Bacterial Infections ; Humans ; Respiratory Hypersensitivity ; microbiology

rative.

Abstract?AlM:To investigate the choice of different treatments for malignant glaucoma.? METHODS: ln this retrospective case series, 21 malignant glaucoma patients ( 21 eyes ) admitted in Wuhan General Hospital of Guangzhou Military Command from May 2012 to May 2013 were analyzed. Sixteen eyes ( 76%) developed malignant glaucoma after filtration surgery, 3 eyes ( 14%) after EX - PRESS glaucoma filtration device, 2 eyes ( 10%) after glaucoma filtration Ahmed valve implantation. Main Outcome of corrected visual acuity, intraocular pressure ( lOP ) , anterior chamber depth and complications were detected.?RESULTS: lOP recovered by drug control in 13 eyes, anterior chamber depth. Four eyes were treated by vitreous water- bag aspiration combined with anterior chambers reconstructing. Two eyes were treated by cataract extraction and intraocular lens implantation. Two eyes were treated by posterior capsule excision combined with anterior vitrectomy. lOP before and after treatment was 29. 81±4. 98, 12. 71±3. 77mmHg, respectively (P=0. 00). Anterior chamber depth before and after treatment was 0.41± 0. 34, 2. 13 ± 0. 54mm, respectively (P = 0. 00). Corrected visual acuity before treatment was 0. 19 ± 0. 17, after treatment was 0. 20±0. 16 (P= 0. 36). Except for vitreous hemorrhage in 1 eye, there were no ocular or systemic adverse events observed in all patients.? CONCLUSlON: lt is good to diagnose malignant glaucoma in early period, and treated it step by step. For this can reduce lOP and restore anterior chamber.

Objective To compare the mid-term results of video-assisted pulmonary veins isolation and box-lesion for lone atrial fibrillation.Methods Between June 2010 to November 2012,80 lone atrial fibrillation(LAF) patients underwent minimally invasive surgical ablation in Beijing Anzhen Hospital,and all of them received left atrial appendage excision and Marshall ligament break in the surgery.Among them,37 cases were performed two epicardial ablation lines in order to created box-lesion based on PVI(14 paroxysmal AF and 23 persistent AF).Follow-up was finished after discharge.Results Mean follow-up was(18.8 ± 7.4) months,and 2 patients were died with non-cardiac disease.The success rate is 78.8％ (Paroxysmal AF 87.9％;Persistent AF 72.3％).In the paroxysmal AF patients,the success rate for PVI and Box lesion treatment was 84.6％ (11/13) and 92.9％ (13/14),P =0.45;in the persistent AF patients,the success rate for PVI and Box-lesion was 58.3％ (14/24) and 87.5％ (14/16),P =0.04.Conclusion Addition of epicedial ablation lines might increase the cure rate for lone AF therapy,especially for persistent AF.

Objective The cardiac synchronization therapy (CRT) was proven to have good treatment for the cardiac conduction disorders patients with serious heart failure. But many disadvantages were gradually be noticed, such as difficulty of sinus electrode implantation, coronary sinus injury and bleeding, still one third CRT cases remain unchanged cardiac function.Recently the epicardial lead CRT therapy by the cardiac surgeons appears promising to provide better clinic resynchronization.The aim of this research is to explore the clinical value of surgical epicardial lead CRT for the cardiomyopathy heart failure with micro-invasive thoracoscopy techniques. Methods During April 2007 to Sep 2009 eleven patients were diagnosed as advanced heart failure with cardiac dysynchronization proven by the ECG and tissue Doppler echo examination. The dysynchronization parameters of tissue Doppler echo includes left ventricle maximize delay time , the left dysynchronization index (Ts-SD), the inter-ventricle mechanical delay time (IVMD), left ventricle end-dilation diameters (LVEDD) and the left ventricle ejection fraction (LVEF). All the patients got the consent agreement before the surgery. In the hybrid operation room the right atrial and ventricle endocardial electrodes were placed firs guided by X ray under the general anesthesia and double lumnen incubation. Then the thoracoscope techniques were used to explore the left ventricle lateral wall. The right atrial and ventricle electrodes were connected into the three chamber pacemaker. The Tissue Doppler Echo TEE technique was used to check which part of the left ventricle lateral wall is suitable for the idea CRT therapy. Usually the latest activated part of the left ventricle wall is the goal place. Then the epicardial electrode was fixed with 4-0 prolene suture at the idea place. All the cases were performed by the same surgeons group in the same medical center. The resynchronization features were examined after surgery and during the follow up. Results The endocardial and epicardial electrodes were implanted successfully without any serious complication. All patients were weaned and discharged without any adverse cardiac episodes. There is no mortality during the follow up period. All the patients received the β-blokers, diuretics, ACEI/ARB and other traditional medicine for the heart failure.The Tissue Doppler showed the E peak wave separated form the A peak which means the good resynchronization between the atrium and the ventricle. After surgery during the follow up the left ventricle maximize delay time decreased from (393.4 ±40.2 ) ms to ( 102.1 ± 34.6) ms, the left dysynchronization index (Ts-SD) decreased from (145.2±29.3)ms to(51.0±21.4) ms, the inter-ventricle mechanical delay time (IVMD) decreased from (59.1 ±23.4) ms to (31.2 ± 11.5 ) ms, left ventricle end-dilation diameters increased from (73.1 ± 13.4) mm to (63.2 ± 6.7) mn and the left ventricle ejection fraction increased from 0.32 ±0.04 to 0.41 ±0.07. Conclusion The micro-invasive surgical synchronization therapy could get good CRT result for the cardiomyopathy heart failure patients. Some patients traditionally in the waiting list for the heart transplant could be considered for the CRT therapy candidates.

Objective To conclude the preliminary results of aortic valve repair with autopericardium.Methods After routine median sternotomy the pericardium was isolated and immersed into the 0.6% glutaraldehyde immersion for 10 minutes, then rinsed off before use.Conventional extracorporeal circulation was established and diseased aortic valves were removed.The curves lengths between three commissures measured with the specific sizers.The corresponding size of the pericardial patchs was used to cut the new aortic leaflets.The continuous Johnson Prolene 4-0 sutures were used to fixed the new aortic valve leaflets to the anulus.Another new 4-0 prolene suture were used to fix the new three commissures outside the aortic wall with mat.The new mat stripes were used to fix the sinus in condition with the aortic sinus dilation or bileaflets malformation.Results Since 2015 October total 27 patients received aortic valve repair with autologous pericardium.The age was in the range of 27 to 60 years old including 18 female and 9 male.There were 7 cases diagnosed as aortic valve stenosis and 20 cases aortic insufficiency.And there were 3 cases bileaflets aortic valve deformity.The mean bypass time is(104±25)mins.Postoperative esophageal ultrasound showed good coaptation of the aortic valve without significant regurgitation.The mean transvalve gradient was(8.5±3.2)mmHg(1 mmHg=0.133 kPa).In the early stage one case diagnosed with aortic valve stenosis and regurgitation received monocusp repaired with autologous pericardial leave.But there was still moderate aortic regurgitation and had to receive the aortic valve replacement.All patients recovered well and were treated with Aspirin for 6 months.The followed up lasted for 3 to 13 months.Mean aortic occlusion time was(104±25) minutes.The patients were followed up for 3-13 months, the cardiac function and aortic valve function were stable, and no gradient increased.Conclusion It is relatively simple to perform the aortic valve repair with individual autologous pericardial sizer technique and the primary clinic results are satisfactory.It is worthy of further study and long-term follow-up.

Objective To assess the application of echocardiography in mini-invasive surgical device closure of ventricular septal defect (VSD). Methods 73 VSD patients including 35 with aneurysm formation and among them 21 with multi-defects in the aneurysm were treated by mini-invasive device closure. A closure device was positioned to the defect through parastemal mini-incision in all patients. TEE was used to monitor the whole procedure, to guide the device positioning and to evaluate the curative effect instantly after operation. All patients were evaluated by TTE one year postoperatively. Results All patients were successfully positioned closure devices by TEE guiding. 9 cases were found with trace to small amount residual shunt instantly after operation. 7 cases still had small amount residual shunt at the time of 48 hours after the operation. In the one year follow-up, 4 cases had residual shunt, but the size and volume of left ventricle were significantly reduced than those before operation, and the pulmonary artery systolic pressure was also reduced. Conclusion Echocardiography possesses an important role in preoperative indication screening, intraoperation monitoring and evaluating the curative effect postoperatively.

Objective To investigate the expression of Phosphorylated-signal transduction and activators of transcription 3 (P-STAT3) proteins in human prostate tissue from patients received re-peated biopsies. And consider the usefulness of detecting expression of P-STAT3 in early diagnosis of prostate cancer (PCA). Methods Fifty-eight patients (29 cases of PCA, and 29 cases of benign prostatic hyperplasia (BPH)) who had received repeated biopsies were involved in this study. Immu-nolabelling has been carried out on PCa patients' samples of cores from initially negative biopsies, typ-ical cores from cancer field, and other cores of the same batch biopsies showing no sign of prostate cancer. BPH patients' samples of cores from initial biopsies were set as control. All specimens were done immunohistochemistry stain with anti-P-STAT3 monoclonai antibody. The association of P-STAT3 expression in prostate tissues with the pathology result was evaluated. Results Compared with 10.3% in specimens of patients free of prostate cancer, the positive rate of anti-P-STAT3 stained in typical cores from cancer field, other cores of the same batch biopsies showing no sign of prostate cancer, and cores from initially negative biopsies, was 93.1 % (27/29), 82.8 % (24/29) and 86.2 % (25/29), respectively. There were significant differences of these values between former and laters' (X2=60.123,P=0.000). If P-STAT3 positive in tissue of initially biopsies was considered as the di-agnostic standard of prostate cancer, then it would show a relatively high sensitivity (86.2%) and specificity (89.7%). Conclusion IHC stain for P-STAT3 in prostate biopsy samples could be served as an adjunct to the current diagnostic approach to prostate biopsy for early diagnosis of pros-tate cancer.

Objective To investigate the clinical results of extracorporeal membrane oxygenation (ECMO) technique during the peri-operative heart transplantation. Methods The clinical data of heart transplantations supported by the ECMO were retrospectively analyzed, including during the bridge to transplant, working as routine bypass in the operation room, and supporting the heart failure after surgery. Results Three 3 cases were supported with ECMO to extend the waiting time: 2cases died of multi organ failure during the waiting, and the third one received the heart transplant and the ECMO was successfully removed. Totally 12 cases of heart transplantation received the modified open style ECMO techniques replacing the routine bypass. The ECMO was removed after assistance for (38 ± 14) h. All the recipients except one death recovered well without right ventricular failure or obvious tricuspid regurgitation which was common after heart transplantation. Ten cases received ECMO support for the heart failure after the transplant. The initial application time ranged from 2 h to 2 days and lasted 43～176 h. One died of infection and two died of multi organ failure nothing to do with ECMO application and other 7 discharged with NYHA Ⅰ/Ⅱ cardiac function. Conclusion Early use of ECMO could safely bridge the heart failure patients to the transplant. Replacing the routine with ECMO techniques in the heart transplantation could get good myocardial protection results even with long cold ischemic time and improve the cardiac function recovery. For the heart failure patients after the surgery the ECMO could afford good support effect.

Objective To investigate the relationship between the expression level of platelet membrane glycoprotein?3(GPⅢa,CD61)and the severity of disease in patients with hemorrhagic fever with renal syndrome(HFRS).Methods One hundred and four patients with HFRS and 30 healthy individuals were recruited.The percentage of CD61 positive platelets and the mean fluores- cence intensities(MFI)of platelet membrane glycoprotein?3 were determined by flow cytometry (FCM).The 104 patients studied were divided into three groups based on their expression levels of platelet membrane glycoprotein?3 at oligurie phase.Clinical data and laboratory parameters in different groups were compared and analyzed.Results The expression levels of CD61 in patients with HFRS were significantly higher than those in control group,although no significant difference in the percentage of CD61 positive platelets between patients with HFRS and controls was detected.The MFI of CD61 expression in patients with HFRS at fever phase,oliguric phase and polyuric phase was 19.75?2.57,17.46?1.48 and 15.55?0.60,respectively,which was significantly higher than that in control group(3 20?0.12).The expression level of CD61 in patients with HFRS at oliguric phase was negatively correlated with platelet count and serum albumin(r=-0.637 and-0.695,respec- tively)and positively correlated with white blood cell count,blood urea nitrogen,serum creatinine and alanine aminotransferase(r=0.945,0.904,0.956 and 0.891,respectively).When the patients were compared according to the expression levels of CD61,it was indicated that the higher the expression level of CD61,the higher the incidence of uremia,hypoalbuminemia,abnormal liver func- tion and leukocytosis.Conclusions The expression levels of platelet membrane glycoprotein?3 in patients with HFRS are different in different clinical phases and are significantly correlated with the severity of the disease in the patients.It suggests that the expression levels of platelet?3 integrin are dramatically increased in patients with HFRS,which may be an indicator for the severity of disease and be helpful for monitoring the state of the patients' diseases and evaluating the severity of the disease.