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2018 Vol. 41, No. 2
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2018, 41(2): 137-141.
doi: 10.3969/j.issn.1674-4500.2018.02.01
Abstract:
Objective To compare the imaging characteristics of odontogenic maxillary sinusitis (OMS) caused by simple chronic periodontitis, combined periodontal-endodontic lesions and chronic periapical periodontitis and to analyze the correlation between the morphological changes of schneiderian membrance (DSM) and the bone damage caused by 3 types of chronic oral inflammations. Methods A total of 150 untreated OMS cases were selected, with 50 cases for each type of chronic oral inflammation, and all subjects received CBCT scan, the result of which was acutely measured and analyzed. Pathogenic teeth and the surrounding bone damage were recorded, and the axillary sinus mucosal thickness was measured in sagittal and coronary position. Results The most common pathogenic teeth were the maxillary first molar (35.33%), followed by the maxillary third molar (27.33%) and the maxillary second molar (20.00%). There were 14.67% patients with more than 1 pathogenic tooth. The DSM (9.04±5.04 mm) in cases with buccal/palatal lateral bone damage was significantly higher than that without buccal/palatal lateral bone damage (6.94±5.03 mm）（t=2.560, P=0.011）. The DSM in cases with oral-maxillary fistula (11.49±6.68 mm) was significantly higher than that without oral-maxillary sinus fistula (6.67±3.75 mm）（t=5.541, P<0.001）. The incidences of oral-maxillary fistula in chronic periodontitis, periodontal-endodontic combined lesions and chronic apical periodontitis were 40%, 34% and 24% respectively. There were no statistically significant differences among the 3 groups （x= 2.703, P= 0.259）. The DSMs in both groups of chronic periodontitis and periodontal-endodontic combined lesions were significantly higher than that in chronic apical periodontitis group (4.26±2.49 mm) （F= 26.157, P<0.001） Conclusion Odontogenic maxillary sinusitis is more likely to happen in cases with chronic periodontitis and periodontal-endodontic combined lesions, in which the range of maxillary bone damage and extent of the maxillary sinus mucosa thickening are larger than those in cases with chronic apical periodontitis.
2018, 41(2): 142-146.
doi: 10.3969/j.issn.1674-4500.2018.02.02
Abstract:
Objective To explore the value of Color Doppler Flow Imaging technology (CDFI), B-flow and contrast-enhanced ultrasound (CEUS) in the blood flow imaging of synovial lesion in small joints of wrist and hand with rheumatoid arthritis (RA). Methods A GE Logiq S8 18M polo stick-form linear array probe was used to examine the wrist joints, metacarpophalangeal joints and proximal interphalangeal joints of 240 RA patients. CDFI was applied to detect the synovial blood flow, and the result was classified into 0 ~ 3 according to Szkudlarek semi-quantitative method. For 250 cases whose synovial blood flow were over level 1, spectral doppler technology was applied to measure the resistance index (RI) of synovial pannus which was then used for the correlation analysis with the semi-quantitative method, and B-flow Ultrasound Imaging technology was used to examine the blood flow of synovium. The results of B-flow and CDFI were compared to study the difference of display rate between two devices. For 90 cases whose synovium of lesion joints had no blood signals as CDFI showed, CEUS was used and the result of which was compared with that of B-flow to study the difference of detection rate of synovial pannus. Results The synovium of 240 RA samples all appeared low heterogeneous echo, among which blood flow of synovium was detected in 200 RA cases (82 of level 1, 72 of level 2, 46 of level 3). As the blood flow classification increased, RI decreased gradually; therefore, blood flow classification correlated negatively with RI. 2. The detection rates of blood flow in synovial lesion joints of RA patients displayed by CDFI and B-flows were (154/250) and (206/250), and the difference was significant (P<0.05).As for the 90 cases whose synovium of lesion joints had no blood signals as CDFI showed, the blood flow detection rates by B-flow and CEUS were (56／90) and (74／90), and the difference was significant (P<0.05). Conclusions Compared with CDFI, B-flow and CEUS have higher detection rates of blood flow of RA synovium, especially CEUS, and they play an important role in the early diagnosis of RA and even the determination of therapeutic endpoints. RI of synovial pannus can effectively evaluate the activity of RA, and has guiding significance to clinical diagnosis, therapy and medication.
2018, 41(2): 147-151.
doi: 10.3969/j.issn.1674-4500.2018.02.03
Abstract:
Objective To investigate the value of ultrasound in the diagnosis of infant congenital cystic biliary atresia and choledochal cyst. Methods 31 children with cystic mass in the hepatic hilar admitted to our hospital from June 2016 to June 2017 were randomly selected, all of which received ultrasound examination and operation. Subjects were divided into cystic biliary atresia group (n=15) and choledochal cyst group (n=16) according to the surgical results. Factors including intrahepatic bile duct dilatation, fibrotic tissue around porta hepatis, the incidence of biliary sludge in the gallbladder, deformed gallbladder, contractile dysfunction of gallbladder, the inside diameter of hepatic artery, gallbladder size and cyst volume were statistically analyzed. Results The incidences of intrahepatic bile duct dilatation and gallbladder biliary sludge in the cystic biliary atresia group (0%; 6.7%, 1/15) were significantly lower than those in the choledochal cyst group (75.0%, 12/16; 50.0%, 8/16)(P<0.05); the incidences of fibrotic tissue around porta hepatis, deformed gallbladder and contractile dysfunction of gallbladder in the cystic biliary atresia group (80.0%,12/15; 86.7%, 13/15; 73.3%, 11/15）were significantly higher than that of the control group (0%; 6.3%,1/16; 12.5%, 2/16） (P<0.05). In the choledochal cyst group, the inside diameter of the hepatic artery was significantly longer than that of the common bile duct cyst (P<0.05), but there was no significant difference in the length of the gallbladder(P>0.05). Conclusion The application of ultrasound in the identification of congenital cystic biliary atresia and choledochal cyst has high value.
2018, 41(2): 152-156.
doi: 10.3969/j.issn.1674-4500.2018.02.04
Abstract:
Objective To explore the CT features of tumor and tumor-like lesions from different origins of the adrenal area, and to improve the related diagnosis and differential diagnosis. Methods CT findings of 158 cases with adrenal tumors or tumor-like lesions confirmed by operation, pathology or clinical follow-up were retrospectively analyzed. Features of these adrenal tumor and tumor-like lesions, including origin, shape, size, density, and enhancing features, were summarized. Results The tumor or tumor-like lesions in 130 cases were originated from adrenal gland, including 52 cases of adrenocortical adenoma, 6 cases of adrenal myelolipoma, 14 cases of pheochromocytoma, 3 cases of cyst, 3 cases of ganglioneuroma, 36 cases of metastatic tumor, 8 cases of sebaceous carcinoma, 3 cases of tuberculosis, and 5 cases of teratoma; and 28 cases were from non-adrenal sources, including 8 cases of retroperitoneal liposarcoma, 3 case of gastric diverticulum, 5 case of pancreatic pseudocyst, 5 case of hepatic cystic metastasis, and 7 case of cystic renal carcinoma. Conclusion Spiral CT is accurate in the positioning and characterization of adrenal gland tumors and tumor-like lesions, and the CT findings have certain characteristics, thus both helpful to clinical diagnosis and treatment.
2018, 41(2): 157-160.
doi: 10.3969/j.issn.1674-4500.2018.02.05
Abstract:
Objective To explore the clinical and brain MRI features of mitochondrial encephalomyopathy（ME）with seizure as the main clinical manifestation, so as to improve the accuracy of the diagnosis. Methods The clinical data and brain MRI findings of 7 cases with clinically diagnosed ME with seizure as the main clinical manifestation were analyzed retrospectively. Results Among the 7 cases, 3 were male and 4 were female, age ranging from 13~39 years old. All patients had history of long-term recurrence of limbs’ convulsion, one had blurred vision and one had debility; the lactate level elevated in 6 cases, and brain MRI showed cerebral hemisphere involvement in all cases, wherein 6 patients suffered from bilateral cerebral hemisphere involvement, 4 cases involved both cortical and subcortical white matter, and bilateral basal ganglia and right cerebellar hemisphere were involved in 1 case, causing the formation of transformation foci and brain atrophy. The multivoxel proton MRS examination findings of 5 patients showed lactate peak in the lesion area, the diffusion weighted imaging of 5 cases showed mild restricted diffusion, and the enhanced scan findings of 2 patients showed gyrus-like enhancement in the cortex of the lesion area. Conclusion The clinical and brain MRI features of ME patients with epilepsy as the main symptom are not typical, and is easy to be confused with other diseases. Comprehensive analysis of the history, simple lactate exercise test result and brain MRI finding is helpful to improve the diagnosis of the disease.
2018, 41(2): 161-164.
doi: 10.3969/j.issn.1674-4500.2018.02.06
Abstract:
Objective To investigate the value of prone multislice spiral CT enterography (MSCTE) with isosmotic mannitol as oral contrast in the treatment of bowel diseases. Methods 70 patients diagnosed with bowel diseases received oral administration of 500ml isosmotic mannitol (2.5%) for four times (2000 mL in total) as intraluaminal contrast media before scanning. They were randomly divided into two groups and received plain and contrast-enhanced CT scanning examination, with 35 patients examined in supine position (supine group) and 35 in prone position (prone group). The width of intestines, intestinal wall thickness, intestinal mucosa, lesions beyond the intestines, mesenteric vascular and celiac lymph node were observed or measured through multiplanar reconstruction (MPR), and the data were then analyzed. Results 62 cases in total had relative good image quality, wherein lesions beyond the intestines, mesenteric vascular and celiac lymph node were observed with a good quality at the same level in each group while intestinal details and mucosa were better displayed in images of those from prone group than those from supine group. Conclusions MSCTE performed in prone position is better for the observation and diagnose of intestinal lesions.
2018, 41(2): 165-168.
doi: 10.3969/j.issn.1674-4500.2018.02.07
Abstract:
Objective To summarize the imaging features of hereditary hepatic carcinoma (HHC) combined with cirrhosis in patients with hepatic cysts. Methods 106 HHC cases were included as the HCC group and undertook upper abdominal enhanced CT examination, while 109 cirrhosis patients with hepatic cysts were included as the control group. CT findings, including HHC’s clinical features, diameter of the cyst, hepatic segment where cysts locate, CT value, were observed and compared with that of the control group. Results Compared with the control group, patients in HHC group were significantly older (P=0.039) and had a higher proportion of hepatitis (P=0.036)and longer course of cirrhosis (P=0.043); he total number of cyst differed significantly between HHC group and the control group (2-9 in HHC group, 1-5 in control group)(P=0.036);the cyst diameter differed significantly between two groups, with it being 3~11cm in HHC group and 2~6cm in the control group(P=0.041); the difference of CT value between two groups was significant, with it being within 15hu in the control group and over 15hu in about half of the HHC group (P=0.023); the segment of cyst distribution differed significantly between the two groups, as the majority of cysts in HCC group located in the right liver, especially in the S6 and S8 section, while that of the control group located in the left half liver, especially in the S3 segment (χ2=2.572, P=2.572). Conclusion Age, hepatitis, cirrhosis of the liver may be risk factors for hepatic cysts in HCC patients. The morphological features of hepatic cysts in HCC patients include multiple lesions, frequent occurrence in the right lobe see, large diameter, and high susceptibility to necrosis.
2018, 41(2): 169-171.
doi: 10.3969/j.issn.1674-4500.2018.02.08
Abstract:
Objective To explore the applicative value of high resolution CT (HRCT) in the treatment of bronchiolitis obliterans (BO) in children. Methods The pulmonary HRCT findings of 38 cases with clinically confirmed BO were retrospectively analyzed. Results All the 38 cases had " mosaic” perfusion signs to different degrees, which displayed a diffuse and patchy distribution, and some cases showed clear boundary, some fuzzy, while in other cases both conditions exist. Blood perfusion in 35 cases decreased, and pulmonary air trapping, bronchial wall thickening, and bronchial dilatation were found in 35, 21 and 23 cases respectively, the latter two of which have a higher incidence in the lower lobe. 7 cases had unilateral hyperlucent lung, and 25 cases had pulmonary parenchyma, including 11 cases of atelectasis, 13 cases of pneumonia, and 11 cases of pulmonary consolidation. Lung nodules were found in 16 cases, subpleural nodules in 7 cases, and bronchial mucus plugs 3 cases. Conclusion HRCT could directly display all sorts of signs of BO in children, wherein the most typical symptom and the primary imaging feature of these diseases is the " mosaic” perfusion pattern. Therefore, HRCT can provide the basis for earlier clinical treatment, and it is an indispensable imaging examination method in children BO treatment.
2018, 41(2): 172-174.
doi: 10.3969/j.issn.1674-4500.2018.02.09
Abstract:
Objective To study the clinical value of 64-slice spiral CT coronary angiography in the detection of mural coronary artery. Methods 49 patients with suspected coronary heart diseases hospitalized in our hospital from August 2015 to August 2017 were included. 64-slice spiral CT coronary angiography was performed on all cases to conduct the curved planar reformation (CPR) of coronary artery, and the examination results were analyzed. Results Coronary angiography findings showed that there were 21 cases with mural coronary artery, wherein there were 13 cases in the anterior descending branch and its branches, 3 cases in the right coronary artery and its branches and 5 cases of multi-vessel lesion. Conclusion The 64-slice spiral CT coronary angiography has a higher detection rate of the mural coronary artery and the length and thickness of myocardial bridge, and is a non-invasive imaging modality, thus worthy of clinical application and promotion.
2018, 41(2): 175-177.
doi: 10.3969/j.issn.1674-4500.2018.02.10
Abstract:
Objective To explore the diagnostic value of multi-slice spiral CT (MSCT) in nodular goiter with coexistent thyroid carcinoma. Methods CT findings of 25 patients with pathologically-diagnosed nodular goiter associated with thyroid carcinoma were retrospectively analyzed. Results In 3 cases the cancerous lesion was located within the nodular goiter, and in the other 22 cases the nodular goiter and the cancerous lesion existed independently. CT plain scan of 20 cases were obvious low density with a relatively well demarcated margin, and contrast-enhanced CT scanning showed homogeneous or heterogeneous enhancement with poorly defined margin of the lesion, known as " boundary reversion” sign. In 23 cases, the margin of lesion was irregular, and the tumor broke through the capsule, forming the so-called " remnant margin” sign. Calcification within the cancerous lesion was observed in 15 cases, and cervical lymph node metastasis in the ipsilateral neck root or clavicular region was detected in 13 cases. Conclusion The MSCT features of nodular goiter with coexistent thyroid cancer have certain characteristics, using which the comprehensive observation of each nodule can effectively reduce the misdiagnosis of thyroid carcinoma associated with nodular goiter．
2018, 41(2): 178-180.
doi: 10.3969/j.issn.1674-4500.2018.02.11
Abstract:
Objective To discuss the clinical value and significance of ultrasonography for fetal umbilical vasa previa. Methods The doppler color sonographic features of 24 pregnant women diagnosed as fetal umbilical vasa previa after delivery in the obstetrics department of our hospital from January 2014 to December 2017 and fetal outcomes were reviewed. Results Among 8000 pregnant women hospitalized at that time, there were 24 vasa previa cases (0.300%), wherein 20 cases were correctly diagnosed by the color Doppler ultrasound (83.33%) and one missed diagnosis case (4.17%) and 3 misdiagnosis cases, including 2 cases of umbilical cord presentation and one case of cord prolapse. Among the 24 vasa previa cases, there were 14 cases of velamentous insertion of umbilical cord, 5 cases of accessory placenta, 4 cases of placenta bipartita and one case of marginal insertion of umbilical cord. All vasa previa cases received Cesarean section, and 28 infants survived while 6 infants dead. All 24 subjects discharged without complications. Conclusion Prenatal ultrasound examination can visualize the traveling of vasa previa and determine the orientation relationship between cord vessels and cervix internal ora. It has higher diagnosis accuracy on the vasa previa of umbilical cord, thus the first choice in screening and examination of vasa previa, so as to reduce the fetal death rate in clinical practice.
2018, 41(2): 181-184.
doi: 10.3969/j.issn.1674-4500.2018.02.12
Abstract:
Objective To explore the significance of multi-slice spiral CT enhancement examination in the diagnosis and differential diagnosis of peripheral lung cancer. Methods Sixty-five patients with lung cancer were selected as the case group and received CT plain and contrast-enhanced scan. The edge and content signs of CT findings and CT value changes were analyzed and compared, and the significance of CT contrast-enhanced scan for CT plain scan was investigated. 32 patients with pulmonary tuberculosis were selected as the control group and underwent the same examinations. The CT enhanced peak of the lesions (the mean value of the maximum CT value) was measured, and the CT enhanced increment (maximum enhanced CT value - flat scan CT value) and the SPH/PPH (the ratio of the focal point of the lesion and that of the aortic enhanced CT) were calculated. The CT value variations of aforementioned factors before and after the enhancement were analyzed and compared. Results IIn the CT plain and contrast-enhanced scan of the lung cancer group, there were significant differences between short spicule signs and high-density points (P<0.01). in the comparison of the diagnosis accuracy of peripheral lung cancer CT scan and contrast-enhanced examination, the sensitivity, specificity, diagnostic index and accuracy of CT scan were lower than that of enhanced inspection, among which the CT enhanced screening diagnostic index was over 150%, thus having certain diagnostic significance. There was no significant difference in CT scan between lung cancer and tuberculosis (P>0.05). In the comparison of the enhanced CT examination findings of lung cancer and tuberculosis, the peaks of enhancement were 60.35±21.56 and 40.09±14.41, and the increments of enhancement were 41.03±13.72 and 12.42±15.04, the SPH/PPH were 22.01±1.93% and 4.53±1.08%, and thet values were 20.71, 18.47, and 3.78, all of which have statistical significance (P=0.000). Conclusion Compared to the CT plain scan, the CT contrast-enhanced scan can significantly improve the diagnostic accuracy of lung cancer; therefore, it has clinical significance in the diagnosis and differential diagnosis of lung cancer and tuberculosis.
2018, 41(2): 185-188.
doi: 10.3969/j.issn.1674-4500.2018.02.13
Abstract:
Objective To evaluate the efficacy of two different dilatation methods in the treatment of lower ureteral stricture. Methods 36 cases of lower ureteral stricture with co-existent ureteral calculi at middle-lower segment treated from 2010 to 2017 in our hospital were retrospectively analyzed, and we adopt either slow dilatation method with ureteral forceps under direct vision or balloon dilation method. There were 20 males and 16 females, ages ranging from 20 to 71 with an average of 45 years. 22 cases had ureteral calculi at lower segment and 14 at middle segment, and the stone size ranged from 6-20 mm, with the average diameter of 11mm. As for the renal function, it was mildly impaired in 6 cases, moderately impaired in 27 cases and severely damaged in 3 cases. In the operation, Wolf F 8/9.8 ureteroscopy’s access to ureter failed. The abovementioned patients were randomly divided into two groups, 19 cases in group A were treated with slow dilatation method with ureteral forceps under direct vision and 17 cases in group B with balloon dilation method, and ureteroscopy successfully gained access to ureter in both groups after dilation. The D-J tubes were removed 6 weeks after the operation and microscopic examinations were performed in the lower segment of the ureter to check the stricture condition. Results Two dilatation methods both caused damages to the ureter to varying degrees, with the frequency of mild injuries, such as the tear of the mask, higher in group A while that of severe ureteral injuries, such as muscle laceration and ureteral perforation, higher in group B. The operation time of group A was significantly shorter than that of group B, and there was no significant difference in intraoperative hemorrhage and postoperative pain between the two groups. After 6 weeks, ureteral microscopies were performed successfully, and the mucosae at perforation point were smooth. Conclusion Two methods of dilatation of the ureter are safe and effective in the treatment of lower ureteral stricture and provide guarantee for the intracavity gravel in ureteral. Compared with balloon dilatation method, dilatation method with ureteral forceps, performed slowly under direct vision, has low probability of ureteral tear or perforation and is low in operative cost, therefore an effective treatment method for patients with ureteral stricture and co-existent ureteral calculi.
2018, 41(2): 189-195.
doi: 10.3969/j.issn.1674-4500.2018.02.14
Abstract:
Rare as iatrogenic ureteral injuries are during abdominal surgery, injury can cause serious complications, such as abdominal infection, ureter fistula, kidney failure, etc. In order to reduce the risk of iastrogenic ureteral injury, medical imaging technologies which enable real-time ureter visualization have been widely studied and clinically applied, such as prophylactic ureteral catheterization (or luminant ureteral stent), gamma detection technique, and fluorescence imaging technology. However, at present only fluorescence imaging technology can acquire the location information through real-time ureter visualization while being non-invasive and having no ionizing radiation. Relevant studies have proved that real-time identification of the ureter during surgery using fluorescence imaging technology combined with exogenous fluorescence dye is feasible and have made important progresses. This review summarizes the recent progress in the research of real-time identification of ureter using fluorescence imaging technology and exogenous fluorescent dye (fluorescein sodium, methylene blue, indocyanine, CW800-CA, and ZW800-1) during abdominal surgery.
Rare as iatrogenic ureteral injuries are during abdominal surgery, injury can cause serious complications, such as abdominal infection, ureter fistula, kidney failure, etc. In order to reduce the risk of iastrogenic ureteral injury, medical imaging technologies which enable real-time ureter visualization have been widely studied and clinically applied, such as prophylactic ureteral catheterization (or luminant ureteral stent), gamma detection technique, and fluorescence imaging technology. However, at present only fluorescence imaging technology can acquire the location information through real-time ureter visualization while being non-invasive and having no ionizing radiation. Relevant studies have proved that real-time identification of the ureter during surgery using fluorescence imaging technology combined with exogenous fluorescence dye is feasible and have made important progresses. This review summarizes the recent progress in the research of real-time identification of ureter using fluorescence imaging technology and exogenous fluorescent dye (fluorescein sodium, methylene blue, indocyanine, CW800-CA, and ZW800-1) during abdominal surgery.
2018, 41(2): 196-200.
doi: 10.3969/j.issn.1674-4500.2018.02.15
Abstract:
Myocaridial protection aims to salvage myocardium from ischemia and reperfusion injury and to reduce infarct size and its consequences. After more than 30 years of development, the concept of ischemic preconditioning has evolved into ‘ischemic conditioning’, a term that encompasses a number of related endogenous cardioprotective strategies, which can be applied either directly to the heart (ischemic preconditioning or postconditioning) or from afar, for example to a limb (remote ischemic preconditioning, preconditioning, or postconditioning). A variety of cardioprotective therapies have shown promising results in reducing infarct size and improving clinical outcomes in patients with ischemic heart disease.
Myocaridial protection aims to salvage myocardium from ischemia and reperfusion injury and to reduce infarct size and its consequences. After more than 30 years of development, the concept of ischemic preconditioning has evolved into ‘ischemic conditioning’, a term that encompasses a number of related endogenous cardioprotective strategies, which can be applied either directly to the heart (ischemic preconditioning or postconditioning) or from afar, for example to a limb (remote ischemic preconditioning, preconditioning, or postconditioning). A variety of cardioprotective therapies have shown promising results in reducing infarct size and improving clinical outcomes in patients with ischemic heart disease.
2018, 41(2): 201-206.
doi: 10.3969/j.issn.1674-4500.2018.02.16
Abstract:
Although oral phosphodiesterase-5 (PDE5) inhibitors and androgen therapy are common treatments for erectile dysfunction (ED), some patients respond poorly to these drugs because of ED’s multiple pathogenic mechanisms. Many researchers have tried to find new treatment strategies, and targeted therapy alternatives include the central and peripheral pathways. Centrally acting agents include melanocortin receptor agonists, dopaminergic agonists and clavulanic acid (paclitaxel), while peripherally acting agents include soluble guanylate cyclase activators and Rho kinase inhibitor. Proteotherapy and gene therapy regenerate damaged erectile tissues by rejuvenating or regenerating cavernous endothelial cells and cavernous nerves or by inhibiting the fibrosis of tissues secondary to neurovascular dysfunction. This article reviews the PDE5 inhibitor therapy and androgen therapy, and introduces clinical and preclinical ED pharmacotherapy strategies, the results of which have laid a solid foundation for future clinical applications.
Although oral phosphodiesterase-5 (PDE5) inhibitors and androgen therapy are common treatments for erectile dysfunction (ED), some patients respond poorly to these drugs because of ED’s multiple pathogenic mechanisms. Many researchers have tried to find new treatment strategies, and targeted therapy alternatives include the central and peripheral pathways. Centrally acting agents include melanocortin receptor agonists, dopaminergic agonists and clavulanic acid (paclitaxel), while peripherally acting agents include soluble guanylate cyclase activators and Rho kinase inhibitor. Proteotherapy and gene therapy regenerate damaged erectile tissues by rejuvenating or regenerating cavernous endothelial cells and cavernous nerves or by inhibiting the fibrosis of tissues secondary to neurovascular dysfunction. This article reviews the PDE5 inhibitor therapy and androgen therapy, and introduces clinical and preclinical ED pharmacotherapy strategies, the results of which have laid a solid foundation for future clinical applications.
2018, 41(2): 207-211.
doi: 10.3969/j.issn.1674-4500.2018.02.17
Abstract:
With the continuous development of the Internet and improvement of the network coverage, search engine has become the main channel for information query. As query keywords directly reflect people´s intent and search data can be counted in real time, the network search data is considered the ideal data source for influenza surveillance. In the practical application, a surveillance and early warning system utilizing the search engine data and the official monitoring data, such as CDC, can perform early warning of major infectious diseases in time so as to take preventive measures, thus reducing the risk of disease transmission and the financial burden of the country and the people. Compared with the traditional disease monitor system, that based on the network search data has the characteristics of fast response, easy access, low cost and so on; however, it still faces many challenges, such as the uncertainty of the netizen’s behavior, the inaccuracy of the search keywords and the incomplete network coverage, etc. Therefore, future research should focus on improving the accuracy of Internet search data and explore the ways to use spatial and temporal data for infectious disease prediction and early warning through combining search engine data with geographic information system (GIS). Furthermore, they need to remove the barriers between data modules and collect data collectively and comprehensively, so as to realize the sharing of big data and improve the utilization of data and the accuracy of the monitoring and early warning system.
With the continuous development of the Internet and improvement of the network coverage, search engine has become the main channel for information query. As query keywords directly reflect people´s intent and search data can be counted in real time, the network search data is considered the ideal data source for influenza surveillance. In the practical application, a surveillance and early warning system utilizing the search engine data and the official monitoring data, such as CDC, can perform early warning of major infectious diseases in time so as to take preventive measures, thus reducing the risk of disease transmission and the financial burden of the country and the people. Compared with the traditional disease monitor system, that based on the network search data has the characteristics of fast response, easy access, low cost and so on; however, it still faces many challenges, such as the uncertainty of the netizen’s behavior, the inaccuracy of the search keywords and the incomplete network coverage, etc. Therefore, future research should focus on improving the accuracy of Internet search data and explore the ways to use spatial and temporal data for infectious disease prediction and early warning through combining search engine data with geographic information system (GIS). Furthermore, they need to remove the barriers between data modules and collect data collectively and comprehensively, so as to realize the sharing of big data and improve the utilization of data and the accuracy of the monitoring and early warning system.
2018, 41(2): 212-218.
doi: 10.3969/j.issn.1674-4500.2018.02.18
Abstract:
Objective To assess the clinical values of 3 non-sentinel lymph node (SLN) metastasis prediction models, including MSKCC, Louisville and SCH, in Chinese population, and to construct a new model for predicting the risk of non-sentinel lymph node metastasis. Methods A total of 220 breast cancer patients who underwent SLN biopsy and axillary lymph node dissection (ALND) in our hospital were included in this study. After performing a univariate analysis and multivariate logistic regression analysis on the clinicopathological data of the patients, a new non-SLN metastasis risk prediction model was established based on the independent predictors we identified. MSKCC, Louisville, SCH and the newly established model were compared using the clinicopathological data of our patients, after which the receiver operating characteristic curve (ROC) was plotted and the area under the curve (AUC) and false negative rates (FNR) of each model was calculated to evaluate the discrimination capability and clinical value of above models. Results Of the 220 breast cancer patients included, 97 patients (44.1%) were found to have positive non-SLNs. Logistic regression analysis indicated that only the size of the primary tumor size, vessel cancerous emboli, number of positive SLN and proportion of positive SLN/total SLN were independent predictors of non-SLN metastasis, based on which a new prediction model was constructed. The AUC values of the MSKCC, Louisville, SCH and the new model were 0.683, 0.747, 0.657 and 0.762 respectively. When FNR was adjusted close to 10%, the percentage of patients who were classified into the low-risk group by MSKCC, Louisville, SCH and the new model were 17.27%, 20.00%, 15.00% and 33.18%. Conclusion The new model established in this study may be more clinically valuable in predicting the risk of non-SLN metastasis than MSKCC, Louisville and SCH, but before its application a larger sample is needed for model validation and adjustment. Doctors should be cautious when using non-SLN metastasis predicting models for decision making as whether patients with positive SLN biopsy should complete ALND.
2018, 41(2): 219-223.
doi: 10.3969/j.issn.1674-4500.2018.02.19
Abstract:
Objective To evaluate the predictive value of PAPP-A, INH-A, β-hCG and uterine artery pulsatility (PI) for preeclampsia at the early stage of second trimester. Methods The prospective nested case-control study was carried out. Serum samples of 416 pregnant women were obtained at 11～12+6 weeks of the gestation. PAPP-A, INH-A and β-hCG concentrations were measured by chemiluminescence method or enzyme-linked immunosorbent assay (ELISA), while uterine artery pulsatility index (PI) was measured by Doppler velocimetry at the same time. Results 23 pregnant women who were found to have developed preeclampsia were used as the preeclampsia group (PE group), and the other 393 cases whose blood pressure remained normal were chosen as the control group. The incidence of PE was 5.52%. The MOM values of PAPP-A, β-hCG, INH-A and PI in PE group were significantly different from the control group(P< 0.05).The logistic regression showed that age and PI have no significant effect on the prediction of PE. Among the relative factors, PAPP-A and INH-A are two factors that are negatively correlated with the occurrence of PE, while β-HCG is a positive factor. Comparing these predictive factors individually, the ranking in terms of predictive ability is following: PAPP-A>β-hCG>INH-A. The predictive ability for PE was significantly improved when PAPP-A, INH-A and β-hCG were combinedly used, and the area under the ROC curve can reach to 0.867. Conclusion Combining the screening of different biomarkers, such as serum PAPP-A, INH-A and β-hCG, could increase the predictive value of PE at the early stage of second-trimester.
2018, 41(2): 224-228.
doi: 10.3969/j.issn.1674-4500.2018.02.20
Abstract:
Objective To investigate the application value of stochastic optical reconstruction microscopy (STORM) in the observation of exosomes. Methods In the experiment, exosomes were extracted by adding EXOQUICK-TC to the culture media supernatants of primarily cultured parathyroid cells from patients with hyperparathyroidism. After the immunofluorescence labeling of the specific transmembrane protein CD63 on the surface of exosomes, STORM was applied to perform ultra-high resolution imaging and diameter measurement of exosomes. Results In the experiment, STORM successfully performed the single molecule positioning, diameter measurement and ultra-high resolution imaging of exosomes extracted from the culture media supernatants of parathyroid cells of patients with hyperparathyroidism. Conclusion Compared to conventional optical microscopy, STORM, with its unique optical characteristics which has broken through the optical diffraction limit, has a resolution of 20-50 nm and can perform single-molecular acute positioning, diameter measurement and ultra-high resolution imaging of exosomes. In view of these outstanding features, we believe that STORM and other ultra-high resolution imaging technologies will play vital roles in the subsequent research on exosomes and exosome-related physiological procedures.
2018, 41(2): 229-232.
doi: 10.3969/j.issn.1674-4500.2018.02.21
Abstract:
Objective To analyze traps in clinicopathologic diagnosis of malignant phyllodes tumors (MPTs) of the breast in adolescent females with intraductal carcinoma and review the literatures. Methods The clinical features, HE staining and immunohistochemical features of one 18-year-old female MPT case with intraductal carcinoma were analyzed combined with literatures. Results Histologic study showed marked cellular atypia in the tumor with rapid growth rate, and tumor necrosis was frequently associated. Before the performance of core needle biopsy (CNB), cryosurgery and routine pathological diagnosis, the diagnosis of fibroadenoma, other types of sarcoma and metaplastic carcinoma should be excluded, and a comprehensive and extensive collection of materials and immunohistochemistry is necessary in making an accurate pathological diagnosis. Conclusions MPTs of the breast in young females are rare, and MPTs in young females with intraductal carcinoma are even rarer. Therefore, improving the understanding of its clinicopathological features can reduce the risk of misdiagnosis.
2018, 41(2): 233-236.
doi: 10.3969/j.issn.1674-4500.2018.02.22
Abstract:
Objective To analysis the predictive value of transient elastography combined with serum index and liver ultrasound examination for the degree of esophageal varices (EV), and to establish a predictive model for EV. Methods A total of 110 patients with post-hepatitis B cirrhosis were enrolled and divided into two groups according to EV grade assessed by gastroscope: non-EV and grade I group and grade II and III group. The parameters, including liver stiffness (LS), platelet count (PLT), prothrombin time (PT), serum albumin level, the thickness of spleen, the portal vein diameter and the liver diameter were assessed by independent sample T test and binary logistic regression analysis, based on which a predictive model was generated. The receiver operating characteristic(ROC) curve was used to evaluate the accuracy of the model. Results The area under the ROC curve for the model was 0.979. The sensitivity of the model was 98.7% and the specificity was 97.1%. Conclusion The non-invasive model for predicting EV composed of LS and other non-invasive parameters was accurate and sensitive, thus an ideal model for EV prediction in clinic.
2018, 41(2): 237-240.
doi: 10.3969/j.issn.1674-4500.2018.02.23
Abstract:
Objective To explore the impact of loop electrosurgical excision procedure (LEEP) on the pregnancy outcomes of cervical intraepithelial neoplasm (CIN) III patients.. Method 80 pregnant women one year after receiving LEEP because of CIN III from June 2014 to June 2015 in our hospital were selected as the observation group, while 80 normal pregnant women were selected as the control group. The incidence rate of pregnancy and fetal complications, delivery modes and fetal conditions were observed and compared. Result The incidence rates of gestational diabetes, fetal distress, preeclampsia and amniotic fluid volume abnormality of the observation group (2.99%, 1.49%, 4.48%, 2.99%) and control group (2.50%, 1.25%, 2.50%, 2.50%) were not significantly different(P>0.05); the successful pregnancy rate of control group (100%) was significantly higher than that of observation group (83.75%)(P<0.05);the incidence rates of premature rupture of membrane and cervical laceration of observation group (13.43%, 10.45%) were significantly higher than that of control group (2.50%, 1.25%) (P<0.05); the incident rates of premature delivery, natural labor and Cesarean section of observation group (7.46%, 40.30%, 52.24%) and control group (5.00%; 50.00%; 45.00%) were not significantly different (P>0.05); the average body weight of observation group was lower than that of control group (P<0.05); the incidence rate of low birth weight of observation group (14.93%) was significantly higher than control group (5.00%)(P<0.05). Conclusion CIN III patients still preserve reproductive potency after the LEEP. However, the incidence rates of premature rupture of membrane, cervical laceration and low birth weight newborn are higher. Therefore, close concern should be paid on the patient’s condition and specific nursing interventions should be taken.
2018, 41(2): 241-244.
doi: 10.3969/j.issn.1674-4500.2018.02.24
Abstract:
Objective To explore the effect of the treatment of gestational diabetes mellitus (GDM) on the offspring’s childhood obesity. Methods 137 women diagnosed with GDM in our hospital were enrolled, and there were similar baseline characteristics between the maternal follow treated and untreated groups. A follow-up study was carried on the offspring of the abovementioned women 5-6 years after their deliveries in our hospital. Height, weight, blood pressure, waist circumference, fasting glucose, fasting insulin, triglycerides, and HDL cholesterol of their offspring were measured. Results The frequency of BMI>P95 (8.8% and 9.5%,P=0.78) and BMI>P85 (16.8% and 19.7%,P=0.65) in their offspring was not significantly different in treated and untreated group. The difference of BMI z score, log waist circumference, log triglycerides, HDL cholesterol, blood pressure, or log HOMA-estimated insulin resistance (HOMA-IR) between treated and untreated group were not significant (P>0.05). However, the difference of fasting glucose and log HOMA-IR between the female offspring of each group was significant(P for interaction = 0.002 and 0.02, respectively) in female offspring. Conclusions Although the treatment of gestational diabetes can reduce the fasting glucose of the female offspring, the overall incident of childhood obesity has not been improved.
2018, 41(2): 245-248.
doi: 10.3969/j.issn.1674-4500.2018.02.25
Abstract:
Objective To compare the analgesic effect of dexamethasone plus ropivacaine and ropivacaine for continuous femoral nerve block in postoperative analgesia of patients undergoing unilateral total knee arthroplasty (TKA). Methods Forty patients undergoing TKA were randomly assigned to the control group and the experimental group, and were given continuous femoral nerve block guided by b-ultrasound. Patients in the control group were given 150 ml 2.5 g/L ropivacaine and those in the experimental group were given 150 ml 2.5 g/L ropivacaine and 0.1 g/L dexamethasone. Visual analog scale (VAS) in rest and in active and passive rehabilitation exercise, morphine consumption, the range of active knee flexion and opioids-related adverse effects were recorded at different time points. Results Postoperative VAS scores in rest at 6, 12, 24, 48 and 72 h and in active and passive rehabilitation exercise at 24, 48 and 72 h in the experimental group were significantly lower than those in the control group (P<0.05). Morphine consumptions in periods of time after 6 h and in 72 h were significantly less in the the experimental group than those in the control group (P<0.05). The postoperative range of active knee flexions at 24, 48 and 72 h in the experimental group were significantly larger than those in the control group (P<0.05). Moreover, the rate of adverse effects was 15% in the experimental group while that was 30% in the control group, and there was no significant difference between them (P>0.05). Conclusion Dexamethasone plus ropivacaine provided better postoperative analgesia than ropivacaine for continuous femoral nerve block in patients undergoing TKA. With low rate of adverse effects, it could enhance recovery after surgery and reduce opioid consumptions, which is worth popularizing.
2018, 41(2): 249-252.
doi: 10.3969/j.issn.1674-4500.2018.02.26
Abstract:
Objective To investigate the prevalence of carotid atherosclerosis (CAS) and its risk factors. Methods 603 cases of inpatients were enrolled and divided into non-carotid atherosclerosis group and carotid atherosclerosis group according to the result of carotid artery ultrasonography examination. The prevalence of CAS was calculated, the clinical data and biochemical indicators of the two groups were compared and analyzed, and the correlation between the risk factors and CAS was analyzed using multi-factor Logistic regression. Results The incidence of CAS among the subjects was 57.5%. The differences in age, glycosylated hemoglobin (HbA1c), serum uric acid (SUA), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), hypertension, diabetes, and smoking history between two groups were statistically significant (P<0.05). Logistic regression analysis showed that age, smoking, hypertension, diabetes, and LDL-C were independent risk factors of CAS. Conclusion Age, smoking, hypertension, diabetes, and LDL-C have obvious correlation with the incidence of CAS. The middle-aged and aged people with these risk factors should take the carotid artery ultrasonography examination as early as possible. The correlation between SUA and CAS needs further study.
2018, 41(2): 253-256.
doi: 10.3969/j.issn.1674-4500.2018.02.27
Abstract:
Objective To compare the cleaning effect and tolerance of bowel preparations with fractionated dose versus single dose polyethylene glycol electrolyte solution (PEG-ES) bowel preparation regimens for colonoscopy. Methods 120 patients who received colonoscopy in our hospital from April 2016 to September 2016 were randomly divided into two groups. Subjects in group A received a single dose of 3L PEG-ES before examination, and subjects in group B drank 1.5 L PEG-ES on the eve and 4 hours before colonoscopy. Score and degree of Boston bowel preparation scale (BBPS) and PEG-ES related adverse effects of the two groups were assessed. Results T Both regimens met the requirements of colonoscopy. The BBPS score was similar (P>0.05),but the score of BBPS was significant higher in group B than in group A (P<0.01). The result of tolerance and adverse reaction test showed that group B was also significantly better than group A (P<0.05). Conclusion Fragmented dose PEG-ES regimen provides a better colonic cleansing quality and tolerance for bowel preparation of colonoscopy, which is superior to that od single dose regimen.
2018, 41(2): 257-260.
doi: 10.3969/j.issn.1674-4500.2018.02.28
Abstract:
Objective To investigate metabolic differences between simple obese children and those comorbid with fatty liver disease. Methods Obese children hospitalized in our center during 2014-2016 were included and divided into simple obese group and obese with fatty liver group by ultrasound-based diagnosis of fatty liver. Epidemiology data and serum biochemical studies were recorded. Body Mass Index (BMI) and homeostasis model insulin resistance index (HOMA-IR) were calculated. Results A total of 186 obese children were enrolled in this study, including 93 cases of obese children and 93 cases obese patients with fatty liver.The proportion of men and the figure of age, waist circumstance (WC) and BMI were significantly higher in the group of obese patients with fatty liver (P<0.05). Age and UA were found to be risk factors for fatty liver disease (OR>1,P<0.05). Conclusion Male, older children or children with higher uric acid are more susceptible to fatty liver among obese children.
2018, 41(2): 261-263.
doi: 10.3969/j.issn.1674-4500.2018.02.29
Abstract:
Objective To evaluate the prognosis of enhanced recovery after surgery (ERAS) on senile patient after laparoscopic cholecystectomy. Methods Eighty senile patients underwent laparoscopic cholecystectomy from June 2013 to June 2016 in our department were included and divided into conventional care group (n=40) and ERAS group (n=40). Statistics, including postoperative hospital stay, hospitalization expenses and postoperative complication were recorded and comparatively analyzed.. Results Compared with conventional care group, the ERAS group spent significantly shorter postoperative hospital stay (P<0.05), less medical cost (P<0.05) and underwent fewer postoperative complications (P<0.05). Conclusion The enhanced recovery measure is a safe, effective and economical treatment scheme for senile patients during the perioperative period of laparoscopic cholecystectomy.
2018, 41(2): 264-267.
doi: 10.3969/j.issn.1674-4500.2018.02.30
Abstract:
Objective To explore the effects of blood lipids and uric acid (UA) on carotid atherosclerosis (CAS) in essential hypertensive patients with different diet habits. Methods The clinical data of 291 patients with essential hypertension from January 2016 to June 2017 were collected, including 164 patients from Zhuhai and 127 patients from Tumxuk. The serum levels of UA, total cholesterol (TC) and total triglyceride (TG) were detected, and the carotid intima-media thickness (CIMT) were observed as a method to evaluate CAS. Results Due to different diet habits, patients from Zhuhai had a higher incidence of hyperuricemia, whereas patients from Tumxuk had a higher incidence of hyperlipemia (P<0.05). UA and TC were risk factors of CAS in the elderly patients with cerebral infarction (P<0.05)from both districts. UA (r=0.420) and CIMT had a higher correlativity in patients from Zhuhai, while TC (r=0.286) and CIMT had a higher correlativity in patients from Tumxuk. Conclusion Since hyperuricemia was closely related with CAS for people from Zhuhai, the local people need to reduce the purine intake; while in Tumxuk hyperlipemia was closely related with CAS, so the local people need reduce dietary fat intake. In this way, essential hypertensive patients can be efficiently protected from CAS.
2018, 41(2): 268-270.
doi: 10.3969/j.issn.1674-4500.2018.02.31
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Objective To investigate the effect of family physician services on infants’ growth and development. Methods 400 infants who had received regular physical examination in our hospital were included and randomly divided into the control group and the experimental group (n=200). Infants in the experimental group received family physician services while subjects in the control group received traditional physical examination service, both till the age of 18 months. Body length and weight at the 1st, 3rd, 6th, 9th, 12th and 18th month and morbidity of nutritional disorders at the 1st and 18th month were recorded. What’s more, infants were tested with Gesell developmental schedules at the 1st and 18th month. Results Body length and weight at the 6th, 12th and 18th month were higher in the experimental group than that in the control group (P<0.05). The development quotient in intelligence fields was higher in the experimental group than that in the control group (P<0.05). Moreover, the morbidity of protein-energy malnutrition and iron deficiency anemia in the experimental group were lower than that in the control group (P<0.05). Conclusion Family physician services could promote infants’ growth and development and reduce the morbidity of nutritional disorders, thus is worth popularizing in China.
2018, 41(2): 271-273.
doi: 10.3969/j.issn.1674-4500.2018.02.32
Abstract:
Objective To investigate the effects of DPP4 inhibitor and long-acting insulin therapy on blood biochemical indexes of type 2 diabetes. Methods 440 cases of type 2 diabetes patients in our department from January 2017 to July 2018 were included and divided into DPP4 group (Saxagliptin) and long-acting insulin group (insulin glargine). All patients received corresponding drugs for 3 months, after which the serum blood glucose, blood lipid, blood insulin and insulin resistance index of each group were detected and recorded. Result Blood glucose was well controlled in both groups, and there was no significance between the control degrees(F=1.296, P=0.578). However, the insulin resistance index of the DPP4 group was significant lower than that of the long-acting insulin group (t=8.11, P<0.05). Compare to long-acting insulin, DPP4 inhibitor improve insulin sensitivity. The level of triglyceride (TG) of DPP4 group was significantly higher than that of the long-acting insulin group, while the level of highly density lipoprotein cholesterol (HDLC) of DPP4 group was significantly lower than that of its counterpart (P<0.05). indicating that DPP4 inhibitor is better at regulating the level of TG and HDLC. There was no significant difference in the level of total cholesterol (TC), very low density lipoprotein cholesterol (vLDL-C) and low density lipoprotein cholesterol (LDLC) between two groups(P>0.05). Conclusion DPP4 inhibitor, as a new drug used for type 2 diabetes, can effectively regulate the blood glucose and blood lipid and increase the insulin sensibility.
2018, 41(2): 274-277.
doi: 10.3969/j.issn.1674-4500.2018.02.33
Abstract:
Objective To learn the prevalence of chronic diseases of the faculty in a certain college in Guangdong province, so as to provide scientific evidence for the implementation of the corresponding health interventions. Methods The physical examinations results of the college’s faculty from 2013 to 2015 were analyzed statistically. Results From 2013 to 2015, dyslipidemia, obesity, fatty liver, kidney stones, hypeluricemia, cholecystic polysus, high blood pressure, hepatic cyst, abnormal electrocardiogram abnormality and hyperglycemia had a high prevalence. The difference between the detection rate of dyslipidemia, fatty liver, kidney stones, and hypeluricemia was statistically significant (P<0.05). Among the female faculty, mammary gland hyperplasia, vaginitis, cervical cyst, bad mammary gland involution and cervical erosion change had a high prevalence, among which the difference of the detection rate of cervical erosion change was statistically significant (P<0.05). The prevalence of dyslipidemia, obesity, fatty liver, hypeluricemia, cholecystic polysus, high blood pressure, electrocardiogram abnormality and hyperglycemia were significantly higher in females than that in males for 3 consecutive years (P<0.05). Significant age differences were observed in the prevalence of obesity, fatty liver, kidney stones, high blood pressure, hepatic cyst, electrocardiogram abnormality and hyperglycemia for 3 consecutive years (P<0.05). Conclusion The health status of the university’s faculty is not optimistic, as the prevalence of chronic diseases is high. A variety of intervention measures should be taken for the effective prevention and reduction of chronic diseases and its development.
2018, 41(2): 278-280.
doi: 10.3969/j.issn.1674-4500.2018.02.34
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Objective To explore the application of problem-based learning (PBL) model in orthopedics teaching. Method 80 medical students from Nanfang Hospital of Southern Medical University who have participated in orthopedics practice with PBL teaching model were included, and the result of questionnaire survey was analyzed. Results 76 effective questionnaires were collected. The necessity, attractiveness and effectiveness of the model were confirmed by 72 (94.7%), 71 (93.4%) and 69 (90.7%) students respectively. Most of the respondents thought PBL teaching model had multifarious advantages, including arousing student’s learning interests, improving clinical thinking and comprehensive application ability, enhancing communication and team-work skills, stimulating creative thinking. Conclusion PBL teaching model is an effective approach in orthopedics teaching. Nevertheless, it should be further improved when applied in medical education in China.
2018, 41(2): 281-283.
doi: 10.3969/j.issn.1674-4500.2018.02.35
Abstract:
This report retrospectively reviewed the medical materials of an aortic dissection patient who had undergone a second operation of endovascular aortic repair, and summarized some experience from this nursing case. This patient had a ten-year history of hypertension, which had not been treated regularly. He had received endovascular thoracic aortic repair because of thoracic aortic dissection, after which the blood pressure was poorly controlled. 18 months later, he was found to have abdominal aortic dissection and a second surgery was performed. Personalized holistic nursing care was carried out, which included blood pressure management, pain nursing care, mental nursing, and prevention of constipation, fall and complications. After 2 weeks of treatment and nursing care, the patient was discharged without any complication, and the nursing care was continued, including lifestyle modification and self-monitoring suggestions. Now the patient recovers well. Personalized holistic nursing care has positive effects on the recovery of postoperative patients.
This report retrospectively reviewed the medical materials of an aortic dissection patient who had undergone a second operation of endovascular aortic repair, and summarized some experience from this nursing case. This patient had a ten-year history of hypertension, which had not been treated regularly. He had received endovascular thoracic aortic repair because of thoracic aortic dissection, after which the blood pressure was poorly controlled. 18 months later, he was found to have abdominal aortic dissection and a second surgery was performed. Personalized holistic nursing care was carried out, which included blood pressure management, pain nursing care, mental nursing, and prevention of constipation, fall and complications. After 2 weeks of treatment and nursing care, the patient was discharged without any complication, and the nursing care was continued, including lifestyle modification and self-monitoring suggestions. Now the patient recovers well. Personalized holistic nursing care has positive effects on the recovery of postoperative patients.
2018, 41(2): 284-286.
doi: 10.3969/j.issn.1674-4500.2018.02.36
Abstract:
Objective To investigate the nursing effect of irrigation combined with intermittent vacuum sealing drainage (VSD) in the treatment of infected wounds. Methods 45 patients with infective wounds admitted to the department of orthopedics in our hospital from May 2015 to September 2017 were included. According to random number table, they were divided into control group (n=20) and observation group (n=25). Cases in the control group were treated with irrigation with continuous VSD, while those in observation group were treated with irrigation with intermittent VSD. Clinical statistics of two groups, including the growth of granulation tissue, hospitalization time, number of damaged electric aspirator during treatment and degree of patient satisfaction, were recorded and analyzed. Results There were no significant differences in the growth of wound granulation tissue and hospitalization time between the two groups (P>0.05). However, the damage rate of negative pressure aspirator in the observation group was lower than that of the control group, and the degree of patient satisfaction in the observation group was higher than that in the control group(P<0.05). Conclusion The application of intermittent VSD combined with irrigation in the treatment of infected wounds can, in the prerequisite of ensuring the curative effect, reduce wear on the machine, relieve the sufferings of the patient, and improve the patient’s sleep quality and satisfaction, thus worthy of clinical application and promotion.
