ABSTRACT
Objective To explore the effect of ultrasound guided percutaneous dilatation tracheotomy in critical ill patients.Methods From January 2016 to January 2018,95 critical ill patients who were treated in the People's Hospital of Quzhou were selected.According to the random number table method,they were divided into control group (n =47) and observation group (n =48).The patients in the control group were treated with traditional tracheotomy,and the patients in the observation group were treated with percutaneous dilatation tracheotomy under ultrasonic guidance.The operation condition of the two groups was observed,including operative bleeding volume,operative time,incision length,extubation time,incision healing time,hospitalization time and so on.The postoperative complications and mortality were recorded in the two groups.Results The operative bleeding volume,operative time,incision length and incision healing time in the observation group were (12.91 ± 1.36) mL,(10.05 ± 1.14) min,(1.46 ± 0.32) cm,(5.48 ±0.39)d,respectively,which were lower than those in the control group[(38.54 ± 3.47)mL,(27.43 ±2.29) min,(3.25 ± 0.68) cm,(7.64 ± 0.72) d],there were statistically significant differences between the two groups(t =40.098,39.616,13.888,15.381,P =0.000,0.000,0.000,0.000).The extubation time,hospitalization time in the observation group were (14.19 ± 1.14)d,(20.17 ± 1.85)d,respectively,which in the control group were (14.23 ± 1.17) d,(20.26 ± 1.89) d,respectively,there were no statistically significant differences between the two groups (t =0.142,0.198,P =0.886,0.843).The incidence rate of postoperative complications in the observation group was 6.25％,which was lower than 21.28％ in the control group,there was statistically significant difference between the two groups (x2 =9.515,P =0.002).The ICU mortality and hospitalization mortality in the observation group were 2.08％ and 4.17％,respectively,which in the control group were 10.64％ and 12.77％,respectively,there were no statistically significant differences between the two groups (x2 =2.937,2.277,P =0.087,0.131).Conclusion Ultrasound guided percutaneous dilatation tracheostomy can improve operation condition,reduce hospitalization time,and has less complications,low mortality,which has good clinical value in critical ill care.
ABSTRACT
Objective: To investigate the expression of grainyhead like 2 (GRHL 2) gene in human colorectal cancer (CRC) tissues and cells, and to explore the effects of GRHL 2 gene silence on the proliferation and cell cycle of CRC cells. Methods: The expression level of GRHL2 mRNA in CRC tissues and their para-cancerous normal tissues as well as CRC cells (HT29, SW480, SW1116, SW620, HCT116, Caco2 and LoVo cells) was detected by real-time fluorescent quantitative PCR. After the recombinant lentivirus carrying GRHL2-shRNA was infected into HT29 and HCT116 cells, the cell proliferation was determined by CCK-8 method and cloning formation assay, the cell cycle distribution was detected by FCM, and the expressions of cell cycle-related proteins (cyclin A, cyclin D1, p21 and p27) were determined by Western blotting. Furthermore, the subcutaneous transplantation models of CRC HT29 and HCT116 cells were established in nude mice, then the effect of GRHL 2 gene silencing on the growth of colorectal cancer xenografts was observed. Results: The expression level of GRHL2 mRNA in CRC tissues was higher than that in paracancerous normal tissues (2.8 times, P < 0.001). GRHL2 mRNA was highly expressed in most CRC cells (HT29, SW480, HCT116, Caco2 and LoVo cells). The expression levels of GRHL2 mRNA and protein in HT29 and HCT116 cells were down-regulated after transfection of GRHL2-shRNA (both P < 0.001). Silencing GRHL 2 gene significantly suppressed cell proliferation (both P < 0.05), produced the cell cycle arrest in G1 phase (both P < 0.01), down-regulated the expressions of cyclin A and cyclin D1 (P < 0.05, P < 0.01), and upregulated the expressions of p21 and p27 (P < 0.01, P < 0.05). Meanwhile, GRHL 2 gene silencing significantly promoted the growth of colorectal cancer xenografts in nude mice. Conclusion: GRHL2 maybe promote the proliferation of CRC cells by regulating the expression of cell cycle-related proteins.
ABSTRACT
Objective To explore the microsurgical treatment strategy of ruptured anterior communicating artery aneurysms.Methods From September 2009 to February 2013,thirty-three patients with ruptured anterior communicating artery aneurysms were treated with microsurgical clipping via modified pterion approach.The clinical and follow-up data were analyzed retrospectively.Results At 3 to 44 months period followed-up after microsurgical clipping of ruptured anterior communicating artery aneurysms were obtained in 32 patients.According to Glasgow Outcome Score,the curative effects score were 5 in 28 cases,four in 2 cases,three in 1 case and death in 1 case.Conclusion Microsurgical clipping of ruptured anterior communicating artery aneurysms via modified pterional approach was an effective method with sufficient exposure.It has less invasiveness to the brain tissue,reliable neck clipping and satisfactory results.Safety and effectiveness of this procedure are based on preoperative radiological evaluation of three-dimensional morphological specificity of aneurysms,identification of the parental arteries and its branches,as well as temporary proximal occlusion.