Treatment for severe abdominal infection caused by acute obstructive suppurative cholangitis combined with diabetes mellitus / 中华消化外科杂志

Acute obstructive suppurative cholangitis (AOSC) is one of the most serious acute abdomen.The incidence of abdominal infection is significantly improved when patients were complicated with AOSC and diabetes mellitus,and then bile leakage,intestinal fistula and even death were induced by abdominal infection.The management of abdominal infection is very important for the prognosis of patients.One patient with AOSC and diabetes mellitus was admitted to the No.425 Hospital of PLA from May to July in 2013.Recurrent abdominal infection and abscess occurred after the operation due to his family members' refusal of surgery at early period and lax control of blood glucose before and after surgery,and then bile leakage and intestinal fistula were induced.The patient underwent operation for 3 times,and was cured after receiving fasting,gastrointestinal decompression,parental nutrition,somatostatin administration and antibiotic treatment.

Effects of sustained abdominal aorta compression-CPR on resuscitation of cardiac arrest in swines / 重庆医学

Objective To investigate the effects of sustained abdominal aorta compression (SAAC) method combined with sim-plex chest compression (SCC) on partial pressure of end-tidal CO2 (PETCO2 ) ,return of spontaneous circulation(ROSC) ,resuscita-tion success rate and 24 h survival rate of the cardiac arrest model in domestic swines .Methods 20 healthy domestic swines were randomly divided into two groups ;the standard cadiopulmonary resuscitation group (S-CPR) by adopting SCC and the SAAC-CPR group by adopting SCC combined with SAAC during the resuscitation process .The cardiac arrest model was established by the ven-tricular fibrillation induced through the right atrium electrode alternating current stimulation .After 9 min of untreated interval ,CPR was performed .The two groups were firstly given SCC ,after 30 s ,the SAAC-CPR group was added with SAAC .PETCO2 ,coronary perfusion pressure(CPP) ,ROSC rate ,resuscitation success rates ,and 24 h survival rate were compared between the two groups .Re-sults PETCO2 in the SAAC-CPR group was higher than that during the SCC period in the SAAC-CPR group and in the S-CPR group during CPR[(22 .50 ± 3 .17 )mm Hg vs .(11 .80 ± 2 .57) mm Hg ,(13 .40 ± 3 .53) mm Hg ,P<0 .01)] .CPP in the SAAC-CPR group was also higher than that during SCC in the SAAC-CPR group and the S-CPR group[(50 .30 ± 6 .49) mm Hg vs .(14 . 12 ± 3 .01)mm Hg ,(14 .62 ± 2 .59)mm Hg ,P<0 .01)] .3 cases in the S-CPR group and 9 cases in the SAAC-CPR group restored ROSC within 3 times defibrillation ,succeeded in resuscitation after 20 min ROSC and underwent 24 h survival .The ROSC rate ,the resuscitation success rate and the 24 h survival rate in the SAAC-CPR group were significantly higher than those in the S-CPR group(P<0 .05) .No abdominal viscera damage was found in post mortem examinations of all the swines subjects .Conclusion SAAC combined with SCC can elevate PETCO2 ,CPP ,ROSC ,resuscitation success rate and 24 h survival rate ,which is conducive to CPR ,safe and easy to operate .