objective To observe the differences between four- and single-channel recording of normal multifocal visual evoked potential (mfVEP). Methods mfVEP of 35 health individuals (70 eyes) were detected by both four- and single-channel recording with VERIS apparatus. The root mean square (RMS) value of reactive amplitude was obtained from the results of the two kinds of recording. Each stimulated patch was analyzed to compare the variational degree of each patch between the two recording methods. Responase sasymmetry coefficient (RAC) was introduced to evaluate the symmetry property between the two eyes in an individual. Results Compared with the single-channel recording,the responses of the stimulated patches of the four- channel recording were increased statistically, with most of the patches below the horizontal meridian and some of patches in the upper field, and there was distinct symmetry property between the two eyes in the same individual recorded by four-channel recording. Conclusion The four-channel recording is better than the single one and could be clinically applied and popularized.(Chin J Ocul Fundus Dis，2004，20：156-159)
Objective
To investigate the myocardial protective effects of Del Nido cardioplegia and analyze its advantages in adult cardiac surgery.
Methods
We retrospectively analyzed the clinical data of 96 adult patients undergoing cardiac valve surgery who received Del Nido cardioplegia (a DNC group) from June 2016 to January 2017 in our hospital. There were 44 males and 52 females with a mean age of 51.36±13.31 years. Meanwhile 96 patients who received conventional cardioplegia were recruited as a control group (a CTC group) and there were 53 males and 43 females with a mean age of 52.91±10.95 years. Cross-clamping time, cardiopulmonary bypass (CPB) time, total volume of and transfusion frequency of cardioplegia, the rate of spontaneous defibrillation, red blood cell transfusion and vasoactive-inotropic score at postoperative 24 hours (VIS 24) were recorded.
Results
No significant difference was found in age, body weight, ejection fraction, hematokrit, CPB time and cross-clamping time between the DNC group and CTC group. There was no significant difference in the rate of spontaneous defibrillation, VIS 24, cardiac enzymes and cardiactroponin I and length of ICU stay between the two groups. The total volume and transfusion frequency of cardioplegia, perioperative blood transfusion were lower in the DNC group. There was no new atrial fibrillation or in-hospital death in the two groups.
Conclusion
Del Nido is a good myocardial protection solution in adult cardiac valve surgery, and requires less static preload volume and reduceshemodilution and perioperative blood transfusion.
Objective To study the method to prepare the animal model of goat cleft palate by injection of anabasine and the effect of the malformation on the development of the facial mid-part. Methods A total of 40 female boer hybrid goats were selected, aging 8-12 months and weighing 35-55 kg. The mating day was 0 day, and at 30 days the goats assured pregnant byB type ultrasonic test were divided into 4 groups (n=10) according to intramuscular injection of 10 (experimental group 1), 15 (experimental group 2), 20 (experimental group 3) mg/ d, and no injection (control group), respectively, from the 31st to 42nd day. At pregnant 120 days and 1 month after birth, 5 fetal goats of each group were used for three dimensional reconstruction ofskull with CT scan. The maxillary bone width named as PPMM and the maxillary bone length named as APMM were measured then the hard palate general observation was performed and dry skull of goats was harvested to observe the development of maxillary. Results After injection, all pregnant lambs aborted in experimental group 3; 2 pregnant lambs aborted and 8lambs maintained pregnancy in experimental group 2. At 120 days of pregnant, no cleft palate was observed in 5 fetal lambs of experimental group 1 and control group, respectively; cleft palate and maxillary dysplasia occurred in 3 fetal lambs of experimental group 2. Among 11 newborn lambs of experimental group 1 and 8 newborn lambs of control group, no cleft palate was observed;among 7 newborn lambs of experimental group 2, cleft palate occurred in 5 with obvious maxillary dysplasia and eating difficultly. General observation of hard palate and dry skull showed obvious hypoplasia of maxillary in experimental group 2. There were significant differences in PPMM and APMM between the experimental group 2 and the control group at pregnant 120 days and 1 month after birth (P lt; 0.05). Five lambs with cleft palates of experimental group 2 survived for 1-2 months. Conclusion The animal models of goat cleft palate can established by intramuscular injection of anabasine at a dose of 15 mg/d from the 31st to 42nd day of pregnant. The facial character of the induced cleft palate goat is similar to that of human cleft palate.
Objective?To study the mid-facial development characteristics of the goats with cleft palate after in-utero surgical repair at different stages.?Methods?Twenty-four Boer hybrid female goats were selected, aged from 8 to 12 months and weighing from 35 to 55 kg. The mating day was designated for 0 day. At 30 days, pregnant was confirmed by B-ultrasound test, and the goats were divided into 5 groups (experimental groups 1, 2, 3, 4, and normal control group). Twenty pregnant goats of 4 experimental groups (n=5) were injected DL-anabasine (15 mg/day) from 31 to 42 days to establish cleft palate model of fetal lamb, 4 pregnant goats of normal control group used as controls without injection. At pregnant 65, 90, and 120 days, cleft palate was repaired in the uterus in experimental groups 1, 2, and 3, while cleft palate was not repaired in experimental group 4. After 1 month of birth, the maxillary bone width (posterior premolar morphological measurement, PPMM) and the maxillary bone length (anterior premolar morphological measurement, APMM) were measured with CT scanning. The dry skull of goats were harvested for gross observation.?Results?There was no significant difference in PPMM and APMM between experimental group 1 and the normal control group (P gt; 0.05), but there were significant differences between experimental groups 1 and 4 (P lt; 0.05) at 1 month after birth. Significant differences were oberved in PPMM and APMM between experimental group 2 and normal control group, experimental group 4 (P lt; 0.05). There were significant differences in PPMM between experimental group 3 and normal control group, experimental group 4 (P lt; 0.05), in APMM between experimental group 3 and normal control group (P lt; 0.05). Five goats with cleft palate in experimental group 4 died at 1-2 months after birth.?Conclusion?At pregnant 65 days, in-utero surgical repair of cleft palate has less influences on mid-facial development. The earlier repair is performed, the higher risk of miscarriage was.
ObjectiveTo investigate the incidence, severity and longitudinal trajectories of symptoms at various time points in the perioperative period of lung cancer patients, and to provide scientific basis for clinical staff to implement predictive nursing and dynamic management of symptom clusters. MethodsA prospective longitudinal investigation was conducted. The patients with lung cancer who underwent thoracoscopic lung surgery in four wards of the Department of Thoracic Surgery in our hospital were investigated by face-to-face and telephone follow-up before surgery, 1-2 days after surgery, on the day of discharge and 2 weeks after discharge. The investigation tool was the revised Chinese version of MD Anderson Symptom Inventory lung cancer specific module. Results A total of 192 patients with lung cancer were included in this study, including 59 males and 133 females, with an average age of (55.68±11.01) years. There were two symptom clusters (respiratory-gastrointestinal and emotional/psychological-disturbed sleep symptom clusters) before surgery, three symptom clusters (respiratory, gastrointestinal, and emotional/psychological-disturbed sleep symptom clusters) 1-2 days after surgery, three symptom clusters (pain-fatigue-emotional/psychological, respiratory, and gastrointestinal symptom clusters) on the day of discharge, and two symptom clusters (pain-fatigue-respiratory and respiratory symptom clusters) 2 weeks after discharge. The composition of symptoms was different in each time point during perioperative period. ConclusionThere are four symptom clusters in patients with lung cancer during perioperative period, which are pain-fatigue-disturbed sleep symptoms, gastrointestinal symptoms, respiratory symptoms and emotional/psychological symptoms. The symptom clusters of lung cancer patients at different time points are relatively stable, but the symptoms within the symptom clusters show dynamic changes. Medical staff should attach great importance to and continuously monitor the dynamic changes of perioperative symptom groups of lung cancer patients, do relevant education and nursing in advance, and timely adjust the management plan according to the symptom group evaluation results.
Objective To investigate the management during offpump coronary artery bypass grafting (OPCAB) for patients with ascending aorta atherosclerosis and to find appropriate treatment for minimizing the postoperative cerebrovascular accidents. Methods 236 patients with ascending aorta atherosclerosis were retrospectively analyzed underwent OPCAB in this hospital from Sep.2004 to Dec.2007, 4 of them received “No-touch” technique, 35 of them had the proximal anastomoses with the Enclose assistant, and 197 of them had the proximal anastomoses with the assistant of Heartstring. Hemodynamic indexes were consecutively monitored, blood streams of grafts was monitored by transit time flow measurement (TTFM) to evaluate the quality. Results Distal anastomoses 881，proximal anastomoses 267, the blood stream of 881 grafts was monitored, the mean flow was 16.2±18.7 ml/min, and the pulsatility index (PI) were 4.9±2.3, indicating the good quality of all grafts. The change of hemodynamic indexes including mean artery pressure (MAP, 78.1±10.4 mmHg vs. 80.9±8.1 mmHg）, pulmonary capillary wedge pressure (PCWP, 11.9±3.6 vs. 10.9±2.1 mmHg）, mean pulmonary artery pressure (MPAP, 17.3±4.3 mmHg vs. 15.3±2.8 mmHg）, cardiac output (CO, 4.2±1.2 L/min vs. 4.5±1.6 L/min）, center vinous pressure (CVP, 9.2±2.3cmH2O vs. 9.3±1.8 cmH2O）, heart rate (HR, 71.4±14.0 beats/min vs. 73.4±16.5 beats/min）, there were no statistically difference between before and after proximal anastomoses (Pgt;0.05). Two patients died of low cardio output during operation, 4 patients with transient ischemic attack were improved by 2 months medical therapy, and others had no postoperative complications as perioperative myocardial infarction etc, and the time of stay hospital was 10.5±4.2d. Followup 3-24 months for 185 patients, all living patients had no myocardial or cerebrovascular accidents, the symptoms were alleviated and myocardiac function improved. Conclusion Assessing the degree of the ascending aorta atherosclerosis sufficiently before and during the operation, choosing different operational strategy, and decreasing the manipulation of aorta can decrease the incidence of cerebrovascular accident and get better clinical result.
Abstract: Objective To investigate the clinical results of the coronary artery bypass grafting (CABG) for coronary artery disease (CAD) patients with completed hypothyroidism. Methods Twentyone CAD patients with hypothyroidism (hypothyroidism group) operated by a single surgeon from September 2002 to June 2009 in our department were enrolled in this study. Among them, there were 6 males and 15 females. Their average age was 60.4 years old. Three patients underwent CABG with onpump beating heart; one underwent CABG with onpump arrested heart; and 17 patients underwent CABG with offpump beating heart. All patients on thyroxine replacement therapy underwent CABG after free triiodothyronine（FT3）,free thyroxin（FT4）, thyroidstimulating hormone（TSH）, total triiodothyronine（TT3） and total thyroxin（TT4） were obviously improved. At the same time, twenty CAD patients without hypothyroidism were chosen as the control group (control group). Among them, there were 6 males and 14 females with an average age of 62.1 years old. The data of thyroid gland function and clinical prognostic indicator were observed after the operation. Results For the hypothyroidism group, one patient with pericardial effusion, heart failure and low thyroxine before surgery died during the onpump operation. Among the 20 survivors who had undergone CABG with beating heart, 17 were offpump CABG patients. Followup was done for 230 months. Postoperative eject factor of the survivors were significantly higher than their preoperative eject factor (55%±21% vs. 48%±17%). Twenty patients in the control group all survived. There was no significant difference in cardiac index ［2.7±1.4 L/(min·m2) vs. 2.8±1.5 L/(min·m2), t=0.530, P=0.530］, hospital stay (12.2±4.7 d vs. 10.1±3.9 d , t=0.170, P=0.170), or mechanical ventilation time (17.6±9.1 h vs. 15.1±13.7 h, t=0.120, P=0.120) between the hypothyroidism group and the control group. Perioperative thyroxine examination showed that there was no profound impact on thyroxine by offpump CABG. Conclusions With full preparation made before operation, CABG with beating heart is comparatively safe for CAD patients with hypothyroidism. The key of the treatment is perioperative thyroxine replacement therapy. There is much risk to perform onpump CABG on patients with severe hypothyroidism.
The automatic detection of arrhythmia is of great significance for the early prevention and diagnosis of cardiovascular diseases. Traditional arrhythmia diagnosis is limited by expert knowledge and complex algorithms, and lacks multi-dimensional feature representation capabilities, which is not suitable for wearable electrocardiogram (ECG) monitoring equipment. This study proposed a feature extraction method based on autoregressive moving average (ARMA) model fitting. Different types of heartbeats were used as model inputs, and the characteristic of fast and smooth signal was used to select the appropriate order for the arrhythmia signal to perform coefficient fitting, and complete the ECG feature extraction. The feature vectors were input to the support vector machine (SVM) classifier and K-nearest neighbor classifier (KNN) for automatic ECG classification. MIT-BIH arrhythmia database and MIT-BIH atrial fibrillation database were used to verify in the experiment. The experimental results showed that the feature engineering composed of the fitting coefficients of the ARMA model combined with the SVM classifier obtained a recall rate of 98.2% and a precision rate of 98.4%, and the F1 index was 98.3%. The algorithm has high performance, meets the needs of clinical diagnosis, and has low algorithm complexity. It can use low-power embedded processors for real-time calculations, and it’s suitable for real-time warning of wearable ECG monitoring equipment.
