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Objective:To evaluate the technical approach and application value of DynaCT biliary reconstruction with CT images fusion (DynaCT-CT fusion) for the treatment of complex hepatolithiasis.Methods:The data of 18 patients with complex hepatolithiasis admitted to the First Affiliated Hospital of Guangzhou Medical University from May 2022 to October 2022 were retrospectively analyzed, including 7 males and 11 females, aged (50.6±15.0) years. Preoperative DynaCT biliary reconstruction with CT images fusion was performed to guide the percutaneous transhepatic one-step biliary fistulation (PTOBF). The technical data, including the bile duct with stones identified by preoperative imaging, the actual bile duct with stones confirmed intraoperatively, the satisfied stone removal time for each targeted bile duct, the actual stone removal time for each targeted bile duct, the intraoperative identification of CT-negative stones, the postoperative complications and reoperation were analyzed.Results:In 18 patients, a total of 95 target bile ducts with stones were identified by preoperative DynaCT-CT fusion technology, involving the first, secondary and tertiary bile ducts. Preoperative CT identified 29 lesions of stones involving the first and secondary bile ducts. CT negative stones were confirmed in 5 patients by DynaCT-CT fusion. Bile duct stricture occurred in 12 patients. All procedures were completed without postoperative bile leakage or hemorrhage. A total of 82 lesions of stones were successfully removed with a removal time of (25.9±12.8) min. The satisfied stone removal time for each targeted bile duct was (10.1±7.6) min, and the actual stone removal time was (10.5±7.4) min. Immediate stone clearance was achieved in 13 patients. Biliary tract infection occurred in 2 patients, and 5 patients underwent reoperation for residual or recurrent stones.Conclusion:The DynaCT-CT fusion technology guided PTOBF is feasible and safe in patients with complex hepatolithiasis. It could effectively detect more stones, shorten the stone clearance time. DynaCT-CT fusion technology provides a new strategy for the treatment of hepatolithiasis.
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Hepatolithiasis is a common disease in hepatobiliary surgery. The changes of bile dynamics in the biliary system, such as flow rate, pressure, viscosity, etc., play an important role in stone formation. In this paper, we introduce the bile fluid dynamics of the biliary system, analyze the influencing factors of bile dynamics change, the relationship between bile dynamics change and calculus, and the application of bile fluid dynamics in the treatment of hepatolithiasis, providing ideas and basis for the prevention and treatment of hepatolithiasis.
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Objective:To explore the effect of the "trinity" training mode with curriculum training as the core, lecture training as supplement and community training as reinforcement, and to improve the health education ability of higher vocational nursing students.Methods:A total of 209 nursing students were selected as the research objects by random cluster sampling, and they were randomly divided into experimental group and control group. The experimental group adopted the "trinity" system to improve the health education ability of higher vocational nursing students, while the control group carried out the routine teaching. The health education ability of nursing students was evaluated by using the health education ability scale of nursing staff, and the nursing students of the experimental group were investigated by questionnaire. Statistics analysis was made by SPSS 15.0 software, the t test was conducted for analysis of measurement data, and Z test was used for counting data. Results:The health education ability of the nursing students in the experimental group was significantly higher than that of the control group ( P < 0.001). Nursing students in the experimental group generally had high recognition of the training mode of "trinity" system. The pass rate was 98.13%. Among them, 68.87% of the nursing students thought it would be a big gain to attend the special lectures; 69.81% of the nursing students thought it would be a big gain to participate in the community activities. Conclusion:The "trinity" health education ability training model can significantly improve the health education ability of higher vocational nursing students.
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Glaucoma is one of the major causes of blindness worldwide.The symptom of glaucoma is not obvious and the rate of blindness is quite high in glaucoma.Over 90％ of the glaucoma patients were unaware about the disease.Increasing awareness of glaucoma will promote the patients to find the sign of glaucoma and will thereby prevent blindness due to glaucoma.Increasing awareness of glaucoma is the most effective way of early detection,early diagnosis,timely treatment and rescuing surviving visual function in glaucoma patients.Many scholars have done a lot of researches on awareness of glaucoma.This article reviewed recent researches on the awareness of glaucoma,including the actuality of glaucoma awareness,the way to get the knowledge of glaucoma,the factors affecting the awareness,the influence of awareness on psychological barriers and the quality of life,and the impact of learning and health education on awareness.
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Objective To investigate the diagnosis and treatment of posterior fossa hemangioblastoma.Methods The data of 44 cases with posterior fossa hemangioblastoma verified by surgery and pathology were analyzed retrospectively.Results Preoperative definite diagnosis cases were 41.Total tumor removal was achieved in 37 cases. Four cases died of the operation.Conclusions Posterior fossa solid hemangioblastoma are still challenging neoplasmas.For this kind of tumor,biopsy and partial removal are forbidden,and this tumor is removed after devascularity of supply blood artery.CT and MRI are major preoperatively diagnosis method for posterior fossa hemangioblastoma. The application of special microsurgical technique can improve surgical efficacy.