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Ma J.,Dalian Municipal Central Hospital
Zhonghua wai ke za zhi [Chinese journal of surgery] | Year: 2013

To analyze anatomy data of popliteal veins (PV), with the purpose of selection of popliteal venous valves construction segment via venography, and to evaluate the surgical results. From February 1998 to November 2010, after analyzing the popliteal vessel anatomy data of 39 limbs and related phlebography research of 862 cases, 102 patients (69 male and 33 female patients, aged from 48 to 71 years, mean 59 years) with severe deep venous insufficiency were selected for popliteal venous valve construction procedures. Doppler ultrasound, continuous dynamic venography, and intraoperative venous pressure measurements were used to assess the hemodynamic changes pre- and postoperatively. Venous clinical severity score (VCSS) were used to evaluate long-term results of deep venous valve construction procedures. In the 102 patients, 93.7% patients had one pair of valves in popliteal vein (PV), locating in the distal 1/3 segment of PV, with gastrocnemius veins (GV) joining with PV above PV valves. Postoperative blood flow volume of the PV was significantly higher than the preoperative volume (732.3 ml/min vs. 150.2 ml/min, t = 8.979, P < 0.001). The proximal pressure was significantly lower than the distal pressure ((12 ± 3) cm H(2)O vs. (15 ± 3) cm H(2)O, 1 cm H(2)O = 0.098 kPa, t = 8.049, P < 0.001). VCSS score was significantly lower after the surgery ((34 ± 15) cm H(2)O vs. (41 ± 14) cm H(2)O, t = 59.780, P < 0.001). Pre- and postoperative hemodynamic changes and VCSS scores were statistically significant (9.3 ± 1.9 vs. 1.8 ± 1.0, t = 59.780, P < 0.001). Mean follow-up were 8.9 years with an ulcer recovery rate of 96.3%, and a 3.7% ulcer recurrent rate. Popliteal vessel anatomy study and venography research provide critical information for the PV valve construction part selection, which stayed proximal to the communications of GV and PV. Restoration of gastrocnemius pump function and satisfactory long-term efficacy are received after valve construction.


Li Y.J.,Dalian Municipal Central Hospital
Zhonghua yu fang yi xue za zhi [Chinese journal of preventive medicine] | Year: 2010

To evaluate the associations between polymorphisms of methionine synthase(MTR) A2756G and methionine synthase reductase(MTRR) G66A and risk of coronary artery disease. Literatures in Medline reporting the relationship between polymorphisms of MTR A2756G and MTRR G66A and risk of coronary artery disease from January 1990 to May 2010 were searched. A total of 14 relevant articles were selected and 13 of them met the criteria. A Meta-analysis was performed to estimate the pooled odds ratio (OR) to evaluate the relationship between polymorphisms of MTR A2756G and MTRR G66A and risk of coronary artery disease. All analyses were performed using the STATA statistical software. Among the 13 studies, eight case-control studies containing 2143 cases of coronary artery disease and 2270 controls were included in the analysis of MTR A2756G and risk of coronary artery disease. Meanwhile, five case-control studies with 811 cases of coronary artery disease and 387 controls were included in the analysis of MTRR G66A and risk of coronary artery disease. In the analysis of MTRR G66A related to the risk of coronary artery disease, there were 246 GG carries, 397 AG carriers and 168 AA carriers in the group of coronary artery disease, against 102 GG carriers, 203 AG carriers and 82 AA carriers in the control group. Compared with the MTRR GG carriers, the risk of coronary artery disease decreased significantly by 27% (OR = 0.73, 95%CI: 0.54 - 0.99) and 25% (OR = 0.75, 95%CI: 0.56 - 1.00) (Egger's test t = -0.19, P = 0.862) in the MTRR 66 AG and AG/AA carriers, respectively, and also decreased in the MTRR AA carriers but significant difference was observed (OR = 0.84, 95%CI: 0.42 - 1.68). There was no significant association between coronary artery disease and MTR A2756G. These results suggest that MTRR66 may play a role in coronary artery disease susceptibility. MTRR 66 A allele carries are associated with a statistically significant decreased risk of coronary artery disease susceptibility.


Zhang Q.,Dalian Municipal Central Hospital
Lin chuang er bi yan hou tou jing wai ke za zhi = Journal of clinical otorhinolaryngology, head, and neck surgery | Year: 2013

To introduce a new surgical treatment for subglottic stenosis. Six patients with subglottic stenosis were retrospectively studied. Four cases had history of intubation or tracheostomy. Two cases were because of B cell lymphoma and Wegener granulomatosis. All cases underwent endoscope assisted coblation surgery. All of the patients were discharged from hospital with no tube in one week after surgery. In a follow-up of 3-21 months, stenosis in 2 cases of B cell lymphoma and Wegener granulomatosis recurred 3 months after operation. These 2 patients were operated by coblation again and are still followed-up by now. The endoscope assisted coblation surgery is a new minimally invasive method for treating subglottic stenosis. Further more,it can be reused to whom has a relapse.


Liang H.,Dalian Municipal Central Hospital | Yu F.,Dalian University | Tong Z.,Dalian Municipal Central Hospital | Yuan B.,Dalian Municipal Central Hospital | Wang C.,Dalian Municipal Central Hospital
Molecular Biology Reports | Year: 2013

This study is designed to investigate the effect of ischemia post-conditioning on IR-induced skeletal muscle injury in limbs of experimental rabbits. Rabbits are randomized to one of the following three groups: sham control, ischemic reperfusion, ischemic postconditioning. The lipid peroxidation level, antioxidant enzymes activities, skeletal muscle mammalian target of rapamycin (mTOR), Bax, Bcl-2 proteins expression and Bcl-2/Bax, and HIF-1α/β-actin mRNA, interleukin-6 (IL-6)/β-actin mRNA and caveolin-3/β-actin mRNA expression were tested in the current study. The results suggested that ischemic postconditioning might decrease lipid peroxidation level, lactic dehydrogenase (LDH), creatine kinase (CK) activities, Bcl-2 proteins expression and Bcl-2/Bax, HIF-1α/β-actin mRNA expression and increase skeletal muscle antioxidant enzymes activities, Bax protein expression and IL-6/β-actin mRNA and caveolin-3/β-actin mRNA expression. These indicated that protective effect of ischemic postconditioning against IR-induced skeletal muscle injury involve into a complex molecular mechanism. Our research results may offer a theoretical guidance for therapy of related clinical diseases. © 2012 Springer Science+Business Media Dordrecht.


Ma T.,Fudan University | Ma J.,Dalian Municipal Central Hospital
Annals of Vascular Surgery | Year: 2014

Background To report the long-term results and clinical outcomes of femorofemoral bypass (FFB) to deep femoral artery (DFA) after failed endovascular attempts in treating critical limb ischemia (CLI) caused by long total occlusion of the unilateral iliofemoral artery. Methods A retrospective review was conducted on 82 consecutive patients (59 men, 23 women; mean age: 73.2 years), who presented with CLI and underwent FFB to DFA performed by a single surgeon. Preoperative and postoperative ankle-brachial index (ABI), runoff blood flow velocities, and long-term patency rates were analyzed, and the clinical and surgical variables influencing the graft patency were assessed. Results The mean ABI rose from 0.19 ± 0.17 preoperative to 0.54 ± 0.18 postoperative (P < 0.001). The postoperative blood flow velocities of popliteal arteries (30.74 ± 11.62 cm/sec) and tibial arteries (21.36 ± 8.59 cm/sec) were significantly higher than the preoperative values (13.96 ± 7.62 cm/sec and 9.83 ± 5.46 cm/sec). At 1, 5, and 10 years, the primary, assisted, and secondary patency rates were 90.3%, 58.5%, and 12.2%; 91.9%, 66.0%, and 45.9%; and 98.4%, 85.1%, and 61.6%, respectively. By multivariate analysis, the graft patency rate was positively related with hypertension but negatively correlated with hypercholesterolemia and single patent tibial runoff. Conclusions Our data suggest that FFB to DFA can be a safe, effective, and durable method for the treatment of CLI after prior failed endovascular attempts. © 2014 Elsevier Inc. All rights reserved.


Chen D.,Dalian Municipal Central Hospital
Chinese Journal of Cerebrovascular Diseases | Year: 2013

Objective: To retrospectively analyze the efficacy and safety of carotid endarterectomy (CEA) in the treatment of carotid artery stenosis in three domestic hospitals and to evaluate the risk factors affecting stroke and death within ≤ 30 days after procedure. Methods The clinical data of 494 patients with carotid artery stenosis (15 of them underwent bilateral operation, each patient was calculated as two separate cases, there were a total of 509 cases.) treated with CEA at Beijing Xuanwu Hospital of Capital Medical University, Liaocheng Brain Hospital, and Dalian Municipal Central Hospital from 2001 to 2011 were summarized retrospectively. The safety and efficacy of the procedure were observed. Univariate and multivariate logistic regression analysis was used to assess the related factors that impacted the adverse events in patients within ≤ 30 days after procedure. Results Circled digit oneIn the 509 patients, 439 with simple stenosis had vascular patency; 70 patients had been completed occlusion or near-total occlusion, seven of them failed recanalization. The success rate of surgery was 98.6%. Circled digit twoWithin 30 days after procedure, 20 cases (3.9%) had adverse outcome, including 6 died (1.2%) and 14 had stroke (2.8%). The secondary adverse outcome occurred in 120 cases (23.6%). Circled digit threeAll the 503 survival patients were followed up at 3 months after procedure, among them 494 (98.2%) were followed up for ≥ 6 months. During the follow-up period, 5 had new attack of stroke, one of them was died; 28 (5.6%) had restenosis and 6 (1.2%) had occlusion. Circled digit fourUnivariate analysis showed that the incidences of stroke and death within 30 days after procedure in patients with preoperative modified Rankin scale (mRS) ≥ 3 were significantly higher than those > 3 (17.4% vs. 2.6%; P < 0.01). Multivariate logistic regression analysis showed that smoking (OR = 2.667, 95% CI 1.048 to 6.791, P = 0.040) and mRS score ≥ 3 (OR = 8.690, 95% CI 3.279 to 23.031; P = 0.000) were the independent influencing factors that impacted postoperative primary adverse outcome within 30 days. The physician's learning curve affected the primary endpoint events within 30 days. Conclusion: In the treatment of carotid artery stenosis, CEA is safe and effective. The risk of surgery will increase in patients with smoke and severe neurological deficits before the procedure.


Li D.,Dalian Municipal Central Hospital
Lin chuang er bi yan hou tou jing wai ke za zhi = Journal of clinical otorhinolaryngology, head, and neck surgery | Year: 2012

To investigate the relationship between the protein expression of MDM2 and P16 in laryngeal squamous cell carcinoma (LSCC), and their relationship with clinic pathological feature. The expression of MDM2 and P16 were detected by S-P immunohistochemical method with mouse monoclonal anti MDM2 antibody and anti P16 antibody in 35 LSCC specimens, 21 specimens of precancerous larynx, 20 normal laryngeal specimens. Expression of MDM2 positive in normal laryngeal specimens, precancerous larynx and LSCC specimens were 10.0%, 38.1%, 54.3% respectively (P < 0.05), and in I - III pathological grade laryngeal carcinoma were 38.1%, 66.7%, 100.0% respectively (P < 0.05); Expression of P16 positive in normal laryngeal specimens, precancerous larynx and LSCC specimens were 85.1%, 52.4%, 34.3% respectively (P < 0.05), and in I - III pathological grade laryngeal carcinoma were 52.4%, 11.1%, 0% respectively (P < 0.05). Expression of MDM2 positive were higher with lower differentiation, so it's maybe helpful to diagnose LSCC. Expression of P16 positive were lower with lower differentiation, and there's no expression in III pathological grade LSCC, so it has positive effect on malignancy determination. Abnormal expression of MDM2 and P16 have different effects on LSCC development. Expression of MDM2 and P16 have negative correlation in LSCC.


Zhang Z.-Q.,Dalian Municipal Central Hospital | Meng H.,Dalian Medical University | Wang N.,Dalian Medical University | Liang L.-N.,Dalian Medical University | And 3 more authors.
Diagnostic Pathology | Year: 2014

Background: Hepatocellular carcinoma (HCC) is regarded as one of the most common malignancies and among the leading causes of cancer death among the whole world. The most urgent needs are to find sensitive markers for early diagnosis or monitor postoperative recurrence and to give adequate treatment for HCC. MicroRNAs (miRNAs) are reported as a group of small non-coding RNAs that can function as endogenous RNA interference to regulate expression of the targeted genes. This study was conducted to detect the application of miR-143 and miR-215 in the diagnosis of HCC.Methods: A total of 340 serum samples (127 samples from controls, 118 samples from hepatitis and 95 samples from HCC patients) were collected. The levels of the two mature miRNAs (miR-143 and miR-215) were detected by probe-based stem-loop quantitative reverse-transcriptase PCR (RT-qPCR) in controls, hepatitis and HCC patients. Besides, the relationship between miR-143 and miR-215 levels and clinical and pathological factors was explored.Results: We found that the expression of serum miR-215 was distinctly increased in chronic hepatitis compared with controls (mean ± SD: 6.79 ± 0.72 vs. 3.46 ± 0.37, P < 0.001 and mean ± SD: 8.38 ± 0.87 vs. 3.46 ± 0.37, P < 0.001). In addition, we conduct ROC analyses to detect the potential application of miR-143 and miR-215 in the diagnosis of chronic hepatitis and HCC. Our results showed that miR-143 and miR-215 might be a potential biomarker for the hepatitis and HCC.Conclusions: In conclusion, the expression of miR-143 and miR-215 in serum were significantly up-regulated in patients with chronic hepatitis and HCC. Due to its reasonable sensitivity and specificity for both diseases, miR-143 and miR-215 could be as potential circulating biomarkers.Virtual Slides: The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1048932281272754. © 2014 Zhang et al.; licensee BioMed Central Ltd.


Zhang Q.,Dalian Municipal Central Hospital
Lin chuang er bi yan hou tou jing wai ke za zhi = Journal of clinical otorhinolaryngology, head, and neck surgery | Year: 2012

To investigate the therapeutic efficacy of coblation-assisting uvulopalatopharyngoplasty (CAUPPP) combining with coblation-channeling of the tongue (CCT) for patients with severe obstructive sleep apnea-hypopnea syndrome (OSAHS). A retrospective analysis was made on patients with severe OSAHS treated by CAUPPP combining with CCT. The adult with severe OSAHS were involved in the study and the apnea-hypopnea index (AHI) were beyond 40/h and lowest arterial oxygen saturation (LSaO2) were under or equal to 80%. Surgical approach: The UPPP was performed to decrease the size of soft palate with coblation and coblation-channeling in the soft palate and decrease the size of tongue by CCT. All patients were followed up for 6 to 12 months and underwent polysomnography (PSG). Subjective symptoms of patients improved more significantly than that of preoperation. The function of soft palate is normal without significant nasopharyngeal regurgitation. Compared with the preoperative data, AHI values were significantly decreased (P<0.01) and the lowest oxygen saturations increased significantly (P<0.01) and the effective rate was 91.7%. There are usually multiple obstruction levels in patients with severe OSAHS and the traditional surgical treatment is not ideal. This study demonstrated that with the assistance of coblation, combining CAUPPP with CCT for patients with severe OSAHS is an effective surgical method. It has less blood loss, minimally invasive, retained the normal function of the soft palate, etc., should be widely applied.


Zhang Q.,Dalian Municipal Central Hospital | Li D.,Dalian Municipal Central Hospital | Wang H.,Dalian Municipal Central Hospital
Auris Nasus Larynx | Year: 2014

Objective: We investigated the long-term effects of partial tonsillectomy, and potential risk factors for tonsillar regrowth in children with obstructive sleep apnea hypopnea syndrome (OSAHS). Methods: Children affected by OSAHS with obstructive hypertrophic tonsils underwent partial tonsillectomy or total tonsillectomy with radiofrequency coblation. Polysomnography was performed prior to and 5 years following surgery. Blood samples from all participants were taken prior to and 1 month following surgery to assess immune function. All participants were interviewed 5 years following surgery to ascertain effects of the surgery, rate of tonsillar regrowth, and potential risk factors. Results: All parents reported alleviation of breathing obstruction. Postoperative hemorrhage did not occur in the partial tonsillectomy group compared to 3.76% in the total tonsillectomy group. Tonsillar regrowth occurred in 6.1% (5/82) in children following partial tonsillectomy. Palatine tonsil regrowth occurred a mean of 30.2 months following surgery, and 80% of children with tonsillar regrowth were younger than 5 years of age. All five patients had a recurrence of acute tonsillitis prior to enlargement of the tonsils. Four of the five had an upper respiratory tract allergy prior to regrowth of palatine tonsils. There were no differences in IgG, IgM, IgA, C3, or C4 levels following partial tonsillectomy or total tonsillectomy. Conclusion: Partial tonsillectomy is sufficient to relieve obstruction while maintaining immunological function. This procedure has several post-operative advantages. Palatine tonsils infrequently regrow. Risk factors include young age, upper respiratory tract infections, history of allergy, and history of acute tonsillitis prior to regrowth. © 2013 Elsevier Ireland Ltd.

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