Barium ; poisoning ; China ; epidemiology ; Humans

OBJECTIVETo analyze the clinical features of patients with acute myocardial infarction underwent successful thrombolytic therapy post cardiopulmonary resuscitation.

METHODSThis retrospective analysis included 65 patients with acute myocardial infarction underwent successful intravenous thrombolysis post cardiopulmonary resuscitation. The cases were collected from Chinese Journal Full-text Database from 1996 to 2006, only patients met the recanalization criteria of coronary artery were included.

RESULTSMost of the patients were male (93.8%, 61/65) and aged less than 65 years (81.5%, 53/65). Cardiopulmonary resuscitation was performed within 5 min after cardiac arrest in 63 patients (96.9%). Defibrillation was performed 3.2 times per patient, chest compression in 52 patients (80.0%) and tracheal intubation in 21 patients (32.3%). The restoration time of spontaneous circulation were achieved within 10 min in 36 cases (55.4%), between 11 - 30 min in 19 cases (29.2%)and between 31 - 107 min in 10 cases (15.4%). Thrombolysis agents (urokinase, recombinant streptokinase or recombinant tissue-type plasminogen activator) were given intravenously at 172 +/- 92 min after acute myocardial infarction. Mild hemorrhage was seen in 12 cases (18.5%) and there was no report on severe hemorrhage event. The hemorrhage incidence tended to be higher than that of reported large Chinese thrombolysis trials (11.1% - 15.1%, P > 0.05).

CONCLUSIONThrombolytic therapy was relatively safe and effective for those middle-aged male AMI patients received rapid cardiopulmonary resuscitation (< 5 min after cardiac arrest) and with shorter spontaneous circulation restoration time (<30 min).

Adult ; Aged ; Aged, 80 and over ; Cardiopulmonary Resuscitation ; Female ; Fibrinolytic Agents ; therapeutic use ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; drug therapy ; therapy ; Streptokinase ; therapeutic use ; Thrombolytic Therapy ; methods

OBJECTIVETo summarize the clinical characteristics of mesenteric arterial embolism (MAE) and mesenteric arterial thrombosis (MAT), and to clarify the diagnosis and treatment status of MAE and MAT in China.

METHODSA retrospective analysis of 111 cases suffering from MAE or MAT was performed. Data of these cases were collected from Chinese Journal Full-text Database from 1994 to 2006.

RESULTSThere were 61 cases (54.9%) with MAE and 50 cases (45.1%) with MAT. Fifty-two patients (46.8%) had arterial fibrillation. Ninety-seven cases (87.4%) were diagnosed by exploratory laparotomy or autopsy, and 14 cases (12.6%) by imageology. Embolism or thrombosis in superior mesenteric artery (SMA) accounted for 92.8%, 4.5% in SMA plus inferior mesenteric artery. 15.2%(14/92) necrosis were located in jejunum or ileum, 39.1%(36/92) in jejunum and ileum, 38.0%(35/92) in jejunum, ileum and colon. Thrombolysis or anticoagulation in artery were operated in 7 cases(6.3%). Extraction of embolism or thrombosis in operation were implemented in 18 cases(16.2%). Intestinal resection were finished in 76 cases(68.5%). Sixty-eight patients (61.3%) were misdiagnosed. Sixty-three cases (60.6%) died.

CONCLUSIONThe manifestation of MAE or MAT is quite complicated and changeable, so that many cases are misdiagnosed. The clinic and image characteristics of MAE and MAT have not been well known by doctors.

Embolism, Cholesterol ; diagnosis ; therapy ; Humans ; Mesenteric Vascular Occlusion ; diagnosis ; therapy ; Retrospective Studies ; Thrombosis ; diagnosis ; therapy

To find the relationship between myelodysplastic syndrome (MDS) and refractory monolineage cytopenia, thirteen cases of MDS with early presentation of monolineage refractory cytopenia were analyzed retrospectively. The results were as follows: (1) The percentage of 13 cases with refractory monolineage cytopenia were 5.9% of the total 219 MDS patients in the past 10 years. (2) The median time of patients with monlineage cytopenia to M DS diagnosed was 48.5 +/- 55.3 months. The median times from monolineage cytopenia to MDS diagnosed for patients with neutropenia, erythrocytopenia and thrombocytopenia were 12.5 +/- 9.5 months, 53.8 +/- 54.6 months and 59.2 +/- 65.5 months, respectively. (3) The common characteristics of 13 cases were as follows: (a) the macrocytic erythrocytes in peripheral blood and the percentage of intermediate and late erythroblast in bone marrow were increased; (b) occasionally few cells with dysplasia could be found; (c) all patients with erythrocytopenia and thrombocytopenia transformed to RA and RAS while the most of patients with neutropenia transformed to RAEB subtype; (d) autoantibody could be found in part of the patients. It is concluded that some of refractory monolineage cytopenias in essence are the early states of MDS.
Adolescent ; Adult ; Aged ; Anemia, Hemolytic ; diagnosis ; Child ; Diagnosis, Differential ; Female ; Humans ; Male ; Middle Aged ; Myelodysplastic Syndromes ; diagnosis ; Neutropenia ; diagnosis ; Purpura, Thrombocytopenic, Idiopathic ; diagnosis ; Retrospective Studies

Child ; China ; Humans ; Living Donors ; Lung Injury ; therapy ; Lung Transplantation ; methods ; Male

OBJECTIVETo investigate the feasibility that transforming growth factor-beta1 (TGF-beta1) -loaded fibrin sealant (FS) promotes bone marrow mesenchymal stem cells (BMSCs) to create tissue engineering cartilage in vivo.

METHODSThe BMSCs were isolated from healthy human and amplified in vitro, and then induced by defined medium containing TGF-beta1 and dexamethasone. After 7 days the induced BMSCs were collected and mixed with TGF-beta1-loaded FS or FS as BMSCs+ FS-TGF-beta1 group and BMSCs+ FS experimental group. Then the mixture was injected by a needle into the dorsum of nude mice. In control group, only FS or BMSCs were injected. The tissue engineering specimens were harvested from nude mice 12 weeks later. Gross observation, average wet weight measurement, glycosaminoglycan (GAG) quantification, histology and immunohistochemistry were used to evaluate the results.

RESULTSThe BMSCs have possessed the shape and functional characters of chondrocyte when transferred to a defined medium. After injection of the mixture, the cartilage-like tissue were formed in two experimental groups. Compared with BMSC+ FS group, the specimens of BMSCs +FS-TGF-beta1 group were larger and firmer. Alcian staining showed better metachromatic matrix formation. The GAG contents were significantly higher. Immunohistochemical staining of collagen type II was stronger. However, no cartilage-like tissue was formed in two control groups.

CONCLUSIONTGF-beta1-loaded FS can promote BMSCs to contract injectable tissue engineering cartilage in vivo.

Animals ; Biocompatible Materials ; Cell Differentiation ; drug effects ; Cells, Cultured ; Chondrogenesis ; drug effects ; Dexamethasone ; pharmacology ; Fibrin Tissue Adhesive ; Humans ; Mesenchymal Stromal Cells ; cytology ; drug effects ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; Tissue Engineering ; methods ; Transforming Growth Factor beta ; pharmacology

BACKGROUNDRadical lung resection is the best chance for cure in patients with anatomically resectable non-small cell lung cancer. A retrospective study was performed in an attempt to investigate general rules of major lung resection for non-small cell lung cancer in patients with compromised pulmonary function.

METHODSBetween June 2002 and December 2008, major lung resection was performed in 127 non-small cell lung cancer patients at our institution, who met the criteria of compromised pulmonary function defined as preoperative forced vital capacity < 50% of prediction or preoperative forced expiratory volume in one second < 50% of prediction. Clinical data of the patients were retrospectively reviewed.

RESULTSThe patients consisted of 108 males (85.0%) and 19 females (15.0%) with a mean age of 61.7 years. The morbidity rate was 44.1% (56/127) and the mortality rate was 4.7% (6/127). Multivariate analysis identified PaCO2 (P = 0.023, OR = 2.959, 95%CI 1.164 - 7.522), the percent predicted postoperative diffusing capacity of the lung for carbon monoxide (P = 0.001, OR = 0.176, 95%CI 0.064 - 0.480) and comprehensive preoperative preparation (P = 0.048, OR = 0.417, 95%CI 0.176 - 0.993) as the independent predictors of postoperative cardiopulmonary complications that were found in 45 cases. Overall 1-, 3- and 5-year survival rates were 90%, 55% and 37% respectively. For overall survival, multivariate analysis revealed that TNM staging (P = 0.004, OR = 1.585, 95%CI 1.154 - 2.178) was the only independent prognostic factor.

CONCLUSIONSOn the premise of integrated preoperative evaluation and comprehensive preoperative preparation, major lung resection provides an optimal therapeutic for selected non-small cell lung cancer patients with compromised pulmonary function. Hypercapnea and the percent predicted postoperative diffusing capacity of the lung for carbon monoxide < 40% could be considered as the independent predictive factors for operative risk in those patients.

Adult ; Aged ; Carcinoma, Non-Small-Cell Lung ; surgery ; Female ; Humans ; Lung ; pathology ; surgery ; Male ; Middle Aged ; Multivariate Analysis ; Postoperative Complications ; Retrospective Studies

OBJECTIVETo compare video-assisted thoracic surgery (VATS) and open thoracotomy (OT) on acute inflammatory responses and immunosuppression after lobectomy for early non-small cell lung cancer (NSCLC).

METHODSPresent prospective randomized study. OT or VATS lobectomy was performed in patients who met enter criteria and clinical data was collected. Plasma concentration of IL-6, IL-8 and IL-10 were measured before surgery and at postoperative day (POD) 1 and POD 3. There were 271 patients underwent lobectomy for early NSCLC, including of 133 patients in group VATS and 138 patients in group OT from January 2007 to June 2008. There were 132 males and 139 females, aging from 19 ∼ 70 years with a mean of (56 ± 8) years.

RESULTSCompared with OT group, shorter postoperative hospital stay [(8.2 ± 2.5) d vs. (9.8 ± 6.2) d, P = 0.03], lower morbidity rate (11.3% vs. 21.7%, P = 0.02) and lower increase of plasma concentration of IL-6 at POD 1 [(35 ± 25)% vs. (65 ± 43)%, P = 0.00], IL-6 at POD 3 [(14 ± 22)% vs. (55 ± 44)%, P = 0.00] and IL-10 at POD 1 [(25 ± 20)% vs. (43 ± 35)%, P = 0.00] were observed in patients of VATS group.

CONCLUSIONVATS lobectomy for early NSCLC is associated with less acute inflammatory responses and less immunosuppression when compared with OT.

Adult ; Aged ; Carcinoma, Non-Small-Cell Lung ; blood ; surgery ; Female ; Follow-Up Studies ; Humans ; Interleukin-10 ; blood ; Interleukin-6 ; blood ; Interleukin-8 ; blood ; Interleukins ; blood ; Lung Neoplasms ; blood ; surgery ; Male ; Middle Aged ; Pneumonectomy ; methods ; Prospective Studies ; Thoracic Surgery, Video-Assisted ; Thoracotomy ; Treatment Outcome ; Young Adult

In order to study whether erythroleukemia was really a subtype of acute leukemia, the clinical laboratory characteristics and development of disease in 21 cases of erythroleukemia were analyzed. The results indicated that the percentage of patients with leucocytopenia, anemia and thrombocytopenia were 42.9%, 81% and 81% respectively at the time of diagnosis. These were 85.7% of patients with myelocytes and premonocyte, 52.4% of patients with erythroblast in their blood smear respectively. All of the bone marrow showed active or significantly active proliferation. The median percentage of erythro-lineage, myeloblast of NEC and displasia were (58.3 +/- 8.0)%, (58.0 +/- 18.4)% and 66.7% respectively, that is different from typical AML. 52.4% of M(6) patients transferred to RAEB/RAEB-T and AML-M(2) subtype in the disease progression. 11/19 cases (57.4%) achieved remission (CR 10; PR 1) after chemotherapy. The median remission length were 6 months for CR patients and 2 months for PR patients, but most of CR patients displayed obvious displasia of bone marrow and cytopenia of blood in the period of CR. The median survival length of M(6) and MDS-->M(6) from time of diagnosis were 13.0 +/- 13.2 and 2.3 +/- 1.3 months respectively. It is concluded that there are differences between M(6) and typical AML. Most of M(6) patients would rather be classified MDS RAEB and RAEB-t with over-hyperplasia of erythron lineage than a subtype of AML.
Adult ; Aged ; Bone Marrow Examination ; Diagnosis, Differential ; Female ; Humans ; Leukemia, Erythroblastic, Acute ; blood ; diagnosis ; Male ; Middle Aged ; Myelodysplastic Syndromes ; classification ; diagnosis ; Retrospective Studies