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Objective To investigate the effect of pulmonary surfactant on neonatal with acute respiratory distress syndrome.Methods98 cases with neonatal respiratory distress syndrome inthe fourth hospital of Ningbo were randomly divided into experimental group and control group, 49 cases in each group.All patients were given warm, anti infection, and maintain the internal environment stability, prevention of bleeding and other conventional treatment.The control group were treated with mechanical CPAP, the experimental group were given pulmonary surfactant 70mg/kg, concentration is 35mg/mL.Pulmonary surfactant was injected slowly by tracheal intubation at supine, lateral(left, right) and semi recumbent position.The drug was distributed evenly in the lung of the patients who were given the drug 1-2 times.Respiratory frequency (RR), pH, oxygen partial pressure (PaO2), partial pressure of carbon dioxide (PaCO2) levels and the incidence of complications, clinical effective rate of the tthe two groups were observed and compared.ResultsCompared with pre-treatment, RR and PaCO2 levels were decreased, pH and PaO2 levels were increased after treatment in the two groups, the differences were statistically significant (P<0.05);compared with the control group, RR, PaCO2 level were lower, pH and PaO2 levels were higher in the experimental group, the differences has statistical significance (P<0.05);compared with the control group, the experimental groupwith a low incidence of complications, clinical effective rate is higher, the difference was statistically significant (P<0.05).ConclusionPulmonary surfactant can reduce the respiratory frequency in neonatal with acute respiratory distress syndrome, improve arterial blood gas levels, which get better clinical curative effect.
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BACKGROUND:At present, percutaneous vertebroplasty has been widely used in clinical treatment of osteoporotic vertebral fractures. Considering the limitations of the underlying disease in elderly patients (> 65 years of age) at surgery, the relevant detailed studies have gradualy attracted the attention of clinicians. OBJECTIVE:To compare and analyze the clinical effects of vertebroplasty with bone cement and conventional fracture reduction for elderly osteoporotic thoracolumbar fractures. METHODS:Totaly 24 elderly patients with osteoporotic thoracolumbar fractures were voluntarily divided into bone cement treatment and conservative treatment groups (n=12 per group) and subjected to vertebroplasty with polymethylmethacrylate bone cement and conventional reduction therapy, respectively. RESULTS AND CONCLUSION:Compared with the conservative treatment group, the visual analog scale scores, Oswesty dysfunction index and Cobb angle were significantly reduced in the bone cement treatment group, while the degree of anterior vertebral compression was increased. These results suggest that minimaly invasive spine treatment is conducive to improve the fracture healing and enhance the quality of life in elderly patients with osteoporotic vertebral compression fractures in stable conditions.
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Objective To study the effect of MRCP for operation difficulty assessment before laparoscopic cholecystectomy. Methods 110 patients with gallbladder stone were randomly selected from March 2011 to July 2012 in our hospital,and all the patients were given LC operation after examined by MRCP. Regarded the average operation time 30 min as a criterion,when the operation time was no more than 30 min,the operation was considered as normal operation;when the operation time was more than 30 min, the operation was considered as op-eration of a certain degree of difficulty. Made a correlation analysis between LC operation difficulty and age,gender,location,volume of gall-bladder,angle of ductus cysticus, thickness of gallbladder wall, circumstances surrounding the cystic duct, length of ductus cysticus, and whether there were calculus in the cervical part of gallbladder. Results The difficulty level of LC operation is related to length of ductus cys-ticus and whether there were calculus in the cervical part of gallbladder,and there is no correlation with age,gender,location,volume of gall-bladder,angle of ductus cysticus,thickness of gallbladder wall,circumstances surrounding the cystic duct. Conclusion Routinely MRCP test in preoperative patients is of important significance to the prediction of LC operation difficulty.
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Objective To investigate the clinical diagnosis and treatment of blunt abdominal trauma(BAT).Methods The clinical data of 64 patients with BAT were retrospectively analyzed.Results 49 patients treated by surgery were cured and 12 cases treated by non-surgery were cured.3 patients died,two of them died for multi-organ dysfunction and one of them died for brain trauma.Conclusion Because the BAT is severe and complicate,so it shoald be diagnosed and treated as soon so possible.
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Objective To evaluate the clinical applications and surgical methods of combined laparoscopic common bile duct (CBD) exploration with choledochoscopy. Methods From 2006 to 2009,clinical data of 42 patients with choledocholithiasis undergoing laparoscopic common bile duct exploration were retrospectively analyzed. We applied a step-by-step electric coagulating incision technique on the CBD,the step-by-step suturing technique, and the step-by-step clamping technique with alligator forceps, and soft tube irrigating technique with suctioning by selecting the proper exploration route, improving the common bile duct incision technique and calculus removing techniques. Results Procedures were successful in all the cases. There was no conversions to open surgery, no postoperative bleeding and no operative mortality. The mean operating time was 120 minutes (ranging, 90 to 150 minutes) with minimal intraoperative blood loss ( ranging, 20 to 40 ml). Ductal stone clearance was successful in 41 out of 42 patients ( 93% ). The largest number of the common bile duct stones was 16. With the diameter of stones larger than 15 mm in 18 cases in which the biggest was 30 mm. Bile leak developed in 1 patient, retained stones found in 3 patients,including intrahepatic cholelithiasis in one case. As a result, 38 out of 42 patients underwent common bile duct exploration. 35 patients were placed on T-tubes. Four patients underwent cystic duct exploration in which 3 had primary suture of the cystic duct and 1 had drainage. There was no infection and stenosis of biliary tract in the 42 followed-up cases. Conclusions Laparoscopic common bile duct exploration with stone extraction can be performed with high efficiency, minimal morbidity and without mortality. Improving the way of operation and selecting suitable exploration can result in better clinical outcomes.
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Objective To explore the correlation between serum concentrations of apolipoprotein (Apo) AV and adiponecfin in patients with coronary heart disease (CHD). Method The levels of serum total cholesterol (TC), triglyceride (TG), high-density lipoprotein-cholesterol (HDL-C), low-density lipoprotein-cholesterol (LDL-C) , ApoA I and ApoB were examined in 99 subjects by biochemistry department. Enzyme-linked immunosorbent assay (ELISA) method was used to determine ApoA V and adiponectin. All subjects were divided into CHD group(59 patients) and control group(40 patients). Results The concentration of TG was significantly higher than that in control group [(1.79±1.28) mmol/L vs (1.27±0.79) mmol/L]. The concentrations of HDL-C, ApoA V and adiponectin in CHD group were signifi-cantly lower than those in control group[(1.17±0.25) mmol/L vs (1.29±0.26) mmol/L, (186.71±78.20) μg/L vs (250.29±110.38)μg/L, and (3.81±0.15)mg/L vs (5.33±0.37) mg/L,P<0.05or <0.01]. Serum ApoA V was negatively correlated with TG (r =-0.208, P = 0.040), but positively correlated with HDL-C (r = 0.241, P= 0.016) and adiponectin (r = 0.238, P= 0.018). Conclusions The patients with CHD have decreased serum levels of ApoA V and adiponectin, but increased levels of TG. ApoA V and adiponectin influence the development of CHD.
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Objective To discuss method,operative characters and curative effect of total hip arthroplasty(THA)in treatment of acetabular fractures combined with ipsilateral femoral head or neck fractures.Methods One stage THA was done in seven patients with acetabular fractures combined with ipsilateral femoral head fracture(one patient)or femoral neck fractures(six patients)7-21 days after fractures.There were five males and two females,at age range of 41-65 years(average 50 years).According to AO classification,there were one patient with type A fracture,three with type B and three with type C.Of all,five patients received biological acetabular replacement after reduction and internal fixation of acetabular fracture and two received PMMA acetabular replacement with metal enforcement ring.All patients received biological femoral stem.Results Of all,six patients were followed up for from 2 years and 3 months to 6 years and 5 months(mean 3 years and 9 months),which showed heterotopic ossitlcation in one patient and dislocation in one who recovered after manipulative reduction.The Harris score was increased from mean prooperative 48 points to mean postoperative 91 points.X-ray found no loosening of prosthesis during follow-up.Conclusions THA can improve function of hip joint significantly,avoid further operation and lessen the burden of patients mentally and economically and hence is effective in treatment of acetabular fracture combined with ipsilateral femoral head or neck fractures.
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Objective To investigate the application of the Doppler echocardiography on the clinical value on the left ventricular myocardial remodel and dysfunction in neonates with hypoxia-induced pulmonary artery hypertension. Methods The Doppler echocardiography (ECHO) datas of 24 neonates of pulmonary diseases with secondary pulmonary artery hypertension were identified by color Doppler echocardiography,and compared with 14 neonates with pulmonary diseases without pulmonary artery hypertension. Results Pulmonary artery systolic pressrure (PASP) (38.23?3.26) mm Hg increased ,the diameter of right ventricular(11.92?2.18)mm vs (7.34?0.93) mm and pulmonary artery(10.20?1.21)mm vs (6.89?0.22) mm and diameter of left ventricular end-diastolic(19.74?0.71)mm vs (14.42?0.32) mm in PAH groups increased significantly ( P 0.05). There was positive correlation between the increased pulmonary artery pressure in pulmonary artery hypertension groups and the AV/EV of the mitral value orifice blood stream ( r=0.4126,P
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Purpose:By ascessing the CT guided percutaneaus biopsy to improve clinical diag- nostic rate and reduce complications.Materials and methods:60 cases of biopsy with complete materials have been reviewed,and the methods of“retain anesthetic tracing needle”has been proposed-to obtain tissues for cytologic and histologic exams with different biopsy needles.Results:Successful rate of the puncfure 100%.39 cases were identified as lung cancer,8 cases as tuberculosis,7 cases as pneumonia. Successful biopsy was 90%.Conclusion:“Retain anesthetic tracing needle”could reduce the times of adjusting direction,improve the one-time successful rate and possess the characteristics of positioning safe,reliable and accurate diagnosis.