【Abstract】 Objective To explore the clinical value of vibration response imaging ( VRI) in patients with chronic obstructive pulmonary disease ( COPD) . Methods 255 COPD patients and 78 healthy volunteers were enrolled and lung function test and VRI examination were performed. The parameters of VRI included dynamic image grades, vibration energy graph grades, vibration value, quantitative lung data ( QLD) of right lung, and crack counts. Results The VRI parameters of the COPD group were as follows, ie.dynamic image grades of 3. 07 ±1. 34, graph grades of 7. 81 ±3. 27, vibration value of 1. 57 ±0. 46, QLD of( 49. 5 ±12. 6) % , crack counts of 5. 27 ±7. 74. The VRI parameters of the control group were as follows, ie.dynamic image grades of 1. 14 ±1. 00, graph grades of 2. 24 ±1. 27, vibration value of 1. 87 ±0. 40, QLD of( 44. 0 ±7. 7) % , crack counts of 0. 21 ±0. 88. There were significant differences in all parameters between the two groups ( all P lt;0. 05) . There was a linear relationship between VRI and FEV1% pred ( r = 0. 548,P lt;0. 01) . The model of the linear regression was Y =80. 833 - 2. 735X1 - 5. 406X2 ( Y: FEV1% pred, X1 :VRI graph grades, X2 : dynamic image grades) . Conclusion VRI is a promising method to diagnose and assess the severity of COPD.
Objective To evaluate the long-term effectiveness of treating early-middle stage avascular necrosis of the femoral head (ANFH) with core decompression and bone grafting. Methods Between January 2000 and December 2006, 87 ANFH patients (114 hips) were treated with core decompression and bone grafting, including 54 cases (62.1%) of alcohol-induced ANFH, 26 cases (29.9%) of steroid-induced ANFH, and 7 cases (8.0%) of idiopathic ANFH. There were 74 males (97 hips) and 13 females (17 hips), aged 20-56 years (mean, 38 years). The disease duration was 3-46 months (mean, 18 months). According to Ficat staging, 16 hips were at stage I, 68 hips at stage II, and 30 hips at stage III. The Harris score and Ficat stage were compared between pre- and post-operation to assess the outcomes clinically and radiologically. The hip survival was analyzed by the Kaplan-Meier method. Results Eighty-seven patients were followed up 5 years to 11 years and 10 months (mean, 8 years and 9 months). The Harris hip score was significantly increased from 73.13 ± 7.17 at preoperation to 81.59 ± 13.23 at postoperation (t= — 9.318, P=0.000). The clinical success rate was 69.3% (79/114) and the radiological success rate was 54.4% (62/114). Kaplan-Meier survival analysis showed that the overall survival rate was 84.2% (96/114); the survival rates of Ficat stage I [100% (16/16)] and stage II [91.2% (62/68)] were higher than that of stage III [60.0%(18/30)] (P lt; 0.01); there was no significant difference between Ficat stage I and II (χ2=1.520, P=0.218). Conclusion Core decompression with bone grafting is a safe and effective procedure for the treatment of Ficat stages I-II (early stage) ANFH, and the long-term effectiveness is satisfactory. But the long-term effectiveness is unsatisfactory for the patients at the Ficat stage III (middle stage).
Objective Through conducting a meta-analysis using the methodology of Cochrane review, to assess the effectiveness and safety of graft-versus-host disease (GVHD) prophylaxis with antithymocyte globulins (ATGs) in allogeneic hematopoietic stem cell transplantation (allo-HSCT). Methods Such databases as PubMed (1966 to March 2011), EMbase (1974 to March 2011), the Science Citation Index databases (1900 to March 2011), The Cochrane Library (1996 to March 2011), CBMdisc (1978 to March 2011), and CNKI (1979 to March 2011) were electronical1y searched. The references of all identified studies were retrieved for collecting more randomized controlled trials (RCTs) and non-RCTs. Two reviewers independently screened the trials according to inclusion and exclusion criteria, abstracted the data, and assessed the methodology quality of the included studies. Meta-analyses were performed using RevMan 5.0.2 software. Results Thirteen clinical trials were included, of which 2 were RCTs involving 310 patients and the other 11 were non-RCTs involving 1480 patients. The results of meta-analyses showed that compared with the Non-ATG group, the pooled risk ratio (RR) and 95%CI of the ATG group in acute GVHD II-IV incidence rate, acute GVHD III-IV incidence rate, chronic GVHD (limited plus extensive) incidence rate, chronic GVHD (extensive) incidence rate, overall survival (OS) rate, non-relapse mortality (NRM) rate, and relapse rate were 0.77 (0.67, 0.87), 0.54 (0.44, 0.68), 0.58 (0.51, 0.65), 0.35 (0.26, 0.46), 1.14 (1.04, 1.25), 0.81 (0.69, 0.93), and 1.24 (0.98, 1.57), respectively. Conclusion The addition of ATGs to GVHD prophylaxis can reduce the incidence of acute and chronic GVHD, decrease NRM, and increase OS, but has no obvious interference with relapse rate.
ObjectiveTo investigate the changes of plasma platelet activating factor (PAF) interleukin-8(IL-8) and interferon-γ (IFN-γ) in patients after surgery with extracorporeal circulation (ECC) and their clinical significance. MethodsSeventy-five patients undergoing surgery with ECC in the First College of Clinical Medicine,China Three Gorges University from June 2012 to June 2013 were enrolled in this study. According to the presence of postoperative acute lung injury/acute respiratory distress syndrome (ALI/ARDS) all the 75 patients were divided into 2 groups. In ALI/ARDS group, there were 28 patients including 20 male and 8 female patients with their age of 53.6±8.2 years. In the control group,there were 47 patients without postoperative ALI/ARDS,including 32 male and 15 female patients with their age of 56.9±11.8 years. Dynamic variations of plasma PAF,IL-8 and IFN-γ of these patients were examined with enzyme-linked immunosorbent assay (ELISA) and compared between the 2 groups. ResultsIn ALI/ARDS group,plasma IL-8 and IFN-γ reached peak levels at 48 hours after surgery and gradually decreased after that;plasma PAF reached the peak level at 96 hours after surgery and gradually decreased after that. Postoperative plasma PAF (96 hours after surgery:16 029.5±4 203.7 mU/ml vs. 4 520.1±312.2 mU/ml,P<0.05) IL-8 (48 hours after surgery:48 580.5±8 095.8 pg/ml vs. 5 990.5±1 179.0 pg/ml,P<0.05) and IFN-γ (48 hours after surgery:258.5±76.1 pg/ml vs. 26.1±11.5 pg/ml,P<0.05) of ALI/ARDS group were significantly higher than those of the control group at 48 hours,96 hours and 144 hours after surgery. ConclusionPlasma PAF,IL-8 and IFN-γ change significantly after surgery with ECC,which may play an important role in the pathogenesis of postoperative ALI/ARDS.
【摘要】 目的 探讨t(8；21)急性髓系白血病(acute myeloid leukemia，AML)的临床特点及预后，提高对t(8；21)AML的认识。 方法 2010年5月收治1例t(8；21)AML患者，对其临床资料并复习相关文献进行分析。患者因乏力、皮下瘀斑入院，查体发现患者有胸骨压痛，脾肋下3 cm触及，血常规:白细胞80.37×109/L，异常细胞 23%，取患者骨髓液行形态学、流式细胞术检测及染色体核型检测。 结果 患者诊断为急性粒细胞白血病部分分化型(AML-M2b)，AML1/ETO融合基因阳性，染色体核型分析t(8；21)(q22；q22)。 结论 t(8；21)AML是一类较为特殊的急性髓系白血病，在诊断时需寻找疾病的预后因素并进行分层，实施个体化治疗。【Abstract】 Objective To obsrve the clinical features and prognosis of acute myeloid leukemia (AML) with t(8;21). Methods The clinical data of one patient with t (8; 21) AML diagnosed in May 2010 was retrospectively analyzed. The chief complaints of the patient were malaise and ecchymosis. The physical examinations revealed sternum pain and splenomegaly; blood routine examination showed that the peripheral WBC count was 80.37×109/L, and the abnormal cells were 23%. Bone marrow samples were collected to perform the morphologic test, flow cytometry analysis and chromosome analysis. Results The patient was diagnosed as AML with maturation (AML-M2) with positive AML1/ETO fusion gene and translocation (8; 21) (q22; q22). Conclusion AML with t (8; 21) is different with other types of AML; patients with AML with t (8; 21) need individualized treatment.
The aim of this study is to evaluate the effect of laparoscopic simulation training with different attention. Attention was appraised using the sample entropy and θ/β value, which were calculated according to electroencephalograph (EEG) signal collected with BrainLink. The effect of laparoscopic simulation training was evaluated using the completion time, error number and fixation number, which were calculated according to eye movement signal collected with Tobii eye tracker. Twenty volunteers were recruited in this study. Those with the sample entropy lower than 0.77 were classified into group A and those higher than 0.77 into group B. The results showed that the sample entropy of group A was lower than that of group B, and fluctuations of A were more steady. However, the sample entropy of group B showed steady fluctuations in the first five trainings, and then demonstrated relatively dramatic fluctuates in the later five trainings. Compared with that of group B, the θ/β value of group A was smaller and shows steady fluctuations. Group A has a shorter completion time, less errors and faster decrease of fixation number. Therefore, this study reached the following conclusion that the attention of the trainees would affect the training effect. Members in group A, who had a higher attention were more efficient and faster training. For those in group B, although their training skills have been improved, they needed a longer time to reach a plateau.
Objective To explore the factors affecting the operation of coronary artery bypass grafting with heart beating and improve the effect of the operation. MethodsFrom January 2012 to June 2016, 898 patients with coronary heart disease who received cardiovascular surgery in the Second Affiliated Hospital of Jilin University were analyzed retrospectively. All patients only underwent coronary artery bypass grafting with beating heart. Among them, 797 patients underwent the off-pump coronary artery bypass grafting (an OPCABG group, 592 males and 205 females, with an average age of 60.5±8.4 years); another 101 patients received on-pump beating heart coronary artery bypass grafting (an OPBH group, 77 males and 24 females, with an average age of 61.5±8.2 years). ResultsThe average number of grafts in the OPCABG group was 3.36±0.74, and in the OPBH group was 3.71±0.69 (P<0.05). The postoperative ventilation time (10.8±9.5 h vs. 20.6±12.3 h), ICU stay (28.8±15.5 h vs. 37.4±30.8 h), hospital stay (10.9±4.8 d vs. 14.8±8.6 d), mortality (1.1% vs. 3.0%), the utilization rate of intra-aortic balloon pump (2.4% vs. 8.9%) and extracorporeal membrane oxygenation (0.5% vs. 5.0%) were significantly different between the OPCABG group and OPBH group (all P<0.05). Twelve patients died after surgery, and the total bloodless operation ratio was 91.3%. ConclusionThe results show that most patients can achieve good results with the help of apical fixation and myocardial fixator, improved surgical techniques and methods, good anesthesia management as well as flexible and accurate use of vasoactive drugs. But extracorporeal circulation is necessary in the patients with large left ventricle, low ejection fraction and hemodynamic instability after intraoperatively moving the heart.