Application of standardized assessment of chest pain in CT angiography of acute pulmonary embolism / 中国基层医药

Objective To evaluate the clinical value of CT angiography (CTA) in the diagnosis of acute pulmonary embolism (APE) after standardized chest pain assessment in patients with acute chest pain.Methods From January 2014 to May 2016,The clinical data of 43 patients with acute chest pain in Wuzhou Hospital of Traditional Chinese Medicine and Wuzhou Worker's Hospital received CTA examination were retrospectively analyzed.After standardized assessment,16 patients with suspected APE through pulmonary artery CTA scan screening were selected as observation group.27 cases of chest pain who were not received standardized assessment were selected as the control group,the chest CTA scan was used to investigate the causes of chest pain.The number of CTA confirmed by APE in two groups was compared.The effect of APE screening scale score and D-Dimer on the diagnosis of APE in the observation group was analyzed,and the application value of standardized evaluation of chest pain in APE was analyzed.Results The positive rate of CTA in the observation group was higher than that in the control group,and the difference between the two groups was statistically significant(x2 =3.93,P ＜ 0.05).The APE screening scale and D-Dimer in the observation group were (9.64 ±4.74) points and (886.73 ± 191.83) μg/L,respectively.which in the APE excluded patients were (2.20 ± 1.64) points,(587.20 ± 35.79) μg/L,respectively,the differences were statistically significant(t =3.363,3.402,all P ＜ 0.01).Conclusion Patients with acute chest pain and chest pain are standardized after the evaluation,optimization of CTA examination and improve the diagnostic rate of APE,reduce the rate of misdiagnosis and missed diagnosis,provide timely and accurate diagnostic basis for clinicians to gain valuable opportunity for further disposal.

Application of modified negative pressure closed drainage technique in early treatment of cobra bite ulcer / 中国基层医药

Objective To investigate the application of modified negative pressure closure drainage in early stage of snakebite .Methods 60 patients with early bite ulcer were selected as study objects ,and they were randomly divided into two groups according to the digital table .30 patients in the observation group received vacuum sealing drainage(VSD) combined with chymotrypsin continuous rinsing treatment .30 patients in the control group were given conventional dressing bandaging treatment .The two stage skin grafting time,wound healing time,complications,disa-bility rate,hospitalization time and C reactive protein ( CRP) levels of the two groups were observed .And the treatment effect was analyzed .Results The incidence rates of complications and disability in the observation group were 0.00％and 3.33％,respectively,which were significantly lower than 16.67％and 26.67％in the control group ,and the differences between the two groups were statistically significant (χ2 =4.356,6.405,all P<0.05).The CRP levels of 3 d and 7 d in the observation group were (15.8 ±1.7)mg/L,(6.9 ±1.6)mg/L,respectively,which in the control group were (18.6 ±2.3) mg/L,(13.8 ±1.9) mg/L,respectively,there were statistically significant differences between two groups(t=5.362,15.214,all P<0.01).The two stage skin grafting,wound healing,hospital stay of the observation group were (9.5 ±1.8) d,(24 ±1.8) d,(25.3 ±1.9) d,respectively,which were significantly shorter than those of the control group [(16.2 ±2.6)d,(32.0 ±3.2)d,(33.2 ±3.7)d],the differences were statistically significant(t=11.604,11.93410.403,all P<0.01).Conclusion For patients with injury of cobra bite to early ulcer,using VSD technology combined with chymotrypsin continuous irrigation ,can significantly reduce the level of CRP and the occurrence of complications and disability rate ,shorten the time of two stage skin grafting ,wound healing time,hospitalization time,reduce the pain of patients,it is the best treatment to accelerate recovery .

Surgical treatment of recurrent pseudocyst of auricle / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the surgical techniques and skills for recurrent pseudocyst of auricle.</p><p><b>METHODS</b>Retrospective analysis of 20 cases from January 2006 to May 2014 in our department, who were treated by the operations with skills as follows, resection the anterior wall of pseudocyst cartilage and perichondrium, grooves cutting the roughing the posterior cartilages wall, and local compression.</p><p><b>RESULTS</b>All 20 patients were followed up for 8 to 42 months and all were cured. No recurrence, infections and malformation were happened.</p><p><b>CONCLUSION</b>Resection the anterior cartilage wall perichondrium of the pseudocyst, grooves cutting and roughing of posterior cartilages of the peudocyst, and in combined with local compression are effective treatment for recurrent cases.</p>