Development trend and new understanding of contemporary vitrectomy / 中华眼底病杂志

Vitrectomy is an important treatment for vitreoretinal diseases. After half a century of innovation and development, it has made a breakthrough from open type to micro-incision surgery. Minimally invasive vitrectomy has the advantages of wide indications and high cutting efficiency, which greatly improves the safety and efficacy of surgery, and minimizes the occurrence of trauma and complications during surgery. At present, with the development of surgical microscope system, ophthalmic microsurgery robot and other equipment, and the development and application of new artificial vitreous materials, vitrectomy is developing toward minimally invasive, accurate and intelligent development. The further development of vitrectomy innovative technology in the field of ophthalmology is hopeful in the future, so that clinicians can achieve the best surgical results with the minimum damage, and bring better light to patients.

Application of a 3D printed trabecular block cage in treatment of patients with basilar invagination and atlantoaxial dislocation / 中华创伤骨科杂志

Objective:To explore the short-term outcomes of a 3D printed trabecular block cage to assist posterior internal fixation for the treatment of patients with basilar invagination and atlantoaxial dislocation.Methods:Between June 2017 and February 2019, 12 patients with basilar invagination and atlantoaxial dislocation underwent atlantoaxial distraction and posterior internal fixation at Department of Orthopedics, The First Affiliated Hospital to Zhengzhou University. They were 5 males and 7 females, aged from 34 to 62 years (average, 45.6 years). 3D printed cages were inserted intraoperatively between the joints of the atlantoaxial lateral mass. The atlanto-dental interval interval (ADI), cervico-medullary angle (CMA) and distance from tip of the odontoid process to Chamberlain's line (DOCL) and the Japanese Orthopedic Association (JOA) scale were compared between preoperation and 12 months postoperation to observe the fusion of the joints of the atlantoaxial lateral mass.Results:Operation went on uneventfully in all the 12 patients. Operation time averaged 116.5 min (from 85 to 190 min), fluoroscopy frequency 9.4 times (from 6 to 21 times), and intraoperative bleeding 82.3 mL (from 50 to 210 mL). No such postoperative complications occurred as cerebrospinal leak, cerebral infarction, or breakage, displacement or loosening of implants. All patients were followed up for 18 to 42 months (mean, 26.3 months). Their preoperative JOA, ADI, CMA and DOCL [8.33±0.98, (8.66±1.64) mm, 119.63°±4.15° and (9.66±2.15) mm] were significantly improved to 14.17±1.03, (2.63±0.59) mm, 153.76°±7.88° and (2.07±0.69) mm ( P<0.05) at 12 months postoperation. Bony fusion was achieved in all the operative segments. Conclusion:In the treatment of patients with basilar invagination and atlantoaxial dislocation, a 3D-printed trabecular block cage can be used to assist posterior internal fixation to achieve satisfactory reduction and maintain the height of joint space, leading to satisfactory short-term outcomes.

Research progress of immune checkpoint inhibitor in the treatment of gastric cancer / 中华消化外科杂志

Recently,the immunological checkpoint inhibitors (ICIs) represented by programmed death-1/programmed cell death-ligand 1 antibody have shown dramatic efficacy in advanced gastric adenocarcinoma.Although the overall response rate is not high,great tumor regression and long-term control can be reported in particular population.More interestingly,efficacy and good tolerance are also documented in adjuvant or neoadjuvant treatments of lung cancer or other tumors.However,the rationality and feasibility of ICIs in perioperative treatments for locally advanced gastric cancer are not yet clear.This review will provide basic data for future clinical research and practice.

Contrast observation of optical coherence tomography angiography between neovascular age-related macular degeneration and myopic choroidal neovascularization before and after intravitreal anti-vascular endothelial growth factor treatment / 中华眼底病杂志

Objective To compare the features of OCT angiography (OCTA) between neovascular agerelated macular degeneration (nAMD) and myopic ehoroidal neovascularization (mCNV) patients before and after intravitreal anti-VEGF treatment.Methods A prospective cohort study.Twenty-nine patients (37 eyes) with nAMD (19 males and 10 females,aged 68.20±8.76) and 31 patients (34 eyes) with mCNV (9 males and 22 females,aged 43.10± 11.80,with the mean diopter of-9.71 ± 1.20 D) from Department of Ophthalmology,West China Hospital of Sichuan University during May and December 2017 were included in this study.Ranibizumab or Conbercept (0.5 mg/0.05 ml) was intravitreally injected in all eyes.The patients were follow-up for 3-6 months.The OCTA was conducted before treatment and 1 day,1 week,1 month and 3-6 months after treatment.In order to ensure that the scanning position was the same,the tracking mode was adopted for each scanning.According to the OCTA images,the lesion area,parafoveal superficial vessel density and perfusion area were measured and analyzed contrastively between nAMD and mCNV patients.Results The mean lesion area before and 1 month after treatment in nAMD patients were 0.38± 1.87 mum2 and 0.06±0.12 mm2,while in mCNV patients,those were 0.26± 1.06 mm2 and 0.03 ± 0.05 mm2,respectively.There were statistically significant differences (Z=4.181,4.475;P＜0.001) in CNV lesion area before and 1 month after treatment between nAMD and mCNV patients.Compared with those before treatment,the absolute change (Z=1.853,P=0.064) and the percentage changes (t=2.685,P=0.010) of CNV lesion area l month after treatment in nAMD and mCNV patients show a statistical meaning.There were significantly decreases in both parafoveal superficial vessel density (F=8.997,P=0.003) and perfusion area (F=7.887,P=0.015) 3 months after treatment in nAMD patients,while decreases in parafoveal superficial vessel density (F=11.142,P=0.004) and perfusion area (F=7.662,P=0.013) could be detected 1 day after treatment in mCNV patients,before rising 1 month after treatment.Conclusions There are significantly differences in lesion area before and after the treatment of intravitreal anti-VEGF between nAMD and mCNV patients by OCTA examination.Moreover,the changes of both parafoveal superficial vessel density and perfusion area after anti-VEGF treatment are statistically different in two groups.

Postoperative delirium prediction model for elderly patients undergoing orthopedic surgery / 中华创伤骨科杂志

Objective To establish a preliminary model which can effectively predict the risk for postoperative delirium (POD) in elderly orthopedic patients and verify its effectiveness.Methods This prospective study involved 2 cohorts.For an analysis cohort,the assessment data of 148 elderly orthopedic patients were collected who had been treated at Department of Orthopaedics,the First Affiliated Hospital of Zhengzhou University from June to October 2017.The relevant risk factors for POD (gender,age,BMI,schooling ＜ 9 years,history of smoking and alcohol drinking,concomitant diseases and perioperative factors) were screened after comparing POD and non-POD patients.All the risk factors were analyzed and a predictive model was established after valuation of independent risk factors.A predictive cohort of 66 patients was included according to the same inclusion and exclusion criteria as the analysis cohort out of the patients who had been treated at our hospital from November to December 2017.The 2 cohorts were scored by the predictive model to verify the validity of the model.Results A total of 18 risk factors were identified in this study.In the analysis cohort,age (P =0.006),schooling ＜ 9 years (P =0.043),cerebrovascular disease or mental illness (P =0.004),preoperative albumin (P =0.038) and intraoperative infusion of allogeneic blood (P =0.019) were risk factors for POD.Of them,age (P =0.037),schooling ＜ 9 years (P =0.003) and intraoperative infusion of allogeneic blood (P =0.042) were independent ones.In the predictive model,age ＞ 75 years was assigned 3 points,schooling ＜ 9 years 2 points and intraoperative infusion of allogeneic blood 5 points.The validity of the ROC curve was verified for the predictive model.According to the ROC curve,the analysis cohort had AUC =0.66 and the predictive cohort AUC =0.75,indicating a certain predictive value of the model.Conclusion Our predictive model can be used to effectively screen out those with a high risk for postoperative delirium from elderly orthopedic patients.

Secondary posterior internal fixation after transoral anterior atlantoaxial release under 3D operative microscopy for irreducible atlantoaxial dislocation / 中华创伤骨科杂志

Objective To explore the clinical efficacy of secondary posterior internal fixation after transoral anterior atlantoaxial release under 3D operative microscopy for treatment of irreducible atlantoaxial dislocation.Methods From January 2014 to May 2016,12 patients with irreducible atlantoaxial dislocation were treated with secondary posterior internal fixation after transoral anterior atlantoaxial release under 3D operative microscopy in our hospital.They were 7 males and 5 females,with an average age of 37.1 years (from 25 to 54 years).The efficacy was analyzed in terms of their visual analogue scale (VAS),Japanese Orthopaedic Association (JOA) scoring,improvement rate of neurological function,American Spinal Injury Association (ASIA) grading,atlas-dens interval (ADI),space available for the cord (SAC) and cervicomedullary angle (CMA) before and one year after operation.Results The patients were followed up for more than one year.All the atlantoaxial joints obtained anatomic reduction.Their preoperative values of VAS (5.73 ± 1.36 points),JOA score (9.03 ± 2.12 points),ADI (8.34 ± 1.12 mm),SAC (9.53 ± 0.69 mm) and CMA (121.23°±4.32°) were significantly improved one year after operation (1.21 ±0.63 points,14.32±2.51 points,2.83 ± 0.36 mm,14.23 ± 1.22 mm and 153.53° ± 9.25°, respectively) (P ＜0.05).The improvement rate of neurological function increased gradually with the postoperative time,reaching 94.14％ ±5.11％ one year after operation.The postoperative ASIA grading was significantly improved too one year after operation (P ＜ 0.05).Conclusion Secondary posterior internal fixation after transoral anterior atlantoaxial release under 3D operative microscopy may lead to fine clinical efficacy one year after operation for patients with irreducible atlantoaxial dislocation.

Clinical diagnosis and treatment for age-related macular degeneration: a brief analysis of the guidelines / 中国医师杂志

Age-related macular degeneration (AMD) is a common cause of blindness among people over 65 in developed countries.With the rapidity of population aging process,the prevalence of AMD will be further increased.The application of anti-vascular endothelial factor growth medicine in ophthalmology has made great progress in the therapeutic effect and prognosis of wet AMD.In this context,many countries and regions have successively formulated guidelines for the AMD clinical diagnosis and treatment,especially the United States,Europe and Australia.Through the analysis of AMD clinical guidelines of American Academy of Ophthalmology (AAO) in 2015,and by comparing it with AMD analysis and treatment guidelines of European Society of Retina Specialists (EURETINA) in 2014,this paper provides an accurate,effective and comprehensive diagnosis strategy and lays a foundation for providing AMD patients with quality diagnosis and treatment plans.

Value of clearance rate of sTREM-1c in assessing prognosis in patients with septic shock / 实用医学杂志

Objective To monitor the dynamic change of soluble myeloid cells trigger receptor 1 (sTREM-1)and the clearance rate of sTREM-1 (sTREM-1 c) in patients with sepsis shock and to explore its value in assessing the prognosis.Methods A total of 54 patients from January to December 2016 were divided into improved group and death group,sTREM-1 and sTREM-1c level at 1,5,7 and 9 d were monitored and the receiver-operating characteristic curve analysis was used to judge its value in prognosis.Results Comparison of baseline of APACHE Ⅱ score,PCT and age in 2 groups was statistically significant.After treatment,the sTREM-1 level declined,especially in improved group.Similarly,sTREM-1c in improved group at 5,7 and 9 d dropped more significantly than that in death group (P ＜ 0.05).At different time points,sTREM-1 7 topped the predictive value of AUC on the prognosis,followed by APACHE Ⅱ and sTREM-1 5,PCT,sTREM-1 9,sTREM-1c 9 and sTREM-1 1,and sTREM-1c 5 and sTREM-1c 7 were the minimum.Conclusion Effect of dynamic monitoring of sTREM-1 and sTREM-1c analysis in clinic is better than that of simply monitoring of sTREM-1.

Role of medical oncologists in multidisciplinary team treatment of malignant acute abdomen / 中华胃肠外科杂志

Acute abdomen in patients with malignant tumors is called malignant acute abdomen, often seen in the digestive system tumor or abdominal pelvic metastasis of the other primary tumors. Bleeding, perforation, gastrointestinal obstruction, biliary obstruction with infection, acute peritonitis are acute and severe, however, prevention is more important than treatment. For high-risk patients, even if acute abdomen does not occur when the disease is diagnosed, we should make precautions, including actively local treatment of local lymph nodes or primary lesions and careful choice of drugs. Malignant acute abdomen is mainly treated by surgical intervention. However, to seize the opportunity of anti-tumor treatment while actively treating acute abdomen requires multidisciplinary team (MDT), including co-management of diagnostic team, treatment team and support team. Most patients with malignant acute abdomen are in late stage, so the role of medical oncologists can not be ignored in the prevention, intervention and management of malignant acute abdomen. For patients with potentially resectable malignant acute abdomen who are suitable for neoadjuvant therapy and technically unresectable malignant acute abdomen, the opportunity for drug treatment should be sought first. For those presenting with obstruction, bleeding or perforation during radiotherapy or chemotherapy, we should carefully evaluate the response of previous antitumor treatment, the reason of acute abdomen and discuss the option of surgery. Some concomitant medications may also increase the risk of malignant acute abdomen. Here, we discuss the role of medical oncologists in the management of malignant acute abdomen in the MDT setting.

Effectiveness and safety of percutaneous vertebroplasty in the treatment of spinal metastatic tumor

Objective: To evaluate the effectiveness, safety and feasibility of percutaneous vertebroplasty in the treatment of spinal metastatic tumor

Methods: Thirty-four patients with spinal metastatic tumor who received treatment in the First Affiliated Hospital of Zhengzhou University from May 2014 to June 2015 were selected. Totally fifty diseased vertebrae were treated by percutaneous vertebroplasty. The curative effects were evaluated according to visual analogue scale [VAS] score, Oswestry Dability Index [ODI] and dose of pain reliever. The leakage conditions of bone cement and clinical complications were observed. The patients were followed up for 3 to 12 months

Results: The average VAS score and ODI 24 h after treatment were much lower than those before treatment, and the difference had statistical significance [P<0.05]. The average VAS score and ODI at different follow up periods after treatment were not significantly different [P>0.05]. During follow up, nine patients stopped taking pain reliever, the dose of 18 patients had obvious reduction, and 7 patients kept previous dose; the incidence of bone cement leakage was 38.25%. Six patients had fever after surgery, but recovered after expectant treatment; 2 patients felt uncomfortable in the right lower limbs, but relieved after expectant treatment

Conclusion: Percutaneous vertebroplasty can relieve pain efficiently, improve the daily living ability, and significantly enhance the living quality of patients with spinal metastatic tumors, with small trauma and high safety

Evaluation value of blood lactic acid dynamic monitoring and APACHE Ⅱ score in prognosis of sepsis / 重庆医学

Objective To investigate the evaluation value of blood lactic acid dynamic monitoring and APACHE Ⅱ score in trhe prognosis of sepsis.Methods The blood lactic acid level,lactic acid clearance rate,shock and MODS occurrence rate and mortality in 76 patients with sepsis in ICU of our hospital from January to October 2015 were statistically analyzed.Various indexes and prognosis were performed the multi-variable Logistic regression analysis.Results The APACHEⅡ scores,shock and MODS occurrence rate and mortality in the lactic acid elevation group were higher than those in the lactic acid normal group,the difference was statistically significant(P0.05);in grouping according to 6 h lactic acid clearance rate,except APACHEⅡscore,the other observation indexes in the high clearance rate group were significantly lower than those in the low clearance rate group,the difference was statistically significant (P<0.05).The lactic acid level at admission,lactic acid peak value,6 h lactic acid clearance rate and APACHEⅡscore in the survival group were significantly better than those in the death group,the difference was statistically significant(P<0.05).In 3 groups according to APACHEⅡ score,the lactic acid peak value,shock,MODS occurrence rate and mortality rate had statistically significant differences among 3 groups (P<0.05).The lactic acid level at admission,6 h lactic acid clearance rate and APACHEⅡscore were the independent risk factors in the patients with sepsis.Conclusion The lactic acid level at admission,6 h lactic acid clearance rate and APACHEⅡ score were the independent risk factors in the patients with sepsis.

PCT and sTREM-1 combined with APACHE Ⅱ score for assessing diagnosis of sepsis and prognostic value / 实用医学杂志

Objective PCT and sTREM-1 combined with APACHE Ⅱ score for assessing diagnosis of sepsis and prognostic value.Methods The clinical data for related patients who had hospitalized between January and October 2015 were collected by prospective study methods.According to China guidelines for treatment of severe sepsis/septic shock (2014).The patients were divided into SIRS group,sepsis group,severe sepsis group,septic shock group,and control group.Results Levels of CRP and sTREM-1 were significantly higher in total sepsis group and subgroups than in SIRS group and control group,with a statistical difference (P ＜ 0.05);but there were no significant differences among he subgroups.Lactic acid level differed statistically between both total sepsis group and its subgroups and both control group and SIRS group,so did level of lactic acid between the other groups and septic shock group (P ＜ 0.05).PCT was significantly higher in total sepsis group and its subgroups than in the control group and SIRS group,so did it in septic shock and severe sepsis group than in sepsis group.PCT level was significantly higher in septic shock than in severe sepsis (P ＜ 0.05).APACHE Ⅱ scores were markedly in total sepsis group and its subgroups than in SIRS group and the control group;and it differed statistically between septic shock group and sepsis group (P ＜ 0.05).According to the ROC curve analysis,the area under the curve was 0.935,0.877,0.816,and 0.856 for PCT,sTREM-1,APACHE Ⅱ,CRP,and lactic acid,respectively.Conclusions Detection of serum PCT and sTREM-1 combined with APACHE Ⅱ score can be used to assess diagnosis of sepsis and prognostic value,which has more benefit to the diagnosis and treatment of sepsis.

Bioremediation of oil-contaminated field by two Pseudomonas aeruginosa strains / 生物工程学报

We studied the remediation of petroleum-contaminated soils. Two Pseudomonas aeruginosa strains were screened from soil samples in the mine environment. The degradation rate of crude oil was 95.67% after 10 days by mixed culture of the two strains, which was 32% higher than that of single bacterium. It means that the two bacteria had synergistic effect on degrading crude oil. Based on the result, bacterial agent was prepared, and the oil pollution sites were artificially constructed to simulate the degradation of crude oil under different operating conditions. During the experiment, the petroleum hydrocarbon content of the sites after treating with the bacterial agent, decreased obviously in 60 days. The content decreased to among 0.1% and 0.3% from the initial 0.8% per gram of soil. Then, the site with organic manure as supplemental source of carbon and nitrogen had the highest degradation rate of 85.28%, compared to that without adding bacterial agent of only 25.85%.

Clinical value of inflammatory factors in sepsis / 实用医学杂志

Objective To study the clinical value of sTREM-1, PCT, CRP in sepsis. Methods A prospective study was conducted and clinical data of related patients from January to October 2015 were collected. Thirty-nine cases of sepsis patients , 15 patients with SIRS and 12 normal controls were detected by ELISA then the prognostic value of sTREM-1, PCT, CRP was determined in sepsis. Results In sepsis and SIRS group, sTREM-1 and PCT level were significantly higher than those in control group (P < 0.05); CRP only in sepsis group and control group was statistically significant (P < 0.05). In sepsis group, sTREM-1,PCT and CRP were significantly higher than those in SIRS group (P < 0.05). The ROC curve analysis indicated that sTREM-1,PCT and CRP for SIRS and non SIRS area under the curve was 0.914,0.887 and 0.831 respectively. Conclusion sTREM-1 is a good indicator for early diagnosis of sepsis, and it has high sensitivity and specificity.

The preoperative assessment of tumor size in breast ductal carcinomain situ:a comparative study between mammography and ultrasonography / 实用放射学杂志

Objective To compare the accuracy of mammography and ultrasonography in evaluating the tumor size of breast ductal carcinoma in situ before operation.Methods Eighty-seven patients with breast ductal carcinoma in situ confirmed by surgery pathology were retrospectively analyzed.All of the mammography and ultrasonography data were well-documented.The maximum diameter of the tumor was measured by mammography,ultrasonography and pathology,respectively.It was considered concordant if the difference between the imaging size and pathologic size was less than 0.5 cm.Pearson correlation analysis was used to determine the relation of imaging size with pathologic size.Results The range of the maximum diameter of the tumors measured by pathology,mammography and ultrasonography was 0.4-7.0 cm,0.8-6.9 cm and 0.5-4.8 cm,respectively.The mean value was (2.4±1.3)cm,(2.6±1.2)cm and (2.3±1.0)cm,respectively.The coefficient correlation between mammographic and pathologic size was 0.724,and between ultra-sonographic and pathologic size was 0.532.Conclusion Mammography is more accurate than ultrasonography in size assessment of breast ductal carcinoma in situ.

Efficacy analysis of short segmental screw fixation on the decayed vertebral of thoracolumbar tuberculosis / 中华骨科杂志

Objective To explore the effectiveness of short segmental screw fixation and bone graft fusion on the decayed vertebral of thoracolumbar tuberculosis.Methods A total of 46 cases undergone one stage anterior debridement,interbody fusion,screw fixation on the decayed vertebral of thoracolumbar tuberculosis were retrospectively analyzed from June 2009 to November 2013.Including 25 males and 21 females,with the mean age of 39.6 years (range,13-69 years).Lesion segments:T6-L4 (segment lesions ≤ 3 segments); 3 B gradecases,6 C grade cases,4 D grade cases and 33 E grade cases assessmed by Frankel grade.The average Cobb angle of kyphosis was 16.34°±3.19° and ESR:19-81 mm/1 h preopration.CT scan and Two-dimensional reconstruction were done before operation,and the effective height of front and middle pillar of residual thoracolumbar vertebral in coronal and sagittal position were measured before operation,when the minimum effective height was higher than 10 mm,combined the intraoperative visual,the appropriate internal fixation for anterior debridement and interbody bone grafting were choosed.The cobb angle,the Frankel grade,the ESR and VAS value were compared with preoperative and postoperative.The stability and bone graft fusion were also observed.Results Fourty-six cases of patients were received followed up from 12 to 48 months,an average of 26 months.All patients with tuberculosis poisoning symptoms disappeared.The ESR:0-15 mm/1 h.Frankel rating at the end of postoperative follow-up:2 D-class cases,44 E-class cases.The VAS score (6.85± 1.22,4.49±0.95 vs.2.06±0.93) and vertebral Cobb angle (16.34°±3.19°,4.16°±2.71° vs.4.52°±1.29°) at post-operation 7 d and the last follow-up were significant lower than those at pre-operation,while the ESR (41.25±1.61 mm/1 h,17.36±6.82 mm/1 h vs.10.67±0.72 mm/1 h) was reduced to normal levelthan that of pre-operation.The comparative difference was statistically significant between pre-operative and post-operative.The fusion rate at the end of post-operative follow-up:44 excellent cases,2 good cases.Conclusion When the effective height of front and middle pillar of residual thoracolumbar vertebral in coronal and sagittal position in vertebral tuberculosis was higherthan 10mm,reliable stability and treatment efficiency were achieved with anteriorinternal fixation.

Oncocytic papilloma in nasal cavity and paranasal sinuses: 3 of cases / 临床耳鼻咽喉头颈外科杂志

Oncocytic papilloma (OP) of nasal cavity and paranasal sinuses are uncommon. We report 3 cases of oncocytic papilloma arising in the nasal cavity and paranasal sinuses, and review the relevant literatures. Unilateral sinonasal lesions are the main clinical manifestation. Pathological feature is multiple layers of epithelial cells. The cytoplasm contains abundant eosinophilic granular and microcapsules filling with mucus. The neutrophils aggregate in the microcapsules which form microabscess. The tendence of recurrence and malignant transformation are the biological character. The best treatment choice is surgical excision completely, and long-term postoperative follow-up is necessary to prevent relapse.

A double-blind RCT of the hemostatic effects of local packing of Nasopore combined with hemocoagulase injection for postoperative management of FESS / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To compare the hemostatic effects of local packing of Nasopore combined with hemocoagulase injection and local packing of Nasopore combined with saline injection for postoperative management of functional endoscopic sinus surgery by a double-blind, randomized control clinical trial.@*METHOD@#Sixty-eight cases of chronic sinusitis needed functional endoscopic sinus surgery were randomly divided into the experimental group of 40 cases and control group of 28 cases, respectively. For the experimental group, 1 U of hemocoagulase dissolved in 0.5 ml saline was injected into Nasopore which was packed into the nasal cavity after operation. For the control group, 0.5 ml of saline was injected. The postoperative bleeding of the two groups were scored by visual analogue scale.@*RESULT@#There was statistically significant difference between the bleeding VAS scores assessed 6 hours and the ones assessed 1, 2 and 3 days after the operation in the control group (P < 0.05). There was the statistically significant difference between the bleeding VAS scores of experimental group and control group assessed 6 h after the operation (P < 0.05).@*CONCLUSION@#The hemocoagulase may improve the hemostatic effect of Nasopore 6 hours after the operation by combined injection with Nasopore as nasal cavity packing.

The study of the changes of QT dispersion and heart rate variability in children with ventricular contraction / 实用医学杂志

Objective To investigate the changes of QT dispersion and heart rate variability in children with ventricular contraction. Methods 50 healthy children who came for medical examinations at Chengdu Women′s and Children′s Central Hospital from January 2012 to January 2014 were selected as control group. 147 children with ventricular contraction admitted in Pediatric Intracardiac Department of Chengdu Women′s and Children′s Central Hospital from January 2012 to January 2014 were divided them into Benign Group (LownⅠ&LownⅡ) and Malignant Group(LownⅢ, LownⅣA, LownⅣB&LownⅤ) according to the results of Lown classification. Benign Group contained 90 cases while Malignant Group contained 57 cases. Difference in QT dispersion and indices of heart rate variability of the three groups were compared. Results There were no statistically differences between control group and benign group in QT dispersion (P > 0.05). QT dispersion of malignant group was much longer than that of control group and the differences had statistically meaning(P50 ms) of malignant group was much shorter than that of control group and benign group and the differences had statistically meaning (P< 0.01). SDNN, SDANN and SDNN index of benign group was shorter than that of control group and the differences had statistically meaning (P<0.05). Conclusions Heart rate variability of children with malignant ventricular contraction becomes significantly shorter and QT dispersion becomes significantly longer. Detection of QT dispersion and heart rate variability can effectively predict the risky degree of ventricular contraction in children.

Occipitocervical fusion angle and lower cervical spine degeneration in patients with craniocervical junction malformation / 中国组织工程研究

BACKGROUND:Occipitocervical fusion is a major method for malformation of craniocervical junction. In patients without osteoporosis, the degeneration of cervical vertebra mainly presents in the intervertebral disk. The height of the vertebral body is constant basical y. Thus, the ratio (S value) of the height of cervical disc and the height of cervical vertebra can be used to measure the degeneration of cervical vertebra. The smal S value indicates severe degeneration of cervical vertebra. OBJECTIVE:To measure the lateral radiograph of cervical vertebra in patients with craniocervical malformation undergoing occipitocervical fusion, to analyze the relationship between occipitocervical fixed angle during fusion and lower cervical spine degeneration after fusion, and to identify an optimal angle of occipitocervical fusion. METHODS:A total of 21 patients with craniocervical malformation undergoing occipitocervical fusion were included. According to the occipitocervical angle (0c-C2 angle) immediately after fusion, the patients with craniocervical malformation undergoing occipitocervical fusion were assigned to three groups:occipitocervical angle 9°-22° group, occipitocervical angle22° group. Immediate postoperative 0c-C2 angle in 9°-22° belonged to the normal angle range. S value and JOA score in each group were measured before and after fusion, during final fol ow-up. The statistics were compared. RESULTS AND CONCLUSION:JOA scores in the occipitocervical angle 9°-22° group, occipitocervical angle22° group, were respectively, (7.3±1.7) points, (7.2±1.6) points, and (7.3±1.5) points, before fusion, and (14.2±1.5) points, (13.5±1.6) points and (13.3±1.5) points after fusion. JOA scores were improved significantly in the three groups. JOA improvement was significantly better in the occipitocervical angle 9°-22° group than that in the occipitocervical angle22° groups. Preoperative S values were respectively 0.440±0.017, 0.441±0.016, and 0.440±0.018 in the occipitocervical angle 9°-22° group, occipitocervical angle22° group, and no significant difference was detected among the three groups. No significant difference in S value was detectable in the occipitocervical angle 9°-22° group between postoperative final fol ow-up and pre-operation. The S value was significantly smal er at postoperative final fol ow-up than pre-operation in the occipitocervical angle22° groups. These results indicated that during occipitocervical fusion, occipitocervical angle should try to be normal, more than or less than normal range wil accelerate the degeneration of lower cervical spine.