Objective: To explore the clinical and echocardiography characteristics between noncompaction of ventricular myocardium (NVM) and dilated cardiomyopathy (DCM) combining hypertrabeculation in order to distinguish NVM from DCM.
Methods: Our research included 2 groups of patients: NVM group,n=31 and DCM combining hypertrabeculation group, n=50. The basic information as gender, age, family history, symptoms, ECG, plasma levels of BNP and echocardiography were recorded and examined in all patients; the size of cardiac chambers, myocardium, endocardium and hemodynamics were particularly focused. The trabeculation was analyzed by 17 segments method.
Results:①Compared with NVM group, the patients in DCM combining hypertrabeculation group had the worse cardiac classiifcation, higher plasma levels of BNP (P<0.05) and more obvious cardiac dilatation.②The patients in NVM group had the most trabeculation segments (9.82 ± 2.02) and the apical (17th segment) was involved, patients had the higher ratio of noncompacton/compaction (NC/C) as (2.84 ± 0.61), there were (4.12 ± 2.68) segments with NC/C > 2.③The patients in DCM combining hypertrabeculation group had the less trabeculation segments (5.56 ± 1.56) and the apical was seldom involved, patients had the lower ration of NC/C as (1.91± 0.42), there was at most 1 segment with NC/C > 2. All P<0.05.
Conclusion: Echocardiography is a simple, practical and noninvasive method to distinguish NVM from DCM. NVM could be diagnosed by obvious left ventricular apex involvement with NC/C >2 in at least 2 segments of free ventricular walls.

OBJECTIVETo compare conventional open chest surgery and robotic surgery for their efficacy, short?term outcomes and patient selection in the treatment of heart tumors. Method The clinical data were collected from 225 patients (a total of 228 operations) who underwent cardiac neoplasm resection in our hospital between January, 1993 and April, 2016. A propensity score matching (PSM) was established according to the vital baseline data of the patients receiving conventional open chest surgery (n=125) and robotic surgery (n=60) after screening. The patients were matched for propensity into 60 pairs, and the efficacy, short?term outcomes and patient selection were compared between the two groups.

RESULTSBefore PSM, the patients in conventional surgery group had significantly greater tumor size (P<0.001) and a higher proportion of patients with New York Heart Association functional class III and IV (P<0.001). The patients' baseline data were nearly balanced (P=0.982) between the two groups after matching. No significant differences were found between the two groups in cardiopulmonary bypass time (P=0.256), crossclamp time (P=0.862), in?hospital mortality (P=1.000), arrhythmia (P=1.000), delayed mechanical ventilation (>24 h; P=0.209), thoracic complications (P=0.611) or systemic embolism (P=1.000). The survival rates were 100% in both groups in the 6?month follow?up after the operation, and no significant difference was found between the two groups in the incidence of major adverse cardiac and cerebrovascular events within 6 months (P=0.438).

CONCLUSIONRobotic heart tumor resection has a favorable efficacy with a good short?term prognosis, and can serve as an alternative for treatment of solitary lesions in low?risk patients receiving operations for the first time.

AIM: To study caspase-9 expression on rat retina in the process of chronic elevation of IOP and the changes with the application of amino guanidine (AG), thus to investigate potential protective function of AG to rat retina with chronic elevation of IOP.METHODS: Immunohistochemistry, RT-PCR and Western blot were used to observe retinal morphology and expression of caspase-9 at different time points of rat with chronic IOP elevation, both affected or not affected by the application of AG.RESULTS: Compared with control group, as time passed retina of experimental group gradually had detectable morphological changes. On 21st day of chronic IOP elevation, retinas became thinner and the quantity of retinal ganglion cells (RGCs) decreased; caspase-9 expression increased, consistent with the morphological changes. The group using AG presented relatively smaller morphology changes and less expression of caspase-9.CONCLUSION: Apoptosis-related gene caspase-9 played a part in the process of chronic IOP elevation; AG protects retina by down-regulating expression of caspase-9.

OBJECTIVETo investigate the clinical outcome and effect of interferon treatment on patients with chronic hepatitis C.

METHODS136 cases of patients with chronic hepatitis C were followed up by methods of retrospective survey combined with prospective study. SPSS16. 0 was used to perform chi-square test and multiple logistic regression.

RESULTS136 cases of patients were infected with HCV virus mainly through blood and blood products transfusion. They were diagnosed mainly between 2000 and 2005. 98 cases of them had anti-viral treatment with interferon and ribavirin, while the rest did not; 12 new cases developed HCV-related cirrhosis or liver carcinoma in five years, which accounted for 8.8% of the total. Among 76 cases once treated with interferon, 46 cases (60.5%) relapsed in five years. For patients with age < 40, the rates of cirrhosis and liver cancer were 0, and patients with age ≥ 40 but < 60 years, the rates of cirrhosis and liver cancer were 12.5% (7/56 cases), while for those ≥ 60 years old the rates were 35.7% (10/28 cases). The difference was significant ( B = 0.111, Wald = 4.324, P = 0.038) as analysed by logistic regression. The rates of cirrhosis and liver cancer were zero for those with normal or within twice the upper normal AST limit in five years, 43.5% (10/23 cases) for those with AST ranging from 2 to 4 fold the upper normal limit, and 58.3% (7/12 cases) for those with AST higher than four times the upper normal limit. The difference was also significant ( B = 2.184, Wald = 5.443, P = 0.02) by logistic regression analysis. The rate of relapse was 29.7% (11/37 cases) for those using pegylated interferon and 89.7% (35/39 cases) for those using interferon. The difference was significant ( Result of logistic regression showed-B = -2.077, Wald = 4.352, P = 0.037). The rate of relapse was 100% (15/15 cases) for those with treatment less than 24 weeks, 76.2% (16/21 cases) for those with treatment more than 24 weeks but less than 48 weeks, and 37.5% (14/40 cases) for those with treatment more than 48 weeks. The difference was significant (Result of logistic regression showed-B = -1.632, Wald = 6.651, P = 0.01). 42 cases of the relapsed (91.3%) were administrated with interferon once again with ideal effect.

CONCLUSIONHepatitis C virus infection increases the risk of liver cirrhosis and liver cancer. Interferon combined with ribavirin therapy could effectively control the virus and improve outcomes. We can reduce the incidence of relapse by choosing the treatment of pegylated interferon instead of interferon and by completing the full treatment.

Adult ; Antiviral Agents ; therapeutic use ; Female ; Follow-Up Studies ; Hepatitis C ; drug therapy ; Humans ; Interferon-alpha ; therapeutic use ; Logistic Models ; Male ; Middle Aged ; Prospective Studies ; Retrospective Studies

OBJECTIVETo investigate the hepatotoxic effects of accidental intravenous diethylene glycol (DEG.) poisoning in patients with liver disease.

METHODSClinical data and liver function results were obtained from 64 patients with liver diseases who had been accidentally treated with diethyl glycol-contaminated agent and 45 cases with hepatorenal failure. The hepatotoxic effects of diethylene glycol DEG on the patients with liver diseases were assessed by multivariable logistical regression analysis.

RESULTSOf the 64 cases with liver diseases, 15 cases (23.4%) developed toxic presentations following the accidental administration of DEG. All affected cases were male. Twelve of the 15 poisoned patients (80%), died within 7 days of exposure to DEG. The most common clinical manifestations included kidney damage, renal failure, metabolic acidosis, and nerve system disturbances. The intravenous administration of DEG resulted in only mild liver function impairment. In terms of risk factors, both gender (r = 4.266, P less than 0.05) and the severity of jaundice prior to DEG administration were related to the occurrence of toxin-induced renal failure (r = 7.640, P less than 0.01).

CONCLUSIONSDEG may worsen liver damage in patients with liver diseases.

Adolescent ; Adult ; Aged ; Chemical and Drug Induced Liver Injury ; etiology ; Child ; Child, Preschool ; Ethylene Glycols ; poisoning ; Female ; Humans ; Liver Diseases ; drug therapy ; physiopathology ; Logistic Models ; Male ; Medication Errors ; Middle Aged ; Young Adult

OBJECTIVETo explore the effect of low doses X-ray on proliferation of hippocampal pyramidal cell in the area of CA1 in prenatal rat and its relevant mechanism.

METHODSA total of 25 pregnant rats were randomly divided into four experimental groups and one control group. The experimental groups, in a duration of consistent 18 days, respectively received different doses as follows: 0.015 mGy/d, 0.03 mGy/d, 0.06 mGy/d and 0.09 mGy/d. The control group received sham radiation. To observe the density and width of hippocampal pyramidal cell in the area of CA1 by HE stained and observe the expression of the ERK1/2 by IHM.

RESULTS(1) Except C group, all other groups presented increment in width of the level of hippocampal pyramidal cell, compared with C group; H group, M group, L1 group and L2 group were higher than that (F value respectively were 8.475, 33.42, 14.395, 44.955; P value respectively were 0.002, 0.048, 0.030, 0.012). But the phenomenon of inhomogeneity in width in H group was observed, at the same time, the density of cell in H group became looser (F = 4.466, P = 0.017). (2) The expression of ERK1/2 in the hippocampus CA1 was seen in cytoplasm of every group, the average optical density of positive ERK1/2 protein significantly increased in L1 group and L2 group, compared with control group respectively (F value respectively were 4.561, 4.103, P value respectively were 0.044, 0.035).

CONCLUSIONLow doses X-ray could promote proliferation of hippocampus CA1 cell in prenatal. The reason could be the increment of the ERK1/2 protein induced by X-ray. When the doses reached 0.09 mGy/d, the excesses proliferation phenomenon was observed.

Animals ; Cell Proliferation ; radiation effects ; Female ; Hippocampus ; cytology ; radiation effects ; Male ; Maternal Exposure ; Neurons ; cytology ; radiation effects ; Pregnancy ; Pyramidal Cells ; cytology ; radiation effects ; Radiation, Ionizing ; Rats ; X-Rays

OBJECTIVETo investigate the therapeutic effect of island flaps pedicled with digital artery for the defects at the end of fingers.

METHODS63 cases with 72 soft tissue defects at the end of fingers were treated with the island flaps. The flap size ranged from 8 mm x 11 mm to 21 mm x 27 mm.

RESULTSAll the flaps survived completely. The follow-up period ranged from 4 to 19 months. The functional and cosmetic results were satisfactory. The two-point discrimination was 7 to approximately 9 mm. The TAM functional examination showed excellent in 59 fingers, good in 11 fingers and common in 2 fingers.

CONCLUSIONSThe technique with island flap is simple and reliable for the defects at the end of fingers.

Adolescent ; Adult ; Aged ; Child ; Female ; Finger Injuries ; surgery ; Fingers ; blood supply ; Humans ; Male ; Middle Aged ; Skin Transplantation ; methods ; Surgical Flaps ; blood supply ; Young Adult

OBJECTIVETo explore the approach and the result in tricuspid valve insufficiency treatment by a cusp remodeling technique.

METHODSNine patients with severe tricuspid regurgitation, congenital lack of chordae in 6 cases and traumatic rupture of chordae in 3 cases, underwent surgical repair between April 1997 and March 2006. There were six male and three female. Their ages ranged from 8 years to 57 years. One or two segments of flail leaflets were presented in these patients. Valve repair was performed by suture of the free edge of the affected cusp segment, plication of the segment of annulus devoid of leaflet, and fixation of the neo-annulus with a flexible annuloplasty ring.

RESULTSAll patients survived and recovered after the operation. Echocardiography showed good coaptation with no regurgitation of the tricuspid valve in six patients and a mild residual tricuspid regurgitation in three. A remarkable decrease in the diameter of the right ventricle (anterior to posterior) was observed: from mean (43.6 +/- 4.2) mm (range 29 mm to 64 mm) preoperatively reducing to mean (24.0 +/- 1.8) mm (range 16 mm to 32 mm) postoperatively. All patients are doing well in 1 month to 109 months follow up.

CONCLUSIONThe procedure provided a simple and valuable option for repair of flail leaflet of tricuspid valve caused by congenital lack of chordae or traumatic rupture of chordae.

Adolescent ; Adult ; Child ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Treatment Outcome ; Tricuspid Valve ; surgery ; Tricuspid Valve Insufficiency ; etiology ; surgery ; Tricuspid Valve Prolapse ; complications ; surgery

OBJECTIVETo investigate the therapeutic effect of free tissue flap anastomosed with reverse descendant branch of lateral femoral circumflex artery for severe soft tissue defect at leg.

METHODSThe severe soft tissue defect at leg, without any vessels for anastomosis of free tissue flap, was reconstructed with free tissue flap, which was anastomosed with proximal end of descendant branch of lateral femoral circumflex artery and great saphenous vein. From Oct. 2004 to Dec. 2009, 36 cases were treated with 15 cases of latissimus dorsi musculocutaneous flaps, 12 cases of anterolateral femoral flaps, and 9 cases of thoracoumbilicus flaps.

RESULTSAll the 36 free flaps survived completely. The patients were followed up for 6 months to 2.5 years with good cosmetic results.

CONCLUSIONSIt is effective and practical to repair the severe soft tissue defects at legs with the reverse descendant branch of lateral femoral circumflex artery to carry the free flaps.

Adult ; Female ; Femoral Artery ; surgery ; Follow-Up Studies ; Free Tissue Flaps ; Humans ; Leg Injuries ; surgery ; Male ; Middle Aged ; Skin Transplantation ; methods ; Soft Tissue Injuries ; surgery ; Thigh ; surgery ; Treatment Outcome ; Young Adult

Objective:To investigate the application of the 7E teaching model (i.e., Elicit, Engage, Explore, Explain, Elaborate, Evaluate, and Extend) combined with standardized patients (SP) in nursing practice teaching for general surgery.Methods:A total of 80 nursing students who were assigned to Department of General Surgery in our hospital were selected and divided into control group and observation group according to the order of admission, with 40 students in each group. The students in the control group received traditional teaching, while those in the observation group received the 7E teaching model combined with SP. Theoretical and practical operation scores were assessed for both groups, and the scores of non-technical skills were compared between the two groups. SPSS 22.0 was used to perform the t-test. Results:Compared with the control group, the observation group had significantly better scores of theoretical assessment (89.36±2.13 vs. 87.64±2.07, P<0.05) and practical operation (92.07±4.33 vs. 85.19±3.46, P<0.05). The observation group had significantly higher scores of non-technical skills (humanistic care ability, ability to stimulate learning interest, communication ability with patients, depth of the understanding of diseases and nursing ability, knowledge extension ability, team collaboration ability, clinical thinking ability, and clinical decision-making ability) than the control group ( P<0.05). Conclusion:The 7E teaching model combined with SP in nursing practice teaching for general surgery can better enhance the theoretical and practical abilities of nursing interns and help to improve the level of non-technical skills.