目的评价单穿刺点经胸微创封堵治疗房间隔缺损（ASD）合并室间隔缺损（VSD）的安全性及有效性。 方法纳入2014年6月至2015年8月于我院成功完成单穿刺点经胸微创封堵术治疗ASD合并VSD的8例患儿，分析患儿在术后第l个月、3个月、6个月的门诊随访资料。观察围术期及随访期间患者残余分流、瓣膜反流、心律失常等并发症发生情况。 结果8例患儿中，术后早期均无残余分流、心律失常，微量三尖瓣反流（TR）患者1例（12.5%）。平均随访时间5～9（6±2）个月，各瓣膜均未发现中度及以上反流，未发现存在血栓、严重心律失常、死亡的患者。 结论单穿刺点经胸微创封堵治疗ASD合并VSD安全、有效，且更为微创。
ObjectiveTo systematically review the diagnostic value of neuron specific enolase (NSE) for malignant pleural effusion. MethodsWe comprehensively searched databases including The Cochrane Library (Issue 1, 2012), EMbase, MEDLINE, CBM, CNKI, WanFang Data and VIP from inception to January 2012 to collect studies about the diagnostic value of NSE for malignant pleural effusion. Literature screening according to the inclusion and exclusion criteria, data extraction and methodological quality assessment were completed by two reviewers independently. Then Meta-DiSc software (version 1.4) was used for pooling analysis. ResultsA total of 12 studies were finally included. The results of meta-analysis showed that the value of pooled specificity, sensitivity, positive likelihood radio, negative likelihood radio and diagnostic odds ratio (DOR) were 0.79 (0.76 to 0.84), 0.55 (0.51 to 0.59), 3.2 (1.94 to 5.29), 0.58 (0.45 to 0.74), 7.56 (3.74 to 15.30), respectively; and the area under SROC curve (AUC) was 0.813 1. ConclusionUsing NSE as a maker to diagnose malignant pleural effusion is of certain clinical value, which is used to differentiate benign and malignant pleural effusion.
ObjectiveTo investigate the protective effect of atomized inhalation of nano-luteolin preparation on acute lung injury caused by extracorporeal circulation, and to explore the anti-inflammatory mechanism of luteolin, so as to provide study basis for clinical application.MethodsThirty male SD rats aged 5-6 weeks and weighting 160-190 g, were randomly divided into a preoperative baseline (BL) group, arteriovenous partial diversion (ECC) group, luteolin atomization pretreatment for 1 h group, 2 h group, and 3 h group by random number method, with 6 rats in each group. In the BL group, lung tissue samples were collected directly without any treatment. The ECC group received mechanical ventilation, and the whole body was heparinized after the jugular arteriovenous intubation. The flow was transferred for 30 minutes, followed by observation for 60 minutes, then lung tissue samples were collected. Subjects in the 1 h, 2 h and 3 h groups were placed in a small animal atomizer 1 h, 2 h and 3 h before flow transfer respectively, and the subsequent operation was the same as that in the ECC group. The inflammatory level of lung tissue was detected to evaluate the degree of pathological injury of lung tissue. Western blotting (WB) was used to detect the contents of p65, IKKα, IKKβ and IKKγ in the cytoplasm of lung tissue samples of each group.ResultsCompared with the ECC group, the levels of IL-6 and TNF-α in lung tissues and the degree of pathological injury in the 1 h, 2 h and 3 h groups decreased, and the difference between the 3 h group and the ECC group was statistically different (P<0.05). WB results showed that compared with the ECC group, the levels of p65 in lung tissue of the 1 h, 2 h and 3 h groups decreased; the levels of IKKβ in the lung tissue increased in the 1 h, 2 h and 3 h groups, and the difference of the 3 h group was statistically different from the ECC group (P<0.05).ConclusionLuteolin has a protective effect on acute lung injury induced by ECC, and atomization 3 h in advance has the best protective effect on lung. The mechanism plays a protective role in ECC-induced acute lung injury, may be through inhibition of IKKβ phosphorylation, thereby inhibiting the classical NF-κB signaling pathway.
Objective To explore the application effect of 3D printed heart models in the training of young cardiac surgeons, and evaluate their application value in surgical simulation and skill improvement. MethodsEight young cardiac surgeons were selected form West China Hospital as the trainees. Before training, the Hands-On Surgical Training-Congenital Heart Surgery (HOST-CHS) operation scores of the 8 cardiac surgeons were obtained after operating on 2 pig heart models of ventricular septal defect (VSD). Subsequently, simulation training was conducted on a 3D printed peri-membrane VSD heart model for 6 weeks, once a week. After the training, all trainees completed 2 pig heart VSD repair surgeries. The improvement of doctors’ skills was evaluated through survey questionnaires, HOST-CHS scores, and operation time after training. ResultsBefore the training, the average HOST-CHS score of the 8 trainees was 52.2±6.3 points, and the average time for VSD repair was 54.7±7.1 min. During the 6-week simulation training using 3D printed models, the total score of HOST-CHS for the 8 trainees gradually increased (P<0.001), and the time required to complete VSD repair was shortened (P<0.001). The trainees had the most significant improvement in scores of surgical cognition and protective awareness. The survey results showed that trainees were generally very satisfied with the effectiveness of 3D model simulation training. Conclusion The 3D printed VSD model demonstrates significant application advantages in the training of young cardiac surgeons. By providing highly realistic anatomical structures, 3D models can effectively enhance surgeons’ surgical skills. It is suggested to further promote the application of 3D printing technology in medical education, providing strong support for cultivating high-quality cardiac surgeons.
ObjectiveTo investigate the feature of the angulation between left pulmonary artery (LPA) and main pulmonary artery (MPA) and its relationship to pulmonary artery development in patients with tetralogy of Fallot (TOF).MethodsA total of 101 TOF patients in West China Hospital from 2014 to 2018 were enrolled in a TOF group, including 62 males and 39 females, aged 6.8 (0.3-45.8) years, and another 20 patients without basic cardiac diseases at the same stage were enrolled in a control group, including 10 males and 10 females, aged 6.9 (0.3-54.0) years. Diameters of LPA, right pulmonary artery (RPA) and MPA, the angulation between LPA and MPA (MPA-LPA), McGoon ratio, and Nakata index were measured and compared between the two groups. The relationship between the above data and MPA-LPA angulation was also analyzed.ResultsThe average MPA-LPA angulation was smaller in the TOF group than that in the control group (113.63° vs. 128.45°, P=0.001 8). The MPA Z score was also smaller in the TOF group than that in the control group (0.46 vs. 2.75, P=0.000 4). No relationship was found by correlation analysis between the MPA-LPA angulation and MPA Z score or LPA Z score in the control group (P=0.239 6, 0.114 7) and the TOF group (P=0.759 3, 0.242 7). The McGoon ratios (2.22±0.72, 2.43±0.94, P=0.340 0) and Nakata index (359.3±294.24, 395.52±329.31, P=0.650 0) were not significantly different between the two groups.ConclusionThe angulation of LPA-MPA and MPA Z score are smaller in the TOF group than those in the control group. There is no relationship between MPA-LPA angulation and pulmonary artery diameters. The LPA-MPA angulation should not be considered as an influence factor for LPA development and trans-annular patch surgery.