Objective To assess potential suitability of the intercostal artery as a conduit in coronary bypass graft.Methods Collected 36 cases of chinese adult thoracic aorta CTA original cross-sectional images,the images were retrospectively reconstructed under volume rendering technology (VR),multi-planar reconstruction (MPR),curved planar reformation (CPR) and maximum intensity projection(MIP).Observed and measured the data of the 8th,9th and 10th bilateral intercostal arteries and internal thoracic arteries.Results Toshiba 320-slice volume scanning CT can clearly display the intercostal arteries.The average length and diameter at corresponding point of the left and right 8-10th intercostal artery is similar,all the length is longer than 180 mm,and the diameter at axillary line is all bigger than 2.1 mm,the mean length of right intercostal arteries is slightly longer than the left intercostal arteries,the diameter at each corresponding point of left and right intercostal artery is similar,and equivalent to approximately 85％-90％ of internal thoracic artery.Conclusion Intercostal artery can be used as an ideal alternative vessel in coronary artery bypass grafting.

The author reviewed technical improvements of XYS.SUI-6X extracorporeal shock wave lithotriptor and illustrated the clinical efficacy of the lithotriptor with clinical study based on clinical trial after its upgraded, which curative ratio and effective ratio were increased to 76.67% and 20.00% respectively. Total cure and relief rate was 96.67%, invalidation was 3.33%, the results were better than the outcomes before its improvements.
Adult ; Equipment Design ; Female ; Humans ; Lithotripsy ; instrumentation ; methods ; Male ; Middle Aged

The paper introduced the principle of extracorporeal shock wave therapy(ESWT) for orthopedics diseases including 60 cases of periarthritis of shoulder, 60 cases of tennis elbow and each compared with 60 control cases. The cure rate of ESWT for periarthritis of shoulder and tennis elbow is more than 93%, higher than the control group.
Adolescent ; Adult ; Aged ; Female ; High-Energy Shock Waves ; therapeutic use ; Humans ; Male ; Middle Aged ; Periarthritis ; therapy ; Physical Therapy Modalities ; instrumentation ; Tennis Elbow ; therapy ; Treatment Outcome ; Young Adult

With the development of molecular biology, biomaterials and tissue engineering, regenerative treatment of pulpal and periradicular diseases is facing new opportunities. At present, a large number of studies on dental pulp regeneration reveal that cytokines are essential for promoting migration, proliferation and osteogenic differentiation of dental pulp stem cells. In this paper, we review several kinds of cytokines related to dental pulp regeneration, and analyze their roles and regulatory mechanisms in dental pulp regeneration.

Objective To introduce the application experience of a new steel bar used in minimally invasive surgery for pectus carinatum.Methods From January to October 2018, Cardiothoracic Surgery Department of Shanghai Xinhua Hospital performed a minimally invasive surgery for 25 cases of patients with pectus carinatum used a new type of steel bar.All 25 pa-tients were male, aged 10 -17 years, with an average age of(13.80 ±1.66)years.The application experience of the new bar in pectus carinatum minimally invasive surgery was summarized .Results All operations were successfully completed .The op-eration time was 35-100 min, averaged(73.44 ±17.49)min, postoperative hospital stay was 3 -6 days, averaged(3.68 ± 0.85)days.Postoperative complications included 5 cases of pneumothorax(the lung compression was about 2％ -10％, not necessary for surgical intervention).One case occured wound healing delay 1 month after operation, and healed after no surger-cal treatment.The other patients recovered smoothly.Conclusion The new steel bar is convenient to use, greatly reduces the difficulty of the pectus carinatum surgery procedure , also reduced surgical trauma and complications , has a good application prospect.

Objective:To investigate the effect of venous blood carbon dioxide binding capacity (CO 2-CP) on the short-term prognosis of patients with acute ischemic stroke (AIS) after thrombolytic therapy. Methods:A total of 86 AIS inpatients who received thrombolytic therapy in the emergency department of Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University from April 2019 to May 2021 were analyzed retrospectively. According to the venous blood CO 2-CP levels at admission, the patients were divided into two groups: low CO 2-CP group (CO 2-CP < 23 mmol/L, n = 52) and high CO 2-CP group (CO 2-CP ≥ 23 mmol/L, n = 34). The CO 2-CP levels and changes between the two groups before and after thrombolytic therapy were compared. The National Institutes of Health Stroke scale (NIHSS) score was used to evaluate the improvement rate of patients after thrombolytic therapy [NIHSS score at admission-NIHSS score at discharge)/NIHSS score at admission ×100%] and in-hospital death was also recorded. The correlation between CO 2-CP levels and prognosis of patients with AIS during emergency visit was analyzed, the receiver operator characteristic curve (ROC curve) was drawn and the area under the ROC curve (AUC) was calculated to evaluate the predictive value of CO 2-CP in the prognosis of AIS patients. Results:The CO 2-CP levels of low CO 2-CP group and high CO 2-CP group after thrombolytic therapy were significantly higher than those before treatment (mmol/L: 23.08±2.34 vs. 20.46±1.51, 25.24±2.16 vs. 23.94±1.07, both P < 0.05). The differences of CO 2-CP before and after treatment in low CO 2-CP group were significantly higher than those in high CO 2-CP group (mmol/L: 2.62±0.83 vs. 1.30±1.09, P < 0.05). The improvement rate of CO 2-CP levels in the high CO 2-CP group (NIHSS improvement rate > 45%) was significantly higher than that in the low CO 2-CP group [85.29% (29/34) vs. 23.08% (12/52)], while the mortality in the low CO 2-CP group was significantly higher than that in the high CO 2-CP group [11.54% (6/52) vs. 0% (0/34), P < 0.05]. The AUC of CO 2-CP for the prognosis of patients with AIS thrombolysis was 0.820, the 95% confidence interval (95% CI) was 0.727-0.924, P = 0.000 1. Conclusion:AIS patients with CO 2-CP levels less than 23 mmol/L have a poor short-term prognosis, which has certain predictive and clinical reference value for choosing thrombolytic time in emergency stroke patients.

Objective    To introduce the surgical and perioperative strategy for giant mediastinal mass. Methods    The clinical data of 21 patients with giant mediastinal mass who underwent surgical treatment in Xinhua Hospital of Shanghai from January 2007 to July 2016 were retrospectively reviewed. There were 14 males and 7 females, with a mean age of 34.62 ± 22.95 years (range: 11 months to 79 years), and mean weight of 58.07±22.24 kg (range: 10.8 to 90.5 kg). Their clinical manifestation, anesthesia methods, surgical treatment and the prognosis were analyzed. Results    The tumor volume ranged from 8 cm×6 cm×6 cm to 25 cm×25 cm×8 cm. For surgical approach, 12 patients received median sternotomy, 5 anterior lateral incision, 1 posterior lateral incision, 2 "L"-shape sternotomy, 1 cervical and thoracic "]"-shape incision. All patients were given mass radical resection, except one patient with two-stage resection. Twelve patients needed other tissues resection besides the single tomor resection. The operation time was 55-480 (207.86±87.67) min, blood loss volume 700 (10-4 000) ml, intraoperative blood transfusion 800 (0-4 100) ml, postoperative mechanical ventilation time 4.75 (0-87) h, postoperative drainage time 3-12 (7.43±2.66) d, the total drainage volume 295-4 940 (1 584.76±1 173.98) ml, average daily drainage volume 62-494 (204.90±105.76) ml, and postoperative hospital stay 7-47 (11.86±8.51) d. The postoperative complications included pericardial effusion in 1 patient, Horner   syndrome in 1, left recurrent laryngeal nerve injury with the left phrenic nerve injury in 1, right phrenic nerve injury in 1 and delayed wound healing in 1. The remaining patients recovered well. All patients were followed up for 1 month to 9 years. Till September 1, 2016, 5 patients died and 2 suffered recurrent tumor. Conclusion    It is safe to perform surgical treatment after comprehensive evaluation of patients with giant mediastinal mass, perioperative mortality is low, and prognosis in patients with benign tumor is good.

Objective To share the experience of single-stage bilateral pulmonary resections by video-assisted thoracic surgery (VATS) for multiple nodules. Methods Clinical records of patients undergoing one-stage bilateral resections of multiple pulmonary nodules between January 2015 and December 2016 in our institution were retrospectively reviewed and analyzed. There were 9 males and 15 females, aged from 33 to 69 (55.0±8.0) years. Two patients underwent bilateral lobectomy. Lobar-sublobar (L/SL) resection and bilateral sublobar resection (SL-SL) were conducted in 9 patients and 13 patients respectively. Results All operations completed successfully. Operation time was 135–330 (231.4±59.1) min, duration of use of chest drains was 2–17 (5.4±3.1) days. Overall duration of hospitalization after surgery was 5–37 (8.6±6.3) days. There was no perioperative death. Postoperative course was uneventful in 17 (70.8%) patients. The postoperative complications included one patient of incision infection and one patient of pulmonary infection. Persistent air leak for >3 days duration and unilateral pleural drainage for more than 200 ml/d were observed in 3 patients and 2 patients respectively. Conclusion Single-stage bilateral surgery in selected patients with synchronous bilateral multiple nodules is feasible and associated with satisfactory outcomes.

Objective To evaluate the feasibility and safety of single utility port video-assisted thoracoscopic surgery (VATS) anatomic segmentectomy for lung diseases. Methods We performed a retrospective review of 155 patients undergoing single utility port VATS anatomic segmentectomy from January 2015 to December 2016. There were 62 males and 93 females with a mean age of 53 (24–82) years. Two ports were used. The camera was through the port for observation which was about 1.5 cm in length and located at the 7th or 6th intercostal space. The instruments were through port for operation that was about 3–4 cm in length and located at the 4th or 3th intercostal space. Pulmonary segment vessel and segmental bronchi were cut and stitched by Hemolock or linear cut stapler. Different segments were separated by linear cut stapler. Perioperative data were collected and analyzed. Results One patient was performed suture under the auxiliary operating hole (three holes) because of pulmonary artery bleeding. The remaining 154 patients underwent single utility port VATS anatomic segmentectomy successfully. No conversion to open procedure or lobectomy was found and there was no perioperative mortality. The median operative time was 102 (65–150) min and the median blood loss in operation was 118 (50–300) ml. The thoracic drainage time was 3.8 (2–7) d and the median hospital stay after operation was 5.6 (3–9) d . Major morbidity occurred in 8 patients (5.2%) including hemoptysis (in 2 patients), pneumonia (in 2 patients), aerodermectasia (in 1 patient), pleural effussion (in 1 patient) and local atelectasis (in 1 patient). All of them above healed after symptomatic treatment. Patholocal examination showed there were 139 patients of primary lung carcinoma (pathologically staged as Tis-T1bN0M0), 9 patients of benign diseases and 7 patients of metastasis tumor. Conclusion Single utility port VATS anatomic segmentectomy procedure is safe and feasible. It can be utilized as an option for those with non-small cell lung cancer staged Ⅰa and those unable to tolerate pulmonary lobectomy.