3.Tricuspid valve replacement in the treatment of severe tricuspid valve disease: a report of 27 cases
Haiyang XUAN ; Kaihu SHI ; Fei ZHANG ; Shengsong XU ; Wenhui GONG
Chinese Journal of Postgraduates of Medicine 2011;34(32):20-22
Objective To analyze the medium and long-term results of tricuspid valve replacement (TVR)and summarize the operative experience for tricuspid valve disease.Methods Clinical data of 27 patients with severe tricuspid valve disease from September 2005 to May 2010 were retrospectively reviewed.Biological valve prosthesis was replaced in 23 patients,while mechanical valve prosthesis was replaced in 4 patients.Accompanying procedures included mitral valve replacement in 8 cases,mitral valve replacement and aortic valve replacement in 4 cases,and repair of atrial septal defect in 4 cases.Results The operative mortality was 11.1%(3/27),among these patients,2 cases died of serious low cardiac output syndrome,1case died of muhiorgan failure on the 7th day after operation,1 case who underwent reoperation for hemorrhage postoperative was improved after treatment.During follow-up,1 patient died of biological valve prosthesis dysfuncion 3 years after operation,1 patient died of cerebral embolism 19 months after operation.Six cases were in New York Heart Association(NYHA)class Ⅰ,and 14 cases in NYHA class Ⅱ during the period of follow-up.Conclusions Because operative and follow-up mortality is high,TVR is the last selection for the treatment of tricuspid valve disease.Appropriate operative technique and perioperative therapy are the key for clinical success.For those older than 50 years,follow-up inconvenience and reproductive-age female patients,biological valve prosthesis should be recommended as a preferential choice.
4.NK/T cell infiltration and prognosis in primary squamous cell carcinoma of the lung
Xuan-Ju GONG ; Mei LI ; Fu-Jin LIU ;
China Oncology 2000;0(06):-
Background and purpose:Both nature killer cells(NK)and cytoxic T lymphocytes in the body tissues of human are the dominant components of cellular immunity,This study was done to explore the degree of infiltration of NK/T in lung squamous cell carcinoma and its relation to patient survival and prognosis.Methods: CCD8 as the markers cytoxic T lymphocyte(CTL)and CD56 as the markers natural killer(NK)were stained immunohistochemically to detect the distribution and infiltration in the lung squamous cell carcinoma specimens. Results:In 39 of 68 lung neoplasm,whose CTL infiltration was zero or mild,the five-year survival rate was 18%, while in 29 with marked CTL infiltration,the five-year survival rate was 42%.In 46 of 68 lung neoplasm,whose NK infiltration was zero or mild,the five-year survival rate was 14%,while in 22 with marked NK infiltration,the five-year survival rate was 45%.In 48 of 68 lung neoplasm,both the NK and T cells were zero or mild,the five-year survival rate was 33%,while in 20 with marked NK and T cell infiltration,the five-year survival rate was 54%.The five-year survival difference among the patients with NK,T infiltration either marked or zero/mild infiltration were significant(x~2=18.62, P=0.00).Conclusions:The degree of NK and T infiltration is positively correlated with the prognosis and survival time of lung squamous cell carcinoma patients.
5.THE DISTRIBUTION DIFFERENCE BETWEEN Mel 1a AND Mel 1b MELATONIN RECEPTORS IN THE CENTRAL NERVOUS SYSTEM OF RATS
Haiwei XU ; Haidi LI ; Xuan WU ; Xiaotang FAN ; Fayun GONG ;
Acta Anatomica Sinica 1954;0(02):-
Objective To exam the expression and the distribution difference between melatonin membrane receptor subtype Mel 1a and Mel 1b in the central nervous system of rats. Methods In situ hybridization technique was used. Results (1)The Mel 1a mRNA positive cells were mainly detected in the hippocampus,cerebral cortex,supraoptic nucleus,paraventricular nucleus,suprachiasmatic nucleus,inferior olivary nucleus,cortex and fastigial nucleus of cerebellar,ventral horn of the spinal cord,facial nerve nucleus,gigantocellular reticular nucleus,striatum cortex and trigeminal nerve nucleus,etc.(2)The Mel 1b mRNA positive cells were mainly observed in the cerebellar cortex,fastigial nucleus,global nucleus,emboliform nucleus of the medullaris cerebelli,hippocampus,cerebral cortex,ventral horn of the spinal cord,supraoptic nucleus and suprachiasmatic nucleus.Conclusion\ Mel 1a mRNA positive neurons were abundant and distributed widely in the CNS,while Mel 1b mRNA\|positive neurons distributed comparatively localized.However,the hippocampus and the cortex were two regions which were rich in both Mel 1a and Mel 1b mRNA positive neurons.\;[
6.Clinical and genetic evaluation of a family with isolated oligodontia
Han QIN ; Lifang MA ; Hongzhi XU ; Yongqing GONG ; Kun XUAN
The Journal of Practical Medicine 2015;(7):1117-1120
Objectives To investigate the mutational characteristics of MSX1 and PAX9 genes in a family affected by non-syndromic oligodonti so as to study the pathogenesis of oligodontia from a molecular prospective. Methods A family with oligodontia, but of different descent and unrelated healthy controls were enrolled in our study. Genomic DNA was isolated from the blood samples. Mutation analyses were performed by amplifying MSX1 and PAX9 exons and sequencing the products. Results DNA sequencing revealed a novel missense mutation c.348C>T in a highly conserved homeobox sequence of MSX1 and a known polymorphisms c. 469+35- c.469+45del in exon 1 and in intron in the two patients and in two unrelated healthy controls. But we did not detect any mutation in PAX9. Conclusion Our finding suggests the samesense mutation (c.348C>T) and the polymorphisms (c.469+35- c.469+45del) may be responsible for oligodontia phenotype in this Chinese family.
7.Adenosarcoma arising in abdominal scar endometriosis: report of a case.
Fan YANG ; Kai-xuan YANG ; Xian-ying YAO ; Jing GONG ; Bo SONG
Chinese Journal of Pathology 2008;37(9):643-644
Abdominal Injuries
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complications
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Adenosarcoma
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etiology
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Adult
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Cicatrix
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complications
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Endometriosis
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complications
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Female
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Humans
8.Surgical treatment of congenital heart disease combined with severe pulmonary hypertension
Kaihu SHI ; Wei CAO ; Shengsong XU ; Wenhui GONG ; Haiyang XUAN ; Junxu WU ; Xudong ZHAO
Chinese Journal of Postgraduates of Medicine 2012;35(2):7-9
ObjectiveTo explore the surgical treatment of congenital heart disease combined with severe pulmonary hypertension.MethodsThirty-two patients of congenital heart disease combined with severe pulmonary hypertension were included in the study.The saturation of arterial oxygen ranged from 0.84 to 0.94 and echocardiography showed left to right slow velocity shunt in 20 eases,double direction shunt in 10 cases and no shunt in 2 cases.The pulmonary arterial pressure was 65-120 (82 ± 14) mm Hg ( 1 mm Hg =0.133 kPa).All patients received surgical repairs under cardiopulmonary bypass and were treated preoperatively with oxygen inhalation therapy,oral intake of beraprost sodium or silaenafil respectively according to the degree of pulmonary hypertension.During cardiopulmonary bypass,pulmonary artery perfusion was performed with protective solution containing ulinastatin for lung protection.Vasoactive drugs were routinely administrated postoperatively.Results Thirty-two cases underwent the surgical treatment successfully with their postoperative pulmonary arterial pressure decreased 20 -40 mm Hg and 2 cases died of severe low cardiac output syndrome and fatal arrhythmia.The mortality was 6.25%(2/32).ConclusionComprehensive perioperative management followed by radical operation can achieve a good clinical result on congenital heart disease combined with pulmonary hypertension.
9.The value of creatine phosphate GIK in cardiac valve disease before operation
Kaihu SHI ; Wenhui GONG ; Fei ZHANG ; Junxu WU ; Shengsong XU ; Wei CAO ; Haiyang XUAN
Chinese Journal of Primary Medicine and Pharmacy 2011;18(18):2451-2452
ObjectiveTo investigate the myocardial protection on cardiac valve replacement surgery with creatine phosphate of myocardial GIK (GIK) in order to reduce the surgical risk and improving the efficacy.Methods126 cases were unergone surgical treatment of heart valve disease,whose cardiac function on admission wereⅢor Ⅳ. 126 patients were randomly divided into two groups. Cardiopulmonary bypass time, aortic cross clamp time, postoperative myocardial injury markers ( CK-MB, cTNI) changes, arrhythmias, heart function recovery, length of stay and mortality rate and other indicators were compared between the two groups. ResultsThe age, gender, body mass,heart disease and surgery combined data were not statistically significant between the two groups( all P >0. 05). The cardiopulmonary bypass time, aortic cross clamp time and mortality had no significant differences between the two groups( all P > 0.05 ). The CK-MB( 21.36± 9.21 ) U/L and cTNI(0.83 ± 0. 35 ) ng/ml of creatine phosphate group were significantly lower than those of the control group. The incidence of arrhythmia in phosphocreatine group (37. 1% ) was significantly lower than ordinary group (57.8 % ) ( X2 = 5. 418, P < 0. 05 ). ConclusionThe application of creatine phosphate GIK before valve replacement surgery could effectively reduce reperfusion injury after myocardial ischemia,myocardial protection,and significantly reduce the incidence of arrhythmia and improve heart function in patients.
10.Discussion on valve re-operative cases after cardiac valve replacement
Haiyang XUAN ; Kaihu SHI ; Fei ZHANG ; Shengsong XU ; Junxu WU ; Wei CAO ; Wenhui GONG ; Xudong ZHAO
Chinese Journal of Postgraduates of Medicine 2011;34(11):8-10
Objective To summarize the results of valve re-operative cases after cardiac valve replacement, to find the better re-operative time, and to estimate the re-operative methods and influencing factors of the operation. Methods Thirteen valve re-operative cases after cardiac valve replacement from October 2008 to February 2010 were retrospectively studied. According to NYHA classification, 9 cases belonged to class Ⅳ, and only 4 cases belonged to class Ⅲ preoperatively. Mitral valve replacement (MVR)was performed in 7 cases, aortic valve replacement (AVR) in 3 cases, MVR + AVR in 3 cases. Results The early-stage postoperative mortality was 7.7%( 1/13),and the reason was low cardiac output syndrome. Two cases who underwent re-operation and re-intubation respectively after operation for hemorrhage were improved after treatment. Twelve cases were discharged in 3-6 weeks after heart valve surgery and all were followed up for 6-15 months. The cardiac function of all the discharged patients recovered well and no death occurred during follow-up. Conclusion The key factors to reduce the death of re-operation are improving preoperative heart function,setting up extracorporeal circulation as soon as possible,consummating myocardial preservation,perfecting operating skills,correcting low cardiac output syndrome in time and preventing complications.