Objective To investigate the value of echocardiography in monitoring the treatment of extracorporeal membrane oxygenation (ECMO) in patients with cardiogenic shock (CS).Methods A total of 21 patientss were included into the present study,who were treated by ECMO due to CS in Wuhan Asia Heart Hospital from January 2013 to December 2015.The left ventricular ejection fraction (LVEF) and Tei index were measured by echocardiography before,in the middle of (flow reduced to one half)and immediately after the process of ECMO.The systolic blood pressure (SBP) and the arterial oxygen saturation (SaO2) were also recorded,and the parameters were compared.The differences of LVEF,Tei index,SBP and SaO2 among different phases of ECMO were compared by using one-way ANOVA and LSD-t test.The differences of heart beat rate,the diameters of left ventricle,diameters of inferior vena cava,subsidence rate of inferior vena cava,pulmonary capillary wedge pressure and central venous pressure among different phases of ECMO were also compared by paired-samples t test.Results Compared with the pre-ECMO level,the LVEF increased during and immediately after the ECMO (t=31.952,59.404,both P ＜ 0.01),while the Tei index decreased significantly (t=34.406,58.969,both P ＜ 0.01).Compared with the pre-ECMO level,the SBP,SaO2 and subsidence rate of inferior vena cava all increased during and immediately after the ECMO,while the diameter of left ventricle,pulmonary capillary wedge pressure and central venous pressure all decreased significantly (t=7.382,37.785,-11.286,3.294,13.923,16.971,all P ＜ 0.01 or 0.05).In contrast,there was no significant change for the parameters of heart beat rate and diameter of inferior vena cava.Conclusion When treating CS patients with ECMO,the echocardiography can monitor the cardiac function effectively,and provide important parameters for the clinical doctors to estimate the ECMO efficacy and decide the weaning time.

Objective To evaluate the diagnostic value and misdiagnosis cause of echocardiography (UCG) and CT in aorto-left ventricular tunnel (ALVT). Methods UCG and CT of 5 patients who were diagnosed as ALVT by surgical operation during August 2010 to October 2014 in Wuhan Asia Heart Hospital were reviewed and analyzed. Results By UCG, 4 cases were diagnosed as ALVT. The abnormal tunnel between aortic root and left ventricle could be clearly displayed with two dimensional echocardiography. On color Doppler flow image (CDFI), it could be clearly demonstrated that the blood flow went into aorta from left ventricle in systolic period via aortic valves and ALVT, and back to left ventricle in diastolic period via ALVT. Bicuspid aortic valve (BAV) was found in 2 patients, and aortic valve reflux in 1 patient. According to Hovaquimian classification, 2/4 patients were diagnosed as ALVT of typeⅠ, and other 2 patients as ALVT of typeⅡ. One case was misdiagnosed as left coronary artery-left ventricle fistula. By CT, 2 cases were diagnosed as ALVT and 1 case was misdiagnosed as left coronary artery-left ventricle fistula. Conclusion The combination of UCG and CT is a reliable technique in the diagnosis of ALVT, which has significance in therapeutic strategy making and prognosis prediction.

OBJECTIVE Identify the effect of Brandt-Daroff exercises for positional vertigo with atypical positioning nystagmus.METHODS 11 cases of positional vertigo during 2006～2007 with atypical positioning nystagmus when carrying Dix-Hallpike and roll test,the nystagmus had the follwing characters:poly-positions,atypical direction,long lasting(more than 3 mins),no fatigue.After ruling out centrul neural system disorders,the patients were instructed to do Brandt-Daroff exercises 2-3 times/day,and 6-10 times every time.RESULTS After doing the exercises for 3-4 days,the vertigo of all the 11 cases were all relieved.After 1-2 weeks,10 cases were cured,syptom of the other 1 was relieved significantly,and the nystagmus was alleviated.CONCLUSION Cases with atypical positioning nystagmus may present a different kind of BPPV related with the otolith and vestibular nerve disease.Brandt-Daroff exercises was a good method for the atypical positioning nystagmus cases.

Objective To investigate the relationship and mechanism between the serum level of high mobility group box protein-1(HMGB1)and the mortality rate in patients with sepsis.Methods The serum levels of HMGB1,superoxide dismutase(SOD)and malondialdehyde(MDA)in 48 patients with sepsis were determined.The clinical outcomes in those patients were recorded and anlyzed.Results After the onset of sepsis,the serum HMGB1 levels of both death group and survival group were increased gradually and peaked at 72h after the onset of the disease.The semm HMGB1 levels of death group were much higher than those of survival group except at 24h(t=6.07,6.20,24.43,all P＜0.05).The activity of serum SOD of death group was markedly lower than that of survival group at 12h,24h,48h and 72h(t=10.24,20.61,11.67,33.33,all P＜0.05),and the level of serum MDA of death group was significantly higher than those of survival group at all time points(t=26.06,22.17,23.86,9.49,5.95,all P＜0.05).There was a significantly positive correlation between the serum HMGB1 and MDA level.Conlusioa The increase in serum HMGB1 level may be the important reasoll for the increased mortality rate in patients with sepsis;Oxidant/antioxidant imbalance may be olle reason for the increase in serum HMGB1 level.

Acrolein ; administration & dosage ; adverse effects ; Acute Lung Injury ; chemically induced ; therapy ; Administration, Inhalation ; Adult ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Young Adult

Aim To investigate the cardioprotective effects and the possible mechanism of trimetazidine in the risky areas during late reperfusion after acute myocardial infarction in canine.Methods Twenty-four adult dogs were randomized into three groups:sham operation group(n=8),late reperfusion group(LR,n=8),late reperfusion after trimetazidine treatment group(LR+TMZ,n=8).Physiological saline was orally given in the sham operation group and LR group and trimetazidine(2 mg?kg-1?d-1) in the LR+TMZ group for fourteen days.After that later,all chests were opened and coronary areteries were exposed.Exceptly shame operation group,the late reperfusion of acute myocardial infarction model was made by ligating the coronary for 10 h,followed by reperfusion of 10 h.Apoptotic index were detected by TUNEL.The Bcl-2,Bax,Cytochrome C and apoptosis-inducing factor(AIF) proteins were detected by immunohistochemistry.Results Compared with those of LR group,myocardial apoptotic index and the expression of Bax,Cytochrome C and AIF proteins in LR+TMZ decreased significantly(all P

The publication of the scientific theses and their management are significant for the development of technology and science in the hospital.Therefore.they play an important role iU the hospital management.The retrospective analysis on the theses that published in the last 5 years and embodied by SCI was conducted using the statistics method and analyzed the first 10 departments in the published theses in this paper.The specialty of our hospital and the shortcoming in the scientific research was concluded from the analysis result.The amount of the theses increased steadily,and the research capability of the key subjects and key departments were promoted.The amount and the quality of the theses reflected an important indicator of the development strategy that means to develop the hospital through science.technology and education.Therefore,these conclusions could offer some valuable information to the manage department of t}le hospital.

ObjectiveTo evaluate biomechanical properties of transoralpharyngeal atlantoaxial reduction plate (TARP) prepared from magnesium alloy and titanium alloy for the atlantoaxial dislocation by using three-dimensional finite element analysis and to exam the feasibility of using magnesium alloy for preparation of TARP system so as to provide a theoretical basis for clinical surgery.MethodsA patient with typical atlantoaxial fracture dislocation was involved in the study,and received thin CT scan with clinically used titanium alloy TARP system for obtaining DICOM image data.Three-dimensional finite element analysis software was imported to simulate magnesium alloy and titanium alloy TARP systems for reduction and fixation.Then,stress changes of the atlas,axis,internal fixators and C2/3 zygapophysial joints were determined with three-dimensional finite element analysis and analyzed statistically.Results ( 1 ) The finite element model of atlantoaxial dislocation reduction and fixation had lifelike outline and good geometric similarity.There were 53 586 nodes and 180 784 units.(2) During the simulation of head in neutral position,the stress concentration region was C2/3 zygapophysial joints followed by the anterior arch,posterior arch and lateral mass of atlas respectively,and C2 vertebral arch again.( 3 )Magnesium alloy and titanium alloy TARP systems showed significant difference in stress distribution (P ＜0.05).Conclusions(1)The atlantoaxial model established according to its structure information on CT can be used for biomechanical experiments.(2) For the treatment of atlantoaxial dislocation using the existing titanium TARP system,maintaining the integrity of anterior and posterior arch of atlas and confirming the bone fusion in lateral mass can better keep the stability of the atlantoaxis.After atlantoaxial fusion,the increased stress of the zygapophysial joints of the adjacent segments accelerates structural degeneration,which should be closely followed up.( 3 ) Magnesium alloy TARP system for fixation and reduction shows the fall in peak value of the stress concentration region,and improvement of the uniformity of stress distribution as compared with titanium alloy TARP.

Objective To compare the recent clinical efficacy between ileal neobladder and orthotopic ileal neobladder.Methods The clinical data of 62 patients with bladder cancer who were performed with cystectomy plus urinary diversion were retrospectively analyzed.Among them,32 patients were performed with orthotopic ileal neobladder(orthotopic ileal neobladder group)and 30 patients were performed with ileal neobladder(ileal neobladder group).The operation time,intraoperative bleeding,intestinal function recovery time,hospital stay,early postoperative complications were compared between two groups.Results All the patients were successful,and there was no operative deaths occurred.There was no significant difference in the postoperative intestinal function recovery time between two groups(P ＞ 0.05).The operation time,intraoperative bleeding,hospital stay in orthotopic ileal neobladder group was higher than that in ileal neobladder group [(463.59 ± 50.24)min vs.(436.07 ± 44.91)min,(1081.16 ± 320.49)ml vs.(867.53 ± 224.61)ml,(46.88 ± 4.67)d vs.(20.37 ± 5.24)d],but the incidence of early postoperative complications in orthotopic ileal neobladder group was lower than that in ileal neobladder group [25.0％(8/32)vs.53.3％(16/30)],and there were significant differences between two groups(P ＜0.05).Conclusions Two kinds of urinary diversion surgical urinary diversion are clinically more mature manner,in clinical practice.Clinicians should be based on the patient's comprehensive situation,combined with the clinical experience to select the most appropriate surgical procedures.

Adult ; Anesthesia, General ; Bronchoalveolar Lavage ; instrumentation ; methods ; Humans ; Male ; Middle Aged ; Pneumoconiosis ; surgery ; Ventilators, Mechanical