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.

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.

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.

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

Humans ; Surgeons ; Thyroid Neoplasms ; surgery ; Thyroidectomy

Ear Canal ; drug effects ; Econazole ; therapeutic use ; Endoscopy ; Humans ; Otomycosis ; drug therapy ; Triamcinolone Acetonide ; therapeutic use

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.

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.

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

BACKGROUND: Chronic rejection limits the long-term success of cardiac transplantation and the underlying causes of the disease are unknown. Connective tissue growth factor (CTGF) is considered as a mitogenic and chemotactic factor for fibroblasts and is associated with cell proliferation and collagen synthesis.OBJECTIVE: To evaluate the role and significance of expression of CTGF in rat chronic rejection heart aliografta.DESIGN, TIME AND SETTING: A randomized controlled animal experiment was performed at the Laboratory Animal Center of the Second Xiangya Hospital between April and August 2007.MATERIALS: Twenty Wistar rats serving as donors and twenty Sprague-Dawely (SD) rats serving as recipients were included. An additional 10 Wistar rats were included as controls.METHODS: After intra-abdominal heterotopic heart transplantations, rats received cyclosporine A, mycophenolate, and methylprednisolone immunosuppression. Ten recipient rats were anesthetized and sacrificed for heart harvesting at 2 and 8 weeks postoperation, respectively.MAIN OUTCOME MEASURES: Coronary vessel density, fibrosis grade, and intimal occlusion were observed by hematoxylin-cosin staining and Van Gieson staining. Myocardial fibrosis was semi-quantitatively scored. CTGF expression was detected by immunohistochemistry. The associations between CTGF expression and allograft fibrosis and CAV formation were analyzed.RESULTS: Allografts harvested at 8-week post-surgery showed more obvious coronary intimal proliferation, fibrosis and higher CTGF expression compared with the 2-week allografts and the controls (P < 0.05-0.01 ) while the cardiac artery density was lower than the control group (P < 0.05). However, the control group in our study showed negligible CTGF expression. There were strong negative correlations between the gray value of CTGF protein expression and cardiac fibrosis and coronary intimal occlusion (r = -0.734, -0.713, P < 0.01), demonstrating that CTGF protein expression was positively correlated with cardiac fibrosis and coronary intimal occlusion.CONCLUSION: CTGF is expressed in cardiac myocyte with CAV. The increased expression of CTGF in the cardiac allograft is associated with CAV development and fibrosis formation and is involved in the pathogenesis of cbronic heart rejection