1.Clinical experience summary of surgical treatment abdominal gastrointestinal foreign body in children
Denghui LIU ; Qiangxing XIANG ; Zhao HUANG ; Yuxiang ZHOU ; Yong LI
International Journal of Surgery 2021;48(4):232-237,F3
Objective:To summarize the clinical experience of surgical treatment abdominal gastrointestinal foreign body in children, thus to provide a theoretical basis for clinical decision-making.Methods:The clinical data, including age distribution, clinical manifestations, surgical treatment strategy and prognosis, from 60 children with abdominal gastrointestinal foreign body treated by operation in Children's hospital of Hu′nan Province from January 2015 to June 2020, were retrospectively analyzed. Among the 60 children, 38 males and 22 females, with a median age of 2.9 years. Observation data included the type and location of foreign bodies in the digestive tract, clinical manifestations and surgical methods, operation time, intraoperative blood loss, postoperative hospital stay. The following-up time was 6 months to 2 years by telephone or clinic. The short/long-term complications was observed.Results:Children under 3 years old accounted for 56.7%. Types of foreign bodies included magnetic foreign bodies, sharp objects[paper clips, nails, screws, fish bone and others, etc], crystal ball, jujube pit, gastric hair stone, batteries and badminton holder. The foreign bodies were mainly located in stomach and small intestine. Abdominal pain and vomiting were the most common symptoms. The patients of foreign body with long residence time had peritonitis such as fever and abdominal pain, among 21 cases were combined with gastrointestinal perforation. There were varieties kind of operaion methods, including gastrointestinal incision and foreign bodies removal( n=22), appendectomy and foreign bodies removal( n=7), repair of gastrointestinal perforation( n=6), intestinal resection and anastomosis( n=17), intestinal resection plus enterostomy( n=5)but whose fistula was closed after 3 months, lateral wall of rectum repair( n=3). Fifty-two patients underwent common open abdomen operation, 8 patients underwent laparoscopic operation. The operating time was(93.5±19.3) min. Intraoperative blood loss was(20.2±4.3) mL. The postoperative hospitalization was 13(5, 19) d. The postoperative complications occurred in 3 patients who were nonoperative treatment recovery. Conclusions:Magnetic foreign body, sharp foreign body, crystal ball, jujube nucleus and corrosive foreign body are the main causes of digestive tract obstruction and perforation in children. Individualized operation plan should be selected as soon as possible according to the number of foreign bodies, retention position and whether or not digestive tract perforation.
3.Effects of heart displacement on hemodynamics during off-pump coronary artery bypass surgery
Wei-Xian ZHAO ; Xiang-Yu LI ; Fei-Peng PAN ; Dong-Mei XIANG ; Yong LI ;
Chinese Journal of Anesthesiology 1997;0(11):-
Objective To investigate the effects of heart displacement on hemodynamics during off-pump coronary artery bypass grafting (OP-CABG) while the sites for anastomosis were being exposed. Methods Forty-seven patients of both sexes (36 male, 11 female) aged 50-82 years undergoing OP-CABG were enrolled in the study. Preoperative cardiac function was assessed : class Ⅱ in 22 patients; Ⅲ in 23 and Ⅳ in 2 according to NYHA classification.The mean ejection fraction was 0.55?0.14 before surgery.They received on average 3.2 grafts. Premedication consisted of intramuscular morphine 10 mg, midazolam 3-5 mg and scopolamine 0.3 mg.Before induction of anesthesia ECG and SpO2 were monitored and radial artery was cannulated for continuous direct BP monitoring. Anesthesia was induced with midazolam 0.1 nig?kg-1 , fentanyl 4?g?kg-1 and pancuronium 0.1 mg?g-1 iv.The patients were mechanically ventilated after tracheal intubation and PETCO2 was maintained at about 40 mm Hg. Anesthesia was maintained with isoflurane and 50%-60% N2O in O2 and intermittent intravenous boluses of fentanyl and pancuronium. Swan-Ganz catheter which can continuously monitor mixed venous blood O2 saturation (SvO2) was placed in pulmonary artery via right internal jugular vein. SvO2, cardiac output (CO), BP, pulmonary arterial pressure (PAP) and HR were continuously monitored. Right atrial pressure (RAP) and PAWP were measured intermittently. Cardiac index (CI),stroke index (SI),systemic vascular resistance index (SVRI),PVRI, left and right ventricular work index (LVWI,RVWI) and left and right ventricular stroke work index (LVSWI,RVSWI) were calculated. The hemodynamic parameters were recorded after induction of anesthesia before surgery (T1,baseline),before heart displacement (T2), while anastomosis to anterior descending branch was being made (T3), while anastonosis to right coronary artery or posterior descending branch (T4) and to left circumflex artery or diagonal branch (T5) was being made, after normal heart position was resumed (T6) and at the end of operation (T7). Results While anastomosis to the anterior descending branch was being made (T3) SI and LVSWI significantly decreased as compared with the baseline (P
4.The effects and mechanisms of berberine on proliferation of papillary thyroid cancer K1 cells induced by high glucose
Jing NI ; Fang WANG ; Ling YUE ; Guangda XIANG ; Linshuang ZHAO ; Yong WANG ; Lizi YE ; Jing DONG
Chinese Journal of Internal Medicine 2017;56(7):507-511
Objective To study the effect and mechanisms of berberine (BBR) on the proliferation of papillary thyroid cancer K1 cells induced by high glucose.Methods K1 cells were cultured under 5.5 mmol/L or 25 mmol/L glucose condition with or without different concentration of BBR (0,10,40 and 80 μmol/L) for 24 hours.The proliferations of K1 cells in each condition were detected by MTT.Western blot was used to measure the expression of nuclear factor erythroid 2-related factor 2 (Nrt2),phosphoinositide 3-kinase (PI3K),protein kinase B (Akt) and phosphorylated-Akt (p-Akt).The distribution pattern of Nrf2 in K1 cells was determined using immunofluorescent staining.Results Compared with 5.5 mmol/L condition,the proliferation rate [(126.64 ± 5.41) % vs (87.31 ± 3.67) %],expression levels of PI3K (0.425 ±0.019 vs 0.272 ±0.039),p-Akt/Akt (0.446 ±0.021 vs 0.168 ±0.035) and Nrf2 (0.597 ± 0.014 vs 0.308 ± 0.026),and Nrf2 distribution (93.0% vs 23.1%) in nuclear of K 1 cells under 25 mmol/L condition were significantly elevated,respectively (all P <0.01).Addition of BBR in 25 mmol/L condition dose dependently (10,40,80 μmol/L) lowered the proliferation rate of K1 cells [(111.76 ± 4.10)%,(70.03 ±2.18)%,(32.41 ±3.76)% vs (126.64 ±5.41)%,all P<0.05],and suppressed the expression of PI3K,p-Akt/Akt,Nrf2,and Nrf2 nuclear distribution (P < 0.05).Conclusions BBR dose dependently inhibited the proliferation of high glucose-induced K1 cells.This effect was associated with the suppression on of PI3K/Akt signaling activation,Nrf2 expression and its nuclear translocation.
5.Voltage-dependent K(+)-channel responses during activation and damage in alveolar macrophages induced by quartz particles.
Jingzhi, SUN ; Yong, MEI ; Xiang, GUO ; Xiao, YIN ; Xuebin, ZHAO ; Zhenglun, WANG ; Lei, YANG
Journal of Huazhong University of Science and Technology (Medical Sciences) 2009;29(4):404-8
The roles of voltage-dependent K(+) channels during activation and damage in alveolar macrophages (AMs) exposed to different silica particles were examined. Rat AMs were collected by means of bronchoalveolar lavage, and were adjusted to 5x10(5)/mL. After AMs were exposed to different concentrations (0, 25, 50, 100, 200 mug/mL) of quartz particles and 100 mug/mL amorphous silica particles for 24 h, the voltage-depended K(+) current in AMs was measured by using patch clamp technique. Meanwhile the leakage of lactate dehydrogenase (LDH) and the viability of AMs were detected respectively. Patch clamp studies demonstrated that AMs possessed outward delayed and inward rectifying K(+) current. Exposure to quartz particles increased the outward delayed K(+) current but it had no effect on inward rectifier K(+) current in AMs. Neither of the two K(+) channels in AMs was affected by amorphous silica particles. Cytotoxicity test showed that both silica particles could damage AM membrane and result in significant leakage of LDH (P<0.05). MTT studies, however, showed that only quartz particles reduced viability of AMs (P<0.05). It is concluded that quartz particles can activate the outward delayed K(+) channel in AMs, which may act as an activating signal in AMs to initiate an inflammatory response during damage and necrosis in AMs induced by exposure to quartz particle. K(+) channels do not contribute to the membrane damage of AMs.
6.Treatment of intertrochanteric fracture with InterTan intramedullary nail:clinical analysis in 100 cases
Xinwei LIU ; Yong ZHAO ; Dapeng ZHOU ; Bing LIU ; Xin MA ; Liangbi XIANG
The Journal of Practical Medicine 2015;(6):964-965
Objective To discuss the clinical effect of intertrochanteric fracture treated with InterTan intramedullary nail. Methods Between Jan 2011 and June 2006 , 100 consecutive patients with intertrochanteric fracture were treated with a new nail (InterTan). We recorded the operation time, blood loss, blood transfusion volume and the modified Harris hip score was used to evaluate outcomes. Results All cases were received follow-up of 6 to 15 months. All cases got bone healing and did not appear various complications. The modified Harris hip score were (75.1 ± 13.4) points. Conclusion The InterTan device appears to be a reliable implant for treatment of intertrochanteric femoral fractures.
7.Relationship between myocardial glucose metabolism in right heart and cardiac function in patients with idiopathic dilated cardiomyopathy
Xinghong MA ; Lei WANG ; Liwei XIANG ; Yong YANG ; Shuliang HU ; Shihua ZHAO ; Wei FANG
Chinese Journal of Nuclear Medicine and Molecular Imaging 2015;35(2):81-84
Objective To explore the relationship between myocardial glucose metabolism in the right heart and cardiac function in patients with idiopathic dilated cardiomyopathy (IDCM).Methods From October 2010 to May 2013,64 consecutive patients (45 males,19 females; mean age:(53 ± 12) years) with IDCM were enrolled in this study.All patients underwent 18F-FDG myocardial PET imaging,late-gadolinium enhancement cardiac MRI (cMRI-LGE) and UCG.TrueD software was used to determine the SUVmax in right (SUV-R) and left (SUV-L) ventricular free wall,and the ratio of SUV-R to SUV-L (SUV-R/L) was calculated.The cMRI-LGE was used to evaluate LVEF,RVEF and LGE in left heart.Pulmonary artery systolic pressure (PASP) was measured by UCG.Two-sample t test and Pearson correlation analysis were used to analyze the data.Results Both SUV-R and SUV-R/L had negative correlation with LVEF (r=-0.48,-0.33; both P<0.01) and also with RVEF (r=-0.45,-0.44; both P<0.01).SUV-R/L positively correlated with PASP (r =0.58,P<0.01).SUV-R/L of patients with and without LGE were statistically different (0.45±0.18 vs 0.36±0.12; t=2.50,P<0.05).SUV-R and SUV-L of patients with LGE were 2.0±0.9 and 4.7±1.6,and those of patients without LGE were 1.7±0.9 and 5.0±2.8.Both differences of SUV-R and SUV-L between the two groups were not statistically significant (t=0.54 and 0.63,both P>0.05).Conclusions Myocardial glucose metabolism in right heart is closely correlated with left and right ventricular function.The assessment of 18F-FDG uptake in right heart by PET imaging is potentially useful for evaluation of the severity and prognosis in IDCM patients.
9.The clinical study on CT-guided percutaneous lumbar diskectomy at plateau area
Xingli XIANG ; Wei DENG ; Zhixi MA ; Yong HOU ; Xumei WANG ; Yanwei GUO ; Jianghua ZHU ; Guofeng ZHAO
Chinese Journal of Radiology 1999;0(10):-
Objective To evaluate the value of CT guided percutaneous lumbar diskectomy (CT PLD) at plateau area. Methods Sixty eight cases of lumbar disc herniation was reated with CT PLD. (1)Before operation, diseased intervertebral disc was scanned, cases were selected, and operation plan was plotted . (2)The best puncture arrangement was chosen on the current video CT picture by designing the puncture path, noting down the puncture parameter, and marking the puncture spot on patient′s body surface. (3)Puncture was performed according to fixed parameter. (4)Operation was performed after the puncture needle was put into the disc ascertained by scan.(5)CT scan was done again after operation to observe if the puncture path had bleeding and intervertebral disc recovery. Results After 3 to 18 months′ follow up, 28 cases were prominent effective and 36 cases effective. The lumbar disc backed 1 to 4 mm. The total effective rate was 94.12%. Conclusion CT PLD is an ideal therapeutic method for lumbar disc herniation at plateau area because it is safe and effective and with less complications.
10.Research in QGY/CDDP hepatoma lines multi-drug resistance reversed by ultrasound contrast agent joint ultrasound mediating ASODN of drug resistance gene transfection
Mingdong JIANG ; Tingxiu XIANG ; Shaolin LI ; Yong YAN ; Zhenghong WANG ; Liang FANG ; Xiaobo HUANG ; Yu ZHAO
Chinese Journal of Ultrasonography 2008;17(3):258-261
Objective To discuss the effect of QGY/CDDP hepatoma lines multi-drug resistance (MDR) reversed by gene transfection of mdr1,mrp-ASODN+ultrasound contrast agent+ultrasound.Methods The QGY/CDDP cells were transfected by mdr1,mrp ASODN+ultrasound contrast agent+ultrasound irradiation respectively and detected of the various indicators:cell adhesion rate,cell sensitivity to cell drug-resistance,the mRNA expression of mdr1 and mrp gene,the expression of P-gp and MRP protein. Results After mdr1-ASODN transfection,the drug sensitivity and expression of P-gp,MRP protein of QGY/CDDP cells were smaller changes(P>0.05),and the rate of cells adherent and expression of resistance gene mRNA were obvious changes(P<0.05).After mrp-ASODN transfection,the cells adherent rate,the drug sensitivity,the expression of resistance gene mRNA and P-gp,MRP protein were obvious changes respectively(P<0.05),the experiment group(group 2')had bigger effects(P<0.05).Conclusions mdr1. mrp-ASODN+ultrasound contrast agent+ultrasound irradiation could safely partly reverse MDR of hepatoma cells,which is a potential new approach for gene therapy.