ABSTRACT
To explore the influence factors of hospital acquired pneumonia (HAP) in patients with cervical spinal cord injury(CSCI).Regression analysis the clinical data of 478 cases of patients with CSCI,the CSCI patients were divided into the infection group and non-infection group.Firstly,the single factor analysis was used to compare the difference of the influence factors between the two groups.And then,logistic regression analysis was used to explore the influence factors of HAP in patients with CSCI.122 suffered HAP in the 478 patients with CSCI,accounted for 25.52％.There's significant difference in injured segments,JOAS scores on admission,methylprednisolone treatment within 8 h after injury,tracheotomy,history of smoking and lung disease between the infection group and non-infection group(P ＜ 0.05).logistic regression analysis showed that the injured segments (OR =4.474),JOAS scores on admission (OR =3.856),tracheotomy (OR =2.452),history of lung disease (OR =1.589) were the independent influence factors of HAP in patients with CSCI.The incidence rate of HAP was high in patients with CSCI,there were a variety of influence factors for the HAP,and we should take targeted intervention measures so as to reduce the incidence of HAP.
ABSTRACT
ObjectiveTo summarize the experience of percutaneous nephrolithotomy under flexible ureteroscope in the treatment of staghorn calculi.Method The clinical data of 30 patieits with staghorn calculi undergoing percutaneous nephrolithotomy under flexible ureteroscope were reviewed for summarizing the surgical cooperation experience.Results All operations were successful,with the clearance rates of stage one and stage two calculi 86.0% and 95.0%,respectively.There occurred one case of massive hemorrhage,but no cases of kidney perforation,peritoneal perforation,liquid pneumothorax or organ damage.Conclusion Well-prepared surgical cooperation,full mastery of surgical procedures and skilled cooperation can increase surgical efficiency and safety by shortening surgical duration.
ABSTRACT
BACKGROUND: A variety of growth factors are involved in regulating cell proliferation and matrix synthesis at the tendon healing process. Vascular endothelial growth factor (VEGF) plays a powerful role on the tissue healing and regeneration. At present, few studies report the VEGF at the process of endogenous tendon healing. OBJECTIVE: To investigate the dose-effect relationship of intrinsic healing of rabbit's achilles tendon, which was topically separated by silicone tube, with the VEGF application. DESIGN, TIM E AND SETTING: Randomized control animal experiments were performed in the Central Animal Laboratory in the Second Xiangya Hospital of Central South University from November 2007 to April 2008. MATERIALS: Forty-eight healthy rabbits, weighing 2.5-3.0 kg, were used to establish the tendon rabbit injury models and were divided into 4 groups randomly, termed blank group and VEGF 100 ng, 50 ng, 10 ng groups, with 12 animals for each group. METHODS: The gastrocnemius bundle branch and soleus muscle bundle branch of the right achilles tendon were sutured after surface skin and subcutaneous tissue discission. The gastrocnemius bundle branch was transected at 2 cm above calcaneal bone insertion and a 2-cm silicone tube was applied to separate the site of suture using 5-0 modified Kessler method. The site of suture was treated with nothing in silicone tube as the blank control group. In other three groups, the site of suture was treated with 100, 50, 10 ng VEGF in silicone tube at the operation day and 7, 14, 21 days post-operation. MAIN OUTCOME MEASURES: At 2, 4, 6 weeks post-operation, the achilles tendon of 4 rabbits in each group were harvested for gross observation and histological evaluation. RESULTS: Compared with 2 and 4 weeks post-operation, the peripheral tissue's adhesion out of the silicon tube at 6 weeks was relieved and required to be separated using passive or operating knife. There were no significant differences in the grading of tendon adhesion between groups at 6 weeks post-operation (P > 0.05). The broken end of the achilles tendon in the silicon tube was connected with new-bom achilles tendon fibre tissues. The healing was well in each group, and the VEGF groups were superior to blank control group (P < 0.05). At 2, 4, 6 weeks post-operation, the fibroblast counting in the 100 ng and 50 ng VEGF groups was greater than that in the 10 ng VEGF group (P < 0.05), but no significant differences were found in the fibroblast counting between 100 ng and 50 ng VEGF groups (P > 0.05). The content of collagen fibres had no significant difference among three VEGF groups. The fibroblast counting and the content of collagen fibres in the VEGF groups were higher than that in the blank control group (P < 0.05). CONCLUSION: The exogenous application of different doses of VEGF at achilles tendon repair site can facilitate the proliferation and maturation of the fibroblasts, increase the secretion of collagen and promote the maturation of collagen fibres, thus facilitating intrinsic healing of the achilles tendon. The 100 ng and 50 ng VEGF is better than 10 ng VEGF with regard to the promotion of achilles tendon healing, and no difference is observed between 100 ng and 50 ng.