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Objective To explore the clinical feasibility and safety of early intervention for severe stenosis of non-infarct related artery(non-IRA)in patients with acute ST-segment elevation myocardial infarction(STEMI) and multi-vessel disease(MVD)after successful primary percutaneous coronary intervention(PCI)for infarct-asso-ciated artery(IRA). Methods From May 1st,2011 to December 30th,2016,165 patients with STEMI and MVD were enrolled in our study. After the completion of primary PCI in IRA ,75 patients still in the hospital agreed to undergo a second staged PCI in severe stenosis of non-infarct arteries. We analyzed the in-hospital adverse events ,the length of hospital stay and clinical outcomes during the follow-up in the study population. Results There was no significant difference in the incidence of adverse events between the two groups during hos-pitalization. However,compared to patients treated with the IRA-only PCI,those treated with early intervention for severe stenosis of non-IRA was associated with greater benefits for clinical outcomes(including rehospitalization for heart failure,rehospitalization for ACS,recurrent angina pectoris,necessity for reintervention)during the follow-up except for the all-cause mortality. Conclusion Early intervention for severe stenosis of non-IRA is a feasible and safe procedure in patients with acute STEMI and MVD after successful primary PCI.
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Objective To evaluate the efficacy and safety of TurboHawk plaque resection system in the treatment of lower extremity arteriosclerosis obliterans.Methods Clinical data of 36 patients with atherosclerotic occlusion of lower extremity treated with TurboHawk from January 2016 to August 2017 were retrospectively collected.The characteristics of lesion,improvement of symptoms,ankle brachial index (ABI) and postoperative complications were analyzed.The measurement data were expressed as ((x) ± s),All patients were reviewed every 3 months after operation,followed up for 3-18 months,with an average of (9 ± 0.5) months.And the ABI comparison before and after treatment were performed by paired t test;the counting data were expressed as rate (％),and the comparison of different stages was performed by chi-square test.Results In 36 patients,the technical success rate was 100％,and the symptoms of lower limbs were significantly improved.The ABI (0.85 ±0.07) and ABI (0.75 ±0.10) were significantly better in 3 days and in 3 months after operation than before operation (0.29 ±0.10)(t =37.76,P ＜0.001).Postoperative complications occurred in 2 cases,in one case,the artery dissection was covered with a bare scaffold,and in the other case,the blood vessel was ruptured after resection,and was closured by using balloon angioplasty.Conclusion TurboHawk plaque resection system is an effective,less traumatic and safer option for the treatment of lower extremity arteriosclerosis obliterans.
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Objective To investigate the value of blood oxygenation level dependent(BOLD)fMRI in assessing the functional changes of the lumbar dorsal extensor muscles before and after exercise in healthy young people.Methods The changes of the R2*value of lumbar dorsal extensor group in 30 healthy young volunteers(15 males and 15 females)before and after exercise was prospectively studied.BOLD-fMRI scans were performed on healthy young volunteers before and after exercise, the exercise mode was to perform the upper body flexion and extension movement with a simple Rome stool.The scanned images were processed and analyzed, the cross-sectional area and R2* value of the lumbar dorsal extensor muscles (including the multifidus,the longissimus and the iliocostalis)were measured at the upper margin of the L3 and L4 vertebral body before and after exercise.The paired t test was used to compare CSA and R2*values of muscles before and after loading. The CSA and R2* value of different muscles in different sides were compared by independent sample t test. Pearson correlation analysis was used to analyze the relevance between CSA and R2* in muscle before and after exercise. Results After exercise, the R2* values of multifidus,longissimus and iliocostalis at the upper margin of the L4 vertebral body were[(39.2±8.6),(38.9± 7.7),(41.6±7.8)]Hz,significantly lower than before exercise[(46.1±6.9),(45.3±6.2),(46.0±6.7)]Hz(P<0.01);the changes of R2*values of the muscles between the left and right sides before and after the movements were not statistically significant(P>0.05).The R2*values of longissimus and iliocostalis at the upper margin of the L3 vertebral body were[(44.2±9.1),(46.6±9.3)]Hz,significantly lower than before exercise[(48.6±7.2),(49.7± 6.8)]Hz (P<0.01), but the R2* values of multifidus after loading was (43.9 ± 9.0)Hz, there was no statistical difference compared with before exercise (46.8 ± 6.6)Hz (P>0.05);there was a significant difference in the changes of R2*value before and after the movement between the left and right side of iliocostalis(P<0.05).A significant negative correlation between CSA and R2*value was found in the iliocostalis on the right side at the upper margin of L3 vertebral body and in the multifidus on the left side at the upper margin of L4 vertebral body,and the correlation coefficients were (-0.697,-0.616).Conclusion BOLD-fMRI can be a new way to assess the functional changes of the lumbar dorsal extensor group before and after exercise.
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[Objective] To observe the muscle relaxation clinical effect and the occurrence of intraoperative and postoperative complications,and the postoperative extubation and muscle strength recovery of Rocuronium and Succinylcholine in children during airway foreign body removal operation.[Methods] 80 cases of children (ASA I) with airway foreign body,among them,30 cases were older than 3 years old,were agreed to be on electively airway foreign body removal surgery.According to anesthesia induction,intravenous injection muscle relaxants were randomly divided into two groups (n =40):Rocuronium group (Group R) 0.9 mg/kg,Succinylcholine group (Group S) 1.5 mg/kg.According to the degree of muscle relaxation and operation time,if necessary,patients in Group R were added intravenous injection with Rocuronium 0.3 mg/kg,patients in Group S were added intravenous injection with Succinylcholine 0.5 mg/kg,the other drugs were consistent.Observation items included:the bronchoscopy conditions,the degree of muscle relaxation during operation,the numbers of intravenous injection muscle relaxant and atropine,the times of tracheal extubation,the dynamic observation about vital sign and hemodynamic intraoperative and postoperative,and the occurrence situation of complications,the incidence rate of muscle soreness in children older than 3 years old 24 h after operation.[Results] (1) There was no significant statistics difference between the two groups in the condition of bronchoscopy (P ＞ 0.05).(2)The patients in Group R were not required to add muscle relaxants and atropine,but all patients in Group S were required to add muscle relaxants and atropine (P ＜ 0.01).(3)The complications such as body movement,hypoxemia,restlessness during recovery period were happened in Group S,and in Group R,there were only 1 case of laryngeal spasm and restlessness during recovery period,there was statistically significant difference between the two groups (P ＜ 0.05).(4)The muscle strength recovery of 15 min in Group S was significantly higher than the Group R (P ＜ 0.01).(5) The time of tracheal cannula extubation was extended after the operation in Group R,there was statistically significant difference between the two groups (P ＜ 0.05).(6)30 cases patients older than 3 years old were followed up 24 h after operation,14 cases in Group S were found with the muscle soreness of trunk and limb,but none was found in 16 cases in Group R,there was statistically significant difference between the two groups (P ＜ 0.01).[Conclusions] The muscle relaxant effect was well during the removal of forcign body in children with Rocuronium and Succinylcholine,but the former provided a more security anesthesia condition,the muscle soreness of trunk and limb was not found in patient 24 h after operation;and the latter must continue to add drugs in operation,and the complications were found during and after the operation,the muscle soreness of trunk and limb was found in patient 24 h after operation.
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Objective To investigate the clinical efficacy of the self-retaining laryngeal microsurgical operation in the treatment of Reinke ’ s edema of vocal cords . Methods There were 24 cases of Reinke ’ s edema who were treated with self-retaining laryngoscope mucosal stripping surgery of vocal cords from January 2004 to December 2009 ( traditional group ) , while another group of 32 cases of Reinke ’ s edema were treated with self-retaining laryngoscopic microsurgery lateral submucosal incision micro-flap operation of vocal cords from January 2010 to December 2015 ( laryngeal microsurgery group ) .The two groups were executed with electronic laryngoscopy and subjective voice evaluation GRBAS ( The Speech and Language Institute of Japanese in 1979, G: Grade, R:Roughness, B:Breathness, A:Asthenia, S:Strain) in pre-operation and post-operation (1 week, 3 weeks, 8 weeks).The wound healing time of vocal cords , hoarseness improved time and voice improvement were retrospectively compared between the two groups . Results The patients in laryngeal microsurgery group had earlier voice hoarse improvement and more rapid mucosal epithelial of vocal cords recovery time in post-operation as compared with the patients in the traditional group [voice improving time, (7.3 ±1.9) d vs. (11.3 ±2.7) d, t=-6.481, P=0.000;mucosal epithelial of vocal cords recovery time , (12.2 ±3.1) d vs.(20.1 ±3.4) d, t=-9.062, P=0.000].The results of pre-operative voice evaluation with GRBAS showed no significant differences between the two groups, but the results of post-operative evaluation of each session (1 week, 3 weeks, 8 weeks) showed that the main data were statistically different.The GRBAS score of laryngeal microsurgery group was lower than that of traditional group in post -operation, especially after 8 weeks (8 weeks after post-operation, G:1.0 ±0.8 vs.1.6 ±0.2, t=-3.584, P=0.000; R:1.0 ±0.9 vs. 1.5 ±0.4, t=-2.536, P=0.014;B:1.0 ±0.6 vs.1.4 ±0.5, t=-2.647, P=0.011).In laryngeal microsurgery group, 24 cases were cured , 5 cases were effective and 3 cases were invalid , contrasting in the traditional group with 11 cases of cured , 7 cases of effective and 6 cases of invalid respectively, with a significant difference (Z=-2.239, P=0.025).No significant difference in effective rate between the two groups [90.6%(29/32) vs.75.0%(18/24),χ2 =1.459, P=0.227]. Conclusion The clinical efficacy of self-retaining laryngoscope microsurgery in the treatment of Reinke ’ s edema of vocal cords is faster and better comparing traditional operation , with a more significant pronunciation quality improvement .
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Objective To investigate the clinical application of temporary balloon occlusion of the common iliac artery in performing cesarean section for patients with pernicious placenta previa and placenta accreta.Methods A total of five cases with ultrasound or MRI diagnosed pernicious placenta previa and placenta accreta were analyzed retrospectively.One of the cases was diagnosed Rh(-)blood type.Prophylactic temporary balloon implantation in bilateral common iliac arteries were carried out before cesarean section.Digital subtraction angiography ensured the position of balloon catheter and the catheter was fixed.The balloon was inflated immediately after the removal of the fetus.The balloon was removed at 6-8 hours after the cesarean section.The amount of blood loss,transfusion requirement,cesarean hysterectomy rate, and X-ray exposured time and dose during the procedure were recorded.Results Temporary balloon implantation in bilateral common iliac arteries in all five patients were obtained successfully.The blood loss was seen <500 mL in one patient and 500-1 000 mL in other four patients.Because of placenta implantation over depth of serosa and placenta percreta in one case,massive intractable hemorrhage occurred in short time,partial hysterectomy had to be carried out.The uterus was retained in other four cases.Conclusion The temporary balloon occlusion of the common iliac artery in performing cesarean section is a safe and effective technique,and it can reduce the amount of blood loss,transfusion requirement and secondary risk due to uncontrollable bleeding during surgery.
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Objective Toexplore the application value of diffusion tensor imaging (DTI) in evaluating evaluation offunctional changes of the in patients with primary trigeminal neuralgia caused (PTN) by neurovascular compression. Methods 40 unilateral PTN patients and 40 healthy volunteers were enrolled in ourstudy.They allAll patients underwent the general sequences and DTI ,and then to measured the ADC and FA values of the trigeminal nerves. Results (1) Compared with contralateral side (0.408 ± 0.054)and bilateral sides in control group(0.423 ± 0.057), FA value of the ipsilateral side in PTN group(0.330 ± 0.056) was significant lower (P< 0.05)compared with the contralateral side (0.408 ± 0.054) and bilateral sides in control group (0.423 ± 0.057).The ADC value of ipsilateralside (2.052 ± 0.473)× 10-3 mm2/s was significantly higher (P < 0.05) thancompared withthe contralateral side (1.541 ± 0.266) ×10-3 mm2/s and bilateral sides in control group(1.431 ± 0.308) ×10-3 mm2/s. (2) An There's a nnegative correlation was found (r = -0.613,P < 0.001) between the loss of FA and the increase of ADC (r = -0.613,P < 0.001). Conclusion DTI could be used to evaluate the changes of neuratrophy and demyelination ,so it canmight be used of in diagnosis and treatment of PTNin further way.
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Objective To compare the bleeding volume during endoscopic sinus surgery in pa-tients with hypertension under total intravenous anesthesia or combination of intravenous with inhaled anesthesia.Methods Forty adult patients with hypertension (ASA Ⅰ or Ⅱ),male 25 and female 1 5,aged 35-54 years,agreed to be on electively endoscopic sinus surgery,were divided randomly into two groups(group A and group B,n =20 each).All patients were injected intravenously with fenta-nyl,propofol and cisatracurium during the induction of general anesthesia.During the maintenance stage of the general anesthesia,patients in group A were injected intravenously with propofol,and patients in group B were inhaled with sevoflurane until 5 minutes before the end of the operation.BIS was 40-60 during the operation in the two groups.After induction of anesthesia and tracheal intubation,ni-troglycerin and esmolol were given to adjust blood pressure and hypervolemic hemodilution was performed.. Bleeding volume and operation duration were recorded at the end of the operation.The arterial blood gas, blood lactate and coagulation function were monitored 30 minutes before the operation (T0 ),30 minutes (T1 )and 90 minutes after the operation beginning (T2 )and 30 minutes after the end of the operation (T3 ). Results Bleeding volume in group A was significantly less than that in group B (P <0.05).Fifteen minutes before the operation,the MAP of all the patients in two groups was controlled slowly to 60 mm Hg.Com-pare to those at T0 ,there was no significant difference in the arterial blood pressure,blood lactate and coag-ulation function at T1 ,T2 and T3 .Conclusion During the endoscopic sinus surgery with intravenous anes-thesia for patients with hypertension,the bleeding volume was less than that with inhalation anesthesia.
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Objective To evaluate the clinical application and therapeutic effect of interventional embolization in treating renal pseudoaneurysms. Methods The clinical data of 11 patients with renal pseudoaneurysm, who had received interventional embolization management at authors’ hospital, were retrospectively analyzed. The embolic agents used in the embolization procedure included conventional steel coil, gelatin sponge particles, PVA, etc. All the patients were followed up for 6-24 months. Results Single renal pseudoaneurysm was found in all the 11 patients. Clinically, symptom of bleeding was seen in 3 cases. The renal pseudoaneurysm was located at the upper (n=1), middle (n=4) and lower (n=5) renal artery of the kidney, and in one case the renal pseudoaneurysm was situated at the accessory renal artery. In performing renal artery embolization, pure PVA was used in one case, spring steel coil in one case, PVA together with spring steel coil in one case, and gelatin sponge combined with spring coil in 8 cases. After the embolization, the pseudoaneurysm was no more visualized, the contrast extravasation disappeared, and the parent artery was manifested as a residual root. During the operation the patients had no obvious discomfort. Within one week after embolization therapy, 2 patients developed hemorrhage, and their hemoglobin, white blood cell count and hematocrit were significantly increased. During the follow-up period, all patients showed no recurrence signs, and routine urine tests were normal. Conclusion For the treatment of renal pseudoaneurysms, interventional embolization is minimally-invasive, safe and reliable; this technique can maximally protect the normal kidney tissue, quickly control the bleeding and effectively save the life of patient. Therefore, it is worth promoting this treatment in clinical practice.
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Objective To discuss the cause and treatment strategy for open laryngotracheal trauma.Methods The clinical data of 38 cases with open laryngotracheal trauma admitted from 1998 to 2012 were collected and analyzed.Of them,one patient died in emergency department despite energetic resuscitation,37 were hospitalized and given advanced treatment after life support measures in emergency department.They were treated with tracheotomy before or during operation.Of them,32 patients were regularly followed up for imaging studies.Result Except 1 patient died of exsanguination from carotid artery rupture,the other 37 survived after successful treatment.Twenty patients were treated with debridement and suture of the wounds and laryngoplasty (20/37,54.1％),8 patients were operated with laryngoplasty plus intraluminal stents implanted (8/37,21.6％) ; the rest 9 patients (9/37,24.3％) were separately given placement of nickel-titanium shape memory alloy stent (n =2),laryngofissure with rubber gloves throat models implanted and laryngoplasty (n =3),linear silicone tube implanted and laryngoplasty with trans-cervical approach (n =1) and tracheoesophageal fistula neoplasty with laryngoplasty and laryngofissure (n =3).The operated patients were followed-up for 0.5 to 3 years after discharge.Of them,35 patients (35/37,94.6％) had successful decannulation,breathing smoothly and swallowing normally,23 patients (23/37,62.2％) had almost normal pronunciation,12 patients (12/37,32.4％) had different degrees in hoarseness of voice,and 2 patients (2/37,5.4％) were referred to other hospital because of failure in extubation with severe stenosis of laryngotrachea.Conclusions When the patients with open laryngotracheal trauma were treated,the essential strategy was to prevent shock,hemorrhage,and asphyxia.In the case of patent respiratory tract and stable vital signs,laryngotracheal reconstruction should be carried out as soon as possible to prevent complications,thereby obtaining good therapeutic effect.
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Objective To observe destruction of tibias created in ablating of the swine limbs in vivo with radiofrequency,the influence on the surrounding organization structure,and the repair process of lesions for treating bony tumor.Methods There were eight pigs included in the first part of the experiment.RFA was performed under DSA guidance at the same position of the diaphysis and the upper end of their right tibias in hind leg during anesthesia,then X-ray and CT examinations were performed at different time points after RFA,and subsequently the pigs were executed by depth anesthesia.Control specimens,specimens of the immediate time,the third day,the tenth day,the twenty-fourth day,the fifth week,the eighth week,the twelfth week after RFA were obtained at the diaphysis and the upper end of their tibias.X-ray and CT examinations of these specimens were performed.These specimens were observed both by naked eye and under microscope.The observation included the general state of the laboratory animals after RFA,the configuration of RFA lesions in the gross specimen and the corresponding histologic changes,the boundary of necrosis in RFA lesions and the corresponding boundary of the gross specimen.There were sixteen pigs in the second part of the experiment.RFA was performed at the same position of the diaphysis and the upper end of their right and left tibias in hind leg during anesthesia,and the pigs were immediately executed by depth anesthesia after RFA to get thirty-two capitulum specimens and thirty-two diaphysis specimens.The scope of necrotic tissue in RFA lesions was observed and measured.The border and scope of necrotic tissue in RFA lesions were observed.Major axis,minor axis,and necrosis volume were measured.The independent sample t test was employed to compare the volume of necrotic tissues between capitulum and diaphysis.The one sample t test was employed to analyze volume of necrotic tissue among capitulum,diaphysis and the standard data.Results No accidental death of the animals occured in the first experimental.The loss of neurological function of the hind leg did not happen.Coagulation necrosis in cancellous bone of capitulum and marrow of diaphysis lesions created in ablating was observed.On 3th to 10th day after RFA,inflammatory cells infiltrated in hemorrhage tape and then granulation tissues formed.Granulation tissues replaced necrotic bone gradually from outside to inside.Low density band was showed on images of X-ray and CT examination in the specimen of 10th day,and it extended inward.The immature bone was observed in fibrous tissue sited at the edge of lesions,which appeared as sclerosis on X-ray and CT examination.The scope of necrotic tissue in RFA lesions included coagulation necrosis and hemorrhagic zone of its periphery.The dead bone and secondary pathological fracture appeared in two of eight pigs.RFA hardly damaged compact bone in the diaphysis,but the damage of soft tissue was observed outside the compact bone.In the second experiment,the shape of lesions in cancellous bone of capitulum was ellipsoid,with long axis of(2.59±0.21) cm,minor axis of(2.15±0.10) cm,and volume of(6.34±0.27) cm3.The shape of lesions in the diaphysis of tibias was ellipsoid,with long axis of(4.53±0.20) cm,minor axis of(1.71 ±0.22) cm,and volume of(7.14±0.36) cm3.There was significantly difference of necrosis volume between the capitulum and diaphysis lesions,(t=2.011,P＜0.05).The virtual necrosis volume of the capitulum and diaphysis lesions was significantly different from the presumed volume with RFA instrument(t=-613.371,-295.878,P＜0.01).Conclusion Cancellous bone of the capitulum can be damaged by RFA,but the compact bone of the diaphysis can hardly be damaged.The intact compact bone can be helpful to protect the surrounding soft tissues.X-ray and CT examination can be used in the evaluation of curative effect of RFA for treating bone tumors.Pathological fracture of the diaphysis may appear after RFA.
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Objective To compare complication,nutritional status and quality of life between total gastrectomy and jejuna interposition after proximal radical gastrectomy in patients with advanced proximal gastric carcinoma.Methods Eighty-five patients with proximal stomach cancer were enrolled from Jan.2002 to Dec.2008,total gastrectomy group(Control group) had 40 cases,jejuna interposition after proximal radical gastrectomy(Experimental group) included 45 cases.Nutritional status,incidence of reflux esophagitis and cholecystolithiasis,5-year survival rate,quality of life were investigated.Results There was no significant difference in 5-year survival rate between two groups(P ＞ 0.05).Incidence of reflux esophagitis in Experimental group was significantly lower than that in Control group(P =0.042).Incidence of cholecystolithiasis in Experimental group was significantly lower than that in Control group (P =0.038).Hemoglobin,albumin,vitamin B12 and ferritin in Experimental group were significantly higher than those in Control group[(142.2 ±8.6) vs (128.4 ±8.4),(41.3 ±5.8) vs (35.9 ±3.8),(271.5 ± 49.7) vs (184.5 ± 24.6),(220.2 ± 59.7) vs (170.2 ± 27.6),P =0.036,0.024,0.032,0.026].Diet and labor in Experimental group were better than those in Control group (P =0.042,0.048).Conclusion Jejuna interposition after proximal radical gastrectomy decrease incidences of reflux esophagitis and cholecystolithiasis,improve nutritional status and quality of life.
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Purpose To explore CT manifestations of thyroid carcinoma and its correlation with neck lymph node metastasis. Materials and Methods CT findings of 165 patients with thyroid carcinoma confirmed by surgical pathology were studied, including number, shape, size, calcium, necrosis, surrounding invasion and enhancement of substantial part, and its correlation with neck lymph node metastasis was also analyzed. Results 107 out of 165 patients (64.85%) suffered from neck lymph node metastasis. Different tumor number, calcium and necrosis were not associated with the rate of neck lymph node metastasis (χ2=0.009, 2.606, 1.522;P>0.05);tumor shape, size, surrounding invasion and enhancement were significantly different from the rate (χ2=26.510, 75.995, 68.922, 20.819;Penh ancement>shape>size>age. However, patients gender, tumor number, calcium and necrosis showed on correlation (r=0.074, 0.126, 0.005, 0.121;P>0.05). Conclusion Lymph node metastasis is mainly associated with factors like age, tumor shape, size, enhancement and surrounding invasion. It is advisable that patients with high risk rate may consider selective cervical lymph node dissection.
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Objective To investigate the influence of the fish oil fatty acid (rich in ω-3 polyunsaturated fatty acids ) acting on the cellular immune and inflammatory response of perioperative patients of gastrointestinal tumors .Methods 79 gastrointestinal tumors patients who took total parenteral nutrition (TPN)after operation are divided into 2 groups randomly(collected from July 2010 to June 2012) .39 patients in study group are supplied with fish oil fatty acid within 24 h after operation and 7 d in total .40 pa-tients in the control group are supplied with ordinary long chain fat emulsion within 24 h after operation ,7 d as a course .The per-centage and the ratio of T lymphocyte subsets(CD3 ,CD4 ,CD8) ,monocyte human leukocyte antigen DR(HLA-DR) expression(per-centage) and the number of monocytes of 2 groups were test by blood test at 1st and 8th day after operation .Results The ratio of CD3、CD4、CD8、CD4/CD8 ,monocyte(HLA-DR) expression(percentage) and the number of monocytes in the study group were sig-nificantly higher than that of control group after received fish oil fat emulsion (P0 .05) .However ,compared with their results shown that they all had obvious difference respectively by a eight-day observation(P0 .05) .Conclusion Given the fat emulsion of fish oil which is rich in ω-3 poly-unsaturated fatty acid can significantly improve the cellular immune function of postoperative patients and release the inflammatory response after operation in patients of gastrointestinal tumors .
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ObjectiveTo observe the treatment effect of seveve acute pancreatitis (SAP) with gabexate combined with Xuebijing after local infusion. MethodsForty-four patients with SAP were randomly divided into receiving intravenous gabexate or Xuebijing alone (control group) group and receiving local infusion with gabexate combined with Xuebijing( experimental group) group. At 1,7,14 days of testing in diamine oxidase (DAO), lipopolysaccharide, IL-18, TNF-α, APACHE- Ⅱ score, T lymphocyte subpopulation and monocyte HLA-DR expression and single change in the number of nuclear cells were tested. ResultsBetween two patients groups at 1,7,14 days diamine oxidase, lipopolysaccharide, IL-18, TNF-α, APACHE-Ⅱ score showed a downward trend; T suppressor cells (Ts) reduced in their percentage; total T lymphocytes, T helper cell (Th), monocyte HLA-DR expression (percentage) and mononuclear cells showed an upward trend in the experimental group than control group, the differences being statistically significant (P ＜ 0.05). In the experimental group and control group, the pain relief time, intestinal function recovery time, the withdrawal of ventilator time, the incidence of sepsis, the rate of conversion to open surgery were statistically significant different (P ＜ 0.05 ). Conclusions Compared with intravenous drug use alone the implementation of gabexate combined with Xuebijing local infusion can reduce the early course of SAP patients intestinal permeability and reduce endotoxin translocation, protect intestinal barrier function of patients with SAP, improve the patients' immune function, symptoms, signs and reduce the rate of sepsis and transit operations.
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BACKGROUND: Improper practice during military training is likely to cause various training wounds, among which patellar tendinosis is the common one.OBJECTIVE: To explore the onset characteristics of patellar tendinosis caused by military training and incidence changes after the implementation of interventions.DESIGN:Sampling investigation.SETTING: Department of Orthopedics, Guangzhou General Hospital of Guangzhou Military Area Command of Chinese PLA; Department of Surgery, Hospital of Chinese PLA Garrison in Hong Kong PARTICIPANTS: Male army soldiers aged 18-24 years were recruited from a full-time training army in August 2000 (non-intervention group) and August 2001 (intervention group). The same training program was carried out among the 2,783 soldiers in non-intervention group and 5,824 soldiers in the intervention group.METHODS: The investigation group was composed of medical workers with senior and intermediate professional titles. Uniform diagnostic standard was made before the investigation, and questionnaire survey wascombined with on-the-spot inspection on soldiers who complained about knee joint pain following training. Those who conformed to the diagnosis were inquired of their training state in detail and possible causes; meanwhile knee X-ray examination was also conducted. Soldiers in the non- intervention group were subjected to the investigation of the incidence and cause of patellar tendinosis due to fulltime training without given any preventive intervention. By contrast, soldiers in the intervention group were given preventive and therapeutic interventions and then subjected to the investigation into the interventional outcomes one year later.MAIN OUTCOME MEASURES: The incidence of patellar tendinosis in soldiers of the two groups.RESULTS: The first and second investigations were conducted on the 2 783 soldiers and 5 824 soldiers, respectively. All of them entered the rediers of the non-intervention group (the incidence of 0.61%) as compared to 15 soldiers in the intervention group (the incidence of 0.26%) (P＜0.01).tenderness. Patel1ar bone X-ray inspection on 12 of them displayed patellar ciated with run-jump training projects; 23 cases were caused by 400 mbarrier training and 7 cases by 5 km cross-country training.CONCLUSION: Patellar tendinosis during military training is mostly caused by run-jump training and can be remarkably prevented by preventive interventions.