Objective To investigate the safety,efficacy and effects of emergent percutaneous coronary intervention (PCI) in patients from Second Affiliated Hospital,Medical College,Zhejiang University with cardiogenic shock (CS) complicating acute myocardial infarction (AMI).Method Twenty-seven patients with CS complicating with AMI were treated by PCI with intraaortic balloon counterpulsation (IABP) support.The change of hemodynamics before and after IABP and PCI,the characteristics of PCI,the mortality during hospitalization, the major adverse cardiac events (MACE) and left ventricular ejection fraction at 30-day follow-up were observed.Results The hemodynamics were significantly improved after IABP.No patients died during PCI.Two patients died after PCI and the total mortality was 7.4% in hospital.During the period of 30-day follow-up, one patient died of heart failure.The left ventricular ejection fraction greatly improved at 30 days after PCI. Conclusions The data suggested that the use of IABP during PCI in patients with CS complicating AMI was safe, decreased mortality and improved prognosis.

Adult ; Humans ; Lumbar Vertebrae ; injuries ; Male ; Spinal Fractures ; surgery ; Surgical Wound Infection ; therapy

Objective To discuss the diagnosis and inductive chemoradiotherapy of stage Ⅲ and stage Ⅳa invasive thymoma.Methods Clinical data of 13 cases with incomplete resected invasive thymoma were analyzed retrospectively,among which 8 cases were in stage Ⅲ and 5 cases in stage Ⅳa.All the 13 cases had invasion of major vessels,pericardial and lung tissues,or had metastasis of pleura and pericardium.Each patient got pathological diagnosis by fine needle aspiration,video-assisted thoracoscopic biopsy or anterior mediastinal biopsy.After 3 cycles of NP or CAP inductive chemotherapy and synchronous radiotherapy,tumors shrank and got palliative or complete surgical resection.The Follow up ranged from 2.8 to 9 years.Results All the 13 cases were malignant thymoma,including 4 cases of type B2,6 cases of type B3 and 5 cases of type C.7 patients got radical resection and 2 got palliative resection.9 patients survived more than 3 years after operation,7 patients survived more than 5 years,one patient even lived 8 years,and the other 4 patients without getting surgery died in 4 years.Conclusion Inductive chemoradiotherapy could shrink stage Ⅲ and stage Ⅳa invasive thymoma,reduce clinical stage,improve the resection rate,and prolong survival.

CCAAT-Enhancer-Binding Proteins ; genetics ; Cytogenetic Analysis ; Cytogenetics ; methods ; Extremities ; Humans ; Liposarcoma ; etiology ; genetics ; Liposarcoma, Myxoid ; etiology ; genetics ; Molecular Biology ; methods ; Oncogene Proteins, Fusion ; genetics ; RNA-Binding Protein FUS ; genetics ; Retroperitoneal Neoplasms ; etiology ; genetics ; Ring Chromosomes ; Soft Tissue Neoplasms ; etiology ; genetics ; Transcription Factor CHOP ; Translocation, Genetic

Adult ; Cell Separation ; methods ; Endothelial Cells ; cytology ; Humans ; Stem Cells ; cytology

Adolescent ; Adult ; CD57 Antigens ; metabolism ; Diagnosis, Differential ; Female ; Glial Fibrillary Acidic Protein ; metabolism ; Humans ; Male ; Middle Aged ; Neurilemmoma ; metabolism ; pathology ; Pelvic Neoplasms ; metabolism ; pathology ; Peripheral Nervous System Neoplasms ; metabolism ; pathology ; Retroperitoneal Neoplasms ; metabolism ; pathology ; S100 Proteins ; metabolism

Objective To study the correlation between serum bilirubin and restenosis after stent implantation of coronary heart disease (CHD).Methods Two hundred and fourtynine patients with CHD were divided into Instent-restenosis (ISR) of CHD group and non-ISR of CHD group according to their angiography findings.Theirserum bilirubin levels were compared and correlation between serum bilirubin level and ISR of CHD was studied.Results The serum bilirubin level was significantlylower in ISRof CHD group than in non-ISR group (P ＜ 0.05),in TBIL (9.9322 ± 3.8748μmol/L) to (12.08 ±4.6679μmol/L)、DBIL (3.1744 ± 1.60μmol/L) to (3.8949 ± 1.825μmol/L)、IBIL (6.757 ±2.822μmol/L) to (8.174 ± 3.388μmol/L).Conclusions The serum bilirubinlevel is lower in CHD patients with ISR than in CHD patients with non-ISR,which is an indepent risk factor for ISR of CHD.

Objective To investigate the effect of intracoronary application of tirofiban on coronary slow flow patients with acute myocardial infarction during primary percutaneous coronary intervention (PPC1).Method It was a retrospective analysis of 187 patients with acute myocardial infarction treated with PPCI in the emergency department of Beijing Anzhen Hospital enrolled in this study from January,2008 through January,2011.The patients divided into 2 groups in terms of intra-coronary administration of tirofiban (tirofiban group) and intra-coronary use of nitroglycerol (control group).Data were statistically analyzed by using SPSS 13.0 software.Categorical variables were analyzed using x2 test and continuous variables were compared by t test.Results Between two groups,there were no differences in preoperative systolic pressure (P =0.245),the rate of TIMI flow 3 (P =0.568) after PPCI and ST segment resolution (P =0.824),LVEF (P =0.275) and in-hospital mortality (P =0.502).Compared with tirofiban group,the systolic pressure was lower and the rate of using intra-aortic counter-pulsation was higher in control group.Although the incidence of slight bleeding in the control group was lower than that in the tirofiban group,no severe bleeding was observed in both groups.Conclusions The effect of intracoronary use of tirofiban was similar to that of nitroglycerol in terms of improving slow flow of coronary artery.It could safely and effectively reduce the incidence of the coronary slow flow in the patients after PPCI,but it produced a little impact on systolic pressure.It may be a better method of choice for AMI patient with low blood pressure.

Objective To compare the effect of thoracoscopic and laparoscopic surgery with conventional thoracic surgery on esophageal cancer and its influence on pulmonary function. Methods Ninety?four patients with esophageal cancer treated in the Second Affiliated Hospital of Chengdu Medical College from March 2010 to March 2016 were selected and were divided into the control group ( 54 cases) and the study group ( 40 cases) according to operation methods. The control group received traditional thoracotomy. The study group received thoracoscopic and laparoscopic surgery. The operation and pulmonary function indexes were compared. Results The operation time of the patients in the study group was significantly longer than that in the control group ( (218. 1±35. 8) min vs. (192. 3±40. 1) min,t=3. 23,P<0. 05). Intraoperative blood loss of the patients in the study group was significantly less than that in the control group ( (286. 4±83. 5) ml vs. (343. 7 ±96. 7) ml,t=3. 01,P<0. 05) . The number of lymph nodes cleared of the patients was significantly higher in the study group ( (18.0±5.4) node vs. (15.5±4.6) node,t=2.42,P<0.05).Thoracic drainage of the patients in the study group was significantly less than that in the control group ( (650. 3±61. 3) ml vs. (1153. 5 ±133. 7) ml,t=22. 12,P<0. 05). Chest tube pull out time in the study group was significantly earlier than that in the control group ( (5. 1±1. 3) d vs. (8. 0±1. 8) d,t=8. 65,P<0. 05). First exhaust time in the study group was significantly earlier than that in the control group ( (33. 2±6. 7) h vs. (40. 7±7. 3) h,t=5. 10,P<0. 05). Hospital stay in the study group was significantly shorter than that in the control group ( ( 13. 8 ± 2. 8 ) d vs. (18. 2± 3. 6) d, t=6. 42, P<0. 05) . Postoperative complications occurred in 4 cases in the study group, accounting for 10%, significantly lower than that in the control group, 15 cases, 27. 8%, the difference was statistically significant (χ2=4. 50,P<0. 05) . VC,FEV1 and MVV in the study group were significantly higher than those in the control group ( VC:( 81. 5 ± 15. 6 )% vs. ( 42. 3 ± 8. 1 )%;FEV1: ( 85. 7 ± 9. 1 )% vs. ( 43. 6 ±6. 8)%;MVV:(76. 0±8. 9)% vs. (48. 3±7. 6)%,t=15. 83,25. 68,16. 24,P<0. 05). 3?year survival rate of the study group and the control group were 45. 0% (18/40) and 44. 4% (24/54),respectively. There was no significant difference between the two groups (χ2 = 0. 01, P> 0. 05 ) . Conclusion Thoracoscopic and laparoscopic surgery for esophageal cancer has the advantages of small trauma,rapid recovery and low incidence of complications and obvious protective effect on pulmonary function. It is safe and feasible.

Objective To investigate the changes of interleukin(IL)-2 and interferon(IFN)-γin serum and synovial fluid of patients with joint injure with Kashin-Beck disease(KBD), and study the roles of IL-2 and IFN-γ in KBD joint injure. Methods In accordance with the "Diagnostic Criteria of Kashin-Beck disease"(GB16003-1995),48 cases of KBD patients and 26 healthy people(control group) from KBD endemic area in Long county Shaanxi province were enrolled in the study. KBD patient were 24 males and 24 females, respectively, aged 40 to 65 years (mean age 51 years). Forty-eight serum specimens and 28 synovial fluid specimens of patients(14 males and 14 females,respectively) were collected. Healthy control group were 13 males and 13 females, respectively. Twenty-six serum specimens of healthy controls were collected. Serum and synovial fluid IL-2 and IFN-γ levels were determined by enzyme-linked immunosorbent assay(ELISA). Results In healthy controls and KBD patients, the midian of serum IL-2 were 46.8 ng/L and 55.7 ng/L, respectively, and IFN-γ were 52.3 ng/L and 48.8 ng/L, respectively. The difference was not statistically significant between healthy controls and KBD patients(t = 0.62, 0.70, all P ＞ 0.05).In synovial fluid of KBD patient, the midian of IL-2 and IFN-γwere 48.3 ng/L and 44.1 ng/L, respectively. The difference was not statistically significant between serum and synovial fluid in KBD patients(t = 0.69, 1.72, all P ＞0.05). Conclusion Serum and synovial fluid IL-2 and IFN-γare not significantly increased in KBD patients with articular damage, indicating that IL-2 and IFN-γare not involved in KBD joint injury.