Objective To follow up long-term clinical events and compare the long-term prognosis between partial and complete revascularization in octogenarians with coronary artery disease.Methods A total of 108 patients aged 80-88 years who underwent elective percutaneous coronary intervention (PCI) in cardiology department of Huashan Hospital were divided into complete revascularization group (n=47) and partial revascularization group (n=61).They were followed up for long-term major adverse cardiovascular events from Jan.1 2005 to Dec.31 2008.Results There were no statistically significant differences in age,percent of female,prevalence of hypertension,diabetes,hyperlipidemia,unstable angina,smoking and renal dysfunction between the groups(all P＞0.05).And the angiography results showed no difference at the number and location of coronary artery lesions,including prevalence of single-vessel disease [15 cases(24.6％)vs.8 cases (17.0％)],dual-vessel disease [18 cases(29.5％) vs.15 cases(31.9％)] and that of tri-vessel disease [28 cases(45.9 ％) vs.24 cases (51.1 ％)] between partial and complete revascularization groups (all P＞0.05).The follow-up time in two groups were (1235±508)d and (1216±560)d (t=0.24,P＞0.05).All-cause death [ 10 cases ( 16.4 ％) vs.8 cases ( 17.0％)],cardiovascular death [8 cases (13.1％) vs.7 cases(14.9％)],hospitalization with angina [12 cases (19.7％) vs.9 cases (19.1 ％)],with hypertension [7 cases( 11.5 ％)vs.5 cases (10.6 ％)],with cardiac arrhythmia [5cases(8.2％) vs.4 cases(8.5％)],with chronic heart failure [4 cases(6.6％)vs.3 cases(6.4％)],and with all-cause cardiovascular disease [33 cases (54.1％) vs.25 cases(53.2％)] had no significant differences between partial and complete revascularization groups (all P ＞ 0.05).Conclusions Long-term prognosis of partial and complete revascularization is similar in octogenarians with coronary artery disease.

Child ; Cryptosporidiosis ; complications ; Cryptosporidium parvum ; Cyclospora ; Cyclosporiasis ; complications ; Diarrhea ; complications ; Humans ; Hypoproteinemia ; complications ; Male

Adult ; Blood Pressure ; Environmental Exposure ; Female ; Heart Rate ; Humans ; Hyperbaric Oxygenation ; adverse effects ; Male ; Middle Aged ; Occupational Exposure ; Personnel, Hospital ; Young Adult

Animals ; Brain-Derived Neurotrophic Factor ; genetics ; Cells, Cultured ; Female ; Gene Expression ; drug effects ; Neurons ; drug effects ; Phenylalanine ; toxicity ; Phenylketonurias ; complications ; Rats ; Rats, Sprague-Dawley ; rho GTP-Binding Proteins ; genetics

In order to optimize acupuncture protocol for stephenipodia after stroke, related papers of the recent 20 years are retrieved. Interrelated factors which may influence the therapeutic effect of acupuncture are analyzed through the aspects such as acupoints, needling methods and opportunities of acupuncture. It is held that importance should be attached on relation between acupoints and anatomy during acupoint selection. Different acupuncture protocol can be adopted in different phases of stephenipodia according to its time of occurrence. And it is found that the combination of acupuncture and rehabilitation can reinforce the therapeutic effect. Relationship between effect of acupuncture and patient's condition, acupoint selection and prescription, acupuncture manipulations (including directions, angles, reinforcing and reducing, quantity of stimulus) are worth to be further studied. On the base of the above all mentioned studies, optimization can be carried out on selection of acupoints and acupuncture manipulations. And therapeutic effect can be enhanced when the optimized acupuncture protocol is combined with rehabilitation therapies.
Acupuncture Points ; Acupuncture Therapy ; Foot Diseases ; etiology ; therapy ; Humans ; Stroke ; complications

Adult ; Aged ; Aged, 80 and over ; Drugs, Chinese Herbal ; therapeutic use ; Esophageal Neoplasms ; radiotherapy ; Female ; Humans ; Lung Neoplasms ; radiotherapy ; Male ; Middle Aged ; Phytotherapy ; Radiation Pneumonitis ; drug therapy

ObjectiveTo evaluate the feasibility of the completely thoracoscopic lobectomy for clinical N0 and postoperatively pathological N2 non-small-cell lung cancer(NSCLC).MethodsFrom Sep.2006 to Jan.2010, 216 patients with NSCLC received completely thoracoscopic lobectomy in our center.Two hundred and six patients were clinical N0 preoperatively(103 males and 103 females, median age of 62.3 years, rang 29 to 85 years).They were divided into two groups based on postoperatively pathological staging, pN0 group and pN2 group.Some perioperative factors including age, gender,tumor size,tumor location,pathological type, pathological differentiation,rate of conversion to thoractomy,operation time,blood loss,lymph node dissection, time of drainge, hospitalization and complications were studied and compared between two groups.Results There were 203 cases of lobectomy, 2 cases of composite lobectomy and 1 case of pneumonectomy.All procedures were carried out safely without serious complication except for one operative death result from respiratory failure.There were 168 cases in pN0 group and 38 cases in pN2 group.Age and gender were similar between two groups.The tumor size in pN0 group was smaller than that in pN2 group [ (2.6 ± 1.6) cm vs (3.7 ± 1.9) cm, P = 0.001 ].The tumors in pN0 group were lesser appearance in the bilateral lower lobes (31.0％ vs 50.0％, P = 0.026).There was a approximate proportion of adenocarcinoma in two groups (82.7％ vs 73.7％, P = 0.181), but the proportion of poorly differentiated carcinoma in pN0 group was significantly lower than that in pN2 group(19.0％ vs 42.1％, P = 0.002).There were no differences in the rate of conversion to thoractomy(7.1％ vs 7.9％, P = 1.000), operation time[ (196.1 ± 53.7) min vs (208.6 ± 56.8) min, P = 0.202 ], blood loss[ (253.2 ±247.9) ml vs(279.0±183.3) ml, P=0.475], time of drainage[ (7.7 ±3.2) days vs (9.7 ±6.3) days,P=0.066], hospitalization[ (10.6 ±4.6) days vs (13.0 ±7.6) days, P =0.063]and complications(12.5％ vs 21.1％,P =0.171).The stations of mediastinal lymph node dissection were equivalent in two groups(3.1 ± 1.2 vs 3.3 ± 1.1, P =0.237) , but there were fewer numbers of mediastinal lymph node dissection in pN0 group (9.9 ± 6.8 vs 12.7 ± 8.4, P =0.038).ConclusionCompletely thoracoscopic lobectomy is a feasible surgical therapy for cN0-pN2 non-small-cell lung cancer without loss of curability.

Objective Summarize all cases received completely thoracoscopic lobectomy,analyze the influence of lymph nodes in conversion thoracotomy and its measurements.Methods Between September 2006 to April 2013,1006 patients (545 males,461 females,median age 60 years,ranged from 13 to 86 years)received completly thoracoscopic lobectomy,including segmectomy(n =13),simple lobectomy(n =846),compound lobectomy(n =131),pneumonectomy (n =8),sleeve lobectomy(n =8).The main procedure was completely video-assisted anatomical lobectomy with mediastinal lymphadenectomy as we have reported.Results The average operative time in the conversion thoracotomy group was significantly longer[(272.7 ± 67.2) min versus (186.9 ± 58.1) min,P =0.001] compared with completely endoscopic surgery group,the average blood loss was significantly increased[(564.2 ±507.7) ml versus(158.0 ± 121.0) ml,P =0.001],the drainage time was significantly longer [(8.9 ± 5.0) days versus (6.6 ± 3.5) days,P =0.001] and the postoperative hospital stay was significantly longer [(12.5 ± 7.7) days versus(9.2 ± 5.8) days,P =0.001].Conclusion Interference of lymph doeds was the main reason for conversion to thoracotomy on VATs lobectomy.It may prolonged the operative time,increase the blood loss in operation and delay the postoperative recovery of the patients.Select the proper indication of conversion thoracotomy may reduce the negative effects of conversion thoracotomy.

Objective Summarize 58 cases with complicated primary lung cancer that accepted completely thoracoscopic lobectomy procedure in People's Hospital of Peking University,to evaluate the procedure of completely thoracoscopic lobectomy in these complicated cases.Methods Between Sep 2006 and Jun 2011,58 cases accepted completely thoracoscopic lobetomy were reviewed.34 male,24 female,aged (59.2 ± 11.4) years.The maximal diameter of solid tumors was(5.50 ± 2.92 )cm.The complicated condition including ①maximal diameter of solid tumor ≥5 cm ; ② Compound lobectomy; ③ post newadjuvant chemotherapy; ④ tummor invased portion of chest wall.The main procedure including three main components:①multiple devices co-operation through a single incision; ② Separate the fissure liketunnel style ; ③ cutting off bronchial artery priority to all step of lobectomy.Results All procedures were carried out smoothly with no death or serious complication.The average surgical duration was( 215.6 ± 60.9 ) min,and average blood loss was ( 271.0 ± 188.3 ) ml.The median postoperative chest tube drainage duration was(8.0 ± 4.7 ) d,and median postoperative hospital stay was ( 11.3 ± 5.9 ) d.There were 14 cases (24.1％ ) of conversion to open thoracotomy and 7 cases ( 12.1％ ) of complications.① There were 34 cases that maximal diameter of solid tumor was ≥5 cm,The average maximal diameter of tumors was( 6.7 ± 2.3) cm,The average surgical duration was( 206.6 ± 49.3 ) min,and average blood loss was (277.1 ± 194.4 ) ml.The median postoperative chest tube drainage duration was (8.3 ± 4.2 ) d,and median postoperative hospital stay was ( 11.9 ± 6.2 ) d.There were 8 cases (23.5％) of conversion to open thoracotomy and 6 cases ( 17.6 ％ ) complications; ②There were 16 cases of Compound lobectomy,The average maximal diameter of tumors was(4.2 ± 3.4 ) cm,The average surgical duration was (213.8 ± 70.0 )min,and average blood loss was(235.6 ± 139.2 ) ml.The median postoperative chest tube drainage duration was( 8.6 ± 6.3 )d,and median postoperative hospital stay was( 12.4 ±6.0) d.There were 4 cases (25％) of conversion to open thoracotomy and 2 cases ( 12.5 ％ ) complications;③There were 5 cases of VATs lobectomy that post newadjuvant chemotherapy,The average maximal diameter of tumors was(3.1 ±0.8) cm,The average surgical duration was(226.0 ±36.3 ) min,and average blood loss was(246.0 ± 219.8) ml.The median postoperative chest tube drainage duration was( 5.6 ± 1.1 ) d,and median postoperative hospital stay was( 7.4 ± 0.5 ) d.There were 2 cases (40％) of conversion to open thoracotomy and no complications; ④There were 3 cases that tumor invased portion of chest wall.The average maximal diameter of tumors was(3.0 ± 2.0)cm,The average surgical duration was(310.0 ± 105.4) min,and average blood loss was(433.3 ± 305.5 ) ml.The median postoperative chest tube drainage duration was( 5.6 ± 2.1 ) d,and median postoperative hospital stay was ( 6.6 ± 2.1 ) d.There were no conversion to open thoracotomy and complications.Conclusion As the skills and experience of thoracoscopic lobectomy improving,Some relative complexity cases and relative contraindications may become relative indications for completely thoracoscopic procedure.As long as the methods and technical processes used properly,these complicated cases of primary lung cancer does not prolong the operation time,not increase bleeding and interfere the reeovery of patients.

Objective To compare the safety and clinical efficacy between paclitaxel liposomes and paclitaxel in patients with advanced esophageal cancer .Methods A total of 90 patients with advanced esophageal cancer were enrolled into this study and were randomly divided into paclitaxel liposomes treatment group(treatment group) and paclitaxel treatment group(control group) . The patients of each group were treated with paclitaxel liposomes or paclitaxel 80 mg/m2 intravenously on day 1 and 8 ,and nedapla‐tin 75 mg/m2 intravenously on day 1 ,respectively .After two cycles of chemotherapy ,three weeks per period ,we evaluated the short term efficacy and adverse reactions according to the WHO standard .Results The short term efficacy between control group and treatment group showed no significance statistically (P>0 .05) .However ,the incidence of allergic reactions in the treatment group was significantly lower than control group (P<0 .05) .Conclusion Paclitaxel liposomal or paclitaxel combine with nedaplatin was effective equivalently in the treatment of patients with advanced esophageal cancer .But the allergic reactions of paclitaxel liposomal were lower than paclitaxel .It is worthy of clinical promotion .