Objective To evaluate the safety and efficacy of low-molecular weight heparin on the prevention of acute closure after percutaneous intracavitary coronary angioplasty.Methods 73 patients were randomly assigned to LMWH and SH groups.All patients underwent SPECT or CAG.Myocardial ischemia and hemorrhage complication were analyzed.Results In Group LMWH,no case of hemorrhage complication occurred,and in 3 cases angina occurred within 24h after the operation,which was proved by CAG to be acute closure of target vessel (the incidence rate 8.6%) .In Group SH,gum and subcutaneous hemorrhage occurred to 2 cases within 7h after the operation,hematuria occurred to 2 cases within 12h and one case died from cerebral hemorrhage,which was confirmed by CT (the total hemorrhage incidence 13.2%).Another 4 cases in Group SH suffered from re-occurrence of angina,which was confirmed by CAG to be acute closure of target vessel (10.5%).There was significant difference in hemorrhage complication between the two groups (P0.05)。Conclusion The results suggest that LMWH is safe and effective in the prevention of acute closure after native vessel coronary angioplasty.

Objective To evaluate the effects of time selection and immediate percutneous transluminal coronary angioplasty (PTCA) in refractory unstable angina pectoris.Methods PTCA was performed in 27 RUAP patients,among which 16 underwent emergency PTCA and 11 patients experienced PTCA after controlling with medicine.ECG and recurrence of symptoms were observed immediately and 6 months after PTCA.Results The procedural success rate was 100%.The immediate relieving rate was 96.3%.The recurrence rate of 11 cases within 6 months (18.2%)was significantly lower than that of 16 cases(37.5%).Conclustion The PTCA for RUAP is relatively safe and effective,but PTCA should be performed after situation is unchanged by use of medicine and PTCA shoulde be carried out immediately if the symptoms can not be controlled by medicine.

Objective To explore the relationship between expression of muc-1 gene in non-small cell lung cancer (NSCLC) tissues and lymph node metastasis and its clinical significance.Methods The expression of muc-1 gene in 36 specimens of NSCLC tissues and 10 normal lung tissues were determined by RT-PCR.Results muc-1 gene was positively expressed in 19 of 36 specimens of NSCLC tissues,the positive expression rate was 52.7%.The expression of muc-1 mRNA in NSCLC tissues was related to metastasis of lymph node(?2 =6.733,P0.05).The positive expression rate of muc-1 gene was higher in NSCLC tissues with lymph node metastasis(N0 10%,N1 58.82%,N2 88.9%).Conclusion The lymph node metastasis rate in NSCLC patients with muc-1 gene positive expression is higher,the detection of muc-1 gene expression can guide the prognosis and therapy of NSCLC patients after operation.

Objective To evaluate the indications,method and prognosis of emergent hepateetomy and tran-scatheter arterial embolization(TAE) for spontaneous rupture of primary liver carcinoma(PLC). Methods Clinical data of 85 cases with PLC were analyzed. Patients were divided into four groups: the group of delayed hepatectomy (group A,n=30);the group of emergent transcatheter arterial embolization (group B,n=22);the group of emer-gent hepatectomy (group C, n=18) and the group of medical treatment (group D, n=15). The hemostasis achieve-ment ratio, operative complications, perioperative morbidity, 1-year and 3-year survival rates among the four groups were compared. Results In group A and B, celiac urteriogram in 52 cases showed that extravasation of contrast media happened in 14 cases (26.9%). The hemostasis achievement ratio was 100% (30/30, 22/22, 18/18) in group A,B and C,respectively,which was remarkably higher than that in group D(40%,6/15) (P<0.05);The in-hospital fatality was 0% (0/30),3.8% (2/52) and 16.7% (3/18),which was lower than that of group D(80.0%, 12/15) (P<0.01). The 1-year survival rate was 76.7% and 3-year survival rate of group A was 53.3%, which was higher than that of group B (45.5 % and 31.8 %) and group C (44.4% and 33.3 %) (P<0.05). The cases in group D did not survive one year(P<0.01). Conclusions Emergent hepatectomy and transcatheter arterial emboli-zation are safe and feasible for spontaneous rupture of primary hepatocellular carcinoma. For those with resectable ca-ses,surgical resection is the first choice after transcatheter arterial embolization.

Objective To study the feasibility of reconstructing trachea by implanting autogenous costal perichondrium tracheal prosthesis.Methods Ten dogs were used.Three pieces of costal perichondrium of every dog were wrapped on a silicon bar used as skeleton and implanted into sternohyoid muscle adjacent to trachea to establish blood supply.Four weeks later,silicon bar was removed and perichondrium ring served as tracheal prosthesis.Trachea resection and prosthesis replacement was performed.Viability of dogs,gross and microscopic pathological changes were studied to evaluate the effect of prosthesis replacement.Results The respiratory tracts of the 8 survival dogs were not obstructed.Their diet,activity and bark were not different from those of the normal dogs.With abundant blood supply,the prosthesis fused tightly with the surrounding tissue.Anastomotic orifice healed without cicatricial tissue and granulation tissue.The internal surfaces of prosthesis were smooth and glossy with white tunica mucosa covered.Under light microscope,internal surfaces of prosthesis were found covered by pseudostratified columnar epithelium with few cilia.Under tracheal mucous membrane,there were fibrous membrane,neonate chondrocytes and striated muscle cells stratum successively.Fibrous membrane was composed of collagen and fibroblasts with a few inflammatory cells scattered.A small number of neonate chondrocytes were found under fiber membrane.Plasma of these chondrocytes looked pale after staining,which indicated that these chondrocytes were neonate.Striated muscle cells connected with the neonate chondrocytes firmly. Neonate capillaries and micro blood vessels of various diameters were abundant in striated muscle stratum.Conclusion It is feasible to reconstruct dog trachea using prosthesis constructed with autogenous costal perichondrium.

Objective:To determine and evaluate the antimicrobial effectiveness of 10% chloral hydrate solution. Methods:The determination of antimicrobial effectiveness of 10% chloral hydrate solution from two different manufacturers was carried out according to Chinese Pharmacopoeia (2015 edition). Results:The antimicrobial effectiveness of 10% chloral hydrate solution met the require-ments of Chinese Pharmacopoeia (2015 edition). Conclusion:10% Chloral hydrate solution shows adequate antimicrobial effective-ness.

Obiective: To verify the effects of aminoguanidine on hemodynamics in sepsis.Method:Experiments were conducted in five groups of anesthetized dogs (each group n=8).In group 1,lipopolysaccharide (LPS)was injected intravenously, Group 2 received both LPS and L-arginine (300mg/kg)intravenously. Group 3 received both LPS and N-nitro-Larginine (L-NNA,20mg/kg) intravenously.Group 4 received both LPS and aminoguanidine (30mg/kg) intravenously. Group 5 received only saline. Hemodynamic and oxygenational data were measured or calculated. Extravascular lung water (EVLW)was measured. Result:L-arginine increased CI and decreased PVRI,while treatment with aminoguanidine without significant increased the BP,SVRI and PVRI.But all of untoward hemodynamic effcts of LPS were exacerbated by the addition of L-NNA,as DO_2 was significantly decreased by L-NNA,Therefore,though O_2ER was also increase (insufficiently),VO_2 was still decreased significantly.EVLW was markedly increased by LNNA. Conclusion:The No-selective inhibition with adiministration of aminoguanidine may have considerable value in the therapy of endotoxin shock.

Objective:To evaluate the curative effects of Masquelet technique and 3D printing in repair of Cierny-Mader type Ⅳ long bone osteomyelitis.Methods:A retrospective study was conducted of the 8 patients who had been treated at Department of Orthopaedics, The Third Affiliated Hospital to Peking University for Cierny-Mader type Ⅳ osteomyelitis of the lower extremity from June 2017 to December 2019. They were 6 males and 2 females, aged from 27 to 79 years (average, 54.6 years). The defects involved femoral shaft in 5 cases, femoral metaphysis in one, tibia shaft in one, and tibial metaphysis in one. The defect lengths ranged from 7.7 to 15.5 cm, averaging 10.2 cm. Stage one was local infection control and temporary stability reconstruction using Masquelet technique, stage two design and 3D printing of the prosthesis and stable pattern design, and stage three prosthesis implantation and rehabilitation. The ranges of motion of the knee and ankle were recoded postoperatively and the functions evaluated using the Johner-Wruhs scores.Results:The average follow-up time for the 8 patients was 12.6 months (from 6 to 18 months). The total treatment time from the first admission to the last discharge ranged from 62 to 125 days (average, 91.0 days), the time for stage one from 13 to 57 days (average, 28.7 days), that for stage two from 30 to 87 days(average, 48.3 d), and that for stage three from 28 to 84 days (average, 63.0 days). The infection was controlled and there was no recurrence, implant loosening or breakage. Seven patients were capable of full weight-bearing at 14.7 days (from 4 to 42 days) after surgery. One patient recovered full weight-bearing 6 months after surgery due to severe osteoporosis. Fine functional recovery was achieved in the 8 patients, with a range of motion from 0° to 100° for the knee and a range from 35° dorsal flexion to 40° toe flexion for the ankle. The Johner-Wruhs scores at the last follow-up showed 2 excellent, 5 good and one moderate cases.Conclusion:In repair of Cierny-Mader type Ⅳ long bone osteomyelitis, Masquelet technique and 3D printing can shorten the treatment process and allow for early recovery.

OBJECTIVETo determine whether the clinical and pathologic characteristics and prognoses of myasthenia gravis (MG) patients below 15 years differ from those patients over 50 years after thymectomy.

METHODSWe reviewed the registry material of 30 pediatric and 32 elderly MG patients after thymectomy, including their age, sex, clinical classification, pathological types, and prognoses. The Chi-square test or Wilcoxon's rank-sum test was used to determine the statistical differences between the children and elderly groups.

RESULTSNo significant difference was seen in sex distribution between the two groups. (Chi-square test, P=0.625), but there were differences in clinical classification: more type I was observed in the pediatric group than in the elderly group, but more type II or III was seen in the elderly group (Wilcoxon's rank-sum test, P<0.001). As to pathological types, the pediatric group was also significantly different from the elderly group (Chi-square test, P<0.01). All of the patients (100%) in the pediatric group had thymus hyperplasia, but in the elderly group more than half (56.26%) were found to have thymoma (benign or malignant). The prognoses after thymectomy were better in the pediatric group than in the elderly group (Wilcoxon's rank-sum test, P<0.001).

CONCLUSIONSBecause the prognoses are generally better than those of the elderly patients, we should be careful when operating on pediatric patients of ocular type. The elderly patients tend to receive more aggressive treatment because of more severe generalized types often associated with thymoma and poor prognoses. Both pediatric and elderly patients are seldom associated with other autoimmune disease.

Adolescent ; Aged ; Child ; Child, Preschool ; Female ; Humans ; Male ; Middle Aged ; Myasthenia Gravis ; mortality ; pathology ; surgery ; Prognosis ; Thymectomy

Objective To assess the efficacy and safety of monoclonal antibody rituximab combined with cyclophosphamide (CTX) in the treatment of refractory and recurrent autoimmune hemolytic anemia.Methods Seven cases with refractory and recurrent autoimmune hemolytic anemia ( including 1 case of Evans syndrome) were recruited during January,2007 to December,2010.Treatment regimens were as follows:rituximab:375 mg/m2,1 time/week,2-6 courses; CTX:1 g,1/10 d,2-7 courses; combined with intravenous immunoglobulin (IVIG) 5 g,1 time/week,given 1 day after rituximab administration.The efficacy and safety of this regimen were assessed during follow-up.Results All the patients showed good responses (7/7).Six patients achieved complete remission (6/7) and one achieved partial remission ( 1/7 ).Average follow-up time for the patients was 27 months.All patients remained in remission during the 12-month follow-up visits.Two patients showed elevated indirect bilirubin and increased reticulocyte counts within 24 months.One patient achieved complete remission after additional rituximab therapy,and another patient remained partial remission after cyclosporine therapy.At the time of 36-month follow-up visit,the patient relapsed and was retreated with 3 courses of rituximab combined with CTX and eventually achieved partial remission.All patients tolerated the treatment well with few mild side effects.Conclusions Rituximab combined with CTX is effective and relatively safe in patients with refractory and recurrent autoimmune hemolytic anemia.Additional treatment to relapse patients about 12-24 months after drug withdrawal continues to be effective.