OBJECTIVETo assess the predict value of European system for cardiac operative risk evaluation (EuroSCORE) II on early death in patients with severe coronary artery disease undergoing active treatment.

METHODSConsecutive 2 240 patients with three-vessel disease ( with or without left main disease) diagnosed by elevtive coronary angiogram between July 2011 and September 2012 were screened for this study, data from 1 892 patients who underwent active treatments (percutaneous coronary intervention or coronary artery bypass grafting) were analyzed retrospectivly. The predicted 30 days operative mortality calculated with EuroSCORE II was compared with the actual one. The calibration and discrimination of EuroSCORE II were tested with Hosmer-Lemeshow χ2 test and area under receiver operating characteristic (ROC) curve respectively.

RESULTSAge was 61.0 (54.0-68.0) years old and 75.8% (1,435/1,892) were male in this cohort, 58.0% (1,097/1,892) patients received percutaneous coronary intervention and 42.0% (795/1,892) patients received coronary artery bypass grafting. The overall 30 days operative mortality was 0.53% (10/1,892), 30 days operative mortality predicted by EuroSCORE II was 0.85% (95% CI:0. 44%-1.26%). The calibration (χ2 = 3.47 and P > 0.10) and discrimination (area under ROC curve was 0.75) of EuroSCORE II were satisfactory.

CONCLUSIONEuroSCORE II could precisely predict 30 days operative mortality for three-vessel disease patients with or without left main disease undergoing active treatments.

Aged ; Coronary Artery Bypass ; Coronary Artery Disease ; mortality ; Female ; Heart ; Humans ; Male ; Middle Aged ; ROC Curve ; Risk Assessment

Objective To study the clinical and pathological features of periodic paralysis.Methods The clinical and pathological data of 9 patients with periodic paralysis were analyzed.Results The clinical manifestation of 9 patients were consistent with the general manifestation of periodic paralysis.The typical tubular aggregates in many fibers were observed in 4 cases of 7 patients with skeletal muscle biopsy.A few degenerating fibers were observed,while necrotic fibers and regenerating fibers were not found.Electromicroscope showed Honeycomb appearance in tubular aggregates of cross section,which was filled with glycogen granule.Conclusions According to the clinical manifestation and the laboratory examination,periodic paralysis can be clinical diagnosis.The tubular aggregates in many fibers are important pathological characteristic of periodic paralysis.In electromicroscope analysis,tubular aggregates may be compose of transverse tubular system or sarcoplasmic reticulum expansion.

Aim To investigate the influence of Tanshinone ⅡA on cytokine secreted by kuppfer cells via LPS stimulation,and explore its mechanism of therapying chronic hepatic disease. Methods The liver cell and kupffer cells were isolated and the model of liver cell injuries was made induced by LPS and D-GlaN, and the effects of TanshinoneⅡA was observed on the injuries of liver cell induced by lipopoly-saccharide(LPS) and D-Galactosamine(D-GlaN). Cytokine were released secreted by kupffer cells through LPS stimulation and the contents of TNF-?,IL-6,IL-8 were determined by radio-immunoassay. The hepatocyte morphological character was observed by HE stain,the expressions of TNF-?、CD14、iNOS、eNOS in kupffer cell were explored by immunohistochemical, double-decker chamber was used for observing the damage of hepatocyte caused by cytokine secreted by kupffer via LPS stimulation. Results Tanshinone ⅡA could restore the injury of liver cell induced by D-GlaN and LPS, the levels of ALT、MAO、LDH-L、GSH-S and contents of MDA were significantly reduce.It could inhibit TNF-? IL-8 secreted by kupffer cells through LPS stimulation ,and the expressions of TNF-?、CD14 Inos、eNOS in kupffer cell through LPS stimulation were inhibited. Blocking injuries of the inflammatory cytokine release excessive on liver cell, it hadn′t the protect action on liver cell damage suffer from inflammatory cytokine.Conclusion The mechanism of Tanshinon ⅡA of blocking liver cell injuries induced by D-GlaN and LPS may be correlation with inhibiting the excessive cytokine by kupffer cells

Parkinson's disease (PD) is a commonly encountered central neurodegenerative disease in elderly people. According to theories of traditional Chinese medicine (TCM), PD is characterized by deficiency in the root and excess in the branch. Deficiency was referred to qi-blood deficiency of the liver and kidney. Excess was referred as the wind, fire, phlegm and stasis. Deficiency was the root and excess was the branch. Good efficacies have been obtained by treatment based on syndrome differentiation, treatment with specific prescriptions, acupuncture and moxibustion and comprehensive treatment. Some experiments had been conducted to elucidate its mechanisms. However, no uni-fied standard for therapeutic evaluation, poor control of medicinal quality, inferior quality of designed clinical trials, and unclear treatment mechanism in the clinical study on therapeutic effect of PD treatment with TCM require fur-ther studied.

Objective To explore the clinical efficacy and the dynamic changes of serum vascular endothelial growth factor(VEGF),connective tissue growth factor(CTGF),hypoxia inducible factor 1α(HIF-1α)and osteopontin(OPN)levels after transcatheter arterial chemoembolization(TACE)combined with sorafenib in the treatment of advanced hepatocarcinoma(HCC)patients.Methods A total of 113 HCC patients in Cancer Hospital of Taizhou,from September 2013 to December 2014 were elected and were randomly divided into control group(n=56)and experiment group(n=57)according to random number.Control group were treated with sorafenib and experiment group were treated with TACE combined with sorafenib.The serum VEGF,CTGF,HIF-1α and OPN levels were tested and compared using indirect ELISA method preoperative and postoperative 1,3,7 days and which were carried out Spearman correlation analysis.The long-term clinical efficacy and adverse reaction in two groups were statisticed.Results The serum VEGF,CTGF,HIF-1α and OPN levels of two groups postoperative 1 day increased than preoperative(P<0.05).From postoperative one to seven days,the serum VEGF,CTGF,HIF-1α and OPN levels of two groups present downward trend(P<0.05 or P<0.01),and there was significant difference between two groups(P<0.01).The level of HIF-1α significantly positive correlated with the levels of VEGF,CTGF and OPN(r=0.951,0.954,0.929,P<0.05).Compared with control group,the median survival time and 1-year-survival rate of experiment group increased significantly(P<0.01).The incidence of hand-foot reaction,alopecia and diarrhea in experiment group were higher than those in control group(P<0.05),while the others had no significant difference between two groups(P>0.05).Conclusion The levels of VEGF,CTGF,HIF-1α and OPN of HCC patients after treated with TACE combined with sorafenib are lower than that treated with TACE alone,Simultaneously,the survival is prolonged and adverse reactions don't increase.

Objective: To investigate the quality of life and its influencing factors among patients with gestational diabetes mellitus (GDM), so as to provide insights into the improvements in the quality of life among patients with GDM. Methods: GDM patients admitted to Department of Obstetrics and Gynecology, Hangzhou First People's Hospital Affiliated to Zhejiang University Medical School from June 2021 to June 2022 were recruited. Participants' demographics, diagnosis and treatment, sleep quality, depression and social support level were collected. Patients' quality of life was evaluated using the Quality of Life Scale for Pregnant Women with Gestational Diabetes Mellitus, and the factors affecting the quality of life were identified among patients with GDM using a multivariable linear regression model. Results: A total of 300 questionnaires were allocated, and 284 valid questionnaires were recovered, with an effective recovery rate of 94.67%. The respondents had a mean age of (32.81±4.93) years, and the mean scores for the quality of life was (92.63±14.10) points. Multivariable linear regression analysis identified depression (β'=-0.293), sleep disorder (β'=-0.177), insulin therapy (β'=-0.316), regular exercise (β'=0.272) and social support level (medium: β'=0.153; high: β'=0.381) as factor affecting the quality of life among GDM patients. Conclusions GDM patients have a low quality of life. Depression, sleep disorders, insulin therapy, and lack of exercises may cause a decline in the quality of life among GDM patients, and strong social support facilitates the improvements in the quality of life among GDM patients.

OBJECTIVETo explore the clinical effects of Dynesys system combined with posterior lumbar interbody fusion (PLIF) in treating multiple lumbar degenerative disease.

METHODSThe clinical data of 46 patients with multiple lumbar degenerative diseases treated by Dynesys system combined with PLIF from September 2010 to May 2013 were retrospectively analyzed. There were 17 males and 29 females, aged from 38 to 68 years old with an average of (56.38±11.63) years. Operation section was in L2-L5 of 16 patients (6 with fusion of L4,5 and 10 with fusion of L4,5,L5S1) and in L3-S1 of 30 patients (11 with fusion of L5S1 and 19 with fusion of L4,5,L5S1). Patients were followed up for three times: postoperative 3 months, 1 year and final follow-up. Visual analogue scale (VAS) and Oswestry Disability Index (ODI) were used to assess clinical symptoms preoperatively and postoperatively. All patients underwent flexion/extension radiographs examinations before surgery and at final follow-up. Range of motion (ROM) and disc height index (DHI) were recorded.

RESULTSAll patients were followed up from 16 to 48 months with the mean of (23.23±7.34) months. At third follow-up after operation, ODI and VAS of lumbago and leg pain were significant improved than that of preoperative (P<0.01). DHI of fusion segment was significantly increased than that of preoperative (P<0.05). There was no significant difference in adjacent non-fusion segment between preoperative and postoperative (P>0.05). Postoperative ROM of fusion and non-fusion segments were obviously decreased than that of preoperative. There was no significant difference in ROM of upper adjacent non-fusion segment between 3 months and 1 year after operation (P>0.05), but at final follow-up, the ROM was increased (P<0.05).

CONCLUSIONThe preliminary clinical results of the Dynesys system combined with PLIF in the treatment of multiple lumbar degenerative diseases are satisfactory. It can be determined in fusion or non-fusion according to the individual needs and can reserve the some intervertebral motion, prevent the early degeneration of adjacent segments. However, its long-term clinical efficacy should be verified with long time.

Humans ; Lumbar Vertebrae ; surgery ; Range of Motion, Articular ; Retrospective Studies ; Spinal Diseases ; physiopathology ; surgery ; Spinal Fusion ; methods ; Visual Analog Scale

Objective To investigate the clinical efficacy of intravitreal injection of Lucentis combined with pan retinal photocoagulation and trabeculectomy for neovascular glaucoma(NVG). Methods Seventeen eyes of 15 patients with NVG were treated by 0.5 mg Lucentis intravitreal injection first. Trabeculectomy was performed 7 days later and Pan retinal photocoagulation 2 weeks later. Iris,anterior chamber angle neovascularization,intraocu?lar pressure ,and visual acuity were observed in the following 6 months. Results Iris and anterior chamber angle neovascularization were completely regressed 7 days after the injection in 17 eyes. Six months after photocoagulation, 6 eyes had different degrees of improvement in visual acuity,10 eyes no change in visual acuity and 1 eye decreased from anterior index to immediate manual. There was significant difference in pre?treatment IOP and postoperative IOP( t = 12.75 ,10.26 ,9.73 ,10.77 ,P < 0.01 ). No serious complications were observed after intravitreal injec?tion and trabeculectomy. Conclusions Intravitreal injection of Lucentis could significantly accelerate the regres?sion of iris and anterior chamber angle neovascularization ,which could improve the successful rate of trabeculecto?my and pan retinal photocoagulation. Intravitreal injection of Lucentis combined with trabeculectomy and panretinal photocoagulation is safe and effective for NVG.

AIM: To evaluate the clinical efficacy of surgery for spontaneous subconjunctival orbital fat prolapse via bulbar conjunctiva under topical anesthesia.
●METHODS: A total of 22 eyes of 11 patients received surgery for spontaneous subconjunctival orbital fat prolapse via bulbar conjunctiva under topical anesthesia were included. Objective and subjective duration of the operation, degree of cooperation during surgery, postoperative recovery, recurrence and complications were observed.
●RESULTS: In the process of surgery, patients without pain and being-cooperated were recorded in 17 eyes. The patients who occasionally felt slight pain, but within endurance after adding topical anesthesia once and the operation was completed successfully were recorded in 5 eyes ( the second eye surgery ) . The operation was successfully completed in all the patients. Compared the coordination degree during surgery of Gradel with GradeⅡ, the difference was statistically significant ( t=-3. 123, P<0. 01). All eyes were healed well after operation.
● CONCLUSION: The surgery for spontaneous subconjunctival orbital fat prolapse via bulbar conjunctiva under topical anesthesia can ensure satisfactory anesthetic effect and get better quality of operation. It′s a simple, safe and effective anesthesia method for spontaneous subconjunctival orbital fat prolapse.

BACKGROUND:Recombinant human epidermal growth factor has been shown to promote granulation tissue formation and to accelerate the healing of burn wounds, but the antibacterial effect of recombinant human epidermal growth factor is limited. OBJECTIVE:To investigate the effect of nano-silver dressing combined with recombinant human epidermal growth factor gel in treatment of burns and the influence on the scar. METHODS:A total of 76 cases of shal ow II and depth II degree were randomly enrol ed and assigned to two groups. In the study group, recombinant human epidermal growth factor was coated on the surface of the wound, and then covered by nano-silver dressing. In the control group, recombinant human epidermal growth factor was coated on the surface of the wound, and covered by ordinary sterile gauze. The healing time, the positive rate of bacteria, scarring and adverse reactions were compared between the two groups. RESULTS AND CONCLUSION:The wound healing time and the rate of hypertrophic scars after healing were lower in the study group than in the control group (P<0.01). The rate of flat scar was greater in the study group than in the control group after healing (P<0.01). The bacterial positive rate was significantly lower in the study group than in the control group at 7, 14 and 21 days after treatment (P<0.05). No significant difference in incidence of al ergies and local burning sensation was detected between the two groups (P>0.05). These data confirmed that recombinant human epidermal growth factor gel combined with nano-silver dressing in the treatment of burn has good efficacy and accelerates the wound healing, reduces scar formation, and improves aesthetics.