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Objective To compare the outcome of combined and staged approach on concomitant carotid and coronary severe stenosis.Methods From March 2013 to May 2015,27 patients with concomitant carotid and coronary severe stenosis were treated by carotid endarterectomy and coronary artery bypass grafting,15 cases received one-stage operation and 12 staged.The basic characteristics,details during surgery,complications,quality of life score,hospital stay and cost were compared.Results 27 patients received carotid endarterectomy and off-pump coronary artery bypass grafting under general anesthesia.Revascularization were performed on 27 carotid and 82 coronary artery.The characteristics of patients were similar between two groups,reflected with WIC,combined approach subgroup was (5.27 ± 0.88) and staged subgroup was (4.92 ± 1.24).The operation time was significantly decreased in the synchronous group [(295.33 ± 49.73)min vs (390.83 ± 73.45) min,P ＜ 0.001].Hospital stay days was also reduced [(30.20 ± 12.91) days vs(44.67 ± 6.34) days,P =0.002],the medical cost was lower in combined approach group,but no significant statistical difference.The complications including 1 case TIA,1 recurrent nerve injury in one-stage group and 1 case myocardial infarction,1 mediastinal bleeding post-operation and 1 pulmonary infection in stage group.No cerebral infarction and death.Quality of life scores(SF-36) of the two groups was 5.53 ± 1.30 and 5.75 ± 1.36 respectively,no significant difference.Conclusion The efficacy and safety of treatment for concomitant carotid and coronary severe stenosis patients with combined or staged approach was similar.But the combined approach program can reduce the hospital stay time and cost in some degree.
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Objective To study the effect of reducing no-reflow after PCI treatment by early using Tirofiban and suction catheter in AMI patients .Methods 76 cases of patients were divided into group A (38 cases) and group B(38 cases) .The group A began to use Tirofiban with suction catheter to aspiration after coronary guidewire entering ,the suction were used in group B when the thrombus burden became exacerbation after balloon dilation .In addition ,chosen 38 cases of AMI patients treated with Tirofiban af-ter balloon dilation as group C .The influence of different treatment options to no-reflow and slow blood flow ,cardiovascular adverse events and the incidence of bleeding were observed .Results Group A compared with other two groups ,the no-reflow and slow flow rate had statistically significant differences (P0 .05) .After three different surgical treatments ,the incidence of bleeding complications had no significant difference (P>0 .05 .The occurrence of adverse cardiovascular events had statistically significant between A group and C (P<0 .05) ,but there was no statistically significant difference between group B and group C (P<0 .05) .Conclusion Three kinds of treatment all have certain effect to reduce no-reflow in emergency PCI of AMI ,but early use of tirofiban with suction catheter in treatment of emergen-cy treatment has great clinical significance to reduce no-reflow .This study provides an effective treatment plan to reduce no-reflow in PCI for AMI .
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OBJECTIVE To study the features of isolated bacteria from sputum specimens in the patients with hospital acquired pneumonia (HAP). METHODS Identification of bacteria specimen and drug sensitivity test were performed in specimens from the lower respiratory tract of patients with HAP from Jan 2007 to Dec 2007. The test results and clinical data were analyzed. RESULTS There were 136 patients with HAP,among them the old persons who were more than 60 years old and 75% of them were infected much more than others. The main pathogens were Gram-negative bacilli (57.62%). CONCLUSIONS Gram-negative bacilli are the major pathogens with high resistance rate and the multi pathogen infection is increasing and difficult to control. To decrease the infection rate,it is necessary to use antibiotic reasonably and control high risk factors.
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Objective To compare the clinical results of endovenous laser treatment(EVLT),radiofrequency endovenous occlusion(RFO)and conventional stripping combined with transilluminated powered phlebectomy(TIPP)for lower extremity varicose vein.Methods From Jun 2004 to Jan 2007,200 cases(232 limbs)were treated by EVLT with TIPP,80 cases(88 limbs)by RFO with TIPP,and 180 cases(202 limbs)by conventional stripping with TIPP.Operation time,number of the incision made,intraoperative bleeding,postoperative hospital stay,complications,and one-year recurrence rate were compared with each other. Results Operation time was longer(41±8)min in RFO group than that in other two groups.Postoperative hospital stay was shorter in EVLT group(1.2±0.4 d)and RFO group (2.1±0.8 d)than that in stripping and TIPP group(P＜0.05).Patients in stripping group also suffered from more intra-operative bleeding more often incidental nervus saphenus injury and more incision numbers when compared with other two groups(P＜0.05).There was no significant difierence in one-year recurrence rate among patients in the three groups. Conclusions The clinical efficacy is almost the same among the three groups in terms of eradication of the varicose veins.EVLT and RFO are safe and minimal invasive for the treatment of lower extremity varicose vein.
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OBJECTIVE To find out the situation of the use of antimicrobials in our hospital and to evaluate the rationality of use.METHODS To make a survey of the use of antimicrobials in our hospital among inpatients during Jan-Jun 2007,the data of reasonable use of antibacterial were obtained after evaluation and analysis.RESULTS The pay for antimicrobials among inpatients occupied for 14.16% of total consumption,mainly for cephalosporins.CONCLUSIONS The medical workers should administer antimicrobials in a more reasonable way to fight for a safe,effective,economical goal in our work.
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OBJECTIVE To analyze the prevalence of pathogen infection and the drug sensitivity of pathogen after liver transplantation so as to provide the reference to the effective clinical prevention and control of pathogen infection and drug resistant strains.METHODS A retrospective survey in 155 patients who underwent 158 orthotopic liver transplantation was carried out.RESULTS The incidence of pathogen infection after liver transplantation was 25.9%,the major pathogens were coagulase-negative Staphylococcus,then Pseudomonas aeruginosa and Acinetobacter.CONCLUSIONS It is very important to prevent pathogen infection and use antibiotic reasonably.Selection of effective antibiotics referring to the etiologic data and resistance of pathogen can help to prevent the drug resistant strains.
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OBJECTIVE:To establish HPLC method for the determination of paeoniflorin in Senqi sodium ferulate cap?sules.METHODS:The determination was performed on C 18 chromatographic column.The mobile phase consisted of acetoni?trile-water(17∶83)with a flow rate of1.0ml/min.The column temperature was30℃;the detection wavelength was230nm and the sample size was10?l.RESULTS:Good linear relationship with peak area occurred when the sample size of paeoniflorin was at a range of0.10ug～1.00ug(r=0.9999).The average recovery was98.76%(RSD=1.35%).CONCLUSION:This method is easy to handle yet with accurate results,good reproducibility and high recovery rate;and it can be used for the as?saying and quality control of Senqi sodium ferulate capsules.