Pub Date : 2015-01-05DOI: 10.3760/CMA.J.ISSN.1673-4904.2015.01.017
Liao Zhimin, Hu Weijiang, Hu Lei, Zheng Wei, Pang Yixiong
Objective To evaluate the effect of chest backplate in treating multiple rib fractures in patients with focal abnormal breathing. Methods The clinical data of 36 patients with multiple rib fractures and focal abnormal breathing who were treated by Chrisofix chest backplate were analyzed. Results Thirty-four patients were cured by chest backplate and other conservative treatments,and 2 patients underwent rib internal fixation surgery. The numeric rating scales scores before and after the application of the chest backplate were (8.1±0.7) scores and (5.2±0.5) scores respectively(P <0.01). Seven patients had skin blisters forming around the shield, which were cured by liquid extraction with a syringe and gauze covered with povidone iodine. No patients stopped treatment because of allergy. Conclusions Chest backplate is an effective, easy and inexpensive method for patient with multiple rib fractures and focal abnormal breathing who doesn't need exploratory thoracotomy. It is worthy to spread in clinical treatment. Key words: Rib fractures; Flail chest; Abnormal breathing; Chest backplate; Conservative treatment
{"title":"The role of chest backplate in treating multiple rib fractures in patients with focal abnormal breathing: analysis of 36 cases","authors":"Liao Zhimin, Hu Weijiang, Hu Lei, Zheng Wei, Pang Yixiong","doi":"10.3760/CMA.J.ISSN.1673-4904.2015.01.017","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4904.2015.01.017","url":null,"abstract":"Objective \u0000To evaluate the effect of chest backplate in treating multiple rib fractures in patients with focal abnormal breathing. \u0000 \u0000 \u0000Methods \u0000The clinical data of 36 patients with multiple rib fractures and focal abnormal breathing who were treated by Chrisofix chest backplate were analyzed. \u0000 \u0000 \u0000Results \u0000Thirty-four patients were cured by chest backplate and other conservative treatments,and 2 patients underwent rib internal fixation surgery. The numeric rating scales scores before and after the application of the chest backplate were (8.1±0.7) scores and (5.2±0.5) scores respectively(P <0.01). Seven patients had skin blisters forming around the shield, which were cured by liquid extraction with a syringe and gauze covered with povidone iodine. No patients stopped treatment because of allergy. \u0000 \u0000 \u0000Conclusions \u0000Chest backplate is an effective, easy and inexpensive method for patient with multiple rib fractures and focal abnormal breathing who doesn't need exploratory thoracotomy. It is worthy to spread in clinical treatment. \u0000 \u0000 \u0000Key words: \u0000Rib fractures; Flail chest; Abnormal breathing; Chest backplate; Conservative treatment","PeriodicalId":10229,"journal":{"name":"Chinese Journal of Postgraduates of Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69929204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2012-10-15DOI: 10.3760/CMA.J.ISSN.1673-4904.2012.29.005
W. Cui, Youzhi Zhu, Xiangjin Chen, Xinmin Lin, Ling-jun Kong
Objective To investigate the diagnostic value of ultrasound on patients with papillary thyroid carcinoma (PTC) coexisted with Hashimoto thyroiditis (HT).Methods The preoperative ultrasonography data of 2144 cases with PTC from January 2006 to December 2011 who treated with operation and diagnosed by pathology were analyzed retrospectively.Among them,265 cases coexisted with HT (PTC coexisted with HT group),1879 cases were not coexisted with HT (non-PTC coexisted with HT group).Results Most of the cancerous nodes in two groups exhibited in the ultrasonographic performance just like irregular shape,unclear boundary and so on (P ＞ 0.05).Most of the cancerous nodes in non-PTC coexisted with HT group exhibited hypoechoic nodules with microcalcifications,those in PTC coexisted with HT group exhibited various internal echoes with mainly microcalcifications,and the coarse calcification occupied a certain proportion(P＜ 0.01 ).The cancerous nodes in PTC coexisted with HT group were not rich in blood flow compared with non-PTC coexisted with HT group,but mostly exhibited blood disorders.When compared with non-PTC coexisted with HT group,the rate of ultrasound diagnosis in PTC coexisted with HT group was lower [ 52.8 ％( 140/265 ) vs.75.0 ％ (1409/1879),P ＜ 0.01 ],and the false positive rate in lymph node was higher [84.0％(487/580) vs.74.8％ (77/103)] (P ＜0.05).Conclusions The nodules are malignant when they appear as hypoechoic solid nodules,have unclear boundary and have microcalcifications should be highly suspected.The hyperechoic solid nodules or coarse calcification nodules should also be awared and taken further observation of the characteristics around the echoes and the internal blood flow,making comprehensive analysis to determine whether it could be malignant transformation and try best to reduce the misdiagnosis and missed diagnosis rates of this disease. Key words: Thyroiditis; Thyroid neoplasms; Ultrasonography
{"title":"The clinical value of ultrasound diagnosis on papillary thyroid carcinoma coexisted with Hashimoto thyroiditis","authors":"W. Cui, Youzhi Zhu, Xiangjin Chen, Xinmin Lin, Ling-jun Kong","doi":"10.3760/CMA.J.ISSN.1673-4904.2012.29.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4904.2012.29.005","url":null,"abstract":"Objective To investigate the diagnostic value of ultrasound on patients with papillary thyroid carcinoma (PTC) coexisted with Hashimoto thyroiditis (HT).Methods The preoperative ultrasonography data of 2144 cases with PTC from January 2006 to December 2011 who treated with operation and diagnosed by pathology were analyzed retrospectively.Among them,265 cases coexisted with HT (PTC coexisted with HT group),1879 cases were not coexisted with HT (non-PTC coexisted with HT group).Results Most of the cancerous nodes in two groups exhibited in the ultrasonographic performance just like irregular shape,unclear boundary and so on (P ＞ 0.05).Most of the cancerous nodes in non-PTC coexisted with HT group exhibited hypoechoic nodules with microcalcifications,those in PTC coexisted with HT group exhibited various internal echoes with mainly microcalcifications,and the coarse calcification occupied a certain proportion(P＜ 0.01 ).The cancerous nodes in PTC coexisted with HT group were not rich in blood flow compared with non-PTC coexisted with HT group,but mostly exhibited blood disorders.When compared with non-PTC coexisted with HT group,the rate of ultrasound diagnosis in PTC coexisted with HT group was lower [ 52.8 ％( 140/265 ) vs.75.0 ％ (1409/1879),P ＜ 0.01 ],and the false positive rate in lymph node was higher [84.0％(487/580) vs.74.8％ (77/103)] (P ＜0.05).Conclusions The nodules are malignant when they appear as hypoechoic solid nodules,have unclear boundary and have microcalcifications should be highly suspected.The hyperechoic solid nodules or coarse calcification nodules should also be awared and taken further observation of the characteristics around the echoes and the internal blood flow,making comprehensive analysis to determine whether it could be malignant transformation and try best to reduce the misdiagnosis and missed diagnosis rates of this disease. \u0000 \u0000Key words: \u0000Thyroiditis; Thyroid neoplasms; Ultrasonography","PeriodicalId":10229,"journal":{"name":"Chinese Journal of Postgraduates of Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69929162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2012-10-05DOI: 10.3760/CMA.J.ISSN.1673-4904.2012.28.007
Xin Liu, Dan-yu Gao, Jin Hu, San-dong Dai
Objective To explore different risk factors in different age groups patients with large-artery atherosclerotic cerebral infarction,in order to reduce the rates of cerebral infarction and relapse by taking different means of prevention.Methods One hundred and ninety-two patients with large-artery atherosclerotic cerebral infarction were divided into three groups by age:youth group (46 cases),middle age group (57 cases) and elderly group (89 cases).The study variables included sex,previous medical history (hypertension and diabetes),long-term smoking,long-term alcohol intake and laboratory parameters (triglyceride,high-density lipoprotein cholesterol,low-density lipoprotein cholesterol,homocysteine).Results The rates of high triglyceride and long-term smokingin youth group were significantly higher than those in elderly group [ 60.9％ (28/46) vs.22.5％ (20/89),65.2％ (30/46) vs.29.2％ (26/89),P ＜ 0.05 ].The rates of male,long-term smoking and long-term alcohol intake in middle age group were significantly higher than those in elderly group [ 80.7％ (46/57) vs.59.6％ (53/89),57.9％ (33/57) vs.29.2％ (26/89),47.4％ (27/57) vs.15.7％ (14/89),P ＜ 0.05 ].The rates of hypertension,diabetes and long-term alcohol intake in middle age group were significantly higher than those in youth group [ 84.2％ (48/57) vs.60.9％ (28/46),54.4％ (31/57 ) vs.26.1％ ( 12/46 ),47.4％ (27/57) vs.23.9％ ( 11/46 ),P ＜ 0.05 ].The rate of high triglyceride in youth group was significantly higher than that in middle age group [60.9％(28/46) vs.29.8％(17/57),P ＜ 0.05 ].The rate of hypertension in elderly group was significantly higher than that in youth group [ 83.1％(74/89) vs.60.9％ (28/46),P ＜0.05].There was no significant difference in low-density lipoprotein cholesterol,homocysteine and high-density lipoprotein cholesterol in the three groups (P ＞0.05).Conclusions Key point is different for the prevention of large-artery atherosclerosis cerebral infarction of different age paragraph.The youth patient emphasizes the change of lifestyle.Middle age patient has more emphasis on blood pressure,blood glucose control of the risk factors based on the lifestyle change.The key of elderly patient is the control of blood pressure. Key words: Brain infarction; Atherosclerosis; Risk factors
{"title":"Comparative analysis of risk factors for large-artery atherosclerotic cerebral infarction in different age groups","authors":"Xin Liu, Dan-yu Gao, Jin Hu, San-dong Dai","doi":"10.3760/CMA.J.ISSN.1673-4904.2012.28.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4904.2012.28.007","url":null,"abstract":"Objective To explore different risk factors in different age groups patients with large-artery atherosclerotic cerebral infarction,in order to reduce the rates of cerebral infarction and relapse by taking different means of prevention.Methods One hundred and ninety-two patients with large-artery atherosclerotic cerebral infarction were divided into three groups by age:youth group (46 cases),middle age group (57 cases) and elderly group (89 cases).The study variables included sex,previous medical history (hypertension and diabetes),long-term smoking,long-term alcohol intake and laboratory parameters (triglyceride,high-density lipoprotein cholesterol,low-density lipoprotein cholesterol,homocysteine).Results The rates of high triglyceride and long-term smokingin youth group were significantly higher than those in elderly group [ 60.9％ (28/46) vs.22.5％ (20/89),65.2％ (30/46) vs.29.2％ (26/89),P ＜ 0.05 ].The rates of male,long-term smoking and long-term alcohol intake in middle age group were significantly higher than those in elderly group [ 80.7％ (46/57) vs.59.6％ (53/89),57.9％ (33/57) vs.29.2％ (26/89),47.4％ (27/57) vs.15.7％ (14/89),P ＜ 0.05 ].The rates of hypertension,diabetes and long-term alcohol intake in middle age group were significantly higher than those in youth group [ 84.2％ (48/57) vs.60.9％ (28/46),54.4％ (31/57 ) vs.26.1％ ( 12/46 ),47.4％ (27/57) vs.23.9％ ( 11/46 ),P ＜ 0.05 ].The rate of high triglyceride in youth group was significantly higher than that in middle age group [60.9％(28/46) vs.29.8％(17/57),P ＜ 0.05 ].The rate of hypertension in elderly group was significantly higher than that in youth group [ 83.1％(74/89) vs.60.9％ (28/46),P ＜0.05].There was no significant difference in low-density lipoprotein cholesterol,homocysteine and high-density lipoprotein cholesterol in the three groups (P ＞0.05).Conclusions Key point is different for the prevention of large-artery atherosclerosis cerebral infarction of different age paragraph.The youth patient emphasizes the change of lifestyle.Middle age patient has more emphasis on blood pressure,blood glucose control of the risk factors based on the lifestyle change.The key of elderly patient is the control of blood pressure. \u0000 \u0000Key words: \u0000Brain infarction; Atherosclerosis; Risk factors","PeriodicalId":10229,"journal":{"name":"Chinese Journal of Postgraduates of Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69929144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2012-02-15DOI: 10.3760/CMA.J.ISSN.1673-4904.2012.05.003
Hong-ming Zheng, Jun-Ying Sun, Sheng-jie Dong, Ye Jin, Qiang Wang
Objective To evaluate the intermediate term efficacy of posterior stabilized (PS) total knee arthroplasty(TKA) and posterior cruciate-retaining(CR) TKA and explore the clinical related problem.Methods The clinical data of 84 patients (87 knees) who treated with primary TKA from May 1992 to May 2006 were analyzed retrospectively.The intermediate term efficacy was compared between PS TKA (PS group,41 cases with 43 knees) and CR TKA (CR group,43 cases with 44 knees).Results All the patients were followed up for 5-10(7.6 ± 1.5 ) years,no infection,dislocation or neurovascular injury occurred in both groups.But 1 knee occurred intraoperative posterolateral femoral condyle fracture in PS group.The lateral retinacular release rate was 2.3％ ( 1/43 ) and 2.3％ (1/44) in PS group and CR group,respectively.The incidence of anterior knee pain was 4.7％(2/43 ) and 4.5％(2/44) after 6 months surgery in PS group and CR group.The incidence of anterior knee pain was 0 at the end of follow-up in both groups.There was no significant difference in the lateral retinacular release rate and the incidence of anterior knee pain between two groups (P ＞0.05).The range of motion and American knee society score (KSS) was similar and no statistical difference was found between two groups(P ＞ 0.05 ).The incidence of patellar tilt or subluxation in X-ray was 2.3％ (1/43) and 2.3％ (1/44) at the end of follow-up in PS group and CR group.There was no significant difference between two groups (P ＞ 0.05 ).At the end of follow-up,no osteolysis,X-ray radiolucent zone and prosthesis loosening were found in both groups.There was no revision owing to loosening or other reasons.Conclusions The intermediate term efficacy of PS TKA and CR TKA is near a tie.However,the future efficacy still need further follow-up. Key words: Arthroplasty,replacement,knee; Treatment outcome
{"title":"Comparison of intermediate term efficacy between posterior stabilized and posterior cruciateretaining total knee arthroplasty","authors":"Hong-ming Zheng, Jun-Ying Sun, Sheng-jie Dong, Ye Jin, Qiang Wang","doi":"10.3760/CMA.J.ISSN.1673-4904.2012.05.003","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4904.2012.05.003","url":null,"abstract":"Objective To evaluate the intermediate term efficacy of posterior stabilized (PS) total knee arthroplasty(TKA) and posterior cruciate-retaining(CR) TKA and explore the clinical related problem.Methods The clinical data of 84 patients (87 knees) who treated with primary TKA from May 1992 to May 2006 were analyzed retrospectively.The intermediate term efficacy was compared between PS TKA (PS group,41 cases with 43 knees) and CR TKA (CR group,43 cases with 44 knees).Results All the patients were followed up for 5-10(7.6 ± 1.5 ) years,no infection,dislocation or neurovascular injury occurred in both groups.But 1 knee occurred intraoperative posterolateral femoral condyle fracture in PS group.The lateral retinacular release rate was 2.3％ ( 1/43 ) and 2.3％ (1/44) in PS group and CR group,respectively.The incidence of anterior knee pain was 4.7％(2/43 ) and 4.5％(2/44) after 6 months surgery in PS group and CR group.The incidence of anterior knee pain was 0 at the end of follow-up in both groups.There was no significant difference in the lateral retinacular release rate and the incidence of anterior knee pain between two groups (P ＞0.05).The range of motion and American knee society score (KSS) was similar and no statistical difference was found between two groups(P ＞ 0.05 ).The incidence of patellar tilt or subluxation in X-ray was 2.3％ (1/43) and 2.3％ (1/44) at the end of follow-up in PS group and CR group.There was no significant difference between two groups (P ＞ 0.05 ).At the end of follow-up,no osteolysis,X-ray radiolucent zone and prosthesis loosening were found in both groups.There was no revision owing to loosening or other reasons.Conclusions The intermediate term efficacy of PS TKA and CR TKA is near a tie.However,the future efficacy still need further follow-up. \u0000 \u0000Key words: \u0000Arthroplasty,replacement,knee; Treatment outcome","PeriodicalId":10229,"journal":{"name":"Chinese Journal of Postgraduates of Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69929101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2011-10-25DOI: 10.3760/CMA.J.ISSN.1673-4904.2011.30.009
Wei Zhao, Wenbing Jiang, Dong-chu Zhang, Lu Yu, Y. Wang, Jian-hua Zhang
Objective To investigate the correlation between serum uric acid level and severity of coronary artery disease.Methods The concentrations of serum uric acid in 112 patients whom had received coronary arteriongraphy(CAG) was measured,among of them,acute coronary artery syndrome (ACS) with 58 cases( ACS group ),stable angina cordis with 25 cases( stable angina cordis group),non-coronary disease with 29 cases(control group).The severity of coronary artery lesion was evaluated by the number of stenosis vessel and Gensini score.They were divided into control group (29 cases),single vessel lesion group (24 cases),double vessel lesion group(26 cases),triple vessel lesion group(33 cases ) according to the number of stenosis vessel and 0-1 score group(29 cases),2-20 scores group(28 cases),21-40 scores group(30 cases),＞40 scores group (25 cases) according to the Gensini score.Results The concentrations of serum uric acid in ACS group were higher than those in control group and stable angina cordis group[ (369.61 ± 91.97 ) μ mol/Lvs. (298.33 ±92.46),(330.43 ±87.42)μmol/L] (P ＜0.05).The concentrations of serum uric acid in control group were lower than those in single vessel lesion group,double vessel lesion group and triple vessel lesion group [(298.33 ±92.46)μmol/L vs. (331.77 ±86.33),(368.24 ±95.21),(396.82 ±94.45) μ mol/L] (P ＜ 0.05).The concentrations of serum uric acid in single vessel lesion group were significantly lower than those in double vessel lesion group and triple vessel lesion group (P ＜ 0.05 ).The concentrations of serum uric acid in 0-1 score group [ (298.33 ± 92.46) μ mol/L] and 2-20 scores group [ (320.77 ± 86.33 ) μ mol/L ] were respectively lower than those in 21-40 scores group [ (366.61 ± 91.97 ) μ mol/L ] and ＞ 40 scores group [ (402.82 ± 91.97 ) μ mol/L] (P ＜ 0.05 ).The concentrations of serum uric acid in ＞ 40 scores group was higher than that in 21-40 scores group (P ＜ 0.05 ).Serum uric acid concentrations was positively correlated with the log of Gensini score (r =0.348,P ＜ 0.05 ).Conclusion The increase in serum uric acid might reflect increase in severity of coronary artery stenosis. Key words: Coronary disease; Uric acid; Gensini coronary score
{"title":"Correlation between serum uric acid level and severity of coromry artery","authors":"Wei Zhao, Wenbing Jiang, Dong-chu Zhang, Lu Yu, Y. Wang, Jian-hua Zhang","doi":"10.3760/CMA.J.ISSN.1673-4904.2011.30.009","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4904.2011.30.009","url":null,"abstract":"Objective To investigate the correlation between serum uric acid level and severity of coronary artery disease.Methods The concentrations of serum uric acid in 112 patients whom had received coronary arteriongraphy(CAG) was measured,among of them,acute coronary artery syndrome (ACS) with 58 cases( ACS group ),stable angina cordis with 25 cases( stable angina cordis group),non-coronary disease with 29 cases(control group).The severity of coronary artery lesion was evaluated by the number of stenosis vessel and Gensini score.They were divided into control group (29 cases),single vessel lesion group (24 cases),double vessel lesion group(26 cases),triple vessel lesion group(33 cases ) according to the number of stenosis vessel and 0-1 score group(29 cases),2-20 scores group(28 cases),21-40 scores group(30 cases),＞40 scores group (25 cases) according to the Gensini score.Results The concentrations of serum uric acid in ACS group were higher than those in control group and stable angina cordis group[ (369.61 ± 91.97 ) μ mol/Lvs. (298.33 ±92.46),(330.43 ±87.42)μmol/L] (P ＜0.05).The concentrations of serum uric acid in control group were lower than those in single vessel lesion group,double vessel lesion group and triple vessel lesion group [(298.33 ±92.46)μmol/L vs. (331.77 ±86.33),(368.24 ±95.21),(396.82 ±94.45) μ mol/L] (P ＜ 0.05).The concentrations of serum uric acid in single vessel lesion group were significantly lower than those in double vessel lesion group and triple vessel lesion group (P ＜ 0.05 ).The concentrations of serum uric acid in 0-1 score group [ (298.33 ± 92.46) μ mol/L] and 2-20 scores group [ (320.77 ± 86.33 ) μ mol/L ] were respectively lower than those in 21-40 scores group [ (366.61 ± 91.97 ) μ mol/L ] and ＞ 40 scores group [ (402.82 ± 91.97 ) μ mol/L] (P ＜ 0.05 ).The concentrations of serum uric acid in ＞ 40 scores group was higher than that in 21-40 scores group (P ＜ 0.05 ).Serum uric acid concentrations was positively correlated with the log of Gensini score (r =0.348,P ＜ 0.05 ).Conclusion The increase in serum uric acid might reflect increase in severity of coronary artery stenosis. \u0000 \u0000Key words: \u0000Coronary disease; Uric acid; Gensini coronary score","PeriodicalId":10229,"journal":{"name":"Chinese Journal of Postgraduates of Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69929064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2011-05-15DOI: 10.3760/CMA.J.ISSN.1673-4904.2011.14.008
Ximeng Chen, X. Liao, Hai-kun Wang, Hui-xu He
Objective To summarize experience to prevent the main postoperative complications after hypospadias repairs. Method The clinical data of 189 cases of hypospadias repairs was from May 2005 to August 2010,retrospectively analyzed. Results One hundred and seventy-four cases were surgically cured by single-stage operation. All cases had been followed up for 4-36 (18.5 ± 5.5) months, the cases who had become adults were normal penile development and erectile function. Postoperative complications occurred in 15 cases,9 cases of them were urethral fistulas,6 cases were urethral strictures,all were cured or improved after symptomatic treatments. Conclusions Some methods are necessary to raise single-stage urethroplasty success rate and decrease the incidence of fistulas and strictures, such as preoperative antibiotic prophylaxis,appropriate procedure,intraoperative suprapublic urinary diversion,the good blood supply of the flap, modified enswathement, postoperative manage and nursing. Key words: Hypospadias; Reconstructive surgical procedures; Postoperative complications
{"title":"Prevention of postoperative complications after single-stage hypospadias repair","authors":"Ximeng Chen, X. Liao, Hai-kun Wang, Hui-xu He","doi":"10.3760/CMA.J.ISSN.1673-4904.2011.14.008","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4904.2011.14.008","url":null,"abstract":"Objective To summarize experience to prevent the main postoperative complications after hypospadias repairs. Method The clinical data of 189 cases of hypospadias repairs was from May 2005 to August 2010,retrospectively analyzed. Results One hundred and seventy-four cases were surgically cured by single-stage operation. All cases had been followed up for 4-36 (18.5 ± 5.5) months, the cases who had become adults were normal penile development and erectile function. Postoperative complications occurred in 15 cases,9 cases of them were urethral fistulas,6 cases were urethral strictures,all were cured or improved after symptomatic treatments. Conclusions Some methods are necessary to raise single-stage urethroplasty success rate and decrease the incidence of fistulas and strictures, such as preoperative antibiotic prophylaxis,appropriate procedure,intraoperative suprapublic urinary diversion,the good blood supply of the flap, modified enswathement, postoperative manage and nursing. \u0000 \u0000Key words: \u0000Hypospadias; Reconstructive surgical procedures; Postoperative complications","PeriodicalId":10229,"journal":{"name":"Chinese Journal of Postgraduates of Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69928997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2010-11-05DOI: 10.3760/CMA.J.ISSN.1673-4904.2010.31.003
Wang Hehua, Wen-fang Chen, X. Tong, Mian-sheng Yan, Duo-rong Xu, L. Juan
Objective To analyze the clinical pathology features of light-chain amyloidosis associated renal disease,and investigate the survival influential factors. Method From January 1998 to March 2009,25 patients with light-chain amyloidosis associated renal disease were reviewed and followed up.Results Of the 25 patients with light-chain amyloidosis associated renal disease,median age was 57(37-69) years old and lamda light-chain predominated (88% ,22/25). Heavy proteinuria and nephrotic syndrome with peripheral edema were typical clinical presentations. Renal biopsy showed that amyloid deposition of light-chain amyloidosis associated renal disease involved the glomeruh mostly, with mesangial area widening. Median survival of all patients was 24.4 months after diagnosis. The estimated 1,2,3 year survival rate was (65 ± 10 )%, (46 ± 12 )% and (15 ± 12 )% respectively. There was significant difference in median survival between the two groups (24.7 months in the group of 14 patients with isolated kidney affected,16.4 months in the group of 11 patients with kidney and other organs involved,P = 0.03). By univariate analysis, kidney associated with other organs amyloidosis and renal dysfunction were relevant to prognosis (P ＜ 0.05) and heart involvement was probably relevant (P = 0.06),whereas sex,age,plasma cell ratio,serum albumin level and hemoglobin level had no relation(P＞ 0.05 ). Multivariate analysis revealed that renal dysfunction at the time of diagnosis was a significant and independent prognostic factor for survival (P ＜0.05). Conclusions Renal dysfunction at the time of diagnosis is the best predictor of survival. The presence of amyloidosis in organs other than the kidney, such as advanced cardiac amyloidosis, predicts a poor survival. Key words: Prognosis; Renal amyloidosis; Immunoglobulin light-chain; Survival analysis
{"title":"Clinical features and survival analysis of light-chain amyloidosis associated renal disease","authors":"Wang Hehua, Wen-fang Chen, X. Tong, Mian-sheng Yan, Duo-rong Xu, L. Juan","doi":"10.3760/CMA.J.ISSN.1673-4904.2010.31.003","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4904.2010.31.003","url":null,"abstract":"Objective To analyze the clinical pathology features of light-chain amyloidosis associated renal disease,and investigate the survival influential factors. Method From January 1998 to March 2009,25 patients with light-chain amyloidosis associated renal disease were reviewed and followed up.Results Of the 25 patients with light-chain amyloidosis associated renal disease,median age was 57(37-69) years old and lamda light-chain predominated (88% ,22/25). Heavy proteinuria and nephrotic syndrome with peripheral edema were typical clinical presentations. Renal biopsy showed that amyloid deposition of light-chain amyloidosis associated renal disease involved the glomeruh mostly, with mesangial area widening. Median survival of all patients was 24.4 months after diagnosis. The estimated 1,2,3 year survival rate was (65 ± 10 )%, (46 ± 12 )% and (15 ± 12 )% respectively. There was significant difference in median survival between the two groups (24.7 months in the group of 14 patients with isolated kidney affected,16.4 months in the group of 11 patients with kidney and other organs involved,P = 0.03). By univariate analysis, kidney associated with other organs amyloidosis and renal dysfunction were relevant to prognosis (P ＜ 0.05) and heart involvement was probably relevant (P = 0.06),whereas sex,age,plasma cell ratio,serum albumin level and hemoglobin level had no relation(P＞ 0.05 ). Multivariate analysis revealed that renal dysfunction at the time of diagnosis was a significant and independent prognostic factor for survival (P ＜0.05). Conclusions Renal dysfunction at the time of diagnosis is the best predictor of survival. The presence of amyloidosis in organs other than the kidney, such as advanced cardiac amyloidosis, predicts a poor survival. \u0000 \u0000Key words: \u0000Prognosis; Renal amyloidosis; Immunoglobulin light-chain; Survival analysis","PeriodicalId":10229,"journal":{"name":"Chinese Journal of Postgraduates of Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2010-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69928895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2010-10-25DOI: 10.3760/CMA.J.ISSN.1673-4904.2010.30.007
Xin-zhong Chen, Zhao Lin, L. Wen, Jian-wei Zhang, Bao-guo Wang
Objective To investigate the effect of propofol combined with remifentanil or sufentanil on cognitive function in patients undergoing awake craniotomy. Methods Sixty ASA Ⅰ or Ⅱ neurosurgical patients undergoing resection of glioma in cerebral cortical functional area were divided into 2 groups by random digits table: propofol + remifentanil (group RF, 30 cases) and propofol + sufentanil (group SF, 30 cases). Scalp nerve block and local infiltration of incision and dura mater were performed in both groups with 0.5% ropivacaine. Propofol, remifentanil and sufentanil were administered by target controlled infusion. The target plasma concentration of remifentanil was set at 1-2 ng/ml and that of sufentanil at 0.1-0.2 ng/ml,propofol was set at 3-6 μg/ml at open skull stage. The patients were inserted laryngeal mask and mechanically ventilated. Bispectral index (BIS) was monitored as the depth of anesthesia. Mini-mental scale examination (MMSE) was investigated at the time of preoperative,intraoperative wake-up after the patients had been targeted capacity. Results Blood concentration of propofol in group RF was (1.10 ± 0.06)μg/ml, group SF was (0.98 ± 0.05)μ g/ml in patients during intraoperative wake-up. BIS in group RF changed from 46.4 ± 2.5 to 90.8 ± 3.2 during wake-up, group SF from 44.8 ± 2.1 to 89.9 ± 3.2. The cognitive function score was not significantly different at the time of preoperative and intraoperative assessment. Conclusion Propofol combined with remifentanil or sufentanil has no effect on cognitive function for the patients undergoing awake craniotomy. Key words: Anesthetics,combined; Cognition; Wakefulness
{"title":"Effects of propofol combined with remifentanil or sufentanil on cognitive function in patients undergoing awake craniotomy","authors":"Xin-zhong Chen, Zhao Lin, L. Wen, Jian-wei Zhang, Bao-guo Wang","doi":"10.3760/CMA.J.ISSN.1673-4904.2010.30.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4904.2010.30.007","url":null,"abstract":"Objective To investigate the effect of propofol combined with remifentanil or sufentanil on cognitive function in patients undergoing awake craniotomy. Methods Sixty ASA Ⅰ or Ⅱ neurosurgical patients undergoing resection of glioma in cerebral cortical functional area were divided into 2 groups by random digits table: propofol + remifentanil (group RF, 30 cases) and propofol + sufentanil (group SF, 30 cases). Scalp nerve block and local infiltration of incision and dura mater were performed in both groups with 0.5% ropivacaine. Propofol, remifentanil and sufentanil were administered by target controlled infusion. The target plasma concentration of remifentanil was set at 1-2 ng/ml and that of sufentanil at 0.1-0.2 ng/ml,propofol was set at 3-6 μg/ml at open skull stage. The patients were inserted laryngeal mask and mechanically ventilated. Bispectral index (BIS) was monitored as the depth of anesthesia. Mini-mental scale examination (MMSE) was investigated at the time of preoperative,intraoperative wake-up after the patients had been targeted capacity. Results Blood concentration of propofol in group RF was (1.10 ± 0.06)μg/ml, group SF was (0.98 ± 0.05)μ g/ml in patients during intraoperative wake-up. BIS in group RF changed from 46.4 ± 2.5 to 90.8 ± 3.2 during wake-up, group SF from 44.8 ± 2.1 to 89.9 ± 3.2. The cognitive function score was not significantly different at the time of preoperative and intraoperative assessment. Conclusion Propofol combined with remifentanil or sufentanil has no effect on cognitive function for the patients undergoing awake craniotomy. \u0000 \u0000Key words: \u0000Anesthetics,combined; Cognition; Wakefulness","PeriodicalId":10229,"journal":{"name":"Chinese Journal of Postgraduates of Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2010-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69928518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2010-09-25DOI: 10.3760/CMA.J.ISSN.1673-4904.2010.27.006
Hai-yang Liu, Tong-yan Chen, Zeng Heng-yu, R. Han
Objective To investigate the effects of total intravenous anesthesia (TIVA) and combined intravenous and inhalation anesthesia on blood glucose and cortisol in spinal neurosurgery.Methods Forty-four spinal neurosurgery patients were divided into propofol combined with remifentanil group (PR group) and sevoflurane combined with remifentanil group (SR group ), 22 cases in each group,they were induced with propofol, sufentanil and rocuronium. Anesthesia was maintained with sevoflurane in SR group while propofol in PR group. Depth of anesthesia adaption according to bispectral index (BIS)(45 -55). Blood glucose, cortisol, haemodynamics were observed at different time points. Results The mean arterial pressure(MAP) was higher after induction in PR group than that in SR group(P ＜ 0.05 ). Sixty minutes after induction, MAP was lower than that before induction in PR group (P ＜ 0.05 ). Heart rate ( HR )in both SR group and PR group were lower at 60 and 120 minutes after induction than those before induction (P ＜ 0.05). HR was lower at 5 minutes after induction in PR group than that in SR group (P ＜ 0.05). No significant difference was showed in blood glucose and cortisol between the two groups (P ＞ 0.05 ). Cortisol level was significantly lower at 120 minutes after induction than that before induction [(40.6 ± 18.3) μg/L vs. ( 129.7 ± 36.7 ) μg/L, P ＜ 0.05 ] and at 24 hours postoperative [ (93.6 ± 19.8 ) μg/L ] recovered to the level before induction in PR group. Cortisol level was significantly higher before induction than 120 minutes after induction [ ( 130.5 ± 32.1 ) μg/L vs. (51.6 ± 16.8 ) μg/L, P ＜ 0.05 ] and 24 hours postoperative was (75.9 ± 18.2) μg/L in SR group. Conclusions Two anesthetic regimens are compatible during spinal neurosurgery, with no apparent fluctuations of perioperative blood glucose. However, longer cortisol inhibition is probably happened when using sevoflurane. Key words: Anesthesia, intravenous; Anesthesia, inhalation; Blood glucose; Hydrocortisone; Spinal neurosurgery
目的探讨全静脉麻醉(TIVA)与静脉吸入联合麻醉对脊柱神经外科手术患者血糖、皮质醇的影响。方法将44例脊柱神经外科患者分为异丙酚联合瑞芬太尼组(PR组)和七氟醚联合瑞芬太尼组(SR组)，每组22例，分别用异丙酚、舒芬太尼和罗库溴铵诱导。SR组以七氟醚维持麻醉，PR组以异丙酚维持麻醉。根据双谱指数(BIS)(45 -55)调整麻醉深度。观察不同时间点血糖、皮质醇、血流动力学变化。结果PR组诱导后平均动脉压(MAP)高于SR组(P < 0.05)。诱导60 min后，PR组MAP低于诱导前(P < 0.05)。SR组和PR组的心率(HR)在诱导后60、120 min均低于诱导前(P < 0.05)。PR组诱导后5 min HR低于SR组(P < 0.05)。两组血糖、皮质醇比较差异无统计学意义(P < 0.05)。PR组诱导后120 min皮质醇水平明显低于诱导前[(40.6±18.3)μg/L vs(129.7±36.7)μg/L, P < 0.05]，术后24 h[(93.6±19.8)μg/L]恢复到诱导前水平。诱导前皮质醇水平显著高于诱导后120 min[(130.5±32.1)μg/L vs(51.6±16.8)μg/L, P < 0.05]，术后24 h SR组皮质醇水平为(75.9±18.2)μg/L。结论两种麻醉方案在脊柱神经外科手术中是相容的，围手术期血糖无明显波动。然而，当使用七氟醚时，可能会发生更长时间的皮质醇抑制。关键词:麻醉;静脉注射;吸入麻醉;血糖;氢化可的松;脊髓神经外科
{"title":"Effects of total intravenous anesthesia and combined intravenous and inhalation anesthesia on blood glucose and cortisol in spinal neurosurgery","authors":"Hai-yang Liu, Tong-yan Chen, Zeng Heng-yu, R. Han","doi":"10.3760/CMA.J.ISSN.1673-4904.2010.27.006","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4904.2010.27.006","url":null,"abstract":"Objective To investigate the effects of total intravenous anesthesia (TIVA) and combined intravenous and inhalation anesthesia on blood glucose and cortisol in spinal neurosurgery.Methods Forty-four spinal neurosurgery patients were divided into propofol combined with remifentanil group (PR group) and sevoflurane combined with remifentanil group (SR group ), 22 cases in each group,they were induced with propofol, sufentanil and rocuronium. Anesthesia was maintained with sevoflurane in SR group while propofol in PR group. Depth of anesthesia adaption according to bispectral index (BIS)(45 -55). Blood glucose, cortisol, haemodynamics were observed at different time points. Results The mean arterial pressure(MAP) was higher after induction in PR group than that in SR group(P ＜ 0.05 ). Sixty minutes after induction, MAP was lower than that before induction in PR group (P ＜ 0.05 ). Heart rate ( HR )in both SR group and PR group were lower at 60 and 120 minutes after induction than those before induction (P ＜ 0.05). HR was lower at 5 minutes after induction in PR group than that in SR group (P ＜ 0.05). No significant difference was showed in blood glucose and cortisol between the two groups (P ＞ 0.05 ). Cortisol level was significantly lower at 120 minutes after induction than that before induction [(40.6 ± 18.3) μg/L vs. ( 129.7 ± 36.7 ) μg/L, P ＜ 0.05 ] and at 24 hours postoperative [ (93.6 ± 19.8 ) μg/L ] recovered to the level before induction in PR group. Cortisol level was significantly higher before induction than 120 minutes after induction [ ( 130.5 ± 32.1 ) μg/L vs. (51.6 ± 16.8 ) μg/L, P ＜ 0.05 ] and 24 hours postoperative was (75.9 ± 18.2) μg/L in SR group. Conclusions Two anesthetic regimens are compatible during spinal neurosurgery, with no apparent fluctuations of perioperative blood glucose. However, longer cortisol inhibition is probably happened when using sevoflurane. \u0000 \u0000Key words: \u0000Anesthesia, intravenous; Anesthesia, inhalation; Blood glucose; Hydrocortisone; Spinal neurosurgery","PeriodicalId":10229,"journal":{"name":"Chinese Journal of Postgraduates of Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2010-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69928454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2010-08-25DOI: 10.3760/CMA.J.ISSN.1673-4904.2010.24.010
Guo-hua Sun, Zhao-ping Zhang, Zheng Zhang, Gao Hong
Objective To investigate the role of fiberoptic bronchoscopy (FOB) in the positioning of ProSeal laryngeal mask airway (PLMA). Methods Sixty ASA Ⅰ or Ⅱ patients undergoing general anesthesia using PLMA were randomly divided into two groups with 30 cases each: inserted PLMA group (group A)and FOB positioning group (group B). After the routine intravenous anesthesia induction,the PLMA inflated to an intracapsular pressure of 50 cm H2O (1 cm H2O =0.098 kPa) with the positive airway pressure by the anesthesia apparatus, the airway seal pressure, airway peak voltage of intermittent positive pressure ventilation and tidal volume were evaluated. Results Patients from two groups achieved adequate lung ventilation (SpO2 ＞0.97,PETCO2 was normal), the operations were all smooth. There were 5 cases adjusted the position two times,and 1 case adjusted 3 times. Patients in group B were all PLMA insertion under FOB and airway seal pressure was higher,but airway peak voltage was lower than in group A (P＜0.05). Conclusion FOB elevates accurate allocation of PLMA,enhances the isolated function from the surrounding tissue of glottis, improves the lung ventilation, and increases the safety of PLMA. Key words: Bronchoscopes; Anesthesia,general; ProSeallaryngeal mask airway; Localization
目的探讨纤维支气管镜(FOB)在ProSeal喉罩气道(PLMA)定位中的作用。方法ASAⅠ或Ⅱ行PLMA全麻患者60例，随机分为两组，每组30例:A组置入PLMA组(A组)和FOB定位组(B组)。常规静脉麻醉诱导后，将PLMA充气至囊内压力为50 cm H2O (1 cm H2O =0.098 kPa)，麻醉器维持气道正压，评估气道密封压力、间歇正压通气气道峰值电压和潮气量。结果两组患者肺通气良好(SpO2 >0.97,PETCO2正常)，手术顺利。2次调整位置5例，3次调整1例。B组患者均在FOB下插入PLMA，气道密封压力较高，但气道峰值电压低于A组(P<0.05)。结论离心式通气可提高声门瓣的准确配置，增强声门瓣与周围组织的分离功能，改善肺通气，提高声门瓣的安全性。关键词:支气管镜;麻醉,一般;咽前面罩气道;本地化
{"title":"The role of fiberoptic bronchoscopy in the positioning of ProSeal laryngeal mask airway","authors":"Guo-hua Sun, Zhao-ping Zhang, Zheng Zhang, Gao Hong","doi":"10.3760/CMA.J.ISSN.1673-4904.2010.24.010","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4904.2010.24.010","url":null,"abstract":"Objective To investigate the role of fiberoptic bronchoscopy (FOB) in the positioning of ProSeal laryngeal mask airway (PLMA). Methods Sixty ASA Ⅰ or Ⅱ patients undergoing general anesthesia using PLMA were randomly divided into two groups with 30 cases each: inserted PLMA group (group A)and FOB positioning group (group B). After the routine intravenous anesthesia induction,the PLMA inflated to an intracapsular pressure of 50 cm H2O (1 cm H2O =0.098 kPa) with the positive airway pressure by the anesthesia apparatus, the airway seal pressure, airway peak voltage of intermittent positive pressure ventilation and tidal volume were evaluated. Results Patients from two groups achieved adequate lung ventilation (SpO2 ＞0.97,PETCO2 was normal), the operations were all smooth. There were 5 cases adjusted the position two times,and 1 case adjusted 3 times. Patients in group B were all PLMA insertion under FOB and airway seal pressure was higher,but airway peak voltage was lower than in group A (P＜0.05). Conclusion FOB elevates accurate allocation of PLMA,enhances the isolated function from the surrounding tissue of glottis, improves the lung ventilation, and increases the safety of PLMA. \u0000 \u0000Key words: \u0000Bronchoscopes; Anesthesia,general; ProSeallaryngeal mask airway; Localization","PeriodicalId":10229,"journal":{"name":"Chinese Journal of Postgraduates of Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2010-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69928435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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