ABSTRACT
Objective:To investigate the clinical efficacy and safety of laparoscopically assisted ventriculoperitoneal shunting for the treatment of hydrocephalus in older adult patients.Methods:Sixty-four older adult patients with hydrocephalus who received treatment in Yiwu Fuyuan Private Hospital from June 2017 to December 2019 were included in this study. They were randomly divided into study and control groups, with 32 patients in each group. The control group was given ventriculoperitoneal shunting and the study group was given laparoscopically assisted ventriculoperitoneal shunting. The Fugl-Meyer assessment of motor recovery, the activity of daily life score, hydrocephalus grading score, excellent and good efficacy rate, and incidence of complications were compared between the two groups.Results:After treatment, the Fugl-Meyer score and activity of daily life score in the study group were (77.05 ± 18.54) points and (84.83 ± 17.75) points, which were significantly higher than (63.25 ± 16.18) points and (63.76 ± 15.04) points in the control group ( t = 3.17, P = 0.002; t = 5.12, P < 0.001). Hydrocephalus grading score in the study group was significantly lower than that in the control group [(3.77 ± 2.41) points vs. (6.61 ± 2.75) points, t = 4.39, P < 0.001]. Excellent and good efficacy rate in the study group was significantly higher than that in the control group [93.75% (30/32) vs. 75.00% (24/32), χ2 = 4.26, P < 0.05]. The incidence of complications in the study group was significantly lower than that in the control group [9.38% (3/32) vs. 40.63% (13/32), χ2 = 8.33, P < 0.005]. Conclusion:Laparoscopically assisted ventriculoperitoneal shunting can accurately locate the catheter and is more effective in the treatment of hydrocephalus in older adult patients compared with ventriculoperitoneal shunting. It can accelerate the recovery of neurological function and is highly safe.
ABSTRACT
Objective To retrospectively analyze the injury characteristics of victims and treatment strategies in the explosion accident on the 17th May 2018 in Xixia county (Xixia "May 17th" explosion accident). Methods Based on the practice featured in pre-hospital emergency of Henan province and Nanyang city Emergency Center in the explosion accident, a retrospective analysis for the Level Three medical rescue was conducted, where a total of thirteen survived victims in Xixia "May 17" explosion accident were studied retrospectively. The data included the gender, age, burned extent and depth of the patients, burns complicated by trauma, complication of burn, respiratory function maintenance, resuscitation during shock stage, skin grafting with excision and scab. Furthermore, the data of organ function and the effect of the 90-day comprehensive treatment for the burned victims wereanalyzed. Results completion the Level Three treatment on time, which was depended on the leading role played by the regional trauma centers was the main rescuing mode of the work in Xixia county, where the primary and secondary treatments were the key parts. The three-level treatment model includes: the local hospital acts as a level-one emergency medical institution, county hospitals function as secondary emergency medical institutions, and other higher medical institutions are the tertiary first aid medical institutions. The pre-hospital and in-hospital emergency procedures were initiated immediately after the large-scale explosive burn being identified, the key to the successfully rescue was to set up a comprehensive treatment team for burns and trauma. Rescue team should involve burn department and other related departments, including the departments of emergency, general surgery, orthopedic, thoracic surgery, neurosurgery, plastic surgery, intensive care unit, blood transfusion unit, anesthesiology, and interventional radiology, etc. All the thirteen burned patients were male, with inhalation injury, blast injury, hemopneumothorax, brain injury, bone fractures, and etc. Eight of them (61.54%) had multiple organ dysfunction syndrome (MODS). MODS mainly involved respiratory, circulatory, liver, gastrointestinal tract, kidney and coagulation function. With the multi-discipline treatment, the wound of 6 severely-burned patients started healing and can be discharged after keeping the patency of airway, applying resuscitation fluid and comprehensive treatments such as debridement and dressing change. Among 7 patients with extensive deep burns, one case with skull-based fracture, open craniocerebral, extensive intracranial hemorrhage and hemopneumothorax, died 9 hours later. Another case died within 24 hours after injury due to obvious exudation on the site of early incision and relaxation of wound. The escharotomy, micro-dermis and allograft skin transplantation were carried out for five cases with extensive deep burns from the 4th day after the recovery of shock. One week later, the second stage of microsphere skin transplantation was performed. But all died of sepsis or fungal infection. Conclusions MODS and infection often occur during the course especially for patients with extensive and deep burns due to the great explosion in Xixia county, most of whom were accompanied with MODS and infection. Therefore, assembling multi-discipline team for treating the group of explosively-burned patients can increase the survival rate and reduce the possibility of disability.
ABSTRACT
Objective Onto investigate the indoor quality control method for qualitatively detecting the laboratory indicators of TORCH infection (rubella virus IgG ,cytomegalovirus IgG and IgM ,toxoplasma IgG and IgM ) .Methods The statistical method , normal distribution data ,ratio and standard deviation of positive rate detected by the ELISA method were adopted ,1+2s was set as the out of control rules ,the semi Lerey‐Jennings quality control chart was drawn;the direct probability calculation method was a‐dopted for the non‐normal distribution data and small probability event .The testing data of 57 batches were retrospectively ana‐lyzed .Results The positive rate of rubella virus IgG was 86 .66% ,cytomegalovirus IgG/IgM positive rates were 98 .87% and 0 .13% ,toxoplasma gondii IgG/IgM positive rates were 2 .43% and 1 .71% ,the data of 151 ,3 ,5 ,176 ,27 samples had the critical value range of five indicators .The number of out of control was once for cytomegalovirus IgG ,once and 4 times for Toxoplasma gondii IgG/IgM .Conclusion The indoor quality control for the ELISA qualitative detection of TORCH infection can adopt the data of daily detection positive rate or negative rate for monitoring the false positive .The critical value range of specimens should be fur‐ther conducted the recheck or confirmation experiment .
ABSTRACT
Polyunstaurated fatty acids (PUFAs) not only are essential component of cells in maintaining function and composing organelle, but also control gene transcription of enzymes which are involved in differentiation, growth and metabolism in organisms. Resent studies have been shown that PUFA interact directly with nuclear receptors such as PPARs, LXR, HNF-4, other mechanism are indirect and rest with transcription factors such as SREBP. PUFA affect cell function through diverse pathways. The roles of such factors and PUFA in mediating the nuclear effects are addressed in order to elucidate the mechanism of PUFA in regulating gene expression. Further understanding of gene mechanism of regulation at the level of molecule would prompt the development of nutrition, health and medical treatment.