目的:总结经鼻内窥镜下手术治疗管内段视神经损伤的疗效。方法:回顾性分析11例视神经损伤住院患者的临床资料。结果:行视神经减压术的11例患者中1例失访，7例有效，其中4例视力有较明显的提高。结论:经鼻内镜视神经减压术损伤小，并发症少，手术时间短，疗效满意。
Objective To investigate the antibiotic resistance distribution and profiles of multidrug resistant bacteria in respiratory intensive care unit ( RICU) , and to analyze the related risk factors for multidrug resistant bacterial infections. Methods Pathogens from79 patients in RICU from April 2008 to May 2009 were analyzed retrospectively. Meanwhile the risk factors were analyzed by multi-factor logistic analysis among three groups of patients with non-multidrug, multidrug and pandrug-resistant bacterialinfection. Results The top three in 129 isolated pathogenic bacteria were Pseudomonas aeruginosa ( 24. 0% ) , Staphylococcus aureus( 22. 5% ) , and Acinetobacter baumannii( 15. 5% ) . The top three in 76 isolated multidrug-resistant bacteria were Staphylococcus aureus ( 38. 9% ) , Pseudomonas aeruginosa ( 25. 0% ) , and Acinetobacter baumannii( 19. 4% ) . And the two main strains in 29 isolated pandrug-resistant bacteria were Pseudomonas aeruginosa ( 48. 3% ) and Acinetobacter baumannii ( 44. 8% ) . Multi-factor logistic analysis revealed that the frequency of admition to RICU, the use of carbapenem antibiotics, the time of mechanical ventilation, the time of urethral catheterization, and complicated diabetes mellitus were independent risk factors for multidrug-resistant bacterial infection( all P lt; 0. 05) . Conclusions There is a high frequency of multidrug-resistant bacterial infection in RICU. Frequency of admition in RICU, use of carbapenem antibiotics, time of mechanical ventilation, time of urethral catheterization, and complicated diabetes mellitus were closely related withmultidrug-resistant bacterial infection.
Objective To investigate the prognostic factors of severe chronic obstructive pulmonary disease ( COPD) in elderly patients, and to guide the clinical assessment and appropriate interventions. Methods A prospective cohort study was carried out from May 1993 to December 2010. A total of 178 elderly patients with severe COPD were recruited for baseline survey, and followed up for the living conditions, whether used non-invasive ventilation, and causes of death. A survival analysis was performed on all patients stratified by lung function. The significant factors on survival rate were analyzed. Results In this cohort the survival rates were 49% and 12% in five and ten years, respectively. The important factors for prognosis were age [ relative risk( RR) = 1. 043, 95% confidence intervals( 95% CI = 1. 010-1. 050] , forced expired volume in one second ( FEV1 , RR = 0. 019, 95% CI = 0. 007-0. 052) , FEV1% pred ( RR = 1. 045, 95% CI = 1. 012-1. 079) , lung function grade ( RR = 2. 542, 95% CI = 1. 310-4. 931) , body mass index ( BMI, RR= 0. 945, 95% CI = 0. 895-0. 952) , and pulmonary heart disease ( RR = 1. 872, 95% CI = 1. 188- 2. 959) . In severe COPD, non-invasive ventilation ( NIV, RR = 1. 167, 95% CI = 0. 041-1. 674) , pulmonary heart disease ( RR = 3. 805, 95% CI = 1. 336-10. 836) , FEV1 ( RR = 0. 081, 95% CI = 1. 001-1. 168) , and arterial partial of oxygen ( PaO2 , RR=0. 956, 95% CI =0. 920-0. 993) were the independent predictors.The patients using NIV had longer survival than those without NIV. The 5 and 10 years survival rate in the patients with NIV were 78% and 50% , much higher than those without ventilation which were 30% and 25% , respectively. In extremely severe COPD, FEV1 ( RR=1. 059, 95% CI =1. 015-1. 105) , arterial partial of carbon dioxide ( PaCO2 , RR=1. 037, 95% CI = 1. 001-1. 074) , age ( RR= 1. 054, 95% CI = 1. 013-1. 096) and pulmonary heart disease ( RR = 1. 892, 95% CI = 1. 125-3. 181) were the independent predictors. Conclusions Age, BMI, FEV1 , PaO2 , PaCO2 , pulmonary heart disease, and NIV were prognostic factors in elderly patients with severe COPD. The prognostic factors between severe and extremely severe COPD were not identical. Patients with severe COPD should be given early intervention, including progressive nutritional support, and long-term home oxygen therapy combining with NIV.
ObjectiveTo explore the risk factors associated with severe hand-food-mouth disease (HFMD) in Chongqing, in order to carry out intervention work in the future, provide reference for reducing the incidence and fatality rate of severe HFMD cases. MethodsNinety severe HFMD cases treated between 2011 and 2014 in Chongqing were enrolled as case group while another 90 mild HFMD cases were randomly selected as control group in the same period. All subjects’ parents or babysitters were asked to fill in a questionnaire which included demography, ways of babysitting, behavior and the like. All HFMD cases were diagnosed by both clinical symptoms and nuclear acid testing. Data were processed by EpiData 3.1 and analyzed by SPSS 13.0. ResultsSingle-factor analysis showed that there were 14 risk factors of severe HFMD including virus type, registered residence type, current address type, cultural degree of their caregivers, season of the onset, existence of fever and rash, first hospital diagnosis type, and whether the first diagnosis was HFMD (P ＜ 0.05) . Multifactor analysis showed the risk factors included the current rural residence type [OR=27.29, 95%CI (3.71, 200.72) ], misdiagnosis as disease other than HFMD in the first visit to the hospital [OR=141.03, 95%CI (12.43, 1 599.70) ], and virus type of EV71 [OR=244.32, 95%CI (18.99, 3 143.74) ]. ConclusionsActive surveillance should be carried out on the risk factors of severe HFMD. At the same time, active and effective preventive measures, and timely treatment of patients with severe HFMD can help to reduce the incidence and case fatality rate.
ObjectiveTo investigate the effect of ozone on oxidative stress and energy metabolism change of blood from aortic dissection (AD) patients for providing preliminary evidence of application of ozonated autohemotherapy (ozone-AHT) in AD patients. MethodsTwenty AD patients (16 males and 4 females with a mean age of 48.51±10.21 years) were consecutively included in the First Affiliated Hospital of Harbin Medical University from March 2016 to August 2016, and blood samples were collected from all participants and ozonized in vitro at different ozone concentrations (0 μg/ml, 40 μg/ml, 60 μg/ml, 80 μg/ml, 160 μg/ml). Malondialdehyde (MDA), red blood cells (RBCs) superoxide dismutase (SOD), Na+-K+-ATP, 2,3-bisphosphoglyceric acid (2,3-DPG) at different ozone concentrations were evaluated by enzyme-linked immunosorbent assay (ELISA). ResultsIn the control group (0 μg/ml), the content of postoperative MDA was significantly higher than that of preoperation (P<0.05). The contents of postoperative SOD, Na+-K+-ATP and 2,3-DPG were significantly lower than that of preoperation (P<0.05). The content of MDA at the concentrations of 40 μg/ml, 60 μg/ml, 80 μg/ml group increased after the operation (P>0.05), and the SOD, Na+-K+-ATP, 2,3-DPG decreased compared with the preoperation (P>0.05). But all the values were not statistically significant at the concentrations of 40 μg/ml, 80 μg/ml and 160 μg/ml respectively between preoperation and postoperation (P>0.05). Compared with other concentration groups, the content of preoperative and postoperative MDA increased in the ozone group (160 μg/ml), and oppositely, the contents ofpreoperative and postoperative SOD, Na+-K+- ATP and 2,3-DPG decreased (P<0.05). Conclusion The concentrations of 40 to 80 μg/ml of ozone can improve the antioxidant capacity of erythrocyte membrane, reduce oxidative stress in blood samples of AD patients and improve the energy metabolism of erythrocyte membranes, so the concentration range of ozone is safe and feasible for the ozone-AHT of perioperative AD.
Objective To review the research progress of the feasibility of a new treatment method for atrophic rhinitis (ATR) based on tissue engineering technology (seed cells, scaffold materials, and growth factors), and provide new ideas for the treatment of ATR. MethodsThe literature related to ATR was extensively reviewed. Focusing on the three aspects of seed cells, scaffold materials, and growth factors, the recent research progress of ATR treatment was reviewed, and the future directions of tissue engineering technology to treat ATR were proposed. Results The pathogenesis and etiology of ATR are still unclear, and the effectiveness of the current treatments are still unsatisfactory. The construction of a cell-scaffold complex with sustained and controlled release of exogenous cytokines is expected to reverse the pathological changes of ATR, promoting the regeneration of normal nasal mucosa and reconstructing the atrophic turbinate. In recent years, the research progress of exosomes, three-dimensional printing, and organoids will promote the development of tissue engineering technology for ATR. ConclusionTissue engineering technology can provide a new treatment method for ATR.