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BACKGROUND:Clinical limb ischemia-reperfusion with no reflow phenomenon after vascular injury repair seriously affects the prognosis of patients. Therapeutic effect of hyperbaric oxygen in myocardial ischemia reperfusion is exactly confirmed, but hyperbaric oxygen is rarely reported in the treatment of limb ischemia-reperfusion. OBJECTIVE:To detect the expression of vascular endothelial growth factor and intracellular adhesion molecule 1 and to investigate the effect of hyperbaric oxygen on the prognosis of limb ischemia-reperfusion with no reflow phenomenon. METHODS:By clinical screening, cases of main arterial injury of the limbs were selected and subjected to vascular repair for restoring limb blood supply. After surgery, al the cases were randomly divided into two groups (Combined treatment group and surgical group), 16 cases in each group. Combined treatment group was treated with hyperbaric oxygen combined with clinical anticoagulant, antiplatelet treatment;surgical group treated with only postoperative clinical treatment. Another 16 adult healthy volunteers were selected to receive hyperbaric oxygen as hyperbaric oxygen group. Expressions of vascular endothelial growth factor and intracellular adhesion molecule 1 were detected using enzyme-linked immunosorbent assay at 8, 72 hours and 7 days after surgery. RESULTS AND CONCLUSION:In the combined treatment and surgical groups, patients exhibited higher expressions of vascular endothelial growth factor and intracellular adhesion molecule 1 than those in the hyperbaric oxygen group (P treatment group than the surgical group (P<0.01). At 8 and 72 hours, the expression of intracellular adhesion molecule 1 was lower in the combined treatment group than the surgical group (P<0.05). These findings suggest that hyperbaric oxygen can induce high expression of vascular endothelial growth factor and inhibit intracellular adhesion molecule 1, which is crucial for improving growth of blood capil ary, formation of endothelial cells, reducing no reflow phenomenon.
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Objective To investigate the clinical value of transumbilical single-port laparoscopic colorectal operation.Methods The clinical data of 25 patients with benign or malignant carcinoma at the upper part of the colon or rectum who were admitted to the No.4 People's Hospital of Zigong from January 2010 to December 2012 were retrospectively analyzed,and the clinical experience of transumbilical single-port laparoscopic colorectal operation was summarized.Surgical procedure was selected according to the position and nature of the lesion.Patients were followed up via out-patient examination and phone call till March 2013.Results Partial colorectal resection was done on 14 patients,radical resection of right colon on 1 patient,radical resection of transverse colon on 1 patient,radical resection of left colon on 1 patient,radical resection of sigmoid colon on 2 patients and radical rectectomy on 6 patients.The operation was successfully carried out on 22 patients,2 patients received four-port laparoscopic colorectal operation,and 1 patient was converted to open surgery.The median length of the incision of single-port laparoscopic colorectal operation was 3.8 cm (range,3.5-4.5 cm),and the operation time was (192 ± 32) minutes.The intraoperative blood loss was (61 ± 21)mL,and the median diameter of the tumor was 2.7 cm (range,1.0-5.0 cm).The median number of lymph nodes dissected was 7 (range,3-22),the mean time of postoperative anal exhaust time was 2 days (range,1-5 days),and the mean time of postoperative hospital stay was 8 days (range,6-20 days).The incidence of postoperative complications was 8.0％ (2/25),including 1 patient with wound infection and 1 patient with anastomotic leakage.The circumferential resection margins of radically resected specimens were negative in 11 patients.Twenty-two patients who received transumbilical single-port laparoscopic colorectal resection were followed up,and the median time of follow-up was 12 months.Colorectal liver metastasis was detected on 1 patient at postoperative month 10,and the other patients survived without tumor recurrence or metastases.Conclusions Transumbilical singleport laparoscopic colorectal operation is safe,micro-traumatic and feasible,and it also has less complication and good cosmetic effect.
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OBJECTIVE@#To find out the clinical characteristics of Meniere's disease in flight aircrew and discuss relevant principles of clinical aviation medicine, in order to summarize experience in medical evaluation of aircrew.@*METHOD@#Collect the data of 35 cases that were diagnosed with Meniere's disease from 1966 to 2011 in our hospital and analyze the clinical characteristics, diagnosis and flight conclusion of them.@*RESULT@#Among the 35 cases, 34 patients complained of vertigo. 27 patients complained of tinnitus and 21 patients complained of hearing loss. (1) 18 cases manifested typical symptoms of Meniere's disease (paroxysmal vertigo, fluctuating neurosensory hearing loss, tinnitus and ear fullness); (2) 7 patients showed the symptoms of vertigo and tinnitus, not complaining of significant hearing loss (after inspection. 4 of them proved the low-frequency hearing loss); (3) 7 patients only manifested as vertigo; (4) 2 patients manifested as tinnitus and hearing loss. 1 patients manifested only hearing loss. On the basis of the diagnostic criteria of Meniere's disease formulated hy Committee on Hearing and Equilibrium of the American Academy of Otolaryngology-Head and Neck Surgery. 22 patients were diagnosed with definite Meniere's disease, 2 patients were diagnosed with probable Meniere's disease, 11 patients were diagnosed with possible Meniere's disease. For patients with definite Meniere's disease and probable Meniere's disease, the phases of the disease were: 11 cases of phase I, 7 case of phase II and 6 case of phase III. The flight conclusion of all the 35 patients was permanent grounding. The time from the attack of the disease to receiving the conclusion of permanent grounding fluctuated from three months to 11 years.@*CONCLUSION@#The diagnosis of Meniere's disease of flight aircrew must he cautious. For patients with atypical symptoms of Meniere's disease, the diagnosis should be made in the case of completely ruling out other possible diseases. Once be diagnosed, a patient should normally be flight unqualified. The flying waiver would he recommended only under exceptional circumstances. The criterion of waiver condition need to be further explored in the future.
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Adult , Humans , Male , Middle Aged , Aerospace Medicine , Methods , Meniere Disease , DiagnosisABSTRACT
Objective To evaluate the hearing function of pilots under physical examination for modification to equipment of high performance aircraft,using pure tone audiometry(PTA) and distortion product otoacoustic emission(DPOAE).Methods Analyzed were all the results of PTA and DPOAE of 75 pilots (150 ears) which accepted physical examination for modification to equipment of high performance aircraft in our department from March 2008 to February 2009.75 cases were divided into two groups according to their flight time.The difference between these two groups was studied.Results According to the Equipments of Physical Constitution for Flying Persons of Air force,PLA,all 75 pilots passed the ENT assessments as being qualified for flying.Of all 150 ears,abnormal DPOAEs were obviously higher than that of abnormal PTA tests.128 ears had normal PTA results.92 ears had normal DPOAE results.36 ears (27.6&) showed abnormal DPOAEs at one or more frequencies,especially at 1,3 and 4 kHz.22 ears had abnormal PTA results.20 ears had noticeable V or U shaped thresholds at 3 kHz and/or 4 kHz.The DPOAE amplitudes showed similar curves.The other two ears showed depressions at all frequencies,in both PTA and DPOAE tests.No statistically significant difference was found between the two groups in DPOAE.But statistical difference was found in DPOAE at 4 kHz compared with other frequencies.No statistically significant differences were found between the two groups in DPOAE amplitudes at 1,2,3 and 4 kHz.but at 6 and 8 kHz.Conclusion The application of DPOAE test helped find pilots who were on the early stage of noise-induced hearing loss.These pilots were the most important objects for us to follow up.