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Objective:To evaluate the technical aspects and examine patency rates of stent placement across the inguinal ligament for managing long-segment iliac venous obstruction.Methods:From Jan 2012 to Jan 2017, a total of 73 patients (42 cases of post-acute deep venous thrombosis(DVT) thrombolysis and 31 of post-thrombotic syndrome (PTS)) with long-segment iliac venous obstruction were treated with interventional surgery. All patients underwent balloon dilatation and placement of at least two stents extending below inguinal ligament.Results:The technical success rate was 100%. No serious perioperative complications occurred. The mean duration of the procedure in the DVT group was shorter than PTS group(35±12) min vs. (62±12) min, P<0.05). The mean number of stents did not differ between the two groups.Mean follow up periods was 28.34 months. Overall cumulative primary, assisted primary, and secondary stent patency rates were 100%, 100%, and 100% at 6 months and 87.7%, 95.9%, and 100% at 12 months and 75.8%, 85.1%, and 96.3% at 24 months, respectively(all P>0.05). Edema and pain alleviated significantly in the two groups. There was no stents compressed or fractured. Conclusions:Stenting across the inguinal ligament for treatment of long-segment iliac venous obstruction is a safe, effective, and feasible method.
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Early hemoperfusion in poisoned patients can remove poisons rapidly and effectively, which plays an important role in improving the prognosis of patients. The key of hemoperfusion therapy is the safe and effective anticoagulation. The local citrate anticoagulation effect acid is good, it also has little effect on the systemic coagulation mechanism and internal environment of patients, so it is worthy of promotion. We retrospectively analyzed the clinical data and treatment of 273 patients who were poisoned by citrate anticoagulant in the emergency intensive care unit of the Second Affiliated Hospital of Shandong First Medical University, aiming at perfusion of citrate anticoagulant in patients with poisoning. Provide a certain clinical reference.
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Objective@#To investigate the clinical effect of plasma exchange (PE) versus double plasma molecular adsorption system combined with PE (DPMAS+PE) in the treatment of toxic hepatic failure.@*Methods@#A total of 67 patients with toxic hepatic failure who were admitted during the same period of time were divided into PE group, DPMAS+ PE group, and control group. The 22 patients in the PE group were treated with PE alone, and the 24 patients in the DPMAS+PE group were given DPMAS combined with PE. The clinical out-come was compared between the three groups.@*Results@#Both treatment groups had significantly higher clinical response rate and 24-week survival rate than the control group. After treatment, both treatment groups had significant reductions in the serum levels of total bilirubin (TBil) , direct bilirubin (DBil) , alanine aminotransfer-ase (ALT) , and aspartate aminotransferase (AST) , and the PE group had significant reductions in the albumin (Alb) level and activated partial thromboplastin time (APTT) (P<0.05) ; the DPMAS+PE group showed no sig-nificant changes in the Alb level and APTT (P>0.05). There were no significant differences in TBil, DBil, ALT, and AST between the two treatment groups after treatment (P>0.05). After treatment, the PE group had significantly higher Alb level and APTT than the DPMAS + PE group (P<0.05). Compared with the control group, both treatment groups had significant reductions in TBil, DBil, ALT and AST after treatment (P<0.05).@*Conclusion@#The two artificial liver support techniques can significantly improve patients' liver function and in-crease their survival rate, and the combined artificial liver support technique can reduce the amount of plasma used.
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Objective To Discuss the effect of surgical treatment from enteral and parenteral nutrition that in perioperative period of hepatolithiasis patients who taking hepatectom.Methods Retrospective analysis 55 cases who taking hepatectomy treatment in Fuling Central Hospital of Chongqing City from March 2011 to March 2015,all elective operations.According to the different nutrition support methods in perioperative period,randomly divided into enteral and parenteral group (n =25) and parenteral nutrition group (n =30).Results The postoperative complication rate and recovery time of bowel function in patients with enteral and parenteral nutrition,it was better than parenteral nutrition group (28 ％ vs 40％),[(4.50 ± 0.50) d vs (5.50 ± 1.00) d],the difference had statistical significance (P ＜ 0.05).Before and after operation in two groups of body mass index [(22.10 ± 1.80) vs (22.30 ± 1.70)],prealbumin impovement [(130.00 ± 45.00) mg/L vs (124.00 ± 55.00) mg/L],albumin impovement [(35.50 ± 2.72) g/L vs (36.50 ± 2.70) g/L],had no statistical significance (P ＞ 0.05).Conclusion Enteral and parenteral nutrition in perioperative can significantly improve the nutritional status of patients and the effect of surgical treatment.
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Objective To develop a Jingcen DY?1 type spraying tanker for Oncomelania hupensis snail control and evaluate its effect of field application as well as the cost. Methods The currently available tractor was used as a vector,and the mechan?ical and electrical equipments and containers were integrated with shafts,pipelines and electric lines to produce a spraying tank?er for snail control,with the functions of carrying people and molluscicides,generating electric power and getting water,mixing stocking solutions,adjusting molluscicide solutions evenly,and spraying drugs. The volume of the molluscicide solution,flow rate of water injection,and the flow rate,range and advance speed of the spray gun were tested,and the solution concentrations of molluscicide in the tanker and at the muzzle of the spray gun at different time were detected. Meanwhile,the molluscicidal ef?fect and cost of the spraying tanker were analyzed by the field test. Results The volume of the liquid storage pot of the Jingcen DY?1 type spraying tanker was 1 800 L,the flow rate of water injection was 400 L/min,the flow rate and the spray range of the standard spray gun were 110-200 L/min and 19.70-23.50 m,respectively,the efficiency of drug spraying of the spraying tanker was 6 000 m2/h,and the ratio of spray width(m)to march speed(m/min)was 1∶200. When 5 min post mother liquid recirculat?ing ,the average concentration of the molluscicide at the upper? ,middle? and lower?layers of the liquid storage pot was (1 030.39 ± 43.00)mg/L,with a variation coefficient of 4.17%. The average concentration of the molluscicide in the spraying process(spraying for 2,4,6,8,9 min)was(953.00 ± 68.87)mg/L,with a variation coefficient of 7.22%. The concentration of the residual drug in the liquid storage pot post spraying was 1 000.43 mg/L,which reached the effect concentration for snail con?trol. After spraying for 7 days in the field,the average density of living snails reduced by 88.20% as compared to that before spraying,and the adjusted mortality of snails was 87.65%. The unit cost of Jingcen DY?1 spraying tanker was 0.086 7 Yuan/m2, which reduced by 58.20% as compared to that of the conventional spraying tanker. Conclusions Jingcen DY?1 type spraying tanker for snail control which integrates various equipments together can effectively control the concentration and dose of the mol?luscicide,and the machine is labor?saving,efficient,economic and well adapted,and is worthy to be widely applied.
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<p><b>OBJECTIVE</b>To investigate the different effect of three methods of blood purification for paraquat poisoning patients:hemoperfusion (HP), hemoperfusion combined with hemodialysis (HP + HD), hemoperfusion combined with continuous veno-venous hemofiltration (HP + CVVH).</p><p><b>METHODS</b>72 cases of paraquat poisoning patients were divided into three groups after giving conventional therapy HP group, HP + HD group, HP + CVVH group. Compared the rate of decline concentrations of paraquat in blood, the liver and the kidney damage between before and after blood purification and contrast the mortality in three groups after different method of blood purification.</p><p><b>RESULTS</b>The rate of decline concentrations of paraquat in blood of the HP + HD group and HP + CVVH group were both significantly greater than the HP group, but this result of HP + HD group has no significant difference compared with HP + CVVH group; Among the three groups of patients after 72 hours, the degree of dysfunction of liver of the HP + HD group and HP + CVVH group were both significantly lower than the HP group, whilely the degree of dysfunction of kidney of the HP + HD group was significantly lower than the HP group and the HP + CVVH group. The survival time of the HP + HD group and the HP + CVVH group were significant linger than the HP group, but the comparison among the three groups had no significant difference in mortality.</p><p><b>CONCLUSION</b>Three blood purification methods can effectively remove paraquat absorbed into the blood, and the hemoperfusion combined with hemodialysis or continuous veno-venous hemofiltration can effectively reduce the degree of damage of liver and kidney and also can prolong survival time, but did not significantly improve the survival rate of patients.</p>
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Humans , Hemofiltration , Methods , Hemoperfusion , Kidney , Liver , Paraquat , Blood , Toxicity , Renal Dialysis , Survival Rate , Treatment OutcomeABSTRACT
Objective To evaluate pigtail catheter mashing thrombosis combined with catheter directed thrombolysis in the treatment of acute iliofemoral venous thrombosis complicated by Cockett syndrome in the left lower limbs.Method Data of 137 cases of acute iliofemoral venous thrombosis complicated with Cockett syndrome in left lower limb by interventional therapy from January 2007 to October 2012 were analyzed retrospectively.Inferior vena cava filters were placed in all of the patients.Patients were divided into two groups:Group A (n =81) treated with catheter directed thrombolysis only,Group B (n =56) treated with pigtail catheter mashing thrombosis combined with catheter directed thrombolysis.After operation,patients were treated by anticoagulation with urokinase and heparin calcium,and then warfarin for 6 to 1 2 months.Results The thrombolysis time in group B was significantly shorter than that in group A (P ＜0.01),the dosage of urokinase was significantly less than that in group A(P ＜ 0.01).The venous patency score in group B after therapy was significantly better than in group A (P ＜ 0.01).121 patients were followed up for 10-60 months.There were no pulmonary embolism.Conclusions Pigtail catheter mashing thrombosis combined with catheter directed thrombolysis in the treatment of acute iliofemoral venous thrombosis complicated with Cockett syndrome in left lower limb can improve thrombolytic efficiency,shorten thrombolysis time,reduce the use of urokinase.
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Objective To investigate the intentions of pension mode of the aged in the unban and rural of Xi' an,and analyze the possible influential factors in old persons' choices of pension modes.Methods The purposive sampling method was used to survey the old persons about their pension intentions by questionnaire,and the collected information underwent statistical analysis.Results Among 317 old persons aged from 60to 91 years old investigated in the study,145 cases were from urban and 172 from rural area.Most old people intended to choose self-pension mode,family pension mode and community pension mode.Only few people chose institution pension mode.Their favorite pension mode was family pension mode,and institution pension mode was the last one to choose for old people.Community pension mode should be developed mostly in their opinion,and self-pension mode must be reduced.Some essential variables had significant influence on their choices of pension models,such as living in urban or rural,occupation,age,marriage,the incomes per month,family support,habitancy and so on.The result of logistic analysis showed that some other variables had no obvious influence on their pension intentions.Conclusions Old people in Xi'an prefer family pension mode mostly.Community pension mode is the one which has a good developing prospect.Social pension mode need to be intensified.
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Objective To investigate the clinical effect and safety of spleen-preserving surgery by microwave tissue coagulation (MTC) therapy.Methods Retrospectively analyzed the clinical data of 45 cases undergoing spleen retaining surgery by MTC therapy (observation group) and comparative study was used on another 45 cases experiencing splenectomy (comparative group),clinical effect and complications were compared.All cases were patients from Jan.2010 to Jun.2013.Results All cases were cured.Hospitalization of observation group is obviously shorter than that of comparative group(P =0.007).The rate of complication in observation group(4.44％) is lower than that in comparative group (20.00％),but the time and amount of bleeding in operation of observation group is much more than that of comparative group.Conclusion MTC can effectively guarantee patients safety,shorten hospital stay,and be worthy of popularization.