0.05).The mRNA expression of Cyclin B1 of IMRT group was significantly higher than that of ART group at each dose point(P

Objective To evaluate the value of 64-slice spiral CT angiography based on pre- contrasted raw data in diagnosing pulmonary arteriovenous fistula.Methods 64-slice spiral CT plain scan and enhanced scan was performed in 16 patients with pulmonary arteriovenous fistula,pulmonary angiography based on pre-contrast and post-contrast raw data was performed respectively,including maximum intensity projection(MIP),shaded-surface display(SSD),and volume rendering(VR).According to the results of angiocardiography and surgical findings,comparson of the three methods was made in the display of PAVF in pre-contrast and post-contrast phase images.Results 8 of the 16 PAVF cases were single lesion,8 cases were multi-lesions.30 PAVF lesions were found in all the patients.MIP,SSD and VR based on pre-contrast raw data displayed PAVF lesions in 20,14,and 22,respectively.The combination of the 3 methods based on pre-contrast raw data could show 26 PAVF lesions.MIP,SSD,and VR based on post-contrast raw data displayed PAVF lesions in 24,18,and 30,respectively.The combination of the 3 methods based on post- contrast raw data could show 30 PAVF lesions.Conclusion 64-slice spiral CT angiography based on pre- contrasted raw data can clearly show the position,number,and shape of PAVF lesions,which is of great value in diagnosing PAVF.

Objective To evaluate the clinical efficacy and safety of almagate combined with lansoprazole in the treatment of stress ulcer patients with heavy craniocerebral injury .Methods A total of 60 stress ulcer patients with heavy craniocerebral injury were included in this study and were divided into experiment group ( n=28 ) and control group ( n=32).Patients in two groups all received regular treatment and nutrition such as dehydration and hormone to maintain electrolyte and acid -base balance.The patients in control group were treated with lansoprazole 30 mg+0.9%NaCl 100 mL by intravenous drip.Patients in the experiment group were given lansoprazole and almagate 1.5 mL by nasal feeding , tid.The course of the two groups were 7 days.The data of total efficacy , gastric acid pH and adverse drug reactions were compared between the two groups.Results The total efficacy were 82.1%and 71.8%in the experiment and control group , respectively , which showed no statistical difference ( P >0.05 ) . The pH of gastric acid after treatment was significantly higer than that before treatment ( P <0.05 ) .The pH of gastric acid was significantly different 6 hours after treatment between the two groups ( P<0.05 ) .No obvious adverse drug reaction was observed in the two groups in the period of treatment .Conclusion Almagate combined with lansoprazole is effective and safe in the treatment of stress ulcer patients with heavy craniocerebral injury.

OBJECTIVETo observe the effect of perivenous support with autologous pericardium on neointimal thickening in canine vein grafts.

METHODSAn autologous pericardium graft of 7 cm x 4 cm was harvested in right anterolateral thoracotomy. Two equal segments of the jugular vein were transplanted to both sides of the femoral arteries in 12 dogs, and on one side of the vein graft, perivenous support with autologous pericardium was applied. The vein grafts were harvested 2 and 4 weeks after operation and the thickness and area of the neointima calculated using computerized image analysis system. Scanning electron microscopy and PCNA immunohistochemistry were also performed.

RESULTSThe thickness and area of the neointima were significantly greater in the control grafts than in the grafts with perivenous support (P<0.05), and the proliferation of vascular smooth muscle cells in the supported graft was less active (P<0.05). Electron microscopy showed extensive destruction of the endothelium in the control graft, but only slight damage was found in the graft with perivenous support.

CONCLUSIONPerivenous support of the vein graft with autologous pericardium can reduce intimal and medial hyperplasia in the graft.

Animals ; Dogs ; Femoral Artery ; surgery ; Graft Occlusion, Vascular ; prevention & control ; Hyperplasia ; Immunohistochemistry ; Jugular Veins ; pathology ; surgery ; transplantation ; Male ; Microscopy, Electron, Scanning ; Muscle, Smooth, Vascular ; metabolism ; pathology ; ultrastructure ; Pericardium ; transplantation ; Proliferating Cell Nuclear Antigen ; analysis ; Random Allocation ; Tunica Intima ; metabolism ; pathology ; ultrastructure

OBJECTIVETo introduce the postero- lateral surgical approach to the posterior malleolar fracture and report its clinical outcomes in 32 cases.

METHODSThis study consisted of 32 cases, 22 males and 10 females with the mean age of 48 years (range, 21-63 years), suffering from posterior malleolar fracture. All cases were treated with the posterolateral surgical approach to the ankle. The average follow-up period was 28 months (range, 24-35 months). The clinical outcomes of these cases were evaluated on the basis of the Olerud-Molander Ankle (OMA) score and plain radiographs.

RESULTSAll cases showed radiological evidence of bony union at follow-up. The average OMA score was 82 points; 21 cases had excellent scores (90-100 points), 9 good (61-90 points), and 2 fair (31-60 points). The excellent-to-good rate was 93.8%. Although most cases did not show any wound dehiscence or necrosis, one patient had a superficial infection which healed after using antibiotic dressing and one had sural cutaneous nerve injury that underwent spontaneous remission without any treatment after three months. In addition, one presented with mild symptoms of peroneal tendonitis that disappeared after plate removal.

CONCLUSIONThe posterolateral approach offers an effective technique for fracture reduction and fixation of large posterior malleolar fragments.

Ankle Fractures ; Ankle Joint ; surgery ; Bone Plates ; Fracture Fixation, Internal ; Humans

OBJECTIVETo test the effect of intramyocardial injection of autologous bone marrow mononuclear cells (MNCs) in improving the cardiac function and myocardial revascularization in miniswine models of myocardial infarction.

METHODSThe miniswine models of myocardial infarction established by ligation of the anterior descending coronary artery were divided into 3 groups including a control and two MNC injection groups. Autologous bone marrow MNCs were injected via the epicardium into the infarcted area in the latter two groups at 1 and 2 weeks after the infarction, respectively. The ventricular segmental wall motion was evaluated after the treatment, and the infarcted myocardium observed with immunohistochemistry on frozen sections.

RESULTSThe left ventricular segmental wall motion differed significantly between the control and the MNC injection groups at 1 and 2 months after the treatment. CM-DiI-positive cells were detected in the infarcted myocardium where MNCs were implanted.

CONCLUSIONIntramyocardial injection of autologous bone marrow MNCs improves the infarcted ventricular segmental wall motion, and significantly increases the number of blood vessels in the infracted area. The transplanted cells can be integrated into the vascular walls of the capillaries and arterioles and differentiate into cardiomyocytes.

Animals ; Bone Marrow Cells ; cytology ; Bone Marrow Transplantation ; methods ; Disease Models, Animal ; Leukocytes, Mononuclear ; transplantation ; Myocardial Infarction ; pathology ; surgery ; Swine ; Swine, Miniature ; Transplantation, Autologous

Adult ; Aged ; Female ; Humans ; Male ; Mediastinoscopy ; methods ; Middle Aged ; Stents ; Superior Vena Cava Syndrome ; diagnosis ; therapy

Objective To explore the effect of curculigoside on the behavior and hippocampal neuronal apoptosis of Alzheimer 's rats.Methods Sixty healthy old male SD rats were given intraperitoneal injection of 60 mg ·kg-1 of D-galactose once daily for 6 weeks and hippocampal injection of 4 mmol ·L-1 of β-like starch protein 25-35 (Aβ25-35) on week 7 to induce Alzheimer's disease. Moreover, the rats were divided randomly into 4 groups: Experimental-L/-M/-H group (oral administration of 24, 48, 72 mg·kg-1 of curculigoside during modeling) , model group (oral administration of equal amount of 0. 9％Na Cl during the modeling) . A total of 15 healthy old male SD rats were set as control group and given oral administration of equal amount of0. 9％ NaCl. The learning, memory function of rats in each group were evaluated by Morris water maze, the neuronal apoptosis in hippocampus were measured by hematoxylin eosin (HE) staining and Td T-mediated dUTP nick end labeling (TUNEL) method. Results The crossing platform number of rats in control group, model group and experimental-L/-M/-H groups were (15. 12 ± 1. 78) times, (5. 03 ± 1. 17) times, (7. 45 ± 1. 36) times, (9. 79 ± 1. 21) times and (12. 33 ± 1. 09) times, respectively, and there were statistically significant differences between the model group and the experimental-L/-M/-H group (all P < 0. 05) . The apoptosis ratio of hippocampus neurons were (8. 42 ± 2. 13) ％, (69. 78 ± 9. 97) ％, (38. 14 ± 8. 62) ％, (24. 77 ± 5. 43) ％ and (10. 02 ± 1. 46) ％, respectively. There were statistically significant differences between the model group and the experimental-L/-M/-H group (all P < 0. 01) . Conclusion Curculigoside can alleviate the damage of hippocampal neurons and inhibit the apoptosis of hippocampal neurons.

OBJECTIVETo summarize the experience with surgical treatment of coronary artery disease with severe ischemic mitral valve regurgitation (IMR).

METHODSFrom January 2006 to December 2009, 45 patients (35 males, 10 females aged 32-74 years) with the diagnosis of coronary artery disease complicated by IMR underwent coronary artery bypass grafting (CABG) combined with mitral valve plasty (MVP, 24 cases) or mitral valve replacement (MVR, 21 cases).

RESULTSPerioperative deaths occurred in 2 cases due to multiple organ failure (MOF). Echocardiography showed a significant reduction of the mitral regurgitation area (from 11.80∓2.45 cm(2) to 2.83∓0.98 cm(2), t=22.80, P=0.00) after CABG combined with mitral valve surgery, with also significantly reduced postoperative left ventricular end diastolic diameter (LVEDD) (from 57.61∓10.06 mm to 51.84∓8.98 mm, t=2.85, P=0.005). No significant difference was detected in the left ventricular ejection fraction after the operation [(52.7∓15.4)% vs (53.2∓13.2)%, t=0.16, P=0.87)].

CONCLUSIONSCABG combined with mitral valve surgery can improve early postoperative left ventricular function in patients with ischemic coronary heart disease complicated by severe mitral regurgitation, but further follow-up study is still needed for evaluation of the long-term results.

Adult ; Aged ; Coronary Artery Bypass ; Coronary Disease ; complications ; surgery ; Female ; Humans ; Male ; Middle Aged ; Mitral Valve Insufficiency ; complications ; surgery ; Myocardial Ischemia ; complications ; surgery ; Treatment Outcome

OBJECTIVETo explore early diagnosis, treatment and prevention of gastrointestinal (GI) bleeding after cardiac surgery.

METHODSIn the last 13 years, cases complicated with GI bleeding after cardiac surgeries were analyzed retrospectively.

RESULTSFourty-four GI bleeding occurred post-operatively in (6 +/- 3) d. The mortality was 23% (10/44). Thirty-eight were located in upper GI tract, of them 26 underwent conservative therapy while 4 died of other than GI bleeding cause; six underwent laparotomy while 1 and 3 died of septicemia and multi-organ failure respectively; six underwent gastric endoscopic hemostasis by electrocautery or clipping the bleeding vessel while all survived. Six were located in lower GI tract, and 2 of them underwent laparotomy without finding bleeding section and died of multi-organ failure. By multivariable logistic regression analysis, deaths were highly related to the post-operative ventilator-dependence, acute renal insufficiency, intra-aortic balloon pump (IABP) assisting and laparotomy.

CONCLUSIONThe mortality of GI bleeding after cardiac surgeries is very high, early gastrointestinal endoscopic examination and minimally invasive intervention can treat this complication more effectively. GI bleeding must be prevented whenever complicating post-operative ventilator-dependence, acute renal insufficiency, and IABP assisting after cardiac surgery.

Adult ; Aged ; Cardiac Surgical Procedures ; adverse effects ; Early Diagnosis ; Female ; Gastrointestinal Hemorrhage ; diagnosis ; etiology ; mortality ; therapy ; Humans ; Male ; Middle Aged ; Postoperative Complications ; Retrospective Studies ; Risk Factors