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Objective To evaluate the efficacy of minimally invasive technique by retroperitoneal approach in the treatment of severe acute pancreatitis with peripancreatic necrosis.Methods The clinical data of 10 patients with severe acute pancreatitis combined with peripancreatic necrosis who underwent retroperitoneal drainage by aspirating and placing tube under B ultrasound guidance on the basis of routine therapy in the First Affiliated Hospital of University of South China from January 2016 to September 2016 were analyzed.Results All of the 10 patients successfully underwent puncture.Drainage was good after puncture and tube placement in 7 patients.The amylase activity was normal within 3 ～ 7 days,and the symptoms of abdominal pain and bloating were alleviated in 2 ～ 4 days.Among them,3 cases had poor drainage after catheterization due to a large necrotic area,and the percutaneous nephroscope was performed to remove the necrotic tissue of the pancreas.Bacteria was detected in the drainage fluid of 7 patients.The complications of pneumothorax,hemothorax and organ injury were not found in all the patients.The average hospitalization time was 19.4 days (10 ～ 34 days).Conclusions Minimally invasive retroperitoneal approach is safe and effective in curing severe acute pancreatitis with peripancreatic necrosis with good efficacy,which is worth for clinical recommendation and application.
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Objective To study the characteristics of craniocerebral injury caused by the handgun bullet impacting on the bulletproof helmet.Methods Fourteen healthy landrace pigs were involved and randomly divided into injury group(n =9)and control group(n =5).The landrace pigs of the injury group were shot vertically on the head under the protection of helmet plate with 9 mm handgun bullet at velocity of 360 m/s.While the landrace pigs of the control group were dealt with the same process as the injury group except for use of unarmed handgun bullet of the same ammunition dose.The changes of vital sign in the early period and the retina injury at two hours after injury were observed.Porcine cerebrospinal fluid (CSF)at pre-injury and at three hours post-injury were obtained for investigating the levels of neuron specific enolase(NSE)andαⅡ-spectrin protein.Then,the landrace pigs were sacrificed and dissected to examine the general morphological changes of the brain.The brain cortex was taken,fixed and stained with hematoxylin-eosin for microscopic observation.Results The landrace pigs in the injury group manifested decrease of the blood pressure and increase of the heart rate and respiratory rate in the early stage after injury.General morphological observation found retinal hemorrhage(3/9),skull fracture(3/9)and brain surface damage including local impact lesion(9/9)and contrecoup lesion(9/9),with severe impact lesion than contrecoup lesion.Optical microscopic observation revealed acute injury of the cerebral cortex neuron both on the impact and contrecoup locations.The concentrations of NSE and αⅡ-spectrinwere significantly increased in CSF three hours after injury(P ＜ 0.05).Conclusions The handgun bullet impacts on the pig head protected by the bulletproof helmet may induce blunt craniocerebral injury in the early period,with severe impact lesion than contrecoup lesion.Therefore,traumatic brain injury of the soldiers armed with the helmets should be stressed and managed early.
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Objective To explore a brief regimen to treat and manage asthmatic patients.Methods 122 asthmatic patients(including 12 inpatients) treated and managed at respiratory clinic were followed up for 1～10 years.The data of these patients were collected and analysed Results On the base of asthma education patients were received inhaled glucocorticoid combined with ? 2 agonist and/or theophylline for two to five years Of 122 patients,20(16 4%) patients remised and remained good control without any medication,90(73 8%) patients relapsed within 1 to 2 years after drug withdrawal Conclusions Asthmatic patients must be treated and managed regularly according to GINA It was especially emphasized that inhaled glucocorticoid is the mainstay of ling term threapy Most patients can remise for quite a long time with agreeable quality of life while a few patients can be cured