Objective To investigate the application value of the Perclose Proglide vascular devices in the thoracic endovascular aortic repair (TEVAR) of aortic dissection.Methods Retrospective analysis of 106 patients who underwent TEVAR for Standford B type aortic dissection were performed.The femoral lumen was measured by CTA be fore,1 month and 1 year after TEVAR.Results A total of 223 Perclose Proglide vascular closure devices were used in the 106 patients,including 97 patients with 2 devices,7 patients with 3 devices,2 patients with 4 devices.The puncture femoral artery diameters had no significant differences between before and 1 month,1 year after TEVAR (all P ＞0.05).Conclusion Per close Proglide vascular closure devices can be effectively and safely used in the TEVAR,which has little influence on the femoral artery diameter,and is worth to be applied in the clinics extensively.

Objective To investigate the effect of video-assisted thoracoscopic surgery( VATS) in thoracic disease,and the feasibility to carry out VATS for basic hospital. Methods The data of VATS treatment were collected to compare the differences between study group and control group,and evaluate the the feasibility to carry out VATS for basic hospital. Results The operation time was (100. 75±22. 72) min, blood loss was (54. 27±26. 21) mL,postoperative drainage was (920. 67±171. 99) mL. The postoperative complications were fewer,post-operative hospital stay was shorter,incision time was shorter(P=0. 000) and pain scores was lower(P=0. 000) in study group than that in control group. Basic hospital has the capacity to conduct this technical. Conclusion VATS is feasible to carry out in basic hospital.

OBJECTIVETo study the relationship between the disturbance of nitric oxide/endothelin-I (NO/ET-1) and the hepatic injury following limb ischemia/reperfusion (I/R) in rats as well as the regulation of NO/ET-1 system by limb ischemia preconditioning (IPC).

METHODSUsing limb ischemia/reperfusion injury model rats, animals were randomly divided into three groups (n = 6): control group, I/R group and IPC group. The contents of alanine aminotransferase (ALT), aspartate aminotransferase (AST) in the plasma as well as nitric oxide (NO), endothelin-1 (ET-1), nitric oxide/endothelin-1 (NO/ET-1) in the plasma and the liver were measured. The levels of total nitric oxide synthase (tNOS), inducible nitric oxide synthase (iNOS), constitutive nitric oxide synthase (cNOS) in the liver were determined. The expression of iNOS and endothelial NOS (eNOS) were detected by the immunohistochemical method. The morphologic changes stained with hematoxylineosin were observed under microscope.

RESULTSIt was found that the levels of NO, ET-1 in the plasma and the liver tissue all increased after reperfusion, while the values of ALT, AST, NO/ET-1 decreased. Liver pathology revealed that after limb I/R there were edema, villous microvascular congestion, infiltration of polymorphonuclear neutrophil (PMN), cell degeneration in part cells of the liver. The hepatic damage was deteriorated. While the expression of iNOS elevated, cNOS (mainly eNOS) reduced and total NOS increased. The protection of the limb IPC attenuated the disturbance of NO/ET-1.

CONCLUSIONThe hepatic injury following limb I/R is related to the disturbance of NO/ ET-1. The protection of the limb IPC might be conducted by its regulation of NO/ET-1 system. The elevation of endothelial NOS and the reduction of non-endothelial NOS generated the NO in this situation.

Animals ; Endothelin-1 ; metabolism ; Extremities ; blood supply ; Ischemic Preconditioning ; Liver ; metabolism ; Male ; Nitric Oxide ; metabolism ; Rats ; Rats, Wistar ; Reperfusion Injury ; prevention & control

BACKGROUNDNominal atrioventricular (AV) interval in dual chamber pacemaker (DDD) is not the best AV delay in the majority of patients with atrioventricular block. To find a simple method for optimizing AV delay adjustment, we assessed surface electrocardiography (ECG) for optimizing AV delay during dual chamber pacing.

METHODSDDD pacemakers were implanted in 46 patients with complete, or almost complete, AV block. Optimal AV delay was achieved by programming an additional delay of 100 ms, to the width of intrinsic P wave or to the interval between pacing spike to the end of P wave on surface ECG. Left ventricular (LV) end diastolic and end systolic volumes, ejection fraction and diastolic parameters were measured by Doppler echocardiography during both nominal and optimal AV delay pacing.

RESULTSCompared to nominal AV delay setting, LV end diastolic volume increased [to (53.2 +/- 11.3) ml from (50.2 +/- 10.2) ml, P < 0.05], end systolic volume decreased [to (26.1 +/- 9.0) ml from (27.9 +/- 8.2) ml, P < 0.05] during adjusted AV delay pacing, resulting in an increase in LV ejection fraction [to (68.2 +/- 5.3)% from (64.5 +/- 4.3)%, P < 0.05]. LV diastolic filling and isovolumic relaxation time were not significantly changed.

CONCLUSIONOptimization of AV delay by surface ECG is a simple method to improve LV systolic function during dual chamber pacing.

Adult ; Aged ; Aged, 80 and over ; Atrioventricular Node ; physiopathology ; Cardiac Pacing, Artificial ; methods ; Electrocardiography ; methods ; Female ; Heart Block ; physiopathology ; therapy ; Humans ; Male ; Middle Aged ; Time Factors

Adult ; Diagnostic Errors ; Female ; Glioma ; diagnosis ; Humans ; Male ; Middle Aged

OBJECTIVETo analyze postoperative morbidity and mortality after gastrectomy for gastric carcinoma and identify main risk factors influencing mortality.

METHODSA total of 1142 patients with gastric cancer received gastrectomy between January 1989 and April 2004. The patients were divided into three groups according to different period, the first group (n=405): from January 1989 to January 1994; the second group (n=377): from February 1994 to January 1999; the third group (n=360): from February 1999 to March 2004. Postoperative morbidity and mortality were compared among three groups, the risk factors influencing postoperative mortality were determined by multiple logistic regression analysis.

RESULTSThe total postoperative morbidity and mortality for all patients were 11.2% (128/1142) and 3.6% (41/1142), respectively. The postoperative morbidity was 13.1%, 10.1%, and 10.3% in the first, second, and third group respectively, there was no significant difference in morbidity among the three groups (P > 0.05). The postoperative mortality was 4.7%, 3.4%, and 2.5% respectively (P > 0.05), there was no significant difference in mortality among the three groups (P > 0.05). The most common postoperative complication was anastomotic leakage (24.2%, 31/128). The following clinicopathologic factors were found to be correlated with postoperative mortality: stage IV; palliative excision; multivisceral resection; and preoperative complications (P< 0.05). Multivariate analysis revealed that the extent of lymph node dissection or surgical procedure were not main risk factors influencing mortality.

CONCLUSIONPatients with advanced gastric cancer have a high risk of postoperative mortality. Unnecessary lymph node dissection or multivisceral resection should be avoided for patients with stage IV gastric cancer.

Adult ; Aged ; Aged, 80 and over ; Female ; Gastrectomy ; mortality ; Humans ; Male ; Middle Aged ; Postoperative Complications ; mortality ; Risk Factors ; Stomach Neoplasms ; mortality ; surgery

Objective To identify the isolates of Shewanella spp.from specimens of food poisoning based on biological and biochemical analysis.Methods Strains were obtained from the investigation on two food poisoning episodes in September and October,2007 in Ma'anshan city,Anhui province.In accordance with the national standard protocol(GB/T 4789),all specimens were enriched and isolated on selective medium,and the suspected strains were ldentified by the VITEK-32 and API20E systems.For Shewanella spp.identified by the biochemical system,more characteristics were analyzed using auxiliary biochemical,growth,hemolytic and drug-resistance tests.DNAs of Shewanella spp.were extracted,16S rDNA was PCR amplified and sequenced with universal 16S rDNA primers.Phylogenetic tree was constructed with MEGA 4.0.Results After enrichment, all specimens were inoculated to selective medium and Shewanella spp.strains were isolated from 8 samples with single colony on both TCBS and BP media.The characteristics of growth in the Triple Sugar Iron (TSI) agar appeared to have had hydrogen sulfide production but no gas production or positive oxidase.No Shewanella spp.strain was detected in WS,SS and EMB media.The 8 strains were identified as Shewanella algae(S.algae) or Shewanella putrefaciens(S.putrefaciens) by VITEK-32,as S.putrefaciens by API20E system.No other enteropathogenic bacteria,including Vibrio cholerae,Salmonella,Vibrio parahaemolyticus,Proteus vulgaris or Staphylococcus aureua,were detected from those 8 samples.From 16S rDNA phylogenetic trees,7 out of 8 ShewaneUa spp.were identified as S.algae.1 as S.putrefaeiens.Conclusion Strains of Shewanella spp.were lsolated from samples of the food poisoning episodes,providing a possible clue to investigate the role of Shewanella spp.on food poisoning

OBJECTIVETo assess the accuracy and reliability of the nest-PCR-sequence specific primer(SSP) method in HLA-A site genotyping of single blastomeres retrieved from human pre-implantation embryos.

METHODSBy nest PCR on HLA-A exon 2, the success rate of first-round amplification was estimated for single blastomeres. Based on the first-round amplification, the HLA-A genotype of every single blastomeres was analyzed by commercially available PCR-SSP kits.

RESULTSThe amplification of HLA-A exon 2 were performed to 120 blasotmeres retrieved from in vitro fertilization(IVF) surplus embryos donated by 10 couples. The average success rate of family 1-5 and 6-10 was 78.2%(43/55) and 93.8%(61/65), respectively. And 86.7%(104/120) in total. Eighty blastomeres were further tested by nest-PCR-SSP, among which 11 blastomeres failed to HLA-A exon 2 amplification and then failed to genotyping while the other 69 blastomeres succeed in HLA-A exon 2 amplification and succeed in genotyping. Except for 6 blastomeres that were uncertain for allele lost because of parents' homozygosity, the left 63 blastomeres had accurate HLA genotyping. Among these 63 blastomeres, 59 blastomeres had genotypes confirmed from their parents(93.6%), 3 blastomeres lost one of parents' alleles(4.8%), and only one blastomere had two more than parents' alleles(1.6%).

CONCLUSIONThe above research results indicated that based on the successful first round amplification of single blastomeres, nest-PCR-SSP strategy offers a convenient and reliable option for HLA genotyping on single blastomeres, which is a key process in pre-selecting HLA-identical sibling for allogeneic cord blood cell transplantation.

Base Sequence ; Blastomeres ; metabolism ; DNA ; analysis ; DNA Fingerprinting ; methods ; DNA Mutational Analysis ; Female ; HLA Antigens ; analysis ; HLA-A Antigens ; analysis ; genetics ; Histocompatibility Antigens Class I ; analysis ; genetics ; Humans ; Male ; Polymerase Chain Reaction ; methods ; Single Person

OBJECTIVETo explore the safety and curative effect of per anus intersphincteric rectal dissection and direct coloanal anastomosis (PIDCA) for patients with very low rectal cancer.

METHODSNineteen patients were prospectively studied from June 2002 to October 2004. There were 11 males and 8 females, with a median age of 56 (range, 41 - 74) years. Nineteen patients had T(1) to T(4) tumors (T(1), n = 4; T(2), n = 10; T(3), n = 4; T(4), n = 1) located between 3.5 and 5.0 cm above the anal verge.The rectum, including the entire width of the internal analsphincter, was transected circumferentially via the anal route to secure the surgical margin of safety under direct vision and was mobilized proximally as far as possible through the intersphincteric plane. Per anus coloanal anastomosis was performed following transabdominal resection of the rectum.

RESULTSThere was no operative mortality. Of nineteen patients, two (10.5%) had anastomotic leakage. Median follow-up duration was 16 (range, 3 - 29) months. Up to now, one patient developed recurrence (5.3%). Acceptable anal function results were obtained in most patients.

CONCLUSIONSCurability and anal function was obtained by PIDCA combined with preoperative or postoperative radiotherapy and postoperative chemotherapy. PIDCA is ideal and safe for selected patients with tumor located below 5 cm from the anal verge.

Adult ; Aged ; Anal Canal ; surgery ; Chemotherapy, Adjuvant ; Combined Modality Therapy ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Proctocolectomy, Restorative ; methods ; Radiotherapy, Adjuvant ; Rectal Neoplasms ; surgery ; therapy ; Treatment Outcome

BACKGROUNDResearches in ocular electromyography (EMG) and Magnetic resonance imaging (MRI) of patients with Duane retraction syndrome (DRS) suggest that there may be additional abnormalities such as paradoxical innervation between horizontal rectus muscles and vertical rectus muscles, hypoplasia of vertical rectus muscle and that oblique muscles may also contribute to the heterogeneity of the clinical manifestation of DRS. This paper reports the results of superior rectus recession for vertical deviation and A pattern in DRS Type III and discusses the pathogenesis of the disease.

METHODSSuperior and lateral rectus recession were performed in 5 cases of Huber type III DRS to treat vertical deviation and A pattern strabismus. Before operation, MRI of the brain, brainstem, cavernous sinus, and orbits were performed.

RESULTSAll subjects had unilateral limitation of both abduction and adduction, with palpebral fissure narrowing and globe retraction in adduction. Three cases had A pattern of strabismus, three cases had hypertropia. The abducens nerves (CN6) were either absent or hypoplasitic in the brainstem in all patients. Two eyes had larger oculomotor foramen. Two eyes had hypoplasia of the superior rectus and the inferior rectus. There was presumably a branch of the third cranial nerve (CN3) innervating the lateral rectus (LR) in one eye. While in another eye, two branches of CN3 sent into medial rectus were revealed. After surgery, vertical deviation in the primary position was reduced in all patients and A pattern was eliminated in 3 patients. One patient developed 10Δ consecutive esotropia postoperatively.

CONCLUSIONThe results suggest that structural abnormalities of vertical muscle and abnormal orbital innervation may be related to vertical deviation and the presence of A pattern in DRS type III. Recession of the superior rectus muscle seems to be a safe and effective treatment for vertical deviation and A pattern strabismus in DRS Type III.

Adolescent ; Child ; Duane Retraction Syndrome ; diagnosis ; Electromyography ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Young Adult