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OBJECTIVE@#To compare the parental acceptance of dental treatment under general anesthesia and deep sedation in children and assess the changes in postoperative oral health-related quality of life and treatment efficacy.@*METHODS@#The parents of 131 children undergoing dental treatment in the Department of Stomatology of Sichuan Provincial People's Hospital from January, 2022 to June, 2022 were surveyed using a questionnaire of children's advanced oral behavior management, and 83 children receiving general anesthesia or deep sedation for dental treatment between January, 2018 and December, 2021 were also investigated for changes in quality of life after the treatment using a questionnaire. The treatment efficacy was assessed at the 1-year follow-up visit in 149 children who received dental treatment under general anesthesia or deep sedation during the same period.@*RESULTS@#The survey of perantal acceptance showed that 62.6% of the parents preferred deep sedation, 29.01% preferred general anesthesia, and 8.4% preferred compulsory treatment. Dental treatments under general anesthesia and deep sedation both significantly improved oral health-related quality of life of the children. While dental surgeries under general anesthesia resulted in the most significant improvement of pain symptoms, deep sedation was associated with both obvious relief of the children's pain symptoms and reduction of the parents' pressure level. No significant difference was found in the efficacy of treatments under general anesthesia and deep sedation at the 1-year follow-up.@*CONCLUSION@#Dental treatment in children under deep sedation has the highest parental acceptance, followed by treatment under general anesthesia, and the acceptance of compulsory treatment is the lowest. The treatments under general anesthesia and deep sedation significantly improve the quality of life of the children and their parents and both have good treatment efficacy.
Subject(s)
Humans , Child , Quality of Life , Deep Sedation , Child Behavior , Treatment Outcome , Anesthesia, General , Parents , Pain , Dental Care , Dental CariesABSTRACT
Objective:To compare the effectiveness and safety of laparoscopic hepatectomy (LH) versus radiofrequency ablation (RFA) in treatment of hepatocellular carcinoma (HCC).Methods:The medical literatures on LH and RFA for HCC were searched in PubMed, Web of Science, Embase, VIP, Wanfang, CNKI and other electronic databases. The retrieval date was from database construction to June 7, 2021. According to the inclusion and exclusion criteria, studies were extracted by two authors, and Revman 5.3 software was used to conduct a meta-analysis to compare differences in operation time, blood loss, length of hospital stay, total complications, overall survival and disease-free survival outcomes between the LH group and the RFA group.Results:Of 3 690 patients who were included in 32 studies, there were 1 708 patients in the LH group and 1982 patients in the RFA group. Meta-analysis showed that compared with the LH group, the RFA group had significantly shorter surgical duration ( MD=-86.41, 95% CI: -116.21--56.60), less blood loss ( MD=-213.22, 95% CI: -273.43--153.00), shorter hospital stay ( MD=-3.23, 95% CI: -4.13--2.32), and lower incidence of complications ( OR=0.33, 95% CI: 0.26-0.43). However, local recurrence rate was significantly higher ( OR=1.83, 95% CI: 1.38-2.41). (All P<0.05). The 5-year survival rate of the LH group was significantly better than the RFA group ( OR=0.68, 95% CI: 0.51-0.90, P=0.008). Conclusion:LH provided better overall survival outcomes and lower local recurrence rates than RFA in HCC patients.
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Objective:To investigate the influencing factors and management strategies of colonoscopy-associated colorectal perforation.Methods:The retrospective case-control study was conducted. The clinical data of 358 patients who underwent colonoscopy in the Affiliated Hospital of Zunyi Medical University from January 2011 to March 2021 were collected. There were 216 males and 142 females, aged (59±14)years. Patients underwent colonoscopy for diagnosis or treatment. Observation indicators: (1) situations of colonoscopy-associated colorectal perforation; (2) analysis of influencing factors of colonoscopy-associated colorectal perforation; (3) construction of prediction model of colonoscop-associated colorectal perforation; (4) management of colonoscopy-associated colorectal perforation. Measurement data with normal distribution were represented as Mean± SD. Measurement data with skewed distribution were represented as M( Q1, Q3), and comparison between groups was analyzed using the Wilcoxom rank sum test. Count data were discribed as absolute numbers, and comparison between groups was analyzed using the chi-square test. Multivariate ana-lysis was conducted using the binary Logistic regression model. The sensitivity and specificity of the prediction model were evaluated by the receiver operating characteristic (ROC) curve. Results:(1) Situations of colonoscopy-associated colorectal perforation. Of the 358 patients, 18 cases developed colorectal perforation, including 6 males and 12 females, with an age of 61(49,69) years. Of the 18 patients, there were 12 cases with colon perforation, including 10 cases of sigmoid colon perfora-tion or rectosigmoid junction perforation, 1 case of transverse colon perforation and 1 case of descending colon perforation, 6 cases with rectal perforation. There were 11 cases with diagnostic perforation and 7 cases with therapeutic perforation. (2) Analysis of influencing factors of colonoscopy-associated colorectal perforation. Results of univariate analysis showed that gender, age, colorectal ulcer, colorectal diverticulum, colorectal tumor, history of abdominal surgery, type of colonoscopy and the experience of operating physician were related factors for colonoscopy-associated colorectal perforation ( χ2=5.77, Z=?3.24, χ2=37.99, 97.34, 37.99, 10.31, 8.07, 6.73, P<0.05). Results of multi-variate analysis showed that colorectal diverticulum and abdominal surgery history were indepen-dent risk factors for colonoscopy-associated colorectal perforation ( odds ratios=287.79, 6.74, 95% confidence intervals as 23.14?3 579.11, 1.19?38.27, P<0.05). Therapeutic colonoscopy was an independent protective factor for colonoscopy-associated colorectal perforation ( odds ratio=0.11, 95% confidence interval as 0.23?0.52, P<0.05). (3) Construction of prediction model of colonoscopy-associated colorectal perforation. With the colonoscopy-associated colorectal perforation as depen-dent variable, colorectal diverticulum, abdominal surgery history and therapeutic colonoscopy as independent variables, a prediction model of colonoscopy-associated colorectal perforation was constructed. The ROC of model showed that the sensitivity was 0.56, the specificity was 1.00, and the area under curve was 0.78 (95% confidence interval as 0.63?0.92, P<0.05). (4) Management of colonoscopy-associated colorectal perforation. Of the 18 cases with colonoscopy-associated colorectal perforation, 15 cases underwent laparoscopic perforation repair surgery immediately, 2 cases under-went endoscopic suture, and 1 case received conservative treatment. All the patients with perfora-tion were cured and discharged from hospital, without death due to colonoscopy-associated colorectal perforation. Conclusions:Colonoscopy-associated colorectal perforation is easy to occur at sigmoid colon or rectosigmoid junction. Colorectal diverticulum and abdominal surgery history are indepen-dent risk factors for colonoscopy-associated colorectal perforation. Therapeutic enteroscopy is an independent protective factor for colonoscopy-associated colorectal perforation. Laparoscopic repair of colon perforation has good effects for patients with colorectal perforation.
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The proportion of boardline resectable pancreatic cancer (BRPC) is relatively high in patients with pancreatic cancer. At present, the main therapeutic treatment of BRPC is surgical resection after neoadjuvant therapy. Therefore, the neoadjuvant therapy of BRPC has drawn more and more attention in recent years. Once making a breakthroug in the treatment plan, it can greatly improve the overall prognosis of patients with pancreatic cancer. In this study, the development process, specific programs, advantages and disadvantages of each plan and the current research progress of BRPC neoadjuvant therapy are discussed.
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Ampoule bottle is a small glass container for liquid medicine, with a capacity of 1-20 mL. It is often used to contain all kinds of liquid medicine for injection, vaccines, etc. Medical ampoules are related to all aspects of clinical work. In the process of operation, the opened ampoule bottle is often placed directly on the operating table. There are many shortcomings and deficiencies, for example, ampoules are easily to be overturned, causing environmental pollution, residual drug pollution, medical personnel exposure damage from their sharp ends, etc. For this reason, the medical staff from Northern Jiangsu People's Hospital designed a return box for ampoule bottle placement and obained a national utility model patent. The utility model has the advantages of being simple structured, convenient, safe and clean in the use process. The box can separate the opened ampoule bottles, reduce the waste of liquid medicine and drug pollution, effectively protect the ampoule bottle and avoid the injury of the medical staff. This new device is worth popularizing in clinical work.
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The scalpel is the most practical tool for surgeons. The traditional scalpel is a blade with a split handle, but the length of the blade cannot be adjusted, and it is easy to scratch medical staff. In order to solve the above problems, a retractable scalpel handle was designed by the medical staffs of department of general surgery, Affiliated Hospital of Yangzhou University (Clinical Teaching Hospital of Dalian Medical University), and obtained the National Utility Model Patent of China (ZL 2019 2 0203154.9). The telescopic scalpel adopted the design of rotary telescopic sleeve and threaded column handle to achieve the purpose of built-in blade. By rotating the handle at one end of the handle, the length of the surgical blade extending out of the sleeve could be adjusted according to the actual needs. The structure of the device is simple and easy to operate. The adjustable blade length could also achieve the purpose of accurate operation while effectively avoiding the injury of medical personnel during the operation.
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When the skin barrier is damaged, surgical dressings are often used to cover wounds, sustain skin barrier, protect the injured area, prevent bacterial infection, and promote wound healing. However, at present, traditional dressings will be come stiffing as it absorbs the exudates of wound and sometimes cause secondary injury to the wound during the application process, which aggravate the pain of patients without analgesic effect. For this reason, the medical staff from Northern Jiangsu People's Hospital designed a new antibacterial analgesic dressing that can reduce the pain and increase the antibacterial ability. The dressings provide a sterile, moist environment to facilitate wound healing. Meanwhile, this dressing has the advantages of low cost, safeness and effectiveness, which can reduce the frequency of dressing changes, the possibility of wound infection, the pain and the medical expenses, which is worthy of clinical promotion.
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Upper limb injury is a common disease in hand surgery. After surgery, it is necessary to raise the patient 's arm to reduce limb swelling and promote recovery. In clinic, clothes or pillows are usually placed under the arm to raise it, but in this way the arm cannot be fixed well and easily slide down, without ideal raising effect. Therefore, the upper limb raising pad for assisting the raising of the affected limb is specially designed. The device is composed of shell, mounting plate, strut, elastic band and spring. The position of the strut is adjusted by squeezing or lifting the spring, so as to change the inclination angle of the mounting plate and to adjust the raising height of the upper limb. After the height is determined, the affected limb is placed comfortably and then fixed with the elastic band. The device can freely adjust the raising height of the affected limb and effectively fix the affected limb to reduce its swelling, thus promoting recovery. This device is worthy to be clinically popularized and applied.
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The infection of blood-borne diseases in medical workers mainly caused by ampule bottles, injection needles, infusion needles, surgical blades and all kinds of medical sharp instruments. Standardize the usage of sharp collection box can effectively prevent sharp injury. However, it has been found some shortcomings in practice and the varieties are few and specifications are unitary. Therefore, the medical workers of general surgery department of Subei People's Hospital in Jiangsu Province designed a new type of sharp collection box, which is convenient to collect sharps and prevent stabs. It is safe and reliable. The product is a hard container, which composes of box body, funnel input port and collection box. The box body is used to hold sharps, and its upper part is a funnel-shaped sharps input port. In order to reduce the possibility of stab and recycle the dropped sharps, we designed a flanging around the funnel input port, which can prevent the sharps from falling. In addition, a transparent observation port is arranged at 3/4 of the sharps box volume, which can facilitate the timely disposure of sharps. Compared with the traditional sharps box, the new funnel sharps collection box can safely collect various medical sharps and reduce the stab probability and occupational exposure risk of medical personnel.
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Objective@#To explore the effect of reconstructing the finger extension function by using partial flexor digitorum profundus tendon transposition.@*Methods@#Twelve patients were treated by using the partial proximal end of the tendon core of flexor digitorum profundus tendon regionⅠand part of region Ⅱ to cut off to the base of the distal digital phalanx, and puncturing at the end of the phalanx with a 2.0 drill. The tendon strips were pierced to the back overlap sutured to the proximal end of the avulsion of the extensor tendon .@*Results@#In 3-18 month follow-up, the average follow-up duration was 10.6 months. According to Dargan function evaluation method, 12 cases were excellent and one case was poor.@*Conclusions@#The method of reconstructing the extensor tendon by partial flexor deep tendon is a reliable method for the treatment of Mallet finger.
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Gauze packing and drainage is a routine treatment for various types of fistula and sinus pressure ulcers. Because the external orifice of pressure ulcer or fistula is relatively small and the sinus deep, the conventional gauze packing has many drawbacks. Under the situation the operator is not skillful enough and no appropriate tools, it is necessary to pull the external orifice by tweezers to dilate the sinus and perform gauze packing and drainage, which brings great pain to patients, possibly leading to wound enlargement and delayed healing. At present, there is lack of auxiliary tools to improve gauze packing. Therefore, we developed and designed a gauze filler for packing and drainage of various kinds of fistula and sinus pressure ulcers, the device has the following advantages: good drainage effect, simple operation, low cost, safety and effectiveness. It not only improves the comfort of patients, reduces the number of dressing changes, reduce the number of dressing changes, shorten the hospitalization time and pay expense, but also reduces the burden of medical workers thus it is worthwhile to popularize and apply the newly designed gauze filler in clinical practice.