Midterm Outcomes of Angioplasty for Pediatric Renovascular Hypertension

PurposeTo evaluate the midterm outcomes of percutaneous transluminal renal angioplasty (PTRA) for pediatric renovascular hypertension (RVH).Materials and MethodsThe clinical data of patients who underwent PTRA for RVH in the authors’ hospital from 2012 to 2019 were retrospectively analyzed. Postprocedural blood pressure, glomerular filtration rate (GFR) of the affected kidney, restenosis, and complications were closely monitored.ResultsPTRA was performed in a total of 30 children (20 boys and 10 girls), with a mean age of 7.3 years ± 0.7 (range, 40 days to 13.9 years) and a mean weight of 25.0 kg ± 2.3 (range, 3.4–53 kg). The median follow-up period was 26.5 months (range, 1 month to 7.5 years). Technical success was achieved in 26 (86.7%) of the 30 patients. Restenosis developed in 3 patients (10.0%). Only 1 patient underwent stent implantation, and the stent fractured 8 months later, requiring further intervention. There were no other complications. In terms of clinical benefit of blood pressure control after the initial PTRA procedure, 15 patients (50%) were cured and 7 patients (23.3%) showed improvement. There was no significant difference in the etiology, lesion location, and lesion length between patients with clinical benefit and failure (P = .06, P = .202, and P = .06, respectively). GFR of the affected kidney was significantly improved from 19.9 mL/min ± 11.2 to 38.1 mL/min ± 11.9 at the 6-month follow-up after PTRA (P < .001).ConclusionsThe overall results of PTRA for pediatric RVH caused by different etiologies are promising. PTRA not only provided a clinical benefit of blood pressure control in 73.3% of the patients but also significantly improved the function of the affected kidney.     

Endoscopic ultrasonography and small‐bowel endoscopy: Present and future

Over the last decade, impressive technological advances have occurred in ultrasonography and small‐bowel endoscopy. Nowadays, endoscopic ultrasonography is an essential diagnostic tool and a therapeutic weapon for pancreatobiliary disorders. Capsule endoscopy and device‐assisted enteroscopy have quickly become the reference standard for the diagnosis of small‐bowel luminal diseases, thereby leading to radical changes in diagnostic and therapeutic pathways. We herein provide an up‐to‐date overview of the latest advances in endoscopic ultrasonography and small‐bowel endoscopy, focusing on the emerging paradigms and technological innovations that might improve clinical practice in the near future.     

双球囊与缩宫素用于促宫颈成熟以及引产的效果比较

目的比较双球囊与缩宫素用于促宫颈成熟并引产的临床效果。方法选取于2017年7月—2018年7月在本院分娩的足月妊娠孕妇100例为研究对象,随机平均分为观察组和对照组各50例,观察组采用双球囊引产,对照组采用缩宫素进行引产,对比2组孕妇的总产程、宫颈成熟度、引产成功率和新生儿Apgar评分、并发症发生率等。结果观察组促宫颈成熟有效率(100%)、引产成功率(96%)均高于对照组(82%,74%),差异均有统计学意义(P<0.05),治疗后新生儿Apgar评分、并发症发生率差异均无统计学意义(P>0.05);宫颈Bishop评分观察组(9.12±1.42)高于对照组(7.92±1.56),观察组总产程(8.23±2.54)h,对照组(13.45±3.77)h,差异均有统计学意义(P<0.05)。结论双球囊用于妊娠引产效果显著,能明显促进宫颈成熟、缩短产程,保障分娩的顺利进行,安全可靠,值得在临床中推广。     

球囊导管取栓术治疗急性下肢动脉栓塞患者的体会

目的探讨球囊导管取栓术治疗急性下肢动脉栓塞患者的临床疗效。方法回顾性分析祈福医院2013年1月至2018年12月应用球囊导管微创取栓术治疗的78例急性下肢动脉栓塞患者的临床资料。结果治愈60例,治愈率为89.6%,患肢血供恢复。好转7例(10.4%),肢体缺血症状明显好转。全部患者无截肢。死亡1例(2.6%)。结论球囊导管取栓术是治疗急性动脉栓塞的有效方法,患者一经确诊应尽早手术取栓,有利于提高其保肢率和降低病死率。     

Design and preliminary results of FRENSHOCK 2016: A prospective nationwide multicentre registry on cardiogenic shock

Central illustration: geographic distribution of the 49 centres participating in the FRENSHOCK registry (35 academic hospitals, 10 general hospitals and four private clinics). Inclusion per centre varied from 1 to 72 patients.

     

小型移动数字成像系统下行经皮冠状动脉腔内成形术

目的 :探讨移动数字成像系统GE OECSeries 980 0进行经皮冠状动脉腔内成形术 (PTCA)的可行性和安全性。方法 :回顾分析 32例应用GE OECSeries 980 0X线机进行PTCA治疗冠心病的临床资料。结果 :①本组病例成功率为 90 6 % (2 9/ 32 ) ,血管成功率为 88 1% (37/ 4 2 ) ,病变成功率 83% (39/ 4 7)。成功病例狭窄由术前目测平均直径狭窄(92 8± 3 5 ) %减少到术后的 (6 5± 4 2 ) %。②AMI溶栓后补救性PTCA成功率高。结论 :应用GE OECSeries 980 0X线机能够满足心血管病区心脏介入治疗的需要 ,是安全可行的和具有良好的成本 效益比     

Effect of Shuxinyin (舒心饮) on In-Stent Restenosis after Coronary Artery Stenting

Objective: To evaluate the effect of anti-platelet regimens and it's combination with Shuxinyin (SXY, 舒心饮,) on in-stent restenosis after stent implantation. Methods: Forty-four patients with successful stent implantation in a coronary artery were randomly assigned to the treated group (n=20) and the control group (n=24). The treated group received: SXY and anti-platelet therapy. The control group were treated with anti-platelet regimens only. Platelet activation was assessed before and immediately after the stenting by flow cytometry, the expression of P-selectin (CD62P) and glycoprotein(GP) Ⅱb/Ⅲa receptor. It was reassessed on the 30th day after stenting. Plasma fibrinogen (Fg) and C-reaction protein (CRP) were measured by biuret and laser scattering turbidimetry respectively at the same time. Observation was made on the scoring of the symptoms of Qi deficiency syndrome, Qi-Yin deficiency syndrome and blood stasis syndrome in the two groups. Differences between groups were compared. Results: Compared with the control group, combination with SXY and anti-platelet therapy was remarkable in reducing plasma CRP (P<0.05), and also with the tendency to decrease plasma Fg, GPⅡb/Ⅲa and CD62P. It could also evidently decrease the scoring of Qi-Yin deficiency syndrome, Qi deficiency syndrome and blood stasis syndrome after stenting (P<0.05, 0.01, 0.01) respectively. Follow-up survey found 40% relapse of angina pectoris with 4 cases of in-stent restenosis proved by angiography in the treated group. But the relapse of angina pectoris in the control group was 67% with 2 cases of myocardial infarction (MI), 7 cases of in-stent restenosis proved by angiography and one death. Conclusions: Combination with SXY and anti-platelet regimens can prevent stent thrombosis and in-stent restenosis after stent implantation, and it seems superior to anti-platelet therapy only.