BACKGROUND Atrial fibrillation(AF)is one of the most common arrhythmias,and radiofrequency catheter ablation is the most effective treatment strategy.The inferior vena cava(IVC)is a common approach for radiofrequency ...BACKGROUND Atrial fibrillation(AF)is one of the most common arrhythmias,and radiofrequency catheter ablation is the most effective treatment strategy.The inferior vena cava(IVC)is a common approach for radiofrequency ablation of AF.However,this approach may not be applied to some cases such as chronic venous occlusions,surgical ligation of the IVC,and heterotaxy syndrome(HS).CASE SUMMARY A 68-year-old man with HS suffered from severely symptomatic persistent AF for 9 years,and we successfully ablated by percutaneous transhepatic access.CONCLUSION In patients without femoral vein access,the use of the hepatic vein for pulmonary vein isolation is a viable alternative for invasive electrophysiology procedures.展开更多
Methicillin-resistant Staphylococcus aureus is an increasingly important cause of nosocomial bacterial infections worldwide. S. aureus is responsible for several pathologies, including skin infections, endocarditis, m...Methicillin-resistant Staphylococcus aureus is an increasingly important cause of nosocomial bacterial infections worldwide. S. aureus is responsible for several pathologies, including skin infections, endocarditis, meningitis, deep-tissue ulcers, and sepsis. S. aureus biofilm formation on catheters and other medical devices is a major post-operative concern, because biofilms are often the source of persistent and difficult to treat bacterial infections. While catheter-related S. aureus infections have been reported, the strains responsible for these infections have not been genetically characterized. We genetically characterized S. aureus strains isolated from hemodialysis catheters in Mexican patients. The frequency of 35 genes coding for adhesins, toxins, and other virulence-associated products in the 55 isolated S. aureus strains was determined using PCR, while real-time PCR was used to examine the level of gene expression. Of the 55 S. aureus strains isolated from 109 patients, 45 (81.8%) were determined to be methicillin-resistant. The icaA, rbf, sarA, and agr genes are involved in biofilm formation and bacterial dispersion and were detected in 96.3%, 40.0%, 74.5%, and 100% of S. aureus strains, respectively, and 70.9% of the strains formed a detectable biofilm. Interestingly, 67.2% of the strains contained the icaA, agr, spa, clfA, sdrC, sdrD, sdrE, seg, seh, and sei genes, suggesting that this gene combination is important for successful catheter colonization. The results of this study provide significant insight into the virulence gene make-up of catheter-colonizing S. aureus strains, and will assist in developing a more targeted treatment approach for persistent S. aureus biofilm contamination of medical devices.展开更多
BACKGROUND Kommerell’s diverticulum(KD)with aberrant left subclavian artery is a rare congenital deformity and also has very little research literature about it(35%of case study).There are three types of aortic arch ...BACKGROUND Kommerell’s diverticulum(KD)with aberrant left subclavian artery is a rare congenital deformity and also has very little research literature about it(35%of case study).There are three types of aortic arch diverticulum.Even literature concerning the treatment options are limited.CASE SUMMARY We present a case report of a 50-year-old male with KD in the right aortic arch with aberrant left subclavian artery.We conducted a total endovascular repair procedure,which is innovative and will spread more light in the medical world.Our patient has no past medical history and is a non-smoker and non-alcoholic.Patient presented with shortness of breath,chest pain and dizziness for six months.Blood tests were done and computerized tomography(CT)angiogram of the chest confirmed the diagnosis,illustrating showed a 3.9 cm KD.On Day 1,the CT angiogram showed mild dilatation of the thoracic aorta,adjacent esophagus,trachea was compressed and displaced.Surgery was planned as the treatment modality.Carotid-Subclavian artery bypass and endovascular aortic repair was conducted.We used prolene 5-0 C1 sutures to precisely anastomose a 6-mm Dacron graft to the left subclavian artery.Haemostasis was secured and wounds were closed.Protamine was administered and patient was shifted to intensive care unit.Post-operative,patient responded favorably and was discharged.Regular follow-up is done.CONCLUSION The procedure we performed is novel.This will help the cardio-thoracic surgeons a better insight about the full procedures we conducted,thereby bringing more light and better treatment options in managing KD with aberrant subclavian artery.展开更多
AIM To examine the efficacy and safety of the 6 French(6F) Rotarex~S catheter system in patients with acute limb ischemia(ALI) involving thromboembolic occlusion of the proximal and mid-crural vessels.METHODS The fi...AIM To examine the efficacy and safety of the 6 French(6F) Rotarex~S catheter system in patients with acute limb ischemia(ALI) involving thromboembolic occlusion of the proximal and mid-crural vessels.METHODS The files of patients in our department with ALI between 2015 and 2017 were examined. In seven patients, the Rotarex~S catheter was used in the proximal segment of the crural arteries. Data related to the clinical examination, Doppler sonography, angiography and followup from these patients were further used for analysis.RESULTS Two patients(29%) had thrombotic occlusion of the common femoral artery, and the remaining five exhibited thrombosis of the superficial femoral artery and popliteal artery. Mechanical thrombectomy was performed in all cases using a 6F Rotarex~S catheter. Additional Rotarex~S catheter thrombectomy due to remaining thrombus formation with no reflow was performed in the anterior tibial artery in two of seven cases(29%), in the tibiofibular tract and posterior tibial artery in two of seven cases(29%) and in the tibiofibular tract and fibular artery in the remaining three of seven cases(43%). Ischemic symptoms resolved promptly in all, and none of the patients experienced a procedural complication, such as crural vessel dissection, perforation or thrombus embolization.CONCLUSION Mechanical debulking using the 6F Rotarex~S catheter system may be a safe and effective treatment option in case of thrombotic or thromboembolic occlusion of the proximal and mid-portion of crural arteries.展开更多
The study aimed to retrospectively evaluate surgical treatment outcomes after delayed parotid gland and duct injuries. Nine patients subjected to parotid gland and duct injuries with l- to 3-month treatment delay were...The study aimed to retrospectively evaluate surgical treatment outcomes after delayed parotid gland and duct injuries. Nine patients subjected to parotid gland and duct injuries with l- to 3-month treatment delay were retrospectively evaluated with special reference of etiology, past medical history, and injury location. Conservative treatment, microsurgical anastomosis, and diversion of salivary flow or ligation were chosen for delayed parotid gland and duct injuries concerning to their site of injury, time of repair and procedures. Assistant treatment as pressure dressing was adopted thereafter. All patients experienced an uneventful recovery at the time of finalizing the study. Two patients received Stensen＇s duct ligation, 5 received microsurgical anastomosis and 2 accepted salivary flow diversion for 5 patients with sialoceles and 4 patients with fistulas, and no re-occurrence was found. Facial paralysis occurred after surgery in 4 patients, and 3 of them recovered after the nerve nutrition treatment. Our study suggested that appropriate surgical treatment is efficient for the re-establishment of the tissue function and facial aesthetic for delayed injury of the parotid and its duct.展开更多
我院自主开发了经外周静脉插入中心静脉导管(Parenterally Inserted Central Catheter,PICC)病人管理系统,系统采用C/S结构开发模式,应用自动更新方法解决C/S系统升级问题。系统应用于医院局域网络环境之内,不但大大减轻了PICC护理人员...我院自主开发了经外周静脉插入中心静脉导管(Parenterally Inserted Central Catheter,PICC)病人管理系统,系统采用C/S结构开发模式,应用自动更新方法解决C/S系统升级问题。系统应用于医院局域网络环境之内,不但大大减轻了PICC护理人员的日常工作量,并且规范了我院对PICC病人管理及静脉治疗管理。展开更多
基金Supported by Shanxi Provincial Health Commission “Four batch” Science and Technology Innovation Project of Medical Development,No. 2021XM45 (to Dr. Wang HX)Academic promotion plan of Shanxi Cardiovascular Hospital,No. XYS20180102 (to Dr. Wang HX)+1 种基金Natural Science Foundation of Shanxi Province,No. 20210302123346 (to Dr. Wang HX)and Scientific Research Incentive Fund of Shanxi Cardiovascular Hospital,No. XYS20190206 (to Dr. Li N)
文摘BACKGROUND Atrial fibrillation(AF)is one of the most common arrhythmias,and radiofrequency catheter ablation is the most effective treatment strategy.The inferior vena cava(IVC)is a common approach for radiofrequency ablation of AF.However,this approach may not be applied to some cases such as chronic venous occlusions,surgical ligation of the IVC,and heterotaxy syndrome(HS).CASE SUMMARY A 68-year-old man with HS suffered from severely symptomatic persistent AF for 9 years,and we successfully ablated by percutaneous transhepatic access.CONCLUSION In patients without femoral vein access,the use of the hepatic vein for pulmonary vein isolation is a viable alternative for invasive electrophysiology procedures.
基金supported by grants from the Universidad Nacional Autónoma de México(PAPIIT IN218211)FES-Iztacala,UNAM(PAPCA 2010-11 Project 7).
文摘Methicillin-resistant Staphylococcus aureus is an increasingly important cause of nosocomial bacterial infections worldwide. S. aureus is responsible for several pathologies, including skin infections, endocarditis, meningitis, deep-tissue ulcers, and sepsis. S. aureus biofilm formation on catheters and other medical devices is a major post-operative concern, because biofilms are often the source of persistent and difficult to treat bacterial infections. While catheter-related S. aureus infections have been reported, the strains responsible for these infections have not been genetically characterized. We genetically characterized S. aureus strains isolated from hemodialysis catheters in Mexican patients. The frequency of 35 genes coding for adhesins, toxins, and other virulence-associated products in the 55 isolated S. aureus strains was determined using PCR, while real-time PCR was used to examine the level of gene expression. Of the 55 S. aureus strains isolated from 109 patients, 45 (81.8%) were determined to be methicillin-resistant. The icaA, rbf, sarA, and agr genes are involved in biofilm formation and bacterial dispersion and were detected in 96.3%, 40.0%, 74.5%, and 100% of S. aureus strains, respectively, and 70.9% of the strains formed a detectable biofilm. Interestingly, 67.2% of the strains contained the icaA, agr, spa, clfA, sdrC, sdrD, sdrE, seg, seh, and sei genes, suggesting that this gene combination is important for successful catheter colonization. The results of this study provide significant insight into the virulence gene make-up of catheter-colonizing S. aureus strains, and will assist in developing a more targeted treatment approach for persistent S. aureus biofilm contamination of medical devices.
文摘BACKGROUND Kommerell’s diverticulum(KD)with aberrant left subclavian artery is a rare congenital deformity and also has very little research literature about it(35%of case study).There are three types of aortic arch diverticulum.Even literature concerning the treatment options are limited.CASE SUMMARY We present a case report of a 50-year-old male with KD in the right aortic arch with aberrant left subclavian artery.We conducted a total endovascular repair procedure,which is innovative and will spread more light in the medical world.Our patient has no past medical history and is a non-smoker and non-alcoholic.Patient presented with shortness of breath,chest pain and dizziness for six months.Blood tests were done and computerized tomography(CT)angiogram of the chest confirmed the diagnosis,illustrating showed a 3.9 cm KD.On Day 1,the CT angiogram showed mild dilatation of the thoracic aorta,adjacent esophagus,trachea was compressed and displaced.Surgery was planned as the treatment modality.Carotid-Subclavian artery bypass and endovascular aortic repair was conducted.We used prolene 5-0 C1 sutures to precisely anastomose a 6-mm Dacron graft to the left subclavian artery.Haemostasis was secured and wounds were closed.Protamine was administered and patient was shifted to intensive care unit.Post-operative,patient responded favorably and was discharged.Regular follow-up is done.CONCLUSION The procedure we performed is novel.This will help the cardio-thoracic surgeons a better insight about the full procedures we conducted,thereby bringing more light and better treatment options in managing KD with aberrant subclavian artery.
文摘AIM To examine the efficacy and safety of the 6 French(6F) Rotarex~S catheter system in patients with acute limb ischemia(ALI) involving thromboembolic occlusion of the proximal and mid-crural vessels.METHODS The files of patients in our department with ALI between 2015 and 2017 were examined. In seven patients, the Rotarex~S catheter was used in the proximal segment of the crural arteries. Data related to the clinical examination, Doppler sonography, angiography and followup from these patients were further used for analysis.RESULTS Two patients(29%) had thrombotic occlusion of the common femoral artery, and the remaining five exhibited thrombosis of the superficial femoral artery and popliteal artery. Mechanical thrombectomy was performed in all cases using a 6F Rotarex~S catheter. Additional Rotarex~S catheter thrombectomy due to remaining thrombus formation with no reflow was performed in the anterior tibial artery in two of seven cases(29%), in the tibiofibular tract and posterior tibial artery in two of seven cases(29%) and in the tibiofibular tract and fibular artery in the remaining three of seven cases(43%). Ischemic symptoms resolved promptly in all, and none of the patients experienced a procedural complication, such as crural vessel dissection, perforation or thrombus embolization.CONCLUSION Mechanical debulking using the 6F Rotarex~S catheter system may be a safe and effective treatment option in case of thrombotic or thromboembolic occlusion of the proximal and mid-portion of crural arteries.
基金This project was supported by the National Natural Science Foundation of China （No. 81372879, No. 81672666）.
文摘The study aimed to retrospectively evaluate surgical treatment outcomes after delayed parotid gland and duct injuries. Nine patients subjected to parotid gland and duct injuries with l- to 3-month treatment delay were retrospectively evaluated with special reference of etiology, past medical history, and injury location. Conservative treatment, microsurgical anastomosis, and diversion of salivary flow or ligation were chosen for delayed parotid gland and duct injuries concerning to their site of injury, time of repair and procedures. Assistant treatment as pressure dressing was adopted thereafter. All patients experienced an uneventful recovery at the time of finalizing the study. Two patients received Stensen＇s duct ligation, 5 received microsurgical anastomosis and 2 accepted salivary flow diversion for 5 patients with sialoceles and 4 patients with fistulas, and no re-occurrence was found. Facial paralysis occurred after surgery in 4 patients, and 3 of them recovered after the nerve nutrition treatment. Our study suggested that appropriate surgical treatment is efficient for the re-establishment of the tissue function and facial aesthetic for delayed injury of the parotid and its duct.
文摘我院自主开发了经外周静脉插入中心静脉导管(Parenterally Inserted Central Catheter,PICC)病人管理系统,系统采用C/S结构开发模式,应用自动更新方法解决C/S系统升级问题。系统应用于医院局域网络环境之内,不但大大减轻了PICC护理人员的日常工作量,并且规范了我院对PICC病人管理及静脉治疗管理。
