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Cardiac arrest (CA) is the most serious clinical emergency situation and cardiopulmonary-cerebral resuscitation (CPCR) performed on site with high quality is the optional therapy for its management. It has been reported that prolonging the resuscitation time after 30-minute failed conventional cardiopulmonary resuscitation (CPR) could improve the in-hospital survival rate of CA patients, and how to improve the out-hospital survival rate and survival quality of these patients is a research hot focus at present. A male patient admitted to Emergency Center of Shihezi People's Hospital reported in Xinjiang in this study had two CAs. In 2002, he experienced Adams-Strokes syndrome due to acute myocardial infarction (AMI) and survived after 35-minute of successful CPR. The criminal vessel was judged to re-canalize clinically 2 hours after thrombolytic therapy with urokinase, and he was cured and discharged from hospital 25 days later. In 2016, the second CA insult him and after the 185-minute CPR, he survived but experienced the post-CA syndrome. As long as 7-day continuous mild hypothermia was performed, the temperature of displacement fluids in continuous blood purification (CBP) was adjusted to 35 ℃ to achieve the goal of brain protection management requirements. He was cured and discharged from hospital 75 days later. During the 9-month follow-up, he did well in activities of daily living and could engage in routine housework. This paper introduces the treatment process of the patient in detail, and provides experience for clinical treatment.
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Objective To analyze of pathogenic bacteria of pulmonary infection in patients with terminal cancer.Methods The clinical data were retrospectively analyzed including the general cultivation of pathogenic bac-teria in sputum and the results of drug sensitivity of hospitalization of patients with lung cancer from July 2013 to May 2014.Results 132 strains of pathogenic bacteria were cultured from120 cases of patients with pulmonary infection, including gram-negative bacilli accounted for the vast majority of 27.3%,accounted for 59.8% of Gram-positive coc-ci,Ranked in the top 5 pathogenic bacteria were Streptococcus pneumoniae,Staphylococcus aureus,Candida albicans, Klebsiella pneumoniae,there arevarying degrees of resistance to commonly used antibiotics in bacteria.Conclusion Selecting and using the antimicrobial agents according to the results of pathogen detection in patients,could improve the effectiveness of antibiotic treatment and reduce bacterial resistance.
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OBJECTIVE@#To investigate the effect and clinical value of simultaneous multiple plane operations in treating severe OSAHS.@*METHOD@#The clinical data of 93 patients with severe OSAHS were retrospectively analyzed. According to different obstruction plane, all the patients were performed different multiple planes of operations. Operations were finished in the same term. All patients underwent PSG examination before operation and 6-month, 1 year after surgical treatment separately.@*RESULT@#No severe complication occurred. According to the assessment guidelines, the response rate was 100% in 6-month and 91.40% in 1-year respectively.@*CONCLUSION@#Most OSAHS have multi-level obstructions in upper airway caliber, such as nasal, nasopharyngeal, velo-pharyngeal and tongue-pharyngeal obstruction. Simultaneous multiple plane operations which based on multiple plane obstruction can improve curative effect.
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Apnea , General Surgery , Nasopharynx , General Surgery , Nose , General Surgery , Otorhinolaryngologic Surgical Procedures , Methods , Pharynx , General Surgery , Polysomnography , Retrospective Studies , Sleep Apnea, Obstructive , General Surgery , Tongue , General SurgeryABSTRACT
BACKGROUND: It remains unclear whether proinflammatory factor, such as tumor necrosis factor-α (TNF-α), γ-interferon and anti-inflammatory cytokine, such as interleukin-10 (IL-10), interleukin-4 (IL-4) levels can change after laryngeal transplantation. OBJECTIVE: To explore the expression of TNF-α and IL-10 in different expressive tissue layers and its relationship during the acute rejection episodes, and to evaluate the role of TNF-α and IL-10 levels in serum for prediction of early acute rejection after laryngeal transplantation. METHODS: Laryngeal heterotopic transplantations were performed in Wistar and Sprague-Dawley rats. According to different dosages of immunodepressant, all recipients were divided into three groups: Group 0 mg, Group 5 mg, and Group 10 mg. Untreated Sprague-Dawley rats served as normal control group. RESULTS AND CONCLUSION: Changes in serum TNF-α and IL-10 levels at postoperation days 3, 7 and 11 were positively correlated with these expressions in the epithelium mucosa and submucosa at various time points after transplantation. These indicate that the high-antigenicity of graft mainly concentrates on the layers of mucosa and submucosa. TNF-α and IL-10 concentrations can serve as indexes for predicting acute rejection after laryngeal transplantation.
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OBJECTIVE To study the therapeutic effect of arytenoid within-shift combining with recurrentlaryngeal nerve (RLN) anastomosis to ansa cervicalis for patients with long-term unilateral vocal cord paralysis (UVCP) . METHODS Twelve patients with traumatic RLNs paralysis were studied. The courses of injury varied from 3 to 22 years. RLN was anastomosed to ansa cervicalis and arytenoid was within-shifted on ipsilateral side in all patients. Therapeutic efficacy was evaluated by laryngoscope, strobe-laryngoscope, voice evaluation, voice acoustics parameter analysis, and laryngeal electromyography (LEMG) . RESULTS The voice was improved in all cases after arytenoid within-shift immediately. The mean values of voice acoustics parameters (jitter, shimmer, NNE) were significantly smaller and maximum phonation time (MPT) were significantly longer after operation compared with those of before treatment. Laryngoscope showed that arytenoid was significantly within-shifted. The glottic posterior chink vanished in 9 cases and reduced in 3 cases. The voice resumed normal, obviously improved, improved and no improved were found in 9、 3、0、0 cases respectively 12 months after operation. The mass and tension of all treated vocal cords may become the same as the contralateral normal vocal cords, thus resuming symmetric vibration of the vocal cords. The reinnervation of the RLNs were approved by LEMG in these patients whose RLNs were restored. CONCLUSION Arytenoid within-shift combining with RLN anastomosis to ansa cervical can restored normal voice in patients with long-term UVCP.
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Objective To introduce a method of dorsal augmentation rhinoplasty using autogenous septal cartilage. Methods Autogenous septal cartilage was obtained through a standard septoplasty approach. Graft was cut into single oval, or divided into two or three parts, then the cartilage was sutured by means of a mattress suture; or graft was made into an inverted V frame, depending on size and shape of dorsal depression, and finally graft was inserted for augmentation of dorsum. Results Since May 1989 to Dec. 2001, this technique was performed in 43 patients, 6 men and 37 women, with a range of 17-35 years and a mean age of 24 years. Follow-up ranged from 6 months to 5 years. The authors asserted the sustained satisfactory outcomes. Conclusion Autogenous septal graft is technically simple and relatively free of complication. Long-term evaluations show no absorption of grafts and preservation of desired shape.
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Objective To introduce a new method of recombinative repair for the old malunion of the fracture of nasal bone. Methods Since 1996.5 to 2001.12, this technique was performed in 28 patients, 23 men and 5 women, with a range of 18～45 years, a mean age of 29 years. The nasal skin was protected with a rubber pad, and malformed nasal bones were beat out with a small hammer, so as to create a new refracture, then manual reduction was performed with finger and the septal periosted elevator. Results Follow-up ranged from 3 months to 5 years. Of all the patients, 23 cases were cured, 5 cases improved, and the overall effective rate was 100 %. Most of them were satisfied with the successful operation. Conclusion The operative procedure of recombinative repair is technically simple and easy, and the patients suffer little. It is an update and efficacious therapeutic method.