Objective To evaluate the effects of cardiac resynchronization therapy with optimized dynamic AV delay.Methods The study included 63 patients who underwent implantation of biventricular pacemakers for congestive heart failure.The dynamic AV delay was optimized on the day 1 week,6 months and 12 months after pacemaker implantation.The echocardiography and ECG,6MHW,QOL and NYHA grade were evaluated at the same time.Results The best optimized AV delay was between 90 ms and 140 ms(110.45?19.47 ms).Comparing the effectiveness 1 week after CRT with the day before CRT:the LVEF increased from 18.53%?4.83% to 22.07%?6.77% with the QRS interval decreased from 138.25?28.00 ms to 129.40?6.65 ms.Comparing the effectiveness of the day before and in 6-12 months after CRT optimized AV delay,the LVFT increased from 293.27?24.79 ms to 347.57?26.21 ms.There was no difference in QRS intervals.The LVEDD was upgraded from 71.43?7.12 mm to 57.06?6.54 mm while the QOL was upgraded from 74.14?6.24 to 55.15?11.02 and the NHYA upgraded from 3.12?0.55 to 1.82?0.43.Conclusion Optimized dynamic AV delay of the pacemaker parameters enhanced the short-term and long-term efficacy of CRT.

Objective To study the safety and efficacy of laparoscopic splenectomy and portoazygous devascularization for portal hyperteation.Methods The data of 58 patients who underwent laparoscopic splenectomy and portoazygous devascularization were retrospectively collected and analyzed.Results The operative time for laparoscopic splenectomy and portoazygous devascularization was (2.6 ±0.6) hours.The intraoperative bleeding was (149.5 ± 32.7) ml.The time taken for the bowel to return function was 3.5 ±1.3 days.The hospitalization time was (5.1 ± 1.2) days.When the splenic volume was greater than or equal to 1.5 liters, the conversion to open surgery rate significantly increased [36.0％ (5/14);P ＜ 0.05].The 1, 2, 3, and 4 years cumulative recurrent gastrointestinal bleeding rates were 0, 5.2％, 10.0％, and 15.8％, respectively.Conclusions Laparoscopic splenectomy and pericardial devascularization was safe, efficacious and feasible.When the splenic volume was greater than 1.5 L, whether laparoscopic surgery should be attempted requires further research.

ObjectiveTo investigate the features of pulmonary function and influencing factors in patients with cervical spinal cord injury (SCI).MethodsThe pulmonary function data of 48 patients with cervical SCI were analyzed. The correlations between the percent predicted values of vital capacity (VC), maximal voluntary ventilation (MVV), forced expiratory volume of 1st second (FEV1) and V75 (expressed as VC%, MVV%, FEV1%, V75%) and ASIA motor/sensory scores were analyzed. Then, four multiple linear regressions were run to use VC, MVV, FEV1, V75 as an independent variable respectively.ResultsThe percent predicted values of the pulmonary function (VC%, MVV%, FEV1%, V75%) in patients with cervical SCI obviously decreased, which suggested that these patients had a restrictive ventilation disorder. There were significant positive correlations between VC%、FEV1%、V75% and ASIA motor scores (by bivariate correlation tests), no significant correlations between any of pulmonary function parameters and the ASIA sensory scores. Of four linear regression models, the height showed as a protecting factor in 3 linear regression models and weight did in the other one respectively. Of parameters associated with SCI, just ASIA motor scores showed as a protecting factor in 3 linear regression models, no sensory scores or duration appeared in any linear regression models.ConclusionBesides the height and weight, the ASIA motor score is a main factor influencing the pulmonary function.

Actins ; metabolism ; Adult ; Aged ; Carcinoma, Squamous Cell ; metabolism ; pathology ; Female ; Humans ; Laryngeal Neoplasms ; metabolism ; pathology ; Lymphatic Metastasis ; pathology ; Lymphatic Vessels ; metabolism ; pathology ; Male ; Middle Aged ; Vascular Endothelial Growth Factor C ; metabolism

Airway Obstruction ; complications ; etiology ; physiopathology ; Asphyxia ; etiology ; physiopathology ; Fibroma ; complications ; pathology ; Humans ; Infant, Newborn ; Oropharyngeal Neoplasms ; complications ; pathology ; Rare Diseases

The aim of this work was to investigate guar gum/ethylcellulose mix coated pellets for potential colon-specific drug delivery. The coated pellets, containing 5-fluorouracil as a model drug, were prepared in a fluidized bed coater by spraying the aqueous/ethanol dispersion mixture of guar gum and ethylcellulose. The lag time of drug release and release rate were adjustable by changing the ratio of guar gum to ethylcellulose and coat weight gain. In order to find the optimal coating formulation that was able to achieve drug targeting to the colon, the effect of two independent variables (the ratio of guar gum to ethylcellulose and the coat weight gain) on drug release characteristics was studied using 3×4 factorial design and response surface methodology. Results indicated that drug release rate decreased as the proportion of ethylcellulose in the hybrid coat and the coat weight gain increased. When the ratio of guar gum to ethylcellulose was kept in the range of 0.2 to 0.7, and the coat weight gain in the range of 250% to 500%, the coated pellets can keep intact for about 5 h in upper gastrointestine and achieve colon-specific drug delivery. The pellets prepared under optimal conditions resulted in delayed-release sigmoidal patterns with T5% (time for 5% drug release) of 5.1-7.8 h and T90% (time for 90% drug release) of 9.8-16.3 h. Further more, drug release was accelerated and T90% of the optimum formulation pellets decreased to 9.0-14.5 h in pH 6.5 phosphate buffer with hydrolase. It is concluded that mixed coating of guar gum and ethylcellulose is able to provide protection of the drug load in the upper gastrointestinal tract, while allowing enzymatic breakdown of the hybrid coat to release the drug load in the colon.

Objective To report the MRI findings of brain damage obsenrved in neonatal patients who suffered from isolated hypoglycemia and to explore the value of diffusion-weighted imaging(DWI) inearly detection of neonatal hypoglycemic brain iniun,. Methods Twelve neonates with isolated hypoglycemia(10 of the 12 were diagnosed to suffer from hypoglycemic encephalopathy)were enrolled in this study.They were first scanned at age from 3 days to 10 days with Tl WI,T,WI and DWI(b is 0 s/mm2,1000 s/mm2),and 4 of them were then scanned from 7 days to 10 days following the initial scan.All acquired MR images were retrospectively analysed.Results First series of DWl images showed distinct hyperintense signal in 11 cases in several areas including bi lateral occipital cortex(2 cases),right occipital cortex(1 case),left occipital cortex and subcortical white matter(1 case),biIateral occipital cortex and flubcortical white matter(2 cases),bilateral parieto-occipital cortex(2 cases),bilateral parieto-occipital cortex and subcortical white matter(2 cases),the splenium of corpus catlosum(4 cases),bilateral corona radiata(2 cases),left eaudate nucleus and globus pallidus(1 case),bilateral thalamus(1 case),bilaterally posterior limb of internal capsule(1 ease).In the initial T1 WI and T2,WI images,there were subtle hypointensity in the damaged cortical areas(3 cases),hyperintensity in the bilaterally affected occipital cortex(1 case)on T1 weighted images,and hyperintensity in the affected cortex and subcortieal white matter with poor differentiation on T2 weighted images.The followed-up MRI of 4 cases showed regional encephalomalaeia in the affected occipital lobes(4 cases),slightly hyperintensity on T2 weighted images in the damaged occipital cortex(2 cases),extensive demyelination(1 case).disappearance of hyperintensity of the splenium of corpus callosum(1 case),and persistent hyperintensity in the splenium of corpus callosum (1 case)on T2 weighted images.Conclusion The findings suggest that posterior parieto-occipital regions are most frequently injured in neonatal period due to severe hypoglycemia.DWI is a useful technique in the early detection and evaluation of hypoglycemic brain injury of neonates.

ObjectiveTo investigate the changes in liver function and the efficacy of either hand-assisted laparoscopic surgery (HALS) or open splenectomy (OS) in combination with pericardial devascularization in the treatment of portal hypertension. MethodsThe clinical data of 94 patients who received splenectomy combined with pericardial devascularization to treat portal hypertension due to cirrhosis from Jan 2002 to May 2008 were analyzed retrospectively. 56 patients received OS and 38patients HALS. The operating time, intraoperative blood loss, postoperative complications, liver dysfunction and mortality were analyzed according to the Child's grading. ResultsThere was no difference in the operating time between HALS and OS (P＞0. 05). The intraoperative blood loss and postoperative complications were 5.6% and 10.8%, respectively (P＜0. 05). There was no significant difference in the serum ALT between HALS and OS, but there was a significant difference in the ALB (P＜0. 05). The AST also had a significant difference on postoperative day 5 (P＜0. 05). The serum ALT and AST were elevated after HALS, but there was a significant difference only for AST (P＜0.05). The serum ALT and AST in OS were significantly higher after than before operation (P＜0. 05). The serum ALB in OS was significantly lower after operation (P＜0.05), but it was significantly lower only on postoperative days 1 and 3 (P＜0.05) in HALS. ConclusionsCompared with OS, HALS combined with pericardial devascularization caused less damage to the intestinal tract and the liver function. It is a feasible and safe operation and it had fewer postoperative complications.

Objective To investigate the effect of estrogen on regression of vascular calcification in rats induced by vitamin D3 plus nicotine.Methods Ninety-six female SD rats were divided randomly into control group (n=24) and calcification group (n=72).Vascular calcification of 72 rats was induced by vitamin D3 and nicotine (VDN).On the day 1,the VDN group rats were injected with vitamin D3(300 000 U/kg,i.m),and were intragastric administrated with nicotine (25 mg/kg),after 9 hours,another dosage of nicotine was given again.After 4 weeks,the VDN group rats were subdivided randomly into 4 groups:VDN group(n=16),Sham operation group (n=16),ovariotomy group (n=16),estrogen group(after ovariotomy,17β-estrogen was subcutaneously injected,50 μg· kg-1· d-1,n=16).Results After 4 weeks,the VDN group showed obvious vascular calcification,and calcium content of the vessel wall was significantly higher than that of control group (P＜0.01).Extensive calcification was witnessed on the aortic tunica media of the VDN group.After 12 and 8 weeks,the calcium content of the vessel wall in each subdivided groups was significantly lower than that at 4 weeks point(P＜0.01),and the lowest calcinm content was in estrogen group,meanwhile the reduction of previously accumulated arterial calcium precipitate in each group was different.Conclusions It is a reversible process that vascular calcification induced by vitamin D plus nicotine in rats.Estrogen can promote the regression of vascular calcification.

Vertebral artery hypoplasia is a congenital vessel variation. Its incidence is from 1. 9 to 26. 5% . In recent years, studies have shown that vertebral artery hypoplasia may be a potential risk factor for posterior circulation infarction, especialy when it coexists with other cerebrovascular risk factors. Vertebral artery hypoplasia may also cause regional hypoperfusion and complex neurovascular regulation, and it also has a certaln link with migralne.