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Objective:To investigate the long-term efficacy and the adverse reactions of uterine artery embolization with polyvinyl alcohol granules in the treatment of adenomyosis.Methods:Sixty patients with adenomyosis who received treatment in The Second People's Hospital of Qinzhou from January 2009 to February 2017 were retrospectively included in this study. They were divided into an observation group ( n = 31) and a control group ( n = 29) according to different treatment methods. The observation group was treated by embolization of the uterine artery with a polyvinyl alcohol granule. The control group was treated with a levonorgestrel-releasing intrauterine system. After treatment, all patients were followed up for 2-5 years. The long-term efficacy was evaluated, including the symptoms of dysmenorrhea, average menstrual fluid volume, sex hormone, and change in uterine size. Results:After 2 years of treatment, the response rate in the observation group was 93.5% (29/31), which was significantly higher than 72.4% (21/29) in the control group ( χ2 = 4.81, P = 0.028). After 5 years of treatment, the response rate in the observation group was 93.5% (29/31), which was significantly higher than 65.5% (19/29) in the control group ( χ2 = 7.35, P = 0.007). After treatment, the improvements in uterine size, menstrual fluid volume, and visual analogue scale score were greater in the observation group than those in the control group (all P < 0.05). After treatment, all patients were followed up for 5 years. There was no significant difference in the incidence of long-term adverse reactions between the observation and control groups [3.2% (1/31) vs. 6.9% (2/29), P > 0.05]. The recurrence rate in the observation group was 3.45% (1/29), which was significantly lower than 23.81% (5/21) in the control group ( χ2 = 4.78, P = 0.029). After 2 and 5 years of treatment, ovarian function was not affected in both groups of patients. Conclusion:Uterine artery embolization with polyvinyl alcohol granules for the treatment of adenomyosis has identified long-term curative effects, is safe, and has a low recurrence rate.
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Trauma is the leading cause of death for people under 40 years old in the world. At present, the rescue and treatment system of trauma patients in China is not yet well established, and the mortality of trauma patients is higher than those in the developed countries. Improving the treatment system is the key to reducing the trauma mortality. In order to innovate the service mode of trauma first aid, further promote the establishment of regional trauma first aid system, improve the ability of trauma treatment, reduce the mortality and disability rate of trauma patients in Jiangxi Province, recently Health Commission of Jiangxi Province and the First Affiliated Hospital of Nanchang University have reached a consensus on the establishment of Jiangxi trauma first aid center. In order to provide reference for the construction of trauma treatment system, the author analyzes the following aspects including functional positioning, basic requirements, organization management, and evaluation of core indicators.
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Objective To explore and evaluate the changes of hemorheology and fracture healing in patients undergoing spinal operation with intraoperative autologuous blood transfusion.Methods A total of 80 patients underwent internal fixation of spine in our hospital from January 2012 to December 2014 were selected in this study.Digital random table method were utilized for dividing them into two groups.Autologous blood transfusion was used in group A,allogeneic blood transfusion was applied in group B.Blood viscosity,plasma viscosity,hematocrit,fibrinogen,erythrocyte sedimentation rate (ESR) and the level of sICAM-1,sVCAM-1 were collected and compared 1,4,8,12 weeks after the operation.Fesults Concentrated red cell and plasma volume infusion in group A was lower than that in group B,the level of sICAM-1,sVCAM-1 1,4,8,12 weeks after operation in group A were significantly lower than that in group B.There was no delayed fracture healing patients in group A,but there was 3 patients with delayed fracture healing in group B (P＜0.05).Blood viscosity,plasma viscosity,hematocrit,fibrinogen,erythrocyte and ESR 1,4,8,12 weeks after the operation compared in both group were not statistically significant (P＞0.05).Conclusion Autologous blood transfusion is not only a safe and effective method for blood transfusion,but also can improve the tissue blood supply,reduce inflammation,and conducive to fracture healing.
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Postoperative pain is an important factor which affects patients'postoperative rehabilitation training.With the application of ultrasound guided nerve block and multimodal analgesia,the quality of postoperative pain management has improved obviously among patients after foot and ankle surgery.The study has reviewed the related research.
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Objective To investigate the clinical efficacy of 90Sr-90Y applicator combined with propranolol (inderal) treatment for infants with large areas of cutaneous hemangiomas.Methods Thirty-nine infants with large areas of cutaneous hemangiomas were randomly divided into two groups:study group (n =18) treated with 90Sr-90Y applicator in conjunction with propranolol,and control group (n =21) treated by 90Sr-90Y applicator only.The results of curative effects between the two groups were analyzed using rank sum test and x2 test.Results The cure rate,remission rate and effective rate for the study group were 44.4％(8/18),55.6 ％ (10/18) and 100.0％ (18/18),respectively,and the corresponding rates for the control group were 14.3％ (3/21),52.4％ (11/21) and 66.7％ (14/21),respectively.The effective rate in the study group was significantly higher than that in the control group (Z =-2.861,P ＜ 0.05).The adverse reaction rates in the study and control groups were 66.7％ (12/18) and 19.0％ (4/21 ;x2 =9.084,P ＜0.05),respectively.Conclusion Combined propranolol with 90Sr-90Y treatment for large infantile hemangiomas is clinically effective,but its side effects should be closely monitored.