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Objective To explore the security and its influencing factors on benign airway stenosis treated with interventional of high pressure balloon expansion catheter.Methods Clinial data of 39 cases of inpatients suffered from benign airway stenosis were chosen.17 cases were male,and 22 cases were female.The ages of them ranged from 15 to 83 years old.According to the clinical symptoms,HRCT 3D reconstruction,and the results of bron-choscope,all patients were treated with balloon expansion catheter at different criterions.The balloon catheter with size that slightly smaller than the targeted normal bronchial tube was chosen,expansion for average 1 -4 times,single balloon expansion time ranged from 0.5 to 4 min,the pressures were kept at 3 -6 atmosphere,and the highest pres-sure did not exceed 8 atmospheric pressure.The efficacy and complications were retrospectively analyzed.Results 19 cases were completely effective,14 cases were basically effective,6 cases were completely ineffective,and the total effective rate was 84.6% (33 /39 ),the incidence of complications was 35.8% (14 /39 ),moreover,no deaths occurred.Conclusion High pressure balloon catheter expansion is one of commonly used technology in breathing interventional treatment;it has the characteristics of easy operation,and immediate curative effect,and so on.But if the improper operation,incorrect selection of the case,or inaccurate evaluation of the stenosis during operation,serious complications and unnecessary iatrogenic injury can be occurred.Therefore,it is worthy of attention and further summarizing by breathing interventional physicians.
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Objective To evaluate the efficacy of epidural anesthesia combined with different doses ropivacaine and sufentanil for stepwise labor analgesia in latent phase.Methods Two hundred and ten ASA Ⅰ or Ⅱ primiparas with a singleton and vertex presentation at full term in our hospital from February 201 5 to April 201 5 were randomized into seven groups (n =30 each):0.125% ropiva-caine with 0.5 μg/ml sufentanil (group 1);0.075% ropivacaine with 0.5 μg/ml sufentanil (cervical dilatation dural block between groups at each time.The latent period of group 2 and 3 were shorter than that in group 1 (P <0.05)and that of group 5 and 6 were shorter than that in group 4 (P <0.05);the ac-tive phase of group 4 were longer than that in group 1 (P <0.05 ).The postpartum hemorrhage of group 2 and 3 were less than that in group 1 (P <0.05),the postpartum hemorrhage of group 5,6 and 7 were more than that in group 2 (P <0.05)and group 3 (P <0.05).The motor nerve block of group 2 and 3 were slightly less than that in group 1 (P <0.05)and the motor nerve block of group 5,6 and 7 were slightly less than that in group 4 (P <0.05).There was no difference of the postpar-tum adverse reactions of maternal and Apgar score in the neonates.Conclusion The dosage of 0.075% or 0.1% ropivacaine with 0.5 μg/ml sufentanil (cervical dilatation < 3 cm),0.125% ropiv-acaine with 0.5 μg/ml sufentanil (cervical dilatation ≥ 3 cm),while producing the exact analgesic effect,hardly interferes with the 1abor process,the amount of postpartum hemorrhage and the lower limb activity,thus they have no significant effect on the safety of the maternal and the infant.
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Objective To preliminaryly explore the effect and adverse reaction of Marine Injection combined therapy through local spray in benign tracheobronchial stenosis.Methods 19 cases of bronchial tuberculosis were collected in our department.By assessing cough,shortness of breath and other symptoms,chest high -resolution CT (HRCT)of three -dimensional reconstruction,and length were observed by ultrafine bronchial stenosis.According to the pathogeny and types of stenosis,combined multiple intervention were sequentially adopted,and then Marine Injec-tion was sprayed through one -off endoscopic spray tube.All the subjects were divided into the two groups,the higher concentration Marine injection (1 200 mg/mL)group was chosen with the condition of serious inflammation,edema, ulcer and necrosis,obvious local granulation tissue hyperplasia,severe scar stenosis,and the length of stenosis greater than 2 cm or the sectional area of stenosis less than 50% of the normal sectional area,otherwise the low concentration (600 mg/mL)group was chosen.The subjects were reexamined by clinical symptoms,high -resolution CT (HRCT) of three -dimensional reconstruction,and ultrafine bronchoscopy a week after the surgery to dynamically observe the local changes.Depending on the situation,the injection was sprayed once a week,adding up to 2 -4 times.Follow -up visit lasted for 3 months,cough,expectoration or hemoptysis,and dyspnea were observed.Results 11 cases were effective fully,17 cases were effective substantially,7 cases were ineffective,the total effective rate was 80% (28 /35).The overall complication rate was 42.8% (15 /35),no deaths occurred.No complications related to local spra-ying of Marine were seen.Conclusion Local spray of Marine Injection may have preferable effect that inhibits scar formationand prevention airway restenosis.It is worth further study with a high security,precise clinic effect,easy oper-ation and etc.
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Objective To retrospectively analyze of clinical application of BF-XP60 micro-bronchoscopy.Methods 135 clinical data of patients who adopted ultrafine micro-bronchoscopy and intervention were collected and analyzed for the complications.Results The frequency of local rhinomusoca damaging and errhysis was in 3 cases,the mucous of the glottis damaging and errhysis was in 2 cases,local mucous of the tracheal bronchus errhysis was in 3 cases.After intervention,the frequency of fever was in 13 cases,massive haemorrhage was in 1 case,pneumothorax was in 1 case,chest pain was in 2 cases,part fiber of inner untrafine micro-bronchoscopy broken was in 2 cases,check failure due to ultrafine micro-bronchoscopy broken in trachea was in 4 cases,and arrhythmia,asphyxia,and death were in 0 case.The overall incidence of side effects was 22.9％ (31/135).Conclusion Application of ultrafine micro-bronchoscopy was contributed to find the lesions within the bronchioles and around the lungs,moreover,it could evaluate the distal bronchus of airway obstruction which was planned to adopt intervention.The topic that how to reduce the incidence of the side effects of the micro-brohchoscopy and improve the success rate and safety of inspection and intervention was worth to be concerned.
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OBJECTIVE:To explore the effect of different plasmapheresis supplement timing on therapeutic efficacy of toxic liver injury. METHODS:96 patients with toxic liver injury and divided into group A,B ,C and D with 32 cases in each group ac-cording to different plasmapheresis supplement timing. All patients received plasmapheresis supplement based on routine treatment. In group A,synchronized fluid replacement was 100% fresh plasma;in group B,synchronized fluid replacement was 40% normal saline firstly,and then 60%fresh plasma;in group C,substitute liquid was given till the in vitro blood reached 12%of circulation amount,supplement order as 40% normal saline for the first supplement,and then add 60% fresh plasma. The clinical symptoms and signs,liver function,prothrombin activity and blood biochemical indicators were observed in each group before and after treat-ment. RESULTS:Plasmapheresis supplement had good therapeutic efficacy on toxic liver injury;but the time of clinical symptoms and signs disappearance in group C was significantly shorter than that in group A and B,and the group B was significantly shorter the group A,with statistical significance (P0.05). CONCLUSIONS:Different plasmapheresis supplement timing have different effect on toxic liver injury. The supplement method that giving 40% normal saline for the first supplement,and then add 60% fresh plasma when in vitro blood reach 12%of circulation amount has more significant effect.
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Objective To retrospectively analyze the effect of two kinds of biological agents in volume -re-duced bullae .Methods 11 patients who suffered from bullae were operated under large C-arm locating ,and infused two kinds of biological agents through micro catheter of fibreoptic bronchoscopy .All of them were randomly divided into the two groups .The biological agents in group A were fibrinogen and diluent thrombin , and that of group B was Porcine Fibrin Sealant Kit .In group A,the micro catheter with diameter of micro thread less than 1.2mm was placed in bullae through fibreoptic bronchoscope ,and then the 2mL lidocaine,5 ml fibrinogen,and double of 500u diluent thrombin were inproperorder injected through micro catheter .In group B,the Porcine Fibrin Sealant Kit was injected at the same method,and then the suspension fluid was exacted .The operation time was recorded ,and then the clinical efficacy and incidence rate of complications were compared .Results The operation time of group A was 5-15 minutes, and that of group B was 6-20 minutes.For all the patients ,4 cases were totally effective ,2 cases were significantly effective,and 2 cases were totally non-effective.The total effective rate was 81.82%(9/11).The incidence rates of common complications in group A and B were 52.38%(22/42),58.33%(14/24),respectively,the difference was not significant (χ2 =0.22,P>0.05).Moreover,there were no serious complications in all cases .Conclusion The security and effect of two kinds of biological agents might be well enough ,but in view of less cases ,they were worth to further popularized and applied in clinical practice .
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<p><b>BACKGROUND</b>Chitosan (CS) scaffolds combined with osteogenically induced bone marrow mesenchymal stem cells (BMSCs) have been proved to be promising substitutes for repairing bone defects. Nevertheless, the bone-forming and scaffold-biodegrading processes are seldom studied. This study aimed to determine the osteogenic ability of CS/osteo-induced BMSC composites by observing the bone-forming process and explore the relationship between bone formation and scaffold biodegradation.</p><p><b>METHODS</b>The CS/osteo-induced BMSC composites (CS+cells group) and the CS scaffolds (CS group) were, respectively, implanted into SD rat thigh muscles. At 2, 4, 6, 8, and 12 weeks postoperatively, the rat femurs were scanned by CT, and the CT values of the implants were measured and comparatively analyzed. Subsequently, the implants were harvested and stained with hematoxylin and eosin and Masson trichrome, and the percentages of bone area, scaffold area, and collagen area were calculated and compared between the two groups.</p><p><b>RESULTS</b>The imaging results showed that the densities of implants of the two groups gradually increased along with time, but the CT values of implants in the CS+cells group were much higher than in the CS group at the same time point (P < 0.05). The histological results showed that the de novo bone and collagen formed in the pores of the scaffolds and gradually increased since 2 weeks postoperation in both groups, and the scaffold gradually degraded along with the boneforming process. However, the comparative analysis results showed that the CS+cells group gained more de novo bone and collagen formation and had less scaffold than the CS group at the same time point (P < 0.05).</p><p><b>CONCLUSION</b>The CS/osteo-induced BMSC composites are excellent bone tissue engineering substitutes, and the scaffold biodegradation is accordant with the bone formation.</p>
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Animals , Humans , Male , Rats , Bone and Bones , Cell Biology , Chitosan , Chemistry , Mesenchymal Stem Cells , Cell Biology , Osteogenesis , Physiology , Rats, Sprague-Dawley , Tissue Engineering , MethodsABSTRACT
ObjectiveTo study the clinical effect of the proximal femoral anatomical locking plate in the treatment of ipsilateral femoral shaft and neck fractures.Methods A retrospective study was done on 10 patients with ipsilateral femoral shaft and neck fractures treated with proximal femoral anatomical locking plate in our hospital from February 2009 to February 2011.After treatment,the outcome was assessed regularly by fracture union as was seen on serial radiographs and clinical function was estimated by Friedman and Vyman System.ResultsAll patients were followed up for 6-24 months ( average 16 months).All the fractures were healed within 2.5-4 months (average 3 months) in the femoral shaft and within 4-9 months (average 6 months) in the neck,respectively.According to Friedman and Vyman System,the overall clinical result was good in eight patients and fair in two,with excellent rate of 80％ (8/10).No osteonecrosis of the femoral head and fixation failure were observed during the followup. Conclusion Proximal femoral anatomical locking plate internal fixation is an effective treatment method for ipsilateral femoral shaft and neck fractures.
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Objective To summanrize the operative method and follow-up data of total aortic arch replacement combined with transaortic stented graft implantation into the descending aorta (Sun's procedure) for acute Stanford type A aortic dissection.Methods Between August 2004 and March 2012,73 patients with acute type A aortic dissection underwent this procedure.60 males and 13 females ranging in age from 26 to 79 years (mean age,49,6 years).Right axillary or femoral artery cannulation was routinely used for cardiopulmonary bypass.Cerebral protection was achieved by bilatero-antegrade or selected hrain perfusion.The stented elephant trunk was implanted throuugh the aortic arch under hypothermic circulatory arrest.The stented elephant trunk was a 10cmlong self expandable graft.Patent false lumina were evaluated using computed tomography 3 months and once each year after discharge to evaluate the postoperative time course of the residual false lumen.Results Mean cardiopulmonary bypass time was (248.1±69.8)min,and selected cerebral perfusion time was (38.2±10.5)min.Hospital morality was 6.85 ％ (5/73).Thrombus obliteration of the residual false lumen in the descending thoracic aorta was observed in 9 1.7％ of the aortic dissections 3 months postoperatively.The mean follow-up time was(36.4 ± 31.6)months (range,2 to91 months).Survival at 1,5,7 years was 97％,87％ and 81％,respectively.Conclusion Total aortic arch replacement combined with transaortic stented paft implantation into the descending aorta is an effective treatment and n more promising choice for acute type A aortic dissection.
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Objective:To observe the therapeutic effects of auricular point sticking in managing functional dyspepsia.Methods:Seventy patients with functional dyspepsia were randomly divided into two groups,with 35 patients in the treatment group receiving auricular point sticking therapy,and the other 35 patients in the control group managed by taking Domperidone orally.The therapeutic effects were evaluated 4 weeks later.Result:The total effective rate was 85.7% in the treatment group and82.9% in the control group.Although the difference of the total effective rate between the two groups was not significant,the treatment group was superior to the control group in the improvement of several symptoms(P<0.05).Conclusion:Auricular point sticking therapy is effective in treatment of functional dyspepsia,and compared to Domperidone,it is better in managing gastric pain,abdominal bloating,and belching.
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Objective To investigate whether the proliferation of human hepatoma cell can be induced by insulin and which can be inhibited by Octreotide. Methods A human hepatoma cell line BEL7402 was used in this study. Using MTT method, cell count and Flow Cytometry (FCM), the effects of insulin and/or Octreotide on the number of viable cell, its ratio, the total number of cells, cell cycle and proliferative index (PI) in phasesynchronized cells were assayed. Results The cell number, the viable cell number and its ratio in insulin (0～5 ?g/ml)treated BEL7402 cells increased, while both in basic and insulininduced ones all decreased when Octreotide 0～2 ?g/ml was used, both in dosedependent manner. 1 ?g/ml of Octreotide resulted in a reduction of PI which was increased by 5 ?g/ml of insulin. Moreover, a S cell cycle block was detectable in phasesynchronised BEL7402 cell treated with 1 ?g/ml of Octreotide. Conclusion In vitro, proliferation of human hepatoma cell can be induced by insulin, while Octreotide exerted an inhibitory effects on basic and insulininduced growth of human hepatoma cell.