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Objective To evaluate the significance of clinical grading methods in acute pulmonary embolism (APE). Methods Clinical data of 259 patients suspected APE were retrospectively analyzed. The clinical probability was classified into low, intermediate and high grade by the Geneva score, the Wells score and the SYSU score. The result was contrasted with gold standard. Results Through the three, methods, pa-tients were classified into low pmbability (43.9%-52.5%), intermediate probability (38.0%-42.1%) and high probability (9.5%-14.0%), and the actual frequencies of APE in each category were 6.2%-14.4% in low probability, 65.9%-76.2% in intermediate probability, 88.5%-90.5% in high probability. The SYSU score had the lowest rate of missed diagnosis in low probability (P<0.05 ).The Geneva score was the most accurate in predicting the intermediate probability (P<0.05). But in high probahility, three prediction rules had no significant difference (P>0.05). Combined with D--dimer test, the rote of missed diagnosis in low probability can be lowered. Conclusions The clinical grading methods can predict the clinical probability of APE. It exists similar accuracy, but has different scope of application. Clinical doctor should choose the ap-propriate grading methods in different patients.
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Objective To investigate the effect of preoperative administration of Dextromethorphan (DM) on cough reflex of patients during tracheal extubation under general anesthesia after obstructive sleep apnea syndrome (OSAS) operation. Methods Forty ASA Ⅰ-Ⅱ adult patients scheduled for uvulopalatopharyngoplasty (UPPP) under general anesthesia were randomly divided into control group and DM group (n=20 in each group). Patients in DM group received 0.3 mg/kg DM and control group took 5 ml normal saline preoperatively. Cough reflex of patients and adverse effects were recorded during tracheal extubation. Results Cough reflex during tracheal extubation was remarkably suppressed in DM group as compared with control group (P
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AIM: To evaluate the protective effect of rapid phase of ischemic preconditioning against spinal cord ischemic injury in rabbits. METHODS: Thirty six male New Zealands white rabbits were randomly assigned to 3 groups (12 in each group): ischemia and reperfusion injury group (IR group), ischemic preconditioning + IR group (IPC+IR group) and sham operation group (sham). In IR group, spinal cord ischemia was induced by an infrarenal aorta clamping for 20 min; The rabbits in IPC+IR group underwent a 6 min ischemic preconditioning followed by 30 min of reperfusion before the 20 min clamping; The rabbits in sham group underwent the same procedures as the IR group except for infrarental aortic unclamping. Neurologic status was scored at 8, 12, 24 and 48 h after reperfusion. All animals were sacrificed at 48 h after reperfusion and the spinal cords (L_(5-7)) were removed for histopathologic study and determination of the activity of Na~+, K~+-ATPase. RESULTS: The neurologic function scores in sham group and IPC+IR group at each observation interval were higher than those in IR group (P
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Objective To observe the influences of different analgesic methods on blood sugar, stress hormones and cytokinesMethods According to different postoperative analgesic methods, 30 patients immediately after elective cholecystectomy, were randomly divided into four groups: normal saline was infused epidurally in group C as control; analgesia via epidural infusion of morphine 2 mg in group EM; patient-controlled analgesia via epidural or intravenous fentanyl in group PCEFA or group PCIFABlood sugar, cortisol, insulin, interlukin-2 (IL-2), interlukin-6 (IL-6) and tumor necrosis factor-?(TNF-?) levels were determined during the perioperative periodResults Postoperative visual analog score was higher in group C than that in group EM, group PCEFA or group PCIFA (P005)Conclusions Postoperative application of PCEFA can much more help to maintain the stability of neuroimmunoendocrinal system
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10mm, the PLG lie in the neck of gallbladder.(3)PLG complicated with clinical symptoms.(4)The PLG diameter increases or complicated with stones.But surgical treatment should be prudent for non-neoplasm PLG, especially cholesterol polys.
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OBJECTIVE:To evaluate the clinical effects of urapidil on cardiovascular response induced by sympathetic stimulation during front approach cervical vertebra operation.METHODS:One hundred and twenty patients undergoing front approach cervical vertebra operation were randomly divided into three groups.Patients in URA group treated with0.5mg/kg urapidil and patients in NIC group treated with5?g/kg nicardipine when systolic blood pressure(SBP)and heart rate(HR)increased by sympathetic nerve stimulation during the operation.And patients in COM group only increased their anesthesia degree with isoflurane at the same situation.The patients’SBP and HR were observed and compared among three groups at the time before the sympathetic nerve stimulation,and5minutes and10minutes after the drugs treatment respective?ly.RESULTS:The patients’SBP and HR in URA group had no significantly increase after administration of urapidil.In NIC group,although the patients’SBP had no significantly increase,the patients’HR increased significantly after nicardipine was used.But the patients’SBP and HR increased significantly after improved anesthesia degree with isoflurane.CONCLUSION:Urapidil has better effect on sympathetic cardiovascular response during the front approach cervical vertebra operation com?pared with nicardipine.
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700 mL/min).Conclusion The CLh-s could be correlated with operation complications,and be considered as an effective supplement to evaluate hepatic functional reserve when combined with ICGR15 and Child-Pugh classification. It could be used to evaluate liver functional reserve more effectively and reliably.