Surgical treatment of atrial septal defect (ASD) mainly includes occlusion or repair under cardiopulmonary bypass. Surgical treatment of atrial fibrillation includes transcatheter radiofrequency ablation or Maze surgery under cardiopulmonary bypass. There are many treatments for ASD patients combined with atrial fibrillation, but each has its own advantages and disadvantages. We reported an ASD patient combined with atrial fibrillation treated by totally endoscopic "one-stop" radiofrequency ablation and simultaneous transthoracic ASD occlusion of atrial fibrillation, with good postoperative results.
ObjectiveTo explore the rehabilitation treatment of postoperative dysfunction in hepatocellular carcinoma based on digital therapy and its clinical significance. MethodsThe postoperative rehabilitation clinic process of a patient was retrospectively analyzed according to the relevant clinical symptoms and dysfunctions, as well as the postoperative rehabilitation measures based on digital therapy and the patient’s prognosis. ResultsCombined with medical history, physical examination and rehabilitation assessment, the patient had pain, activity intolerance, insomnia, and symptom of anxiety and depression. The physical ability, pain, fatigue condition, symptom of anxiety and depression, and insomnia improved on 1 month after digital therapy-based exercise rehabilitation. ConclusionExercise rehabilitation based on digital therapy can improve the adverse symptoms and dysfunctional condition of patients with certain advantages.
Objective To explore the effect of " closed-loop rehabilitation”-based digital mirror therapy (MT) on the recovery of upper limb function after stroke. Methods Between December 2017 and April 2018, 90 stroke patients were recruited and randomly assigned to digital MT group (MG) or conventional group (CG), with 45 in each group. Patients in MG received digital MT for 60 minutes and subsequent hand function rehabilitation for 30 minutes, which was a " closed-loop rehabilitation”; moreover, patients in CG received therapeutic exercises, occupational therapy, and hand function rehabilitation for 30 minutes separately (totally 90 minutes). Both interventions were daily provided, 5 days per week and lasting for 4 weeks. Clinical assessments were provided before and after the interventions, including the Fugl-Meyer Assessment Upper Limb (FAM_UL) for motor function evaluation, the Modified Barthel Index (MBI) for the activities of daily life (ADL) evaluation, and the Modified Ashworth Scale (MAS) for the spasticity of wrist extensor/flexor. Results Five patients did not complete the study (3 in MG and 2 in CG), so there were totally 85 subjects analysed in the end. After 4-week interventions, significant improvements of FMA_UL scores (Pre: MG, 25.86±17.41; CG, 21.71±15.60. Post: MG, 33.43±17.08; CG, 26.48±16.47) and MBI scores (Pre: MG, 66.62±21.73; CG, 59.14±21.58. Post: MG, 84.62±15.06; CG, 71.10±19.95) were found in both groups; moreover, higher scores of FMA_UL and MBI were investigated in MG comparing with CG after interventions. However, there were no significantly differences in MAS. Conclusions The " closed-loop rehabilitation”-based digital MT can improve the motor function of upper limb and the ability of ADL in patients with stroke. Moreover, it is more effective than conventional treatments.
Objective To analyze the efficacy and safety of closure of patent foramen ovale (PFO) guided by transesophageal echocardiography (TEE), and summarize the experience of some difficult cases. MethodsThe patients who underwent the percutaneous PFO occlusion in our hospital from January 2020 to May 2023 were retrospectively enrolled. Dynamic monitoring data of TEE before, during, and after the operation were recorded. Results A total of 68 patients including 30 males and 38 females at an average age of 45.6±16.3 years were included. There were 7 patients with complex PFO. Under TEE guidance, 65 patients successfully completed the occlusion treatment, and 3 patients failed to close. During the operation, the two-dimensional TEE images of the patients were clear, which fully and clearly showed the process of the sheath canal passing through the ovale foramen and the continuous observation of the occlusive umbrella after releasing the occlusive umbrella. The position of the umbrella was secure and the shape of the umbrella was satisfactory. No blood shunt or pericardial effusion was found at 6-month and 1-year follow-up. The heart structure and heart rhythm were improved, the atrioventricular valve function was normal, the blocking umbrella was firm and stable, and there was no shedding or displacement. ConclusionThe percutaneous PFO occlusion guided by TEE is safe and effective, and has fewer side effects on patients compared with traditional interventional methods, but the complex PFO occlusion surgery is still challenging.