Objective To discuss the clinical value of transesophageal echocardiography used in extracorporeal circulationcardiac valve replacement. Methods 89 patients received extracorporeal circulation cardiac valve replacement in our hospital from January 2012 to December 2014 were included in the study. Transesophageal echocardiography were performed preoperatively, intraoperation and postoperatively and the findings were compared to the result of preoperation transthoracic echocardiography exam. The measurement of aortic annulus diameter and detection rates of calcification obtained by transthoracic and transesophaged echocardiography were compared. Changes in heart function parameters before and after operation were compared. The alternations in surgery plan made after pre-operative transesophageal echocardiography exam and any relevant treatment or procedure performed according to intra-operation transesophageal echo findings were recorded. All the patients were followed up for 6 months - 40 months. Results Before extracorporeal circulation cardiac valve replacement, the aortic annulus diameter measured and detection rates of calcification by transthoracic echocardiography were smaller and lower than actual surgical pathology results ( P < 0. 05 ) . No differences in the results from transesophageal echocardiography of two-dimensional and three-dimensional examination when compared to pathological findings ( P > 0. 05 ) . Conclusions For patients receiving extracorporeal circulation cardiac valve replacement, transesophagus echocardiography examination is helpful to guide the selection of valve stent and operation methods.

Adult ; Aged ; Anthracosis ; blood ; Humans ; Leptin ; blood ; Male ; Middle Aged ; Resistin ; blood

OBJECTIVETo explore the clinical effects of PLIF surgery for elderly patients with lumbar degenerative disease.

METHODSFrom March 2010 to May 2013, 28 patients with lumbar degenerative disease, aged more than 80 years were treated with PLIF surgery. There were 10 males and 18 females, aged from 80 to 93 years old with an average of (85.44±3.66) years. Course of disease was from 3 to 20 years. The operation time, intra-operative blood loss, operation complications were recorded and JOA scores and Macnab criteria were used to evaluate the clinical outcomes.

RESULTSAll patients were followed up from 12 to 40 months with an average of 26.5 months. The average operation time was (150.00±26.42) min and the average intra-operative blood loss was (373.33±99.88) ml. The pre-operative JOA score was 12.30±2.43, and the corresponding postoperative JOA score at the final follow-up was 24.81±2.09 which was much higher than the preoperative one (P<0.01). According to the modified Macnab criteria to evaluate at the final follow-up, 16 patients got an excellent result, 10 good, 2 fair. In the weeks postoperatively, injuries of nerve root happened in 3 cases, superficial wound infection with delayed healing in 3 cases, and tear of the dural sac accompanied with cerebrospinal fluid leakage in 1 case. After long term follow-up, adjacent segment degeneration and the corresponding spinal canal stenosis occurred in 1 case at 34 months after operation. All cases got successful fusion without any displacement of internal fixation and pseudoarthrosis formation.

CONCLUSIONWith proper cases, fully preoperative preparation, perfect intra-operative manipulation and active treatment after operation, even advanced ages older than 80 years with lumbar degenerative disease could get satisfactory outcomes after PLIF surgery.

Aged ; Aged, 80 and over ; Female ; Humans ; Lumbar Vertebrae ; surgery ; Male ; Operative Time ; Spinal Diseases ; surgery ; Spinal Fusion ; methods

Objective To detect the serum levels of IL-6 and CRP in patients with acute type A aortic dissection complicated with pulmonary injury and inflammatory response. Methods From January 2007 Month to February 2016,216 patients with acute type A aortic dissection were admitted to our hospital. Among them,there were 120 male and 96 female patients,with a mean age of 52.1 years. All patients underwent cardiac ultrasound and other imaging studies. They were diagnosed and hospitalized immediately after the onset. Treatment lasted for more than 1 week. In a calm state of oxygen ,oxygenation index ≤200 preoperative lung injury is defined as positive. In this study ,according to the definition of the lung injury ,patients were divided into positive and negative lung injury groups. There were 72 positive and 144 negative cases among 216 patients. All patients were hospitalized. Every 4 hours,arterial oxygenation index is calculated. At the same time blood samples were tested for C-reactive protein(CRP)and interleukin-6(IL-6)levels. Data was analyzes by SPSS20.0 statistical software and counted byχ2 test. The results were plotted as the percentage,the measurement data with the t test,with(x ± s) to represent,evaluate serum levels of CRP and IL-6 levels with acute type A aortic dissection complicated by the relationship between lung injury. Results The differences of patients from two lung injury groups in gender,age, smoking,alcohol consumption,and other aspects of common chronic diseases were not significant(P>0.05);the difference between the pre-operative examination of several experimental studies in echocardiography were also no statistically significant(P > 0.05);two groups of patients,serum CRP positive group lung injury peak level and peak IL-6 levels were significantly higher in patients with acute lung injury negative group (P > 0.05). Further study of lung serum CRP in patients with damage to the relationship between IL-6 levels and oxygenation index found after dissection. Patient's oxygenation index decreased ,and serum C-reactive protein and interleukin-6 levels were rising rapidly ,reaching peak levels ,and then ,with the patients with inflammatory response decreased oxygenation index showed an upward trend. Conclusion Inflammatory reaction in acute type A aortic dissection plays a key role in the lung injury. In result ,patients'sicken time is prolonged ,which was closely related to serum C reactive protein(CRP),interleukin 6 levels and hypoxemia. Active anti-inflammation treatment before surgery may improve the patient's oxygenation status.

DNA microarrays have been acknowledged to represent a promising approach for the detection of viral pathogens. However, the probes designed for current arrays could cover only part of the given viral variants, that could result in false-negative or ambiguous data. If all the variants are to be covered, the requirement for more probes would render much higher spot density and thus higher cost of the arrays. Here we have developed a new strategy for oligonucleotide probe design. Using type I human immunodeficiency virus (HIV-1) tat gene as an example, we designed the array probes and validated the optimized parameters in silico. Results show that the oligo number is significantly reduced comparing with the existing methods, while specificity and hybridization efficiency remain intact. The adoption of this method in reducing the oligo numbers could increase the detection capacity for DNA microarrays, and would significantly lower the manufacturing cost for making array chips.

OBJECTIVETo explore the transverse relaxation rate with gradient echo R2(*) changes in patients with Parkinsonian variant of multiple system atrophy (MSA-P) with a voxel-based analysis of R2(*) map.

METHODSWhole brain structural images and multi-echo T2(*) weighted image were acquired in 27 patients with probable MSA-P and 24 healthy individuals. R2(*) maps of the MSA-P were compared with the controls by voxel-based methods.

RESULTCompared with the controls, MSA-P patients showed significant R2(*) decrease bilaterally in brain stem, cerebellar hemispheres, insular lobe, temporal lobes, caudate nucleus, and corpus callosum (P<0.005).

CONCLUSIONSR2(*) can reveal the significant brain involvements of MSA-P. The introduction of gradient echo may increase the sensitivity, although the susceptible artifact may interfere the detection efficiency of R2(*).

Adult ; Case-Control Studies ; Female ; Humans ; Image Processing, Computer-Assisted ; methods ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Multiple System Atrophy ; diagnosis ; Sensitivity and Specificity

Objective:To compare the efficacy of pars plana vitrectomy (PPV) and nonvitrectomizing vitreous surgery (NVS) in the treatment of idiopathic epimacular membrane (IMEM).Methods:A prospective , randomized and comparative clinical study. From April 2019 to May 2020, 21 eyes of 21 patients with IMEM diagnosed in Chongqing Aier Eye Hospital were included in the study. Among them, 11 males had 11 eyes, and 10 females had 10 eyes. Best-corrected visual acuity (BCVA), optical coherence tomography angiography (OCTA), and corneal, intraocular, and global aberration measurements were performed in all eyes. The international standard logarithmic visual acuity chart was used for BCVA examination, and the visual acuity was converted into logarithm of minimum angle of resolution (logMAR) during statistics. The iTrace visual function analyzer was used to measure the corneal, intraocular and whole ocular aberrations, and the dysfunction lens index (DLI) was calculated. Lens density in Scheimpflug images was calculated using Pentacam three-dimensional anterior segment analysis and diagnosis system. The 6 mm×6 mm area of the macular area was scanned by OCTA, which was divided by the software automatically into three concentric circles with the fovea as the center, namely the central area with a diameter of 1 mm, the inner ring area with a diameter of 1-3 mm, The outer ring area of 3-6 mm was used to measure the superficial vessel density (SVD) and superficial perfusion density (SPD) of the entire macular area, the central area, the inner ring area, and the outer ring area. The patients were divided into PPV combined with epimacular membrane (MEM) peeling group (PPV group) and NVS direct peeling MEM group (NVS group) by random number table method, 10 cases with 10 eyes and 11 cases with 11 eyes, respectively. The age of the two groups ( t=-0.72), logMAR BCVA ( t=-0.98), lens density ( t=-1.10), DLI ( t=1.15), SVD ( t=0.82) and SPD ( t=1.19) of entire macular area, corneal aberration ( t=0.45), intraocular aberration ( t=-0.22), and whole eye aberration ( t=0.83), there was no significant difference ( P>0.05). All eyes were operated on with a 27G vitrectomy system. The MEM was removed from the eyes of the NVS group under NVS condition, and the MEM was removed from the eyes of the PPV group under the condition of PPV, and the operation time was recorded at the same time. The follow-up period after surgery was 12 months. Relevant examinations were performed using the same equipment and methods before surgery. Taking the last follow-up as the time point for efficacy judgment, the BCVA, lens opacity, DLI, visual quality, SVD, SPD and MEM recurrence in the macula were compared between the two groups. The two groups were compared by paired t test. Results:The operation time of eyes in PPV group and NVS group was 20.81±3.52 and 5.70±1.30 min, respectively, and the difference was statistically significant ( t=7.23, P<0.001). At the last follow-up, the logMAR BCVA of PPV group and NVS group were 0.65±0.25 and 0.44±0.20, respectively, and the difference was statistically significant ( t=-2.16, P=0.04); compared with before operation, the BCVA of eyes of the two groups was significantly improved, and the difference was statistically significant. ( t=2.52, 4.41; P=0.033, P<0.001). The lens density and DLI of the affected eyes in the PPV group and NVS group were 10.64±1.58, 6.24±3.99 and 5.77±1.63, 7.74±1.55, respectively, and the differences were statistically significant ( t=-3.90, 2.85; P<0.05). The macular area SVD ( t=1.03), SPD ( t=1.77), corneal aberration ( t=-0.42), intraocular aberration ( t=-1.10), and whole-eye aberration ( t=-1.17) of eyes of the two groups, the difference was not statistically significant ( P>0.05). During the follow-up period, there were 2 eyes with MEM recurrence, 1 eye in the PPV group and 1 eye in the NVS group; there was no significant difference in the recurrence rate of MEM between the two groups ( χ2=0.005, P=0.94). Conclusion:Compared with PPV combined with MEM stripping, the BCVA after NVS surgery increases more, has a better protective effect on the lens, and has a shorter operation time.

Objective:To explore the clinical effect of a new method for nipple reduction and shortening in nipple hypertrophy.Methods:A retrospective analysis was made with patients with nipple hypertrophy who were admitted to Shanghai Mylike Medical Cosmetic Hospital from January 2018 to December 2019. The optimal size of the postoperative nipple was determined according to the patient’s requirements at the un-erectile state. Two wedge-shaped tissues resection were designed at the two symmetrical edges of the nipple to determine the diameter of the new nipple, and two dual wing shaped flaps were designed at the top of the nipple to determine the height of the new nipple. After local anesthesia, the redundant skin and subcutaneous tissue were cut off, and the corresponding points were closed and sutured. The appearance of the nipple was observed after operation. The nipple sensation and erectile function were evaluated by touching the nipple with cotton swab.Results:A total of 22 patients with nipple hypertrophy, aged from 24 to 35 years old, were female patients after childbirth and lactation. No wound nonunion or infection occurred. The blood supply and sensation of the nipple were good, and the shape of the nipple was significantly improved. All patients were followed up for 3-9 months, and the nipple sensation and erectile function recovered completely. All patients were satisfied with the postoperative result.Conclusions:The reduction of nipple by wedge tissue resection and wing flap can correct both the diameter and height of the nipple, while the nipple sensation and erection function are not affected. The procedure is easily performed with satisfactory result.

Objective:To explore the clinical effect of a new method for nipple reduction and shortening in nipple hypertrophy.Methods:A retrospective analysis was made with patients with nipple hypertrophy who were admitted to Shanghai Mylike Medical Cosmetic Hospital from January 2018 to December 2019. The optimal size of the postoperative nipple was determined according to the patient’s requirements at the un-erectile state. Two wedge-shaped tissues resection were designed at the two symmetrical edges of the nipple to determine the diameter of the new nipple, and two dual wing shaped flaps were designed at the top of the nipple to determine the height of the new nipple. After local anesthesia, the redundant skin and subcutaneous tissue were cut off, and the corresponding points were closed and sutured. The appearance of the nipple was observed after operation. The nipple sensation and erectile function were evaluated by touching the nipple with cotton swab.Results:A total of 22 patients with nipple hypertrophy, aged from 24 to 35 years old, were female patients after childbirth and lactation. No wound nonunion or infection occurred. The blood supply and sensation of the nipple were good, and the shape of the nipple was significantly improved. All patients were followed up for 3-9 months, and the nipple sensation and erectile function recovered completely. All patients were satisfied with the postoperative result.Conclusions:The reduction of nipple by wedge tissue resection and wing flap can correct both the diameter and height of the nipple, while the nipple sensation and erection function are not affected. The procedure is easily performed with satisfactory result.

OBJECTIVETo compare balance ability between elderly individuals who practiced Tai-Chi-Chuan (TCC) for average 9.64 years and elderly individuals who did not practice TCC and its relationship with lower extremity muscle strength and ankle proprioception.

METHODSTwenty-five elderly volunteers were divided into two groups according to their TCC practcing experience. Sixteen were TCC group and the other nine were control population. Subjects completed a static balance test and ankle proprioception test using a custom-designed evaluation system, and concentric and eccentric knee extensor and flexor muscle strength tests. Subjects stood on the plate form to measure the proprioception in functional standing position which was differed from the previous studies. Multiple linear regressions were also used to predict the important factor affecting balance.

RESULTSTCC group performed better than the control group in balance, proprioception, and muscle strength of lower extremity. The proprioception was the most important factor related to balance ability and it can be accounted for explaining 44% of variance in medial-lateral sway direction, and 53% of variance in antero-posterior sway direction. The proprioception may be a more important factor which affecting the balance ability.

CONCLUSIONTCC training is recommended to the elders; as it can improve balance ability through better proprioception.

Aged ; Ankle Joint ; physiology ; Female ; Humans ; Kinesthesis ; Linear Models ; Male ; Middle Aged ; Muscle Strength ; physiology ; Postural Balance ; physiology ; Posture ; physiology ; Proprioception ; physiology ; Tai Ji