1.Surgical Treatment of Single Ventricle
Zhiwei XU ; Zhaokang SU ; Wenxiang DING
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2001;8(1):5-7
Objective To review and sum up experience of surgical repair of single ventricle. Methods Since January 1973 to December 1999, 47 patients with single ventricle have been repaired. Right ventricle type was 17 patients, left ventricle type was 14, and unrecorded type was 16. Surgical procedure consisted of pulmonary banding 1, Fontan operation 23, and bidirection superior cavopulmonary anastomosis 23. Results Seven patients died. The motality was 15%. There was no death in bidirection superior cavopulmonary anastomosis patients. Conclusion For the single ventricle, early surgical intervention is required to prevent pulmonary congestion and severe cyanosis. The bidirection superior cavopulmonary anastomosis can improve single ventricle function secondary to pressure and volume load to decrease surgical mortality and to minimize the risk factors for subsequent Fontan operation.
2.The Inhibitory Effect and Mechanism of Ester Catechin Monomers-EGCG, GCG on the Growth of Human Colon Carcinoma Cell Line SW480
Yanhui YU ; Renkui DING ; Zhiwei ZHANG
Journal of Chinese Physician 2001;0(02):-
Objective To investigate the inhibitory effect of ester catechin monomers-EGCG, GCG on the growth of human colon carcinoma cell line SW480 and its potential mechanism. Methods MTT assay, soft-agar colony formation test, Hoechst 33258 stain and flow cytometry analysis were used to determine the inhibitory effect of theasinesin(TS), and its monomers-EGCG, GCG on SW480 growth. Results EGCG, GCG and TS significantly inhibited the growth of human colon carcinoma cell line SW480 in dose-dependent manner, and their half inhibitory concentration (IC 50 ) was 108.88, 183.21, and 83.36?g?ml -1 , respectively. 24 hours after treatment with IC 50 of EGCG, GCG and TS, the colony formation rate of SW480 cells in the experimental group was obviously lower than that in the control group. Hoechst 33258 staining showed typical apoptotic features such as cell shrinkage, nuclear condensation and cell splinter in the experimental group. A subdiploid peak before G 0/G 1 phase in the experimental group was observed by flow cytometry. Conclusion In accord with TS, EGCG and GCG could inhibit the growth of colon carcinoma cell line SW480 cells, the mechanism of which may be related to inducing cell apoptosis.
3.Clinical value of detecting serum tumor markers in postoperative breast cancer patients
Haoshu DING ; Kejin WU ; Zhiwei QUAN
Journal of Endocrine Surgery 2009;3(6):365-369
Objective To investigate the relationship between serum levels of CA15-3, CA-125 and CEA in postoperative breast cancer patients and clinicopathological parameters and pathogenetic condition turnover. Methods From January 2004 to December 2007, 219 breast disease cases with integrity clinical information, admitted to general surgery and oncology department of Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, were collected. The serum concentrations of CA15-3, CA-125 and CEA were determined by chemiluminescent immunoassay(CLIA). Wilcoxon Kruskal Wallis analysis, crosstable analysis and spearman correlation analysis were used to investigate the association between the serum concentration and clinical parameters and pathogenetic condition turnover. Results The serum concentrations of CA15-3,CA-125 and CEA in metastatic breast cancer group were significantly higher than those in nonmetastatic group(P=0.000). The sensitivity of the 3 tumor markers in combination was 64.1% in metastatic breast cancer diagnosis. CA15-3 and CA-125 at the time of initial metastasis were correlated with estrogen receptor state(PCA15-3=0.039, PCA-125=0.049). The level of 3 tumor markers in multiorgan metastatic group were significantly higher than those in single organ metastastic patients(P=0.000). There were significant differences between the levels of CA15-3 and CEA in distant metastatic group and those in local metastatic group (PCA15-3=0.001,PCEA=0.022). Conclusion The high serum concentrations of CA15-3,CEA and CA-125 were useful in monitoring the metastasis. The high serum levels of CA15-3 and/or CA-125 may indicate that the patients will be more sensitive to endocrine therapy.
4.The use of enteral nutritional support in treating superior mesenteric artery syndrome
Kai DING ; Zhiming WANG ; Zhiwei JIANG
Parenteral & Enteral Nutrition 1997;0(02):-
Objective:To observe the role of enteral nutritional support in treating superior mesenteric artery syndrome. Methods: Enteral nutritional support was used in two patients with superior mesenteric syndrome after percutanous endoscopic jejunostomy.Enteral nutrition was used for 69 days and 180 days.The symptoms were observed.Body weight and index of nutrition were measured.Results: After enteral nutritional support,symptoms of two patients disappeared.Body weight and fibronectin and prealnumin increased.Conclution: Enteral nutritional support is one of effective methods of treating superior mesenteric artery syndrome.
5.Application value of hand acupuncture holographic method in endoscopy
Xiangyu HE ; Xiuqing ZENG ; Zhiwei DING
Chinese Journal of Primary Medicine and Pharmacy 2013;20(z2):20-21
Objective To explore the Application value of hand acupuncture holographic method in endosco -py.Methods According to randomized controlled holographic method ,200 patients who underwent endoscopy were divided into the hand acupuncture holographic group (68 cases),the hand acupuncture group (65 cases) and the con-trol group(67 cases).The hand acupuncture holographic group pushed the needle sticking and made use of press and hand acupuncture combination of both methods ,and the hand acupuncture group was taken hand-hole method ,and the control group was taken normal gastroscopy operation .A questionnaire survey ( after checking the content of what dis-comfort,fear,are you willing to accept gastroscopy retest ) was taken and observed the patient's discomfort after the op-eration that nausea,vomiting,abdominal distension and pain,salivation volume,mirror smooth interpolation degree. Results The subjective feelings of the hand acupuncture holographic group were better than those of the hand acu -puncture group and the control group (all P<0.05);The adverse reactions of the hand acupuncture holographic group were lower than those of the hand acupuncture group and the control group before and during the endoscopy ( all P<0.05).Conclusion The hand acupuncture holographic therapy is a combination method of hand side of the second metacarpal holographic acupuncture massage gastroscopy which can reduce pain and fear of the patients ,and its side effects is small ,and it is inexpensive ,the risk factor is small ,and it is easy to operate easy to spread .
6.Clinical study of percutaneous endoscopic gastrostomy for long-term enteral nutrition in patients with cancers of head and neck
Zhiwei JIANG ; Zhiming WANG ; Kai DING
Medical Journal of Chinese People's Liberation Army 1982;0(01):-
Objective To evaluate percutaneous endoscopic gastrostomy (PEG) for long-term enteral nutrition in patients with cancers of head and neck. Methods PEGs were performed for 12 patients with head and neck cancers, the indication for which included serious buccal mucositis, difficulty in swallowing, anorexia, and obstruction of the digestive tract. Before PEG and 8 weeks after PEG, serum concentrations of total protein and albumin of the patients were measured, body composition including body weight, free fat mass, and fat mass were measured by bioelectric impedance analysis (BIA), and Karnofsky performance score ( KPS) was evaluated. Results After enteral nutrition for 8 weeks through PEG, the serum concentrations of total protein and albumin of the patients increased significantly (63.8?0.3g/L vs 57.4?0.2g/L, P
7.Double-switch operation for corrected transposition of great arteries with pulmonary stenosis
Jinghao ZHENG ; Zhiwei XU ; Jinfen LIU ; Zhaokang SU ; Wenxiang DING
Chinese Journal of Thoracic and Cardiovascular Surgery 2010;26(2):76-79
Objective To compare the results of surgical repair for congenitally corrected transposition of the great arter-ies(ccTGA) with pulmonary stenosis(PS), and to analyze the risk factors that may affect early results and surgical technique. Methods From Aug. 2001 to Dec. 2008, 21 patients with ccTGA and PS were treated in our hospital. They aged 3.5 months to 6.3 years [(31 ± 18) months], weighted 6.28 kg [(13.1± 6.5) kg]. Fifteen cases had paramembranous ventricular sep-tal defect (VSD), 1 noncommitted VSD and 5 subpulmonary VSD. The repairs comprised of Senning and Rastelli operation. RV-PA reconstruction was done by xenopericardial conduit in 13 patients. RV-PA direct anastomosis plus pericardial patch in 6 patients and homograft patch with autopulmonary valve in 2 patients. Results All the patients were alive. During 2 - 5 years follow-up, blood flow rate in superior vena cava increased to 1.8 - 2.2 m/s in 3 cases. One of them needed reoperation to re-lease the stenosis and the rest 2 were in follow-up. Tow patients had right ventricular outlet obstruction with a pressure gradient of 30 -45 mmHg were in follow-up. There was no other stenosis and valve insufficiency. Conclusion Double-Switch opera-tion is practical and impressive in treating of CCTGA with PS. It is important to evaluate the size of VSD and the reconstruction of RV-PA. But it still need more cases and longer time to evaluate the long-term effects.
8.The clinical application of Konno operation in left ventricular outflow tract obstructionin in children
Jinghao ZHENG ; Zhiwei XU ; Jinfen LIU ; Zhaokang SU ; Wenxiang DING
Chinese Journal of Thoracic and Cardiovascular Surgery 2013;(5):265-268
Objective Reviewed and evulated the prognosis of multiple levels of left ventricular outflow tract obstruction (LVOTO) with Konno operation.Methods Between May 2006 and May 2012,we performed Konno operation in 16 children with LVOTO.They aged from 1.9 to 13.6 years,averaged(5.1 ± 0.7)years,and weighted from 12 to 39 kg,averaged (18.3 ±6.3) kg.There are 13 cases of patients who were multiple levels of LVOTO.The pressure gradient of LVOTO was 56-185 mmHg[(96 ± 31) mm Hg].The operations were performed with middle low temperature in cardiopulmonary bypass (CPB).The time for CPB and Aortic clamp arrest was 70-182 min [(98 ± 21) min] and 34-148 min[(51 ± 11) min] respectively.There were 3 cases,4 cases and 9 cases for Konno,Konno ± Ross and Konno-Rastan respectively.Results All the pacients were alive.The time for making use of respirometer and staying in ICU was 3-9 days [(4.0 ± 1.5) days] and 5-16 days [(8.0 ±2.9) days] respectively.Follow-up with 6 months to 3 years,the ECHO showed no residual obstruction.The pressure gradient of LVOTO was 1.10-2.42 m/s.LVEF was 0.58-0.72 (0.66 ± 0.03).There were 2 cases for mild to middle aortic valve regurgitation,1 case for middle to severe aortic valve regurgitation and 1 case for middle pulmonary valve regurgitation and middle tricuspid valve regurgitation.Conclusion Konno procedure is safty and effective operation for LVOTO in children and is beneficial to the recovery of left ventricular function.It is necessary to follow up the complication in the future.
9.Perioperative managements of VLBW preterms with hsPDA
Cheng ZHANG ; Shaoru HE ; Zhiwei ZHAGN ; Yiqun DING
Chinese Journal of Thoracic and Cardiovascular Surgery 2013;29(9):513-516
Objective The aim of this study is to retrospectively analyze perioperative managements of very-low-birth-weight(VLBW) preterms with hemodynamic significant patent ductus arteriosus (hsPDA).Methods Between January 2006 and December 2011,totally 22 VLBW preterms with hsPDA underwent surgical ductal ligation.There were 12 boys and 10 girls.The median gestatianal age was 29 weeks (24 + 5-32 +6 weeks).The birth weight was (1103 ± 228) g(640-1440 g).The Apgar score was 6.1 ± 2.2 at 1 minute,8.6 ± 1.2 at 5 minutes.The average ductal size was (3.79 ± 1.01)mm (2.0-5.9 mm)、(2.69 ± 0.84) mm/kg(1.23-4.23 mm/kg),left atrial diameter to aortic root ratio(LA:AO) was 1.69 ± 0.41.The median weight at surgery was 1500 g(640-2100 g),average (1512 ±539) g.The median age at surgery was 24 days (11-167 days).Results 1 case death because of anesthetic accident.The average hospitalization days were (67.1 ± 36.1) days.The days of ventilation treatment after surgery were 2-44 days,15 cases (68.2%) weaned from mechanical ventilation within seven days after surgeries.The complications includes pulmonary hemorrhage (18.2%),necrotizing enterocolitis (13.6%),septicemia(22.7%),broncho-pulmonary dysplasia (63.7%),brain injury(18.1%),retinopathy of prematurity (31.8%),pneumonia (86.4%) and metabolic acidosis (45.5 %).Conclusion For VLBW preterms with hsPDA,early diagnosis and early interfere are key points.Surgical PDA ligation is a promising option to avoid severe complications when medical treatments are ineffective.
10.The emergency operation of total obstructive anomalous pulmonary venous connection in newborn
Jinghao ZHENG ; Zhiwei XU ; Jinfen LIU ; Zhaokang SU ; Wenxiang DING
Chinese Journal of Thoracic and Cardiovascular Surgery 2011;27(12):709-712
Objective Evaluate the outcome of total anomalous pulmonary venous connection (TAPVC) repair in newborn,controlling for anatomic subtypes and surgical technique.Methods Between 1999 and 2011,68 patients (median age 16 days) underwent repair for supracardiac (21),cardiac ( 8 ),infracardiac ( 36 ) or mixed ( 3 ) TAPVC.All patients were emergencies,due to obstructed drainage.Supracardiac and infracardiac TAPVC repair included the side-to-side anastomosis between the pulmonary venous (PV) confluence and the left atrium.Coronary sinus unroofing was preferred for cardiac TAPVC repair.Results Early mortality was 2.9% (2/68).The echo showed no obstruction in the pulmonary vein anastomosis and flow rate was 1.1 m/s ~ 1.42 m/s in the follow-up of 3 years.Side-to-side anastomosis provides excellent results for TAPVC repair while left atrial enlargement procedures appear to be associated with higher risk of late arrhythmias.Although early and aggressive reintervention for recurrent PV obstruction is mandatory,intrinsic PV stenosis remains a predictor of adverse outcome.The incidence of pulmonary vena is gradually reduced to 6% ~ 11%.This often occurred in the infracardiac or mixed TAPVC.Conclusion The nicety of preoperative diagnose,the improvement of protection of heart function,using of pulmonary vena tissue for anastomose and avoiding of distortion of pulmonary venues and delayed closure of stemum can reduce the mortality.The preoperative degree of pulmonary veno obstruction and the time of emergency operation and the infracardiac or mixed TAPVC can affect prognosis.Along with the surgical technique,the mortality of TAPVC is gradually reduced and the result is amazing,but it is important to attach importance to the patient with re-stenosis of pulmonary veno,the time and method for reoperation.