Objective To investigate the clinical features and pathogenic characteristics of different types of deep sternal wound infection in dif?ferent types after cardiac surgery. Methods A retrospective study was performed. From January 2012 to December 2014,84 patients with sec?ondary DSWI after cardiac surgery underwent the pectoralis major muscle flap transposition in our department were recruited for the study. Re?sults The average age of 84 patients with DSWI was 54.6 ± 14.8 years old,of which typeⅡDSWI patients were the most common(49/84, 58.3%). Both typeⅠand typeⅡDSWI patients showed typical clinical manifestations and early chest X?ray or Computerized tomography(CT) showed mediastinal widening(P<0.01). Some patients with typeⅢDSWI showed only local symptoms of surgery. The organisms most common?ly isolated in patients with DSWI were gram gram?negative bacilli(GNB,54.8%). Although there was no significant difference between the 3 types of DSWI patients(P>0.05),but the pathogenic results of the 3 types of those DSWI patients showed such a trend:typeⅠDSWI patients with GNB is was more common,and typeⅡDSWI patients was more prone to complicated infection. Conclusion Different types of DSWI may dis?play different features,the prevention and treatment of DSWI should be closely combined with the clinical manifestations and local pathogenic char?acteristics.

Objective To analyze the change of the proportions of the hospitalization causes in patients with chronic heart failure(CHF) in a single-central hospital in late 20 years.Methods 1 259 hospitalized cases diagnosed primarily as chronic heart failure were selected from the First Central Hospital of Tianjin during 1983-2002,and divided into two groups with a decade interval.A comparative analysis was performed to explore the proportions of the primary,concomitant and multiple causes of hospitalization for CHF patients between two groups.Results(1) The most common primary causes in general cases was coronary artery disease(CAD,56.6%),rheumatic heart disease(RHD,20.9%) and pulmonary heart disease(PHD,9.2%).During the latter decade,the proportions of CAD and dilated cardiomyopathy(DCM) increased,while RHD,PHD,congenital heart disease(CHD) decreased.(2) The causes of concomitant disease for CHF was essential hypertension(EHT,44.0%),diabetes mellitus(DM,16.4%),chronic obstructive pulmonary disease(COPD,14.3%),cerebral-vascular disease(CVD,11.4%) and anemia(5.2%).All proportions of these concomitant diseases except COPD increased during the latter decade(P

Objective To investigate the survival rate and status of cerebral performance category in patients who received cardiopulmonary resuscitation (CPR) with return of spontaneous circulation (ROSC) (abbreviated by ROSC-CPR) after discharge,and to analyze the risk factors which influencing the prognosis of these patients.Methods A retrospective analysis of the clinic data coming from the patients who received cardiopulmonary resuscitation with return of spontaneous circulation and admitted to the Department of Intensive Care Unit from January 2009 to December 2016 was carried out to find corresponding risk factors influencing the prognosis.Results A total of 185 patients who received ROSC-CPR with 59.5％ male,the average age of (67.15 ± 17.64) years old and the average Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) score (28.80 ± 7.16) were divided into two groups,the survival group (n =56) and the death group (n =129).The total survival rate was 56/185 (30.3％).Compared to the death group,the usage rate of ventilation,blood purification and target temperature management in survival group was no significant (P ＞ 0.05).The most common aetiology of the survival patients was cardiogenic disease,but the number of those patients with the good cerebral performance category (CPC 1/2) discharged from hospital were 16 cases (8.6％).According to logistic analysis,high value of APACHE Ⅱ score,the duration from CPR to ROSC over 10 minutes,admission took place out-of-hospital were unfavorable predictors for the prognosis (P ＜ 0.05),while admission took place in the second four years and cases with cardiogenic aetiology were favorable predictors for the prognosis of these patients who suffered from ROSC-CPR.Conclusions The survival rate of the patients who received CPR with ROSC after discharge was still low,especially the rate of good status of CPC was very low.To shorten the duration from CPR to ROSC as possible as we can,and to strengthen target temperature management would improve the prognosis of the patients who received CPR with ROSC in our hospital in future days.

Professor MA Rou has been engaged in clinical and basic research of hematology for more than 40 years. He is excel in the treatment of refractory hematological diseases under the guidance of holism and syndrome differentiation in Chinese medicine. Application of arsenic-containing Chinese herbal medicine in treating myelodysplastic syndrome (MDS), primary polycythemia vera (CMPD-PV), primary thrombocythemia (CMPD-ET), MDS-U, myeloproliferative disease, acute non lymphocytic leukemia except for promyelocytic leukemia, Prof. MA has made great innovation and exploration. For some diseases, he has obtained much mature experiences. Although some are still in the stage of exploration, ideal clinical effects has been shown primarily.
Arsenic ; therapeutic use ; Drugs, Chinese Herbal ; chemistry ; therapeutic use ; Hematologic Diseases ; drug therapy ; Humans ; Phytotherapy ; methods

OBJECTIVETo analyze and summarize the clinical features and experience in surgical treatment of deep sternal infection (DSWI).

METHODSThis was a retrospective study. From January 2008 to December 2013, 189 patients with secondary DSWI after cardiac surgery underwent the pectoralis major muscle flap transposition in our department. There were 116 male and 73 female patients. The mean age was (54 ± 21) years, the body mass index was (26. 1 ± 1. 3) kg/m2. The incidence of postoperation DSWI were after isolated coronary artery bypass grafting (CABG) in 93 patients, after other heart surgery plus CABG in 13 patients, after valve surgery in 47 patients, after thoracic aortic surgery in 16 patients, after congenital heart disease in 18 patients, and after cardiac injury in 2 patients. Clean patients' wound and extract secretions, clear the infection thoroughly by surgery and select antibiotics based on susceptibility results, and then repair the wound with appropriate muscle flap, place drain tube with negative pressure. Of all the 189 patients, 184 used isolate pectoralis, 1 used isolate rectus, and 4 used pectoralis plus rectus.

RESULTSThe operative wounds of 179 patients were primary healing (94. 7%). Hospital discharge was postponed by 1 week for 7 patients, due to subcutaneous wound infection. Subcutaneous wound infection occurred again in 8 patients 1 week after hospital discharge, and their wounds healed after wound dressing. Nine patients (4. 7%) did not recover, due to residue of the sequestrum and costal chondritis, whom were later cured by undergoing a second treatment of debridement and pectoralis major muscle flap transposition. Eight patients died, in which 2 died of respiratory failure, 2 died of bacterial endocarditis with septicemia, 2 died of renal failure, 1 died of intraoperative bleeding leading to brain death and the 1 died of heart failure. The mortality rate was 4. 2% . The average length of postoperative hospital stay was (14 ± 5) days. The longest postoperative follow-up period was 40 months, the median time was 26 months, the follow-up rate was 83. 9% . Totally 179 patients were no-reinfected, 2 patients were reinfected because of artificial vascular rejection.

CONCLUSIONTo perform surgical debridement and then reconstruct the sternal defect with pectoralis major muscle flap actively for the patient is an effective measure to improve patient's survival rate.

Adult ; Aged ; Cardiac Surgical Procedures ; adverse effects ; Coronary Artery Bypass ; Debridement ; Female ; Heart Defects, Congenital ; Humans ; Incidence ; Length of Stay ; Male ; Middle Aged ; Pectoralis Muscles ; transplantation ; Postoperative Complications ; Postoperative Period ; Retrospective Studies ; Sternum ; surgery ; Surgical Flaps ; Surgical Wound Infection ; surgery ; Wound Healing

Ginseng contains multiple components, such as saponins and saccharide, etc. The major is ginsenoside, which includes more than 40 kinds of monomers. It has been applied to treat blood-deficiency syndrome, but the action mechanism is still unclear. The fundamental researches on the effect of ginseng and its components on hematopoiesis and their clinical application were reviewed in this article. They were found to have effects on hematopoietic cells, microenvironment and regulatory factors, indicating they are potential for prevention of hemocytopenia, protection from injury of radiotherapy/chemotherapy and even for transplantation of hematopoietic stem cell.
Animals ; Cell Proliferation ; drug effects ; Ginsenosides ; isolation & purification ; pharmacology ; Hematopoiesis ; drug effects ; Hematopoietic Stem Cells ; cytology ; drug effects ; Humans ; Panax ; chemistry

OBJECTIVETo explore the relationship between blood stasis (BS) syndrome and coronary lesion in patients with coronary heart disease (CHD).

METHODSSyndrome types of 500 patients collected from multiple centers whose diagnosis of CHD confirmed by coronary angiography were differentiated. And the relationship between BS syndrome, its subtypes, and coronary lesion (affected branches, degree of constriction) were analyzed.

RESULTSThe affected branches of coronary artery in patients of BS syndrome was 2.28 +/- 0.28, while that in the non-BS syndrome patients was 2.07 +/- 0.86, showing significant difference between them (P < 0.05); as compared to patients of non-BS syndrome, the coronary lesions in patients of BS syndrome were mostly multi-vascular, and of more severe degree (P < 0.05). In patients of various BS syndrome subtypes, the average number of affected coronary branches in patients of yang-deficiency subtype was 2.58 +/- 0.65, which was significantly more than the number in patients of other BS syndrome subtypes. The constriction degree of coronary lesions in patients of yang-deficiency BS syndrome subtype were mostly severe or moderate, and single branch lesion was rarely seen, as compared with those in patients of phlegm-stasis obstruction subtype, the difference was significant (P < 0.05). The corresponding correlative analysis showed that close correlation was found between yang-deficiency subtype of BS syndrome and severe coronary constriction with the correlation distance of 0.1899.

CONCLUSIONRelationship between BS syndrome and coronary lesion (its number of branches and degree of constriction) truly exists to a certain extent.

Adult ; Aged ; Coronary Angiography ; Coronary Disease ; diagnosis ; diagnostic imaging ; Coronary Thrombosis ; diagnosis ; diagnostic imaging ; Female ; Humans ; Male ; Middle Aged

In order to investigate the chemical constituents from the fraction with cardiovascular activtiy of Chrysanthemum indicum, the isolation and purification of compounds from this active fraction were performed, and the chemical structures were elucidated by spectral analysis and comparison of the spectral data with those reported in the literature. As a result, twelve compounds were obtained and identified as (2S) -eriodictyol-7-O-beta-D-glucuronide (1), (2S) -eriodictyol-7-O-beta-D-glucoside (2), (2S) -hesperetin-7-O-beta-D-glucuronide (3), luteolin-7-O-beta-D-glucoside (4), luteolin-7-O-beta-D-glucuronide (5), diosmetin-7-O-beta-D-glucuronide (6), quercetin -7-O-beta-D-glucoside (7), (2S)-eriodict-dicaffeoylquinate (8), 3, 5-dicaffeoylquinic acid(9), 3, 5-cis-dicaffeoylquinic acid (10), 1, 5-dicaffeoylquinic acid (11), and 1, 3-dicaffeoylquinic acid (12). The above result indicated that flavonoids were the ma-dicaffeoylquinate (8), 3, 5-dicaffeoylquinic acid (9), 3, 5-cis-dicaffeoylquinic acid (10), 1, 5-dicaffeoylquinic acid (11), and 1, 3-dicaffeoylquinic acid (12). The above result indicated that flavonoids were the major components of the active fraction. Compounds 2, 3, 7, 8 and 10 were obtained from this genus for the first time, and compounds 5, 6, 9, 11, and 12 were first isolated from C. indicum.
Cardiovascular Agents ; chemistry ; isolation & purification ; Chromatography, High Pressure Liquid ; Chrysanthemum ; chemistry ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Magnetic Resonance Spectroscopy ; Molecular Structure

This study was aimed to observe influence on clinical symptoms of Qing-Fei Pei-Yuan Wei-Wan (QFPY-WW) for pulmonary infection HIV/AIDS cases with the syndrome of phlegm-heat obstructing the lung. A total of 141 pulmonary infection HIV/AIDS cases with the syndrome of phlegm-heat obstructing the lung were randomly divided into the treatment group (94 cases) and the control group (47 cases). The treatment group was given basic western medication combined with QFPYWW. The control group was given basic western medication. After 4 weeks treat-ment, observation was made on changes of main symptoms. The results showed that on the 28th day, compared with the control group, there was improvement on symptoms such as cough, breathing and chest tightness (P< 0.05). Com-parison on coughing up phlegm degree showed that the treatment group was significantly better than the control group (P< 0.05). On the 7th day treatment, the treatment group had better effect on lowering body temperature than the control group (P< 0.05). It was concluded that QFPYWW can improve symptoms such as cough, breathing, chest tightness and cough up phlegm among pulmonary infection HIV/AIDS patients.

Objectives To report the ifrst Chinese case of early onset argininosuccinic aciduria. Methods A girl aged three days was admitted because of vomiting and lethargy from the second day of life. General laboratory examination, blood amino acids analysis, urine organic acids tests and gene studies were performed for the diagnosis. Results Severe hyperam-monemia, liver dysfunction, metabolic acidosis, hypokalemia and hypocalcemia were found. Bood citrulline was extremely elevated (1098.12μmol/L vs normal range 5 to 25μmol/L), while blood arginine was decreased. Urine orotic acid, uracil and argininosuccinic acid were signiifcantly elevated. Two known heterozygosis mutations on ASL gene, c.544C>T (p.R182X) and c.706C>T (p.R236W), conifrmed the diagnosis of argininosuccinic aciduria. Unfortunately, protein-restricted diet with L-arginine supplement showed no effect. The patient died at the 23th day of life. Conclusions Argininosuccinic aciduria is a severe inherit-ed metabolic disorder. Clinical diagnosis is dififcult. It is characterized biochemically by severe citrullinemia. Urine organic acids analysis and ASL gene analysis are important for the differential diagnosis. In this study, a case of neonate death due to early-on-set argininosuccinic aciduria was diagnosed by post-mortem investigation. ASL gene study is helpful for the genetic counseling and prenatal diagnosis of the disease.