Objective To analyze the mean flow in left internal m am mary artery ( L IMA) graft and the influencing factors in off- pump coronary artery bypass grafting ( OPCAB) in the Chinese. Methods One hundred and eighty patients with OPCAB were studied.Transit- tim e flowmeter( TTFM) was utilized to measure and record the L IMA’s blood flow wave,pulsatility index( PI) ,value of mean flow,systolic and diastolic peak flow,vascular resistance,insufficiency ratio and mean blood pressure and to analyze the relationship between mean flow of LIMA and other factors. Results Total mean flow calculated from that of all patients was2 8.19± 2 .89ml/ min( 6 - 178 ml/ m in) .Majority m ean value ( 6 4 .4 % ) was in the range of 10 - 30 ml/ min.Statistics showed that mean flow was significantly related to systolic and diastolic peak flow and vascular resistance rather than the other factors( r=0 .75 , 0 .94 ,- 0 .95 ) . Conclusions For the Chinese,over 10 ml/ min mean flow of L IMA graftis acceptable and ov...更多er 2 2 ml/ min is satisfactory.The diastolic peak flow and vascular resistance are two most important factors in influencing mean flow.
With the rapid development of day surgery mode in China, day surgery management has shifted from extensive to refined, but there are still many problems in the information system of day surgery in Chinese hospitals. The Second Affiliated Hospital Zhejiang University School of Medicine has developed a day surgery information management system since 2018, established a pre-hospital and in-hospital day surgery ecological management, and integrated daily management concepts and management rules into the system through the whole-process information management. It realized the whole process, full data, closed-loop and path-based information management of day surgery. This paper introduces the day surgery information management system of the Second Affiliated Hospital Zhejiang University School of Medicine, and aims to share the experience of building the day surgery information management function module.
ObjectiveTo analyze the relation between regulatory T cell (Treg)/ helper T cell 17 (Th17) imbalance and the pathogenesis of acute pancreatitis (AP) and to explore the relation between Treg/Th17 cell imbalance and helper T cells 1, helper T cells 2 and cytokines in patients with AP, so as to provide a new therapeutic target for immunotherapy of AP. Methods From January to December 2020, 40 patients diagnosed with AP ( AP group) in The People’s Hospital of Xinjiang Uygur Autonomous Region and 40 healthy subjects who underwent physical examination (normal control group) during the same period in this hospital were selected as the research objects. Their peripheral bloods were collected and the proportion of Treg and Th17 cells was detected by flow cytometry. Plasma levels of interleukin-10 (IL-10) and interleukin-17 (IL-17) were detected. Results Compared with the normal control group, the proportions of Treg and Th17 cells increased before treatment in the AP group, the differences were statistically significant (t=5.78, P<0.001; t=5.82, P<0.001). The levels of IL-10 and IL-17 increased, the differences were statistically significant (t=7.14, P<0.001; t=35.22, P<0.001). After treatment, the AP group as compared with the normal control group, the proportions of Treg and Th17 cells increased but the differences were not statistically significant (t=1.87, P>0.05; t=0.29, P>0.05), the level of IL-10 increased and the difference was statistically significant (t=3.98, P<0.001), the level of IL-17 increased but the difference was not statistically significant (t=1.67, P>0.05). After treatment as compared with before treatment in the AP group, the proportions of Treg and Th17 cells decreased, the differences were statistically significant (t=3.07, P<0.01; t=4.99, P<0.001). The levels of IL-10 and IL-17 decreased, the differences were statistically significant (t=3.38, P<0.001; t=30.63, P<0.001). Conclusion In AP, Treg cells mediate immunosuppression and Th17 cells mediate inflammatory response, promoting the occurrence and development of inflammation in the disease. IL-10 and IL-17 may play an important role in regulating their differentiation and homeostasis.
Objective To investigate the effects of allogenic transplantation of acellular muscle bioscaffolds (AMBS) seeded with bone marrow mesenchymal stem cells (BMSCs) on the repair of acute hemi-transection spinal cord injury (SCI) in rats. Methods AMBS were prepared by reformed chemical approach and sterilized by compound cold sterilization; BMSCs were harvested by density gradient centrifugation and cultured with adherent method. The 3rd generation BMSCs labeled by Hoechst 33342 were injected into AMBS to construct the BMSCs-AMBS composite scaffolds; the biocompatibility was observed under scanning electron microscope (SEM) and fluorescence microscope in vitro at 14 days. Forty-eight adult female Sprague Dawley rats were used to build SCI model by hemi-transecting at T9-11 level, then randomly divided into 4 groups (n=12). Defects were repaired with BMSCs-AMBS composite scaffolds, BMSCs, and AMBS in groups A, B, and C, respectively; group D was blank control by injecting PBS. At 1, 2, 3, and 4 weeks after surgery, the functional recovery of the hind limbs was evaluated by the Basso-Beattie-Bresnahan (BBB) locomotor rating score. At 4 weeks after surgery, HE staining and immunofluorescent assay were adopted. Results Masson staining and HE staining showed that AMBS was mainly of the collagen fibers in parallel arrange, without muscle fibers. After 14 days of BMSCs and AMBS co-culture, a large number of survival BMSCs labeled by Hoechst 33342 were seen under fluorescence microscope; SEM showed that BMSCs grew and attached to the inner surfaces of AMBS. At 2-4 weeks, the BBB score in group A was significantly higher than that in groups B, C, and D (P lt; 0.05), and it was significantly lower in group D than in the other 3 groups (P lt; 0.05); at 4 weeks, the BBB score in group B was significantly higher than that in group C (t=10.352, P=0.000). HE staining revealed that the area of spinal cord cavity after SCI was markedly smaller in group A than in the other 3 groups; immunofluorescent assay showed that more neurofilament 200 positive fibers and Nestin positive cells were detected in group A than in groups B, C, and D, but glial fibrillary acidic protein (GFAP) positive cells significantly decreased. The integral absorbance (IA) values of GFAP were 733.01 ± 202.04, 926.42 ± 59.46, 1 069.37 ± 33.42, and 1 469.46 ± 160.53 in groups A, B, C, and D, respectively; the IA value of group A was significantly lower than that of groups B, C, and D (P lt; 0.05), and it was significantly higher in group D than in groups A, B, and C (P lt; 0.05). Conclusion With relatively regular internal structures and good biocompatibility, AMBS can inhibit glial scar and enhance the survival, migration, and differentiation of BMSCs, so AMBS is the ideal nature vector for cell transplantation. Co-transplantation of AMBS and BMSCs has synergistic effect in treating SCI, it can promote rat motor function recovery.
Objective To explore association of apolipoprotein B (ApoB) gene rs676210 and rs2854725polymorphisms with gallstone disease and differences of polymorphisms between Uygur population and Han population. Methods A case control study was used. One hundred and eighty-nine patients with gallstone disease from 2010 to 2014 in our hospital were collected, of which 99 cases of Uygur population and 90 cases of Han population. One hundred and ninety age- and sex-matched healthy volunteer accepted physical examination in our hospital over the same period were collected as control, of which 93 Uygur population and 97 Han population. The ApoB genotyping of DNA samples were amplified by using SNaPshot single nucleotide polymorphism (SNP). The differences of polymorphisms between Uygur population and Han population and between patients with gallstone disease and healthy volunteer were analyzed. Results ① The differences of ApoB gene rs676210 and rs2854725 allele frequencies were not found between the patients with gallstone disease and healthy volunteer whether Uygur population or Han population (Uygur population: rs676210:χ2=0.229,P=0.633; rs2854725:χ2=0.028,P=0.866. Han population: rs676210:χ2=0.608,P=0.435; rs2854725:χ2=2.673,P=0.102). ② The differences of ApoB gene rs676210 and rs2854725 allele frequencies were not found between Uygur population and Han population whether the patients with gallstone disease or healthy volunteer (Patients with gallstone disease: rs676210:χ2=0.103,P=0.748; rs2854725:χ2=3.139,P=0.076. Healthy volunteer: rs676210:χ2=0.000,P=0.990; rs2854725:χ2=2.673,P=0.102). ③ The differences of ApoB gene rs676210 and rs2854725 genotype frequencies were not found between the patients with gallstone disease and healthy volunteer whether Uygur population or Han population (Uygur population: rs676210:χ2=2.301,P=0.317; rs2854725:χ2=3.040,P=0.219. Han population: rs676210:χ2=4.909,P=0.086; rs2854725:χ2=0.107,P=0.744). ④ The differences of ApoB gene rs676210 and rs2854725 genotype frequencies were not found between Uygur population and Han population patients with gallstone disease (rs676210:χ2=0.235,P=0.899; rs2854725:χ2=3.630,P=0.057). The difference of ApoB gene rs676210 genotype frequency was not found between Uygur population and Han population with healthy volunteer (χ2=1.026,P=0.599). While the difference of ApoB gene rs2854725 genotype frequency was found between Han population and Uygur population with healthy volunteer (χ2=9.153,P=0.010). When it was compared in pairs,α=0.05/3=0.016, the difference of G/T and T/T frequencies was found between Uygur population and Han population (χ2=6.128,P=0.013), G/T of Han population (27.8%) was higher than that of Uygur population (12.9%). Conclusions ApoB gene rs676210 and rs2854725 polymorphisms are not associated with gallstone disease. For healthy volunteer, ApoB gene rs676210 polymorphism shows no ethnics-specific difference between Uygur population and Han population, but ApoB gene rs2854725 polymorphism mightbe show a difference between Uygur population and Han population. Larger sample sizes and multicenter study are needed to confirm it.
For speech detection in Parkinson’s patients, we proposed a method based on time-frequency domain gradient statistics to analyze speech disorders of Parkinson’s patients. In this method, speech signal was first converted to time-frequency domain (time-frequency representation). In the process, the speech signal was divided into frames. Through calculation, each frame was Fourier transformed to obtain the energy spectrum, which was mapped to the image space for visualization. Secondly, deviations values of each energy data on time axis and frequency axis was counted. According to deviations values, the gradient statistical features were used to show the abrupt changes of energy value in different time-domains and frequency-domains. Finally, KNN classifier was applied to classify the extracted gradient statistical features. In this paper, experiments on different speech datasets of Parkinson’s patients showed that the gradient statistical features extracted in this paper had stronger clustering in classification. Compared with the classification results based on traditional features and deep learning features, the gradient statistical features extracted in this paper were better in classification accuracy, specificity and sensitivity. The experimental results show that the gradient statistical features proposed in this paper are feasible in speech classification diagnosis of Parkinson’s patients.
ObjectiveTo compare the effectiveness of Taylor spatial frame (TSF) and unilateral external fixator in the treatment of tibiofibular open fractures.MethodsBetween January 2016 and July 2018, 74 patients with tibiofibular open fracture who met the selection criteria were divided into TSF group (43 cases, fixed with TSF) and unilateral group (31 cases, fixed with unilateral external fixator) according to the principle of entering the group every other day. There was no significant difference in gender, age, affected side, cause of injury, type of fracture between the two groups (P>0.05). The operation time, fracture healing time, removal time of external fixator, and complications were recorded and compared between the two groups. The limb function was evaluated according to Johner-Wruhs criteria for evaluating the final effectiveness of tibial shaft fracture treatment. The recovery of lower limb force line was ecaluated by LUO Congfeng et al. criteria.ResultsAll patients were followed up 8-22 months, with a median of 12 months. All fractures healed, and no complication such as delayed union, nonunion, or osteomyelitis occurred. The operation time, fracture healing time, and removal time of external fixator in TSF group were significantly shorter than those in unilateral group (P<0.05). At 3 months after the removal of the external fixator, the limb function was evaluated according to the Johner-Wruhs standard. In TSF group, 41 cases were excellent, 1 case was good, and 1 case was fair, and the excellent and good rate was 97.67%; in unilateral group, 30 cases were excellent and 1 case was fair, and the excellent and good rate was 96.77%; there was no significant difference between the two groups (P=0.666). At 4 months after operation, the recovery of lower limb force line was ecaluated by LUO Congfeng et al. criterion. In TSF group, 41 cases were excellent, 2 cases were good, and 1 case was fair, and the excellent and good rate was 97.67%; in unilateral group, 29 cases were excellent, 1 case was good, 1 case was fair, and the excellent and good rate was 96.77%; there was no significant difference between the two groups (P=0.666).ConclusionFor tibiofibular open fracture, on the premise of fracture healing, TSF technology is superior to unilateral external fixation in terms of shortening operation time, fracture healing time, and removal time of external fixator.
Objective To investigate the feasibility of magnetic resonance diffusion tensor imaging (MRDTI) technique in displaying myocardial fiber architecture. Methods In five ex vivo swine heart, diffusion tensor imaging (DTI) was acquired in 25 directions within 2 hours after excision. The myocardial fiber was reconstructed by using brain white matter tractography algorithm to display its course, distribution and arrangement. Results In the swine heart 1 hour after excision, MRDTI revealed that the arrangement of the myocardial fiber had certain continuity. It spiraled and twisted to form the left and right ventricle. The divection of general myocardial fiber in the left ventricle was vertical below endocardium, horizontal below epicardium and oblique in stratum medium, which is consistent with the theory of ventricular myocardial band. Conclusion MRDTI can reveal the myocardial fiber architecture, showing its integrity and arrangement, and at some level confirming the theory of ventricular myocardial band.
Objective To investigate the factors influencing the occurrence of postoperative pulmonary complications (PPCs) in liver transplant recipients and to construct Nomogram model to identify high-risk patients. Methods The clinical data of 189 recipients who underwent liver transplantation at the General Hospital of Eastern Theater Command from November 1, 2019 to November 1, 2022 were retrospective collected, and divided into PPCs group (n=61) and non-PPCs group (n=128) based on the occurrence of PPCs. Univariate and multivariate logistic regression analyses were used to determine the risk factors for PPCs, and the predictive effect of the Nomogram model was evaluated by receiver operator characteristic curve (ROC) and calibration curve. Results Sixty-one of 189 liver transplant patients developed PPCs, with an incidence of 32.28%. Univariate analysis results showed that PPCs were significantly associated with age, smoking, Child-Pugh score, combined chronic obstructive pulmonary disease (COPD), combined diabetes mellitus, prognostic nutritional index (PNI), time to surgery, amount of bleeding during surgery, and whether or not to diuretic intraoperatively (P<0.05). Multivariate logistic regression analysis showed that age [OR=1.092, 95%CI (1.034, 1.153), P=0.002], Child-Pugh score [OR=1.575, 95%CI (1.215, 2.041), P=0.001], combined COPD [OR=4.578, 95%CI (1.832, 11.442), P=0.001], combined diabetes mellitus [OR=2.548, 95%CI (1.024, 6.342), P=0.044], preoperative platelet count (PLT) [OR=1.076, 95%CI (1.017, 1.138), P=0.011], and operative time [OR=1.061, 95%CI (1.012, 1.113), P=0.014] were independent risk factors for PPCs. The prediction model for PPCs which constructed by using the above six independent risk factors in Nomogram had an area under the ROC curve of 0.806. Hosmer and Lemeshow goodness of fit test (P=0.129), calibration curve, and decision curve analysis showed good agreement with Nomogram model. Conclusion The Nomogram model constructed based on age, Child-Pugh score, combined COPD, combined diabetes mellitus, preoperative PLT, and time of surgery can better identify patients at high risk of developing PPCs after liver transplantation.
Objective To review the progress of total ankle arthroplasty (TAA) in treatment of end-stage ankle osteoarthritis (AOA). Methods The domestic and foreign literatures about TAA in recent years were reviewed. The current status and progress of TAA were summarized from the results of traditional and computer-assisted TAA clinical outcomes. Results End-stage AOA often leads to severe pain and dysfunction, and arthrodesis is still the main selective treatment option. In recent years, with the advancement of surgical techniques and prosthesis design, TAA which can remain joint mobility has increased gradually, and the surgical results also have significant progress. Accurate prosthesis implant and mechanical alignment restoration are critical factors for TAA, and surgery-related malalignment is correlative to the prosthesis failure. Computer assisted patient-specific guide can simplify the TAA procedures and obtain the accuracy of tibia and talus osteotomy. Conclusion The clinical efficiency of preoperative CT based patient-specific guide technology for TAA needs further clinical follow-up. Meanwhile, it is necessary to further develop intraoperative navigation and robotic surgery system suitable for TAA.