简介:客观:调查创伤的有三个尖头的不足的外科的治疗的最佳的时间和过程。方法:从1984年5月到2004年9月,八个病人为创伤的有三个尖头的阀门不足经历了操作。所有病人,男性,从7~67年变老[中部:38年,意味着:(38。5±18。1)年]。在损伤和操作之间的间隔从1个月到20年[中部:19个月,意味着:(52.5±80.3)月)]。Inseven病人,有三个尖头的不足被归因在三个病人包括车辆事故弄钝胸损伤,另外的病人是一处stab创伤。诊断是证实的byechocardiography。在病人的外科手术前的心脏的功能作为纽约HeartAssociation(NYHA)班Ⅱ-Ⅳ被分类。在手术期间,有三个尖头的阀门的前面的传单完全或部分在所有病人由于索的破裂被乱摆。氏族的传单的索的破裂在一个病人被发现。前面的传单在二个病人被穿孔。Septalleaflet被缩回并且支持者到在二个病人的室的中隔。阀门修理为所有病人被打算。最后,阀门修理在3个病人成功地被执行,有三个尖头的代替在5个病人被执行。结果:没有早或迟了的死亡发生了。与follow-upthrough为7-129月的临床的表明和回响心动描记法[中部:39个月,平均数:(53.4±42.8)月],所有病人作为NYHA班Ⅰ被分类,没有任何changes.Conclusions:创伤的有三个尖头的不足的令人满意的治疗能被外科的治疗获得。更早的外科可以增加有三个尖头的阀门修理的可行性并且阻止恰好室的功能的恶化。
简介:Objective: ToinvestigatethevalueoftranscranialDoppler(TCD)ultrasonographyinevaluatingtheoutcomeofseveretraumaticbraininjuryandtocorrelatetheTCDvalueswithintracranialpressure(ICP)andcerebralperfusionpressure(CPP)monitoring. Methods: AprospectivestudywasconductedtoevaluatethecontributionofTCDultrasonographytoneurologicaloutcomeinaseriesof96severetraumaticbraininjurypatients.ThequantitativevariablesofTCDultrasonographyincludedthemeanbloodflowvelocityofthemiddlecerebralartery(MCA)andpulsatilityindexwithinthefirst24hoursofadmission.TheICPandCPPvalueswerealsorecorded.Outcomein6monthspostinjurywasevaluatedusingtheGlasgowOutcomeScale(GOS4-5wasconsideredas“good”andGOS1-3as“poor”). Results: ThemeanbloodflowvelocityoftheMCAwaslargerthan40cm/sin30(51%)patientswithgoodoutcomewhereasitwaslessthan40cm/sin27(73%)patientswithpooroutcome(P<0.025).ThemeanPIincasesofgoodoutcome(34patients,57%)waslowerthan1.5whereasinpooroutcome(30patients,83%)washigherthan1.5(P<0.001).ThecorrelationsofICPandCPPtopulsatilityindexwerestatisticallysignificant(P<0.01). Conclusions: TCDultrasonographyisvalidinpredictingthepatientsoutcomeof6monthsandcorrelatessignificantlywithICPandCPPvalueswhenitisperformedinthefirst24hoursofseveretraumaticbraininjury.
简介:客观:借助于高分辨率图象分析(HRIA)预言食道的上皮的发育异常的结果。方法:无征状的成年人从Linxian县的Heshun公社在1983为食管的汽球细胞学被检查。93严重发育异常和食管的122温和发育异常被选择。借助于与电视照相机装备的一台Axiomat显微镜,在染色奶头的有鳞的上皮的中间的层的保存得很好的房间的100个正常原子核随机被检验。结果:93个cytologically诊断的严重发育异常盒子,24,14和7分别地在3,5和9年里进行了到癌。在另外的48个盒子中,发育异常仍然是马厩或regressed到正常。另外的盒子被用作控制。根据染色质特征,盒子的正确诊断被HRIA在75.0%完成(18/24),85.7%(12/14)并且(6/7)85.7%盒子检验了,分别地(P<0.001)。122cytologically诊断的温和发育异常,16,13和12个盒子分别地在3,5和9年里进行了到癌。另外的81个盒子仍然是马厩或regressed到正常。正确诊断被HRIA在93.8%做(15/16),76.9%(10/13)并且(10/12)833%盒子检验了,分别地(P<0.001)。结论:HRIA检验的染色质原子特征能预言癌症前期的损害的结果并且从non-progressor区别progressor。它能为chemo预防试用的效率的评估被用作代理人端点biomarkers。
简介:Traumaticbraininjury(TBI)isamajorpublichealthproblemthroughouttheworld.Morethan400000patientswithTBIintheUnitedStatesofAmericaandmorethanamillionpatientswithTBIinChinaareadmittedtohospitaleveryyear.HeadtraumaisalsoNo.1killerofyoungpeopleinthedevelopedcountriesaswellasinsomedevelopingcountries.Unfortunately,theoutcomeofpatientswithsevereTBIisstillpoorallovertheworld.ThemortalityofsevereTBIpatients(GCS3-8)inmajorityofhospitalsisover30%andverysevereTBIpatients(GCS3-5)isover80%withonly15%functionalrecovery.1,2However,recentadvanceincerebralprotectionbymild(35-33℃)tomoderatehypothermia(32-30℃)iscertainlyencouraging,whichbringsneurosurgeonsthehopetoimprovetheoutcomeofsevereheadinjuredpatients.
简介:ObjectivesToinvestthesuccessprocedure,immediateoutcomeafterprocedure,therateofmainadversecardiaceventsafterprocedureandrestenosisafterstentplacementinsmallcoronaryvessels.Methods290patientswithselectedoremergencystentimplantationinsmallvesselsfromApril,1997toMarch,2002.Total299vessels,304lesionsand316stentswerestatisted.Thesuccesssrateofprocedure,immediateoutcomeafterprocedure,therateofmainadversecardiaceventsafterprocedureandrestenosisafterstentplacementinsmallcoronaryvesselswereassessed.Thepatientswerefollowedup1monthto4years.Re-catheterangiographyweredonein122/290patients.ResultsThenarrowrateoflesiondroppedfrom89%±12%beforeprocedureto5%±5%afterprocedure(diameter).202patientswerefollowedup1month(69.7%).197/202casesweresurvival.5/202casesdiedin3hrsto7days.2/5casesdiedofpersistenthypotensionafterprocedure.1/5casediedofacuteleftheartfailure.2/5casesdiedofsuddendeath.180caseswerefollowedup5monthsto4years.Thenon-eventsurvival(NES)ratewas73.3%(132/180).There-angiographyweredonein122cases.Restenosishappenedin39cases(30.3%).37patientsrepeatedPCI.2patientswenttoCABG.2casesgotanginarecurrenceandwereprovedsecondtimerestenosisbyre-angiography.ThethirdtimePCIwasdonein1patient.TheotherpatientswenttoCABG.1casediedofchronicheartfailureafter2years.1casesufferedacutemyocardialinfarctiononarterystentimplanted.ConclusionsTherearehighsuccessrateofprocedureandperfectimmediateoutcomeinstentplacementinsmallvessels.Mainadversecardiaceventsdidnotincreased.Non-eventsurvialwassatisfiedinlongtermfollow-up.Restenosisratewasshowedslightlyhigherthantheoneofmainvessels.
简介:Objective:Toinvestigatetheinfluenceofintracranialpressure(ICP)andcerebralperfusionpressure(CPP)onneurologicaldeteriorationandoutcomeofseveretraumaticbraininjury(STBI).Methods:Atotalof245patientswithseveretraumaticbraininjurywerestudiedretrospectivelywithunivariateandmultivariatestudiestoevaluatethecontributionofICP/CPPtoneurologicaldeteriorationandoutcome.Results:Themortalityratesrosefrom16.2%in142patientswhosecourseofdiseasewassmoothto66.7%in103patientswhosufferedfromneurologicaldeterioration.Correspondingly,thefavorableoutcomefallfrom54.2%inthepatientswithoutneurologicaldeteriorationto18.3%inthosewithneurologicaldeterioration.Inthepatientswithclinicalevidenceofneurologicaldeterioration,therelativeinfluenceoftheICPandtheCPPonoutcomewasassessed.Themosepowerfulpredictorsofneurologicaldeteriorationwasthepresenceofintracranialhypertension(ICP>30mmHg,1mmHg=0.133kPa).TheCPPalsohadaprognosticpoweronneurologicaldeteriorationwhenitslevellessthan60mmHg.Conclusions:Itsuggeststhatit'sveryimportanttolowertheintracranialhypertensionandkeeptheCPPnotlessthan60mmHgduringthetreatmentofSTBI.
简介:Objective:ToelucidatetheroleofS-100Bandneuronspecificenolase(NSE)inpredictingtheoutcomesofpatientswithsevereheadinjury.Methods:Fortypatientswithsevereheadinjurywereincludedinthisstudy.TheserumconcentrationsofS-100BandNSEweremeasuredwithin12hoursafterheadinjurytoinvestigatethecorrelationbetweenserumlevelsofS-100BandNSEandoutcome.ValidityofbothS-100BandNSEinoutcomepredictionwasassessedwithReceiverOperatorCharacteristic(ROC)curve.Results:TheserumconcentrationsofS-100BandNSEofbothgroups,withfavorableorunfavorableoutcomes,weresignificantlyhigherthanthoseofthenormalgroup.Theserumconcentrationswithin12hoursafterheadinjurywerecloselycorrelatedwiththeprognosis.Furthermore,accordingtotheROCcurvesof100BandNSE,S-100BwasfoundbetterinpredictingoutcomesthanNSE.Conclusions:S-100BandNSEmayplayimportantrolesinoutcomepredictionaftersevereheadinjury.Moreover,S-100BisclearlysuperiortoNSEintermsofpredictivevalueandappearstobeamorepromisingserummarkerinoutcomepredictionaftersevereheadinjury.
简介:Inthepresentstudy,theeffectofblockageofthecostimulatorysignalCD86attimeofimplantationontheexpressionsofTGF-β1,MMP-9,TIMP-3andPAI-1proteinsatthematernal-fetalinterfaceandtheoutcomeofpregnancyinmurineabortion-pronemodelwasinvestigated,inwhichtheCBA/JxDBA/2matingswereusedastheabortion-pronemodelandtheCBA/J×BALB/cmatingsusedasthenormalpregnantmodel.Thestudywasperformedinfollowingthreegroups:2groupsoftheabortion-pronemodel,whichwereexperimentalgroupandcontrolexperimentalgroup,and1groupofnormalpregnantmodel,andeachgrouphad10pregnantCBA/Jmiceexclusively.FemalepregnantCBA/Jmiceintheexperimentalgroupreceivedanintraperitoneal(i.p.)injectionof100μgofantimouseCD86mAbin200μlofPBSatday4.5ofgestation,andtheirrelevant-isotopematchedratIgG2bwasadministratedinthecontrolexperimentalgroupwiththesamedosageandatsametime.Forthenormalpregnantgroup,notreatmentwasgiven.ThepregnantCBA/Jmicewerekilledonday13.5ofgestation.Then,theembryoresorptionratewascalculatedandtheexpressionsofTGF-β1,MMP-9,TIMP3andPAI-1weredetectedbyusingimmunohistochemicalmethods.Itwasdemonstratedthattheembryoresorptionrateintheexperimentalgroupwassignificantlyreducedincomparisonwiththatinthecontrolexperimentalgroup(x2=7.441,P=0.006),buttherewasnosignificantdifferencewiththatinnormalpregnantgroup(x2=0.016,P=0.898).TheexpressionsofTGF-β1andPAI-1intheexperimentalgroupweresignificantlyincreasedincomparisonwiththatinthecontrolexperimentalgroup(P=0.010,P=0.003,respectively),withnosignificantdifferencefromthatinthenormalpregnantgroup(P=0.500).However,theexpressionofMMP-9intheexperimentalgroupwassignificantlyreducedincomparisonwiththatinthecontrolexperimentalgroup(P=0.012)withnosignificantdifferencefromthatinthenormalpregnantgroup(P=0.500).Theexpression