RESUMO
Objective :To study therapeutic effect of levosimendan on aged patients with acute decompensated heart failure (ADHF) and its influence on cardiac function ,serum levels of galectin‐3 (Gal‐3) and copeptin (CPP).Methods :A total of 96 aged ADHF patients ,who were treated in our hospital from Jan 2014 to May 2017 ,were selected .Patients were ran‐domly and equally divided into routine treatment group and levosimendan group (received levosimendan based on routine treatment group) ,both groups were treated for 7d.HRV indexes :SDANN ,SDNN ,SDNNI ,PNN50 ,rMSSD ,LF ,HF , LVEDd ,LVEF ,transmitral early diastolic peak flow velocity／late diastolic peak flow velocity (E／A) ,serum levels of Gal‐3 and CPP before and after treatment ,and incidence of adverse reactions were observed and compared between two groups . Results :Compared with before treatment ,after treatment ,there were significant rise in SDANN ,SDNN ,SDNNI ,PNN50 , rMSSD ,LF ,HF ,LVEF and E／A ,and significant reductions in LVEDd ,serum levels of Gal‐3 and CPP in two groups ,P＜0.01 all.Compared with routine treatment group after treatment ,there were significant rise in SDANN [(63.65 ± 6.38) ms vs.(91.32 ± 9.15)ms] ,SDNN[(89.75 ± 9.04)ms vs.(118.65 ± 12.85)ms] ,SDNNI [(37.86 ± 3.81)ms vs.(45.32 ± 4.62)ms] ,PNN50[(5.15 ± 0.52 )% vs.(5.42 ± 0.58 )%] , rMSSD [(31.98 ± 3.31 )ms vs.(37.44 ± 3.77 )ms] , LF [(189.87 ± 19.92)ms2 vs.(223.85 ± 22.57)ms2 ] ,HF [(79.93 ± 8.22) ms2 vs.(94.12 ± 9.53)ms2 ] ,LVEF [(47.38 ± 4.75)% vs.(52.84 ± 5.31)%]and E／A[(0.98 ± 0.26) vs.(1.38 ± 0.31)] ,and significant reductions in serum levels of Gal‐3[(28.69 ± 2.93)ng／L vs.(16.37 ± 1.65)ng／L]and CPP[(1.50 ± 0.16)μg／L vs.(0.93 ± 0.11)μg／L]in levosimendan group , P＜0.05 or ＜0.01. There was no significant difference in incidence rate of adverse reactions during treatment be‐tween two groups , P＝0.473. Conclusion :Levosimendan can effectively reduce serum levels of Gal‐3 and CPP ,improve HRV and cardiac function with good safety in ADHF patients ,which is worth extending .
RESUMO
Objective To explore the treatment effect and application value of ultrasonic guided mammotome minimally invasive whirling surgery and open surgery for benign breast tumor.Methods 264 patients with benign breast diseases were randomly divided into observation group and control group,132 cases in each group.The control group took open surgery,the observation group used mammotome minimally invasive surgery,rotary cutting system.Recorded clinical surgery treatment of the two groups.Results The operating time,intraoperative blood loss,operation scar size of the observation group were (18.27 ± 3.05) min,(10.86 ± 1.69) mL,(2.76 ± 0.85) mm respectively,those of the control group were (53.48 ± 6.17) min,(97.54 ± 14.28) mL,(27.63 ± 4.31) mm respectively,the differences between the two groups were statistically significant (t =58.7753,69.2560,65.0429,all P ＜ 0.05).In the observation group,breast deformation in 0 case,postoperative occurrence skin pigmentation in 1 case,itchy skin in 2 cases,with lateral swelling in 1 case,the patients' satisfaction score was (93.42 ± 3.89) points.In the control group,breast deformation in 5 cases,postoperative occurrence skin pigmentation in 8 cases,skin itching in 9 cases,lateral swelling in 7 cases,the patients' satisfaction score was (88.16 ± 1.45) points,the differences between the two groups were statistically significant(x2 =5.096,5.636,4.648,4.604,t =14.557,all P ＜0.05).Conclusion Using ultrasonic guided mammotome minimally invasive rotary surgical treatment for benign breast diseases can shorten the operation time,reduce intraoperative bleeding,reduce the incidence of postoperative complications,patients' satisfaction is higher,and it is worthy of popularization and application in clinic.
RESUMO
Objective To evaluate the advantages and disadvantages of cervical strap muscles longitudinal incision and linea alba cervicalis incision in thyroid surgery.Methods The clinical data of 91 patients with thyroid surgery wefe retrospectively analyzed.They were divided into two groups by random digits table,46 patients with cervical stsap muscles longitudinal incision as the observation group,45patients with linea alba cervicalis incision as the control group,the surgery effect of two groups was compared. Results The operative time,blood loss and postoperative complications between the two groups,the differences were not statistically significant(P>0.05).Compared with control group,the exposure evaluation scores in the upper pole[(3.88±0.32)points vs.(2.15±0.22)points],under pole[(3.68±0.46) points vs.(2.18±0.42) points]and lateral side[(3.55±0.47)points vs.(2.18±0.39)points]of thyroid in observation group were significantly better (P<0.01),but the exposure effect scores in thyroid gorge were signilicantly lower [(2.31±0.39) points vs.(3.48±0.52) points](P<0.01),SF-36 score was better [(77.1±7.3) points vs.(66.4±6.8)points](P<0.05).Conclusion The effects of cervical strap muscles longitudinal incision and linea alba cervicalis incision in thyroid surgery are satisfactory,but the exposure effect of two incision are different,thus it is required to choose the applications according to the conditions ofpatients.