Clinical study on the different lengths of inferior vena cava stent implantation for non-thrombotic iliac vein lesions / 国际外科学杂志

Objective To assess the safety and influence of the stents extended into inferior vena cava in patients with non-thrombotic iliac vein lesions (NIVLs) on the bilateral iliac vein blood flow.Methods We retrospectively reviewed data from July 2008 to June 2017 in 197 patients with NIVLs who underwent iliac vein stenting and complete follow-up was obtained at our institution.Of these patients,stents extended into IVC more than 10 mm in 141 cases,less than 5 mm in 22 cases,and 34 cases were between 5 and 10 mm.Restenosis and thrombosis of bilateral iliac vein and patency of these stents were assessed in the follow-up.The count data were expressed by percentage (％),and the sample comparison rate was analyzed by Fisher exact test formula.The measurement data were first tested for normal distribution and homogeneity of variance,and then corrected t test.Results The two hundred and five iliac vein stents were placed in 197 patients.During a mean follow-up of 58.7 months (6 to 98 months),there were no thrombosis occurred in the contralateral iliac vein,6 patients suffered restenosis or new thrombosis in the stents,the incidence between stenting positions less than 5 mm (13.6％,3/22) and those more than 5 mm (3.43％,6/175) was sighificantly different (P ＜0.001),and 5 of 6 patients had a good patency after endovascular therapy.During the fllow-up,the primary and assisted-primary patency rates were 97.0％ and 99.5％.Conclusions From these data,it appears that there is a very high patency rates of the stenting treatment for the NIVLs,and it is safe for the stents extended into the IVC,stenting across the iliocaval confluence can result in a small number of new contralateral thromboses.Moreover,the risk of stents restenosis or occlusion is high when stents are not extended into IVC.

Current Living Situation of Survival Patients with Spinal Cord Injury 40 Years after Tangshan Earthquake / 中国康复理论与实践

Objective To survey the survival status, functional status, marital status and the present situation of the survival patients with spinal cord injury 40 years after Tangshan earthquake. Methods From February to May, 2016, a total of 216 patients with spinal cord injury were surveyed with questionnaire, in which 139 cases lived centralized and 77 cases lived scattered. The questionnaire was self-designed and included eleven items and 51 questions, which related to ability of daily life, marital status, employment status and socioeconomic status and so on. Results A total of 960 (25.15%) patients with spinal cord injury survived 40 years after Tangshan earthquake. In 216 surveyed pa-tients, the employment rate was 9.3%, the married rate was 53.2%, and 44.9%earned less than 500 yuan every month. The incidence was 25.9%for pressure score, 50.50%for neuralgia (severe pain accounted for 23.51%), and 19.40%for urinary tract stones. 56%of patients could take their own basic self-care. Conclusion There were many problems such as high complication rate, low employment rate and poor economic condition in the spinal cord injury group 40 years after Tangshan earthquake.

Analysis of Current Status of Research on MOOC in China and Its Enlightenment on Medical Education Development / 医学信息学杂志

The introduction of MOOC to medical education in China can greatly promote the development of modern medical education.Using the content analysis method,the paper systemizes the research literatures on MOOC published in 2013-2015 in China.According to the analysis,currently,the research on MOOC in China is still in the initial stage.Therefore,it proposes the focus of domestic research on MOOC and the research development direction in medical education in the future.

Investigation of the Cause of Death in Patients with Spinal Cord Injury from Tangshan Earthquake (1976) / 中国康复理论与实践

Objective To discuss the cause of death in patients with spinal cord injury from Tangshan earthquake 37 years latter, and compare them with the survey before. Methods The causes of death of the spinal cord injury patients lived in 1 sanatorium and 1 rehabilita-tion village in Tangshan city, and 6 sanatoriums in villages from 2003 were surveyed. The questionnaire included their general condition, the main cause of death, time of death, age at death, etc., and the findings in 1988 and 2003 were compared. Results Uremia and pressure sore infection were the most major causes of death, in which pressure sore infection was the first cause in the village, and uremia was the first both in the village and city, and the epidemiology of them decreased than before. Cardiovascular disease and cerebrovascular disease were the second and third causes of death respectively. The epidemiology of malignancies increased in this survey, and the longest life time of pa-tients with cervical spinal cord injury was 36 years. Conclusion The top causes of death in spinal cord injury patients from Tangshan earth-quakeare uremia, pressure sore infection, cardiovascular disease and cerebrovascular disease. 37 years after Tangshan earthquake, the cause of death and the life expectancy of patients with spinal cord injury have been close to general levels.

Endovenous laser treatment for venous ulcer of lower extremities / 国际外科学杂志

Objective To explore the value of endovenous laser treatment (EVLT) in treating the variceal ulcer of lower extremities (VULE).Methods Twenty cases of chronic venous insufficiency with VULE were treated with endovenous laser and received regular postoperative follow-up survey.Results No complication,such as burning of skin happened,all superficial varicose veins disappeared,and most of ulcers were healed within 2 -4 weeks after EVLT.Conclusion EVLT is one of the important methods which is minimally invasive and safe to treat VULE.

Pathogenic Bacteria Distribution and Drug Resistance in Inpatients of Burn Department / 中华医院感染学杂志

OBJECTIVE To analyze the pathogenic bacteria distribution and drug resistance in inpatients of burn department,and instruct clinical application of antibiotics reasonably.METHODS Pathogenic bacteria were isolated from inpatients of burn department from 2003 to 2006.K-B slip diffusion method was taken to carry out the sensitive test.Rate of drug resistance of the pathogenic bacteria was analyzed.RESULTS Totally 1325 strains were isolated,among them 846 strains were Gram-negative bacteria,464 strains were Gram-positive ones,and 15 strains were fungi.The percentage of these three groups was 63.85%,35.02% and 1.13%,respectively.The main strains of the Gram-negative bacteria were Pseudomonas aeruginosa,Escherichia coli,Acinetobacter baumannii,Enterobacter cloacae and Klebsiella pneumoniae,and that of the Gram-positive bacteria were Staphylococcus aureus,Enterococcus and Staphylococcus epidermidis.The major strain of fungi was Candida albicans.The pathogenic bacteria tested showed high drug resistance.The detection rate of the meticillin-resistanct S.aureus(MRSA) was 82.12%.The detection rate of the ESBLs from the K.pneumoniae and the E.coli was 60.17% and 41.89%.CONCLUSIONS It was showed that the major pathogenic bacteria infected of the inpatients of burn department are Gram-negative bacteria.The pathogenic bacteria are the multidrug-resistant ones.Enhanced monitoring on pathogenic bacteria distribution and drug resistance analyses among inpatients of burn department could benefit for the guide of clinical rational administration and depression of multidrug-resistant bacteria.

Interventional Therapy for Deep Venous Thrombosis in the Lower Limbs / 中国微创外科杂志

Objective To investigate the clinical effectiveness of interventional therapy for deep venous thrombosis(DVT) in the lower limbs.Methods A total of 38 patients with DVT were treated by intravenous thrombolysis;12 of them received percutaneous transluminal balloon angioplasty and intravascular stenting after the thrombolysis.According the evaluation criteria of our hospital,the outcomes of the patients were classified as cure(angiography showed complete lysis of the thrombus and smooth venous wall),markedly improved(the deep vein was patent with intravascular mural thrombi,the inner radius was reduced by less than 1/3),improved(angiography showed residual thrombi in the deep vein,and the inner radius was reduced by more than 1/3),and failure(the vein was still obstructed).Results After the treatments,cure was achieved in 22 patients,markedly improved in 14,and improved in 2.No severe complications occurred during the operations.Thirty-four of the patients were followed up for 3-24 months(3-6 months in 7 cases,7-12 months in 12,and 13-24 months in 15).Two patients had recurrence during the follow-up and were cured by intravenous thrombolysis.Conclusion Interventional therapy is continent,effective,and safe for DVT.

The diagnostic value of plasma D-dimer as an early marker in acute mesenteric Ischemia / 中国现代普通外科进展

Objective:In this study we evaluated the diagnostic value of plasma D-dimer level as an early indicator in acute mesenteric ischemia in rats.Methods:Forty-eight mature male Wistar rats were divided equally into experimental group (EG) and control group (CG),The superior mesenteric artery was ligated In EG,and while a simple laparotomy was performed in CG.Blood samples were taken for laboratory test in both groups at 1h、6h、12h respectively.Results:The longer the duration of mesenteric ischemia,the higher were the serum D-dimer levels in the study groups,and statistical significance was obtained between these two groups (P=0.0375).Otherwise,significant difference was not found in other laboratory parameters between them.Conclusions:Serum D-dimer dynamic measurements may be a important valuable screening parameter in the early diagnosis of mesenteric ischemia.

Effect of nitric oxide and inducible nitric oxide synthase in experimental aortic aneurysm / 中国现代普通外科进展

Objective:To investigate the effects of nitric oxide(NO) and inducible nitric oxide synthase (iNOS) in the experimental abdominal aortic aneurysm (AAA) rat model.Methods:An intra-aortic elastase infusion model was used.Control rats received intra-aortic saline infusion.In the remaining groups,intra-aortic elastase infusion was used to induce aneurysm formation.These rats were treated with intraperitoneal injections of saline postoperatively(experimental group),aminoguanidine postoperatively(medicine group).Serum NO and aortic diameter were measured,Changes of histology,iNOS and MMP-9 were observed in the aortic wall.Results:Experimental group produced AAAs with significant production of iNOS,MMPs and serum NO compared with controls.In medicine group reduced aneurysm size and displayed suppression of MMPs expression,inflammatory infiltrates and serum NO production were detected.Conclusion:Expression of iNOS and MMP-9 are induced and serum NO levels are increased in experimental AAA,iNOS and NO production by iNOS play an important role with detrimental effects during experimental aneurysm development.

Diagnosis and treatment of infected pseudoaneurysms resulted from drug injecti on / 中国普通外科杂志

Objective To study the diagnosis and treatment of infected pseudoaneurysms(PA) resulting from drug injection. MethodsThe clinical data of 11 cases of i nfected PA resulting from drug injection were reviewed retrospectively.1 pat ient was treated by non-operation,10 cases were treated by artificial blood ve ssel transplantation after removal of PA and local debridement. Results One case dead. All the 10 cases treated by operation had satisfactory results and none had ischemic symptom of the limbs.Eight grafts were patent d emonstrated by color Dopler ultrasonography 3 months postoperatively. Conclusions The diagnosis of PA induced by drug injection can be m ade by the history of drug injection, pulsate mass of injection site. The eff ective treatment should include control of infection,local debridement,PA res ection and blood vessel implantation .

Simultaneous determination of ephedrine and pseudoephedrine in Zhisou Lixiao Oral Liquid by HPLC / 中成药

AIM:To set up a method of simultaneously determining the contents of ephedrine and pseudoephedrine in Zhisou Lixiao Oral Liquid (Herba Ephedrae, Radix et Rhizoma Glycyrrhizae, Semen Raphani, etc). METHOD: The HPLC-quantitative analysis was carried out on a column of Sinochrom ODS-BP by using a mobile phase of acetonitrile-0.02 mol/L potassium dihydrogen phosphate (pH=2.7), (4∶100, with 0.1% triethylamine) under a flow rate of 1.5 mL/min. 207 nm was selected as the wavelength of detector. RESULTS: The linear range of ephedrine was 20.8-208.0 ?g/mL(r=0.999 7) and pseudoephedrine's was 15.0-150.0 ?g/mL(r=0.999 8). The recoveries of them were all between 95% and 105%(RSD