Objective To discuss the clinical efficacy of stent treatment for the benign or malignant colorectal obstruction. Methods Under fluoroscopic and / or endoscopic guidance stent implantation was performed in 30 patients with colonic or rectal obstruction. The obstruction sites were located at rectum (n = 20), recto-sigmoid juncture (n = 2), sigmoid colon (n = 3), descending colon (n = 3) and transverse colon (n = 2). Results Thirty-one colorectal stents were implanted in total 30 patients, the technical success rate was 92% by once-through operation. The patients were immediately relieved of the symptoms of intestinal obstruction. No complications related to stent implantation occurred. The average survival time in patients with malignant obstruction was 271 days. Conclusion For colorectal obstruction, stent implantation through anus is a minimally-invasive, safe and effective treatment with few complications. The procedure can effectively relieve the patients of the intestinal obstruction symptoms and, thus, improve their living quality.

Objective To explore the application of echocardiography to guide interatrial septal puncture and evaluate the clinical effect in PBMV. Methods One hundren and sixty two patients were categorized into two groups according to whether echocardiography was applied in atrial septal puncture and real time monitoring. X-ray fluoroscopy guidence was used during atrial septal puncture in group 1 and in group 2, X-ray as well as echocardiography were used. The clinical outcomes were analyzed and contrasted between the 2 group. Results (1) The mean mitral pressure gradient dropped obviously in group 2 immediately after PBMV compared with group 1 (6.4?2.6 mm?Hg vs 10.2?3.7 mm?Hg,P

10.3969/j.issn.2095-4344.2013.24.005

Objective To summarize the clinical experiences of total cavopulmonary connection (TCPC), investigate the applications and short and mid term effects. Methods From 1999 to 2007,31 patients with complex congenital heart disease underwent TCPC. All patients were divided into child group(≤16 years old ,n =21 ) and a-dult group( n = 10 ), including 15 cases of functional univentricle, 8 cases of complete atrioventricular septal defect with double outlet of right ventricle, 3 cases of transposition with double outlet right ventricle, 3 cases of tricuspid atresia, 1 case of double outlet of right ventricle with hypoplastic left heart. 1 case of corrected transposition of the great arteries with TOF. Among them, 1 patient had cortriatriatum, 10 patients had left superior vena cave, moderate or severe mitral valve insufficiency occurred in 1, moderate atrioventricular valve insufficiency occurred in 3.28 pa-tients underwent TCPC with cardiopulmonary bypass ( CPB ) and 3 patients without CPB ;Of them, 21 patients were treated with extracardiac conduit and 10 cases with intratrial lateral tunnel. Results There was no early death,post-operative death or large quantities of pleural effusion in child group;but two deaths and three patients with large quantities of pleural effusion in adult group. One case caught up in inferior venous stasis and was cured. Follow- up was carded out from 6 months to 6 years. 26 patients were in NYHA class Ⅰ ,2 patients in NYHA class Ⅱ and only one patient in NYHA class Ⅲ. Conclusions TCPC is effectively used for complex congenital heart disease which can not be corrected in anatomy;serious postoperative complications often occur in adults. Atrioventricular valve in-sufficiency decisively affects the short and midterm effects, even the long-term effects.

Objective To observe changes in mean platelet volume ( MPV) and investigate its possibility as a predictor and influence in patients with pulmonary artery hypertension associated with secundum atrial septal defect (ASD-PAH) . Methods 627 patients who suffered from secundum ASD were included in the study from the First Affiliated Hospital of Xinjiang Medical University Heart Center between January 2010 and March 2014. Patients were divided into two groups based on whether they had PAH or not (PAH group, n = 420 and non-PAH group, n = 207) . We also included 690 healthy people as a control group who received routine body check up at the same time. Examinations including complete blood count, serum biochemistry and ECG were done. Right heart catheterization examination was performed in patients who suffered from secundum ASD. Results The MPV was significantly higher in secundum ASD patients than in the control group [ (9. 4 ± 1. 6) fl vs. (8. 9 ± 1. 5) fl, P ﹤ 0. 001] . No significant difference was observed in MPV between PAH group and non-PAH group (P = 0. 268) . In univariate and multivariate logistic regression analysis, age ( OR 1. 401, 95% CI 1. 087 to 1. 806, P = 0. 009), RV diameter (OR 1. 101, 95% CI 1. 026 - 1. 181, P = 0. 008) and ASD defect diameter (OR 1. 064, 95% CI 1. 013 - 1. 118, P = 0. 013) were associated with ASD-PAH. Conclusions Our study demonstrated that age, RV diameter and ASD defect diameter were associated with ASD-PAH. Platelet activation exists in ASD-PAH, but this may not be the precipitating cause that contribute to the pathogenesis of ASD-PAH. MPV at admission does not predict the risk of PAH in patients with secundum ASD.

Objective To explore the application value of diffusion tensor imaging and diffusion tensor tractography in the benign lesion of spinal cord.Methods 30 cases with the benign lesions of spinal cord and 10 healthy volunteers underwent MRI and DTI scanning by 1.5T MR.Results Compared with normal control group,ADC values [(1.29±0.24)×10 -3 mm2/s]of extramedullary group-Ⅰwere increased slightly,and FA values (0.46±0.06)were decreased slightly(P <0.05).In extramedullary group-Ⅱ,ADC values [(2.03±0.19)×10-3 mm2/s]were significantly increased and FA values (0.37±0.03)decreased in the lesion level (P <0.05).The ADC values [(1.71±0.24)×10 -3 mm2/s]of intramedullary group was significantly elevated,and the FA values (0.30±0.06)was obviously reduced (P <0.05 ).The fiber tracts showed the abnormality of the white matter,including compression,sparseness, grow downwards,interruption and other changes.Conclusion The changes of the FA and ADC values,diffusion tensor imaging of the bundle can quantitatively evaluate the severity of spinal cord damage and stereo display fiber bundle damage.

Objective To assess the efficacy and safety of antiplatelet threapy after transcatheter aortic valve implantation.Methods Databases including PubMed , EMBASE, MEDLINE, the Cochrane Library, CMB and CNKI were searched to collect the randomized controlled trials ( RCTs) and cohort study trials ( CSTs ) about the efficacy and safety of antiplatelet threapy after transcatheter aortic valve implantation.The literature was screened according to the inclusive and exclusive criteria by two reviewers independently.The quality was evaluated.The data were extracted and meta-analyses were performed by using RevMan 5.3 software.Results 4 trials were included, of which 2 were RCTs involving 199 patients, and 2 were cohort studies involving 441 patients.Efficacy analysis showed that there were no differences between mono versus dual antiplatelet therapy in terms of 30-day rates of stroke ( OR 0.55 ,95%CI:0.22-1.35 ,P =0.19 ) , myocardial infarction ( OR 1.70 , 95% CI:0.25 -11.65 , P =0.59 ) , and all-cause mortality ( OR 0.77 , 95% CI:0.40 -1.49 , P =0.44 ) .Safety analysis showed that mono antiplatelet therapy had lower incidence of bleeding events , compared to dual antiplatelet therapy ( OR 0.37 , 95%CI:0.23-0.59,P<0.0001).Conclusions Mono versus dual antiplatelet therapy in the prevention of stroke , myocardial infarction and all-cause mortality after TAVI has similar protective effects .Mono antiplatelet threapy presents lower bleeding event rate .Due to limited quality and quantity of the included studies , the above conclusions need to be verified by more high quality studies .

Objective To assess the effectiveness of carotid endarterectomy(CEA) in the surgical treatment of stenosis of carotid artery.Methods From December 2003 to June 2006,28 patients of carotid arteriosclerotic stenosis received CEA and vascular repair or plasty(VP).Before and after operation,the hemodynamic parameters including inner diameter of internal carotid canal,blood flow rate,blood flow and blood flow rate of middle cerebral artery of 28 patients were measured by color Doppler flow imaging(CDFI) and transcranial Doppler(TCD).Results The inner diameter of internal carotid canal in all patients recovered to normal range.Blood flow rate and blood flow after operation were improved.No postoperative complications occurred,and no aneurysms formed.Conclusion CEA is one of the effective ways to manage carotid stenosis and angioplasty can improve the long-term efficiency.

Discipline evaluation is an effective and boosting mean of constructing high level key disciplines,but if there is something wrong or flaws with the means,indicators,process,ways,the effect may be just the opposite.Therefore,establishing scientific evaluation system is an important premise to construct key disciplines,promote discipline development and improve the level of academy construction.This article which is aimed at current situation of discipline evaluation system,puts forward some major principles to establish scientific evaluation for discipline,it is significant to play a right evaluation guide and promote the discipline construction.Carrying out discipline evaluation needs to have right guiding thought,establish and perfect indicator system of discipline evaluation,strengthen orderly management of evaluation work,offer scope to stimulate function of discipline evaluation.Only in these ways,can we construct a batch of characteristic and competitive key disciplines.

Objective To investigate the cell survival of the combination of fibrin glue and adiposederived stem cells (ADSCs) in rats when implanted into ischemic myocardium and the improvement of heart function.Methods The rat ADSCs were isolated from the subcutaneous adipose tissues.The surface phenotype of these cells was analyzed by flow cytometry.Myocardial infarction was induced in female rats using coronary artery ligation.One week after MI,surviving rats were randomized (random nuber) into 4 groups,control group (n =10),fibrin group (n =10),cell group (n =10) and combination group (n =10).100 μl of PBS was injected into the ischemic myocardium in control group.100 μl of Fibrin glue were injected into ischemic myocardium in fibrin group.100 μl of ADSCs labeled with DAPI were injected into the infract along the border zone in cell group.ADSCs in 100 μl of fibrin glue were injected into the infract in combination group.Four weeks after the injection the surviving rats underwent examination of heart functions by the Hemodynamics.The rats were killed and their hearts were taken out to undergo immunohistochemistry with 4,6-diamidino-2-phenylindole (DAPI) and actin and factor Ⅶ to measure the area of cardiac infarction and the capillary density.The heart infarcted size was calculated by masson trichrome staining.All data was analyzed by software SPSS 15.0,ANOVA comparison tests and the student t test were used,and P ＜ 0.05 was considered as statistically significant.Results Four weeks after the cells were transplanted,LVSP and + dp/dtmax of combination group were highest among all groups.The heart infarcted size of the combination group was (28.5 ± 3.6) ％,significantly less than those of the cell group (33.33 ± 2.3) ％ and fibrin group (35.96 ± 2.11) ％,both P ＜ 0.05.The capillary density of the combination group was (108.7 ± 11.38) /mm2,significantly greater than those of the cell group and that of the fibrin group,and greater than that of the control group.DAPI and actin double staining detected a varied increase in the number of surviving cardiomyoctyes at the heart infarcted area.Conclusions Transplantation of ADSCs with fibrin glue brings better improvement in cell survival and in restoration of heart function than either cellular or fibrin therapy alone.