Cochlear Implantation ; adverse effects ; Female ; Humans ; Infant ; Meningitis ; etiology ; Postoperative Complications

Objective To investigate the efficacy of emodin in the treatment of acute pancreatitis in rats.Methods Forty-five SD rats were divided into control group,pancreatitis group and treatment group.The apoptotic index of pancreatic acinar cells.the expression of NF-κB mRNA and Bax mRNA,the apoptosis rate of peripheral polymorphonuclear neutrophil(PMN),and the expression of PMN caspase-3 and PMN caspase-8 were detected.Results Compared with the panereatitis group,the apoptotic index of pancreatic acinax cells and PMN,and the expressions of NF-κB mRNA,Bax mRNA.PMN caspase-3 and PMN caspase-8 in pancreas tissue were significantly increased in the treatment group(F=853.199,327.126,143.586,48.857,231.750,96.552,P＜0.05).The histopathologic score of panereatitis Was negatively correlated with the apoptotic index of the pancreatic acinar cells and PMN(r=-0.96,-0.94,P＜0.05).The apeptotic index ofthe pancreatic acinar cells Was positively correlated with the expression of NF-κB mRNA,Bax mRNA in pancreas tissue(r=0.73,0.76,P＜0.05).The expression of NF-κB mRNA was positively correlated withthat of Bax mRNA(r=0.94,P＜0.05).The apoptotie index of PMN was positively correlated with the expression of PMN caspase-3 and PMN caspase-8 (r=0.99,0.99.P＜0.05).Conclusions Emodin alleviates acute pancreatitis via regulating the apoptosis of pancreatic acinar cells through Bax pathway,and regulating the PMN apoptosis through caspase pathway.

Objective To study the accuracy and the clinical significance of sentinel lymph node biopsy (SLNB)after neoadjuvant chemotherapy for breast cancer.Methods A total of 90 patients with StageⅡorⅢbreast cancer and negative axillary node after neoadjuvant chemotherapy were enrolled in the study.Mapping proce- dure and SLNB were performed using methylene blue injected at the site of the primary breast cancer,followed by the axillary lymph node dissection.Results The sentinel lymph node(SLN)was successfully identified in 82 out of 90 patients(91.1%).The number of sentinel harvested nodes ranged from 1 to 4(average 1.6).The accuracy of SLNB to predict the axillary lymph node status was 93.9 %(77/82),the sensitivity,positive predictive value,nega- tive predictive value and false negative rate were 87.5 %(40/45),100 %,88.1% and 11.1%(5/45),respectively. The SLN identification rate tended to be higher and false negative rate tended to be lower in patients with T2 prima- ry tumor before neoadjuvant chemotherapy.Conclusion Our study indicated that SLNB after neoadjuvant chemotherapy in patients with StageⅡorⅢbreast cancer had a similar effect as SLNB in non-neoadjuvant studies. SLNB was considered to be able to accurately predict the axillary lymph node status in patients with T2 primary tu- mor before neoadjuvant chemotherapy.

Objective To investigate whether the percutaneous ethanol injection (PEI)under sedation and analgesia can in-crease the energy deposition and curative efficiency of the high intensity focused ultrsound(HIFU)in treating unresectable middle and advanced stages of primary liver cancer.Methods Thirty-six cases of clinically diagnosed unresectable middle and advanced sta-ges of primary liver cancer were randomly divided into the PEI+ HIFU group(combination group,n = 23)and the simple HIFU group (HIFU group,n=13);10mL of the mixture of 99.7% ethanol and iodized oil (9:1)was given by intratumoral injection at 30 min before ablation in the PEI+HIFU group,while 0.9% physiological saline 10mL was replaced in the simple HIFU group.The ablation energy efficiency factor(EEF)and irradiation time were compared between the two groups.Results The ablation EEF in the PEI+HIFU group and the simple HIFU group were (13.82+4.26)J/mm3 and (25.63+6.31)J/mm3 respectively,the PEI+HIFU group was significantly lower than the simple HIFU group (P <0.05);the irradiation time were (1 468.28+253.21)s and (2 352.56+463.34)s respectively;which in the PEI+ HIFU group was significantly shortened (P <0.05).Conclusion PEI can enhance the HIFU ablation energy deposition and improve the efficiency of HIFU for treating unresectable primary liver cancer.

Objective: To explore the clinical efficacy of surgical radiofrequency ablation-modified Maze procedure in treating atrial fibrillation (AF) patients with large left atrial heart valve disease. Methods: A total of 267 patients received cardiac valve replacement and radiofrequency ablation-modified Maze procedure at the same time in our hospital from 2014-01 to 2015-15 were retrospectively studied. Based on the size of left atril, patients were divided into 2 groups: Group A, patients with left atrial size<60 mm, n=182 and Group B, patients with left atrial size≥60 mm, n=85. All patients were followed-up for 6 months after operation, clinical efficacy of surgical radiofrequency ablation-modified Maze procedure in treating AF was compared between 2 groups. Results: ①All patients were successfully completed the operation, radiofrequency ablation time was similar between Group A and Group B [18-32 (24±4) min] vs [22-38 (25±6)min], P>0.05. ②The ratios for recovering to sinus rhythm at the end of operation and discharge in Group A were 156/182 (86%) and 152 (84%), in Group B were 56/85 (66%) and 54 (64%); at 3 and 6 months post-operation in Group A were 149/182 (81.6%) and 146 (80.2%), in Group B were 48/85 (56.4%) and 46 (54.1%), all P<0.05. ③No patients needed installing permanent pacemaker, no operative mortality and no ablation related complications.Conclusion: Radiofrequency ablation-modified Maze procedure was safe, simple and effective in treating heart valve disease complicated AF, the effect in patients with left atrial ≥60 mm was inferior than left atrial<60mm; it could be used in clinical practice.

OBJECTIVETo investigate the protective effects of adiponectin on myocardial ischemia-reperfusion injury and the potential mechanisms in rats.

METHODSThirty-two male rats aged 8 weeks were randomly assigned to sham operation (sham), myocardial ischemia-reperfusion (MIR), diltiazem treatment (diltiazem) or adiponectin administration (APN) groups (n = 8 each). MIR rats underwent left anterior descending artery (LAD) occlusion for 30 min followed by 60 min reperfusion. Diltiazem (7 microg/g) and APN (120 ng/g) were given by caudal intravenous injection at the end of 30 min ischemia and the beginning of reperfusion for rats in diltiazem or APN groups. Animals were sacrificed after 60 min reperfusion for determining the myocardial nitric oxide (NO), Caspase 3, activity of AMP-activated protein kinase(AMPK) and concentration of peroxisome proliferators-activated receptor gamma (PPARgamma). Apoptotic cells were stained by Caspase 3 Activity Assay Kit and mitochondria in myocardial cells were observed by transmission electron microscope (TEM).

RESULTSThe myocardial Caspase 3 level was significantly increased [(168.50 +/- 30.08) micromol/L vs. (53.25 +/- 11.41) micromol/L, P < 0.01], AMPK activity, PPARgamma and NO concentrations were significantly reduced in MIR group compared with those in sham group (all P < 0.05) [(0.74 +/- 0.59) IU/ml vs. (25.63 +/- 4.61) IU/ml, P < 0.01; 0.1894 vs. 0.7949, P < 0.01; (6.359 +/- 1.355) micromol/L vs. (10.396 +/- 1.901) micromol/L, P < 0.01], these effects could be significantly reversed by APN. In comparison with MIR group, the levels of Caspase 3 in cardiac muscles were significantly lowered in Adiponectin group [(88.75 +/- 6.92) micromol/L vs. (168.50 +/- 30.08) micromol/L, P < 0.01], whereas the level of AMPK and PPARgamma, NO concentration in the cardiac muscle was remarkably increased [(27.22 +/- 4.76) IU/ml vs. (0.74 +/- 0.59) IU/ml, P < 0.01; 0.8613 vs. 0.1894, P < 0.01; (15.755 +/- 1.045) micromol/L vs. (6.359 +/- 1.355) micromol/L, P < 0.01]. APN also preserved the function and structure of mitochondria in rats post ischemia/reperfusion injury. The protective pharmacologic actions of APN were superior to that of diltiazem.

CONCLUSIONAdiponectin could protect myocardial tissues from myocardial ischemia-reperfusion injury in rats, possibly by upregulating myocardial AMPK and PPARgamma expressions and preventing myocardial cells from apoptosis.

AMP-Activated Protein Kinases ; metabolism ; Adiponectin ; pharmacology ; Animals ; Apoptosis ; drug effects ; Caspase 3 ; metabolism ; Diltiazem ; pharmacology ; Male ; Myocardial Reperfusion Injury ; metabolism ; prevention & control ; Myocardium ; metabolism ; Nitric Oxide ; metabolism ; PPAR gamma ; metabolism ; Rats ; Rats, Sprague-Dawley

BACKGROUNDFrequent premature ventricular complexes from the right ventricular outflow tract (RVOT-PVCs) are associated with left ventricular dysfunction. This study adopted two-dimensional speckle tracking imaging to evaluate global and regional left ventricular myocardial function in patients with frequent RVOT-PVCs.

METHODSThis study included 30 patients with frequent RVOT-PVCs and 30 healthy subjects. Aortic systolic velocity-time integral (AoVTI) and myocardium strain in circumferential (CS), radial (RS) and longitudinal (LS) directions were evaluated by conventional echocardiography and speckle tracking imaging. All values of patients with RVOT-PVCs were recorded during sinus (PVC-S) and PVC beats (PVC-V).

RESULTSSignificant differences were demonstrated in global CS, RS and LS between the control subjects and the PVC-V (CS: (17.46 ± 2.48)% vs. (11.52 ± 3.28)%, RS: (48.26 ± 10.20)% vs. (20.92 ± 9.78)%, LS: (19.89 ± 2.62)% vs. (11.79 ± 3.66)%, P < 0.01), and in segmental RS and LS of nearly all the left ventricular segments. Statistical differences in segmental CS between the PVC-V and the control subjects were only observed in anterior, anteroseptal and septal segments (only seen in anteroseptal and septal segments at apex). Furthermore, V/S AoVTI (AoVTI during the PVC beat divided by AoVTI during the sinus beat, then multiplied by 100%) correlated with coupling interval (r = 0.67, P < 0.001) and global strain (CS: r = 0.48, P = 0.007; RS: r = 0.65, P < 0.001; LS: r = 0.65, P < 0.001).

CONCLUSIONSFrequent RVOT-PVCs can induce global and regional left ventricular systolic dysfunction. The reduction of hemodynamic parameters relates to the coupling interval and the global systolic function.

Adult ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Ventricular Function, Left ; physiology ; Ventricular Premature Complexes ; physiopathology

OBJECTIVETo compare the anastomotic leakage rates after esophagectomy and reconstruction through different routes for esophageal cancer and analyze the causes for higher anastomotic leakage rate after esophagectomy, systemic lymph node dissection and reconstruction through retrosternal route and its prevention.

METHODSData of 1105 cases of esophagectomy were reviewed retrospectively. Patients in group A (n=229) underwent esophagectomy through left thoracotomy and intrathoracic anastomosis, patients in group B (n=716), esophagectomy through right anterio-lateral thoracotomy and cervical reconstruction through posterior mediastinal route, patients in group C (n=160) esophagectomy, systemic lymph node dissection and cervical anastomosis through the retrosternal route.

RESULTSThe leakage rate was significantly higher (19.4%) in group C than that in group B (11.9%, P< 0.05) and much significantly higher than that in group A (2.2%, P< 0.01). In group C, there was no significant difference in leakage rate between the patients with hand-sewn or mechanical anastomosis (22.2% vs.11.6%, P=0.133), between the patients who had whole stomach or tube-typed gastric reconstruction (25% vs.15.6%, P=0.146). The leakage rate was significantly decreased from 23.3% to 9.1% after prolonged nasal-gastric drainage for seven days (P< 0.05).

CONCLUSIONThe high anastomotic leakage rate after retrosternal reconstruction is mainly due to compression of the stomach in the anterior mediastinum. Prolonged nasogastric drainage is an effective way to decrease the leakage rate after systemic lymphadenectomy.

Anastomosis, Surgical ; methods ; Esophageal Neoplasms ; surgery ; Esophagectomy ; adverse effects ; Female ; Fistula ; etiology ; prevention & control ; Humans ; Male ; Middle Aged ; Postoperative Complications ; prevention & control ; Retrospective Studies ; Surgical Stomas ; pathology

OBJECTIVETo approach the incidence rate, symptoms, etiologies, correlating reasons, consequences and treatments of local responses caused by implant after cochlear implantation and to provide reference for the future works.

METHODSFrom 1995 to 2007 there were 997 cases adopted cochlear implantation in Peding Union Medical College Hospital. Ten cases experienced local responses were analyzed retrospectively.

RESULTSThe incidence of local response was 1.003%. There were 6 males and 4 females. The ages were between 13 months to 8 years old. The average age was 34 months. The devices mainly were made by Cochlear and Med-EL companies. The mainly symptoms and signs were local swellings, complaint of pruritus after ear, decrease of sound legibility and so on. Onset frequencies of this disease was 1 to 8 times. The bacterium cultured of displacing liquids was negative. But the IgE was detected in 2 cases. Results showed the patients were midrange status of hypersensitivity. Positive conservative treatments must be done including antibiotics, antihistamines, necessarily using immunotherapy.

CONCLUSIONSBesides local infection of bacteria, the allergy caused by silicone of implant coupled be a reason. Although the diagnose of this disease was difficult, but the screening of source of hypersensitivity was necessary before operation. It was recurrent attacks and maybe liable by kindred patients. Onset age was more below 4 years old. The patch test should be done again when the symptoms were occurrence after operation. If severe secondary infection was occurred and the states could not be well controlled the devices in the body must be explanted immediately. When the conditions were stable reimplantation could be experienced by non-sensibilisinogen devices.

Child ; Child, Preschool ; Cochlear Implantation ; adverse effects ; Cochlear Implants ; adverse effects ; Female ; Humans ; Hypersensitivity ; etiology ; Infant ; Male ; Postoperative Complications ; Retrospective Studies

OBJECTIVETo evaluate the effect of exteral use of papaverine cream on enhancement of skin graft.

METHODSFive mini-pigs were used for the study. 20 full-thickness wounds were created on the back of each animal. Along the midline of the abdomen, a 40 cm x 2 cm full-thickness skin graft was harvested and the wound sutured.The full-thickness graft was prepared and trimmed to 2 cm x 2 cm of 0.6 mm thickness split-skin grafts, which were transplanted to each wound with tie-over bolsters. The sutures were removed 2 weeks after the operation. Twelve pairs of 100%-survived skin grafts were selected and divided into group A (the left side) and group B (the right side), with each pair locating on the same and opposite position. From the day of suture removal, 2% papaverine cream was used to group A while plain cream was used to group B. The grafts were measured and observed for healing condition at the time of suture removal and the first, second, third, fourth, fifth, and sixth month. The surface area of the graft was measured and the shrinking ratio was calculated. After the animals were killed at the sixth month, samples of the skin grafts were taken and processed with 10% formalin, routine paraffin wax and Hematoxylin-eosin staining. The tissue structure was observed and the results were analyzed statistically.

RESULTSThe grafts in two groups did not have significant differences at the time of suture removal. Observations from the first to the sixth month showed that the two groups had significant differences in skin graft contracture and histological changes. HE stains demonstrated that the skin grafts in group A had less fibroblasts, more microvessels and orderly-arranged collagenous fibers.

CONCLUSIONSExternal use of papaverine cream can inhabit the contraction of skin grafts. It is a safe, effective, simple, and reliable method,which has the advantages of easy delivery,cheapness, less injury and infection,and no side effects.

Animals ; Contracture ; prevention & control ; Male ; Papaverine ; pharmacology ; Skin Transplantation ; adverse effects ; Swine ; Swine, Miniature ; Wound Healing ; drug effects