OBJECTIVETo investigate the application of the retroperitoneal approach in aortic surgery.

METHODSWe collected and analyzed data of 7 patients in Macau who presented with aortic diseases from 2007 to 2008 and were treated with aorta repair through retroperitoneal approach. Demographic features as well as intraoperative and postoperative data were analyzed. One case of thoracoabdominal aneurysm and 4 cases of abdominal aneurysm received artificial graft, among which hybrid iliac artery reconstruction with Zenith stent covering the ostium of the left subclavian artery was performed in 2 cases of infrarenal abdominal aneurysm. Aortic-iliac artery bypass was performed in 2 cases of aortoiliac occlusion.

RESULTSNo operative or early postoperative death was observed. No perioperative intestinal adhesion or ureteral obstruction was found. One case reported delayed paraplegia and graft infection as postoperative complications. The complications were partially removed 3 months later after rehabilitation.

CONCLUSIONRetroperitoneal approach is a safe and feasible technique, which associated with a low incidence of postoperative pulmonary complications.

Aged ; Aorta ; surgery ; Humans ; Myocardial Revascularization ; methods ; Peritoneal Cavity ; Treatment Outcome ; Vascular Surgical Procedures ; methods

Objective To observe the efficacy and safety of applying sirolimus-eluting stents in emergency percutaneous coronary intervention (PCI) for the patients with acute myocardial infarction (AMI).Methods In total,220 patients with AMI were enrolled in this study at Shanghai Tongji Hospital, divided into two groups,one with bare-metal stent and the other with sirolimus-eluting stent.Cardiovascular fatality,major adverse cardiac events (MACE) and target vessel revascularization (TVR) were observed one and six months after PCI in the two groups.Results There was no significant difference in overall fatality and MACE in the 1~(st) or 6~(th) months after PCI between the two groups.Three cardiogenic deaths occurred in bare-metal stent group with a fatality of 2.8 percent,and five deaths in sirolimus-eluting stent group with a fatality of 4.5 percent in six months after PCI.However,rate of restenosis in those with sirolimus-eluting stents was significantly lower than that of bare-metal stents (6.0 percent vs 16.1 percent,P

Objective To determine the changes of cerebrospinal fluid(CSF) ?-endorphin(?-EP) and C-reactive protein(CRP) in children with central nervous system(CNS) infection.Methods Sixty-five children suffered from CNS infection were determined the plasma and CSF ?-EP and CRP concentration during the acute and recovering stage with radioimmunoassay, which included 48 viral encephalitis, 12 purulent meningitis and 5 tuberculou meningitis,and 24 non-CNS disease children were as control group.Results The concentrations of plasma and CSF ?-EP of every experimental group were obviously higher than those of control group during the early stage of CNS infection and these were obviously lower during the recovering stage. The serum concentration of CRP during acute stage was significantly higher than that during recovering stage. No change of serum and CSF CRP concentration was determined during either the acute or recovering stage in the other two experimental groups.Conclusions Determining the plasma and CSF ?-EP is mea-(ningful) in early diagnosis of CNS infection,and determining the serum CRP at the same time may be helpful in differentiating septic and inseptic infection.

Metabolic syndrome (MetS) describes a set of risk factors that can eventually lead to the occurrence of cardiovascular and cerebrovascular disease. A detailed understanding of the MetS mechanism will be helpful in developing effective prevention strategies and appropriate intervention tools. In this article, we discuss the relationship between the clinical symptoms of MetS and differences in the gut microbial community compared with healthy individuals, characterized by the proliferation of potentially harmful bacteria and the inhibition of beneficial ones. Interactions between gut microbiota and host metabolism have been shown to be mediated by a number of factors, including inflammation caused by gut barrier defects, short-chain fatty acids metabolism, and bile acid metabolism. However, although we can clearly establish a causal relationship between gut microbial profiles and MetS in animal experiments, the relationship between them is still controversial in humans. Therefore, we need more clinical studies to augment our understanding of how we can manipulate the gut microbiota and address the role of the gut microbiota in the prevention and treatment of MetS.

OBJECTIVETo describe a hybrid endovascular procedure for aorta repair with different kinds of bypass followed by concomitant placement of stent graft in the aorta.

METHODSFrom June 2007 to May 2008, 5 consecutive patients who presented with aortic aneurysm or dissection were treated with a new hybrid aorta repair technique. Complete surgical rerouting of supra-aortic vessels was simultaneously created by endovascular repair of aortic arch aneurysm with stent graft. Hybrid left carotid-subclavian bypass with stent graft deployment covering the ostium of the left subclavian artery was performed in a Debakey type III aortic dissection case. The supra-aortic branch was revascularized in 2 cases from ascending aorta to bilateral common carotid arteries using a 16-8 mm bifurcated graft, then total aortic arch and descending artery was occluded with stent-graft. The left carotid artery to the left subclavian artery bypass was created in 1 case, followed by stent-graft deployment. Two cases of infrarenal abdominal aortic aneurysm underwent left external iliac artery to left internal iliac artery bypass by a retroperineal route, then hybrid procedure was performed with bifurcated stent-graft. All stent grafts were deployed via a retrograde femoral artery approach in 5 patients.

RESULTSTechnical success with complete aneurysmal exclusion was achieved in all patients. There was no incidence of endoleak. During a follow-up period of 2 to 10 months, documented perioperative neurologic events did not occur in all patients. One patient suffered from adult respiratory distress syndrome. After received tracheostomy, he recovered later. There was one death resulting from a postoperative myocardial infarction.

CONCLUSIONHybrid arch repair provides an alternative therapy to patients otherwise considered prohibitively high risk for traditional open arch and thoracoabdominal aorta repair.

Aged ; Aorta ; surgery ; Aortic Aneurysm ; diagnostic imaging ; surgery ; Blood Vessel Prosthesis Implantation ; methods ; Humans ; Iliac Artery ; surgery ; Male ; Tomography, X-Ray Computed ; Vascular Surgical Procedures ; methods

OBJECTIVETo evaluate the selection of different procedures and the feasibility for the treatment of long segment urethral stricture.

METHODSSeventy-six patients with complex urethral stricture greater than 8 cm long underwent different procedures of urethroplasty. Of them various mucosa grafts urethral reconstruction were adopted in 42 cases (colonic mucosal graft, n = 26; buccal mucosal graft, n = 10; bladder mucosal graft, n = 6); One-stage pedicle flaps urethroplasty in 20; two-stage urethroplasty of Johanson procedure in 12; and penile urethra-prostatic urethra anastomosis, three-stage urethroplasty in 2.

RESULTSIn early followed up (within 6 months postoperatively), 67 patients (88%) voided well and complications developed in 10. Among the 70 patients who lasted more than 1 year after operation, 51 cases were followed up. Forty-four patients voided well, and complications developed in 8. Of the 8 cases urethral restructure developed in 2 (18%) for pedicle flaps urethroplasty, 2 for colonic mucosal urethroplasty (9%), 1 for buccal mucosal graft (1/7), 1 for bladder mucosal graft (1/3); penile chordee in 2 (2/5), and one of them was accompanied by hair bearing neourethra for two-stage urethroplasty of Johanson procedure.

CONCLUSIONSColonic mucosal and buccal mucosal grafts urethroplasty are feasible procedures for the treatment of long segment urethral stricture, and Colonic mucosal graft urethroplasty may be considered when more conventional procedures fail or complicated urethral strictures greater than 10 cm long.

Adolescent ; Adult ; Aged ; Follow-Up Studies ; Humans ; Intestinal Mucosa ; surgery ; Male ; Middle Aged ; Mouth Mucosa ; surgery ; Surgically-Created Structures ; Treatment Outcome ; Urethral Stricture ; pathology ; surgery ; Urologic Surgical Procedures, Male ; methods

OBJECTIVETo establish the theories and methods to determine solubility parameters of multiple components for the traditional Chinese material medica (TCMM) with HPLC.

METHODThe mathematical expresses to determin the solubility parameters were established according to chromatographic and Hildebrand-Scatchard theories, The HPLC experiments were carried out at 40 degrees C on an Alltech Apollo C18 column (4.6 mm x 250 mm, 5 microm) eluted with acetone and water in gradient mode. The flow rate was 1.0 mL min(-1), and the detection wavelength was 254 nm. The injection volume was 1 0 microL.

RESULTThe mathematical expresses between the retention time and the solubility parameters were established and used to determin caffeine solubility parameter as 28.31 J(1/2) cm(-3/2) in accordance with 28.84 J(1/2) cm(-3/2) reported by literature, and those of aloe-emodin, rhein, emodin, physcione as 39.70 J(1/2) cm(-3/2), 39.08 J(1/2) cm(-3/2), 38.37 J(1/2) cm(-3/2), 36.42 J(1/2) cm(-3/2) respectively.

CONCLUSIONThe retention time of HPLC can be used to determine the solubility parameters of multiple componets. The established method is useful for the compatibility rule study of traditional Chinese medicine.

Anthraquinones ; chemistry ; Caffeine ; chemistry ; Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal ; chemistry ; Emodin ; analogs & derivatives ; chemistry ; Materia Medica ; chemistry ; Models, Chemical ; Regression Analysis ; Solubility ; Temperature

OBJECTIVETo analyze the maternal mortality ratio (MMR) of residential and migrant women in Beijing.

METHODSA retrospective study from 1995 to 2004 was performed to analyze data from the maternal death cases.

RESULTSThe MMR of resident and migrant of Beijing from 1995 to 2004 were 17.9 and 51.3 per ten thousand respectively. The main reasons of maternal deaths among residents were embolism (21.2%), hypertensive disorder complicating pregnancy (18.3%), postpartum hemorrhage (14.4%) and ectopic pregnancy/heart disease (9.6%). The main reasons of migrant maternal deaths were postpartum hemorrhage (25.2%), embolism (19.7%), hypertensive disorder complicating pregnancy (17.3%) and liver disease (9.5%). The avoidable deaths were accounted for 18.9%.

CONCLUSIONThe MMR in Beijing local residents was close to that in developed countries. To further reduce MMR in Beijing would depend on the better administration of related issues among floating population. Poor quatily delivery must be banned together with strengthening the training programs on health workers. It is also important to improve the knowledge and skills of medical staff for rescuing the complications of pregnancy and ectopic pregnancy.

China ; epidemiology ; Female ; Humans ; Liver Diseases ; mortality ; Maternal Health Services ; Maternal Mortality ; Postpartum Hemorrhage ; mortality ; Pregnancy ; Pregnancy Complications ; mortality ; Pregnancy Complications, Cardiovascular ; mortality ; Retrospective Studies ; Transients and Migrants ; statistics & numerical data

OBJECTIVETo find out the nasendoscopic changes of velopharyngeal configuration and movement after palatoplasty with or without velopharyngeal muscle reconstruction.

METHODSThe nasendoscopy was taken in forty-one patients with palatoplasty, 22 repaired by velopharyngeal muscle reconstruction and 19 with modified von Langenbeck's procedure (non-reconstructive group).

RESULTSIn patients with velopharyngeal muscle reconstruction, the velopharyngeal ports are smooth and full with a definite reduction in size than patients without velopharyngeal muscle reconstruction. During phonation, the complete and marginal velopharyngeal competence rate in reconstructive group (90.91%) is higher than the group of non-reconstruction (37.31%) The major velopharyngeal closure is circular movement in reconstructive group, otherwise coronal closure in nonconstructive group.

CONCLUSIONSBased the observation of nasendoscopy, the velopharyngeal muscle reconstruction in palatoplasty has more definite improvement to velopharyngeal closure than non-reconstructive procedure. Palatoplasty with velopharyngeal muscle reconstruction could reduce the size of velopharyngeal port and make the complete velopharyngeal closure easier.

Adolescent ; Child ; Child, Preschool ; Cleft Palate ; surgery ; Endoscopy ; methods ; Humans ; Infant ; Nose ; surgery ; Pharyngeal Muscles ; abnormalities ; surgery ; Reconstructive Surgical Procedures ; methods

OBJECTIVETo explore the clinicopathological correlation between CD4(+) T lymphocyte count and superficial lymphadenopathy HIV/AIDS patients.

METHODSA total of 1066 HIV/AIDS patients were included in this study. The incidence of superficial lymphadenopathy, peripheral blood CD4(+) T lymphocyte counts and histological features of superficial lymphadenopathy were analyzed.

RESULTSAmong 1066 patients, 126 cases (11.8%) presented with superficial lymphadenopathy. Of the 126 cases, there were 69 cases with CD4(+) T lymphocyte counts < 100/µl and clinical diagnoses including tuberculosis (37 cases), reactive hyperplasia (8 cases), AIDS-related lymphadenopathy (18 cases), penicillium diseases (12 cases), fungal infection (5 cases) and non-tuberculous mycobacterial infection (1 case). Twenty-six cases had CD4(+) T lymphocyte counts between 100/µl to 200/µl and clinical diagnosis including tuberculosis (12 cases), reactive hyperplasia (8 cases), AIDS-related lymphadenopathy(6 cases), penicillium disease (2 cases) and non-Hodgkin lymphoma (1 case). Twenty-nine cases had CD4(+) T lymphocyte counts > 200/µl and clinical diagnoses including tuberculosis (11 cases), reactive hyperplasia (12 cases), AIDS-related lymphadenopathy (3 cases), Penicillium diseases (1 case) and non-Hodgkin lymphoma (4 cases). The CD4(+) T lymphocyte counts among patients with tuberculosis, AIDS-related lymphadenopathy and Penicillium diseases were significantly different (χ(2) = 8.861, P = 0.012). A significant correlation between the incidence of superficial lymphadenopathy and CD4(+) T lymphocyte counts was found (χ(2) = 375.41, P = 0.000).

CONCLUSIONSThe most common cause of superficial lymphadenopathy in HIV/AIDS patients is tuberculosis, followed by lymph node reactive hyperplasia, AIDS-related lymphadenopathy and Penicillium disease. Low CD4(+) T lymphocyte count correlates with an increased incidence of superficial lymphadenopathy and the risk of opportunity infection. Therefore, determination of peripheral blood CD4(+) T lymphocyte count should become an integral marker for the early diagnosis and treatment of superficial lymphadenopathy in HIV/AIDS patients.

AIDS-Related Complex ; blood ; complications ; pathology ; AIDS-Related Opportunistic Infections ; blood ; complications ; pathology ; Acquired Immunodeficiency Syndrome ; blood ; complications ; pathology ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; CD4 Lymphocyte Count ; Child ; Female ; HIV Infections ; blood ; complications ; pathology ; Humans ; Lymph Nodes ; pathology ; Male ; Middle Aged ; Tuberculosis ; blood ; complications ; pathology ; Young Adult