Objective To evaluate the effectiveness and safety of interventional embolectomy in the treatment of acute massive pulmonary embolism. Methods Interventional managements, including fragmentation, aspiration and dissolving of the embolus, were performed in 12 patients with CTPA-or pulmonary angiography-proved acute massive pulmonary embolism. Clinical manifestations, blood gas tension, hemodynamic changes, the recanalization of the pulmonary artery as well as the occurrence of complications were observed. Results Eleven patients survived and nine patients showed significant clinical improvement. PaO2 was increased from (54.92 ? 6.17)mmHg before the procedure to (90.91 ? 1.62)mmHg after the procedure (P = 0.001), and SaO2 was also increased from (85.17 ? 8.39)mmHg before the procedure to (95.75 ? 1.96)mmHg after the procedure (P = 0.001). Miller score (21.75 ? 4.35 vs 13.83 ? 5.69, P = 0.001) and mPAP (25.59 ? 7.68 mmHg vs 30.04 ? 7.93 mmHg, P = 0.001)decreased significantly. One patient died of pulmonary embolism and one died of intracerebral bleeding three days after the procedure. Conclusion Interventional embolectomy is an effective and safe technique for the treatment of acute massive pulmonary embolism.

Objective To explore the surgical technique and its promising future of coblation in knee arthroscopic surgery. Methods Twenty cases of different knee problems were treated arthroscopically for partial meniscectomy, cartilage or ligament trimming, synovictomy or lateral retinaculum release with usage of ArthroCare 2000 radiofrequency machine. Arthroscopic diagnosis for these 20 cases were as follows, meniscus tear 6 cases, degenerative cartilage injury on femoral condyle 6 cases, patellar subluxation 5 cases, inflammatory synovitis 2 cases and partial injury of anterior cruciate ligament 1 case. Results The clinic results showed that treatment of injured tissue handled by coblation technique was much precise than that handled by the conventional technique, the former was featured by relative less invasive to the near normal areas and spontaneous coagulation function. No compression wraps were needed to be applied during operation. All patients were comfortable postoperatively with their pain- free and no swelling knees. Conclusion Less pain and easy for early rehabilitation for all ArthroCare 2000 treated cases imply that coblation technique could greatly enhance the clinic results of arthroscopic surgery for knee diseases.

Objective To explore the cytological mechanism of bi ological reaction of prosthetic loosening mediated by wear particles from joint prosthesis. Methods Three special particles of UHMWPE, Ti- 6Al-4V and Co-Cr-Mo with the same average size of 2.5 ?m were injected respe ctively into rabbit knee joint to induce synovitis, in which the changes of syno vial cells and its cytoplasm as well as ultrastructure were observed by transmis sion electron microscopy. Results Three kinds of particles mainly induced type A synovial cell reaction with proliferation of subsynovial h istocytes. Wear particles and lysosomes existed in the cytoplasms of the synovia l cells and histocytes. Co-Cr-Mo particles could also accelerate infiltrating reaction of regional cytoplasms. Conclusions The biological effect of wear particles inducing prosthetic loosening is mainly non-immunolog ic inflammatory reaction. Certain immunologic factors may involve in biological reaction induced by Co-Cr-Mo wear particles.

Objective To explore the way of soft tissue balance in total knee arthroplasty for patient with flexion contracture. Methods A relevant protocol of soft tissue balance was designed and used in 33 TKA cases with knee flexion contracture of at least 20? (from 20? to 60? ). Tight medial collateral ligament or lateral collateral ligament was released firstly, followed by the release of posterior capsule. Osteotomy or a second osteotomy at tibial or femoral side were performed at final step. Results Twenty cases (60.6%) whose flexion deformities could be corrected solely by soft tissue release, the rest 13 (

Diagnostic Errors ; Humans ; Inflammation ; diagnosis ; etiology ; Laryngeal Neoplasms ; surgery ; Male ; Middle Aged ; Papilloma ; surgery ; Pneumonia ; diagnosis ; Postoperative Complications ; diagnosis

Animals ; Arginine ; pharmacology ; therapeutic use ; Female ; Male ; Myocardial Ischemia ; drug therapy ; pathology ; physiopathology ; Myocardial Reperfusion Injury ; drug therapy ; pathology ; physiopathology ; Rabbits

Objective To explore the correlation between personality traits in children and parental rearing patterns.Methods Two hundred and seventy-nine middle school students were investigated with egma minnenav bardndasnauppforstran(EMBU)and Eysenck personality questionnaire,and then Pearson correlation was analyzed.Results High positive correlation were found among scores of parental rearing patterns and those of neuroticism(N)and psychoticism(P).P score correlated significantly with parent's punishment,rejection and negative reaction,over interference and over protection,while high negative correlation with the score of parent's emotional warmth.N correlated significantly with parent's punishment,overprotection and rejection,high positive correlated the score of lie with parent's emotional warmth.Conclusion Parental rearing patterns play very important roles in children's personality development.

Objective To evaluate the value of creatine kinase MB(CK-MB) and cardiac troponin I(cTnI)to earlier diagnosis on myocardial injury in newborn infants with asphyxial.Methods Dynamic variation of serum CK-MB and cTnI levels were measured at birth 1,5 and 10 days,respectively,in 40 asphyxia newborn infants and 20 control neonates.Results Serum CK-MB and cTnI levels of asphyxia neonates were significantly higher than those in control group(P0.05).Conclusion The determination of CK-MB and cTnI levels can help the prediction of myocardial injury after asphyxia.

BACKGROUND: Severe acute pancreatitis (SAP) can result in intestinal mucosal barrier (IMB) dysfunction. This study was undertaken to demonstrate the effect of IGF-I on the intestinal mucosal barrier in rats with SAP and its possible mechanisms. METHODS: Seventy-two male Wistar rats were randomly divided into three groups: a sham operation (SO group,n=24), a SAP group not treated with IGF-I (SAP group,n=24), and a SAP group treated with IGF-I (IGF-I group,n=24). SAP was induced in the rats by injecting 5.0％ sodium taurocholate into the biliary-pancreatic duct. The SO rats were given an infusion of normal saline instead. The rats in the IGF-I group underwent the SAP procedure and were given a subcutaneous injection of IGF-I at 30 minutes before the operation and at 3 hours after the operation. Eight rats in each group were sacrificed at 6, 12 and 24 hours after operation. Apoptosis of mucosal cells in the small intestine was determined by TUNEL. The levels of endotoxin and DAO and serum amylase were also measured. Pathologic changes in the small intestine were monitored. Changes of bax and bcl-2 mRNA expression in the small intestine were determined by reverse transcription polymerase chain reaction (RT-PCR). RESULTS: The levels of serum amylase were lower in the IGF-I group than in the SAP group at all three time points (P<0.05). The levels of endotoxin in the IGF-I group were higher than those in the SAP group at 6 hours, but lower in the IGF-I group than in the SAP group at 12 and 24 hours (P<0.05). The levels of diamine oxidase were higher in the IGF-I group at 6 hours but lower than those in the SAP group at 12 and 24 hours. The pathological score of the small intestine was lower in the IGF-I group than in the SAP group, and the difference was statistically significant at 12 and 24 hours. The pathologic changes observed under electron microscopy were better in the IGF-I group than those in the SAP group. The apoptosis index of intestinal epithelial cells was significantly decreased in the IGF-I group compared with the SAP group. Compared with the SO group, the mRNA expression levels of bax were increased at each time point in the SAP group, and were significantly decreased in the IGF-I group as compared with the SAP group at each time point (P<0.05). The expression levels of bcl-2 were weak and not different between the SO group and the SAP group (P>0.05). They were significantly increased in the IGF-I group versus the SO and SAP groups (P<0.05). The ratio of bax and bcl-2 mRNA expression levels at each time point in the SAP group were significantly higher than those in the SO group, but they were obviously decreased in the IGF-I group. CONCLUSIONS: Exogenous IGF-I seems to protect mucosal cells in the small intestine against SAP-induced apoptosis and could alleviate SAP-induced injury of the intestinal mucosa. The underlying mechanisms include enhanced mRNA expression of bcl-2 and inhibition of bax mRNA expression.

Humans ; Liver Diseases ; Practice Guidelines as Topic ; Prognosis