ABSTRACT
At present, there is no unified gold standard for the treatment of laryngeal clefts. Type Ⅰ laryngeal clefts with mild symptoms can be treated conservatively, such as thick diet feeding and using proton pump inhibitor to control reflux, while Ⅱ-Ⅳ laryngeal clefts mostly requires surgical intervention.There are many different surgical methods for the treatment of laryngeal clefts, including injection laryngoplasty, endoscopic surgical repair of laryngeal clefts and open laryngoplasty through anterior cervical approach. How to choose a more suitable surgical plan for children is a problem worth discussing. This article will review the literature on the surgical treatment of laryngeal clefts both domestically and internationally, and summarize the current situation and challenges of surgical treatment of laryngeal clefts.
Subject(s)
Child , Humans , Congenital Abnormalities/surgery , Endoscopy , Laryngoplasty/methods , Laryngoscopy/methods , Larynx/surgeryABSTRACT
Objective:To analyze the efficacy of endoscopic surgical repair in the treatment of type Ⅲ laryngeal clefts and to explore the feasibility of the treatment for type Ⅲ laryngeal clefts. Methods:The clinical data of 6 children with type Ⅲ laryngeal clefts who underwent endoscopic surgical repair in our department from June 2018 to January 2023 were analyzed retrospectively. The operation was performed under combined intravenous and general anesthesia,preserving the spontaneous breathing of the children. With the assistance of 4 mm/0° endoscope, radiofrequency knife or laryngeal scissors were used to make fresh wounds along the edge of laryngeal clefts,and cotton pads infiltrated with adrenaline （1:10 000） were used to compress the wound. 6-0 PDP suture was used to suture 3-6 stitches according to the extent of laryngeal clefts. Modified barium swallowing test （MBS） was performed 3 months after operation. Results:All the children were successfully treated with endoscopic surgical repair. After surgery, 2 cases were transferred to pediatric intensive care unit （ICU） for 7 days of monitoring, and the rest were transferred back to the general ward. There were no postoperative complications. The symptoms of dysphagia, laryngitis and recurrent pneumonia were improved in all children. According to the follow-up results of postoperative MBS,no aspiration was found in all children, and 2 children had intermittent cough when drinking large amounts of water. During the follow-up, there were 2 cases of recurrence, and the cracks were completely repaired after the second endoscopic surgical repair treatment,and no recurrence has been observed so far. Conclusion:Endoscopic surgical repair can be applied to some children with type Ⅲ laryngeal clefts with less intraoperative bleeding and fewer operative complications. It can significantly improve the symptoms such as swallowing dysfunction and recurrent pneumonia. It is a safe and effective surgical treatment.
Subject(s)
Child , Humans , Laryngoscopy/methods , Laryngoscopes , Retrospective Studies , Larynx/surgery , Pneumonia , Congenital Abnormalities/surgeryABSTRACT
Objective To calculate the standardized cesarean delivery rate by considering the individual characteristics of puerprae, and to evaluate the medical quality of obstetrics in the hospital. Methods Medical records of 69 406 puerprae from January to December in 2016 were collected from 33 tertiary general hospitals in Shanxi province. A logistic regression model was used to construct a maternal risk adjustment model of cesarean delivery, with the area under the ROC curve (AUC) used to evaluate the goodness of fit of the model. Results Of the 69 406 puerprae, 30 881 used caesarean delivery, accounting to 44. 37% . The cesarean section rate difference was statistically significant among those of different age, nationality, conditions upon admission, whether to participate in a clinical pathway, fetus number, birth weight and maternal gestational age, as well as the severity of complications (P< 0. 001). According to the logistic model, those of older age, history of cesarean delivery, twins or triplet births, neonatal overweight, malposition, placenta previa, and those with various pregnancy complications tend to use maternal cesarean section surgery, with a goodness-of-fit of 0. 82. With risk adjusted, the ranking of actual cesarean section rate and standardized cesarean section rate varies among the hospitals. Conclusions With the factor of puerprae factor adjusted, the standardized cesarean delivery rate can eliminate risk factors of the puerprae, it is feasible to scientifically evaluate the cesarean delivery rate of the hospital′s obstetric department.
ABSTRACT
Objective To establish a method for the determination of patchouli alcohol in Huoxiang Qingwei Tablets by gas chromatography (GC).Methods HP- 5 column( 30 m? 0.32 mm? 0.25 ? m) was used and 5 % crosslinked phenyl polydimethyl siloxane was used as the mobile phase. The increase of column temperature was controlled by programming: the initial temperature was 150 ℃ and maintained for 23 min, and then rose at 8 ℃ /min up to 230 ℃ for 2 min. The injector temperature and the detector temperature both were 280 ℃ .The flow rate was 0.9 mL/min and the injection volume was 1 ? L, split ratio was 5∶ 1.Result A good linearity was obtained in the range of 0.057～ 1.140 mg/mL,r=0.9994. The average recovery was 99.38 % with a RSD of 1.82 % (n=5). Conclusion The method is simple and accurate and can be used for the quality control of Huoxiang Qingwei Tablets.
ABSTRACT
Objective To determinate the content of Danshensu in Xingkenin g Capsules by HPLC.Methods HPLC with Hypersil ODS2 column was used, MeOH- 1 % acetic acid( 12:88) as a mobile phase and detection wavelength at 280nm.Re sults The linear range of Danshensu was in the range of 0.256～ 1.278 ? g. Th e average recovery of Danshensu was 102.73 % with a RSD of 1.34 % .Conclusio n The method is simple with a good reproducibility and can be used for the qu ality control of Xingkening Capsules.