摘要:目的:探讨小切口全髋关节置换的疗效及优缺点。方法:针对性选取我院行THA的病员48例,分为初期小切口THA组、熟练小切口THA组、传统切口THA组,各组16例。记录切口长度、术中出血量、术后12小时引流量、手术时间及Harris评分,对其治疗效果进行回顾性分析。结果:初期小切口THA组平均出血量,术后12小时平均引流量,平均手术时间等指标均高于传统组,术后Harris评分低于传统组,熟练组与传统组比较,切口长度较短、术中出血量略少,术后早期Harris评分高,远期Harris评分接近。结论:熟练小切口THA与传统切口THA比较远期疗效无明显优点,初期小切口THA不具微创优势,不必强求小切口THA,并应注重学习曲线。
目的:探讨辅助后内侧切口及抗滑钢板治疗复杂胫骨平台骨折的临床疗效。方法:对我院2006年4月至2008年12月的28例复杂胫骨平台骨折病患(男19例,女9例,平均年龄37岁)进行辅助后内侧切口及抗滑钢板的临床手术治疗。结果:术后随访,24例效果良好,4例出现不良反应,经修复后愈合。结论:术后关节功能及切口恢复良好,外侧支撑钢板+后内侧抗滑钢板的双切口双钢板的手术方法是治疗复杂胫骨平台骨折安全、有效的方法,故在临床上有推广价值,但有待大规模病例来验证。
In the American Heart Association’s Scientific Sessions 2021, the results of six clinical trials related to cardiovascular surgery were revealed. The PALACS trial demonstrated that posterior left pericardiotomy during open heart surgery was associated with a significant reduction in postoperative atrial fibrillation; the EPICCURE study found that injection of mRNA encoding vascular endothelial growth factor (VEGF-A mRNA) directly into the myocardium of patients undergoing elective coronary artery bypass grafting (CABG) improved patients’ heart function; the VEST trial once again proved the safety and potential value of external stent for vein graft. This article will interpret the above-mentioned three studies.
Left atrial appendage occlusion is a common procedure for patients with atrial fibrillation history when they underwent cardiac surgery. Before the LAAOS Ⅲ research results, this operation has been lacking strong evidence-based support. LAAOS Ⅲ is a prospective, double-blind, international multicenter, randomized blinded trial. According to the results of LAAOS Ⅲ, the left atrial appendage occlusion can reduce the risk of stroke and systemic embolism. This article will perform detailed interpretation of LAAOS Ⅲ research.
Cardiac surgery presents specific challenges in conducting randomized controlled trials (RCTs). The American Heart Association made a scientific statement of methodological standards, with the purpose to review key concepts and standards in design, implementation, and analysis of cardiac surgery RCTs, and to provide recommendations. Recommendations include an evaluation of the suitability of the research question, clinical equipoise, feasibility of enrolling a representative patient cohort, impact of practice variations on the effect of the study intervention, likelihood and impact of crossover, and duration of follow-up. Trial interventions and study end points should be predefined, and adequate deliverability of the trial interventions should be ensured. Every effort must be made to keep a high completeness of follow-up. Trial design and analytic techniques must be tailored to the specific research question and trial setting. In this paper, the authors made an interpretation of this scientific statement based on their practical experience.
This paper reports the study and design of a visualization system of the ultrasonic rhinitis therapeutic apparatus with the function of endoscopic sinus. On Linux operating platform, we captured the video data of a video capture card that connected the endoscopic sinus using Video4Linux (V4L2) that was provided by the operating system. The video images were displayed by Qt. The visualization system solved the problem that the current ultrasonic rhinitis therapeutic apparatus had to rely on the large and expensive endoscopy equipment. And this simplified the doctors' operation, met the need of monitoring nasal cavity in the process of operating, greatly reduced the costs of treatment and would contribute to the promotion of the instrument. As a result, it has been tested that the nasal endoscopic image achieved by the system is clear and smooth, and fully meet the clinical needs of ultrasonic treatment of rhinitis.
Objective To investigate the role of endothelin（ET） in lung injury during cardiopulmonary bypass （CPB） and study the possible mechanism of ET-mediated lung injury and the protective effect of ferulic acid（FA） during the procedure. Methods Twelve dogs were randomly divided into 2 groups and models of CPB with pulmonary perfusion were established by perfusion of 4 C FA solution through proximal pulmonary artery in the experiment group while control group only received 4 C crystal cardiac arrest solution without pulmonary perfusion. Changes in the content of ET, NO, malonaldehyde （MDA）, dry to wet （D/W） in lung tissue and lung function- related indices PaO2/FiO2, airway pressure （AWP）, pulmonary vascular resistance （PVR）, lung compliance before and after CPB in both groups were measured respectively. Results ET content increased after CPB in control group （P〈0. 05） ,while experiment group had a lower level of ET than that of control group （P〈0.05）; D/W, MDA levels in experiment group decreased （P〈0. 05）, but NO content increased （P〈0. 05） as compared with control group. After pulmonary perfusion with FA, PaO2/FiO2 and lung compliance values in experiment group were higher than those of control group （P〈0.05）,AWP, PVR values lowered accordingly（P〈0. 05）. Lung injury was less severe in the experiment group. Conclusion ET is involved in pathogenesis of lung injury during CPB, FA can effectively reduce lung injury and improve lung function thus having a good protective effect on the lung.
ObjectiveTo analyze the platelet (PLT) count, coagulation function, and portal vein thrombosis (PVT) in the patients underwent splenectomy due to different etiologies. MethodsThe patients who underwent splenectomy in the Affiliated Hospital of Southwest Medical University from January 2013 to December 2022 were collected. According to the etiology, the patients were assigned into the occupying group (splenic and pancreatic occupying lesions), hypersplenism group (portal hypertension and hypersplenism), and splenic rupture group (traumatic splenic rupture). The changes of PLT, white blood cells (WBC), red blood cells (RBC), neutrophils (Neut), prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (Fib), D-dimer (DD), and PVT were observed after splenectomy. ResultsA total of 166 patients were collected, including 42 in the occupying group, 22 in the hypersplenism group, and 102 in the splenic rupture group. There were no statistically significant differences in the age and preoperative Child-Pugh score among the patients of the three groups (P>0.05). There were 12 (7.2%) patients with PVT, including 2 in the occupying group, 6 in the hypersplenismn group, and 4 in the splenic rupture group. The PVT incidence among the three groups had a statistical significant difference (Fisher exact test, P=0.003), which in the hypersplenismn group was higher than the occupying group (P=0.016) and the splenic rupture group (P=0.002), while there was no statistically significant difference between the occupying group and the splenic rupture group (P=1.000). The overall trend was that the PLT, RBC, WBC, and various coagulation function indicators such as PT, APTT, and Fib among the three groups all showed an upward trend immediately after splenectomy, but the postoperative peak time and change trends had no markedly regular among the three groups. The PLT of the patients with and without PVT changed over time during the observation period (patients without PVT: F=60.238, P<0.001; patients with PVT group: F=9.700, P=0.043), and which showed a continuous upward trend after surgery, reaching a peak on the 14th day and then beginning to decline in the patients of both 2 groups. However, there was no statistically significant intergroup effect between the 2 groups (F=0.056, P=0.816). ConclusionsThe results of this study suggest that the peak value of PLT in the hypersplenism group is lower as compared with the occupying group and the splenic rupture group, and the PVT is more likely to occur. However, no difference of the PLT level is found in the patients without and with PVT.
【摘要】 目的 观察自制富血小板血浆治疗难治性创口的临床疗效。 方法 2007年4月-2009年11月对38例难治性创口患者进行自制富血小板血浆治疗，观察创面愈合变化情况。 结果 38例患者中30例愈合，2例显效，2例有效，总有效率为90%。 结论 自制富血小板血浆治疗难治性创口是一种简便、安全、价廉、有效的治疗方式，特别适合中小（25~60 cm2）创面的难治性创口。【Abstract】 Objective To observe the clinical effect of homemade platelet-rich plasma on refractory wound. Methods Thirty-eight patients with refractory wound from April 2007 to November 2009 were treated by homemade platelet-rich plasma, and the changes in wound healing were observed. Results Thirty patients were healed, two patients were markedly effective, two patients were effective and the total effective rate was 90%. Conclusion Homemade platelet-rich plasma is a simple, safe, inexpensive and effective treatment on refractory wound, especially for small and medium refractory wounds (25-60 cm2).