Objective To compare the results of Danielson procedure with and without prosthetic valve ring in treating Ebstein anomaly and to define the effect of prosthetic valve ring on the procedure.Methods From January 2006 to December 2009,31 cases of Ebstein anomaly over 10 years old were classified as type A or type B according the Carpentier＇s classification scheme.Patients were treated by Danielson procedure or Danielson procedure plus prosthetic valve ring at Anzhen hospital.They were retrospectively classified as Danielson procedure group (group A,n =19) and Danielson procedure plus prosthetic valve ring group (group B,n =12 ).Results There was 1 early in-hospital death due to lung infection and hypoxemia in group A,and no early death in group B ( Fisher exact test,P =0.51 ).The mean follow-up time was ( 23.0 ± 18.5 ) months (5 -41 months).The cumulative follow-up time was 59.42 patient-years.There was one late death in group A due to the redo tricuspid valve plastic procedure because of severe tricuspid regurgitation,and no late death in group B.With echocardiography inspection,11 patients had mild and 7 had moderate to severe tricuspid regurgitation in group A,and only 2 mild tricuspid regurgitation in group B.The tricuspid valve competence after surgery in group B was better than in group A ( Fisher exact test,P=0.024).The 6-minute walk distance test (6MWD) in group B was significantly better than in group A(415 ±41 )m vs ( 382 ± 46 ) m( t test,P =0.047 ).The New York heart functional class in group B was statistically better than in Group A ( P =0.024).Conclusion Although there was no significant difference in the early and late mortality rate between the two groups after surgery,Danielson procedure plus prosthetic valve ring was better than pure Danielson procedure in prevention of late tricuspid regurgitation recurrence,heart function and 6MWD test during follow-up.

OBJECTIVETo investigate the antioxidant effect of melatonin (MT) in the rats with phosgene-induced lung injury and its possible mechanism.

METHODSFifty male SD rats were equally randomized into phosgene exposure group, air control group, MT treatment group, dexamethasone (DX) treatment group, and negative control group. All groups except the air control group were exposed to 8.33 mg/L phosgene for 5 min, and the MT treatment group, DX treatment group, and negative control group were injected with MT (10 mg/kg), DX (2.5 mg/kg), and 1% ethanol saline (1 ml/kg), respectively, via the caudal vein 1 hour after exposure. The rats were sacrificed 6h later. Then, the wet/dry ratio of the lung, the total protein content and neutrophil count in bronchoalveolar lavage fluid (BALF), and the malonaldehyde (MDA) content and superoxide dismutase (SOD) and myeloperoxidase (MPO) activities in lung homogenate were measured; pathological observation was made on the lung tissue under an optical microscope; the protein expression of inducible nitric oxide synthase (iNOS) and NF-κB in the lung tissue was measured by Western blot.

RESULTSCompared with the air control group, the phosgene exposure group showed significantly increased wet/dry ratio of the lung and total protein content and neutrophil count in BALF (P < 0.01) as well as significantly increased MDA content and MPO activity in the lung tissue (P < 0.05). Compared with the phosgene exposure group, the MT treatment group showed significantly decreased MDA content and MPO activity and significantly increased SOD activity (P < 0.01), and the MT treatment group and DX treatment group showed significantly decreased protein expression of iNOS and NF-κB (P < 0.01).

CONCLUSIONMT has protective effect in phosgene-induced lung injury, and its protective mechanism may be associated with scavenging free radicals and inhibiting expression of iNOS and NF-κB.

Acute Lung Injury ; chemically induced ; metabolism ; prevention & control ; Animals ; Disease Models, Animal ; Male ; Malondialdehyde ; metabolism ; Melatonin ; pharmacology ; therapeutic use ; NF-kappa B ; metabolism ; Nitric Oxide ; metabolism ; Nitric Oxide Synthase Type II ; metabolism ; Peroxidase ; metabolism ; Phosgene ; toxicity ; Rats ; Rats, Sprague-Dawley ; Superoxide Dismutase ; metabolism

OBJECTIVETo assess the effectiveness and safety of acupuncture and moxibustion for treatment of ulcerative colitis.

METHODSRandomized controlled trials or clinical controlled trials of acupuncture and moxibustion for interfere of ulcerative colitis in recent 10 years were reviewed and Meta-analysis was made for the literature results.

RESULTSAltogether 11 papers of clinical study were enrolled. Heterogeneous tests were conducted for the results of the 11 studies, as a result, chi2 = 8.55, P = 0.67. The fixed effect model was used for statistical analysis, after combination OR = 3.82, confidence interval of 95% was 2.65-5.52. The rhombus was located at the right side of the medium line. After Z test, Z = 7.14, P < 0.01, the therapeutic effect and the cured rate in the treatment group were significantly higher than those of the control group.

CONCLUSIONThe therapeutic effect of acupuncture and moxibustion on ulcerative colitis is superior to that of western medicine with safety and less adverse reactions.

Acupuncture Therapy ; Colitis, Ulcerative ; therapy ; Humans ; Moxibustion ; Randomized Controlled Trials as Topic

OBJECTIVETo explore the effect of general anesthesia, acupuncture at acupoints compound general anesthesia and acupuncture at non-acupoints compound general anesthesia on the perioperative analgesic effect in patients with laparoscopic cholecystectomy.

METHODSNinety patients scheduled to undergo laparoscopic cholecystectomy were randomly divided into a general anesthesia group (group A), an acupuncture at acupoints compound general anesthesia group (group B) and an acupuncture at non-acupoints compound general anesthesia group (group C), 30 cases in each group. General anesthesias were all induced by Fentanyl, Propofol and Vecuronium Bromide. The bilateral Hegu (LI 4), Neiguan (PC 6), Zusanli (ST 36) and Yanglingquan (GB 34) were selected in the group B, and the middle points of the line connecting the meridians where every acupoint mentioned above belonged and their lateral neighbor meridians selected in the group C. The dosage of anesthetics, the time of goggle and the time of evulsion cannulation and direction location in all the patients were compared, and the dosage of analgesia pump within 4, 6, 8, 24 and 44 hours and Visual Analogue Scale (VAS) of pain were recorded after surgery.

RESULTSThe dosage of Fentanyl in the group B was obviously lower than that in both the group A and the group C (both P<0.05), and the dosages of Propofol and Vecuronium Bromide in the group B were obviously lower than those in the group A (P<0.05, P<0.01). The time of goggle, evulsion cannulation and direction location in the group B were significantly shorter than those in the other groups (all P<0.01). After surgery, the dosage of analgesia pump in the group B was significantly fewer than that in the group C within 4 and 6 hours (both P<0.05), and it was significantly fewer than that in the group A within 4, 6, 8 hours (all P<0.05). The scores of VAS of pain at 44th hour after surgery in the group B were obviously lower than those in the other groups (both P<0.05).

CONCLUSIONAcupuncture at acupoints can enhance the anesthetic effect of compound general anesthesia and prolong the analgesia period. Acupuncture at non-points has a certain effect, but their effectiveness is less than that of acupoints. Thus, the acupoint has the specificity and accurate acupoint selection is the key factor affecting analgesia effect.

Acupuncture Analgesia ; Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Aged, 80 and over ; Cholecystectomy, Laparoscopic ; Female ; Gallbladder Diseases ; surgery ; Humans ; Male ; Middle Aged ; Pain Management ; Perioperative Care

OBJECTIVETo compare the influence of acupuncture combine with general anesthesia (ACGA) and general anesthesia (GA) on immune function in patients of laparoscopic cholecystectomy (LC) in peri-operational period.

METHODSThirty-nine cases undergoing LC were randomly divided into an ACGA group and a GA group. The ACGA group was treated with electroacupuncture at Hegu (LI 4), Zusanli (ST 36) and Yanglingquan (GB 34) for 15-30 minutes and subsequently with the general anesthesia followed by continuous electroacupuncture stimulation till the operation finished. The GA group was treated with simple general anesthesia. Changes of T cell subset, tumor necrosis factor-apha (TNF-alpha) and interleukin-6 (IL-6) were observed at time points of before anesthesia induction, 2 hours after operation, 1 and 3 days after operation and the occurrence of adverse reaction after operation was recorded.

RESULTSThe percentages of CD3+ and CD8+ in both groups at 2 hours after operation were significant lower than that before anesthesia induction (all P < 0.05), and the percentage of CD4+ in the GA group decreased significantly at that time point (P < 0.05), while there was no significant difference in the ACGA group and CD4+/CD8+ increased significantly (P < 0.05). The level of TNF-alpha in the ACGA group decreased significantly at 3 days after operation as compared with that of before anesthesia induction (P < 0.05). There were significantly less cases nauseated after operation in the ACGA group than that in the GA group (P < 0.05).

CONCLUSIONAcupuncture combine with general anesthesia has very little effect on immune function in patients of LC with less adverse reactions.

Acupuncture Analgesia ; Adult ; Aged ; Aged, 80 and over ; Anesthesia ; methods ; CD4-CD8 Ratio ; Cholecystectomy, Laparoscopic ; Female ; Humans ; Immunity ; Male ; Middle Aged ; Perioperative Period

OBJECTIVETo explore the influence of T lymphocyte activation on HIV-1 susceptibility of Han Chinese.

METHODSIn 2008, 37 HIV-1 highly exposed persistently seronegative individuals (ESNs) and 101 healthy controls were screened from Shenzhen. Flow cytometer was used to assay the expression difference of HIV-1 infection related co-receptor, the difference between the two groups were analyzed by Mann-Whitney U statistics methods.

RESULTST cell HLA-DR(+) CD4 T cells and HLA-DR(+) expression of ESNs (12.64 (5.94 - 21.90), 21.12 (10.74 - 30.21)) were all significantly lower than that of healthy controls (22.52 (7.91 - 58.60), 32.28 (14.72 - 67.82)) (P values all < 0.05). T cell CD45RA-RO(+), CCR5(+)CD4 expression of ESNs (58.68 (49.06 - 72.44), 21.93 (15.84 - 25.89)) were all significantly higher than that of healthy controls (53.17 (42.63 - 63.21), 16.14 (11.94 - 21.98)) (P values all < 0.05). T cell CXCR4(+)CD4 T cells expression of ESNs (93.67 (92.17 - 94.96)) was significantly lower than that of healthy controls (95.16 (92.99 - 96.77)) (P values all < 0.05). Healthy controls and ESNs could be divided into low expression group and high expression group according to HLA-DR(+)CD8 T cells bimodal distribution. A total of 89.2% (33/37) ESNs fell into HLA-DR + CD8 low expression group, and 58.4% (59/101) of the healthy controls located in low expression group (P < 0.05).

CONCLUSIONTo Han Chinese, the low activation status of T lymphocyte has significant correlation with HIV-1 low susceptibility.

Acquired Immunodeficiency Syndrome ; immunology ; pathology ; Adult ; Asian Continental Ancestry Group ; CD4-Positive T-Lymphocytes ; cytology ; immunology ; Case-Control Studies ; Disease Susceptibility ; Female ; HIV-1 ; Humans ; Lymphocyte Activation ; Male ; Young Adult

OBJECTIVETo probe the diagnostic value of the infrared radiation spectrum of acupoint for ulcerative colitis (UC).

METHODSA high sensitivity PHE 201 infrared spectrum instrument was used to determine the infrared radiation spectrum of Hegu (LI 4) and Shangjuxu (ST 37) in 34 cases of UC.

RESULTSOf 59 waves detected, there were significant differences in infrared radiation intensity of 28 different waves between the healthy people and the patients with UC in right Hegu (LI 4) (P < 0.05 or P < 0.01) and 13 waves in left Hegu (LI 4) (P < 0.05); there were significant differences in 16 different waves in right Shangjuxu (ST 37) (P < 0.05 or P < 0.01) and in 17 waves in left Shangjuxu (ST 37) (P < 0.05 or P < 0.01); there was a significant difference in 18 waves between right and left Hegu (LI 4) of the patients (P < 0.05 or P < 0.01) and 7 waves between right and left Hegu (LI 4) of the healthy people (P < 0.05). There was a significant difference in 4 waves between right and left Shangjuxu (ST 37) of the patients and one wave between right and left Shangjuxu (ST 37) of the healthy people (P < 0.01).

CONCLUSIONBoth Hegu (LI 4) and Shangjuxu (ST 37) show changes of infrared radiation spectrum when the intestine gets lesion, and Hegu (LI 4) can better show the change.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Colitis, Ulcerative ; therapy ; Female ; Humans ; Infrared Rays ; Intestine, Large ; anatomy & histology ; Male ; Middle Aged

OBJECTIVETo evaluate the efficacy and analyze the prognostic factors of sorafenib treatment in patient with unresectable primary hepatocellular carcinoma (HCC).

METHODSDuring the period from December 2005 to March 2009, 50 patients with unresectable primary HCC of Child-Pugh status A were treated with sorafenib (400 mg, Bid). The tumor response was evaluated with CT or MRI imaging every 6 - 8 weeks according to the RECIST criteria. The overall survival (OS) and time to progression (TTP) were defined as the time from administration of sorafenib to the death or the last follow up and were evaluated by Kaplan-Meier method.

RESULTSThere was no PR or CR, but 28 patients (56.0%) achieved stable disease. The median follow up time was 15 months with a median OS of 14 months and median TTP of 4 months. The common adverse events were dermal reaction (68.0%, 34/50), diarrhea (52.0%, 26/50), hypertension (4.0%, 2/50), hair loss (14.0%, 7/50), myelosuppression (16.0%, 8/50), and liver dysfunction (20.0%, 10/50). However, most of the drug-related adverse events were grade I-II and reversible. The patients with lower tumor burden and without distant metastasis had better prognosis.

CONCLUSIONSoafenib is effective for unresectable primary HCC with tolerable toxicity. Tumor stage is a predominant prognostic factor.

Adult ; Aged ; Alopecia ; chemically induced ; Antineoplastic Agents ; adverse effects ; therapeutic use ; Benzenesulfonates ; adverse effects ; therapeutic use ; Carcinoma, Hepatocellular ; drug therapy ; Chemoembolization, Therapeutic ; methods ; Diarrhea ; chemically induced ; Disease Progression ; Follow-Up Studies ; Humans ; Hypertension ; chemically induced ; Liver Neoplasms ; drug therapy ; Male ; Middle Aged ; Neoplasm Staging ; Niacinamide ; analogs & derivatives ; Phenylurea Compounds ; Pyridines ; adverse effects ; therapeutic use ; Skin Diseases ; chemically induced ; Survival Rate

OBJECTIVEThe aim of this study was to evaluate the therapeutic efficacy and to determine the prognostic factors of TACE in patients with colorectal liver metastases (CRLM).

METHODSThe clinical data of 183 patients with unresectable CRLM treated with TACE from Jan. 2002 to Dec. 2008 were retrospectively reviewed. Log-rank method was used for univariate analysis and Cox proportional hazard model was used for multivariate analysis of the prognostic factors.

RESULTSThe median survival time was 22 months, and the 0.5-, 1-, 2-, 3-, 5-year survival rates were 93.9%, 81.1%, 39.8%, 18.2%, and 3.9%, respectively. Multivariate analysis showed that tumor involved more than one lobe of the liver, and elevated CEA and CA19-9 levels were independent risk factors for the overall survival (P < 0.01). Females, more times of TACE, combination with regional therapy and received phase II resection were related with a good survival (P < 0.01) in CRLM patients after TACE treatment.

CONCLUSIONSTranscatheter arterial chemoembolization is an effective therapy for unresectable colorectal liver metastases. Patients with tumor spread more than one lobe of the liver, high CEA and CA19-9 levels are independent poor prognostic factors. Females, patients received more times of TACE, combined with regional therapy and received phase II resection may have a good survival.

Adult ; Aged ; Aged, 80 and over ; Antigens, Tumor-Associated, Carbohydrate ; blood ; Carcinoembryonic Antigen ; blood ; Chemoembolization, Therapeutic ; Colonic Neoplasms ; pathology ; Female ; Fluorouracil ; administration & dosage ; Follow-Up Studies ; Humans ; Iodized Oil ; administration & dosage ; Liver Neoplasms ; blood ; secondary ; surgery ; therapy ; Male ; Middle Aged ; Mitomycin ; administration & dosage ; Organoplatinum Compounds ; administration & dosage ; Proportional Hazards Models ; Rectal Neoplasms ; pathology ; Retrospective Studies ; Survival Rate

OBJECTIVETo study the clinical safety and effect on local recurrence in unresectable small hepatocellular carcinoma treated by radiofrequency ablation (RFA) with and without chemotherapy through a prospective randomized trial.

METHODSThirty-eight unresectable small hepatocellular carcinoma patients with diameter

RESULTSThere was no local recurrence of the tumor in the two groups 1 month after RFA treatment. The 6- and 12-month local recurrence rates were significantly lower in the combined group than that in RFA group alone (P < 0.01). There were no severe complications in the two groups, and nor was there any significant difference in liver function and WBC count.

CONCLUSIONRFA combined with systemic chemotherapy is safe, and it can reduce the local recurrence of unresectable small hepatocellular carcinoma
Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Carcinoma, Hepatocellular ; drug therapy ; therapy ; Catheter Ablation ; Cisplatin ; administration & dosage ; Combined Modality Therapy ; Epirubicin ; administration & dosage ; Female ; Fluorouracil ; administration & dosage ; Follow-Up Studies ; Humans ; Liver Neoplasms ; drug therapy ; therapy ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Prospective Studies ; Ultrasonography, Interventional