1.Treatment with plasma in canine abdominal wurds combined with seawater immersion
Jian CEN ; Pingdi YANG ; Jianliang SHEN ;
Medical Journal of Chinese People's Liberation Army 2001;0(08):-
Objectives To explore the effects of hyperosmosis of sea water and low temperature on hemorrhage and coagulation sys- tem of dogs after open abdominal injury followed by sea water immersion,and to observe the efficiency of plasma in addition to routine first aid,so as to provide a theoretical basis for the early treatment of open abdominal wound in naval warfare.Methods 24 dogs with open in- jury of the abdomen were randomly divided to three groups with 8 animals for each group.The dogs in control group were not subjected to sea water immersion and received routine treatments;dogs in conventional therapy group were immersed in sea water and then given the routine first aid;dogs in plasma group were immersed with aqua marina and then given a combined treatment of routine first aid plus an in- fusion of plasma.The following parameters were measured and recorded:survival time,body temperature,mean arterial blood pressure, osmotic pressure of plasma,prothrombin time,partial thromboplastin time,d-dimer and factorⅡ.Results Prothrombin time and partial thromboplastin time were significantly prolonged,D-Dipolymer increased and factorⅡdecreased after sea immersion with open abdominal wound.The survival time of dogs in plasma group(45.6?12.5h)was significantly longer than that of dogs in both control and conven- tional therapy groups(P
2.Minimally invasive techniques in arthroscopic resection of soft tissue cysts
Jian LI ; Wenkai SONG ; Shiqiang CEN
Chinese Journal of Minimally Invasive Surgery 2001;0(04):-
Objective To evaluate the techniques and effects of arthroscopic resection of cystic lesions of soft tissue. Methods Twenty-six patients with soft tissue cysts underwent arthroscopic shaving of cyst wall from February 1998 to February 2001. Results Follow-up observation ranged from 6 months to 12 months, with a mean of 8.6 months. The total effective rate reached 96.2% (25 of 26), and no postoperative complications occurred. Recurrence was only seen in 1 patient with thecal cyst on the right dorsal wrist. Conclusions Arthroscopic resection of cystic lesions of soft tissue can be a less invasive method, with fewer complications, a high effective rate and a rapid recovery.
4.Quantified diagnositic standard for large intestinal cancer of spleen qi deficiency syndrome.
Fenggang HOU ; Yi CEN ; Jian GUAN ; Lingyun ZHU ; Xiaoling YIN
Journal of Integrative Medicine 2009;7(9):814-8
Objective: To set a quantified diagnostic standard for large intestinal cancer of spleen qi deficiency syndrome. Methods: The spleen qi deficiency syndrome was identified by experts on the basis of clinical epidemiological investigation of 311 patients suffering from large intestinal cancer. Corresponding points were assigned to the correlative factors (traditional Chinese medicine symptoms) on the basis of symptom differences between spleen qi deficiency syndrome and non-spleen-qi-deficiency syndrome. The best threshold was determined by receiver operating characteristic curve (ROC) according to syndrome differentiation from expert team, and the quantified diagnostic standard was established. The syndrome identification from the expert team which was regarded as golden standard was tested retrospectively. Results: All the traditional Chinese medicine symptoms possibly related to spleen qi deficiency syndrome were analyzed based on the opinions of experts, and 28 symptoms were confirmed as candidate correlative factors. The occurrence of 11 symptoms between spleen qi deficiency syndrome and non-spleen-qi-deficiency syndrome showed statistical differences by means of crosstabs analysis (P<0.05). The 11 symptoms were filtered by logistic regression analysis, and tiredness, fatigue, loose stool, and poor appetite were finally determined as the symptoms relative to large intestinal cancer. These four symptoms were analyzed with conditional probability conversion and endowed with 16, 11, 4 and 8 points respectively. The diagnostic standard of spleen qi deficiency syndrome of large intestinal cancer was over 13 points. The sensitivity, specificity and accuracy of retrospective examination were all above 80%, and its positive likelihood ratio was 9.89. Conclusion: The quantified diagnostic standard for spleen qi deficiency syndrome of large intestinal cancer is in accordance with clinical characteristics of large intestine cancer and the characteristics of TCM syndrome diagnosis.
5.Anatomical feature of the blood supply in the repair of the meniscus of knee joint
Jian LI ; Xin JIANG ; Fuxing PEI ; Shiqiang CEN
Chinese Journal of Tissue Engineering Research 2005;9(26):254-256
BACKGROUND:The blood supply is essential for the repair of the meniscus after the suture of it in the injured knee joint. According to the condition of blood supply, the meniscus was divided into three zones by Arnoczk in 1982. The absolute vascularization zone, in which the distance to the combination part of meniscus and synovial membrane is inferior to 3mm, is called the red zone. The absolute devascularization zone, in which the above-mentioned distance is superior to 5 mm, is called the white zone.And the relative vascularization zone with the distance between 3 mm to 5mm is called red-white zone.OBJECTIVE: To observe and discuss the anatomical features of the blood supplyof the meniscus.DESIGN:Single sample observation.SETTING:Department of Orthopaedics, Huaxi Hospital of Sichuan University.PARTICIPANTS: The study was conducted in Huaxi Hospital of Sichuan University during the period from September 2000 to March 2001.Nineteen cases were collected, including 19 knees (38 menisci) from the subjects, 17 male and 2 female, whose age varied from 21 to 43 years old.All the samples were obtained in the amputation operation, the isolated limbs were without the change of re-transplantation and the voluntary donations from the non-minorities living in Sichuan.meniscus samples: 7 knees (14 menisci) were taken. After the femoral artery intubation and infusion of the heparinized normal saline, the vascular bed had no blood and then was infused with the normal saline and ink of 0.5 volume fraction and the infusion pressure was 13 kPa. The infused meniscus samples underwent the dehydration of gradient ethanol,the transparency of dimethylbenzene, and preservation with ilex pedunculosa, and then the blood supply of the menisci was observed and distribution of the meniscus section: 6 knees (12 menisci) with fresh and uninfused menisci were taken. The sections obtained at the sagittal plane,the coronal plane and the horizontal plane underwent hematoxylin-eosin staining. Then the tissues structure and blood supply of the meniscus samples were observed with light microscope. Another 6 knees (12meniscus) underwent the specific CD34 antibody immunohistochemical staining. Then the tissue structure and blood supply distribution of the meniscus samples were observed with the light microscope.in the devascularization zone of the meniscus.RESULTS: Nineteen cases with 38 menisci all went into the final result resourced from the medial and lateral genicular arteries and the middle genicular artery. The small vessels from them form the peripheral capillary vessel plexus and annular vessel meshwork in the synovium and joint capsule and then go into the menisci for the nutrition of the lateral The apparent lunar artery is sent by the vessel plexus around the meniscus into the body of the meniscus and arranges in the inferior,middle and superior layers and dominates 25%-30% of the zone around The vessels of the angular part of the semilunar plate cover the whole meniscus. The nutrition is supplied by the membranous synovium on the surface of the meniscus.Rich blood supply was observed in the anterior and posterior angular laminated blood supply in the body of the meniscus was newly devascularization zone of the meniscus is supplied from the joint synovial fluid is explicit.
7.Clinical analysis of HAA induction regimen for newly diagnosed and refractory relapsed acute myeloid leukemia
Xiaoshan HU ; Lizhong GONG ; Jian CEN ; Defeng ZHAO ; Yi LIU ; Wenjie YIN ; Jianliang SHEN
Journal of Leukemia & Lymphoma 2013;22(4):226-229
Objective To analyze the efficacy and safety of HAA induction regimen consisted of homoharringtonine (HHT),cytarabine (Ara-C) and aclacinomycin (ACM) in naive and refractory relapsed acute myeloid leukemia.Methods Data from 66 acute myeloid leukemia (AML) cases hospitalized and treated with HAA induction regimen was analyzed retrospectively.Results 45 of the 66 cases suffered from naive AML,and 21 were refractory relapsed.HAA efficacy in naive AML was evaluated in 41 cases with 36 in complete remission (CR) and 1 in partial remission (PR).The efficiency of HAA induction regimen was 90.2 % (37/41)in naive AML group and 42.9 % (9/21) in refractory relapsed group,respectively.There were no differences (P > 0.05) when considering patient' s gender,age,disease subtype and white blood cell count at onset.14 patients in CR with naive AML were followed-up for a median time of 9 months (2-17 months),and 5 cases relapsed (35.7 %) in a range of 2-8 months.The median myelosuppression period was 14 days (3-23 days).Nausea and vomiting [20 % (13/66)] were the major side effects of HAA regimen,and the other side effects were abdominal pain and diarrhea [9 % (6/66).After chemotherapy,53 % (35/66) of the cases experienced infection/fever due to neutropenia.Other severe non-hematological side effects did not occur.Conclusion HAA regimen may be an ideal choice for the induction chemotherapy of naive and relapsed refractory AML.
8.Modified extracardiac Fontan operation with direct total cavopulmonary connection
Xiaobing LIU ; Jimei CHEN ; Jianzheng CEN ; Yiqun DING ; Gang XU ; Shusheng WEN ; Jian ZHUANG
Chinese Journal of Thoracic and Cardiovascular Surgery 2014;30(2):65-67
Objective In order to optimize the Fontan circulation,a technique for direct total cavopulmonary connection was devised.To evaluate its surgical feasibility as well as surgical outcomes,our clinical experience was retrospectively reviewed.Methods From August 2005 to March 2012,23 consecutive patients underwent modified extracardiac Fontan operation with direct total cavopulmonary connection.Clinical profile of the patients,and procedural variables were examined and analyzed.Results All patients had adequately developed main and branch pulmonary arteries.Inferior caval vein was contralateral to the pulmonary trunk main pulmonary artery in 7 cases,ipsilateral in 8,and others in 8.There was 1 hospital death.The other 22 patients remained hemodynamically stable postoperatively.Prolonged effusions (n =13,62%) was a challenging problem.No obvious stenosis was found at the direct cavopulmonary anastomosis.Conclusion we are convinced that a direct total cavopulmonary connection is feasible in select subset of patients.This modified Fontan procedure retains the advantage of extracardiac connections together with the avoidance of prosthetic materials.
9.The activated pathways by hypoxia in patients with Obstructive sleep apnea hypopnea syndrome
Ling LUO ; Xinglin GAO ; Dongfeng LI ; Shaohua LUO ; Jian WU ; Qi LIN ; Qiong OU ; Ruijin CEN
The Journal of Practical Medicine 2014;(24):3902-3905
Objective To investigate the activation of nuclear factor-B (NF-B)and hypoxia-inducible factor-1 (HIF-1)in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS). Methods Subjects were classified into mild-to-moderate OSHAS group (n = 16), severe OSAHS group (n = 14) and the matched control group (n=30). Gene and protein expressions of NF-B and HIF-1 were measured by RT-PCR, Western blot in peripheral blood mononuclear cells (PBMC). Results NF-κB p65 mRNA and NF-κB p65 protein,HIF-1α mRNA and HIF-1α protein in PBMC were significantly higher in severe OSAHS group than those in mild–to-moderate group and control group (P<0.01). But there were no significant difference in NF-κB p65 mRNA and NF-κB p65 protein between mild-to-moderate group and control group (P=0.068, P=0.254 respectively). Only gene (P<0.05) not the protein (P=0.777) of HIF-1αwas higher in mild-to-moderate as compared with control group. Both NF-κB p65 mRNA and HIF-1αmRNA were positively correlated with AHI (r=0.493, P=0.006, r=0.508, P=0.004), while negatively correlated with nighttime lowest blood oxygen saturation (LSaO2)(r=-0.488, P=0.006, r=-0.46, P=0.011). There was a positive correlation between NF-κB p65 protein level and AHI (r=0.669, P<0.001). HIF-1αprotein level was positively correlated with AHI, ODI (r=0.628, P=0.001;r=0.480, P=0.018). There were positive correlations between NF-κBp65mRNA and HIF-1αmRNA (r=0.543, P=0.002), NF-κBp65 and HIF-1αprotein respectively (r=0.716, P<0.001). Conclusions As the gene and protein of NF-κB and HIF-1 were up-regulated in patients with OSAHS, and also positively correlated with the severity of sickness. We conclude that both NF-κB and HIF-1 were involed in the pathogenesis of OSAHS.
10.Surgical management of atrioventricular valve regurgitation in single-ventricle
Jianzheng CEN ; Jian ZHUANG ; Jimei CHEN ; Yiqun DING ; Gang XU ; Shusheng WEN
Chinese Journal of Thoracic and Cardiovascular Surgery 2014;30(4):199-202
Objective The aim of this article is to review and analyze the timing and surgical management of mediate and severe atrioventricular valve regurgitation(AVVR) in single-ventricle patients.Methods Between June 2006 and October 2011,twenty-three cases of single-ventricle patients accompanied with AVVR underwent atrioventricular valve plasty or replacement.There were 17 males and 6 females.Their ages ranged from 2.1 to 22.0 years,and their weight from 12.5 to 59.0 kg.There were 3 cases of A type of single ventricle,17 of B type,2 of C type,and 1 of D type.All cases had one atrioventricular valve except one of D type with 2 groups of atrioventricular valves.There were 18 patients with sever AVVR and 5 with the moderate.Before the management of AVVR,12 patients had undergone the first stage palliation,including B-D Glenn procedure 11 cases and A-P shunt 1 case.The periods between the two stages operations were 7-96 months.Among the all,there were 7 cases of atrioventricular valve replacement ; 3 cases of atrioventricular valve replacement and TCPC ; 5 cases of atrioventricular valve replacement and B-D Glenn procedure ; 2 cases of atrioventricular valve repair and TCPC ; 4 cases of atrioventricula repair and B-D Glenn procedure; 1 case of atrioventricular valve repair,B-D Glenn procedure and TAPVC repair; 1 case of atrioventricular valve repair,B-D Glenn procedure,PA Banding and TAPVC repair.Results In this group,there were 65.2% patients who underwent atrioventricular valve replacement.The ones with moderate regurgitation underwent atrioventricular valve repair.Only 3 of the 18 cases with severe regurgitation could underwent atrioventricular valve repair(P =0.002).Three cases died.The mortality was 13%.All cases undergone atrioventricular valve repair were alive.The mortality of atrioventricular valve replacement was 20%.All the post-operative alive were followed up.Their follow-up period were between 0.8-6.3 years,withoud a dead case.Conclusion The regurgitation with single ventricle should be managed before the image of myocardium occurred.It is the best time to manage the atrioventricular valve when the regurgitation was moderate.The atrioventricular valve replacement is effective to the cases of single ventricle with severe AVVR.