Catheter Ablation ; Child ; Humans ; Male ; Tachycardia, Atrioventricular Nodal Reentry ; surgery

Objective To evaluate the TriVex system in the treatment of varicose veins of lower extremities,focusing on postoperative complications and management.Methods Clinical data of 108 patients (146 legs) of varicose veins of the lower extremity undergoing TriVex procedure were retrospectively analyzed.Deep veinons patency was verified in all patients by preoperative sonography.Above knee stripping of the great saphenous vein was done first when necessary.The below knee phlebectomy of the side branches was done with the new system (Trivex System/Smith and Nephew).Postoperative patients were followed-up,and results were evaluated.Results Procedure was successful in all cases.98 cases were followed up for 1 ～ 24 months.The mean operation time per leg was (34±8) minutes.Complications were as following:26 legs (17.8%) developed postoperative hematoma which was healed by conservative therapy including two cases in which the tension seroma,which was successfully managed by puncture aspiration.Transien skin numbness or paraesthesia developed in 13.0% (19/146).Subcutaneous induration in 11.6%(17/146) cases.Residual varicose and recurrence in 3.4% (5/146).Incision related complications developed in 4.8% (7/149) cases.Conclusion Transilluminated powered phlebectomy (TriVex) is a safe and effective cosmetic procedure for less invasive varicose vein surgery.

In the basis of a large amount of literatures, this article sumed up the characteristics and application of eggshell membrane.

BACKGROUND: Surgical guides designed based on a three-dimensional cone-beam CT (CBCT) model have been reported. However, CBCT cannot remodel fine soft tissue such as gums, and it can only be used to design a simple dental retainer with relatively poor stability. OBJECTIVE: To establish a high-precision three-dimensional (3D) integrated maxillodental model by matching CBCT model with 3D digital maxillodental model using 3D automatic registration method, based on which, we designed and manufactured individualized miniscrew surgical guides. METHODS: CBCT maxillodental models and laser-scanned dentition models obtained from six malocclusion cases were matched and overlapped using the 3D automatic registration method to fabricate the 3D integrated maxillodental model. Then, we accurately positioned and virtually implanted a micro-implant into the 3D integrated maxillodental model. Subsequently we prepared a high-precision individualized resin surgical guide by rapid prototyping technology. The inner diameter of the guide track was detected by a vernier caliper. Patients tried on the resin surgical guide, and then occlusion condition, guide seating and retention were detected. RESULTS AND CONCLUSION: Due to the high-precision registration of the model, all the resin surgical guide plates were suitable. The plate retention was enhanced after tooth clinching, and all the patients felt comfort when wearing the surgical guide plate, with no compression or other discomforts. The inner diameter of the guide track was (1.79±0.23) mm, and the measurement error was not statistically significant (P >0.05). These findings demonstrate that the high-precision surgical guide plate based on the high-precision 3D integrated model can provide the foundation for further investigations on the clinical application of surgical guides.

PURPOSE: Insulin resistance plays a role in the development of dementia and hypertension. We investigated a possible relationship between cognitive impairment and insulin resistance in elderly Chinese patients with primary hypertension. MATERIALS AND METHODS: One hundred and thirty-two hypertensive elderly patients (>60 years) were enrolled in this study, and assigned into either the cognitive impairment group (n=61) or the normal cognitive group (n=71). Gender, age, education, body mass index (BMI), waist hip ratio (WHR), total cholesterol (TC), triglyceride (TG), C-reactive protein (CRP), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), creatinine (Cr), fasting plasma glucose (FPG), fasting insulin (FINS), homeostasis model of assessment for insulin resistance index (HOMA-IR), systolic blood pressure, diastolic blood pressure, smoking history, atherosclerosis and the proportion of uncontrolled hypertension were compared between the two groups. Multi-factorial logistic regression analysis was performed. RESULTS: No significant differences were found in gender, age, TC, CRP, HDL-C, LDL-C, Cr, BP, smoking history, atherosclerosis and the proportion of uncontrolled hypertension between the two groups. The cognitive impairment group had lower education levels, and higher BMI, WHR, TG, FPG, FINS, and HOMA-IR levels than the control group. Logistic regression analysis revealed the levels of education, BMI, WHR, and HOMA-IR as independent factors that predict cognitive impairment in patients. CONCLUSION: Our study demonstrates that poor education and increased BMI, WHR, and HOMA-IR are independent risk factors for cognitive impairment in elderly patients with hypertension. Insulin resistance plays an important role in the development of cognitive impairment in primary elderly hypertensive patients.
Aged ; Case-Control Studies ; Cognition Disorders/*etiology ; Female ; Humans ; Hypertension/*complications ; *Insulin Resistance ; Logistic Models ; Male ; Risk Factors

OBJECTIVETo sum up the experience in treating very severe traumatic brain injuries.

METHODSRetrospective analysis of 68 patients with very severe traumatic brain injuries treated in our hospital from 1997 to 2002 was done.

RESULTSForty-one (60%) patients died. In the 50 patients treated surgically 27 (40%) survived, 8 recovered well, 9 had moderate disability and 10 had severe deficits. The 18 patients treated non-operatively all died.

CONCLUSIONSMuch attention should be given to the observation of the changes of severe brain injuries with cranial base injury. Timely operative decompression, basic life support, keeping effective brain blood perfusion and effective oxygen supply, improving cerebral microcirculation and preventing or controlling complications are the main methods to raise the successful rate of treating very severe brain injuries and the life quality of the patients.

Adolescent ; Adult ; Aged ; Brain Injuries ; diagnosis ; mortality ; therapy ; Cohort Studies ; Combined Modality Therapy ; Craniotomy ; Critical Care ; methods ; Decompression, Surgical ; Drug Therapy, Combination ; Female ; Glasgow Coma Scale ; Humans ; Injury Severity Score ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Oxygen ; therapeutic use ; Prognosis ; Retrospective Studies ; Risk Assessment ; Survival Analysis ; Treatment Outcome

Objective:To observe the effects of electroacupuncture (EA) of different frequencies on the expression levels of substance P (SP) and vasoactive intestinal peptide (VIP) in the colon of rats with slow transit constipation (STC).Methods:One hundred healthy male Sprague-Dawley (SD) rats were randomly divided into a normal group,a model group,a low-frequency EA group,a high-frequency EA group and a variable-frequency EA group,with 20 rats in each group.The rats in the normal group were fed with normal diet.The rats in the other groups were fed with phenethylpiperidine in the diet at a dose of 8 mg/(kg·bw) per day,for 120 d,to establish the STC model.Rats in the normal group and the model group did not receive any treatment;rats in the low-frequency EA group were treated with 2 Hz continuous wave EA,rats in the high-frequency EA group were treated with 100 Hz continuous wave EA,and rats in the variable-frequency EA group were treated with 2 Hz/100 Hz sparse-dense EA.The current intensity of the EA was determined by the slight vibration of the rat limbs without painful screaming.The intervention was performed once a day,15 min/time for continuous 15 d.After treatment,the intestinal transit function and the expression levels of SP and VIP in the colon of the rats in each group were determined.Results:After treatment,the defecation duration of the first dark stool in the model group was significantly longer than that in the normal group (P＜0.05);the defecation durations of the first dark stool in the low-frequency EA group,high-frequency EA group and variable-frequency EA group were significantly shorter than the duration in the model group (all P＜0.05);compared with the low-frequency EA group,the first dark stool defecation duration of rats in the variable-frequency EA group was significantly shorter (P＜0.05);compared with the normal group,the SP and VIP expression levels in the colon of the model group were significantly decreased (both P＜0.01);the SP and VIP expression levels in the colon of the low-frequency EA group,the high-frequency EA group and the variable-frequency EA group were significantly higher than those in the model group (all P＜0.05);compared with the high-frequency EA group,the SP expression levels in the colon in the low-frequency EA group and the variable-frequency EA group were significantly increased (both P＜0.05);compared with the low-frequency EA group,the VIP expression levels in the colon in the high-frequency EA group and the variable-frequency EA group were significantly increased (both P＜0.05).Conclusion:EA improves the intestinal function of STC model rats by regulating the expression levels of SP and VIP in rat colon.The EA stimulation with 100 Hz continuous wave,2 Hz/100 Hz sparse-dense wave shows a better improvement in the colonic transit function in STC rats,followed by 2 Hz continuous wave.

OBJECTIVE: To investigate the genetic polymorphism in the 5' and 3' region of TPH2 gene of Northern Chinese Han population and to explore its application value in forensic medicine. METHODS: The sequence variants and the genetic polymorphisms of 6 SNP loci (rs4570625, rs11178997, rs11178998, rs41317118, rs17110747 and rs41317114) within a 905 bp 5' flanking region and a 1,104bp 3' flanking region of TPH2 gene were analyzed by DNA sequencing in a total of 244 unrelated healthy individuals in Northern Chinese Han population. The statistical analysis was carried out by Haploview v4.2 software. RESULTS: The genotypic distributions of the 6 SNP loci in the TPH2 gene were in accordance with Hardy-Weinberg equilibrium. One C/T variant in 92922 site was found. There was a high linkage disequilibrium among the 3 SNP loci (rs4570625, rs11178997 and rs11178998) in the 5' region and the 3 SNP loci (rs41317118, rs17110747 and rs41317114) in the 3' region of TPH2 gene, respectively. The parameters of population genetics of 6 SNP loci were obtained. CONCLUSION There are great polymorphisms in the 5' and 3' region of TPH2 gene in Northern Chinese Han population, which could be used as genetic indexes for association analysis of the related diseases, as well as for forensic individual identification and paternity testing.
3' Untranslated Regions ; 5' Untranslated Regions ; Asian People/genetics* ; China/ethnology* ; Forensic Genetics ; Gene Frequency ; Genetics, Population ; Genotype ; Humans ; Linkage Disequilibrium/genetics* ; Microsatellite Repeats ; Polymerase Chain Reaction ; Polymorphism, Single Nucleotide ; Tryptophan Hydroxylase/genetics*

Objective: To explore whether the pro-inflammatory effect of endoplasmic reticulum stress in placental tissues involves in the genesis of gestational diabetes mellitus (GDM). Methods: Forty gravidas who underwent regular prenatal examinations and delivered at Tongji Hospital were recruited from January to December, 2016. Among them, 20 were GDM women (GDM group), and the remaining twenty were served as the control, which were selected from those without GDM and matched for age and gestational weeks to the GDM group. Placental tissues were collected from the two groups. The ultrastructure of endoplasmic reticulum in trophoblast cells was observed under transmission electron microscope. The expression of glucose-regulated protein-78 (GRP-78), a marker protein for endoplasmic reticulum stress, and C/EBP homologous protein (CHOP) were detected using Western blotting. Five placental tissue samples were collected from normal gravidas for explant culture. Three subgroups were set up according to different culturing methods including culturing with IL-1β (5 ng/ml) for 20 h (IL-1β model group), 30 μmol/L thapsigargin (TG, an endoplasmic reticulum stress agonist) for 2 h after treating with IL-1β (5 ng/ml) for 18 h (IL-1β+TG intervention group) or with no stimulation (blank control group). Western blotting was used to detect the expressions of GRP-78, CHOP and glucose transporter 4 (GLUT4) in placenta explants. The mRNA expressions of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were determined by real-time fluorescence quantitative polymerase chain reaction (RT-PCR). Statistical analysis was performed using one-way analysis of variance, LSD and t test. Results: (1) In the GDM group, increased number and size of endoplasmic reticulum cisternae were observed in trophoblast cells. Moreover, obviously dilated endoplasmic reticulum and different size of fragments and vesicles were also seen under electron microscope. While the endoplasmic reticulum in the placental tissues of the control group showed no obvious swelling. (2) The expression of GRP-78 and CHOP protein in the GDM group were higher than those in the control group (0.90±0.17 vs 0.48±0.08, t=2.24; 0.85±0.13 vs 0.46±0.12, t=2.10; both P<0.05). (3) Compared with the blank control group, the expression of GRP-78 and CHOP protein in the IL-1β model group increased significantly (0.87±0.18 vs 0.36±0.07, t=2.67; 1.14±0.09 vs 0.78±0.06, t=3.20; both P<0.05); but the expression of GLUT4 protein significantly decreased (1.00±0.14 vs 2.21±0.49, t=2.40, P<0.05); the expressions of IL-6 and TNF-α mRNA significantly increased (0.89±0.23 vs 0.30±0.06, t=2.31; 0.62±0.16 vs 0.17±0.09, t=2.29; both P<0.05). Compared with the IL-1β model group, the expression of GRP-78 and CHOP protein significantly increased in IL-1β+TG group (2.02±0.32 vs 0.87±0.18, t=3.11; 2.18±0.31 vs 1.14±0.09, t=3.16; both P<0.05); the expression of GLUT4 protein significantly decreased (0.39±0.19 vs 1.00±0.14, t=2.66, P<0.05); the expression of IL-6 and TNF-α mRNA increased significantly (1.67±0.25 vs 0.89±0.23, t=2.26; 1.42±0.27 vs 0.62±0.16, t=2.51; both P<0.05). Conclusions Endoplasmic reticulum stress may be associated with increased release of pro-inflammatory cytokines in placental tissues of some GDM women and involved in the onset and development of GDM.

Objective　To investigate whether methylenetetrahydrofolate reductase (MTHFR) gene C677T polymorphism is linked with coronary heart disease (CHD). Methods　 Transmission/disequilibrium test(TDT), sib transmission/disequilibrium test(STDT), and sibship disequilibrium test(SDT) were used. Forty-five CHD pedigrees with at least one CHD patient in the first degree relatives of probands were recruited from Oct. 1998 to Feb. 1999. Among those recruited were 21, 2 and 22 pedigrees with the genotypes of both parents known, one parental genotype unknown and both unknown, respectively. MTHFR genotype was measured by PCR-RFLP technique. Results　 Neither the TDT for 23 nuclear families with at least one parental genotype known or the STDT and SDT for 40 sibships found significant difference between the transmitted and untransmitted MTHFR gene 677T allele distributions. Conclusion　 The above results suggest that MTHFR gene 677T allele is probably not linked with CHD in Chinese population.