ObjectiveTo summarize clinical results and experience of subarterial ventricular septal defect (sVSD) closure through a minimal right vertical infra-axillary incision in children, and evaluate the feasibility of this technique. MethodsClinical data of 27 sVSD patients who underwent surgical repair through a minimal right vertical infra-axillary incision from March 2009 to January of 2013 in the First Affiliated Hospital of Zhengzhou University were retrospectively analyzed. There were 20 male and 7 female patients with their age of 1.1-11.0 (4.4±2.8) years and body weight of 7.6-28.0 (14.6±5.3) kg. After induction of anesthesia, the patients were placed in a 90 degree left lateral position. The incision was performed along right midaxillary line vertically between the superior border of the third rib and inferior border of the fifth rib. The thoracic cavity was entered through the fourth intercostal space. The pericardium was opened 2 cm anterior to the phrenic nerve and suspended to elevate the heart and great vessels by the pericardial traction sutures. Cardiopulmonary bypass (CPB) was established after cannulation of the ascending aorta, superior vena cava and inferior vena cava. Closure of sVSD was performed through longitudinal pulmonary incision. After procedures under CPB finished, the aortic cannula was removed and the pericardium was closed with interrupted sutures. The thoracic drainage tube was placed through the sixth intercostal space. All the patients were followed up 3, 6 and/or 12 months after surgery. Satisfactory degree of the patients and their relatives were evaluated. Chest X-ray, electrocardiography and echocardiography were examined. ResultsSurgical repair of sVSD was performed in all the patients through this incision without any difficulty, incision prolongation or conversion to another incision. There was no in-hospital death, reexploration for bleeding, postoperative atelectasis, pulmonary infection, pleural effusion, impairment of central nervous system, phrenic nerve damage, poor wound healing, wound infection or pericardial effusion. Incision length was 4.4-7.0 (5.07±0.66) cm. Echocardiography before discharge showed no residual shunt in all the patients. All the patients were followed up 3, 6 and/or 12 months at the outpatient department or via the phone. During follow-up, there was no late death, residual shunt or chest asymmetry. The short incision under the armpit was obscured and provided favorable cosmetic results. All the patients and their relatives were satisfied with the cosmetic results. ConclusionRepair of sVSD through a minimal right vertical infra-axillary incision is feasible and safe for children. The advantages of this technique are favorable for children with sVSD.
Objective To explore the diagnosis accuracy of cardiac tumor and effectiveness of surgical treatment. Method We retrospectively analyzed the clinical data of 103 patients with cardiac tumor in our hospital from 2011 through 2014 year. There were 65 females and 38 males, aging from 3 months to 82 years (average age of 59.71±13.80 years). We analyzed age distribution and clinical manifestation of the patients, as well as size and location of tumors. Then we compared effects of different surgical procedures. Result There was no death during evaluation. Early postoperative complications included arrhythmia (47 patients), electrolyte disturbance (13 patients), and cardiac dysfunction (9 patients). One patient with B-cell non-Hodgkin's lymphoma auto-discharged because of cardiac dysfunction. No relapse was obse-rved in the patients with atrial myxoma or lipoma (2 patients) during follow-up. One patient with benign myogenic tumor was lost during the follow-up. Six patients with malignant tumor were with poor long-term effect including 2 patients lost in the follow-up and 4 deaths due to tumor relapse during 1 year after surgery. Conclusion Surgery is still the most effective and major therapy of cardiac tumor.
ObjectiveTo study the influence of myxobacteria metabolites NX52 and NX83 on the proliferation of colorectal carcinoma cells and investigate its probable mechanism. MethodsThe human colorectal carcinoma cell lines HT-29, SW480, and SW1463 were respectively treated with the two metabolites (NX52 and NX83) at different concentrations (0.1 mg/mL, 1.0 mg/mL, and 10.0 mg/mL), the cells of negative control were treated without metabolite. The proliferation inhibition was examined by methyl tthiazolyl tetrazolium assay. The cell morphology character was compared by inverted microscope, and the apoptosis of cell was analyzed by flow cytometry. ResultsTwo kinds of metabolites NX52 and NX83 had time-dose inhibitory effects on proliferation of human colorectal carcinoma cells HT-29, SW480, and SW1463 (P < 0.05). The metabolite NX83 had more obvious proliferation inhibition in the colorectal carcinoma cells as compared with the metabolite NX52 (P < 0.05). After 48 h, the apoptosis rate of the metabolite NX83 for SW1463 cell was observably increased as compared with the negative control group (P < 0.01). ConclusionsThe two kinds of metabolites NX52 and NX83 from myxobacteria could kill colorectal carcinoma cells in vitro. The possible mechanism might be induced by apoptosis of tumor cells.
ObjectiveFor better health interventions, blood pressure control and reducing risk of cardiovascular events, we explored the effects of health education by nurses on hypertension patients after discharging. MethodsHypertensive discharging-patients from the department of cardiology of the West China Hospital of Sichuan University were enrolled from January to October in 2011. They were divided into two groups, including a health education group and a control group. The patients in the health education group were given all-side care, health guidance, education lectures and telephone follow-up by nurses. The control group got no intervention. After one year follow-up, the information about situation of blood pressure control, new-onset cardiovascular events and changes of life habits were collected from the two groups. SPSS 19.0 was used to perform statistic analysis. ResultsA total of 300 discharged hypertensive cases were included, with 150 cases in each group. The systolic blood pressure of patients in the health education group was significantly lower than that of the control group (P < 0.05). Both blood control rates and the habit of low salt intake in the health education group were also better than those of the control group (both P < 0.05). There was no significant difference in changes of smoking, drinking, physical exercise and new-onset cardiovascular events between the two groups. ConclusionHealth education by nurses could effectively improve the management of blood pressure in patients with hypertension.
ObjectiveTo evaluate the early and mid-term outcomes of GK bileaflet mechanical valve applied in mitral valve replacement. MethodsTwenty patients with rheumatic mitral stenosis underwent mitral valve replacement in our hospital from March 2008 to June 2011. Ten patients of them chose GK bileaflet mechanical valve for surgery (a GK group, 5 males and 5 females, aged 56.4±8.9 years), while the other 10 patients chose Medtronic Open Pivot mechanical valve (a Medtronic group, 4 males and 6 females, aged 50.2±8.0 years). The preoperative, perioperative and postoperative data were analyzed and compared between the two groups. Cardiac CT angiography (CTA) and transesophageal echocardiography (TEE) were performed to evaluate leaflets opening angle, the morphological features of the mechanical valve and the hemodynamic features in the third year after surgery during the follow-up. ResultsNo mortality, defect, low cardiac output syndrome or bleeding after surgery occurred in either group. The result of 3-year follow-up showed that the function of the mechanical valve showed no difference between the two groups. Cardiac CTA and TEE showed good morphological features in all patients. ConclusionThe GK bileaflet mechanical valve has equivalent effect as Medtronic Open Pivot mechanical valve for mitral valve replacement during the 3-year follow-up.