Bone Plates ; Fracture Fixation, Internal ; instrumentation ; methods ; Humans ; Minimally Invasive Surgical Procedures ; instrumentation ; methods ; Tibial Fractures ; surgery

Objective To observe the therapeutic effect of Qiliqiangxin capsule combined on refractory heart failure.Methods 60 patients with refractory heart failure were randomly recruited into a control group and a therapeutic group. The control group received the conventional treatment, and the therapeutic group took Qiliqiangxin capsule on the base of the conventional treatment (3 times a day, 4 granules/each time) combined with 120 mg cAMP meglumine. Treatment in both group lasted 14 days. Results: After the treatment, the therapeutic group showed improvement in the symptoms of heart failure. Comparing with the control group, the difference was significant (P＜0.05). Conclusion The therapeutic effect of Qiliqiangxin capsule combined on refractory heart failure is satisfied and can improve the quality obviously.

0.05),but the expression of CD19+ in the 3rd month and the 6th month were lower than that of healthy control group(Pa

Purpose:To explore the therapeutic effects of combining chemotherapy and TCM recipe “Xiao Zheng Fang” for advanced colorectal cancer.Methods:A prospective and comparable clinical study was made in 85 cases of advanced colorectal carcinoma seen over 6 years , Who were not suitable for radical operation or had metastases after operation. Survival time,life quality, objective effect and blood flow rate indexes were studied and analysed. Results:Integrated therapy of tranditional Chinese and Western medicine is superior to chemotherapy alone in life quality ( P

Objective To evaluate the efficacy and clinical feasibility of the computer-assisted full plan- ning system for tibial fracture treatment with intramedullary nailing.Methods After analyzing the functional structure and operative procedures of the system,nine plastic tibia and 12 cadaver lower limbs were used for image mosaicing based on C-arm (PHILIPS BV Libra) fluoroscopic images in the operation room to assess the correctness of the mosaicing and planning algorithms.The plastic tibial model was used for analysis of the mosaicing precision.The cadaver tibial bone was used for reduction experiment with the reduction mechanism to analyze the operation feasi- bility.Results Only 7 to 10 [fluoroscopy time:(19.75?0.61)s] valid C-ann projection images were needed to produce a long bone panorama of the lower limb.The total time for image acquisition and mosaicing was within (4.17?0.86)minutes and the mosaicing precision in the plastic tibial model was (1.26?0.76)mm.The opera- tion of the reduction mechanism was very simple and could be controlled by a surgeon automatically or free of hand. An integrated reduction strategy could be produced for rough positioning in general and elaborate operations in de- tails.Conclusion The computer-assisted full planning system can be used for anatomical analysis based on the C-arm panorama,full surgical planning,virtual simulation,selection of proper intramedullary nails and fracture reduction in treatment of long bone fractures.

Cardiac surgery carried out on cardiopulmonary bypass(CPB) in a pregnant woman is associated with poor neonatal outcomes although maternal outcomes are similar to cardiac surgery in non-pregnant women.Most adverse maternal and fetal outcomes from cardiac surgery during pregnancy are attributed to effects of CPB.The CPB is associated with utero-placental hypoperfusion due to a number of factors,which may translate into low fetal cardiac output,hypoxia and even death.Better maternal and fetal outcomes may be achieved by early pre-operative optimization of maternal cardiovascular status,use of perioperative fetal monitoring,optimization of CPB,delivery of a viable fetus before the operation and scheduling cardiac surgery on an elective basis during the second trimester.

Objective The prosthesis used for aortic valve replacement (AVR) can be too small in relation to body size,thus causing valve prosthesis-patient mismatch (PPM).The aim of this article was to summarize the preventive strategy of PPM during AVR.Methods A total of 357 patients [203 males,154 females; mean age (54.9 ± 18.7 ) years ] underwent AVR between February.2010 and December 2011.The weight and body surface area (BSA) of the group is( 60.1 ± 11.4 )kg and (1.67 ± 0.21 )m2 respectively.The aortic valve prosthesis effective orifice area (EOA) was divided by body surface area (BSA) to obtain the EOA index (EOAI).PPM was then defined as none or mild if EOAI was ＞ 0.85 cm2/m2,as moderate for (0.65 - 0.85 ) cm2/m2 and as severe for ＜ 0.65 cm2/m2.To avoid PPM,a simple three-step algorithm was applied:Step 1,Calculate the patient's BSA from weight and height;Step 2,Calculate the minimal valve EOA required based on the BSA to ensure an EOAI ＞0.85 cm2/m2 ; Step 3,Select the type and size of prosthesis that has reference values for EOA greater or equal to the minimal EOA value obtained in step 2.For patients with a small aortic root,the following three methods was used:( 1 ) Replace aortic valve with simple interrupted suture technique ; (2) Apply new type and high-performance prosthetic valves such as St.Jude Medical Regent mechanical valve ; (3) Enlarge the narrowed aortic root when necessary.Results Of all 357 patients,272 patients received mechanical AVR and 85 bioprosthetic AVR.Among the 49 patients who received AVR with simple interrupted suture technique.St.Jude Medical Regent mechanical valve was implanted in 38 patients and the aortic root enlargement was performed in 11 patients.The total prevalence of PPM was 6.4％ and there was no severe PPM.The prevalence of PPM with mechanical AVR and bioprosthetic AVR was 1.8％ and 21.2％ respectively.There were 4 deaths during early period of operation,and the operative mortality was 1.1％.Conclusion Prosthesis-patient mismatch can be effectively prevented at the time of AVR with appropriate measurement.

The effects of subclinical epileptiform discharges (SEDs) on children with cerebral palsy cannot be ignored. Data from neurodevelopmental clinic studies showed that the overall incidence of SEDs in cerebral palsy was 18%～40%, with the highest in spastic hemiplegia and diplegia. The major pattern of SEDs was focal and multifocal, and was usually found in centro-temporal and parietal regions. The cortex impairment and other complications were risk factors related to SEDs in cerebral palsy. Paroxysmal or frequent long-time SEDs, with the Results of transient or chronic cognitive impairment, have been found to lead to subsequent death of cortical neurons of cerebral palsy patients thereby worsening their prognosis. Valproic acid (VPA), benzodiazepines (BZs) and lamotrigine (LTG) have a role in inhibiting SEDs, while adrenocorticotropic hormone (ACTH) and glucocorticoids have a great role in it.

Heart Failure ; prevention & control ; Humans ; Mitochondria

Objective To determine the efficacy of coronary artery bypass grafting (CABG) in children with coronary obstructive disease subsequent to Kawasaki disease. Methods Between Feb 2005 and Sep 2009, 6 children with ischemic heart disease due to Kawasaki disease comprised the study group. The age of patients at operation was ranged from 6 to 12 years with a mean of ( 8.0 ± 2.3 ) years. The preoperative EF was ranged from 0.33 to 0.71 with a mean of 0.57 ± 0.15. There was one case with moderate mitral valve regurgitation. Results All patients survived the procedures. The mean number of bypass graft was 2.0 ±0.6,with 4 internal thoracic arteries and 7 radial arteries. Mitral valve repair was employed in 1 case. The cardisc function ( NYHA and EF) was significantly improved postoperatively. Postoperative CTA showed no graft disease in all cases. Conclusion CABG using the arterial grafts can provide attractive mid-term results in patients with obstructive coronary arteries associated with Kawasaki disease.