Animals ; Cardiovascular Diseases ; etiology ; Cerebrovascular Disorders ; etiology ; Homocysteine ; metabolism ; Humans ; Methylenetetrahydrofolate Reductase (NADPH2) ; genetics ; Polymorphism, Genetic

Objective To evaluate the clinical value of electron beam computed tomography (EBCT)in the diagnosis of atherosclerotic aortic ulcer.Methods Sixty-eight consecutive patients(55 men and 13 women,aged 40—85 years,mean 65.12?9.55 years)with atherosclerotic aortic ulcer,who underwent EBCT scans from December 2001 to December 2004,were studied retrospectively.Contrast- enhanced continuous volume scanning(CVS)was performed by Imatron C-150XP EBCT scanner with 6 mm or 3 mm slice thickness and 100 milliseconds acquisition time.The scan was started 18—30 s after the injection of 80—100 ml contrast medium at the rate of 3.5—4.5 ml/s.Results In sixty-eight patients with atherosclerotie aortic ulcer,50 patients had acute aortic syndromes,36 had intramural hematomas,15 had atherosclerotic aortic aneurysms,3 had aortic dissections.46 patients with progresive ulcer usually had acute aortic syndrome while 22 patients with stable ulcer didn't(P

Carcinoma ; metabolism ; Cell Differentiation ; genetics ; Gallbladder Neoplasms ; genetics ; metabolism ; Gene Expression Regulation, Neoplastic ; Humans ; Kangai-1 Protein ; genetics ; metabolism ; NM23 Nucleoside Diphosphate Kinases ; genetics ; metabolism

Objective To summarize our experience in prevention and treatment of stricture after esopageal burns in the past thirty years.Methods There were 168 cases in this series.Of them,158 cases underwent surgical management in this study.Modified intraluminal stenting was used in 34 cases, colon interposition without resection of strictured esophagus in 77 cases,gastric transposion with resection of the stricture in 27,repair of cervical stricture with platysma myocutaneous flap in 22,and miscellane- ous operation in 12.Eleven cases experienced operation twice or more at our department.Results Twenty-nine cases recovered after treatment with intraluminal stenting,and 5 re-experienced stricture after stent removal.One of the 5 cases with failed stent responded to bougienage,and the remaining 4 cases re- quired esophageal reconstruction later.Of the 77 colon interpositions,5 cases died postoperatively,and complications of cervical anastomotic fistula occurred in 14 cases,anastomotic stenosis in 4,and abdomi- nal incision dehiscence in 2 cases.In the 27 cases with gastric transpositions,postoperative complications of anastomotic stricture occurred in 2 cases and empyema in 1 patient.There was a cervical leak in 3 ca- ses of the 22 cases treated with the repair of cervical esopageal or anastomotic stricture with a platysma myocutaneous flap.In the 12 cases treated with miscellaneous operation,one died of intestinal obstruc- tion.All the survivors had regular diet after discharge.Conclusions Intraluminal stenting can prevent the formation of caustic esophageal stricture.The location of the cicatricial esophagus dictates whether to perform concomitant esophagectomy during esophageal reconstruction.Platysma myocutaneous flap repair is an excellent method for the treatment of severe cervical esophageal or anastomotic stricture.

OBJECTIVETo explore the prevalence of chronic obstructive pulmonary disease (COPD) and its risk factors in rural area in the southern part of Hubei province and to provide evidence for prevention and treatment.

METHODSUsing uniform scheme, procedures and questionnaire, a multistage survey for 1883 people in rural area in southern part of Hubei province was performed, and physical examinations and lung function tests were conducted for every participant.

RESULTSIn this survey, 186 COPD cases were identified with a overall prevalence of 9.88%. The prevalence for male was 13.68% while in female it was 6.46%. The prevalence was higher in males than in females (chi2 = 27.48, P< 0.001) and higher with the increase of age (chi2 = 79.22, P<0.001). Factors associated with COPD were identified in one-way variance model as follows: sex, age, smoking, time for cooking, using biomass fuels for in-door cooking, family history, frequent cough before age 14, low body index and having house remodelling in the last five years. Results from multivariate logistic regression analysis showed that sex (OR= 1.3010), age (OR = 1.8506), smoking (OR= 3.0118), cooking time (OR= 1.7651), family history (OR = 1.5278), frequent cough before age 14 (OR = 2.8965) were risk factors.

CONCLUSIONThe prevalence of COPD in the southern part of Hubei province was high, suggesting that comprehensive intervention measures should be taken.

Adult ; Age Factors ; Aged ; China ; epidemiology ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Multivariate Analysis ; Population Surveillance ; Prevalence ; Pulmonary Disease, Chronic Obstructive ; epidemiology ; Risk Factors ; Rural Health ; statistics & numerical data ; Rural Population ; Surveys and Questionnaires

Objective　To explore the risk factors and indications for perioperative tracheostomy in patients with myasthenia gravis. Methods　A total of 174 patients with myasthenia gravis undergoing thymectomy were reviewed retrospectively between April 1980 and August 1999. Perioperative tracheostomy was performed on 44(25.3%) cases. Myasthenic or cholinergic crisis happened in 38 cases (21.8%). The relationship of the crisis incidence and Osserman classification, state of illness, present of thymoma, preoperative pulmoary function and the dose of anticholinergic agents given preoperatively were analyzed. At the same time the indications of perioperative tracheostomy were discussed. Results　The highest incidence of myasthenic or cholinergic crisis and perioperative tracheostomy were found in cases with long history of the disease, high dose of anticholinergic agents administration, Osserman classification over stageⅡb, with infiltrated thymoma, and preoperative pulmoary function impairment. Conclusion Perioperative tracheostomy and artificial ventilation are most important approaches when myasthenic or cholinergic crisis after thymectomy appeared. But the indications for postoperative prophylactic tracheostomy and artificial ventilation must be strictly selected.

Objective　To explore the effect of video-assi sted thoracic surgery (VATS) on common diseases of chest. Methods　Video-assisted thoracoscopic surgery was performed on 131 patients with ches t diseases from April 1994 to December 2000 in which 109 cases were spontane ous pneumothorax and hemothorax, 10 pulmonary tuberculoma, 5 pulmonary carcinoma , 3 esophageal carcinoma, 2 localized benign mesothelioma, 1 pulmonary hamartoma and 1 myasthenia gravis. Results　There was no operative death in all cases. Four patients with spontaneous pneumothorax complicated persist ent air leak(more than 7 d) and 1 patient with hemopneumothorax formed hemoth orax after the operation, which was stopped by the second VATS. The others recov ered well without any postoperative complications. Conclusion　 VATS is characterized by safety and mild tissue injury in the operation, and les s pain, fewer complications, rapid recovery and short duration of hospitalizatio n after the operation.

OBJECTIVE: To observe the effect of sevoflurane on the induction and maintenance of anaesthesia in children, and to evaluate its safety and effectiveness. METHODS: Forty child patients who conformed to the selection standard were operated under anaesthesia with intubation.Without premedicant, all the patients inhaled 100% oxygen(1L/min) and sevoflurane by mask, and escalated the concentration of sevoflurane (to the maximum concentration 7%) until the lash reflex disappeared, and the maintenance concentration was controlled under 4%. All the patients were intubated, together with vecuronium 0.1mg/kg. RESULTS: With little tract excretion, the achievement ratio of induction by sevoflurane was 100%, and the children tolerated well. With stable hemodynajmics,1% approximately 4.0% maintenance concentration of sevoflurane during the operation showed effective anaesthesia, no decreased heart rate or blood pressure appeared, and all the patients' body temperature was normal. CONCLUSION Sevoflurane for children induction can bring fewer stimuli in the respiratory tract,less cardiac vascular inhibition and palinesthesia time. Anaesthesia in children induced by sevoflurane is safe and effective.
Anesthesia ; methods ; Anesthesia, Inhalation ; Anesthetics, Inhalation ; administration & dosage ; Child ; Child, Preschool ; Female ; Humans ; Male ; Methyl Ethers ; administration & dosage ; Sevoflurane ; Treatment Outcome

To study relevant risk factors of Shenmai injection induced adverse reactions by using Logistic model and ROC curve, and made the prediction for the occurrence of relevant adverse reactions/events. Case data of patients treated with Shenmai injection were collected by using the prospective, multi-center, large-sample, nested-case control method, in order to analyze the risk factors of Shenmai injection-induced adverse reactions/events, establish the logistic model and draw the receiver operating characteristic (ROC) curve for risk factors. During the study, 7632 patients (including 3 477 males and 4 155 females) were included, and eight of them suffered adverse reactions/events. Based on a multi-factor Logistic model analysis, the age (> or = 50 years) (OR = 5.061, 95% CI: 2.197-7.924; P = 0.001), the total number of medication days (OR = -1.020, 95% CI: -l.652 - 0.388; P = 0.002) and the single dose (OR = 0.245, 95% CI: 0.127-0.364; P = 0.000) were significant independent risk factors for Shenmai injection-induced adverse reactions/events. According to the results, ROC curves were drawn with age (> or = 50 years), the total number of days of inedication and single dose; The area under ROC curves the joint predictor (0.9753, 95% CI: 0.9443-1.000, P < 0.005) was larger than that of the other three single indexes, with a higher risk prediction value. The independent risk factors for Shenmai injection-induced adverse reactions/events included the age (> or = 50 years), the total number of days of medication and single dose. In clinical practice, the age (> or = 50 years), the total number of days of medication and the medication dose can be substituted in the joint predictor calculation formula (P = 1 / [1 + e(-(-21.58 + 5.061 x Xage - 1.020 x Xd + 0.245 x X(mL)] to predict the potential adverse reactions of patients and adjust the dosage regimen.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; China ; epidemiology ; Drug-Related Side Effects and Adverse Reactions ; epidemiology ; etiology ; Drugs, Chinese Herbal ; administration & dosage ; adverse effects ; Female ; Humans ; Infant ; Logistic Models ; Male ; Middle Aged ; Prospective Studies ; ROC Curve ; Risk Factors ; Young Adult

OBJECTIVETo observe the experience and the outcome of pharyngo-colonic anastomosis for esophageal reconstruction in diffuse corrosive esophageal stricture involving hypopharynx.

METHODSThis retrospective report reviews the experience and results of 14 patients who underwent esophageal reconstruction by pharyngo-colonic anastomosis without resection of intra thoracic stricture esophagus. The left half colonic segment was pulled up to the neck through the substernal space in all patients.

RESULTSThere was no operative or hospital death. Postoperative complications include cervical anastomotic fistula in four patients, rupture of the abdominal incision in 1. The length of follow-up ranged from half year to 10 years with an average of 4 years. Anastomotic stenosis occurred in 2 patients. One case improved after dilatation and the other one healed by plastic operation. One patient began to vomit after diet in seven months later with barium swallowing the abdominal colon graft was redundant and this patient was cured with side by side between the colon and the stomach.

CONCLUSIONThe successful reconstruction for hypo-pharyngo-esophageal stricture requires a correct and larger hypopharyngeal opening and a good anastomotic technique. From our experience this procedure is shown to be safe and effective.

Adolescent ; Adult ; Anastomosis, Surgical ; Burns ; complications ; Child ; Child, Preschool ; Colon ; surgery ; Esophageal Stenosis ; etiology ; surgery ; Esophagoplasty ; methods ; Female ; Humans ; Male ; Pharynx ; surgery ; Retrospective Studies