparative analysis was carried out on these data between the group and between affected and healthy limbs. RESULTS AND CONCLUSION:114 patients were folowed up for over 12 months, including 61 in the preserving-remnant group and 53 in the removing-remnant group. There were significantly statistical improvements in knee mobility, Lysholm score, IKDC score and knee stability at 6 and 12 months after reconstruction in the two groups (P 0.05). The knee proprioception was significantly improved at 3, 6 and 12 months after reconstruction in the two groups (P < 0.01), and it was also better in the removing-remnant group than the removing-remnant group at 3 and 6 months after reconstruction (P < 0.05). These findings indicate that the anterior cruciate ligament reconstruction with remnant preservation is beneficial to the recovery of postoperative proprioception and knee function.
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BACKGROUND: Traditional repair for Achilles tendon rupture has disadvantages of long cast immobilization times, poor outcomes and many complications.OBJECTIVE: To explore the safety and efficacy of early isokinetic rehabilitation training for patients after repair of Achilles tendon ruptures.METHODS: A total of 11 patients with Achilles tendon ruptures received treatments at the Department of Orthopedics, East District of Qingdao Municipal Hospital, from September 2007 to September 2009, were included. Nine of them underwent 8-week isokinetic exercises by using lsomed-2000 at 4 weeks after tendon repair. The evaluative indicators included Arner-Lindholm score, the ankle range of motion, and extensor-flexor peak torque.RESULTS AND CONCLUSION: The follow-up averaged 6 months, ranging from 3 to 12 months. The excellent and good rate of Arner-Lindholm score was 88.9%. The results showed a significant improvement in the ankle range of motion and extensor-flexor peak torque (P < 0.05). There were no infection or re-rupture cases. It is indicated that early isokinetic rehabilitation is safe and effective for patients with Achilles tendon ruptures at 4 weeks postoperatively. It provides evidence for early rehabilitation in patients with Achilles tendon ruptures.
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[Objective]To explore the results of the treatment of the ischemic necrosis of femoral head using titanium alloy cage in animal models.[Method]The ischemic necrosis of femur head was made with the liquid nitrogen in 15 hybrid adult dogs.The titanium alloy cage of threaded central empty cylinder with multi-hole periphery was driven into the full depth of the center decompression canal to the subchondral bone.The dogs were divided into 3 groups,5 dogs in each groups were sacrificed respectively at 3,6,12 weeks after operation.Radiograph and histologic examination were used to evaluate the results.[Result]No collapse of femoral head was observed postoperation.The position of the cages was located wall in X-ray films.Under microscope,the cancellous bone of necrotic femoral head rebuilted up gradually.The cancellous bone grew into cage.After 12-week creeping substitution,the cancellous bone filled up the hollow and the peripheral holes of the cages.[Conclusion]The titanium alloy cage can provide structural support to the subchondral bone and prevent collapse.The cancellous bone grows into the cages through the peripheral holes.The necrotic femoral heads are restoration.The titanium alloy cage could be recommended for the treatment of the ischemic necrosis of femoral head.
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BACKGROUND: Due to the trouble of body image and self-esteem, more and more women hope to reduce their body mass.OBJECTIVE: To assay the characters and correlation between body image and self-esteem in women who reduce weight positively.DESIGN: Transect investigation.SETTING: Department of Dermatology of Xiangya Hospital and Xiangya Second Hospital of Central South University. PARTICIPANTS: Totally 100 patients for weight loss was collected in Department of Acupuncture and Moxibustion of Xiangya Hospital Affiliated to Central South University from November 2002 to September 2003 and they were included in experimental group. Severe physical disorders or other chronic physical disorders were excluded, such as cardiac vascular disease and diabetes and various metal disturbances were excluded too. In addition,the patients did not taken psychoactive drugs recently. Those were in over-body-mass group if body mass index(BMI) ≥ 24 and those were in normal body mass group if BMI＜24. In the control, there were 100 healthy women participating in the study in volunteer at the same time. The exclusive standards for them were same as the experimental group and they did not taken psychoactive drugs recently and had done nothing for weight loss in 5 years.METHODS: After instructed, the receptors filled up the following questionnaire: a self-rating scale of body image(SRSBI) and the self-esteem scale (SES). SRSBI is the subjective assessment on the beauty and strength of the body individually. SES is the assessment on holistic perception of self-value and self-acceptance.MAIN OUTCOME MEASURES: Results of SRSBI and SES in weight loss women.RESULTS: According to intention, general results of SRSBI: The score in experimental group(15.14±9.99) was higher than that in the control (7.89±6.18) (t= 6.15, P＜0.001) . The score was(15.65±10.36) in normal body mass group and was(13.81 ±10.03) in over-body-mass group. By the comparison between both, no difference presented(t=0.91, P ＞0.05) . Results of SES: the score in experimental group (27.01±4.19)was lower than that in the control(28.23±3.65) (t= 2.16, P＜0.05).The score was(27.31±4.50) in normal body mass group and was (26.86±3.82) in over-body-mass group. By the comparison between both,no difference presented (t=0.54, P＞0.05) . It was indicated in linear correlation analysis on SRSBI and SES in experimental group that the correlation coefficient between SRSBI and SES was-0. 088(P＞0.05).CONCLUSION: The people who seek for weight loss actively present inferior subjective perception of body image and low level of self-esteem, and there is no correlation between both of them and neither of them is relevant t.o obesity.
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In this article,we analyzed E-leaning's characteristics and trend of development,and then we put forward an opinion that in such situation students should have a capacity of making use of network to have autonomous study without the limit of time and space,and at the same time teachers also should use the information technology to train students' capacity of evaluating and processing information,in order to be able to conduct the self-management learning through the network.
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By means of cell hybridization in situ with digoxigenin labeled probe, we detected the expression of C-myc protooncogene in peripheral blood mononuclear cells from 31 SLE patients and 10 healthy persons. The results showed that the level of C-myc mRNA in SLE patients was significantly higher than that in normal controls, and the increased level correlated with disease activity. There was also a positive correlation between C-myc mRNA and serum levels of ANA, anti-dsDNA, IgG, C3. Our study indicates that C-myc gene is important for the pathogenesis of SLE.
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Objective To evaluate the possible association between depression and cellular immunologic status in patients with condyloma acuminatum (CA). Method Depression was assessed with the Self-rating Depression Scale (SDS) and the activity of natural killer (NK) cells, the interleukin-2 (IL-2) produced by peripheral blood mononuclear cells (PBMC) were measured in 60 patients with CA. Results The SDS scores in patients with CA were significantly higher than those in the controls (P 3 months) were significantly higher than those in patients with short duration (≤3 months) (P
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The urokinase type plasminogen activator (u-PA) antigen level in tumorand adjacent tissues was evaluated in 35 cases of gastrointestinal carcinomas and lungcancer with the u-PA ELISA sandwich method developed in our laboratory. The concentrations of u-PA antigen in 5. 0ml of extracts, each of them made from0. 5 gram tumor tissue, were 118. 4?121. 1, 138. 8?115. 8, 103. 3?56. 7, 85. 8?54. 5 and197. 4?86. 3 ?g/L for the cases of gastric (n=10), esophagus (n=8), colon (n=6),rectum (n=6) carcinoma and lung cancer (n=5), respectively. It showed that the u-PAantigen levels in all the 5 kinds of tumor tissue were significantly higher than that oftheir adjacent tissues (P