Application value of intracranial vascular hemodynamics in neonatal subependymal hemorrhage / 中国医师杂志

Objective To explore the related factors of subependymal hemorrhage (SEH) and cerebral hemodynamic changes.Methods From October 2012 to October 2017,200 cases of children with subependymal hemorrhage diagnosed by ultrasound in our department of pediatrics were selected as the observation group,and a total of 150 children who were admitted to the Department of Pediatrics in the same period due to craniocerebral diseases and other serious diseases were selected as control group.The independent risk factors of the children in the observation group were analyzed,and the difference of the maximum systolic blood flow velocity (SV),the diastolic maximum flow velocity (DV),the systolic and diastolic velocity ratio (S/D),the resistance index (RI),and the pulsatile index (PI) were compared between the two groups.Results Neonatal asphyxia,preterm birth,acidosis,neonatal respiratory distress syndrome (NRDS),patent ductus arteriosus and coagulation dysfunction were independent risk factors for subependymal hemorrhage.The bleeding side SV and DV of the observation group were higher than those of the control group,with statistically significant difference (P ＜ 0.001).In the observation group,the bleeding side SV and DV were higher than those of the healthy side,with statistically significant difference (P ＜0.001).There was no significant difference in bleeding side SV,DV,S/D,RI and PI in 110 cases of single side ependymal hemorrhage (P ＞ 0.05).Conclusions Children with ependymal hemorrhage can observe the hemodynamic indexes of anterior cerebral artery (ACA) dynamically by craniocerebral ultrasound,and judge the therapeutic effect by evaluating the systolic and diastolic blood flow velocity,so as to prevent the further aggravation of subependymal hemorrhage

Application value of intracranial vascular hemodynamics in neonatal subependymal hemorrhage / 中国医师杂志

Objective@#To explore the related factors of subependymal hemorrhage (SEH) and cerebral hemodynamic changes.@*Methods@#From October 2012 to October 2017, 200 cases of children with subependymal hemorrhage diagnosed by ultrasound in our department of pediatrics were selected as the observation group , and a total of 150 children who were admitted to the Department of Pediatrics in the same period due to craniocerebral diseases and other serious diseases were selected as control group. The independent risk factors of the children in the observation group were analyzed, and the difference of the maximum systolic blood flow velocity (SV), the diastolic maximum flow velocity (DV), the systolic and diastolic velocity ratio (S/D), the resistance index (RI), and the pulsatile index (PI) were compared between the two groups.@*Results@#Neonatal asphyxia, preterm birth, acidosis, neonatal respiratory distress syndrome (NRDS), patent ductus arteriosus and coagulation dysfunction were independent risk factors for subependymal hemorrhage. The bleeding side SV and DV of the observation group were higher than those of the control group, with statistically significant difference (P<0.001). In the observation group, the bleeding side SV and DV were higher than those of the healthy side, with statistically significant difference (P<0.001). There was no significant difference in bleeding side SV, DV, S/D, RI and PI in 110 cases of single side ependymal hemorrhage (P>0.05).@*Conclusions@#Children with ependymal hemorrhage can observe the hemodynamic indexes of anterior cerebral artery (ACA) dynamically by craniocerebral ultrasound, and judge the therapeutic effect by evaluating the systolic and diastolic blood flow velocity, so as to prevent the further aggravation of subependymal hemorrhage

Simulation-based learning combined with debriefing in neonatal resuscitation training / 中华围产医学杂志

ObjectiveTo explore and analyze the effect of simulation-based learning combined with debriefing in neonatal resuscitation training.MethodsA total of 114 clinical medical staffs attended the neonatal resuscitation training course hold by Department of Neonatology, Quzhou Maternal and Child Health Hospital from November 2014 to May 2015, and were randomly assigned to observation (n=60) and control group (n=84) by coin tossing. Staffs in the observation group adopted to training skills with simulation-based learning combined with debriefing,while those in the control group were educated with traditional method. The examinations on theoretical knowledge were taken before and after the training. Operational exam and self-confident questionnaire for all staffs on each procedure taught in the course were taken at last. Scores of the exams and self-confident questionnaire were compared between the two groups witht-test and Mann-WhitneyU test.ResultsThe mean score of theoretical test rose up significantly after the training in both observation and control group (25.19±2.62 vs 20.17±3.71,t=7.725,P<0.01; 25.44±2.64 vs 18.90±4.27,t=11.170,P<0.01), but no difference was found in this score after the training between the two groups (t=0.492,P=0.624). The practical operation examination score in the observation group was higher than that in the control (34.05±1.34 vs 31.32±4.10,t=4.183,P<0.01). All questionnaires sent to the staffs were retrieved (100%), and the total values after the training in the observation group were higher than in the control (mean rank: 92.81 vs 57.99; rank sum:5 569 vs 4 872,Z=-4.96,P<0.01).ConclusionsSimulation-based learning combined with debriefing is a much more effective teaching methods for neonatal resuscitation training, which might quickly improve the resuscitation skills of clinical staffs.

Analgesic Effect of Ketorolac Tromethamine Combined with Butorphanol Tartrate in the Treatment of Acute Pain after Fracture Surgery / 中国药房

OBJECTIVE:To observe analgesic effect and safety of ketorolac tromethamine combined with butorphanol tartrate in the treatment of acute pain after fracture surgery. METHODS:76 acute pain patients after fracture surgery were selected and ran-domly divided into control group and observation group,with 38 cases in each group. Control group was given Ketorolac trometh-amine injection 30 mg,ivgtt,and then 2 ml/h,0.5 mg/kg,ivgtt;observation group was additionally given butorphanol tartrate 10 mg,ivgtt,on the basis of control group. Pain degree was evaluated with VAS before and 10 min,1,2,4 and 6 h after treatment, and the occurrence of ADR was observed in 2 groups. RESULTS:10 min,1,2,4 and 6 h after treatment,VAS score of 2 groups were significantly lower than before,with statistical significance(P0.05). The incidence of ADR in observation group (5.26%)was significantly lower than in control group(21.05%),with statistical significance(P<0.05). CONCLUSIONS:Com-pared with ketorolac tromethamine alone,ketorolac tromethamine combined with butorphanol tartrate shows shorter analgesia dura-tion,similar therapeutic efficacy,and lower incidence of ADR.

Simultaneous laparoscopic resection of colorectal carcinoma and synchronous liver metastasis / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the safety and feasibility of simultaneous laparoscopic resection of colorectal carcinoma and synchronous liver metastasis.</p><p><b>METHODS</b>Clinical data of 11 patients undergoing simultaneous laparoscopic resection of colorectal carcinoma and synchronous liver metastasis in our hospital from January 2011 to October 2013 were reviewed retrospectively. Feasibility, safety and efficacy of this procedure were investigated.</p><p><b>RESULTS</b>Procedure was completely successful in all the cases without conversion. The mean operation time was (284.6 ± 28.8) min and the mean blood loss was (322.7 ± 75.4) ml. The mean time to intestinal function recovery was (2.9 ± 0.7) d and the mean hospital stay was (12.3 ± 1.9) d. There were no anastomosis leakage, bile leakage, abdominal massive bleeding or infection, and liver failure after operation. During follow-up of 3-35 months, only one patient died of tumor progression.</p><p><b>CONCLUSION</b>Laparoscopic approach for colorectal carcinoma and synchronous liver metastasis is safe and feasible in selected patients.</p>

The Effect of Cervical Canal Mucosa Ring Excision on Cervical Columnar Eversion in Loop Electrosurgical Excision Procedure / 实用妇产科杂志

Objective:To study the effect of cervical canal mucosa dng excision on cervical columnar eversion in Loop electrosurgical excision procedure(LEEP).Methods:A prospective randomized control trail was performed in 125 cervical intraepithelial neoplasia(CIN)patients.Cervix and cervical canal were conically excised with triangle electrode in 62 patients in the control group;in the study group,a small ring electrode was put into the cervical canal and the cervical canal mucosa was excised about 0.5～0.8cm,after excision as the control group.Follow-up was performed postoperatively in 1,3,6 months respectively.The operation time,the bleeding volume,the rate of cervical columnar eversion and cervical adhesion or stenosis were compared between the two groups.Results:The rate of cervical columnar eversion in the study group (1/63,1.59%)was lower than that in the control group(9/62,14.52%).There was significantly statistical difference between them(P=0.008).There was no statistical differences between them in the operation time,the bleeding volume,and the rate of cervical adhesion or stenosis (P>0.05).Conclusions:The cervical canal mucosa ring excision in LEEP can effectively prevent postoperative cervical columnar eversion.

Therapeutic effect of Marvelon on adenomysis / 中国基层医药

Objective To evaluate the efficacy of Marvelon on treatment of adenomyosis.Methods A total of 42 women with adenomyosis were recruited in the study.They were given Marvelon on the first day of menstruation,1 piece,qd,continouly for 21 days.With an alternation of seven days a new cycle begins.There are 6 cycles in total.We observe their degree of dysmenorrheal,menstrual blood volume(MBV) ,hemoglobin and the volume of uterus before and after Marvelon used.Results After 6 months,the dysmenorrheal remitted obviously,the score decline from (8.51±1.73 ) to (0.62±0.70) ,P <0.01.The MBV reduced and hemoglobin rise distinctly ,before treatment Hb is (104.71±12.09) while (112.00±8.57)after therapy,P <0.01.After treatment the volume of uterus shrinks a little, but not significant(P > 0.05).Conclusion Marvelon is an effective drug in treatment of adenomyosis in the near future,and is cheap,convcnieat.

Cell apoptosis in atrophic skeletal muscle induced by immoblization in rabbits--an experimental study using TUNEL / 生物医学工程学杂志

This experiment was designed to explore the correlation between the mechanism of immobilization-induced skeletal muscle atrophy and the apoptosis of muscular cells. The models of skeletal muscle atrophy induced by immobilization for different length of time were established according to Sievanen II methods. 24 rabbits, each of them having one hind leg fixed by the tubal plaster and the other one free as control, were randomly divided into four groups depending on time of fixation (3, 7, 14, and 28 days respectively). The animals were sacrificed by the end of fixation. TdT-mediated d-UTP nick end labeling (TUNEL) was used to investigate the apoptotic muscle cells in the animal's bone. By comparing the apoptotic muscle cells with the morphology of the skeletal muscle, the correlation between cell apoptosis and skeletal muscle atrophy were analyzed. Apoptotic muscle cells did appear after immobilization in the atrophied skeletal muscle. In various groups, some cells with false positive stained TUNEL were found in the atrophic muscle, which could be distinguished from apoptotic cells by their characteristics. In conclusion, cell apoptosis participates in the process of skeletal muscle atrophy induced by immobilization; the amount of apoptotic cells is strongly associated with the time of immobilization, its peak appears on the 14th day of immobilization; the distribution of apoptotic skeletal muscle cell varies with the time of fixation. The severity of skeletal muscle atrophy is associated with the degree of the muscle cell apoptosis.