A giant left atrial myxoma transits across patent foramen ovale a PFO mimicking biatrial myxoma: a case report.

Background: Multiple myxomas are rare and often associated with Carney syndrome. We present a giant left atrial myxoma that passes through a patent foramen ovale (PFO), mimicking biatrial myxoma. Case summary: A 46-year-old female was admitted to the hospital with a cardiac neoplasm without symptoms. The physical examination did not reveal any abnormalities in the skin and endocrine system. Transthoracic echocardiography revealed a large, hypoechoic mass attached to the atrial septum, occupying both the left and right atria. This mass appeared as a bilateral atrial mass on echocardiography. Contrast-enhanced echocardiography revealed a slight enhancement in the mass. The patient was scheduled for surgery without any contraindications. During the operation, a large jelly-like mass originating from the left atrial side of the fossa ovale was found, extending to the right atrium through a PFO. The entire mass was successfully removed, and the atrial septum was repaired. Histopathology confirmed the diagnosis of cardiac myxoma. At the 3-month follow-up, no cardiac abnormalities were observed. Discussion: Multiple myxomas have been reported in certain cases of Carney syndrome. A single left atrial myxoma that passes through an atrial septal defect or a PFO can sometimes be misdiagnosed as a bilateral atrial myxoma. Echocardiography plays a crucial role in providing diagnostic information by accurately identifying the location of the myxoma pedicle.

Human muscle fatigue monitoring method and its application for exoskeleton interactive control / 生物医学工程学杂志

Aiming at the human-computer interaction problem during the movement of the rehabilitation exoskeleton robot, this paper proposes an adaptive human-computer interaction control method based on real-time monitoring of human muscle state. Considering the efficiency of patient health monitoring and rehabilitation training, a new fatigue assessment algorithm was proposed. The method fully combined the human neuromuscular model, and used the relationship between the model parameter changes and the muscle state to achieve the classification of muscle fatigue state on the premise of ensuring the accuracy of the fatigue trend. In order to ensure the safety of human-computer interaction, a variable impedance control algorithm with this algorithm as the supervision link was proposed. On the basis of not adding redundant sensors, the evaluation algorithm was used as the perceptual decision-making link of the control system to monitor the muscle state in real time and carry out the robot control of fault-tolerant mechanism decision-making, so as to achieve the purpose of improving wearing comfort and improving the efficiency of rehabilitation training. Experiments show that the proposed human-computer interaction control method is effective and universal, and has broad application prospects.

Application of Different Types of Hybrid Aortic Arch Repair: Toward to Solve Dissection Involving the Aortic Arch.

BACKGROUND: To investigate the outcomes and effectiveness of different types of hybrid aortic arch repair for aortic dissection involving the aortic arch. METHODS: From 2013 to 2020, 168 patients underwent hybrid aortic arch repair for dissection involving the aortic arch. We collected data from our electronic medical records, including the presenting pathology, perioperative details, and postoperative outcomes. We included the following types of hybrid aortic arch repair: classic type I, type II, and type III hybrid aortic arch repair, as well as the new type IV hybrid aortic repair. We defined type IV hybrid aortic arch repair as revascularization of supra-aortic branches through extra-anatomy bypass without sternotomy, followed by stent-graft placement. RESULTS: There were 23, 82, and 63 patients who underwent type I, type II, and type IV hybrid aortic arch repair, respectively. There were no type III hybrid aortic repairs performed. Forty-nine cases were performed urgently. The technical success rate was 99.4%. The early mortality rates of the total group, type I group, type II group, and type IV group were 6.5%, 4.3%, 8.5%, and 4.8%, respectively. Postoperative complications mainly included tracheotomy (8.9%), stroke (6%), wound infection (4.2%), renal insufficiency (8.9%), and endoleak (7.7%). With a mean follow-up of 45.1 ± 28.5 months, the total 1-year and 5-year actual survival rates were 93.5% and 89.0%, respectively. At 6 months, the aortic diameter at the level of the diaphragm decreased significantly (30.8 ± 4.9 mm vs. 28.5 ± 6.3 mm, P = 0.012), and the rate of thrombosis of the false lumen at the level of pulmonary bifurcation and diaphragm were 95.7% and 83.1%. Ten patients underwent reintervention of the aorta, including 7 endovascular reinterventions, 2 total thoracoabdominal aortic aneurysm repairs, and 1 open total arch replacement. For the total group, the free from aorta reintervention rate at 5 years was 91.4%. CONCLUSION: Our results with hybrid aortic arch repair for aortic dissection involving the aortic arch are acceptable. The hybrid aortic arch repair could promote thrombosis of the distal false lumen while excluding intimal tears in the aortic arch.

Epidemiological investigation of hypertension and its control on maintenance hemodialysis patients in Anhui province / 中华肾脏病杂志

Objective To understand the prevalence,treatment and influence factors of hypertension in maintenance hemodialysis (MHD) patients in Anhui Province.Methods A total of 2724 adult patients on MHD from January 1st 2014 to March 31st 2014 in 26 hospitals of southern,northern and central Anhui Province were investigated.Their demographic characteristics,primary disease,complications,medications,dialysis and laboratory examination were explored.The prevalence treatment rate and control rate of hypertension were analyzed.Associated factors for controlling hypertension [systolic blood pressure (SBP) ＜ 140 mmHg and diastolic blood pressure (DBP) ＜ 90 mmHg] were assessed by logistic regression analysis.Results (1) The prevalence of hypertension in the hemodialysis patients was 87.0％.Their treatment rate and control rate were 93.2％ and 23.9％ respectively.The average of SBP was (145.90±21.18) mmHg,and the DBP on average was (83.60± 12.21) mmHg.The most commonly used anti-hypertensive drug is calcium channel blocker (88.2％).Over one third (45.7％) of patients were treated with two kinds of anti-hypertensive drug,26.2％ with 1 kind,21.7％ with 3 kinds,and 6.4％ with 4 kinds or more.(2) Compared with non-hypertension patients,patients with hypertension have older age,higher body mass index (BMI),phosphorus,SBP and DBP,as well as lower hemoglobin and Kt/V (all P ＜ 0.05).(3) The multivariate logistic regression analysis showed that Ca ＞ 2.50 mmol/L (OR=2.084,95％CI 1.008-4.307,P=0.047) positively correlated with controlling hypertension,while smoke (OR=0.594,95％CI 0.356-0.911,P=0.046) and BMI 18.5 ～ 23.9 kg/m2 (OR=0.516,95％CI 0.293-0.907,P=0.022) negatively correlated with it.Conclusions High prevalence yet low control rate of hypertension in MHD patients in Anhui Province were observed.Hypocalcemia may be a protective factor for hypertension control,while smoke and BMI may be risk factors for it.

Intervention efficacy of antimicrobial clinical application in internal medi-cine and pediatrics departments / 中国感染控制杂志

Objective To explore intervention efficacy of clinical application of antimicrobial agents in internal medicine departments of a hospital.Methods 1 880 medical records from internal medicine and pediatrics departments this hospital in July-December 2010 were randomly selected as control group (before intervention),and 2 207 medical records in July-December 2011 were as trial group (after intervention),antimicrobial use of two groups was compared.Results The over-all usage rate of antimicrobial agents after intervention was lower than before intervention (48.12% vs 58.62%,χ2 =44. 45,P <0.001).Except endocrinology,pediatrics and hematology departments,the usage rates of antimicrobial agents in the other departments after intervention were all obviously lower than before intervention(all P <0.05).The usage rate of antimicrobial agents in endocrinology and hematology departments were both low(<40%),which met the requirements of Ministry of Health.Conclusion Comprehensive intervention in clinical use of antimicrobial agents reduced the usage rate of antimicrobial agents in internal medicine and pediatrics departments in this hospital.

Analysis on the award-winning achievements of medical researches in Guangdong Province from 1999 to 2010 / 中华医学科研管理杂志

Objective To investigate reveal the main general situations of medical researches,levels,especially progresses and accomplishments,and progresses of medical research in Guangdong Province.Methods The We collected informations about prizes of of medical researches achievements awarded by National Science and Technology Award and Guangdong Science and Technology Award in Guangdong Province from 1999 to 2010 were collected,and analyzed these prizes in the respect of distribution byof years,regions,institutions and subjectsdiscipline.Results In the last 12 years,There were 30 medical researches achievements won theawarded National Science and Technology Awards,and 865 won awarded Guangdong Science and Technology Awards in the last 12 years.The amounts of distribution by year award-winning achievements awarded of National Science and Technology Awards were was not average evenevery year,which while were opposite to those awarded the distribution of Guangdong Science and Technology Awards was.Geographically,Mmost of these medical research achievements centered were in economically developed cities like Guangzhou,Shenzhen,Shantou,etc.The amounts of awards-winning achievements of won by medical institutionshospitals and colleges were far more than those of enterprises,research institutions and management agencies,.But the awards of hospitals and the fluctuation fluctuated of annual distribution of award-winning achievements ofmore than the those of medical institutions was bigger.Among the award-winning achievements awarded National Science and Technology Award,the amounts on oOncology,ophthalmology,traditional Chinese medical science and Chinese materia medica were won the most of the awards,but the amount onand basic medical medicine won the was fewerfewest awards.The distribution of subjects of award-winning achievements awarded Guangdong Science and Technology Award were largercovered more disciplines than the other.Conclusion Medical research in Guangdong Province has achieved a great accomplishment much but with some deficiencies existingcertain problems.Guangdong Province must take some appropriate measures in order to achieve a greater accomplishmentMeasures need to be taken to overcome those problems,for example,increasing its input in medical research including funds,equipments and talented persons,etc.

Congenital giant aneurysm of the left coronary artery.

We report an unusual case of congenital giant coronary aneurysm. A 23 year-old male with a history of acute myocardial infarction presented an abnormal shadow in the left cardiac border on routine X-ray. Electrocardiogram and physical examination were normal without any clinical signs of inflammation, but computed tomography (CT) scan and cardiac magnetic resonance imaging (MRI) revealed a giant (>50mm) coronary aneurysm. Coronary artery bypass grafting (CABG) with coronary artery aneurysm (CAA) resection resolved the CAA. Coronary artery aneurysms are entities of localised dilation and can be common events in chronic infectious disease as a result of the systemic inflammatory state; however, giant coronary aneurysms (measuring more than 50mm) are rare. This is especially true where the pathological aetiology was not clearly defined or was believed to be of congenital origin. To date only a few published case reports exist for this type of pathological entity.

Optimal timing for perioperative internal aortic balloon pumb support in high-risk coronary artery bypass grafting / 中国医师进修杂志

Objective To study the clinical experience and determine the optimal timing for periop-erative internal aortic balloon pumb (IABP) support in high-risk patients who had coronary artery bypass grafting (CABG) had been demonstrated. Methods Fifteen cases of emergency CABG with IABP were performed from September 2003 to April 2008. Eight cases were supported by IABP before operation,1 case was supported after succeeding in cardiopulmonary resuscitation,2 cases were supported by IABP for acute myocardial infarction,5 cases were supported by IABP for acute coronary syndrome. Seven cases were supported by IABP in the time of intra-or postoperation,2 cases were supported by IABP in order to help re-moving cardiopulmonary bypass in the operation. Result Three cases supported by IABP in the time of in-tra-or postoperation were dead, the other 12 cases were healed. Conclusions IABP can improve the heart function effectively and therefore can increased the success rate of operation.The beneficial effect of preoperative IABP in high-risk patients who have CABG is confirmed.

Expression of hMLH_1 gene in gastric cancer and its significance / 吉林大学学报(医学版)

Objective To investigate the expression of hMLH_1 in gastric cancer and its significance,Methods The expressions of hMLH_1 protein and mRNA were detected by immunohistochemistry and reverse transcription polymerase chain reaction(RT-PCR) in 68 cases of gastric cancer tissues,33 cases of para-cancer tissues and(35 cases) of normal gastric tissues.Apoptosis was assayed by terminal deoxytransferase mediated dUTP nicked labeling.Results The positive expression rates of hMLH_1 mRNA were 63.3%(43/68),100%(33/33) and 100%(35/35),and those of protein were 61.8%(42/68),93.9%(31/33),100%(35/35),respectively,in gastric cancer tissues,para-cancer tissues and normal gastric tissues.There was a correlation between the expression of hMLH_1 and clinical grade of gastric cancer(r=0.531,P

Report on skin-sparing mastectomy with immediate breast reconstruction in 15 cases / 中国组织工程研究

BACKGROUND: Recently the prevalence rate of mass in mammary gland increases significantly than before. To use which kind of technology is not only related with the post-operation recurrence, but also related with the reconstruction of their confidence. Therefore, how to reduce the trauma physically and psychologically in patients to the maximal degree has become the chief factor to choose technology by surgeons.OBJECTIVE: To observe the effects of transverse rectus abdominis musculocutaneous (TRAM) flap, latissimus dorsi musculocutaneous flap with breast prothesis, local flap and simple breast prothesis after skin-sparing mastectomy with immediate breast reconstruction.DESIGN: Case analysis.SETTING: Department of Plastic Surgery, Shenzhen People's Hospital,Second Clinical Medical College of Jinan University.PARTICIPANTS: A total of 15 ductal carcinoma in situ (DCIS) and huge breast benign tumor patients were enrolled into Shenzhen People's Hospital between October 1997 and May 2004, aged from 20 to 46 years. They all got disease in single breast, and 8 of them had preoperative diagnosis of DCIS, T1N0M0 and 7 of them had huge breast benign tumor. Operation program was informed to the patients before operation so as to gain their agreement.METHODS: Skin-sparing mastectomy was performed with circular shape incision at areola and using TRAM flap, latissimus dorsi musculocutaneous flap with breast prothesis, local flap and simple breast prothesis to fill breast. Slight skin of musculo-cutaneous flap could compensate the nipple and areola when performing reconstruction. At the reoperation, nipple was made at the transferred flap.MAIN OUTCOME MEASURES: To observe the patients with or without recurrence or transfer after operation and local healing of wound.RESULTS: With the cooperation of general surgeons the operation was done in 15 cases and 14 cases of them were followed up for more than 1 year. The reconstructed breasts were with good symmetry with the opposite one, normal skin sensation, natural shape and inconspicuous scar.CONCLUSION: This is an excellent alternative method for mastectomy and breast reconstruction based on the avoidance of recurrence of breast cancer in severe operation.

Expression and clinicopathologic significance of OPN, CD44v6 and MMP-2 in squamous cell carcinoma and adenocarcinoma of the lung / 中国肺癌杂志

<p><b>BACKGROUND</b>There are a lot of studies on relationship of surface adhesion molecule (CD44) and matrix metalloproteinase (MMP) with tumors in recent years, however study on osteopontin (OPN) is still few. The aim of this study is to investigate the levels of OPN, CD44v6 and MMP-2 in squamous cell carcinoma and adenocarcinoma of the lung, and to clearly understand their roles in growth, invasion and metastasis of squamous cell carcinoma and adenocarcinoma.</p><p><b>METHODS</b>OPN, CD44v6 and MMP-2 were detected in 69 patients with squamous cell carcinoma and adenocarcinoma by immunohistochemical method.</p><p><b>RESULTS</b>The expression rate of OPN, CD44v6 and MMP-2 was significantly related to histological classification, TNM stages and lymph node metastasis (P < 0.05), but not to cell differentiation (P > 0.05). There was a positive correlation between OPN and CD44v6 expression (P < 0.001), as well as between OPN and MMP-2 expression (P < 0.001). There was no correlation between CD44v6 and MMP-2 expression.</p><p><b>CONCLUSIONS</b>OPN, CD44v6 and MMP-2 expression is related to the histology, TNM stages and lymph node metastasis of lung cancer. They might be used as clinical indicators to predict the progress and metastatic potential for squamous cell carcinoma and adenocarcinoma of the lung.</p>

Reduction mammoplasty by central pedicle flap transposition / 中华医学美学美容杂志

Objective To explore a surgical procedure of reduction mammary plasty to assure the viability and sensory of the nipple-areolar complex (NAC) after transposition and to keep the lactiferous function partly. Methods Reduction was accomplished by using perforating vascular branches from the pectoralis major muscle and its fascia supplying the nipple and breast parenchyma instead of the subdermal plexus. The central vascular pedicle supplying the nipple-areola complex was preserved. And the sensory nerve of the NAC was not injured. The erection of the nipple could be observed in operation. Lactation was possible because of preservation of the lactiferous ducts. The technique had been used in 17 patients since 1996. Results The nipple-areola complex was safely transposed with great freedom, and the amount of resection was accurately adjusted for symmetry. No cases of nipple-areola complex sensory change occurred postoperatively in all 17 patients. Breast-feeding was possible at least in one patient after operation. Conclusion This method is ideal for the patients, which keeps the viability and sensory of the nipple-areolar complex and the function of lactation. In another case, the amount of resection is easily adjusted for symmetry.

Effect of Astilbin on expressions of perforin and granzyme B in activated T cells of mouse heart transplantation model with acute rejection / 中国医师杂志

Objective To investigate the effect of astilbin on expressions of perforin and granzyme B in activated T cells of mouse heart transplantation model with acute rejection.Methods Cardiomyocytes of BALB/C mouse and spleen cells of C57BL/6 mouse were harvested and made into single cell suspensions.The cardiomyocytes(2?10~5 ml~(-1))as stimulators and spleen cells(1?10~6 ml~(-1)) as responsers were mixed and cultured.The model of mouse heart transplantation with acute rejection in vitro was therefore established.There were two groups in the experiment.Control group is the mixed culture of the cardiomyocytes and spleen cells;Astilbin group is the mixed culture of the cardiomyocytes and spleen cells with astilbin(15?g/ml).Apoptosis of T cells were analyzed by TUNEL assay.The expressions of perforin and granzyme B were measured by RT-PCR.Results Apoptosis of activated T cells in Astilbin group was significantly increased than that of the control group(P

Expression of vascular endothelial growth factor in proliferative maxillo-facial hemangioma of infant / 中华医学美学美容杂志

Objective To evaluate the relative quantities of flt-1, KDR, endostatin mRNA in tissue specimens of human hemangioma and great saphfenous vein with the modified reverse transcriptase-polymerase chain reaction (RT-PCR). Methods Total RNA from human specimens by Trizol was reverse-transcribed and amplified by PCR in 4 deffirent tubes containing one of the primer pairs such as flt-1, KDR, endostatin or ?-actin. The target genes and beta-actin PCR products were about 200 bp in length. The ratio of the yield of the target gene PCR product to the beta-actin PCR product could be calculated after 35 cycles of amplification.Results These ratios were correlated positively ( P=0.014,P=0.019) in two groups, but no relationship in endostatine level was observed (P=0.436).Conclusions VEGFR may play a very important role in the pathogenesis of the congenital hemangioma in children. But the endostatin may take little effect on it.

Angiographic analysis of renal arteries in Chinese / 中国介入心脏病学杂志

Objective To study the angiographic anatomic characteristics of renal arteries in Chinese.Methods Selective renal angiography was performed immediately after coronary artery angiography in(1?057) Chinese patients,including 702 males and 355 females.The mean age of them were 59.3?8.3 years.Six French JR4 catheters were used via transfemoral approach.Three to five milliliters nonionic contrast media were injected manually into each renal artery and cine pictures were taken at an anterior-posterior view.Results A single-renal-artery was found in most of the patients(87.23% at the left side and 89.97% at the right side).In the others,two or even more independent renal arteries were found at one or both sides.Most of the renal arteries (87.79% at the left side and 91.20% at the right side) originated between the upper third of the first lumbar vertebra and the upper third of the second lumbar vertebra.The right renal artery ostium was located superior to the left one in 45.13% of the cases.In the other 45.41% of them,renal artery ostia of both sides were at a same level.Conclusion Anatomic variations in the number and origin of renal arteries are not nare in Chinese.Understanding the angiographic anatomic characteristics of renal artery would be useful for renal artery interventions.

Antagonistic effects of new endothelin antagonist CPU0214 on cardiac endothelin receptor binding and vascular activity and its reduction on mean arterial pressure in conscious DOCA-salt hypertensive rats / 中国药理学通报

AIM To determine the antagonistic activities of new endothelin receptor antagonist CPU0214 on the left ventricle membranes and the aorta ring contraction in normal rat and its reduction effect on the mean arterial pressure in conscious DOCA salt hypertensive rats. METHODS Left ventricle membranes of normal rat hearts achieved for competition binding assay was used to investigate the antagonistic effects of CPU0214. Aorta ring contraction induced by ET 1 in normal rat was used to investigate the antagonistic activity of CPU0214. DOCA salt hypertensive rats were induced by injection of deoxycorticosterone acetate (DOCA, sc) following with 1% NaCl as drinking for 4 wk. A multiple physiological recorder was used to record the mean arterial pressure of femoral artery. The endothelin receptor change in the left ventricle membranes of DOCA salt hypertensive rat was measured by binding assays. Intraperitoneal injection of CPU0214 was used to investigate its effect on reduction of mean arterial pressure. RESULTS In the left ventricle the IC 50 of endothelin receptor antagonist CPU0214 is 16 nmol?L -1 and CPU0214 (10 ?mol?L -1 ) inhibited the ET 1 induced isolated aorta rings contraction in normal rats. Mean arterial pressure as well as B max and K d of left ventricle were increased significantly in DOCA salt hypertensive rat. CPU0214 (60 mg?kg -1 ip) significantly reduced the mean arterial pressure of conscious DOCA salt hypertensive rats especially during 60～90 min after administration. CONCLUSIONS CPU0214 has significantly antagonistic effects on the left ventricle membrane and the isolated aorta ring contraction in normal rat, which is verified by CPU0214 as a strong endothelin receptor antagonist. Furthermore its effect on the mean blood pressure reduction in conscious DOCA salt hypertensive rats, which is manifested as an abnormal endothelin system, shows its prosperity of drug development value as a new endothelin receptor antagonist.