ABSTRACT
OBJECTIVE@#To evaluate the effectiveness of Kirschner wire fixation and coracoclavicular ligament reconstruction with suture anchor in the treatment of Cho type ⅡC distal clavicle fractures.@*METHODS@#The data of 17 patients with Cho type ⅡC distal clavicular fractures, who were treated with Kirschner wire fixation and coracoclavicular ligament reconstruction with suture anchor between June 2019 and June 2021, was retrospectively analyzed. There were 11 males and 6 females with an average age of 38.7 years (range, 19-72 years). The fractures were caused by falling in 12 cases and traffic accident in 5 cases. All patients had fresh closed fractures. The interval from injury to operation was 1-5 days (mean, 2.6 days). The preoperative injury severity score (ISS) was 6-27 (mean, 10.2). The operation time, intraoperative blood loss, hospital stay, fracture healing, and postoperative complications were analyzed. The shoulder joint function was evaluated by disabilities of the arm, shoulder, and hand (DASH) score and Constant score at last follow-up.@*RESULTS@#All operations were completed successfully. The operation time was 20-50 minutes (mean, 31.6 minutes). The intraoperative blood loss was 30-100 mL (mean, 50.6 mL). The hospital stay was 4-9 days (mean, 5.3 days). All incisions healed by first intention. All patients were followed up 12-16 months (mean, 13 months). All clavicle fractures healed, and the healing time was 8-15 weeks (mean, 11 weeks). No complications such as fracture displacement or nonunion caused by internal fixation failure occurred. During the follow-up, skin irritation caused by the Kirschner wire withdrawal occurred in 3 cases. The Kirschner wires were removed after fracture healing in 17 patients. At last follow-up, the Constant score of shoulder joint was 90-100 (mean, 98.2). The DASH score was 0-10 (mean, 1.5).@*CONCLUSION@#Kirschner wire fixation combined with coracoclavicular ligament reconstruction with suture anchor in the treatment of Cho type ⅡC distal clavicle fractures has less postoperative complications and slight complications. It is convenient to remove the internal fixator. The Kirschner wire does not fix the distal clavicle fracture through the acromion, which has little effect on shoulder joint function and can obtain good effectiveness.
Subject(s)
Male , Female , Humans , Adult , Bone Wires , Clavicle/injuries , Suture Anchors , Blood Loss, Surgical , Retrospective Studies , Fractures, Bone/surgery , Fracture Fixation, Internal , Ligaments, Articular/surgery , Postoperative Complications , Treatment OutcomeABSTRACT
Objective:To develop and examine the reliability and validity of the adolescent health literacy evaluation scale under public health emergencies (AHLES-PHE) in junior middle school students.Methods:The initial version of AHLES-PHE was formed by combining the characteristics of public health emergencies and adolescent health literacy.The expert version of AHLES-PHE was formed by two rounds of Delphi expert consultation.Totally 1 729 adolescent students from three junior middle schools in Changzhou City were tested.The formal version of AHLES-PHE was formed through item analysis and factor analysis (structural validity). The content validity of the formal version of AHLES-PHE was evaluated by specialist analysis and sensibility analysis, and its correlation validity with the everyday health information literacy (EHIL) was tested.The internal consistency reliability, parity split-half coefficient and test-retest reliability were calculated.Results:(1)Item analysis: the correlation coefficient between the scores of each item and the total score of AHLES-PHE expert version was 0.420 to 0.722 ( P<0.01), and the CR of decision value was 10.140 to 66.980 ( P<0.01). (2)Validity analysis: the formal version of AHLES-PHE with 45 items and 8 factors was obtained by exploratory factor analysis.The 8 factors could explain 61.30% of the total variation.The fitting indexes of the confirmatory factor analysis model were χ2/ df=3.325, RMSEA=0.052, GFI=0.853, CFI=0.912, TLI=0.904, NFI=0.880.Sensibility analysis of the formal version of AHLES-PHE showed the Cronbach's α ranged from 0.957 to 0.958.The correlation coefficient between the total score of AHLES-PHE formal version and the total score of EHIL was 0.340 ( P<0.01). (3)Reliability analysis: the Cronbach's α coefficient and parity split-half coefficient of the formal version of AHLES-PHE were 0.958 and 0.975, respectively.The test-retest reliability of the formal version of AHLES-PHE was 0.753 ( P<0.01). Conclusion:The formal version of AHLES-PHE developed in this study has good reliability, structural validity and content validity, and the correlation validity with EHIL is common.This scale has a certain degree of applicability to the assessment of health literacy for junior middle school students under public health emergencies.
ABSTRACT
Objective From the economic point of view,this study was to systematically assess the status quo on lung cancer screening in the world and to provide reference for further research and implementation of the programs,in China.Methods PubMed,EMbase,The Cochrane Library,CNKI and Wanfang Data were searched to gather papers on studies related to economic evaluation regarding lung cancer screening worldwide,from the inception of studies to June 30th,2018.Basic characteristics,methods and main results were extracted.Quality of studies was assessed.Cost were converted to Chinese Yuan under the exchange rates from the World Bank.The ratio of incremental cost-effectiveness ratio (ICER) to local GDP per capita were calculated.Results A total of 23 studies (only 1 randomized controlled trial) were included and the overall quality was accepted.22 studies were from the developed countries.Nearly half of the studies (11 studies) took 55 years old as the starting age of the screening program.Smoking history was widely applied for the selection of criteria on target populations (18).Low-dose computed tomography (LDCT) was involved in every study used to evaluate the economic effectiveness.Annual (17) and once-life time (7) screening were more common frequencies.22 studies reported ICERs for LDCT screening,compared to no screening,of which 17 were less than 3 times local GDP per capita,and were considered as cost-effectiveness,according to the WHO's recommendation.15 and 7 studies reported ICERs for annual and once-life time screening,of which 12 and 7 studies were in favor the results of their cost-effectiveness,respectively.Additionally,the cost-effectiveness of once-lifetime screening was likely to be superior to the annual screening.Differences of cost-effectiveness among the subgroups,by starting age or by the smoking history,might exist.Conclusions Based on the studies,evidence from the developed countries demonstrated that LDCT screening programs on lung cancer,implemented among populations selected by age and smoking history,generally appeared more cost-effective.Combined with the local situation of health resource,the findings could provide direction for less developed regions/countries lacking of local evidence.Low frequency of LDCT screening for lung cancer could be adopted when budget was limited.Data on starting ages,smoking history and other important components related to the strategy of screening programs,needs to be precisely evaluated under the situation of local population.
ABSTRACT
Objective From the economic point of view,this study was to systematically assess the status quo on lung cancer screening in the world and to provide reference for further research and implementation of the programs,in China.Methods PubMed,EMbase,The Cochrane Library,CNKI and Wanfang Data were searched to gather papers on studies related to economic evaluation regarding lung cancer screening worldwide,from the inception of studies to June 30th,2018.Basic characteristics,methods and main results were extracted.Quality of studies was assessed.Cost were converted to Chinese Yuan under the exchange rates from the World Bank.The ratio of incremental cost-effectiveness ratio (ICER) to local GDP per capita were calculated.Results A total of 23 studies (only 1 randomized controlled trial) were included and the overall quality was accepted.22 studies were from the developed countries.Nearly half of the studies (11 studies) took 55 years old as the starting age of the screening program.Smoking history was widely applied for the selection of criteria on target populations (18).Low-dose computed tomography (LDCT) was involved in every study used to evaluate the economic effectiveness.Annual (17) and once-life time (7) screening were more common frequencies.22 studies reported ICERs for LDCT screening,compared to no screening,of which 17 were less than 3 times local GDP per capita,and were considered as cost-effectiveness,according to the WHO's recommendation.15 and 7 studies reported ICERs for annual and once-life time screening,of which 12 and 7 studies were in favor the results of their cost-effectiveness,respectively.Additionally,the cost-effectiveness of once-lifetime screening was likely to be superior to the annual screening.Differences of cost-effectiveness among the subgroups,by starting age or by the smoking history,might exist.Conclusions Based on the studies,evidence from the developed countries demonstrated that LDCT screening programs on lung cancer,implemented among populations selected by age and smoking history,generally appeared more cost-effective.Combined with the local situation of health resource,the findings could provide direction for less developed regions/countries lacking of local evidence.Low frequency of LDCT screening for lung cancer could be adopted when budget was limited.Data on starting ages,smoking history and other important components related to the strategy of screening programs,needs to be precisely evaluated under the situation of local population.
ABSTRACT
Objective@#To evaluate the changes of volume and mass of pulmonary nodules which were detected in low-dose computed tomography (LDCT) screening, and to analyze the influencing factors.@*Methods@#This retrospective study analyzed the CT images of the participants who underwent at least two chest LDCT scanning from March 2009 to December 2015 in National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College. The inclusion criteria was the nodule diameter ≥6 mm; the volume growth was defined as ≥20%. Fifty-one pulmonary nodules (PNs) were selected among 51 enrolled participants (26 men and 25 women). According to characteristic of nodule and risk stratification of participant, the nodules were classified into different groups (10 non-solid nodules, 17 part-solid nodules and 24 solid nodules; 14 PNs in high-risk group, 12 PNs in moderate-risk group and 25 PNs in low-risk group). The Lung-VCAR software was used to measure the diameter and volume of the PNs, and all nodules were calculated for the volume doubling time (VDT) and mass doubling time (MDT).@*Results@#Among the 51 PNs, the diameter of 33 nodules increased more than 1.5 mm while 18 nodules increased less than 1.5 mm. The median VDT of part-solid nodules was 364 days, which was shorter than that of non-solid nodules and solid nodules (761 and 819 days, respectively), the differences were statistically significant (both P<0.05). The median MDT of part-solid nodules was 351 days, which was lower than that of non-solid nodules and solid nodules (772 days and 840 days, respectively). The difference was statistically significant (P<0.05). The median VDT and MDT of the pulmonary nodules in the high-risk group were 181 days and 256 days, respectively, which were lower than those in the low risk group (1 037 days and 1 035 days, respectively). VDT has good correlation with MDT (r=0.909, P<0.001).@*Conclusions@#Both the characteristic of PNs and the risk status of the participants could affect the growth of nodules in LDCT screening. The part-solid nodules and high-risk group nodules grew relatively faster, which should be closely focused on. Compared with the two-dimensional diameter, the three-dimensional quantitative indicators (VDT and MDT) were more sensitive for nodule growth. The mass changes of part-solid nodules were earlier than that of volume.
ABSTRACT
Objective:To study influence of intravenous injection urapidil and nitroglycerin micro pump on blood pressure and heart rate (HR) of hypertension patients undergoing tooth extraction.Methods:116 hypertension patients underwent electrocardiographic monitoring tooth extraction in our hospital from January 2015 to October 2016 were enrolled in this study.According to the random number table method,the patients were divided into observation group and control group with 58 cases,the control group was given nitroglycerin plus pump static point to maintain,the observation group was given intravenous urapidil and pump maintenance,compared the changes of systolic blood pressure (SBP),diastolic blood pressure (DBP) and HR in two groups before operation,at anesthesia,10min after anesthesia,in operation,10 min after operation,and compared the adverse reactions condition of the two groups.Results:The levels of SBP and DBP in two groups in operation and 10 min after operation were significantly lower than that before operation,and the SBP and DBP levels in the observation group in operation were significantly lower than control group,the differences were statistically significant (all P＜0.05).The HR in control group in operation,10 min after operation were significantly higher than before operation,while the observation group were significantly lower control group,the differences were statistically significant (P＜0.05).The total incidence of adverse reactions in the observation group was 6.90％(4/58),which has no significant difference than 10.34％ (6/58) in control group (P＞0.05).Conclusion:Intravenous injection urapidil has little effect on blood pressure and HR in hypertension patients undergoing tooth extraction,and with good safety,which is worthy of promotion.
ABSTRACT
Objective The aim of this study is to investigate the influence of cone beam computed tomography (CBCT) and micro-ultrasound technique for the treatment of three mesial canals in mandibular first molars. The three mesial canals according to Pomeranz's classification were characterized. Methods A total of 75 permanent mandibular first molars for root canal treatment were randomly selected from patients belonging to the age group of 14-60 years. After preparing the access cavity and locating the main canals, the middle mesial canal orifices in all teeth were determined with an endodontic explorer under direct vision (StageⅠ), under magnification with the aid of micro-ultrasound (Stage Ⅱ), and with the combined use of CBCT and micro-ultrasound to remove the dentin wall and calcifications (Stage Ⅲ). Results Middle mesial canals were detected in 4.0%, 18.7%, and 22.7% of the teeth in StagesⅠ-Ⅲ, respectively. Statistical analysis showed significant differences (P<0.05) between StagesⅠand Ⅱ with regard to middle mesial canal detection. The number of Stage Ⅲ was more than that of Stage Ⅱ. The difference between the two stages was no significant. Among the 17 middle mesial canals, "confluent", "fin" and "independent" anatomies were 52.9%, 35.3%, and 11.8%. Conclusion When used with adjunctive aids, including CBCT, micro-ultrasound facilitates dental clinicians in the location and treatment of middle mesial canals.
ABSTRACT
Objective To analyze the imaging characteristics of lung cancer detected by LDCT ( low-dose CT )lung cancer screening. Methods Between July 1st, 2007 and June 30th, 2013, 7 141 asymptomatic enrolled participants aged 40-88 years old (male 4 710, female 2 431, median age 47), and 1 071 volunteer participants aged ≤39 underwent chest LDCT. The imaging characteristics were analyzed retrospectively in lung cancer pathologically proved. Three types were classified according to the imaging findings: solid lesion, part-solid lesion and non-solid lesion. Results A total of 31 participants (32 lesions) were diagnosed as lung cancer, including 30 adenocarcinomas, 1 carcinoid and 1 small cell lung cancer. The detecting rate of the lung cancer was 0.4%(31/8 212). The solid lesion was further classified as classical solid nodule, irregular solid lesion and atypical solid nodule, and the part-solid lesion was further classified as part-solid nodule, irregular part-solid lesion and cystic part-solid nodule. Lung cancer or probably lung cancer was diagnosed in 24 cases (77.4%), and uncertainty diagnosis was made in 3 cases (9.7%). Benign or probably benign was diagnosed in 3 cases, and another 1 cases were missed at baseline screening. The false positive rate and the false negative rate was 9.7%and 3.1%, respectively. Conclusion The imaging characteristics of lung cancer detected by LDCT are varied, which provide preliminary experience in lung cancer screening.
ABSTRACT
<p><b>OBJECTIVE</b>To report the results of low-dose computed tomography (LDCT) screening for early lung cancer in 4 690 asymptomatic participants at the Cancer Hospital, Chinese Academy of Medical Sciences between July 2007 and June 2012.</p><p><b>METHODS</b>After informed consent and questionnaire forms were obtained, 4 690 asymptomatic participants ≥ 40 years underwent chest low dose spiral CT scanning. According to the National Comprehensive Cancer Network (NCCN) guideline for lung cancer screening (version 1.1, 2012), all participants were assigned to three groups, namely high-risk, moderate-risk and low-risk groups. In terms of gender, smoking history and second-hand tobacco smoking exposure history, two other groups named male and female never-smoker groups who were exposed to second-hand tobacco smoking were designated. The positive results were identified as at least one solid or part-solid nodule measuring ≥ 5 mm, or non-solid nodule ≥ 8 mm in diameter. LDCT scanning protocol, criteria of management according to the size and consistency of pulmonary nodules were compliant with the International Early Lung Cancer Active Program (I-ELCAP). TNM staging of all lung cancers were based on the clinical evidence and pathological findings.</p><p><b>RESULTS</b>In various risk status group of the participants, the percentage of positive results of baseline CT were 27.0% (86/319), 19.3% (199/1 029) and 11.3% (377/3 342), respectively. A total of 26 participants (27 lesions) were diagnosed as lung cancer (11 in men, 15 in women). The detection rate of lung cancer was 0.6% (26/4 690). Besides a SCLC (limited-disease, LD), 25 cases (76.0%) were stage I including 24 NSCLC and one cacinoid on baseline LDCT and the surgical resection rate was 88.5% (23/26). The diameter of resected cancers was 6.9-29.5 mm (median, 16.3 mm). For female never smokers aged 40 years or older who were exposed to second-hand smoking, the detection rate of lung cancer was higher than that of the high-risk and male never smokers who were exposed to second-hand smoking (1.4% vs. 0.9%, 0.4%).</p><p><b>CONCLUSIONS</b>The results indicate that LDCT can detect small lung cancers and most of the cancers are detected at an early stage. Emphasis should be placed on the non-smoking female individuals who are exposed to second-hand smoking in China.</p>
Subject(s)
Female , Humans , Male , Carcinoma, Non-Small-Cell Lung , Diagnosis , Epidemiology , China , Early Detection of Cancer , Lung Neoplasms , Diagnosis , Epidemiology , Mass Screening , Neoplasm Staging , Prevalence , Risk Factors , Smoking , Epidemiology , Tomography, Spiral Computed , Tomography, X-Ray ComputedABSTRACT
Adiponectin is one of the cytokines secreted by fat cells.It has a variety of physiological functions,including anti-inflammation,anti-atherosclerosis,anti-diabetes,and anti-obesity,etc.Studies in recent years have demonstrated that there are certain correlations of adiponectin with vascular risk factors and cerebrovascular disease.
ABSTRACT
ObjectiveTo evaluate the performance of computer-aided detection (CAD) system for detection of pulmonary nodules in 64-slice low-dose CT screening and to investigate whether CAD can improve the performance of radiologists in detecting pulmonary nodules.MethodsOne hundred low-dose screening CT examinations were randomly selected from the database containing 578 consecutive cases between Jun 2007 and Jun 2008.All the examinations were performed on a 64-MSCT scanner with the exposure of 120 kVp,30 or 40 mA,or automatic exposure control.Before the study started,the screening reports had been made with double reading by two radiologists.All the selected images were analyzed with the lung VCAR software from GE Healthcare with a nodule diameter threshold 3.0 mm.All discrepancies between the screening reports and the CAD results were reviewed and the true non-calcified nodules were determined in consensus by two experienced chest radiologists.Detected nodules were classified by density,size and location.The performance of the double reading and the CAD system were compared and analyzed statistically.McNemar-Bowker test was used for the statistical analysis.ResultsA total of 257 true noncalcified nodules were determined in all 100 low-dose screening CT examinations.The detection rate of CAD system was 91.1％ (234/257),with the missed rate of 8.9％ (23/257).Twenty three nodules were missed by CAD,in which 10 were solid with the diameter ranged from 2.4 to 6.0 mm,and 13 were nonsolid with the diameter ranged from 2.1 to 8.6 mm.Of the 23 nodules,17 were located in the outer zones of lungs and 6 in the inner zones.The double reading showed a detection rate of 59.1％ ( 152/257 )and a missed rate of 40.9％ ( 105/257),which was significantly lower than CAD.The diameter of all the 105 missed nodules by radiologists were ranged from 2.4 to 11.8 mm,in which 94 nodules were solid,10 were partly solid and 1 was nonsolid,with 69 located in outer zones of lungs and 36 in the inner zones. Conclusions The capability of the CAD system for detecting non-calcified pulmonary nodules is superior to double reading in low-dose screening CT examination,especially for the nodules located in the inner zone of the lung.When lung VCAR is used,nonsolid pulmonary nodules are more easily missed so that it should be paid more attentions by radiologists.
ABSTRACT
Objective To compare the image quality of chest low dose CT (LDCT) using automatic exposure control (AEC) and constant current control (CCC) and explore a more reasonable scanning protocol. Methods Two hundred and eighty participants were examined with 64 CT scanner at 7 centers in China. All were divided into 4 groups. Two groups underwent LDCT using AEC with standard deviation set at 25 (A1) and 30 (A2) respectively and the tube current ranged from 10 mA to 80 mA. The other two groups underwent LDCT using CCC with tube current set at 40 mA (C1) and 50 mA (C2) respectively. The axial and MPR images were evaluated by two radiologists who were blinded to the scanning protocols.The radiation dose, noise and the image quality of the 4 groups were compared and analyzed statistically.Differences of radiation dose and noise among groups were determined with variance analysis and t test,image quality with Mann-Whitney test and the consistency of diagnosis with Kappa test. Results There was a significant lower DLP in AEC group than in CCC group [(82.62±40.31)vs ( 110.81±18.21) mGy·cm (F =56. 88 ,P ＜ 0. 01 )], whereas no significant difference was observed between group A2 and group A1 0. 05]. The noisy of AEC group was higher than that of CCC group both on lung window(41.50±9.58 vs 40.86±7.03) and mediastinum window (41.19±7.83 vs 40.92±9.89), but there was no significant difference( Flung =0.835, P=0.476, Fmediastinum =1.910, P=0.128).The quality score of axial image in AEC group was higher than that in CCC group (superior margin of the brachiocephalic vein level: 4.49±0.56 vs4.38±0.64,superior margin of the aortic arch: 4.86±0.23 vs 4.81±0.32,the right superior lobar bronchus Level:4.87±0.27 vs 4. 84 ± 0. 22, the right middle lobar bronchus Level: 4.90±0.25 vs 4.88±0.21) except on the right inferior pulmonary vein level(4. 92 ±0. 25 vs 4. 93 ±0. 17) and superior margin of the left diaphragmatic dome level (4. 91±0.27 vs 4.93±0.22) on lung window, but no significant differences (F=0.076-1.748, P＞0.05) were observed. A significant higher score in AEC group was observed on mediastinum window compared with CCC group on superior margin of brachiocephalic vein level (2.57±0.77 vs 2. 46 ± 0. 59, F = 8. 459, P ＜ 0. 05 ), however, the score of AEC group was lower than that of CCC group on other levels without significant differences (superior margin of the aortic arch:3.36 ±0. 63 vs 3.45 ±0. 60,the right superior lobar bronchus level: 3.94 ±0. 56 vs 3. 95 ±0. 51 ,the right middle lobar bronchus Level: 3.80 ±0. 58 vs 3. 87 ±0. 50,the right inferior pulmonary vein level: 3.72 ±0. 56 vs 3.78 ±0. 53, superior margin of the left diaphragmatic dome level: 3.58 ± 0.63 vs 3.68±0.56,F=0.083-3.380,P ＞ 0.05 ). The MPR image quality of AEC group was better than that of CCC group both on lung window and mediastinum window (Zlung =-2.258, Zmedlastinum=-1.330, P＞0.05). For all participants including the underweighted group, the normal group and the overweighted group, the image quality of A1 group was better than that of A2 group without significant differences (the underweighted group: Zlung=0.000, P=1.000, Zmedastinum= 0.000, P=1.000;the normal group: Zlung =-0.062, P=0.950, Zmediastinum =-0.746, P = 0.456; the overweighted group: Zlung = - 1.177, P = 0.239,Zmediastinum =-1.715, P=0.144) both on lung and mediastinum windows, and for the higher BMI participants, a better image quality was obtained in A1 group than in A2 group on the mediastinum window (Z = -1. 715, P = 0. 144). Conclusions The total radiation exposure dose of AEC group is significantly lower than that of CCC group, but no statistical significant differences are observed between both groups in image quality and noise level. The AEC technique is highly recommended in thoracic LDCT scan for screening program, and the SD25 ( SD value = 25) scan protocol is suggested for higher BMI population while the SD30 (SD value = 30) scan protocol for lower BMI population.
ABSTRACT
BACKGROUND: Osteolysis has always occurred in pelvis. Percutaneous injection of bone cement stabilized bone fracture, relieved pain or even treated tumor. However, leakage of bone cement might cause severe complications. OBJECTIVE: To explore the therapeutic effect of peroutaneous injection of bone cement on treating osteolysis pelvic disease in 9 cases by the CT guidance. METHODS: By the CT guidance, needing degree was determined firstly. Focal size and scanning layers were used to calculate focal volume and estimate injected dose of bone cement. Three-dimensional targeting device was used to introduce the puncturation. The bone cement which was 0.2-0.5 mL less than the calculated volume was injected into osteolysis site. The accuracy, injected dose, clinical efficacy, and complications were investigated. RESULTS AND CONCLUSION: The following-up ranged from 5 months to 4 years, with mean duration of 1.5 years. At 1-48 hours after operation, symptoms were recovered, including complete recovery (n=6), partial recovery (n=2), and light recovery (n=1). Leakage of bone cement was not detected out around focal region. This suggested that percutaneous injection of bone cement into the erosion site is an effective method to treat pelvic osteolysis disease, characterizing by security, effective, and less invasive.
ABSTRACT
So far, the method of detection of patent foramen ovale (PFO) by transcranial Doppler (TCD) has had two decades of history. Standardization in contrast-enhanced transcranial Doppler US procedures for cardiac right-to-left shunt detection was proposed in the Venice Consensus Paper in 1999, and some questions were raised at the same time. Over the past 10 years, the researchers have conducted a more in depth study on the method. This article reviews the related research progress.
ABSTRACT
This study was designed to establish methods to measure partition coefficients of inhaled anesthetics at 1 atmosphere and 37 C by using syringe-flask double equilibration technique. Olive oil/gas (O/G), saline/gas (S/G), and water/gas (W/G) partition coefficients of isoflurane were 90.20?2.01, 0.6256?0.109, and 0. 741?0.025, respectively. Even though O/G was 150 folds of S/G,coefficients of variation for both O/G and S/G were less than 3%. The results indicate that the established double-equilibration technique has a very high repeatability and is applicable to wide ranges of inhaled anesthetics' solubilities.
ABSTRACT
Objective To evaluate efficacy,feasibility and safety of the self-made percutaneous catheterized thrombectomy divice in animal model for thrombus removal. Methods Seven dogs were selected,with acute massive pulmonary embolism animal models created by injecting thrombi into the pulmonary arterial trunk via percutaneous femoral vein approach. After half an hours the catheter sheath was inserted into the occluded pulmonary artery through right femoral vein in 5 dogs,left femoral vein in 1 dog and right internal jugular vein in another one. The procedure began to remove the thrombi with simultaneous recording the thrombectomy time and the blood volume drainage. Blood gass was tested before and after embolization together with those of thrombi removement,continuously monitored pulmonary arterial pressure and intermittently performed angiography. The mean time form vascular recanalization to euthanasia was 2 hours,and then the lung specimens were resected for histological examination. Results One animal died of pulmonary arterial penetration during thrombi removal,but others were all alive by the end of the test. Mean time of removing thrombi was 2.4 minutes with mean volume blood drainage of 84 ml. Angiograms showed the approximately complete patency of the pulmonary arterial trunk after reopenning of occlusion but still with remnont thrombi within distal branches and arterial pressure with blood gas returned to normal level. Pathology revealed the recanalization of pulmonary arterial trunk but with thromi still staying in the distal branches,and effusion around the arteries. Conclusions The self-made percutaneous catheterized thrombectomy device is effective,feasible and comparatively safe in the treatment of acute massive pulmonary embolism in this primary test.