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Objective To explore the bias between the real pressure and the measured values when handheld pressure gauge (HPG) was used to monitor intermittently the pressure in the intubation balloon,so as to provide some measures for the correct use of HPG.Methods In the first part of the study,HPG was used to measure the pressure with the balloon connected with a three-way tube with which to control the inflation and deflation in a laboratory to measure the pressure in the air bag.After gaining the deviation in this in vitro experiment,it was tested and verified in vivo in adult patients undergoing endotracheal intubation.Results After 132 times of measurements,it was found that measurement with a HPG might result in an inherent loss (3.928 ± 0.291) cmH2O (1 cmH2O=0.098 kPa,t =155.273,P =0.000) between inflation value [(30.000 ± 0.000) cmH2O] and measured value [(26.072 ± 0.291) cmH2O].In addition,after 214 times repeated measurements,the pressure loss during disconnection of the gauge was as high as (1.196 ± 0.954) cmH2O (t=18.348,P=0.000) between filled values [(30.000 ± 0.000) cmH2O] and measured values [(28.804 ± 0.954) cmH2O] and it was named as error loss.At last,the total error was verified by clinical test,and it was (5.270 ± 2.583) cmH2O (t=29.632,P=0.000) between pressure of filled value [(30.000 ± 0.000) cmH2O] and measured value [(24.730 ± 2.583) cmH2O].Conclusions When the balloon pressure was Monitored intermittently with HPG,the real value should be the measured value plus the error.In addition,subglottic aspiration should be done before the connection of the balloon to the gauge to prevent the secretions on the cuff falls into the deeper airway,and to maintain the cuff pressure at 30 cmH2O.
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ObjectiveTo review the etiology and classification of cholangiectasia. MethodThe clinical data of 1098 patients with cholangiectasia treated from January 2000 to December 2009 were retrospectively analyzed. Results For the 1098 patients, 69 patients (6.3％) had congenital choledochal cyst, and 1029 patients (93.7％) had secondary cholangiectasia which were secondary to 22 diseases, The top 5 of the etiological diseases were bile duct stones (366 patients, 33.3 ％), pancreatic head carcinoma (137 patients, 12.5％), peri-ampullary carcinoma (122 patients, 11.1％), cholangiocarcinoma (68 patients,6.2％),and chronic pancreatitis or pancreatic head cyst (62 patients,5.6 ％). ConclusionsCholangiectasia can be divided into two major categories (congenital and secondary). Congenital choledochal cyst accounted for 6.0％, secondary cholangiectasia accounted for 94 ％.The most common etiologies were bile duct stones, pancreatic head carcinoma and peri-ampullar carcinoma.
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Objective To summarize the clinical efficacy of Millikan's modified modality using tension-free mesh-plug inguinal herniorrhaphy. Methods A retrospective study was performed in 185 cases with in-guinal hernias. They received surgical treatment using Millikan's modality in our hospital from Jan. 2005 to Dec. 2006. Results There were 184 males and 1 female in these patients with a average age of 47 years ( range 32 - 75 years). Among them, 7 cases had bilateral hernia. The mean operative time of each hernia was 49 min (range 30 -70 min), and the average postoperative hospital stay was 5. 1 days (range 3 - 18 d). The complication rate was 10. 8% (20/185). All patients had no recurrence after following-up over 24 months. Conclusion Millikan's modified mesh-plug hemioplasty is a safe and effective modality in the pri-mary inguinal hernia repair, and has fewer complications and lower recurrence rate.
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Objective To investigate the therapeutic effects of latarjet nerve and pylous preserved pancreaticoduo-denectomy (LPPPD). Methods Clinical data and postoperative follow-up of Latarjet nerve and Pylous Preserved Pancreaticoduodenectomy since1996 of 32 cases were analyzed retrospectively, and 36 cases being carried out con-temporaneous Pylous Preserved Pancreaticeduodenectomy(PPPD) were compared with. Results The recovery time of postoperative gastrointestinal function recory time is five days of LPPPD group on average; but the time is eight days of PPPD group on average, and significantly slower than LPPPD group ( t = 3.01, P < 0.05 ) ; the occurrence of abdominal distenal, retention of gastric juice and enterogastric recurrent flow are significantly slower in LPPPD group than that in PPPD group( P < 0.05 ). Conclusion The postoperative gastrointestinal function recovered fas-ter, and the postoperative complications were less in LPPPD group than that in PPPD group.
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Objective To investigate the peripheral blood cytopenias in patients with portal hypertension complicated with splenomegaly. Methods The clinical data of 309 patients with portal hypertension who had been admitted to our department from January 1991 to December 2006 were retrospeetively analyzed. Results Of all patients, 278 showed peripheral blood cytopenia, ineluding 71 with paneytopenia, 48 with leukocyte and platelet decrease, 25 with erythroeyte and platelet decrease, 33 with leukocyte and erythroeyte decrease, 28 with platelet decrease, 26 with leukocyte decrease, and 47 with erythrocyte deerease. The number of blood cells increased significantly after splenectomy ( t=6.53, P<0.01). The whole blood cells of the remaining 31 patients without hematocytopenia were normal. Conclusions Patients with portal hypertension eomplieated with splenomegaly do not always accompany peripheral blood eytopenia. Peripheral blood cytopenia is one of the complications of splenomegaly, hut it dose not always appear. Splenectomy is effective in the treatment of hematocytopenia. The reason for some patients do not have peripheral blood cytopenia may be related to the slight pathological changes of spleen and severe hyperplasia of bone marrow.
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The facial, retromandibular and external jugular veins of the neck were studied in a total of 230 Chinese cadavers.1. The external jugular vein can be divided into six types and fourteen subtypes. Type Ⅰ(40.22％) and type Ⅲ (29.13％) occurred more frequently in this series.2. The facial vein drains into the external jugular vein in 41.09％. It drains directly or indirectly into the internal jugular vein in 43.91％.3. The anterior branch of the retromandibular vein usually drains into the internal jugular vein and it runs through the space deep to the posterior, belly of the digastric and the stylohyoid muscles in 83.70％.4. The presence of the so called common facial vein occurred only in 29.13％.5. The external jugular vein often drains into the subclavian vein. It appears in 46.57％ in our observation.6. The external jugular vein crosses the inferior belly of the omohyoid muscle, when it runs downwards in the lower part of the external cervical triangle. It usually lies superficial to the omohyoid in 66.16％, deep to it in 26.35％.