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Objective To investigate the relationships of MR indexes such as acromio humeral intervals (AHI),lateral extension of the acromion (LEA) and inclination angle of the acromion with the subacromial impingement syndrome (SIS).Methods 151 patients underwent MRI examination of shoulder joints,they were grouped according to age,gender and location of acromion.The differences in age,gender and MR indexes were compared between SIS group and non SIS group.The distribution statuses of SIS in different groups were compared at the same time,the relationships of various MR indexes with SIS were investigated and analyzed.Results There were no statistical differences in age,location distribution,the average shortest AHI value and the thickness of the subacromial bursal effusion between SIS group and non SIS group (P ＞ 0.05).There showed statistical difference in gender between the two groups (P =0.000),and there were more males than females in both groups.The acromion exactly covered the supraspinatus tendon in 79 patients,the average value of LEA in the SIS group was greater than that in the non SIS group,and there showed statistically significant difference between the two groups (P =0.002),the Youden index of LEA was 0.40,the sensitivity was 61％ and the specificity was 79％.The inclination angle of the acromion in the SIS group was smaller than that in the non SIS group,and there was a statistically significant difference between the two groups (P =0.019),the Youden index of the inclination angle of the acromion was 0.18,the sensitivity was 62％ and the specificity was 56％.47 patients in the SIS group had subacromial bursal effusion,51 patients in the non SIS group had subacromial bursal effusion.The thickness of the subacromial bursal effusion in the SIS group was greater than the non SIS group,and there showed statistically significant difference between the two groups (P =0.002),the Youden index of the thickness of the subacromial bursal effusion was 0.34,the sensitivity was 78 ％ and the specificity was 56 ％.Conclusion LEA,the inclination angle of the acromion and the thickness of the subacromial bursal effusion can be used as quantitative MR diagnostic criteria of SIS.The LEA measured by cardiothoracic ratio is simple and easy to use.
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Objective To review the experiences of 31 cases of totally thoracoscopic cardiac surgery of cardiopulmonary bypass in children with congenital heart disease.Methods Thirty one children with congenital heart disease received totally thoracoscopic cardiac surgery procedures during the period from October 2012 to May 2016.The ages of these children were ranged from 2 years and 7 months old to 6 years old with average value (4.6 ± 1.4)years old.The body weights were ranged from 12 ～ 24 kg with average value (17 ± 3.5) kg.Among 31 children,there were 12 cases of atrial septal defect,and 19 cases of ventricular septal defect.Through three-hole shape incision at the right chest wall,each hole was 1.5 to 2.0 cm long,and operation field were revealed totally by thoracoscope.Cardiopulmonary bypass was built through femoral arteriovenous intubation.Results Thirty one children were all cured.None of them suffered severe complications such as renal failure,respiratory failure,low cardiac output syndrome,atrioventricular block,and residual shunt.Duration of cardiopulmonary bypass was 62 ～ 185 (126.4 ± 45.2) min,and duration of myocardial ischemia was 18 ～ 118 (53.4 ± 31.2)min.Duration of Postoperative mechanical ventilation was 2 ～ 7 (5.3 ±-1.5) h.Duration of intensive care unit (ICU) stay was 15 ～ 21 (19 ± 1.3) h.Drainage volume of 24 hours after operation was 0～ 130(57 ± 36.2)ml.Volume of red blood cell transfusion was 0 ～ 2 (1.2 ± 0.8) U.Postoperative hospital stay was 4 ～ 7 (6.2 ± 1.2) d.Conclusions For children with congenital heart disease as simple atrial septal defect or ventricular septal defect,thoracoscopic surgical repair can be achieved the same therapeutic results as traditional median sternotomy surgery while having advantages such as smaller incision,less bleeding and none sternal maluniorts.
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10.3969/j.issn.1000-8179.2013.12.009
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Objective To study the changes of Prealbumin (PA),C-reactive protein (CRP) and D-dimer (DD) levels in septic shock patients due to pneumonia so as to explore the relation to the severity of disease and prognosis.Methods PA,CRP and DD levels of 48 sepsis patients were measured on 1st 、 3rd、5th day after admission and the last day before discharge or death.Meanwhile APACHE Ⅱ score were documented.According to prognosis,patients were divided into death group and non-death group.Results The levels of PA、CRP and DD on the 1 st day were of no significant difference between the death group and non-death group( t = 2.315 ,P ＞ 0.05;t =2.013,P ＞0.05; t =2.511 ,P ＞0.05).The level of PA in death group on the 3rd day,the 5th day and the last day was much lower than that in non-death group ( t = 2.422,P ＜ 0.05; t = 2.557,P ＜ 0.05; t = 2.906,P ＜ 0.05 ).The level of CRP and DD in death group on the 3rd day,the 5th day and the last day was much higher than those in nondeath group(t =2.061 ,P ＜0.05 ;t =2.843,P ＜0.05 ,t =3.519,P ＜0.01 and t = 2.576,P ＜0.05,t = 2.823,P ＜0.05; t = 3.371 ,P ＜ 0.01 ).There was a negative correlation between PA and APACHE Ⅱ scores ( r = - 0.631,P ＜0.01 ) ,while a positive correlation was found between CRP,DD and APACHE Ⅱ score(r =0.687 ,P ＜0.01 and r =0.651 ,P ＜ 0.01 ).Conclusions Persistent low level of PA and high level of CRP,DD indicated severe disease course and unflavored prognosis.It is of clinical value to evaluate the severity of disease and predict prognosis in sepsis by combined dynamic observation of PA,CRP and DD levels.
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Objective To explore the effect of inhaled iloprost (Ventavis) for patients with congenital heart disease associated with pulmonary hypertension.Methods Twenty-two patients with congenital heart disease associated with pulmonary hypertension were selected to inhale Ventsvis by atomizer before surgery ,the required dosage is 25-30ng/(kg.min),aerosolization of iloprest was inhaled by PARI Junior BOY N after diluted with 2ml physiological saline at 3-hour intervals .The change of hemodynamic effects was measured by Doppler ultrasonography after 60min,120min,and 180min.Results The left and fight vemfieular cardiac output at 60min,120min and 180rain after therapy were markedly higher than that before inhaled iloprost ,respirator therapy time was shorter in patients inhaled iloprost.Conclusion inhaled iloprost can increase cardiac output and improve patients cardiac function.Thus,the therapy with inhaled iloprost is effective and feasible.
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Objective To evaluate the efficacy and safety of enoxacin in the treatment of lower respiratory tract bacterial infection in the old patients.Methods 48 cases were given enoxacin and 46 cefotaxime.Results There was no significant difference between the two groups in cure rate,effective rate,bacterial clearance and side effects incidence.Conclusion Enoxacin is effective and safe in the treatment of lower respiratory tract bacterial infection of the old patients.
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To compare immunogenicity of vaccine produced by three rabies virus stains( aG-,CTN.,CaG) respectively and determine their the ability against lethel challenge of rabies virus.Methods: By ELISA to determine sera potency of rabbits as well as hamsters and guinea-pigs which have been vaccinated different rabies respectively .To neutralize three different rabies strain with sera of hamster vaccinated and carry on neutralization experiments in mice.Results:In rabbits and guinea-pigs groups,rabies vaccine protency(by ELISA determination) vaccinated cell-adapted virus strain (CaG and CTN) is higher than one of vaccinated guinea-pig' strain virus strain's (aG), sera ability of hamster vaccinated cell-adapted strain against three rabies virus lethel challenge is higher than one of guinea-pig strain virus strain' g, too. Conclusion: Immunogenicity of rabies vaccine produced by cell-adapted strain is better than one of guinea-pig'sbrain virus strain's.