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

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

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.

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 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.

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 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

Objective To look into the current distribution of iodine deficiency area in Shandong province and to guide the re-defined iodine deficiency area and to supplement iodine scientifically. Methods In 2008, 100 iodine deficiency counties(cities, districts), designated in Shandong province's "to supplement iodized salt to eliminate the hazard of iodine deficiency management regulations", were selected in the study. One to three samples were collected from water source which was used by the majority of local residents in the 100 iodine deficiency places and iodine concentration was tested by As3+-Ce4+ catalyzing spectrophotometry. Results A total of 65 716 water samples were collected. Sample recovery efficiency reached 99.8%(65 572/65 716). The median water iodine was 5.57 μg/L, with 82.05%( 1097/1337 ) of the township(town) met criteria for the classification of iodine deficiency areas(water iodine ＜ 10 μg/L), 17.43%(233/1337) of the township (town) water iodine moderate(water iodine 10 - 150 μg/L), and 0.52%(7/1337)of the township(town) should be defined high iodine areas(water iodine ＞ 150 - 300 μg/L). Conclusions The iodine deficiency areas should be redefined because water iodine concentrations of iodine deficiency areas have changed. We suggest that the smallest place to supply salt with different range of iodine content is set to the township(town).

Objective To explore the influence of vascular endothelial growth factor(VEGF) gene-transfected bone marrow mesenchymal stem cells (MSCs) on pulmonary alveolar structure and microvascular in rats with bronchopulmonary dysplasia.Methods Bone marrow MSCs were isolated from SD rats by way of density gradient centrifugation,purified,and transfected with pcDNA3.1 (-)/VEGF164 and blank plasmid pcDNA3.1 respectively using the liposome mediated method.After placing newborn SD rats in the oxygen box of 950 mL/L for 14 days,they were randomly divided into the transfected group(MSCs/VEGF group),the control group(MSCs group),and the blank group(serumfree medium group),with 10 rats in each group respectively,and they were injected respectively with 1 × 105 MSCs transfected by VEGF,MSCs and the same amount of simple serum-free medium by airway.After transplantation for 1 week and 4 weeks,lung tissue was observed by means of hematoxylin eosin staining to study lung structure and radial alveolar counts(RAC),and VEGF protein expression and angiogenesis densities were evaluated by immunohistochemistry,and finally VEGF164 protein was detected using Western blot.Results After transplantation for 1 week,4 weeks,the RAC,VEGF expression,vascular density by immunohistochemistry in transfected group were significantly more than those in the control group and the blank group(all P ＜0.05).After transplantation for 1 week,4 weeks,the VEGF164 protein level in transfected group was significantly more than that in the control group and the blank group (all P ＜0.05).Conclusions Eukaryotic expression vector pcDNA3.1 (-)/VEGF164 can effectively be expressed in MSCs.Transplantation of vascular endothelial growth factor gene by means of transfected MSCs brings better improvement in pulmonary alveolar structure and microvascular regeneration.VEGF is closely related to lung development in newborn rats.