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Objective To explore the predictor of invalid conservative treatment of acute calculous cholecystitis (ACC) in pregnant women.Methods A total of 107 pregnant patients with ACC in a tertiary hospital from Jan.2010 to Jun.2017 were studied retrospectively.Results Univariate analysis revealed that body temperature ＞ 37.3 ℃ (x2 =4.721,P ＜ 0.05),gallbladder dilation (x2 =4.764,P ＜ 0.05),TBiL (t=-2.518,P＜0.05),ALT (t=-2.860,P＜0.05),AST (t=-3.014,P＜0.05),hospital stay (x2 =9.769,P ＜ 0.05),rate of pregnancy termination (x2 =7.349,P ＜ 0.05) were all significantly higher in conservative therapy failure group than those in the conservative therapy success group.Multivariate analysis showed that gallbladder dilation,TBiL,body temperature ＞ 37.3 ℃,AST were the independent risk factors predicting invalid conservative management.Conclusion Gallbladder dilation,body temperature ＞ 37.3 ℃,high level of TBiL and AST are the early predictors for the invalid conservative management for ACC in pregnant women.
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Objective To compare the influence degree of laparoscopic operation and open operation on peripheral blood T lymphocyte subsets and Th1Th2 in patients with severe acute pancreatitis.Methods 54 patients who underwent surgical treatment in our hospital from February 2013 to December 2014 were selected as the subjects, 27 patients with severe acute pancreatitis who were treated with open operation as group A , 27 cases who were treated with laparoscopic operation at the same time were selected as group B , and then the peripheral blood T lymphocyte subsets and serum Th1Th2 indexes of two groups before the operation and at first,third and seventh day after the operation were respectively detected, then the detection results of two groups were compared.Results The peripheral blood T lymphocyte subsets and serum Th1Th2 indexes of group B at first, third and seventh day after the operation were all significantly better than those of group A , the difference was statistically significant ( P<0.05 ) , and the detection results of group A and group B at third day after the operation were worse than those at other time , the difference was statistically significant (P<0.05).Conclusion The influence of laparoscopic operation and open operation on T lymphocyte subsets and Th1Th2 in peripheral blood of patients with severe acute pancreatitis, the adverse effects of laparoscopic operation on the above indicators were relatively small.
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Objective To study the role of clinical nursing pathway (CNP)in health education for patients undergoing percutaneous nephrolithotomy (PCNL).Methods Ninety patients with PCNL were randomized into the observation group and the control group in equal number: the former received CNP health education and the latter routine health education while hospitalization. The two groups were compared in terms of scores on health education,satisfaction with nursing,incidence of postoperative extubation and hospital stay.Result The scores on health education,satisfaction with nursing and incidence of postoperative extubation in the observation group were all significantly higher than those of the control group (allP<0.05) and the hospital stay in the former was significantly shorter than that of the latter (P<0.05).Conclusions PCNL in use of CNP health education can promote patients’ health education quality,reduce their incidence of extubation,shorten their hospital stays and improve their satisfaction of nursing. It is worthy of clinical promotion and application.
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Objective To evaluate the TriVex system in the treatment of varicose veins of lower extremities,focusing on postoperative complications and management.Methods Clinical data of 108 patients (146 legs) of varicose veins of the lower extremity undergoing TriVex procedure were retrospectively analyzed.Deep veinons patency was verified in all patients by preoperative sonography.Above knee stripping of the great saphenous vein was done first when necessary.The below knee phlebectomy of the side branches was done with the new system (Trivex System/Smith and Nephew).Postoperative patients were followed-up,and results were evaluated.Results Procedure was successful in all cases.98 cases were followed up for 1 ～ 24 months.The mean operation time per leg was (34±8) minutes.Complications were as following:26 legs (17.8%) developed postoperative hematoma which was healed by conservative therapy including two cases in which the tension seroma,which was successfully managed by puncture aspiration.Transien skin numbness or paraesthesia developed in 13.0% (19/146).Subcutaneous induration in 11.6%(17/146) cases.Residual varicose and recurrence in 3.4% (5/146).Incision related complications developed in 4.8% (7/149) cases.Conclusion Transilluminated powered phlebectomy (TriVex) is a safe and effective cosmetic procedure for less invasive varicose vein surgery.
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Objective Baicalin reduces the severity of severe acute pancreatitis (SAP) in a rat model. This study was carried out to examine the effect of baicalin on TNF-α mRNA, caspase-3 and P-selectin protein expression in the pancreas of rats with SAP. Methods Rats with SAP were randomly assigned to untreated, baicalin-treated, octreotide-treated and sham-operated group. The TNF-α mRNA expression level, caspase-3 and P-selectin protein expression levels of pancreatic tissue were measured 3, 6 and 12 hours after operation. Results The caspase-3 protein expression level was significantly higher in the treated groups than that in the untreated group at 3 hours (p <0.01). P-selectin protein expression level in pancreas of the treated groups was significantly lower than that of the untreated group (p <0.05 or <0.01). TNF-α mRNA expression level in pancreas decreased in baicalintreated group while untreated group increased at different time points (p <0.05). Conclusion Baicalin increases caspase-3 expression and inhibits TNF-α mRNA and P-selectin protein expression in pancreatic tissue of SAP rats.