Objective To study the therapeutic effect, side-effect and safety of uterine artery embolization of hysteromyoma with pinyangmycin and lipiodol emulsion. Methods Embolization carried out selectively through uterine artery with pinyangmycin and lipiodol emulsion of 158 hysteromyoma was followed up for 3-18 months with observation of the size of hysteromyoma, the change of corpus uteri and the degree of reactions. Results All cases were embolized successfully including 150 cases of bilateral and 8 cases of unilateral uterine arterial embolization. The appearance of uterine arteries showed obvious arterial enlargement with spiral hypervasculature, tumor staining and prolonged opacification. Six patients underwent hysteroectomy 1 week after the embolization. The specimens demonstrated flaky necrosis with small bloody specks under pathologic examination. The alleviation rate of symptoms were 90.5% with recovery of normal menstrual cycle as 89.4%. The compressive symptoms of hypogastric pain and abdominal distention disasppeared in 91.3%. The reduction in size of hysteromyoma and corpus utei were 80% and 48% on average respectively. Conclusion The primary results demonstrates that uterine artery embolization of hysteromyoma is safe and effective, with low complication rate and more advantage over surgical approach.

Objective To investigate the effects of percutaneous coronary intervention(PCI) and conventional drugs on autonomic nervous system and C-reactive protein (CRP)in the patients with unstable angina pectoris combined by QRS complex fragment. Methods A total of 60 patients aged (46.2± 10.3) years with unstable angina combined by QRS complex fragment were randomly divided into drug therapy group and PCI group (n=30 for each group).The changes of heart rate variability (HRV) including SDNN,SDANN,rMSSD,PNN50,HF and LF,heart rate turbulence(HRT) such as TO and TS,and CRP were measured before and 1 month after treatment. Results The values of SDNN[(88.2±20.6)ms vs.(122.5 ± 15.5)ms; (86.9± 23.4)ms vs.( 106.7± 18.8)ms],SDANN [(76.2±9.3)ms vs.(105.3±5.2)ms; (74.3±10.4)ms vs.(89.8±7.6)ms],rMSSD[(18.6±7.9)ms vs.(49.3± 4.3)ms; (19.3± 7.4)ms vs.(29.4± 5.2)ms],PNN50 [(5.5± 2.8)％ vs.(9.1 ±1.8)％; (5.3±2.1)％ vs.(7.2±3.2)％],HF[(219.4±131.6) Hz vs.(292.5±125.5) Hz;(217.2±133.2) Hz vs.(213.2±120.2 ) Hz] and LF[(459.6±135.2) Hz vs.(345.1±175.1) Hz ;(445.8± 144.3) Hz vs.(396.1 ± 182.3) Hz] were improved after treatment as compared with pretreatment in PCI group (t=9.4,15.69,8.37,4.68,3.26,3.57,P＜0.01 or 0.05) and in drug therapy group (t=7.3,12.36,6.98,2.94,4.89,5.01,P＜0.01 or 0.05),respectively.The changes of above indexes were more remarkable in PCI group than in drug therapy group(t=8.90,13.75,7.52,3.27,4.21,4.01,P＜0.01 or 0.05).The values of turbulence onset(TO) [(0.45±0.44)％ vs.(0.16±0.20)％,t=15.63,P＜0.01; (0.49±0.38)％ vs.(0.32±0.26)％,t=16.78,P=0.001] and turbulence slope (TS) [(2.12±0.13)ms/RR vs.(2.98±0.25)ms/RR,t=14.36,P=0.001; (2.15±0.19)ms/RR vs.(2.51±0.11)ms/RR,t=19.52,P=0.001] and CRP [(5.74±2.46)mg/L vs.(2.61±1.22)mg/L,t=12.49,P=0.001; (5.81±2.35)mg/Lvs.(3.56±1.43)mg/L,t=9.76,P=0.01] were also improved after treatment as compared with before treatment in PCI and drug therapy groups,respectively,and the the changes in TO (t=15.95,P＜0.001),TS (t=18.13,P=0.001) and CRP(t=10.73,P=0.001) were more obvious in PCI group than in medicine group. Conclusions PCI may obviously reduce inflammatory response,provide more myocardial blood supply and improve autonomic nervous function in the patients with unstable angina pectoris combined by QRS complex fragment.

Aim To study clinical efficacy of valsartan,in comparison with amlodipine, in hypertentive patients with left ventricular hypertrophy. Methods 65 hypertentive patients with left ventricular hypertrophy is divided into two groups, with 33 cases in valsartan group and 32 cases in amlodipine group Valsartan 80～160mg and amlodipine 5～ 10 mg were taken by the patients in the two groups for 6 months respectively. 24 h ambulatory blood pressure monitoring ( 24 h ABPM) and color echocardiography were performed in the two groups before and after treatment. Results The parameters of 24 h ABPM ( 24 h SBP? 24 h DBP?dSBP?dDBP?nSBP?nDBP) and color echocardiography (IVST?PWT?LVMI)after treatment in the two groups were significant decreased compared with those before treatment respectively (P0.05). Conclusion Valsartan can lower significantly the blood pressure level and make left ventricular hypertrophy remarkably dispelled in hypertensive patients with left ventricular hypertrophy and has the effect similar to that of amlodipine.

Objective To study the changes in serum adiponectin level in children with severe sepsis,and to explore its clinical significance.Methods A prospective study was conducted,and 39 cases of critically ill children with severe sepsis and 47 cases of sepsis were enrolled into the Pediatric Intensive Care Unit(PICU),Children's Hospital of Nanjing Medical University from July 2012 to July 2014.Thirty cases of critically ill children without sepsis were enrolled as a control group.The plasma adiponectin,procalcitonin(PCT),and C-reactive protein(CRP)were determined with enzyme linked immunosorbent assay(ELISA)within 24 hours after PICU admission.The pediatric critical illness score(PCIS)was recorded.Results Among severe sepsis group,sepsis group and control group,there was no statistical significance in body temperature,heart rate,body mass index,PCIS,white blood cell count,platelet count,bilirubin,creatinine,pH value and activated partial thromboplastin time(APTT)(all P>0.05).Plasma adiponectin in the severe sepsis group[(0.102±0.041)mg/L] significantly decreased compared with that in the sepsis group[(0.125±0.046)mg/L] and the control group[(0.147±0.047)mg/L](F=8.456,P=0.000).The level of CRP in the severe sepsis group[(60.68±59.43)mg/L] significantly increased compared with that in the sepsis group[(52.76±26.67)mg/L] and the control group[(33.89±6.87)mg/L](F=17.416,P=0.000).There was a statistical significance in PCT level in the severe sepsis group,the sepsis group and the control group(x2=27.269,P=0.000).Further comparison showed that there was a significant difference in PCT level between the severe sepsis group and the sepsis group(Z=-4.679,P=0.000),which was also statistically significant between the severe sepsis group and the control group(Z=-4.244,P=0.000);there was no significant difference between the sepsis group and the control group(Z=-0.340,P=0.733).Negative correlation was found between plasma adiponectin and CRP(r=-0.219,P=0.042),PCT(r=-0.303,P=0.005).The correlation between plasma adiponectin and PCIS was positively correlated(r=0.332,P=0.002).Conclusions Plasma adiponectin decreased in severe sepsis children and was significantly associated with the severity of the disease.Detection of plasma adiponectin levels in children with sepsis has an important clinical significance in evaluating the severity of sepsis.Plasma adiponectin is negatively correlated with CRP and PCT,and plays a role in diagnosis of infection.

BACKGROUND: Fracture healing occurrs by two ways: healing by first intention and healing by second intention, with the latter one similar to natural healing process. It has been proved that only 37% tibial farcture can reach healing by first intention, even it is fixed with strong AO steel plate. Different materials for intramedullary fixation have different influences on callus formation and callus content in the process of fracture healing.OBJECTIVE: To explore the influences of different internal fixations on callus formation and content in the course of fracture healing analysis with X ray computer image.DESIGN: Randomized controlled trialSETTING: At the Department of Orthopeadics of Changhai Hospital Affiliated to the Second Millitary Medical University of Chinese PLA and the Experimental Animal Center of the Second Millitary Medical University of Chinese PLA.MATERIALS: This study was carried out at the Experimental Animal Center and Orthopeadic Laboratory of the Second Millitary Medical University of Chinese PLA between March 2000 and July 2001. Totally 51New Zealand rabbits were randomly selected without gender limitation and divided, accccording to intermeduallry nails, into three groups with 17 rabbits in each group: rectangle-shaped intramedullary nails (RIN), Ender's nails (END) and stainless steel plates (SPL) groupsMETHODS: Fracture models were succccesufly established on rabbits.And then intramedullary nails were fixed 2 mm below the border of left tibial and fibula without exopexy. Positve and lateral X-ray films of each operational tibia were obtained at postoperational 2,3,4,8,12 weeks.Three rabbits in each group were killed for callus observation with naked eyes, and the maximal callus diameter at different time points was measured. The X-ray films at different periods were read carefully and quanatatively analyzed with computor image analysis system (lAS). The difference was compared with the analysis of variance and SNK test.MAIN OUTCOME MEASURES: The maximal callus diameter was determined with X-ray image at different time points so as to calculate the corrssponding integral of callus grey level.RESULTS: Totally 51 rabbits were enrolled in this study, 6 missed the experiment because 4 died for diarrhea and other two has exposed bone due to local infection, and then two rabbits were derived from each group; thereby, data of 45 rabbits were subjecte to the final statistical to the epak at postoperational 8 weeks; it was the longest in RIN group of the same stage,followed by Ender group and SPL group [(11.24±0.38), (10.86±0.65), (8.12±0.36) mm at postoperatively 4 weeks; ( 13.56±0.88 ), (12.84±0.20), (10.52±0.68) mm at postoperatively 8 weeks; ( 12.66±0.65 ), ( 11.84±0.55 ), (9.68±0.27) mm at postoperatively 12 weeks]. The difference between RIN, Ender and SPL was statistically significant, but the difference between the former two was unobvigroup; at the same postoperational time point, the intergral of callus grey level was the highest in RIN group, followed by Ender group and SPL group (89.11 ± 1.05,86.42±3.12,47.28 ± 1.57 at postoperatively 4weeks;159.69 ±3.64,148.72 ±1.68,79.63 ±2.41 at postoperatively 8 weeks;192.46 ±4.96,186.53 ±1.84,107.34 ±2.37 at postoperatively 12 weeks),The difference between RIN, Ender and SPL was obvious and moreover,the difference between RIN and Ender was significant at 8th week.CONCLUSION: The callus content in RIN and Ender group were higher than that in SPL group at each postoperational time point, which benefited for fracture healing. Callus content examination is a traditional means for the judgement of fracture healing. It prossesses that properties of intuition and persicuity, reliability, simplicity and practicibility. Moreover, subjectivity could be avioided if used in combination with X-ray image analysis system, since the digital management can help judging not only callus content but also callus quality, which may provide guidance for clinical treatment.

We developed and designed a new type of artificial trachea. The basic structure of the artificial trachea was polytetrafluoroethylene vascular prosthesis linked with titanium rings on both sides. Dualmesh was sutured on titanium rings. This experimentation follows the replacement of trachea in dogs with a combined artificial trachea to investigate the feasibility of this type of prosthesis. Sixteen dogs were implanted with the combined artificial trachea after resection of 5 cm of cervical trachea. The 5 cm-long trachea of dogs on the necks were resected and the reconstruction of the defect of the trachea was performed with trachea prosthesis. According to the method of trachea reconstruction, the models were divided into 2 groups, artificial trachea implantation group (the control group, n = 8) and group of artificial trachea implantation with growth factor (the experimental group, n = 8). Then computer tomography scan (CT), bronchoscope and pathologic examination were conducted periodically to observe the healing state of the hybrid artificial trachea. None of the dogs died during operation of cervical segmental trachea construction. But four dogs in the control group died of apnea in succession because artificial trachea was displaced and the lumen was obstructed, while 2 dogs died in the experimental group. In the first month there was granulation around anastomosis with slight stenosis. The rest of dogs were well alive until they were sacrificed 14 months later. The mean survival time of the experimental group was longer than that of the control group. The rate of infection, anastomotic dehiscence, severe stenosis and accidental death in the experimental group were lower than the control group (P < 0.05). Artificial trachea was encapsulated by fibrous tissue and no mucous membrane was seen in the lumen of the artificial trachea. The artificial trachea can be used to reconstruction of the defect of the trachea with long-term survival of the animals. The unique design of artificial trachea reduces stenosis around anastomosis effectively but infections and split or displacement of the artificial trachea are still major problems affecting long-term survival of the animals. Application of growth factors to a certain extent promotes tissue healing by changing the local environment.
Animals ; Artificial Organs ; Dogs ; Prostheses and Implants ; Prosthesis Design ; Prosthesis Implantation ; Reconstructive Surgical Procedures ; Titanium ; Trachea ; surgery

Olfactory neuroblastoma is a rare malignant tumor. Although multiple therapeutic modalities including surgery, radio-therapy, or chemotherapy could be used in patients with olfactory neuroblastoma, no standardized treatment has been achieved. This re-view introduces a case of adult olfactory neuroblastoma treated by a multiple disciplinary team in Tianjin Medical University Cancer In-stitute and Hospital. This review also aims to explore a complete set of diagnostic and treatment practices for the benefit of future pa-tients.

Objective To explore the spiral computed tomography (CT) imaging feature of post-intubation tracheal stenosis (PITS) and to discuss its clinical significance. Methods The clinical data and CT imaging findings of 27 patients with PITS were retrospectively analyzed. The location, degree and shape of PITS were analyzed, and the imaging features were summarized. Based on the imaging features the etiology of PITS was suggested, and the role of imaging feature in assessing PITS condition and in planning clinical management was evaluated. Results A total of 35 tracheal strictures were detected in the 27 patients. The location of the strictures included trachea incision site (n=10), balloon level (n=5) and distal end of tube (n = 20). In all patients the degree of stenosis was > 30%. Localized stenosis was seen in 15 cases, which presented as “hourglass”or “girdle”shape. Segmental stenosis was found in 4 cases, which was characterized by a “ribbon” or “dumbbell” stricture on CT scans. Complex stenosis was found in 8 cases. With the help of imaging findings, all patients got timely, proper and individualized treatment. Conclusion PITS has typical imaging characteristics. Spiral CT scanning should be regarded as the imaging examination of first choice. Based on the different imaging characteristics, the relevant departments can evaluate patient’s condition and make individualized treatment plan. The imaging finding is very helpful for anesthesiologists and other clinicians in recognizing and in managing the post-intubation tracheal stenosis.

Objective To evaluate the therapeutic results of comprehensive interventional therapy for antiphospholipid syndrome (APS) complicated by deep vein thrombosis (DVT). Methods A total of 10 patients with APS complicated by DVT, who were encountered at authors’ hospital during the period from January 2001 to October 2013, were enrolled in this study. The patients included 3 males and 7 females with a mean age of 45 years (39-74 years). The patients were divided into pure anticoagulantion therapy (group A, n = 4) and catheter-based thrombolysis via the jugular vein combined with anticoagulantion therapy (group B, n = 6). The clinical data were retrospectively analyzed. After the treatment warfarin was orally administered in all patients for at least one year. Results There were no significant differences in general clinical characteristics between the two groups. Before the treatment, the circumference difference of the thighs was (5.55 ± 0.51) cm in group A and was (5.13 ± 0.45) cm in group B. After the treatment, the circumference difference of the thighs was (1.85 ± 0.31) cm in group A and was (0.95 ± 0.26) cm in group B. In both groups, the postoperative calf size was significantly reduced when compared with the preoperative one (both P < 0.01), which was more obvious in group B than in group A (P < 0.05). The detumescence rate in group B was significantly higher than that in group A, which was (81.7 ± 4.1)% vs (67.3 ± 3.6)%(P <0.01). The average hospitalization days of group B and group A were (13.83 ± 0.75) days and (20.75 ± 2.63) days respectively, and the difference was statistically significant (P < 0.05). In group A, clinical effective result was obtained in three patients and ineffective result in one patient, while in group B clinical cure was obtained in all patients. Conclusion In treating APS complicated by DVT, catheter-based thrombolysis via the jugular vein combined with anticoagulantion therapy is safe, effective and time-saving, while pure anticoagulation therapy has only limited efficacy.

Objective To investigate the feasibility,safety and efficiency of the establishment of model for Budd-Chiari syndrome with hepatic vein obstruction through endovascular technology in canine.Methods Twenty four dogs were randomly divided into experimental group (n=18) and control group (n=6).Under the surveillance of digital subtraction angiography,the balloon catheter was sent to the target hepatic vein via right external jugular vein,and then the balloon was filled by contrast agent until the target hepatic vein was blocked completely.In the experimental group,3～5 ml the mixture of N butyl-cyanoacrylate and lipiodol was infused into the target hepatic vein through the end hole of the balloon catheter until the hepatic vein flow stasis was achieved.In the control group,equal volume of normal saline was injected.The changes of liver function,portal vein pressure were measured and pathological varieties of target hepatic vein as well as the liver parenchyma were observed in the different periods in the two groups.Results The successful rate of the technique was 100 percent.There were no serious complications such as pulmonary embolism and death in the two groups.In the experimental group,the serum levels of alanine transpeptidase were (52.5 ± 12.5)U/L,(61.3±5.7)U/L,(38.6±9.4)U/L,which were higher than those in control group(P＜0.05) and prealbuminwere (0.18±0.04)g/L,(0.22±0.02)g/L,(0.19±0.06)g/L,which were lower than those in control group(P＜0.05) in the fourth,sixth and eighth weeks after the procedure,respectively.A common trunk formed by the middle and left hepatic veins which was looked as the targetic hepatic vein were completely occluded.the color of the liver appeared light red,dark red and dull black in the fourth,sixth and eighth weeks after the procedure,respectively.However,the hepatic veins were patented in the control group.In experimental group,histopathological observation revealed hepatic cells congestion and edema while a lot of inflammatory cells were seen in the wall of hepatic vein in the fourth week,the hepatic cells changed with severe edema,adipose kind,inner and middle membranes became thicker in the sixth week,and part of the hepatic cells showed hydropic degeneration,besides,inner and middle membrane became more thicker,there was substantially proliferation in elastic fiber hyperplasia in the eighth week.Conclusion Endovascular technology was a safely and effectively way to establish the canine model of Budd-Chiari syndrome with hepatic vein obstruction.