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Objective To explore the difference in gastric residual volume (GRV) between singledose and split-dose bowel preparation before colonoscopy under general anesthesia.Methods From October 8th to December 30th in 2016,the out-patients undergoing gastroscopy and colonoscopy with anesthesia services on the same day were selected and divided into the traditional single-dose bowel preparation group and split-dose bowel preparation group.The GRV and intestinal preparation quality were compared between the two groups.T test was used for statistical analysis and multiple linear regression analysis was performed for the influence factors of GRV analysis.Results A total of 121 patients were enrolled,60 patients in the spilt-dose bowel preparation group and 61 in the traditional single-dose bowel preparation group.The mean GRV of the split-dose bowel preparation group was (17.3 ± 12.2) mL,which was lower than that of the single-dose bowel preparation group ((23.7 ± 14.6) mL),and the difference was statistically significant (t =2.642,P=0.009).The score of intestinal preparation quality of the split-dose bowel preparation group was 8.05 ± 0.85,which was higher than that of the single-dose bowel preparation group (7.67±1.19),and the difference was statistically significant (t =-2.002,P=0.048).Fasting time was related with GRV (odd ratios (OR)=1.732,95％ contidence interval (CI) O.299 to 3.168,P=0.018).Conclusion The GRV of patients with split-dose bowel preparation before colonoscopy is lower than that of traditional single-dose bowel preparation,thus reducing the risk of aspiration during anesthesia.
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Objective To explore the outcome of the tibial bone-skin flap grafts in the management of severe traumatic osteomyelitis complicated with bone and skin defect in leg.Methods Twenty-seven cases of the traumatic osteomyelitis complicated with bone and skin defect in leg were treated with vascularized tibial bone-skin flap grafe from August, 2007 to November, 2013.Reconstruction of limb tibia continuity and cover the wound.Results The tibial bone-skin flaps were completely survived in 26 of the 27 cases except 1 ease which was repaired by adjacent flap because of the disorder blood circulation.The followed-up showed that all flaps had good blood circulation.The infection was controlled completely.The leg function and contour were satisfactory.Conclusion The tibial boneskin flap has the advantages of abundant blood supply, full bone-skin flap supply, shortens hospitalization and suitable for treatment of traumatic osteomyelitis complicated with bone and skin defect in leg.
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Objective To analyze the reliability of the Boston bowel preparation scale (BBPS) for the assessment of bowel preparation quality. Methods Demonstration video of Boston bowel preparation scale provided by Boston Medical Center were viewed by 49 clinicians,who came from several hospitals in Guangdong province and participated in an education conference.Then 3 testing colonoscopy videos were scored with BBPS and inter-observer reliability was assessed. 13 participants repeated the above test 3 months later,and intra-observer reliability was assessed.Results The correlation coefficient of inter-observer for BBPS scores was 0.987 (95％ CI:0.949 - 1.000 ),and that of intra-observer was 0.713(95 ％ CI:0.452 -0.849).Conclusion BBPS is a reliable measure of bowel preparation,while the validity of BBPS deserves further analysis.
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BACKGROUND: Recent studies have demonstrated that ligustrazine removed oxygen-derived free radicals and protected vascular endothelial cells. Howerver, the effect of ligustrazine on skin flap ischemia-reperfusion injury was less reported. OBJECTIVE: To investigate the effect of ligustrazine on skin flap ischemia-reperfusion injury, and to analyze reaction pathway. METHODS: A total of 24 healthy SD rats were used to establish ischemia-reperfusion injured skin flap along superficial epigastric artery. All rats were randomly divided into sham-surgery, model control, and ligustrazine groups, with 8 rats per group. Ischemia-reperfusion injury was not induced in the sham-surgery group; saline (4 mL/kg) was given in the model control gorup 30 minutes prior to operation; an intraperitoneal injection of ligustrazine (4 mL/kg) was given in the ligustrazine group immediately after ischemia-reperfusion injury. Distal tissue was selected from skin flap in the model control group immediate after formation of skin flap, 8 hours after ischemia, and 1 hour after reperfusion, as well as in the sham-surgery group immediate after formation of skin flap, 8 and 9 hours after operation to measure superoxide dismutase (SOD) and malonaldehyde (MDA) contents. Histological morphology was observed under optic and electron microscopes.RESULTS AND CONCLUSION: At 8 hours after ischemia and 1 hour after reperfusion, SOD activity in the model control group was significantly less than in the sham-surgery group (P< 0.05-0.01), but the SOD activity in the ligustrazine group was significantly greater than in the model control group (P < 0.05-0.01). At 1 hour after reperfusion, MDA content in the model control group was significantly greater than sham-surgery group (P< 0.01), but the MDA content in the ligustrazine group was significantly less than in the model control group (P< 0.01). As compared with model control group, ultramicrostructure and vascular endothelial cell were mildly damaged in the ligustrazine group, suggesting that ligustrazine inhibited activation and adhesion of neutrophilic granulocytes, relieved inflammatory reaction, protected endothelial cells, resisted lipid peroxidation of free radicals, and prevented skin flap ischemia-reperfusion injury.
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ve method of limb salvage.
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Objective To explore the clinical significance of cytokeratin(AE1/AE3) immunohistochemical staining in detecting the lymph node micrometastasis of gastric cancer.Methods Immunohistochemical S-P method was used to examine AE1/AE3 in 118 lymph nodes in 64 cases of primary gastric cancer.Results Among 118 lymph nodes,micrometastasis was found in 13 lymph nodes of 8 patients with primary gastric cancer by AE1/AE3 staining.The positive rate of micrometastasis was 12.5% and the positive rate of lymph nodes was 11.02%.The incidence of micrometastasis was related with the depth of invasion,and in the cancer with deep invasion,the positive rate of micrometastasis was higher than that in the cancer with superficial invasion(P