objective To observe the differences between four- and single-channel recording of normal multifocal visual evoked potential (mfVEP). Methods mfVEP of 35 health individuals (70 eyes) were detected by both four- and single-channel recording with VERIS apparatus. The root mean square (RMS) value of reactive amplitude was obtained from the results of the two kinds of recording. Each stimulated patch was analyzed to compare the variational degree of each patch between the two recording methods. Responase sasymmetry coefficient (RAC) was introduced to evaluate the symmetry property between the two eyes in an individual. Results Compared with the single-channel recording,the responses of the stimulated patches of the four- channel recording were increased statistically, with most of the patches below the horizontal meridian and some of patches in the upper field, and there was distinct symmetry property between the two eyes in the same individual recorded by four-channel recording. Conclusion The four-channel recording is better than the single one and could be clinically applied and popularized.(Chin J Ocul Fundus Dis，2004，20：156-159)
目的:分析以眼睑下垂为首发症状的甲亢性眼肌病的误诊原因。方法:对我院10例不典型的甲亢性眼肌病进行系统分析。结果:误诊为重症肌无力5例、颅内动脉瘤2例、颅底炎症1例、脑干腔隙性梗死1例、糖尿病性周围神经病变1例。结论:以眼睑下垂为首发症状的甲亢性眼肌病极易误诊,加强对该病的认识及尽早进行甲状腺功能检查,可有效减少误诊机会。
Objective To investigate the myocardial protective effects of Del Nido cardioplegia and analyze its advantages in adult cardiac surgery. Methods We retrospectively analyzed the clinical data of 96 adult patients undergoing cardiac valve surgery who received Del Nido cardioplegia (a DNC group) from June 2016 to January 2017 in our hospital. There were 44 males and 52 females with a mean age of 51.36±13.31 years. Meanwhile 96 patients who received conventional cardioplegia were recruited as a control group (a CTC group) and there were 53 males and 43 females with a mean age of 52.91±10.95 years. Cross-clamping time, cardiopulmonary bypass (CPB) time, total volume of and transfusion frequency of cardioplegia, the rate of spontaneous defibrillation, red blood cell transfusion and vasoactive-inotropic score at postoperative 24 hours (VIS 24) were recorded. Results No significant difference was found in age, body weight, ejection fraction, hematokrit, CPB time and cross-clamping time between the DNC group and CTC group. There was no significant difference in the rate of spontaneous defibrillation, VIS 24, cardiac enzymes and cardiactroponin I and length of ICU stay between the two groups. The total volume and transfusion frequency of cardioplegia, perioperative blood transfusion were lower in the DNC group. There was no new atrial fibrillation or in-hospital death in the two groups. Conclusion Del Nido is a good myocardial protection solution in adult cardiac valve surgery, and requires less static preload volume and reduceshemodilution and perioperative blood transfusion.
目的 分析多功能空气消毒机在普通内科病房的动态消毒效果，为病房空气质量的控制提供参考依据。 方法 2010年9月－2011年4月对普通内科病房在动态状态下进行细菌检测并使用多功能空气消毒机消毒，并就消毒前后的空气细菌菌落总数进行分析比较。 结果 在动态状态下，病房关门关窗并开启空调机时，使用多功能空气消毒机消毒前的空气细菌菌落总数显著高于消毒后，差异有统计学意义（P＜0.05）；病房在开门开窗时，使用多功能空气消毒机消毒前后的空气细菌菌落总数比较，差异无统计学意义（P＞0.05）。 结论 普通内科病房在关门关窗并开启空调机动态状态下，使用多功能空气消毒机可以降低空气细菌菌落总数，改善房间空气质量。
ObjectiveTo determine the effects of the management mode participated by doctors, nurses and patients on the safety of medical tubes for restlessness patients in the Neurosurgery Intensive Care Unit (NICU). MethodsA total of 133 restlessness patients treated between May 17 and November 22, 2013 were included in the study as control group, who were admitted to the NICU before application of the management mode participated by doctors, nurses and patients; another 119 restlessness patients treated between May 17 and November 22, 2014 were included in the study as research group, who were admitted to the NICU after application of the management mode participated by doctors, nurses and patients. Then we compared the accidental extubation situation between the two groups. ResultsThe accidental extubation rate of all kinds of medical tubes in the research group was lower than that in the control group, among which the extubation rate of urethral catheter (0.67% vs. 4.32%), gastric tube (2.26% vs. 10.14%), trachea cannula (1.08% vs. 7.84%), and arterial cannulation pipeline (1.12% vs. 6.93%) was significantly different between the two groups (P<0.05). ConclusionThe management mode participated by doctors, nurses and patients can effectively reduce the accidental extubation rate of medical tubes for restlessness patients, prevent the occurrence of adverse events and ensure the treatment and nursing safety in the NICU.
Objective To investigate the application of the fibrous envelope of tissue expanders for the tension reduction. Methods Between June 2005 and May 2011, 21 patients with facial scar were treated with skin soft tissue expansion. There were 6 males and 15 females, aged 19-33 years (mean, 24.5 years), including 19 cases of hypertrophic scar and 2 cases of atrophic scar with disease duration of 1-31 years. The scars ranged from 4 cm × 2 cm to 25 cm × 10 cm. The tissue expander was implanted under normal skin adjacent to lesions in the first stage. And the post-expanded skin flap was designed as advance flap or transpositional flap as supplement in the second stage. Fibrous envelope at the base was fixed to the periosteum or fascia nearby first, and then sutures were used between envelopes at the base and on the skin flap or to the dermis of the skin flap to keep the mouth and lower eyelid in proper position. It reduced the tension of incision and maintained the contour of the face and neck. Results After the first stage operation, 2 cases had replaced expanders because of infection and leakage. No complication of infection or hematoma occurred after the second stage operation. The patients were followed up 1-18 months (mean, 10.2 months); of them,12 were followed up more than 1 year. No secondary deformity (deviation of mouth angle, eyebrows pulling, or eyelid ectropion) occurred. The flaps had good appearance and color. The satisfactory results were achieved. Conclusion In skin soft tissue expansion of the face, the fibrous envelopes at the base could reduce the tension of the incision and prevent the deformity of the mouth and lower eyelids.
目的 探讨全人/整体护理对晚期癌症患者生活质量的影响。 方法 将2007年11月－2008年7月60例确诊为晚期癌症的患者随机分为试验组和对照组，均规范接受阿片类药物镇痛和针对其他痛苦症状的药物控制治疗。在此基础上，试验组再增加躯体照护、心理疏导、灵性关怀等全人/整体护理，并就两组在疼痛缓解、活动能力和生活质量改善等方面的效果进行比较。 结果 观察期内，试验组在疼痛缓解、活动能力及生活质量改善方面明显优于对照组，两组比较差异均有统计学意义（P＜0.05）。 结论 在药物治疗基础上，运用全人/整体护理能够明显提高晚期癌症患者及其家属的生活质量。
Objective To study the mid-facial development characteristics of the goats with cleft palate after in-utero surgical repair at different stages. Methods Twenty-four Boer hybrid female goats were selected, aged from 8 to 12 months and weighing from 35 to 55 kg. The mating day was designated for 0 day. At 30 days, pregnant was confirmed by B-ultrasound test, and the goats were divided into 5 groups (experimental groups 1, 2, 3, 4, and normal control group). Twenty pregnant goats of 4 experimental groups (n=5) were injected DL-anabasine (15 mg/day) from 31 to 42 days to establish cleft palate model of fetal lamb, 4 pregnant goats of normal control group used as controls without injection. At pregnant 65, 90, and 120 days, cleft palate was repaired in the uterus in experimental groups 1, 2, and 3, while cleft palate was not repaired in experimental group 4. After 1 month of birth, the maxillary bone width (posterior premolar morphological measurement, PPMM) and the maxillary bone length (anterior premolar morphological measurement, APMM) were measured with CT scanning. The dry skull of goats were harvested for gross observation. Results There was no significant difference in PPMM and APMM between experimental group 1 and the normal control group (P gt; 0.05), but there were significant differences between experimental groups 1 and 4 (P lt; 0.05) at 1 month after birth. Significant differences were oberved in PPMM and APMM between experimental group 2 and normal control group, experimental group 4 (P lt; 0.05). There were significant differences in PPMM between experimental group 3 and normal control group, experimental group 4 (P lt; 0.05), in APMM between experimental group 3 and normal control group (P lt; 0.05). Five goats with cleft palate in experimental group 4 died at 1-2 months after birth. Conclusion At pregnant 65 days, in-utero surgical repair of cleft palate has less influences on mid-facial development. The earlier repair is performed, the higher risk of miscarriage was.
Objective To investigate the management during offpump coronary artery bypass grafting (OPCAB) for patients with ascending aorta atherosclerosis and to find appropriate treatment for minimizing the postoperative cerebrovascular accidents. Methods 236 patients with ascending aorta atherosclerosis were retrospectively analyzed underwent OPCAB in this hospital from Sep.2004 to Dec.2007, 4 of them received “No-touch” technique, 35 of them had the proximal anastomoses with the Enclose assistant, and 197 of them had the proximal anastomoses with the assistant of Heartstring. Hemodynamic indexes were consecutively monitored, blood streams of grafts was monitored by transit time flow measurement (TTFM) to evaluate the quality. Results Distal anastomoses 881，proximal anastomoses 267, the blood stream of 881 grafts was monitored, the mean flow was 16.2±18.7 ml/min, and the pulsatility index (PI) were 4.9±2.3, indicating the good quality of all grafts. The change of hemodynamic indexes including mean artery pressure (MAP, 78.1±10.4 mmHg vs. 80.9±8.1 mmHg）, pulmonary capillary wedge pressure (PCWP, 11.9±3.6 vs. 10.9±2.1 mmHg）, mean pulmonary artery pressure (MPAP, 17.3±4.3 mmHg vs. 15.3±2.8 mmHg）, cardiac output (CO, 4.2±1.2 L/min vs. 4.5±1.6 L/min）, center vinous pressure (CVP, 9.2±2.3cmH2O vs. 9.3±1.8 cmH2O）, heart rate (HR, 71.4±14.0 beats/min vs. 73.4±16.5 beats/min）, there were no statistically difference between before and after proximal anastomoses (Pgt;0.05). Two patients died of low cardio output during operation, 4 patients with transient ischemic attack were improved by 2 months medical therapy, and others had no postoperative complications as perioperative myocardial infarction etc, and the time of stay hospital was 10.5±4.2d. Followup 3-24 months for 185 patients, all living patients had no myocardial or cerebrovascular accidents, the symptoms were alleviated and myocardiac function improved. Conclusion Assessing the degree of the ascending aorta atherosclerosis sufficiently before and during the operation, choosing different operational strategy, and decreasing the manipulation of aorta can decrease the incidence of cerebrovascular accident and get better clinical result.
Objective To investigate the current status of control preference in the surgery of lung cancer patients and explore its correlation with perceived social support. MethodsGeneral information questionnaire, control preference scale, and perceived social support scale were used to investigate the lung cancer patients who underwent surgery in Beijing Cancer Hospital from February to May 2022. Results A total of 360 survey questionnaires were distributed, and 344 valid questionnaires were collected, with an effective rate of 95.6%. The expected participation style of patients was passive in 145 patients (42.2%), while the actual participation style was more inclined to be active in 154 (44.8%) patients. The compliance rate of patients’ expected and actual participation styles in the treatment control preference process was 61.9% (Kappa=0.437, P＜0.001). The results of the analysis of influencing factors showed that the level of cultural education was an influencing factor in the actual participation of lung cancer patients in surgery control preference (P=0.029). The results of Spearman's correlation analysis showed that the actual participation of lung cancer patients in surgery control preference was positively associated with perceived social support (r=0.159, P＜0.01), and its dimensions including family support (r=0.152, P＜0.01), friend support (r=0.133, P＜0.05), and other social support (r=0.142, P＜0.01). ConclusionPatients’ expected control preference style is generally consistent with their actual control preference style, which is influenced by their cultural education and positively correlated with perceived social support. Medical and nursing staff should pay attention to the participation style of patients taking surgery decisions, develop decision aids according to different education levels, and develop individualized interventions from the perspective of improving social support initially, to improve patients’ treatment compliance and treatment care satisfaction.