Objective To determine the effectiveness of sodium hyaluronate (SHA) in preventing intraperitoneal (IP) adhesion. Methods Thirty-eight rats were randomly divided into A,B,C groups, normal saline, 6% Dextran-40 or SHA were applied on the present serosal injury respectively, during operation. Biopsy was taken on the 14th postoperative day.Results There were statistically significant differences in the extent of adhesion among three groups (Ｐ＜0.01). Mild inflammatory changes and less fibrous proliferation were found in group C by microscopy and decreased production of collagen (by fibroblast) and active mesothelial cells proliferation were observed in group C under electron microscope. Conclusion SHA appeares to reduce the extent of postoperative IP adhesion, which is more satisfactory than Dextran-40.
It has been certificated that hip and knee arthroplasty can improve quality of life and relieving pain and discomfort for ageing population and patients with muscloskeletal disorders. However, the outcomes of prosthetic joint infections (PJI) after arthroplasty usually are disastrous. The incidence of PJI is lower, but the number of this population is huge, which makes the strong impacts on quality of life for patients and healthcare economics. This review discusses the prevention strategies of PJI based on clinical epidemiology, diagnostic definition, pathogenesis, microbiology and risk factors, combined with some guidelines for prevention surgical site infections published recently.
ObjectiveTo explore the causes of bile duct injury due to laparoscopic cholecystectomy (LC) and the preventive methods. MethodsA total of 18 patients with bile duct injury (with the occurrence rate of 0.4%) after LC between January 2003 and December 2012 were included. The patients included 5 males and 13 females with the age of 29-63 years old[averaging (42.3±3.6) years old]. The clinical data of the patients were retrospectively analyzed. ResultsIn the 18 cases of bile duct injury, 5 cases occur in emergency operation, 13 cases in selective operation. The operators were attending physician in 13 cases, and senior position in the other 5 cases. The reasons of the injury included misjudgment of the cystic duct in 9, duct aberrance in 3, excessive stretch of cystic duct in 2, 2 Mirizzi syndrome withⅠ-type surgical injury in 2, and right liver duct injury because of inappropriate stripping of gallbladder in 1. ConclusionThe operator's experience, severe conglutination and the bile duct aberrance are the chief causes. Preventive methods include strict system of operation accession, careful selection of candidates, timely laparotomy, and paying attention to the accumulation of operation experience and skills.
ObjectiveTo investigate the clinical efficacy of sarpogrelate hydrochloride in preventing restenosis after femoral artery stent implantation. MethodsTwo hundreds and fifty-one cases of ischemic disease of lower extremity (286 affected limbs in total) who got treatment in our hospital were collected, and were divided into prevention group(125 cases with 146 affected limbs) and control group(126 cases with 140 affected limbs) according kinds of medicine. At the basement of medicine in control group, cases of prevention group got treatment of sarpogrelate hydrochloride in addition. Comparison of related indexed was performed by SPSS 17.0 software. ResultsCompared with before treatment in prevention group, only foot skin ulcer and gangrene score decreased(P<0.05), and there were no significant difference on other indexes included visual anafogue scales(VAS), intermittent claudication distance score, ankle brachial index (ABI), and vascular stenosis score(P>0.05). But in control group, compared with before treatment, foot skin ulcer and gangrene score and ABI value decreased(P<0.05), the VAS score, intermittent claudication distance score, and vascular stenosis score increased(P<0.05). There were significant difference on the difference between after treatment and before treatment of all 5 indexes(P<0.05), that the changed value of foot skin ulcer and gangrene score was higher in prevention group, but lower on other 4 indexes. There were no untoward effect happened during treatment. ConclusionClinical effect of sarpogrelate hydrochloride in the prevention of restenosis of the femoral artery after stent implantation was significantly, and it can keep related indexes stable.
ObjectiveTo discuss the clinical characteristics, treatment and prevention of abdominal wall endometriosis (AWE). MethodsA retrospective analysis of 295 cases of AWE from February 2007 to August 2011 in our hospital was performed. ResultsAll of the patients had abdominal operations before and 99% of them had a history of caesarean section. The mean age of the patients was (31.55±4.52) years old. The average size of the mass was (2.66±1.12) cm, significantly larger than the estimation of ultrasonography before operation which was (1.91±0.83) cm (P<0.001). No relapse was discovered five months to three years after the operation. ConclusionIt is easy to diagnose abdominal wall endometriosis through medical history, clinical characteristics, physical signs and ultrasonic assessment. The prevention of AWE is very important. Operation is still the best treatment for AWE.
OBJECTIVE To evaluate the effects of sodium hyaluronate on adhesion prevention after flexor tendon surgery. METHODS In 47 cases with the flexor tendon surgery, two kinds of sodium hyaluronate jelly preparations were injected into the tendon sheath before suture. Preparation I (20 mg/2 ml) was for group A (17 patients) and preparation II (20 mg/2 ml) was for group B (16 patients). The control group (group C, 14 patients) were treated in the same way except injection of sodium hyaluronate. The functions of afflicted fingers including flexibility, pain and swelling were measured immediately, at the first, second and the third month after operation. RESULTS All 47 patients were followed up 1 to 3 months. 64.71% patients in group A and 68.75% in group B showed significant improvement. There were significant difference compared with group C (P lt; 0.05). There were no significant adverse reactions were observed in all groups. CONCLUSION Two sodium hyaluronate preparations have effects in adhesion prevention after flexor tendon surgery with safety and expedience.
Objective To determine the ability of the polyactic acid glue (PLA-G) in preventing epidural adhesion after laminectomy. Methods Each of the 24 randomly selected rats was done laminectomyof L2 and L5. The PLA-G, which would change from liquid to solid when meets with serum, was used in the epidural site of L5 to become a half-solid membrane(the experimental group, EG). The PLA-G was not used in the same site of L2(the control group, CG) .The gross anatomical, histological, and microscopical evaluation were made 2，4，6，8，10 and 12 weeks after operation; electron microscope observation was also made on two rats 4 weeks after operation(both EG and CG). Results Obvious epidural space was observed between dura mater and scar tissue(ST), but no cells in the epidural space were observed inEG 2 weeks after operation. Corps of the red cells between dura mater and ST and proliferation of fibroblast cell(FB) were observed in CG 2 weeks after operation. Some remaining glue shiver in the epidural space with lightly increasing fibroblast and smooth dura mater were observed in EG 4 weeks after operation. However, fragile scar conglutinated with dura mater diffusely and more FB were observed in CG. From the 6th week to the 12th week, a potential interspace between scar and dura mater was observed and PLA glue was absorbed completely in EG. However, tougher scar, which was very difficult to dissect from dura mater and surrounding tissues, was observed. According to the fibroblast ultrastructure observation, bigger nucleus and more plentiful rough endoplasmic reticulum were observed in CG. Conclusion The PLA-G can effectively reduce the epidural scar and adhesion in animal experiment.
ObjectiveTo learn the status quo and characteristics of multi-drug resistant organism (MDRO) infection in a comprehensive hospital of the first grade in Sichuan Province, analyze the effect of prevention and control intervention, in order to provide a scientific basis for clinical MDRO prevention and control. MethodsWe collected MDRO data from January to June 2014 and from January to June 2015 through multi-drug resistance reporting software, and analyzed and compared the infection of MDRO during those two time periods. Then, we evaluated the prevention and control effect of MDRO infection. ResultsThe number of inpatients from January to June 2014 was 24709, among which 813 were detected with MDRO infection. Of those infected patients, 196 had nosocomial infection of MDRO and the other 617 had community infection/colonization. The proportion of nosocomial MDRO infection was 24.10%. The MDRO nosocomial infection case rate was 0.79%. The proportion of community MDRO infection/colonization was 75.90%. The number of inpatients from January to June 2015 was 25329, and 739 of them were found with MDRO infection, of whom 132 had nosocomial infection and 607 community infection/colonization. The proportion of nosocomial MDRO infection was 17.86%. The MDRO nosocomial infection case rate was 0.52%. The proportion of community infection/colonization was 80.14%. Compared with the first half of 2014, the proportion of nosocomial MDRO infection was lower with a statistically significant difference (χ2=9.062, P<0.001), and MDRO nosocomial infection case rate was also significantly lowered (χ2=14.220, P<0.001). There were significant differences between the first half of 2015 and the same period of 2014 in hospital department distribution of MDRO infection, patient infection site distribution and pathogen detection. ConclusionThe nosocomial MDRO infection control situation of our hospital is improved after the comprehensive prevention and control interventions, and we should focus on the prevention and control of key departments, important infection sites and major resistant bacteria in the future MDRO hospital infection control work.