Objective To explore the cause, clinical feature, rescue measures and prognosis of tracheo-innominate artery fistula (TIF). Methods From January1995 to January 2015, there were 621 patients who were performed tubotomy, and 8 patients had TIF. The diagnosis of TIF were established by surgery exploration or autopsy. Results The interval between tracheostomy and TIF was 8- 78 d. Before TIF, hemoptysis occurred in 4 patients. When TIF occurred, bedside aid was performed and 4 patients quickly died of asphyxia because of massive blood in the trachea. The others lived long enough to reach the operating room. The family of 1 patient refused surgical therapy and he eventually died. Three patients accepted median sternotomy. One patient underwent vascular repair and died after surgery because of infection in repaired area. The other patients accepted ligation of the innominate artery without suction drains in the mediastinum and died after surgery because of re-bleeding due to mediastinal infection. The last one patient underwent ligation of the innominate artery with suction drains in the mediastinum, and was still alive without long-time neurological complications and re-bleeding after a follow-up of 14 months. Conclusion A prompt diagnosis and surgical intervention can save the life of TIF patient. Prevention is very vital because of the high mortality of this disease.

Rectal cancer is a common malignancy in the alimentary tract with an increasing incidence, the current treatments of which include surgery, radiotherapy, chemotherapy, and integrated comprehensive options. Sexual dysfunction, especially erectile dysfunction (ED), is one of the commonest complications in men after rectal cancer treatment and is generally attributed to the damage to the pelvic autonomic nerves. However, recent studies show that ED after rectal cancer treatment is a complex pathophysiological process associated with neurogenic, vasculogenic, and psychological factors. This article reviews the pathogeneses of ED after rectal cancer treatment in order to provide some theoretical evidence for its prevention and treatment.
Erectile Dysfunction ; etiology ; Humans ; Male ; Postoperative Complications ; etiology ; Rectal Neoplasms ; surgery

OBJECTIVETo explore the relationship of the classification of talus fracture and surgery methods with avascular necrosis.

METHODSFrom March 2009 to November 2013, 78 patients with talus fracture were treated, of them, 43 cases were followed up from 2 to 5 years. There were 27 males and 16 females, aged from 17 to 65 years old with the mean of 38.6 years. Thirty-nine cases had talar neck injury and 4 cases had talar body injury. Different treatments were performed according to different injury conditions. The time from injury to treatment was from 6 to 48 hours. The effect of classification of talus fracture and surgery methods on avascular necrosis was analyzed.

RESULTSIn 43 cases,19 cases occurred avascular necrosis, including talar neck fracture of type I in 2 cases, type II in 5 cases, type III in 5 cases, type IV in 5 cases and talar body fracture in 2 cases (combined with talar neck fracture). And 29 patients were treated with operation, there was no statistically significant differences in avascular necrosis with different operations.

CONCLUSIONCompared with talar body fracture, talar neck fracture is more easily to develop into avascular necrosis. In the 4 types of talar neck fracture, the possibilities of type III and IV were the most ones.

Adolescent ; Adult ; Aged ; Female ; Fracture Fixation, Internal ; methods ; Fractures, Bone ; classification ; surgery ; Humans ; Male ; Middle Aged ; Osteonecrosis ; surgery ; Talus ; blood supply ; injuries

Animals ; Computational Biology ; Digestive System Neoplasms ; metabolism ; Electrophoresis, Gel, Two-Dimensional ; Humans ; Mass Spectrometry ; Proteomics ; methods

Angioplasty ; history ; methods ; Cardiovascular Surgical Procedures ; history ; methods ; Coronary Artery Bypass ; history ; methods ; Coronary Artery Disease ; surgery ; Heart Transplantation ; history ; methods ; History, 20th Century ; History, 21st Century ; Humans ; Stem Cell Transplantation ; history ; methods

Objective To investigate the clinical values of extracapsular invasion at sentinel lymph nodes in patients with breast cancer.Methods From Jan,2010 to Jan,2013,80 patients underwent axillary lymph node dissection due to sentinel lymph nodes invasion were enrolled in this prospective study.Patients were signed to extracapsular at sentinel lymph nodes positive group (n =45)and control group (n =35)according to the intra -operative pathology.The primary outcome was rate of positive non -sentinel lymph nodes and the second outcomes were 3 -year recurrence -free survival,mortality and health -related quality of life.Results Compared with the control group,the patients in extracapsular at sentinel lymph nodes positive group got a significantly higher rate of positive non -sentinel lymph nodes (91.11% vs.28.57%,χ2 =33.321,P <0.001 );a significantly lower rate of 3 -year recurrence -free survival(57.78% vs.88.57%,χ2 =9.114,P =0.003);a significantly higher rate of mortality (17.78% vs.2.86%,χ2 =4.390,P =0.036);and a significantly lower level of health -related quality of life[(78.43 ±12.43)vs.(87.54 ±11.89),t =11.324,P =0.000].Conclusion Extracapsular invasion at sentinel lymph nodes was a reliable predictor for non -sentinel lymph nodes invasion and long -term clinical outcomes.

Objective To explore the diagnostic value of MRI on fetal congenital limb deformities.Methods Sixteen pregnant women,aged from 22 to 40 years (average 29 years) and with gestation from 22 to 39 weeks (average 29 weeks) were studied with a 1.5 T superconductive MR unit within 24 to 48 hours after ultrasound studies. Acquisitions consisted of coronal, sagittal, and axial slices relative to the fetal brain, spine, thorax, abdomen, especially limbs using 2D FIESTA sequences. Prenatal US and MR imaging findings were compared with postnatal diagnoses (4 fetuses) or autopsy (12 pregnant women,13 fetuses). Postnatal evaluation included US, MR imaging, computed tomography, and physical examination. Results Of the sixteen pregnant women (15 with a single fetus and 1 with twin fetuses) ,17 fetuses were found. Those limb deformities of sixteen pregnant women included congenital both upper extremities amelia (1 case), sirenomelia sequence (1 case), micmmelia (5 cases, 1 of which were twins),bilateral clenched hands (2 cases), right pelydactyly (1 case), simple right ectrodactyly (1 case), right dactylolysis(1 case), simple club foot (2 cases), hydrocele spinalis with club foot (2 cases), 1 of the 2 cases with bilateral clinodactyly. In 14 of 16 cases, the diagnoses established by MR imaging were correct when compared with postnatal diagnosis, and prenatal MR diagnosis was inaccurate in 2 cases. Conclusion Prenatal MRI is effective in the assessment of congenital limb deformities of fetuses, it can yield information additional to that obtained with US, and further correct US diagnosis.

Activities of Daily Living ; Acupuncture Therapy ; Cerebral Infarction ; rehabilitation ; therapy ; Humans ; Recovery of Function ; Time Factors

Objective To investigate the effect and safety of primary percutaneous coronary intervention (PCI) of acute ST-segment elevation myocardial infarction (STEMI) in elderly patients.Methods 103 consecutive patients with STEMI treated by primary PCI were divided into two groups according to the age:the elderly group [aged≥65 years,with a mean age of (75.7 ±6.2) years(n =49],the non-elderly group [aged＜65 years,with a mean age of (43.0±8.6) years(n =54].Clinical characteristics,complications related to PCI procedure and success rate were analyzed,and major cardiovascular events (MACE) were followed up for(5.7 ± 1.2) months.Results The proportion of female,patients with Killip ≥ Ⅲ,three vessels disease and higher level of serum brain natriuretic peptide were higher in elderly group than in non-elderly group (all P＜0.05).No significant difference was observed between the two groups in success rate and complications of PCI procedure (both P＞0.05).Patients were followed up for (5.7± 1.2) months.The in-hospital and one-month mortalities were higher in elderly group than in non-elderly group [8.2％ (4 cases)vs.0％ (0 case),10.2％(5 cases) vs.0 ％ (0 case),respectively,all P＜0.05].There was no significant difference in six-month mortality and MACE between the two groups.Multivariate logistic regression analysis showed that Killip ≥ Ⅲ was related with the increase of one-month mortality in patients with STEMI undergoing primary PCI,whereas age was not.Conclusions Primary PCI is effective and safe in elderly patients with STEMI.