Significant atrioventricular valve (AVV) insufficiency has been associated with increased mortality and morbidity in patients with single ventricle. Although techniques such as annuloplasty, chordal elongation, and the use of pericardial patches can improve AVV function in many patients, a number of patients continue to have significant AVV insufficiency and may require AVV replacement. The present review made a comprehensive literature review concerning the outcome, optimal timing, key points of technique skills and prognosis evaluation.
Objective To observe the effect of “Luo’s Roujin Technique” on the inflammatory response and joint capsule fibrosis in white rabbits with scapulohumeral periarthritis model. Methods Thirty healthy male New Zealand white rabbits were randomly divided into a control group, a model group, and a treatment group, with 10 rabbits in each group. Scapulohumeral periarthritis models were established in the model group and the treatment group, while the control group received identical restraint procedures at the same timepoints. Six rabbits in the model group and seven in the treatment group were successfully modeled. The subsequent experiment included all six successfully modeled rabbits from the model group, along with six rabbits randomly selected from each of the control and treatment groups. On the second day after successful modeling, blood samples were collected from the auricular marginal vein in all three groups. After blood collection, the treatment group began massage therapy for 21 consecutive days, while the other two groups underwent the same restraint procedure simultaneously. On Day 22, all the three groups were euthanized after blood collection from the auricular marginal vein, and the synovial tissue of the affected shoulder joint was completely collected. Hematoxylin-eosin staining was used to examine the histopathological features of the synovial tissue. Enzyme-linked immunosorbent assay was employed to measure the concentrations of interleukin (IL)-1β, IL-6, IL-17, and tumor necrosis factor-α (TNF-α). Western blot and reverse transcription polymerase chain reaction were used to assess the protein and mRNA expression levels of vascular endothelial growth factor (VEGF), connective tissue growth factor (CTGF), transforming growth factor-β1 (TGF-β1), and Smad3. Results After treatment, the control group showed no significant inflammatory cell infiltration or fibrous tissue proliferation in the synovial tissue. The model group exhibited synovial cell hyperplasia in the lining layer and inflammatory cell infiltration in the sublining layer. The treatment group displayed mild inflammatory cell infiltration in the sublining layer. Compared with the control group, the model group showed significantly increased concentrations of IL-1β, IL-6, IL-17, and TNF-α in both serum and synovial homogenate, as well as elevated protein and mRNA expression of VEGF, CTGF, TGF-β1, and Smad3 in synovial tissue (P<0.05). Compared with the model group, the treatment group exhibited significantly lower serum levels of IL-1β, IL-6, and TNF-α, as well as reduced synovial homogenate levels of IL-1β, IL-6, IL-17, and TNF-α (P<0.05); furthermore, protein expression of VEGF, CTGF, TGF-β1, and Smad3 and mRNA expression of VEGF and CTGF in synovial tissue were significantly decreased in the treatment group (P<0.05). Conclusions “Luo’s Roujin Technique” can significantly alleviate local inflammatory infiltration in the synovial tissue of rabbits with scapulohumeral periarthritis, and reduce the levels of IL-1β, IL-6, IL-17, and TNF-α in both serum and synovial tissue. The underlying mechanism may involve suppression of VEGF, CTGF, TGF-β1, and Smad3 expression, leading to attenuated inflammatory responses and inhibition of fibroblast-to-myofibroblast transition. Thereby, it mitigates fibrotic changes in the shoulder joint capsule, exerting anti-inflammatory and analgesic effects and improving joint mobility.
【Abstract】ObjectiveTo discuss the technique for pancreas transplantation alone(PTA). MethodsEighty-eight SD rats were used as donors and recipients. The PTA was performed with enteric drainage（E-D group, n=22） or bladder drainage（B-D group, n=22）. The donor’s abdominal aorta(splenic artery) and portal vein(splenic vein) were anastomozed with the recipient’s abdominal aorta(end-to-side) and left renal vein(end-to-end). Blood glucose, food intake, water intake and urine volume were recorded before transplantation and on the 1st day, 3rd day, 7th day, 14th day and 30th day after transplantation. Results The mean PTA time was (33.1±11.1) min (donors) and (51.7±14.7) min(recipients). The grafts experienced no warm ischemia and the mean cold ischemia time was (46.5±17.1) min. After the successful PTA, the recipients’ blood glucose decreased on the first day after transplantation and reached normal on the third day. Their food intake, water intake and urine volume decreased and became stable 14 days later. ConclusionSuccessful PTA can restore the pancreatic endocrine function in diabetic rats. It is very important to master the technique for the operation.
ObjectiveTo assess the effect of short-axis and long-axis punctures of thyroid nodules on the diagnostic rate of ultrasound guided aspiration biopsy (US-FNAB). MethodsWe retrospectively analyzed the clinical data of 2 686 thyroid nodule patients who underwent US-FNAB between March 2011 and November 2014. The US-FNAB was performed by 5 beginners (571 each for Dr1-Dr4 and 402 for Dr5). Yields of US-FNAB were divided into two levels according to the classification standard of the Bethesda system:adequacy and inadequacy. Short-axis puncture technique was used by Dr2 and long-axis puncture was performed by the others. According to chronological sequence of thyroid nodules examined, we compared the inadequate diagnostic rate between Dr2 and the others for the first 200 cases and the last 200 cases, respectively. The inadequate diagnostic rate was compared among the 4 doctors who used long-axis punctures for the first 200 cases and the last 200 cases, respectively. ResultsThe inadequacy rate of US-FNAB for Dr2 was higher than that for Dr1, Dr3, Dr4 and Dr5 in the first 200 cases, with statistical significance (P=0.036,<0.001,=0.007 and <0.001, respectively). There was no significant difference in inadequate diagnostic rate among the 4 doctors who used long-axis punctures for the first 200 cases (P=0.033, 0.551, 0.011, 0.122, 0.672 and 0.050). The inadequacy rate of US-FNAB for Dr2 was higher than that for Dr5 and lower than that for Dr4 in the last 200 cases with statistical significance (P=0.027 and 0.003, respectively). The inadequacy rate of US-FNAB for Dr5 was lower than that for Dr3 (P=0.005) and Dr4 (P<0.001) among the 4 doctors who used long-axis punctures for the last 200 cases. ConclusionFor beginners, the inadequacy rate of short-axis puncture is higher than long-axis puncture. We suggest beginners learn long-axis puncture method. There is no significant difference in inadequate diagnostic rate among short-axis and long-axis punctures, when the number of operated cases reaches 200. At this point, the operator can choose either way to puncture according to the disease condition or personal interests.
【Abstract】Objective To investigate the result of liver transplantation for end stage liver disease. Methods A retrospective analysis was made for 7 cases orthotopic liver transplantation(OLT) and 4 cases living related liver transplantation (5 patients with hepatitis B cirrhosis and 6 with Wilson’s disease),cirrhosis group was treated with lamivudine plus low dose anti-HBV-Ig. Results Ten patients were completely recovered discharged(including 4 cases LRLT) and only 1 died of ARDS.The complications after operation were: 2 cases of abdominal hemorrhage,3 cases of acute respiratory distress syndrome; and 4 cases of hepatitis B cirrhosis were HBV-DNA(-) after operation.Copperoxidase in all with Wilson’s disease became normal. Conclusion Liver transplantation is effective measure for end stage liver disease and living related liver transplantation is suitable for the present medical condition in China.Surgical technique is crucial for reducing perioperative complications.
Objective To discuss the operative technique and curative effect of minor-incision cholecystectomy. Methods The clinical data of 672 patients with application of mini-cholecystectomy from June 2001 to June 2009 were analyzed. Perioperative management and operative technique were emphasized. Results Six hundred and fifty-two cases (97.0%) were cured with mini-cholecystectomy and 20 cases (3.0%) with incision lengthened. Operation time was （40.0±10.0） min. One case with hemorrhoea during operation was cured by interventional embolotherapy. Bile duct injury was found in 1 case during operation， and adopted suture with T tube. There were no infection of incisional wound or death in this study. Conclusion On the basis of skillful conventional cholecystectomy, by controlling indication and improving operative technique, it is an economical and safe way to perform minor-incision cholecystectomy.
Objective To analyze the surgical techniques for the procurement and back-table surgery of the graft in living-related small bowel transplantation. Methods Eligible donor was chosen according to the donor selection criteria of living-related small bowel transplantation, and preoperative plan was designed. A segment of ileum of 120 cm was procured 20 cm proximal to the ileocecal valve which was preserved in the donor. The techniques for the procurement and back-table surgery of the graft were summarized, which included measurement of entire small bowel length from Treitz to ileocecal valve, palpation and transillumination to identify the distal branch of the superior mesenteric artery， and transient blockage of isolated blood vessels with vascular clamps in order to observe the influence on the blood circulation of graft and residual ileum. The detailed manipulation techniques in processing the graft blood vessels were discussed. Results The operations were successful both on the donor and the recipient. The functions of implanted segment of bowel were well. The donor had no other complications, such as mesenteric thrombi and anastomosis leakage of intestine, except for transient moderate diarrhea. She was discharged 14 days after operation. In the next 8 months of following-up, the donor has not experienced significant alteration in bowel habits or weight loss. Now she is in good appetite, without any changes in the habit and amount on diet. No changes have been found in lifestyle, work habits, or psychosocial conditions after the small bowel donation. Conclusion The procurement of a segment of ileum as graft and preservation of 20 cm proximal to the donor ileocecal valve may be ideal protocol. Using a standardized technique with attention presents little recent or long-term risks for the donor and brings satisfied effect for the recipient.
ObjectiveTo explore the application of PDCA (plan, do, check, action) circulation method in basic life support (BLS) technique training among non-medical personnel in hospitals. MethodsIn a third-level grade-A hospital, BLS technique training was carried out for 66 non-medical personnel of various working categories between July and September 2011. During the training process, PDCA circulation method was applied to each step. The existing problems were searched and causes of the problems were found. Improving strategies were made and carried out, and finally, the effect of training was statistically analyzed. ResultsAfter the application of PDCA circulation method, the test scores in the three training stages were significantly different (P ＜ 0.05) . ConclusionPDCA circulation method can help non-medical personnel to master the operation process and the technique points of BLS quickly, and it also can improve the quality of BLS technique training for non-medical personnel in hospitals.