Objective: To explore the mechanism of traditional Chinese medicine(TCM) combined with regular therapy in the treatment of pneumonia with systemic inflammatory response syndrome(SIRS) in(children).Methods: Sixty-four children with pneumonia including 51 cases with SIRS complication were(randomly) divided into three groups: treatment group(regular therapy+TCM,n=26),control group Ⅰ((regular)(therapy) only,n=25) and the control groups Ⅱ(13 pneumonia children without SIRS(receiving)(routine) treatment). The dynamic changes of tumor necrosis factor-?(TNF-?),interleukin-6(IL-6) and IL-8 were measured before and after treatment in all children.Serum Creactive protein(CRP) and total white blood cell(WBC) count were measured simultaneously.Clinical symptom and sign scores were(performed)(5 days) after treatment in children with pneumonia and SIRS complication.Results: Before(treatment),serum TNF-?,IL-6,IL-8 and CRP concentrations were significantly higher in treatment group and(control) group Ⅰ than(control) group Ⅱ(all P

We sought to explore the feasibility of global area strain to assess left ventricular global systolic function in patients with essential hypertension and normal ventricular geometry. Thirty-five essential hypertensive patients with normal ventricular geometry and 30 normally healthy persons as controls were enrolled in this study. The two groups were comparable for age, sex ratio, height, weight, body mass index (BMI), and heart rate. Blood pressures (BPs) were significantly higher in the hypertension group than the control group. Two-dimensional echocardiography and three-dimensional speckle tracking imaging were performed. Left ventricular global area strain (GAS), global longitudinal strain (GLS), global circumferential strain (GCS), global radial strain (GRS), LV volumes, ejection fraction (EF), sphericity index (SPI), left ventricular end-diastolic and end-systolic mass (EDmass and ESmass) and LV mass index (EDmassI and ESmassI) were obtained. Compared with those of the controls, GAS, GLS, GCS, GRS were significantly reduced in hypertensive patients Call P < 0.001). GAS (r = 0.672, P < 0. 001), GLS (r = 0.587, P < 0.001), GCS (r = 0.639, P < 0.001) and GRS (r = 0.685, P < 0.001) were correlated with EF in the pooled population. GAS showed an excellent correlation with GCS (r = 0.905, P < 0.001), GLS (r = 0.892, P < 0.001) and GRS (r = 0.990, P < 0.001). EF measured with 3D-STI was significantly lower in group of hypertension (P < 0.001) than that in the controls. There were no significant differences between the two groups in cardiac output, sphericity index, EDmass and ESmass, LV mass index (EDmassI and ESmassI) calculated with 3D-STI. The study showed that GAS could identify early changes of left ventricular global systolic function in hypertensive patients with normal ventricular geometry.
Adult ; Aged ; Case-Control Studies ; Echocardiography, Three-Dimensional ; methods ; Female ; Humans ; Hypertension ; diagnostic imaging ; physiopathology ; Male ; Middle Aged ; Myocardial Contraction ; physiology ; Ventricular Function, Left ; physiology ; Young Adult

OBJECTIVETo compare the perioperative complications between Ivor-Lewis approach and McKeown approach in minimally invasive esophagectomy and gastric tube reconstruction for the treatment of middle and lower thoracic esophageal cancer.

METHODSRetrospective analysis of clinical data was performed on 288 patients with middle and lower thoracic esophageal cancer who underwent completely minimally invasive esophagectomy by one surgical team in Fujian Medical University Union Hospital from December 2010 to March 2014. Among the 288 patients, 103 patients underwent combined laparoscopic and thoracoscopic esophagectomy and intrathoracic esophagogastric anastomosis using a transoral anvil(Orvil)(Ivor-Lewis group, 2-incision) and 185 patients underwent combined laparoscopic and thoracoscopic esophagectomy and cervical anastomosis(McKeown group, 3-incision). Patients were stratified by surgical approach and perioperative outcomes were compared between the two groups.

RESULTSThere were no statistical differences between two groups in intra-operative blood loss, conversion to open, extubation time, time to resume oral intake, postoperative hospital stay, the median number of lymph nodes resected. The operation time of Ivor-Lewis group was significantly shorter than that of McKeown group [(283.4±32.0) min vs. (303.6±43.7) min, P=0.003). The hospital cost of Ivor-Lewis group was significantly higher than that of McKeown group [(76 492±18 553) yuan vs. (68 923±17 331) yuan, P<0.01]. There were no statistical differences between two groups in chylothorax, delayed gastric emptying, atrial fibrillation, postoperative bleeding, admission to ICU, short-term postoperative mortality (P>0.05). The total postoperative complication morbidity of Ivor-Lewis group was significantly lower than that of McKeown group(16.5% vs. 31.4%, P<0.01). Ivor-Lewis group had lower pulmonary complication(8.7% vs. 25.9%, P<0.01), anastomotic leakage(1.9% vs. 13.0%, P<0.01), anastomotic stricture (0% vs. 4.9%, P<0.05), recurrent laryngeal nerve injury(1.0% vs. 7.0%, P<0.05).

CONCLUSIONIvor-Lewis approach is associated with less postoperative complications, but higher cost as compared to McKeown approach in the treatment of middle and lower thoracic esophageal cancer.

Anastomosis, Surgical ; Anastomotic Leak ; Blood Loss, Surgical ; Esophageal Neoplasms ; surgery ; Esophagectomy ; methods ; Humans ; Laparoscopy ; Length of Stay ; Minimally Invasive Surgical Procedures ; methods ; Operative Time ; Postoperative Complications ; Reconstructive Surgical Procedures ; methods ; Retrospective Studies

OBJECTIVETo explore the application of mesoesophagus suspension technique to improve the upper mediastinal lymph node dissection during thoracoscopic esophagectomy in the treatment of esophageal cancer.

METHODSClinical data of 164 thoracic esophageal cancer patients who underwent combined thoracoscopic and laparoscopic esophagectomy with two-field lymph node dissection in the Union Hospital of Fujian Medical University between October 2012 and June 2015 were retrospectively analyzed. Among 164 patients, 80 cases underwent upper mediastinal lymph node dissection by traditional method (traditional group), and the remaining 84 cases underwent upper mediastinal lymph node dissection by mesoesophagus suspension technique (suspension group). The operation time, estimated blood loss, number of excised lymph nodes and postoperative complications were compared between the two groups.

RESULTSThere were no significant differences in gender, age, location of tumor and pathology stage between the two groups. The operation time in the two groups was similar. The suspension group had significantly less thoracic blood loss than traditional group [(85±5) ml vs.(140±7) ml, P=0.000]. The number of dissected lymph nodes of bilateral recurrent laryngeal nerve was more in suspension group [median (interquartile range): left: 3 (2 to 4) vs. 2 (1 to 3), P=0.013; right: 3(2 to 6) vs. 2(1 to 3), P=0.007]. There was no significant difference in metastatic rate of lymph node in different sites between the two groups. The highest metastatic rate of suspension and traditional group was found at paracardia lymph nodes[22.6%(19/84) and 22.5%(18/80)], the next was at right laryngeal nerve lymph nodes [17.9%(15/84) and 15.0%(12/80)] and left laryngeal nerve lymph nodes [16.7%(14/84) and 12.5%(10/80)]. There were no significant differences with regard to the incidence of major postoperative complications between two groups, including respiratory complication, anastomotic leakage, vocal cord palsy.

CONCLUSIONSUpper mediastinal bilateral recurrent laryngeal nerve lymph node is the predilection site of lymphatic metastasis of thoracic esophageal cancer. Application of mesoesophagus suspension technique in thoracoscopic esophagectomy can improve the clearance quality of bilateral recurrent laryngeal nerve lymph nodes.

Anastomotic Leak ; Blood Loss, Surgical ; Esophageal Neoplasms ; surgery ; Esophagectomy ; adverse effects ; methods ; Female ; Humans ; Laparoscopy ; Lymph Node Excision ; adverse effects ; methods ; Lymph Nodes ; anatomy & histology ; pathology ; surgery ; Lymphatic Metastasis ; physiopathology ; Male ; Mediastinum ; surgery ; Operative Time ; Postoperative Complications ; Recurrent Laryngeal Nerve ; physiopathology ; Retrospective Studies ; Treatment Outcome

Abstract In recent years, the prevention and treatment of eye diseases in children has become one of the worldwide recognized public health issues. Both genetic and environmental factors can influence the development of offspring visual systems, leading to abnormal vision acuity such as refractive errors, strabismus, and nystagmus. With the aim of elucidating the influencing factors and mechanisms of early life adverse exposures on offspring vision outcomes, the article summarizes the research on exposure in early life and visual acuity in offspring from different perspectives, including tobacco exposure during pregnancy, exposure to microelements, gestational diabetes, gestational hypertension, and drug abuse during pregnancy, so as to provide scientific evidence for the development of more effective strategies to prevent and control eye diseases in children and adolescents.