1.Long-term outcomes in elderly patients after percutaneous coronary intervention
Ruiyan ZHANG ; Zhenkun YANG ; Qi ZHANG
Chinese Journal of Practical Internal Medicine 2006;0(24):-
0.05)compared to bare metal stents.Conclusion Age is an important clinical factor influencing mortality rate after PCI in patients with coronary artery disease,and the use of drug-eluting stents should be the preferred for the improvement of long-term outcomes in the elderly.
2.Clinical experience of coroflex intracoronary stent
Zhenkun YANG ; Weifeng SHEN ; Jiansheng ZHANG
Chinese Journal of Interventional Cardiology 1996;0(01):-
Objective To evaluate the clinical efficacy of coroflex (BRAUN, Germany) intracoronary stent. Methods To retrospectively analyze the immediate angiographic and clinical follow-up outcomes of 81 patients (pts) receiving coroflex intracoronary stenting. Results 88 coroflex intracoronary stents were implanted in 81 pts. According to ACC/AHA classification, 38 lesions were type A-B 1, 50 lesions were type B 2-C. 52 lesions were de novo, 22 were suboptimal results after PTCA and 14 lesions were bailout for dissections. Stent deployment was successful in 82/88 (93.2%). High-pressure (16-18 atm) balloon was used for stent deployment in 3 lesions with severe calcification. Dissection was occurred at distal of stent in 2 lesions but no inducing flow reduction. Angiography showed TIMI 2 grade after intracoronary stenting in 1 diffused lesion. There were no adverse events occurred during hospital stay. Clinical follow-up of in 75 pts were conducted for 7.5?3.0 (3-13) months, there were no cardiac death or myocardial infarction reported. Complain of angina (CCS class Ⅰ) occurred in 17 pts (22.7%). Repeat angiography was performed in 7 pts, there were 2 in-stent restenosis with successful revascularization. Conclusion Coroflex intracoronary stenting appears to be safe and effective in the treatment of coronary lesions with favorable outcomes.
3.Intravascular ultrasound-guided clinical decision-making for intermediate coronary stenosis
Zhenkun YANG ; Weifeng SHEN ; Jiansheng ZHANG
Chinese Journal of Ultrasonography 2003;0(08):-
Objective To evaluate the role of intravasc ular ultrasound (IVUS) in determining strategy for coronary artery stenosis of intermediate severity.Methods The study population consisted of 75 patients who had de novo coronary lesions of intermediate severity (40% to 70% diameter stenosis) in coronary angiography. IVUS examination was performed in all patients using standard methodology. Minimal lumen cross-sectional area (MLA) ≤ 4.0- mm 2 or percent area stenosis≥60% were identified as an IVUS index of functionally severe coronary stenosis, and used as an indication of coronary stenting. Major adverse cardiac events (cardiac death, acute myocardial infarction and recurrent angina) and the use of nitrates were recorded during follow-up. Results There were 44 patients (59%) with functional coronary artery stenosis, and all underwent successful coronary stenting. Acute coronary syndromes, soft plaque and positive coronary arterial remodeling were more common compared with the remaining 31 patients (41%) only treated medically. During a mean of (14?7) months of follow-up, there was no cardiac death and acute myocardial infarction. Readmission occurred in 5 patients (11%) due to in-stent restenosis in patients with interventional therapy and 4 patients (13%) due to exacerbation of coronary artery stenosis in patients with medical therapy. The use of nitrates was discontinued in 18(41%) and 14(45%) patients treated with interventional therapy and medical therapy, respectively. Conclusions It is valuable to perform IVUS examination in clinical decision making for intermediate coronary artery stenosis. IVUS criteria of MLA≤ 4.0- mm 2 or area stenosis≥60% may be a reliable index of functional coronary stenosis, determining the therapeutic strategy in patients with intermediate coronary artery stenosis.
4.Cutting balloon angioplasty for treatment of lesions in small coronary arteries
Zhenkun YANG ; Weifeng SHEN ; Dadong ZHANG
Journal of Interventional Radiology 1992;0(01):-
Objective To evaluate the clinical efficacy of cutting balloon angioplasty (CBA) for treating lesions in small coronary arteries. Methods The diameter for reference of coronary artery is less than 2.7mm which is considered as “small vessel”. CBA procedures were performed on 25 lesions in 22 patients. Results The procedure was successfully obtained in 21 lesions(84%). Seven severe stenotic lesions (diameter of stenosis≥90%) underwent dilatation with small conventional balloon(1.5 mm diameter). Bail out stenting was performed in 2 lesions because of severe dissections. Failure of cutting balloon to pass through the stenosis in one lesion. During follow up, 5 patients had recurrence of coronary angina and 3 of them underwent coronary angiography for check up, In stent restenosis (ISR) occurred in one patient, which was successfully redilated using CBA. One patient had total occlusion of the diagonal branch with ISR of LAD. One patient developed new lesion in other coronary artery.Conclusions CBA is safe and effective, and provides a new therapeutic strategy for lesions in the small coronary arteries.
5. Application of alginate based hydrogels/dressings in wound healing: Sustained, dynamic and sequential release
Chinese Journal of Tissue Engineering Research 2021;25(4):638-643
BACKGROUND: Alginate can improve the hydrophilic quality of wound dressing, create moist wound microenvironment, and remove wound exudate. Currently, alginate bimolecular materials have been used in the design and development of various wound dressings to improve the efficiency of wound healing. OBJECTIVE: To summarize the research and progress of alginate based hydrogels/dressings in skin wound healing. METHODS: We searched PubMed, Science Direct and CNKI databases from 2000 to 2020 with the English terms of “alginate hydrogel, wound healing, wound dressing, mesenchymal stem cell, growth factor, nanoparticles, diabetic wound, antibiotics, bioactive peptide, three-dimensional printing” and the Chinese terms of “alginate, wound healing”. Based on the inclusion and exclusion criteria, 60 articles were finally reserved for review. RESULTS AND CONCLUSION: (1) The cross-linking of alginate with other organic or inorganic materials can improve the mechanical properties and biodegradability of composite materials, and create a moist and mild wound microenvironment. (2) Alginate based hydrogel/dressing can be used as a delivery platform to load seed cells, growth factors or other bioactive substances to speed up wound healing. (3) It still need to be further explored by researchers to make alginate materials have better cell recognition sites, improve the mechanical properties of composite scaffold materials, control the microstructure of alginate biomaterials and control the dynamic, sustained and sequential release of drugs or cells.
6.Application of philosophy on comprehensive analysis of adenoid hypertrophy space occupying effect in meticulous adenoidectomy.
Yuanyuan LU ; Qingxiang ZHANG ; Zhenkun YU
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2015;29(13):1209-1212
OBJECTIVE:
To achieve targeted and meticulous surgery of adenoid hypertrophy, a comprehensive analysis of adenoid hypertrophy space occupying effect and morphological evaluation were conducted and the clinical results were retrospectively analyzed.
METHOD:
One hundred and sixty-three children with adenoid hypertrophy were treated in our department from May 2013 to May 2014. All children received three examinations preoperatively, including: Nasopharyngo-fiberoscopy, Audiometry and Tympanometry. Based on the results, space occupying effect of adenoid hypertrophy was divided into three types: vertical hypertrophy type, horizontal hypertrophy type and vertical & horizontal hypertrophy type. We assumed the causal relationship with vertical hypertrophy type to snoring (nasal blockage) and horizontal hypertrophy type to secretory otitis media respectively. All children received transoral endoscopic adenoidectomy with radiofrequency ablation.
RESULT:
The postoperative followup of these children for 6 to 12 months showed that the vertical hypertrophy type and horizontal hypertrophy type children all recovered from the syndromes of snoring (nasal blockage) and secretory otitis media respectively. The nasopharyngo-fiberoscopy showed that the nasopharyngeal space was smooth and the bilateral choanas opened well. No recurrence was found.
CONCLUSION
The philosophy of comprehensive analysis on adenoid hypertrophy space occupying effect could help the surgeons understand adenoid hypertrophy better and can guide the adenoidectomy more meticulously.
Acoustic Impedance Tests
;
Adenoidectomy
;
Adenoids
;
pathology
;
surgery
;
Child
;
Endoscopy
;
Humans
;
Hypertrophy
;
Nasal Obstruction
;
diagnosis
;
Nasopharynx
;
pathology
;
Otitis Media with Effusion
;
diagnosis
;
Recurrence
;
Retrospective Studies
;
Snoring
;
diagnosis
7.Thyroid operation after the discussion on drainage technology.
Haidong ZHANG ; Danchun GONG ; Qingxiang ZHANG ; Yaqun LIU ; Zhenkun YU
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2015;29(2):194-196
OBJECTIVE:
To investigate the possibility of thyroidectomy/lobectomy without drainage after surgery.
METHOD:
Eighty-eight consecutive cases with thyroid mass have been underwent operations including: lobectomy group(42 cases), thyroid lobectomy with contralateral partial thyroidectomy group (17 cases) and total thyroidectomy group (29 cases) from 2013. 06 to 2014. 06 in Nanjing Tongren Hospital. FIfteen patients with thyroid operation in other hospital were collected from 2014. 01 to 2014. 06, the recovery of postoperative incision were compared.
RESULTS:
Eighty-four cases were smoothly discharged from hospital except 4 thyroidectomy cases suffered from a small amount of effusion in surgical cavity. Our postoperative wound recovery were more in line with the principle of cosmetology compared with other hospital operation group.
CONCLUSION
Drainage following thyroidectomy is not essential, if the thyroid surgery is meticulous in each step of the surgery, and can increase the effect of beauty.
Drainage
;
methods
;
Humans
;
Postoperative Period
;
Thyroid Diseases
;
Thyroidectomy
9.Effect of the use of computer generated pressure hemostat on venous thrombosis of the lower limbs of elderly patients
Yanhua ZHU ; Xiaoling XIE ; Chunli YE ; Luyun ZHANG ; Zhenkun CHEN
Chinese Journal of Practical Nursing 2014;30(20):9-11
Objective To study the effect of computerized pressure hemostat on lower limb deep vein thrombosis in high-risk elderly patients.Methods From September to December 2013,36 orthopedic hospitalized patients who received operations were divided into the hemostat group and the non-hemostat group with 18 patients in each group.D-dimer changes and lower limb deep vein thrombosis were observed in both groups.Results D-dimer was significantly increased in both groups compared with that before operation,but the extent of elevation in the non-hemostat group was lower than that in the hemostat group.D-dimer and cases of lower limb deep vein thrombosis in the hemostat group was higher than those in the non-hemostat group after operation,which showed significant difference.Conclusions The use of computerized pressure hemostat will increase the risk of lower limb deep vein thrombosis in elderly patients,so the technical operation procedures should be strictly enforced accompany with safely use of computerized pressure hemostat.
10.Treatment of recurrent laryngeal papilloma by submucosal resection and the effect on prognosis.
Huiying HU ; Qingxiang ZHANG ; Guoyan SUN ; Zhenkun YU
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2015;29(21):1873-1877
OBJECTIVE:
To investigate the efficacy of submucosal resection by CO2 laser in the treatment of recurrent laryngeal papilloma and the effect on prognosis.
METHOD:
A total of 11 patients diagnosed as recurrent laryngeal papilloma were included in this review. Papilloma was marked before operation and checked under fibro-laryngoscope. Papilloma was resected completely including the submucosal tissure with CO2 laser or microequipment. In widespread papilloma, false membrane in raw surface were cleared 7-10 days after operation. Surgical specimens (including membrane) were detected by routine pathology, HPV typing and immunohistochemical pathologic examination. The patients were checked once a month in the first 3 months after operation, and then once for every 3 months. Once the hoarseness and other symptoms aggravated or the disease was recurrent, the patients were treated immediately.
RESULT:
HPV viral DNA was found in 10/11 cases, with HPV11 (7/11 cases) and HPV6 (3/11 cases). Cases with regards to follow-up, from 6 months to 1 year, 3 cases were followed up 1 year after operation, without recurrence. Five patients including 2 children were followed up 6 to 12 months after operation, without recurrence. Two children underwent 2 or 3 operations, were followed-up more than 6 months withouting recurrence.
CONCLUSION
Papilloma submucosal resection could decrease postoperative recurrence and is worth to be further investigated.
Child
;
DNA, Viral
;
blood
;
Human papillomavirus 11
;
isolation & purification
;
Human papillomavirus 6
;
isolation & purification
;
Humans
;
Laryngeal Neoplasms
;
diagnosis
;
surgery
;
Laryngoscopes
;
Lasers, Gas
;
Neoplasm Recurrence, Local
;
Papilloma
;
diagnosis
;
surgery
;
virology
;
Papillomavirus Infections
;
diagnosis
;
surgery
;
Postoperative Period
;
Prognosis
;
Respiratory Tract Infections
;
diagnosis
;
surgery