Objective To assess the technical feasibility and efficacy of the combined application of a flexible,self-expanding neurovascular stent(Neuroform)and Gugliebni detachable coils(GDC)in the management of wide-necked intracranial aneurysms in humans.Methods Sixty-five wide-necked aneurysms which underwent 65 endovascular procedures were performed by using intracranial stent and GDC.There was a total of 30 aneurysms at basilar artery including 16 at the basilar tip,9 at the basilar trunk and 5 at the beginning of the basilar artery.And there were 30 aneurysms located at the posterior communicating artery, and 5 aneurysms located at the vertebral artery.The Neuroform stents were deployed to cover the neck of aneurysms.Another microcatheter was introduced into the aneurysm sac through the stent interstices and then detachable coils were released to embolize the aneurysms.Results The combined procedures were successful in all of the 65 patients with wide-necked aneurysms.The stent could pass smoothly through the intracranial artery and got released.Complete occlusion was achieved in 60 patients and incomplete occlusion in 5 patients.In-stent thrombosis occurred in 2 patients.All patients recovered well.Forty-two patients had followe-up angiography at 3 to 6 months after the procedure.Among them,no filling was found for the 39 aneurysms which were densely packed,and 3 aneurysms had neck remnant.Conclusion The implantation of Neuroform stent as a complimentary device to GDC coiling is easy and safe for embolization of wide-necked intracranial aneurysms.It has great advantage for treatment of wide-necked intracranial aneurysms.

No abstract available.
Choanal Atresia* ; Microphthalmos*

OBJECTIVETo investigate the related factors and pathogens of ventilator-associated pneumonia (VAP) after heart surgery.

METHODSVAP was diagnosed in 105 patients out of 1688 cases (6.2%) who underwent heart surgery in our department between January 2004 and January 2011. Clinical data, pathogens and treatments were analyzed.

RESULTSIncidence of VAP was 6.2% (105/1688), and 53.0% (105/198) in patients who required more than 48 hours of mechanical ventilation. One hundred and ninety-eight pathogen strains were isolated by bacterial culture, in which Gram negative bacteria accounted for 69.2% (137/198), Gram positive bacteria 27.8% (55/198), and fungi for 3.0% (6/198). Pseudomonas aeruginosa, Klebsiella pneumoniae, Acinetobacter baumannii, Escherichia coli, and Staphylococcus aureus were the main pathogens of VAP. The independent risk factors for VAP were: age > 70 years, emergent surgery, perioperative transfusions, reintubation and days of mechanical ventilation (all P < 0.01). Median length of stay in the ICU for patients who developed VAP or not was (24.7 ± 4.5) days versus (3.2 ± 1.5) days, respectively (P < 0.05) and in-hospital mortality was 25.7% (27/105) versus 2.9% (46/1583) respectively (P < 0.05).

CONCLUSIONSPatients undergoing heart surgery have a high frequency of developing VAP, especially in patients that require more than 48 hours of mechanical ventilation. VAP is associated with high in-hospital mortality. Age > 70 years, emergent surgery, perioperative transfusions, reintubation and prolonged mechanical ventilation use are independent risk factors for VAP in patients following cardiac surgery. Pseudomonas aeruginosa, Klebsiella pneumoniae, Acinetobacter baumannii, Escherichia coli, and Staphylococcus aureus are the main pathogens of VAP.

Acinetobacter baumannii ; Adult ; Aged ; Cardiac Surgical Procedures ; adverse effects ; Female ; Humans ; Klebsiella pneumoniae ; Male ; Middle Aged ; Pneumonia, Bacterial ; microbiology ; Pneumonia, Ventilator-Associated ; microbiology ; Pseudomonas aeruginosa ; Retrospective Studies ; Risk Factors

Objective To investigate the change of the basic fibroblast growth factor(bFGF) leve in human detrusor muscle(DM)in bladder outlet obstruction(BOO)due to benign prostatic hyperplasia(BPH)and its implication.Methods Fifty-four patients with BPH were divided into two groups:the obstructive DM stability and instability groups;and 15 men with bladder tumor who underwent operation in the same period were enrolled in the control group.The bFGF mRNA level in DM was measured by reverse transcription and polymerase chain reaction(RT-PCR)and the bFGF protein level was measured by immunohistochemical staining method.Results The bFGF-mRNA expression level of bladder smooth muscle cells was significantly lower in the control group than that in the obstructive DM stability and instability groups(all P＜0.05),but there was no significant difference between the obstructive DM stability and instability groups(P＞0.05). Conclusions The expression level of bFGF mRNA in bladder DM is elevated in BOO due to BPH,but there is little or no correlation between the increased expression of bFGF mRNA and detrusor muscle instability.

OBJECTIVETo investigate the methodology of mimic resection system on liver.

METHODSHepatic arteries, portal vein, inferior cava vein, hepatic veins and biliary ducts of liver with integrate hepatic portal were perfused with filling materials in different colors. And then the sample was embedded, frozen and slice-cut to obtain serial sectional images. After image registration and segmentation, the 3D reconstruction model which contained the liver's surface and its internal structures was constructed with MIMICS 9.0. Based on the freeform modeling system and its accessories (the software GHOST and the force-feedback equipment PHANTOM), the virtual hepatectomy system was established which could manipulate the virtual scalpel to perform optional resection on virtual liver model.

RESULTSAfter slice-cutting the cast liver, 910 serial cross-section images were obtained sharply and clearly. The 3D reconstructed liver model looked like the liver sample exactly, and could be magnified, contracted and rotated. In the virtual surgery system with good interaction, powerful immersion and great imagination, the virtual scalpel could be manipulated to perform optional resection on 3D liver model with the haptic device (PHANTOM).

CONCLUSIONSThe 3D visualized liver and the virtual hepatectomy system has been satisfactorily developed using the hepatic serial sectional images. The process of simulation operation was consistent with clinical practice.

Adult ; Anatomy, Cross-Sectional ; Hepatectomy ; methods ; Humans ; Image Processing, Computer-Assisted ; Imaging, Three-Dimensional ; Liver ; anatomy & histology ; blood supply ; surgery ; Models, Anatomic ; Models, Biological ; User-Computer Interface

OBJECTIVELong term glucocorticoid (prednisolone) treatment on human growth hormone (hGH) secretion in children and adolescents and to investigate the effectiveness and safety of the recombinant human growth hormone (rhGH) treatment.

METHODSTwelve patients (age: 10.4∓1.2 years) who were treated in Peking Union Medical College Hospital from September 1999 to November 2009 were enrolled in this study. All of them had taken prednisolone with a dose of 0.5∓2.0 mg/(kg.d) for 6~18 months. Two different hGH stimulating tests was done and their growth and development was evaluated at regular intervals. Seven patients were given rhGH with a dose of 0.1 U/(kg.d) for 6~12 months to improve their growth and development after half a year of prednisolone withdrawal when their disease conditions were improved.

RESULTSThe growth speed of these 12 children decreased significantly during prednisolone treatment compared with before prednisolone treatment (1.2∓0.3cm/year vs.3.7∓1.2 cm/year,P12 months than those with a 6~12 months course (P0.05). The growth speed of seven children who received rhGH therapy for half a year were increased from 2.2∓0.1cm/year to 7.8∓0.5cm/year (P<0.05), and then to 6.9∓0.4cm/year one year later.

CONCLUSIONSThe long-term glucocorticoid treatment can decrease the hGH secretion, and thus leads to short stature and agenesis. However, the rhGH replacement can safely and effectively improve growth and development in these children after their primary diseases are improved and glucocorticoids are withdrawn.

Adolescent ; Child ; Female ; Follow-Up Studies ; Glucocorticoids ; adverse effects ; therapeutic use ; Human Growth Hormone ; secretion ; therapeutic use ; Humans ; Male ; Recombinant Proteins ; therapeutic use ; Treatment Outcome

OBJECTIVETo study the best time of taking liver biopsy for chronic HBV carriers of age ranges and then guiding antiretroviral treatment.

METHODThe liver biopsy pathologic results of 292 cases of chronic HBV carriers were collected from the First Affiliated Hospital of Kunming Medical College. The patients were divided into three groups according to ages. The differences between groups were compared by calculating the ratio of inflammation above G2 or fibrosis staging above S2.

RESULTThe percentages of the chronic HBV carriers with liver histopathology inflammation graded above G2 or fibrosis staging above S2 were 26.5% (36/136) in 11 to 29 year-old group, 39.4% (37/94) in 30-39 year-old group and 58.1% (36/62) in 40-60 year-old group. Significant difference existed among groups in general (P less than 0.01). 39.4% (37/94) of chronic HBV carriers were found with inflammation graded above G2 or fibrosis staging above S2 in 30-39 year-old group, no statistically significant difference found between group 30-39 years old and group and 40-60 years old 58.1% (36/62) (P less than 0.01). 26.5% (36/136) of chronic HBV carriers under 30 years old were with inflammation graded above G2 or fibrosis staging above S2 as compared with the percentage of 46.8% (73/156) in the chronic HBV carriers over 30 years old group, and significant difference existed between the two groups (P less than 0.01).

CONCLUSIONThe best time choice of taking liver biopsy should be at the ages elder than or equal to 30.

Adolescent ; Adult ; Age Distribution ; Biopsy ; Child ; Female ; Hepatitis B, Chronic ; pathology ; Humans ; Liver ; pathology ; Male ; Middle Aged ; Young Adult

Objective To study the prevalence and distribution of mental disorders among registered and non-registered residents in Shenzhen. Methods An epidemiological survey on mental disorders were carried out in Shenzhen by stratified multi-stage randomized sampling method; 7134 respondents were assessed through face-to-face interview, using the WHO standardized version on World Mental Health (WMH) Survey Initiative of the Composite International Diagnostic Interview (CIDI3.1). Results (1)The weighting prevalence of mental disorders was 21.87%. The prevalence of non-registered residents was significantly higher than that of the registered residents (22.34% vs. 19.99% ; OR= 1.15,95%CI: 1.03-1.29; P<0.05) and the prevalence of females was significantly higher than that of males (22.68% vs. 19.67%; OR=1.20,95%CI: 1.07-1.34; P<0.05). The weighting prevalence of mood disorders, anxiety disorders and psychoses were 9.62%, 14.45% and 1.40%, respectively. (2) The weighting twelve-month incidence of mental disorders was 13.42%. The incidence of non-registered residents was significantly higher than that of the registered residents (13.80% vs. 11.90%; OR=1.19, 95%CI: 1.03-1.36; P<0.05). (3)The co-morbidity rate between mental disorders was 35.76%. (4)The prevalence and severity of mental disorders were associated with sex, household situation of registration, marital status, education, economic condition and occupation status. Conclusion Mental disorders have become common diseases and serious public health problem in Shenzhen, with non-registered residents and females deserve more attention.

OBJECTIVE: Autonomic imbalance is considered a psychopathological mechanism underlying major depressive disorder (MDD). Heart rate variability (HRV) is an index for autonomic activation. Poor sleep quality is common among patients with MDD. HRV biofeedback (BF) has been used for regulating autonomic balance among patients with physical illness and mental disorders. The purpose of present study was to examine the effects of HRV-BF on depressive symptoms, sleep quality, pre-sleep arousal, and HRV indices, in patients with MDD and insomnia. METHODS: In this case-controlled study, patients with MDD and Pittsburgh Sleep Quality Index (PSQI) score higher than 6 were recruited. The HRV-BF group received weekly 60-minute protocol for 6 weeks, and the control group who have matched the age and sex received medical care only. All participants were assessed on Beck Depression Inventory-II, Back Anxiety Inventory, PSQI, and Pre-Sleep Arousal Scale. Breathing rates and electrocardiography were also performed under resting state at pre-testing, and post-testing conditions and for the HRV-BF group, also at 1-month follow-up. RESULTS: In the HRV-BF group, symptoms of depression and anxiety, sleep quality, and pre-sleep arousal were significantly improved, and increased HRV indices, compared with the control group. Moreover, in the HRV-BF group, significantly improved symptoms of depression and anxiety, decreased breathing rates, and increased HRV indices were detected at post-testing and at 1-month follow-up, compared with pre-testing values. CONCLUSION: This study confirmed that HRV-BF is a useful psychosocial intervention for improving autonomic balance, baroreflex, and symptoms of depression and insomnia in MDD patients.
Anxiety ; Arousal ; Baroreflex ; Biofeedback, Psychology ; Case-Control Studies ; Depression ; Depressive Disorder, Major ; Electrocardiography ; Follow-Up Studies ; Heart Rate ; Heart ; Humans ; Mental Disorders ; Respiration ; Sleep Initiation and Maintenance Disorders

The title should be corrected as follows: Heart Rate Variability Biofeedback Increased Autonomic Activation and Improved Symptoms of Depression and Insomnia among Patients with Major Depressive Disorder.