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find Author "张辉" 49 results
  • Edwards MC3成形环行三尖瓣成形术治疗中至重度三尖瓣反流

    目的 探讨Edwards MC3成形环在三尖瓣中、重度关闭不全患者中行三尖瓣成形术的近、中期效果,总结临床经验。 方法 2004年6月至2007年12月我科收治心脏病(包括风湿性心瓣膜病、房间隔缺损、Ebstein畸形)伴中、重度三尖瓣关闭不全患者55例,其中男28例,女27例;年龄28~78岁,平均年龄50.50岁;三尖瓣中度反流22例,重度反流33例。根据手术方式不同将55例患者分为3组:De Vega成形组(De Vega组):18例,行De Vega成形术;硬质Carpentier成形环成形组(Carpentier组):12例,用硬质Carpentier成形环行三尖瓣成形术;Edwards MC3成形环成形组(MC3组):25例,用Edwards MC3成形环行三尖瓣成形术。术后比较3组的手术疗效,对所有患者均进行随访,在不同的时间采用彩色超声心动图观察术后三尖瓣的反流情况。 结果 术后3组患者均无手术死亡;随访55例,随访时间0.5~4.0年。术后心功能分级均较术前改善2~3级;术后3个月、1年和3年超声心动图检查提示:MC3组三尖瓣反流明显少于其他两组(Plt;0.05);与De Vega组和Carpentier组比较,MC3组患者三尖瓣反流的复发率明显降低(Plt;0.05)。 结论 应用Edwards MC3成形环行三尖瓣成形术, 其近、中期效果优于De Vega成形术和硬质Carpentier三尖瓣成形术,但其远期效果还有待进一步随访观察。

    Release date:2016-08-30 06:02 Export PDF Favorites Scan
  • 风湿性心脏病联合瓣膜病变引发电风暴一例

    Release date:2016-08-30 06:15 Export PDF Favorites Scan
  • 胸骨上段小切口径路行心脏瓣膜手术

    目的总结心脏瓣膜疾病患者经胸骨上段小切口径路行心瓣膜手术的临床经验。方法对48例心脏瓣膜疾病患者在体外循环下经胸骨上段小切口径路行心脏瓣膜手术,手术切口长8~10cm,上端起自胸骨角向下至第3或第4肋间后,向右侧锯开胸骨至肋间隙,使胸骨切口呈“”形。行主动脉瓣、二尖瓣双瓣膜置换术23例,二尖瓣置换术10例,二尖瓣成形术3例,主动脉瓣置换术12例,9例同期行三尖瓣DeVega成形术。结果全组无手术死亡。46例经胸骨上段小切口顺利完成手术,1例主动脉瓣置换术和1例主动脉瓣、二尖瓣双瓣膜置换术患者因胸骨上段小切口显露不满意,分别将原胸骨切口向下延长一个肋间后顺利完成手术。术后纵隔、心包引流量为90~420ml(260±110ml),术中输血量为400~800ml(560.6±120.0ml)。结论经胸骨上段小切口行心脏瓣膜手术有安全可靠、创伤小、出血少和美观等优点。

    Release date:2016-08-30 06:25 Export PDF Favorites Scan
  • COMPARATIVE STUDY ON SINGLE CELL SUSPENSION OF NEURAL STEM CELLS AND NEUROSPHERES TRANSPLANTATION FOR SPINAL CORD INJURY IN RATS

    Objective To compare single cell suspension of neural stem cells (NSCs) with neurospheres transplantation for spinal cord injury (SCI) so as to explore the therapeutic effectiveness of two NSCs transplantation methods for SCI. Methods The NSCs were isolated from the spinal cord of adult Sprague Dawley (SD) rats, purified and cultured. At passage 3, the cells were identified by Hoechst33342, Nestin staining, and gl ial fibrillary acidic protein staining for differentiated cells. Sixty adult SD rats (weighing 230-250 g) were made the SCI models at T10 level with modified Allen method and randomlydivided into 3 groups (20 rats in each). The injury sites were treated by injecting 5 μL sal ine (group A), 5 μL single cellssuspensions of NSCs at passage 3 (group B), and 5 μL neurospheres cell suspensions at passage 3 (group C). At preoperation and 3, 7, 14, 21, and 28 days after operation, the locomotor functions of each group were assessed using the Basso, Beattie, and Bresnahan (BBB) rating scale. HE staining was applied to observe the morphology of spinal cord. Subsequently immunofluorescence staining was used to observe microtubule-associated protein 2 (MAP-2). Results The cells cultured were NSCs by morphological observation and immunofluorescence staining. After 3 days of modeling surgery, BBB score significantly decreased when compared with preoperative score, and there was no significant difference among 3 groups at 3 and 7 days (P gt; 0.05). BBB score increased in different degrees with time; at 14, 21, and 28 days, BBB score of groups B and C was better than that of group A, and group C was better than group B, showing significant differences (P lt; 0.05). HE staining showed that spinal cord structure of group C was more clear than that of groups A and B, and had less scar. There was no significant difference in the number of MAP-2 positive cells among 3 groups at 3 and 7 days (P gt; 0.05). At 14, 21, and 28 days, the number of MAP-2 positive cells of groups B and C was significantly more than that of group A, and group C was more than group B, showing significant differences (P lt; 0.05). Conclusion Transplantation of neurospheres suspension compared with single cell can significantly promote NSCsto differentiate into neurons and is conducive to recover the lower extremity function after SCI.

    Release date:2016-08-31 04:23 Export PDF Favorites Scan
  • THE PATHOGENIC MECHANISM AND PREVENTION AND TREATMENT OF MUSCLE CONTRACTURE AFTER REPLANTATION OF SEVERED PALM OR WRIST

    OBJECTIVE To explore the pathogenic mechanism of intrinsic muscle contracture after replantation of severed palm or wrist, and put forward the prevention and treatment methods. METHODS From 1985 to 1997, 48 cases were received replantation of severed palm or wrist, among them, 9 cases with thumb adductor contracture and 6 cases with intrinsic muscle contracture were occurred in different degree. Two cases with mild thumb adductor contracture were received conservative treatment, and 7 cases with moderate thumb adductor contracture and 6 cases with intrinsic muscle contracture were received operative treatment. The pathogenic mechanism, clinical results, and prevention methods were studied in those 15 cases. RESULTS The postoperative function recovery was better in 4 cases, moderate in 5 cases with thumb adductor contracture, and better in 3 cases, moderate in 1 case with intrinsic muscle contracture, and moderate in 1 case, poor in 1 case with intrinsic muscle contracture of cord-like induration. Followed up 1 to 10 years, no recurrence was observed in all of 15 cases. The incidence and degree of thumb adductor contracture and intrinsic muscle contracture were closely related to the ischemia time of replanting graft. CONCLUSION Prevention of thumb adductor contracture and intrinsic muscle contracture is most important in severed palm or wrist replantation. When the ischemia time of replanting graft is longer than 12 hours, the effective decompression in myofascial compartment is performed in time to reach satisfactory result.

    Release date:2016-09-01 10:25 Export PDF Favorites Scan
  • Impact of Immunonutrition in Organ Transplantation

    Objective To investigate the impact of immunonutrition in organ transplantation.Methods The literatures of recent years on the studies of immunonutrition in organ transplantation were reviewed. Results Immunonutrition including ω-3 fatty acid and special amino acids etc could reduce inflamation and supress immunal response following organ transplantation markably. Conclusion Application of immunonutrition associated with immunosupress could take the place of traditional steroids completely in the treatment following organ transplantation, even shorten clinical course of immunosupress.

    Release date:2016-09-08 11:49 Export PDF Favorites Scan
  • Differentiation of CEA and CEARelated Substances by Western Blot Technique in Biliary and Gastric Diseases

    【Abstract】ObjectiveTo eliminate the interference of CEA-related substances in CEA measurement and increase the specificity of CEA in the detection of malignant digestive diseases. MethodsCEA level of peripheral blood and digestive juice (bile, gastric juice) from patients with benign or malignant digestive diseases was measured by ELISA, and semi-dry electrophoretic transfer method of Western blot technique to distinguish CEA and CEA-related substances. ResultsIn malignant diseases, the CEA level of digestive juice was significantly higher than that in the blood, and there was no difference of CEA level in digestive juice and blood in benign diseases. Meanwhile, the CEA level of digestive juice and blood in malignant diseases were significantly higher than that in benign diseases. A specific band (molecular weight about 210×103) was detected in all malignant diseases except four cases whose CEA level was too low (less than 5 μg/L), whereas no one of benign diseases had this specific band no matter how high or low the CEA level was. ConclusionThe specificity of CEA detection in malignant digestive diseases can be improved by using digestive juice as sample and combining with Western blot technique.

    Release date:2016-09-08 11:52 Export PDF Favorites Scan
  • Analysis of Electric Stress in Human Head in High-frequency Low-power Electromagnetic Environment

    Action of electromagnetic radiation exerting on human body has been a concerned issue for people. Because electromagnetic waves could generate an electric stress in a discontinuous medium, we used the finite difference time domain (FDTD) as calculation methods to calculate the electric stress and its distribution in human head caused by high-frequency low-power electromagnetic environment, which was generated by dual-band (900 MHz and 1 800 MHz) PIFA antennas with radiated power 1 W, and we then performed the safety evaluation of cell phone radiation from the angle whether the electric stress further reached the human hearing threshold. The result showed that there existed the electric stress at the interface of different permittivity organization caused by the two kinds of high-frequency low-power electromagnetic environment and the maximum electric stress was located at the interface between skin and air of the phone side, and the electric stress peak at skull did not reach the threshold of auditory caused by bone tissue conduction so that it can not produce auditory effects.

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  • Research Progress of Pancreatic Fistula Following Pancreaticoduodenectomy

    ObjectiveTo summarize the prevention method for pancreatic fistula following pancreaticoduodenec-tomy. MethodLiteratures related to the prevention methods for postoperative pancreatic fistula at home and abroad in recent years were retrieved and summarized. ResultsThe pancreatic fistula was a common complication following pancreaticoduodenectomy. It was mainly caused by preoperative continuous high jaundice, selection of intraoperative anastomosis, and early postoperative pancreatic juice secretion. Trypsinogen was activated by alkaline intestinal juice and then the nearby tissue was digested. Pancreatic juice flowed into abdominal cavity to digest the tissue, then caused serious complications or even death. Through the prevention of drugs, preoperative biliary drainage and intraoperative anastomosis, etc., the incidence of postoperative pancreatic fistula was slightly decreased. ConclusionThe prevention for postoperative pancreatic fistula is an integrated process, and it needs to be ran through the whole perioperative period.

    Release date:2021-06-24 01:08 Export PDF Favorites Scan
  • Staged Bilateral Single-port Thoracoscopic Lung Volume Reduction Surgery: A Clinical Analysis

    ObjectiveTo investigate the feasibility and efficacy of staged bilateral single-port thoracoscopic lung volume reduction surgery (LVRS) for the patients with chronic obstructive pulmonary emphysema (COPE). MethodsWe retrospectively analyzed clinical data of eleven male patients with bilateral COPE and bullae in Xuzhou Central Hospital Affiliated to Southeast University from January 2013 through June 2014. All the patients underwent staged bilateral single-port thoracoscopic LVRS with their age of 60.27± 12.11 years. The hyperinflated bullae were resected using endoscopic staplers (Endo-GIA), followed by continuous suture and biological glue for reinforcement of the margin. Besides, the pulmonary function, blood gas assay, 6-minute walk distance (6-MWD), and life quality evaluated by short form 36 Health survey questionnaire (SF-36) were recorded before and after LVRS respectively. ResultsAll the patients survived after surgery. Chest tube drainage time was 9.09± 1.31 days. Postoperative hospital stay was 15.73± 2.75 days. There were 5 patients with persistent air leakage and 7 patients with pulmonary infection who were cured finally. The pulmonary function, arterial partial pressure of oxygen(PaO2), 6-MWD and life quality after unilateral or bilateral LVRS improved than those before surgery in postoperative 3 months. However, there was no statistical difference in outcomes between unilateral and bilateral LVRS patients. ConclusionStaged bilateral single-port thoracoscopic LVRS could improve short-term life quality of patients with COPE.

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