Objective:To observe the effects of testosterone on optic nerve an d retinal ganglion cells (RGC) in experimental autoimmune encephalomyelitis (EAE ). Methods:Fourty one female Wistar rats were randomly divide d into 3 groups: the normal group (10 rats), the untreated control group (15 rats) and the testos terone group (16 rats). The rats in the first two groups were fed with 1% ethano l every day, and the rats in the testosterone group were fed with methyltestoste rone (0.25 mg/kg) every day. On the 20th day, EAE model was induced in the untre ated control group and the testosterone group by injecting guinea pig spinal cor d homogenate in complete Freund's adjuvant and bordetella pertussis vaccine. RGC were labeled with flurogold (FG) by injecting it in superior colliculus and lat eral geniculate body 7 days before establishing EAE model. All rats were fed wit h drugs continuously, and after 1430 days, rats in normal group and rats in un t reated control and testosterone groups who had symptoms within 48～72 hours were observed by light microscopy and flash visual evoked potential (FVEP) to detect the functional and morphological changes of optic nerve. The number of RGC was counted by fluorescence microscopy，and apoptosis of RGC was observed by termina l deoxynucleotidyl transferasemediated biotinylated UTP nick end labeling (TUN E L) Results:EAE rats presented weakness or paralysis of tail a nd hind limbs 10 days after establishing EAE model. Compared with the rats in the untreated contr ol group, the rats in the testosterone group had longer disease delitescence and lower clinical score (P=0.042). Extensive demyelination of optic nerves wi th the circuitous configuration was found in the untreated control group; while mild demyelination of optic nerves with regular figure was found in the testosterone group. In the testosterone group, the latency of N1、P and N2 wave was shorter w hile the amplitude ofN1-P and P-N2was higher than that in the untreated cont rol group (Plt;0.05). The number of RGC was (2284plusmn;132), (934plusmn;78, and (1725 plusmn;95)cells/mm2 in the normal, untreated control and testosterone groups, respectively; w hich was higher in testosterone group than that in untreated control group (P=0.028). The number of TUNEL positive cells was (4.02plusmn;0.16), (24.44plusmn;2.22), and (9.84plusmn;2.36) cells per high power field (times;400) in the 3 grou ps, respectively; wh ich was less in testosterone group than that in untreated control group (P＝0.025). Conclusions:Testosterone may reduce the incidence and clinical score of EAE, inhibit the apoptosis of RGC, alleviate the demyelinatio n of optic nerves, and improved the conduction function of optic nerves.
Objective To evaluate the validity of video-assisted thoracoscopic surgery (VATS) pneumonectomy in thoracic diseases treatment. Methods We retrospectively analyzed the clinical data of 34 consecutive patients who underwent VATS pneumonectomy in Xiangya Hospital Central South University between January 2013 and October 2015. There were 26 males and 8 females at age of 35–69 (53.8±7.7) years. Results VATS pneumonectomy was completed successfully in 32 patients (5.8% conversion rate). The average operation time was 182.5±52.4 min. The average blood loss was 217.1±1 834.8 ml. Chest tube drainage flow was 3–11 (6.0±1.7) days and postoperative hospital stay was 5–12 (7.6±1.8) days. Eleven patients got postoperative complications (34.3%), mainly pulmonary infections. The 32 patients were followed up for 10 (1–21) months. Two patients died of lung metastasis 16 or 17 months after the operation. One patient died of sudden cardiac arrest 3 months after operation. Bronchopleural fistula (BPF) happened in one patient after hospital discharge in 2 months. Conclusion VATS is feasible for pneumonectomy. However, further studies and follow-up are needed to verify the benefits of VATS pneumonectomy for lung cancer.
ObjectiveTo compare the safety and efficacy of simple mitral valve replacement with the third intercostal incision on the right side and the conventional midsternum incision.MethodsFrom February 2017 to February 2019, heart surgery in the Affiliated Hospital of Jining Medical College completed the first simple mitral valve replacement (MVR) operation in 103 patients, of whom 39 patients were received minimally invasive right third intercostal small incision (a minimally invasive surgery group). There were 10 males, 29 females at average age of 59.51 years. There were 64 patients with MVR via the middle section of the common sternum (a conventional surgery group), 22 males and 42 females, with an average age of 60.22 years. Types of lesions: 65 patients were with mitral stenosis, 22 patients with incomplete closure, 16 patients with incomplete closure.ResultsThere was no significant difference in preoperative clinical data between the two groups (P>0.05). The entire group of patients successfully completed the operation. Surgical replacement of mitral valve mechanical valve in 74 patients and biological valve in 29 patients. There was no significant difference between the two groups in the extracardiopulmonary cycle time, aortic blockade time and total hospitalization time. In the early stage of operation, 3 patients were examined for secondary hemostasis, 1 patient was minimally invasive surgery, and the remaining 2 patients were with routine surgery. The infection of incision occurred in 3 patients, all of them were in the routine operation group. All three patients died early after operation in the routine operation group: two were postoperative low cardiac volumetric syndrome leading to multiple organ failure, and the other was sternum infection accompanied by artificial valve endocarditis.ConclusionThere is no significant difference between MVR through the third rib of the right chest and traditional MVR in the safety. However, it has the advantages of small trauma, beauty, low incidence of incision infection and reduced postoperative pain.
ObjectiveTo analyze the safety and effectiveness of minimally invasive small incision through the right third intercostal and standard aortic valve replacement.MethodsThe clinical data of 123 patients with the first simple aortic valve replacement in our hospital from June 2013 to May 2020 were retrospectively analyzed. The patients receiving aortic valve replacement through the right third intercostal small incision were allocated to a minimally invasive group, and patients receiving aortic valve replacement through the median sternal incision were allocated to a common group. The clinical outcomes of the two groups were compared.ResultsThere were 40 patients in the minimally invasive group, including 11 (27.5%) females and 29 (72.5%) males, aged 54.60±9.98 years with the body mass index (BMI) of 23.16±2.48 kg/m2. There were 83 patients in the common group, including 27 (32.5%) females, 56 (67.5%) males, aged 58.77±9.71 years, with the BMI of 24.13±3.13 kg/m2. Compared with the common group, the aortic cross-clamping time, cardiopulmonary bypass time, and operation time were longer (P<0.05), the ventilator support time was shorter (P<0.05), and the blood loss, postoperative 24 h chest drainage volume and total expense were less (P<0.05) in the minimally invasive group. The ICU stay, postoperative hospital stay, and total hospital stay were not statistically different between the two groups (P>0.05).ConclusionThe aortic valve replacement through the right third intercostal small incision is safe and effective, with less blood loss, 24 h chest drainage volume and invasiveness.
Objective To assess the therapeutic effect of sulodexide for diabetic patients with early nephropathy. Methods A total of 60 patients with early diabetic nephropathy (albuminuria: 30 to 300 mg/24 h, male/female: 30/30, mean age: 51.23 years, mean course of disease: 12.9 years) were randomized equally into three groups: the routine treatment group, cozaar group (50 mg qd, po for 12 weeks) and sulodexid group (600 LSU qd, iv or im for 4 weeks, 250 LSU bid, po for 8 weeks). The levels of urinary albumin excretion rate (UAER), urea nitrogen and creatinine were determined. Results After three months of treatment, the level of UAER was decreased significantly in both the sulodexide group and cozaar group (Plt;0.01), but not in the routine treatment group (Pgt;0.05). The level of UAER was reduced by 34.04% and 33.62% in the cozaar group and the sulodexide group, respectively. Significant difference was noted in the level of UAER between the cozaar/sulodexide groups and the routine treatment group (Plt;0.01), but no significant difference was observed between cozaar group and sulodexide group (Pgt;0.05). Conclusion Sulodexide could decrease the level of UAER in patients with early diabetic nephropathy. It has similar efficacy to cozaar.