Objective To explore the incidence, causes and management of peripheral vascular complications after cardiac catheterization Methods Cardiac catheter data and clinical data of 1?745 patients were reviewed Results One hundred and two patients (5 9%) had peripheral vascular complications, including local hematoma (77, 4 4%), pseudoaneurysm (4, 0 23%), arteriovenous fistula(2, 0 11%), femoral arterial thrombosis(2, 0 11%), femoral venous thrombosis (3, 0 17%), pulmonary thromboembolism (2, 0 11%), external hemorrhage(13, 0 74%) The mortality was 0 06% (1/1745), and the surgery repair rates 0 11% ( 2/1?745 ) Conclusion Peripheral vascular complications of cardiac catheterization is not so rare, and has a good prognosis after conservative management

OBJECTIVETo investigate the clinical value of pleural biopsy in the etiological diagnosis of pleurisy in children.

METHODTotally 213 cases with pleurisy, who underwent pleural biopsy and hospitalized in Children's Hospital of Chongqing Medical University from January 2007 to April 2014 were enrolled into this study. Clinical symptoms, imaging manifestations, pleural fluid characteristics, the results of pleural biopsy and postoperative complications were retrospectively analyzed to evaluate the clinical value and security of pleural biopsy in making the etiological diagnosis of pleurisy.

RESULT(1) Of the 213 cases, 144 were boys and 69 were girls, their mean age was (6. 5 ± 4. 1) years. (2) Two hundred and thirteen patients had a surgical pleural biopsy under general anesthesia, the cause of 97 cases (45. 5%) were made clear by histopathological examination, including 35 purulent pleurisy, 55 tuberculous pleurisy and 7 paragonimus infection. For the remaining 83 (41. 3%) cases a final diagnosis was made based on the full analysis of clinical data, including 63 cases of purulent pleurisy, 3 cases of tuberculous pleurisy and 17 cases of paragonimiasis pleurisy but for 33 patients no exact cause was found at the end. (3) The mean operating time of the biopsy was (1. 4 ± 0. 6) hours. Seventy one (33. 3%) patients required blood transfusion during or after the operation. Thirty one (14. 6%) cases used the ventilator after surgery, and the ventilator supporting time was (6. 6 ± 5. 8) hours on average. The wound healing reached grade A in 200 cases (93. 9%), grade B in 13 cases (14. 6%). Postoperative complications included pneumothorax in 92 cases (43. 2%), subcutaneous emphysema in 18 cases (8. 5%), bronchopleural fistula in 3 cases(1. 4%). The average days of hospitalization was (17. 7 ± 7. 1) d.

CONCLUSIONPleural biopsy is of great diagnostic value in the etiological diagnosis and differential diagnosis of pleurisy in children, and it is considered reasonable to be used in the clinical practice when appropriate.

Biopsy ; Child ; Diagnosis, Differential ; Female ; Humans ; Infection ; diagnosis ; Male ; Pleura ; Pleurisy ; diagnosis ; etiology ; Retrospective Studies ; Tuberculosis, Pleural ; complications ; diagnosis

Objective To evaluate the feasibility and effectiveness of endoluminal grafting for the treatment of abdominal aortic aneurysms in high-risk patients with serious co-morbidities.Methods Endoluminal stent grafting was performed in fifty-one patients(45 males and 6 females,with a mean age of 71.6±7.5 years)with abdominal aortic aneurysms.Of all the patients,21(37.7%)were high-risk surgical candidates because of associated co-morbidities.These patients were classified in grade Ⅱ and Ⅲ according to the criteria assigned by the"Society for Vascular Surgery"and"International Society for Cardiovascular Surgery".Based on the preoperative CT and DSA findings,the appropriate stent was selected for every patient.Post-operative clinical observation and CT scan were regularly carried out,the occurrence of complications and the morphological changes of the aneurysms were observed.The results were evaluated and analyzed.Results Primary technical success was achieved in all patients(100%).No death occurred during the procedure or in 30 days after the procedure.An average follow-up period of(29.1±20.5)months was made.Minor endoleak was noted on CT scans in 10 patients,and the endoleak disappeared in 5 patients during the follow-up period.One patient died from unknown cause.The total mortality rate was 2.0%(1/51).The major complications rate was 9.8%(5/51),including stent thrombosis(n=2),thrombosis at femoral artery(n=1),lymphatic fistula at femoral incision(n=1) and stent dislocation(n=1).Conclusion Endoluminal stent grafting is a safe and feasible technique for the treatment of abdominal aortic aneurysms with excellent medium-term results.This technique is especially suitable for the patients with high surgical risk.

Objective To analyze the clinical and histological features of drug-induced autoimmune hepatitis (DI-AIH).Methods From January 2008 to June 2011,five patients with auto-immune hepatitis (AIH),having a definitive history of medicine taking prior to the onset of disease and accepted liver biopsy were retrospectively analyzed.The general information was collected,which included gender,age,onset of the disease,medication,clinical manifestations,treatment and follow-up.The laboratory findings were also collected,which included total bilirubin (TBil),direct bilirubin (DBil),alanine transaminase (ALT),aspartate transaminase (AST),alkaline phosphatase (ALP),gamma glutamyl transpeptidase (GGT),globulin,γ-globulin percentage,albumin (Alb),eosinophils,antinuclear antibodies,antimitochondrial antibodies,anti-smooth muscle antibodies and the type of live injury.The liver tissue sections of patients were stained with hematoxylin-eosinstaining (HE) and reticular fiber staining and then pathological changes were observed.Patients with DI-AIH were scored with AIH scoring scale.Results All five patients with DI-AIH were female,average age was 48.0--+7.5.Prior to the onset of disease,all patients had taken Chinese traditional medicine.Anorexia and fatigue were the most common clinical symptoms.Among laboratory findings,the level of ALT ((795.0+467.4) U/L),AST ((730.44-451.5) U/L),TBil ((80.3-+ 64.1) μmol/L) and DBil ((65.2 +_ 58.0) μmol/L) significantly increased.One patient was antinuclear antibody positive.One patient had drug-induced liver injury,pathological features were spotty necrosis of liver cells,liver tissue eosinophil infiltration and liver cell microbubble type degeneration.All the patients had interface hepatitis,periportal infiltration of lymphocytes or lymphocytes-plasma cells,liver cells adjacent to lesion showed rosette-like structure.All the patients received glucocorticoid treatment.After glucocorticoid withdrawal,the liver function was normal during the follow-up period.Conclusion There are no specificity of clinical manifestations,laboratory findings and histological features in patients with DI-AIH.

ObjectiveTo investigate the efficacy of acupuncture in ataxia children with cerebral palsy. Methods40 patients were divided into 2 groups, treatment group and control group. Patients in the control group were treated with routine rehabilitation, while those in the treatment group received acupuncture in addition. All patients were assessed with balance function before and after treatment.ResultsThere was a significant difference (P<0.05) of balance function between the treatment group and the control group after treatment. ConclusionThe acupuncture in addition to the conventional therapy improved significantly balance function of ataxia children with cerebral palsy.

Adult ; Angiomyolipoma ; pathology ; Antigens, CD34 ; metabolism ; Diagnosis, Differential ; Female ; Hemangiopericytoma ; pathology ; Humans ; Kidney Neoplasms ; metabolism ; pathology ; surgery ; Nephrectomy ; Sarcoma, Synovial ; pathology ; Solitary Fibrous Tumors ; metabolism ; pathology ; surgery ; Vimentin ; metabolism

Objective To observe the extent of bone coagulation and the thermal field distribution created in ablating the swine vertebral bodies in vitro with multi-polar radiofrequency and to discuss the correlation between the electrode position in the vertebral body and the safety of the spinal cord as well as the soft tissue injury around the vertebral body. Methods Thirty fresh adult porcine vertebrae, were randomly and equally divided into two groups. The depth of the electrode needle was 10 mm or 20 mm. When the ablation process reached to a stable state, the temperature at the scheduled spots was estimated. Twenty minutes after ablation, the vertebral body was cut along the electrode needle plane and also along the plane perpendicular to the electrode needle to observe the extent of bone coagulation. Results The temperature at the scheduled spots reached to a stable state in 3.5 minutes. The more close to the electrode the spot was,the more quickly the temperature rose. No soft tissue injury around the vertebral body was observed in both groups and no spinal cord injury occurred when the electrode needle was 10 mm or 20 mm deep in the vertebral body. Conclusion In treating vertebral metastases, the radiofrequency ablation is safe and reliable if the posterior wall of the vertebral body remains intact.

OBJECTIVE To find the differences in QOL between patients treated with total laryngectomy with voice rehabilitation or without voice rehabilitation and subtotal laryngectomy, to analysis the factors affecting QOL of patients after laryngectomy by HNQOL. METHODS With HNQOL,a survey was conducted in patients treated with total laryngectomy (30cases) with voice rehabilitation, 30 cases without voice rehabilitation, and 30 cases treated with subtotal laryngectomy for laryngeal cancer. We discuss changes of QOL with time went by,and analysis the factors affecting QOL of patients after laryngectomy. RESULTS There is no difference between patients treated with total laryngectomy with .voice rehabilitation and the one treated with subtotal laryngectomy in their quality of life, however, there is difference between patients treated with total laryngectomy without voice rehabilitation and the one treated with subtotal laryngectomy. CONCLUSION Through voice rehabilitation ,we could advance quality of life of the patients treated with total laryngectomy. Through the integration of psychological, clinical and social intervention, the quality of life of patients may have an overall improvement.

BACKGROUND: It has been found that vascular endothelial growth factor can induce the differentiation of bone marrow mesenchymal stem cells into endothelial cells, but can the vascular endothelial growth factor gene promote the differentiation of bone marrow mesenchymal stem cells into vascular endothelial cells in the damaged organ under the hypoxic environment? OBJECTIVE: To observe whether human bone marrow mesenchymal stem cells induced by vascular endothelial growth factor could differentiate into vascular endothelial cells under hypoxia. METHODS: The third passage of human bone marrow mesenchymal stem cells were cultured in vitro. Cells in the control group were cultured with conventional culture medium, while those in experimental group were cultured with adenovirus vector containing vascular endothelial growth factor in 5% O2. After 2 weeks of culture, morphological observation and surface-related molecular detection were performed. The levels of vascular endothelial growth factor and endothelial nitric oxide synthase were detected by ELISA. The expression of endothelin and prostacyclin was detected by RT-PCR and western blot assay. RESULTS AND CONCLUSION: (1) The number of cells in the control group was more than that in the experimental group. The cells in the control group were crowded and arranged irregularly, showing a fiber-like growth, while those in the experimental group were mostly triangular or polygonal, exhibiting a colony-like growth. (2) CD31 was negative in the control group, while CD105 was positive and the positive rate was 99.7%, indicating that the cells still showed the phenotype of bone marrow mesenchymal stem cells. The positive rate ofCD31 was significantly increased to 30.33% in the experimental group and the positive rate of CD105 expression was decreased to 58.11%, indicating a typical phenotype of endothelial cells. (3) Compared with the control group, the expression of endothelin, vascular endothelial growth factor and endothelial nitric oxide synthase increased significantly in the experimental group (P < 0.05), and the expression of prostacyclin decreased significantly (P < 0.05). All these findings indicate that vascular endothelial growth factor can promote the differentiation of human bone marrow mesenchymal stem cells into vascular endothelial cells under hypoxia.

Objective: To explore the relationship between the ratio of neutrophil/lymphocyte (NLR) and in-hospital major adverse cardiac events (MACE) in patients with acute ST-elevation myocardial infarction (STEMI) at early admission.
Methods: A total of 420 acute STEMI patients admitted and received primary PCI in our hospital from 2010-01 to 2014-12 were retrospectively studied. The patients were divided into 2 groups:In-hospital MACE group, n=47 and Normal discharged group, n=373. Uni-and multivariate analyses were conducted to assess whether high NLR is the independent predictor for in-hospital MACE occurrence.
Results: Univariate regression analysis indicated that the occurrence rate of in-hospital MACE in high NLR patients were higher than those in low NLR patients (OR=3.19, 95%CI 1.55-2.65, P=0.012). Multivariate regression analysis showed that high NLR was the independent risk factor for in-hospital MACE occurrence in STEMI patients (OR=3.05, 95%CI 1.59-10.54, P=0.015).
Conclusion: High NLR is the independent risk factor for in-hospital MACE occurrence in STEMI patients at the early admission.