Objective To explore the safety and clinical efficacy of right chest minithoracotomy for left atrial myxoma resection. Methods We retrospectively analyzed clinical data of 32 patients with left atrial myxoma resection by right chest minithoracotomy (a small incision group, 9 males, 23 females at age of 59.1±9.5 years) in our hospital from July 2011 through March 2015. Meanwhile, we selected 17 patients with left atrial myxoma treated by conventional chest median sternotomy as a control group (7 males, 10 females at age of 60.0±9.0 years). Clinical results of the two groups were compared. Results There was no statistical difference in preoperative clinical data of the patients between the two groups. All the patients were successfully operated. Patients in the small incision group had longer aortic clamping time than that in the control group. But there were shorter postoperative mechanical ventilation time (9.5±4.9 h), shorter ICU stay time (18.6 ± 6.2 h), less amount of thoracic cavity drainage 24 h after drainage (103.8±19.4 ml), lower bleeding reoperation rate (0.0), less blood transfusion after surgery (1.4±1.1U), shorter ambulation time (38.5±6.9 h), shorter hospital stay (8.1 ± 0.9 d), lower postoperative complication rate (0.0) than those of the control group (P<0.05). Conclusion Right chest minithoracotomy left atrial myxoma resection is feasible, safe and effective, is worth promoting.
Objective To investigate the effects of nitric oxide precursor L-arginine on traumatic pulmonary contusion. Methods Sixty Sprague-Dawley rats were randomly divided into three groups, ie. a normal group, a model group, and a L-arginine group. The model of traumatic pulmonary contusion was established with self-made chest-impacter. Then the rats in the L-arginine group was injected intravenously with L-arginine in a dose of 250 mg/kg. All rats were sacrificed at 24 hours after these models established.Levels of TNF-α and nitric oxide ( NO2 - /NO3- ) in serum were measured by ELISA and diazo-reaction method. Lung wet/dry weight ratio, NF-κB, endothelin-1, apoptotic cell, and ICAM-1 ( intercellular adhesion molecule-1) mRNA expressions in the lung tissue were measured. Results Compared with the model group,TNF-αand lung wet/dry weight ratio decreased significantly in the L-arginine group( P lt; 0. 05) . After the L-arginine treatment, the concentration of nitric oxide, apoptotic index were significantly higher than the model group ( P lt; 0. 05) . The expressions of NF-κB, endothelin-1, and ICAM-1 mRNA in the L-arginine group were lower than those in the model group ( P lt;0. 05) . Conclusion L-arginine treatment can downregulate the expressions of NF-κB, ET-1, ICAM-1 mRNA and apoptosis obviously, and ameliorate the microcirculation of rats lung with traumatic pulmonary contusion.
Objective To investigate the effectiveness of three-dimensional strapping reduction in treatment of patellar fracture. Methods Between January 2015 and June 2015, thirty-two patients were randomly allocated to three-dimensional strapping reduction group (trial group) and towel clamp reduction group (control group). There was no significant difference in age, gender, damage side, interval from injury to opreration, fracture pattern, and cause of injury (P>0.05). The operation time, fluoroscopy time, fracture healing time, postoperative Hospital for Special Surgery (HSS) scores, and complications were collected and analysed. Results All incisions healed at stage I. All patients of 2 groups were followed up 10-14 months (mean, 12.4 months). The operation time and fluoroscopy time of trial group were both shorter than those of control group (t=6.212, P=0.000; t=6.585, P=0.000). X-ray films showed that the fractures in both groups healed successfully and there was no significant difference in healing time between groups (t=1.973, P=0.058). Bone nonunion, infection, and failure fixation were not found in both groups. HSS scores of trial group (91.6±3.8) was higher than that of control group (86.4±5.5) (t=–3.105, P=0.004). Conclusion Compared with towel clamp reduction, the three-dimensional strapping reduction in treatment of patellar fracture has the advantages of shorter operation time and fluoroscopy time, better knee function after operation, and satisfactory fracture healing.