Objective To treat the patients with primary dysmenorrhea by puncturing Shiqizhui (EX-B8) and observe the change and regularity of the analgesic effect with different needle-retaining time, for providing evidence for the optimal needle-retaining time. Method Ninety eligible subjects with primary dysmenorrhea were randomized into a 20 min group of 30 cases, a 30 min group of 30 cases, and a blank control group of 30 cases. Visual Analogue Scale (VAS) was used to observe the change before and after intervention with the time, and to compare the intergroup differences. Result The acupuncture groups started to show analgesic effect 10 min after needling, and the effect increased with the needle-retaining time (P＜0.05);the therapeutic efficacy of the 30 min group was significantly superior to that of the 20 min group (P＜0.01). Conclusion Acupuncture at Shiqizhui can produce a real-time analgesic effect for patients with primary dysmenorrhea, and retaining the needle for 30 min is superior to 20 min.

Objective To evaluate the outcomes achieved by using left internal mammary artery(LIMA) to radial artery (RA) total arterial composite grafts in minimally invasive direct coronary artery bypass grafting (MIDCAB) for patients with multiple vessel disease.Methods From January 2009 to September 2015, 39 patients(24 males) with multiple vessel disease underwent MIDCAB with LIMA-RA total arterial composite grafts without cardiopulmonary bypass in our hospital .MIDCAB was performed through a left anterior minithoracotomy .Results All patients successfully underwent MIDCAB with LIMA-RA total arterial composite grafts.No patient required to convert to strenotomy during the surgery.Mean operation time was(176.1 ± 14.1)min.Revascularization was performed for 2 target vessels in 11 cases, 3 target vessels in 25 cases and 4 target vessels in 3 cases.Mean postoperative ventilation time was(21.9 ±27.9) h.Mean ICU time was(2.8 ±2.1) days, and mean postoper-ative inhosptial time was(11.2 ±3.3)days.There was no early death in perioperation.At a follow-up of 6 to 86 months[aver-age(27.5 ±18.0) months], one patient died.The overall survival at 2 years postoperatively was(96.0 ±3.9)%.The paten-cy rate of LIMA was 100%.The overall patency rate of RA grafts at 2 years postoperatively was(91.8 ±4.0)%.Conclusion MIDCAB with LIMA-RA total arterial composite grafts is a safe and effective procedure with favorable early and mid-term out-comes for patients with multiple vessel disease .

Objective To evaluate the effect of keeping atrial septal fenestration in correction of total anomalous pulmonary venous connection (TAPVC) with left ventricular hypoplasia.Methods We reviewed 44 TAPVC patients between June,2006 and June,2013 in Shanghai Xinhua Hospital.According to whether keeping atrial septal fenestration during operation,patients were divided into group A(keeping fenestration,25 cases) and group B(no fenestration,19 cases).Retrospective statistical analysis was carried on the in-patient data and follow-up outcomes.Results No statistically significant differences between the two group on age,weight,left ventricular volume and crossclamp time (P ＞ 0.05).While cardiopulmonary bypass time,ventilation time,dosage of positive inotropic drugs,and ICU stay time of group A were shorter compares with group B (P ＜ 0.05).4 patients in group A (16.00％) suffered from low cardiac output syndrome (LCOS) postoperatively,and 6 in group B(31.58％).Pulmonary edema occurred in 3 patients,1 in group A(4.00％),and 2 in group B(10.53％).Total post-operative mortality was 6.82％ (3/44).2 cases died of serious LCOS(1 from group A,and the other from group B),1 cases died of infection and multiple organ dysfunction syndrome(group B).No significant difference of mortality was observed between two groups.Follow-up data showed some fenestrations can close naturally.Conclusion Keeping atrial septal fenestration can be done as a feasibility tactic in correction of TAPVC with left ventricular hypoplasia.

Objective To summarize our clinical experience of surgical treatment for pediatric patients with ventricular septal defect(VSD) and mitral regurgitation(MR).Methods A retrospective study was performed including consecutive 84 patients with VSD and MR receiving mitral valvuloplasty(MVP) and VSD closure from January 2006 to January 2012 in Shanghai Xinhua Hospital.All patients were associated with pulmonary hypertension(PH,32-85 mm Hg).The diameters of ventricular septal defects were between 0.7 and 1.6 cm.Echocardiography showed that trivial MR (+) in 9 cases,mild MR (++)in 18 cases,moderate MR(+++) in 33 cases,and severe MR(++++) in 24 cases.VSD closure and MVP were performed with cardiopulmonary bypass under moderate systemic hypothermia.The results of repair were evaluated by transesophageal echocardiography (TEE) during operation.Results Intra-operative TEE results: no residual shunt of VSD,none MR in 80 cases,residual trivial MR in 4 cases.Mean Cardiopulmonary bypass (CPB) time was (84.6 ± 18.5) mins.Mean Aortic clump time was(50.8 ± 11.5) mins.Mean postoperative ventilation time was (38.7 ± 30.2) hours,and mean postoperative inhosptial time was(10.5 ±4.6) days.The in-hospital mortality was 1.2％ (1 case died).78 cases were fully followed up.There was no late death.Echocardiography showed that none MR in 62 cases,trivial MR in 10 cases,mild MR in 4 cases,moderate MR in 2 patients.The overall freedom from reoperation at 5 years was (97.4 ± 1.8) ％.Conclusion Ventricular septal defect with pulmonary hypertension need early surgical repair.MR was treated at the same time of VSD closure could effectively improve the surgical outcome of pediatric patients with ventricular septal defect and mitral regurgitation.

Objective To review the surgical methods and mid-term results of mitral valve repair in pediatric patients with moderate to severe mitral regurgitation (MR).Methods 132 children with moderate to severe MR,aged (18.9 ± 7.2)months,weighted(11.3 ±4.8) kg.The etiology for mitral regurgitation is congenital heart disease in 126 cases,infective endocarditis in 5 cases and Marfan syndrome in 1 case.Mitral valvuloplasty(MVP) was performed with cardiopulmonary bypass under moderate systemic hypothermia.The methods of MVP included annuloplasty,annuloplasty ring,cleft closure,reconstruction of posterior leaflet.The coucomitant cardiac anomalies were treated at the same time.The results of repair were evaluated by saline injection test and transesophageal echocardiography (TEE) during operation.Results Intra-operative TEE results: 131 cases had none to mild MR,and only one case had moderate MR.The patient underwent second repair immediately,subsequent TEE was mild.Mean cardiopulmonary bypass (CPB) time was (80.0 ± 31.1) minutes.Mean aortic clump time was (48.0 ± 17.9) minutes.The in-hospital mortality was 2.3％ (3 cases died).One died of heart failure on postoperative day 7,the other died of low cardiac output syndrome resulting on postoperative day 2.Another one was large ventricular septal defect(VSD) with pulmonary hypertension (PH),died of pulmonary infection.Mean postoperative ventilation time was (34.4 ± 31.9) hours,and mean postoperative inhosptial time was (9.0 ± 5.4) days.The average follow-up period was (40.5 ± 8.3) months (2 to 74 months).122 cases were fully followed up.Echocardiography showed that moderate MR was in 7 patients,and 3 patients had severe MR.4 patients underwent re-do mitral valve repair or mitral valve replacement.There was no late death.The overall survival rate at 5 years was 97.7％ and the overall freedom from reoperation at 5 years was 92.0％.Conclusion Pediatric patients with moderate to severe MR need early surgical treatment,the early and mid-term results were satisfactory.Individualized treatment protocol based on specific pathology was the keypoint of surgical therapy.

Objective To summarize the preliminary experience of early anticoagulant therapy after endovascular stent graft exclusion for Stanford B type aortic dissection.Methods From June 2006 to June 2011,75 patients[ 65 males,10 fe males,mean age (59.1±13.5) years,range 22 -81 years ] under went endovascular stent-graft exclusion for Stafford B type aortic dissection in Shanghai Xinhua Hospital.Computed tomography angiography (CTA) was used to evaluate the lesions of aortic dissection before endovascular stent-graft exchusion.The descending thoracic aortic diameters were 22 mm to 42 mm [ mean (30.3±4.0) mm ].The distance from the breakage of dissection to the left vertebral artery(LSA)was longer than 1.5 mm in 29 cases,and shorter than 1.5cmin 46 cases.During the operation,left subclavian artery revascularization was per formed to patient,whose left vertebral artery was advantage and needs to be fully or partially covered From the second day after operation,asprin was given to patint,whose left subclavian artery was fully or partially coverd by endovascular stent-graft(no endoleak and residual distal tear).Early anticoagulant therapy lasted 3 months.The symptoms or signs about nervous system were observed in the early stage of postoperation,and the CTA was examined at postoperative 3 months.Results The operation succeeded in 75 patients.The diameters of aortic stent were 26mm to 46rmm[ mean(34.3±4.0) mm ].Left subclavian ar tery revascularization was carried out for 2 cases of all patients.The left subclavian artery was fully or partially coverd in 58 patients(fully covered in 19 cases,2/3 covered in 15 cases,1/2 covered in 24 cases),and 56 patints(no endoleak and residualdistal tear) were given anticoagulant therapy to prevent vertebral artery thrombosis.2 patients(2.7％)died in the early stage after operation.1 patient died of renal failure,1 patient died of dissection rupture,The duration of hospitalization was 4 to 19 days [ mean (7.9±3.5)days ].No neurological complications occurred in hospital.The follow-up period was 6 to 66 months.1 patient died during the follow-up,1 patient had recurrence of Stanford A type aortic dissection and was cured by ascending aorta and aortic arch replacement,1 patient had recurrence of Stanford B type aortic dissection and was cured by second endovascular stent-graft exclusion.All patients had no neurological complications,such as cerebral infarction and paraplegia.Concluslon Early anticoagulant therapy could safely and effectively prevent the neurological complications (such as cerebral infarction and paraplegia) related to vertebral artery thrombosis for Stanford B type aortic dissection patients whose left subclavian artery was fully or partially coverd by endovascular stent-graft.

Objective:To explore a classification method for critically ill emergency patients undergoing intra-hospital transport based on cluster analysis, and analyze the changes in vital signs between different categories, so as to provide references for targeted nursing interventions.Methods:Using the convenient sampling method, a total of 416 critically ill patients who were transferred from emergency department to ICU in 2 hospital areas of Beijing Tongren Hospital, Capital Medical University from January to December 2021 were selected as the research objects. General data and vital signs before and after transport were collected. Five vital signs, including body temperature, heart rate, respiratory rate, systolic blood pressure and peripheral capillary blood oxygen saturation measured at the last time before transport, were taken as cluster variables. Patients were classified based on second-order cluster analysis and compared among different categories.Results:The 416 patients included in this study could be divided into 3 categories, such as stable group, low oxygen saturation group and high heart rate group, and the clustering contour coefficient was 0.30. The systolic blood pressure before and after transport of the three groups were compared, and the differences were statistically significant (all P<0.05). Moreover, there was a statistically significant difference in respiratory frequency between the low oxygen saturation group and the high heart rate group (both P<0.05) . Conclusions:It was of great significance to monitor the vital signs of the critically ill patients transferred in the hospital, and the classified management of patients can better guide the clinical practice of transportation.

Morulaes and blastocysts obtained from Guanzhong dairy goats 6-7 days after mating were treated with whole embryo cultivaton, enzymatic digestion and immunosurgery separately. The goat embryonic stem cells (ESC) were isolated and cultured on a feeder layer of mitomycin-inactivated mouse embryo fibroblasts (MEF). The characteristics of goat ESCs were analyzed by immunohistochemisty, RT-PCR and inducing differentiation in vitro. The results indicated that the embryos were easier to attach the culture dish and form primary colonies with whole embryo method. There were colonies that maintained undifferentiated for 18 passages. The ESCs expressed the protein of Nanog, Oct4 and SSEA-3, whereas the protein of SSEA-4 was absent and the protein of SSEA-1 was weakly expressed. In addition, the genes of Nanog, Oct4, TERT and CD117 were expressed in goat ESCs. The cells also could differentiate to myocardial cells when induced in vitro by DMSO. These results suggest that the goat ESCs have characteristics of ESCs.
Animals ; Blastocyst ; cytology ; Cell Differentiation ; physiology ; Cell Separation ; methods ; Cells, Cultured ; Embryo Culture Techniques ; Embryo, Mammalian ; cytology ; Embryonic Stem Cells ; cytology ; metabolism ; Female ; Goats ; Male ; Mice ; Myocytes, Cardiac ; cytology ; Rabbits

OBJECTIVE: To explore the genetic basis and pregnancy outcome of fetuses with urinary system anomalies. METHODS: Ultrasonographic features, genetic testing and pregnancy outcomes of 337 fetuses with urinary system anomalies identified by prenatal ultrasonograhy were collected for analysis. RESULTS: Ultrasonographic features of the fetuses were mainly characterized by hydronephrosis or hydronephrosis, polycystic kidney disease, and renal dysplasia. Thirty four fetuses (10.1%) were found to harbor a genetic defect, including 14 numerical chromosomal disorders, 10 structural chromosomal aberrations, and 10 pathogenic copy number variations (CNVs). In 31 cases, the parents elected induced labor. For the 303 fetuses with negative findings, 142 were born by spontaneous delivery or Caesarean section, 48 cases underwent induced labor, 1 case had miscarriage, and the remaining 112 cases had unknown or missed pregnancy outcomes. CONCLUSION Hydronephrosis or hydronephrosis, polycystic kidney disease, and renal dysplasia are the most common findings among fetuses with urinary system anomalies. Approximately 10.1% of such fetuses are positive by genetic testing.
Cesarean Section ; Chromosome Aberrations ; DNA Copy Number Variations ; Female ; Fetus ; Genetic Testing ; Humans ; Pregnancy ; Pregnancy Outcome ; Prenatal Diagnosis ; Ultrasonography, Prenatal