目的：观察前房冲洗术联合尿激酶治疗严重外伤性前房积血的临床疗效。方法：选择近3年来我科收治的严重外伤性前房积血患者57例(56眼)，随机分为Ａ组29例(29)眼)、Ｂ组28例(28眼)，Ａ组采用先前房注入尿激酶再行前房冲洗的方法，Ｂ组行单纯前房冲洗术。观察术中及术后并发症；术后视力、眼压情况。结果：Ａ组术中干净清除血凝块29眼(100％)，术中出血5眼(17.24％)，无虹膜损伤，术后第一天矫正视力≥0.5有24眼，眼压≥21 mm Hg者4眼(13.79％)；Ｂ组术中仍有少量血凝块4眼(14.29％)，术中出血4眼(14.29％)，虹膜损伤1眼(3.57％)，术后第一天矫正视力≥0.5有16眼，眼压≥21 mm Hg者8眼(28.57％)。Ｂ组术后仍有少量血凝块者加用药物治疗后吸收，两组病例中高眼压均加用药物控制正常，一周时视力无明显差异(P＞0.05)。结论：前房冲洗术前先使用尿激酶治疗严重外伤性前房积血是一种操作更安全，更有效的手术方法。
Lung cancer is an epithelial cancer arising from the bronchial surface epithelium or bronchial mucous glands. Non-small lung cancer constitutes about 75%-80% of all lung cancer. At the time of diagnosis, a lot of people have got stage Ⅲb non-small lung cancer which is unresectalbe. Both chemotherapy and radiotherapy are widely used in unresectable stage Ⅲ non-small lung cancer. The regimes of chemotherapy or radiotherapy are varied too. Systematic reviews and randomized controlled trials have provide much convincing evidence for us to choose and utilize the most appropriate treatment.
Tissue engineering technology and stem cell research based on tissue engineering have made great progresses in overcoming the problems of tissue and organ damage, functional loss and surgical complications. Traditional method is to use biological substitute materials to repair tissues, while tissue engineering technology focuses on combining seed cells with biological materials to form biological tissues with the same structure and function as its own to repair tissue defects. The advantage is that such tissue engineering organs and tissues can solve the problem that the donor material is limited, and effectively reduce complications. The purpose of tissue engineering is to find suitable seed cells and biomaterials which can replace the biological function of original tissue and build suitable microenvironment in vivo. This paper mainly describes current technologies of tissue engineering in various fields of urology, and discusses the future trend of tissue engineering technology in the treatment of complex urinary diseases. The results of this study show that although there are relatively few clinical trials, the good results of the existing studies on animal models reveal a bright future of tissue engineering technology for the treatment of various urinary diseases.
Interventional micro-axial flow blood pump is widely used as an effective treatment for patients with cardiogenic shock. Hemolysis and coagulation are vital concerns in the clinical application of interventional micro-axial flow pumps. This paper reviewed hemolysis and coagulation models for micro-axial flow blood pumps. Firstly, the structural characteristics of commercial interventional micro-axial flow blood pumps and issues related to clinical applications were introduced. Then the basic mechanisms of hemolysis and coagulation were used to study the factors affecting erythrocyte damage and platelet activation in interventional micro-axial flow blood pumps, focusing on the current models of hemolysis and coagulation on different scales (macroscopic, mesoscopic, and microscopic). Since models at different scales have different perspectives on the study of hemolysis and coagulation, a comprehensive analysis combined with multi-scale models is required to fully consider the influence of complex factors of interventional pumps on hemolysis and coagulation.
Objectives To assess the efficacy and safety of statins for adult osteoporosis. Methods We electronically searched The Cochrane Library (Issue 4, 2007), MEDLINE (1990 to November 2007), EMBASE (1990 to November 2007), Current Controlled Trials, The National Research Register, CBM (1990 to November 2007), VIP (1990 to November 2007) and CNKI (1990 to November 2007). We also handsearched some related journals and identified randomized controlled trials of statins versus placebo in adults with osteoporosis. Results Two randomized controlled trials were included. We didn’t perform meta-analysis due to heterogeneity. No significant differences were observed in the changes of bone density at the lumbar spine and total hip from baseline between statins and placebo. However, a significant increase in bone density was found in response to simvastatin at the forearm. Biochemical markers of bone metabolism changes from baseline did not differ significantly between statins and placebo groups. Conclusions The evidence currently available does not support the use of statins in the treatment of osteoporosis. Further randomized, double-blind, placebo-controlled trials are needed in order to define the efficacy and acceptability of statins in the treatment of osteoporosis.
Objective To study the effect and mechanism of recombinant human brain natriuretic peptide (rh-BNP) in alleviating myocardial ischemia-reperfusion (I/R) injury by regulating mitogen activated protein kinase (MAPK) pathway. Methods A total of 128 adult male Sprague-Dawley (SD) rats with specific pathogen free were selected. The SD rats were divided into groups according to random number table, including, sham operation (Sham) group, I/R group, I/R+rh-BNP group, negative control adenovirus (Ad-NC)+Sham group, Ad-NC+I/R group, Ad-NC+I/R+rh-BNP group, p38 mitogen-activated protein kinase adenovirus (Ad-p38MAPK)+I/R group and Ad-p38MAPK+I/R+rh-BNP group, with 16 SD rats in each group. Myocardial I/R injury model was established by ligation of left anterior descending coronary artery. Before modeling, rh-BNP was injected intraperitoneally or adenovirus was injected into myocardium; 180 minutes after reperfusion, the contents of lactate dehydrogenase (LDH), creatine kinase isoenzyme (CK-MB) in serum, myocardial infarction size, the contents of reactive oxygen species (ROS), tumor necrosis factor-α (TNF-α) and the expression of phosphorylated p38MAPK (p-p38MAPK), phosphorylated JNK (p-JNK) and phosphorylated extracellular regulated protein kinases 1/2 (p-ERK1/2) were detected. Results The contents of LDH, CK-MB, myocardial infarction size, the contents of TNF-α, ROS and the expression of p-p38MAPK and p-JNK in I/R group were higher than those in Sham group, p-ERK1/2 expression level was lower than that in Sham group (P<0.05). The contents of LDH, CK-MB, myocardial infarction size, the contents of TNF-α, ROS and the expression of p-p38MAPK in I/R+rh-BNP group were lower than those in I/R group (P<0.05), the expression of p-JNK and p-ERK1/2 had no significant difference compared with I/R group (P>0.05). The contents of LDH, CK-MB, myocardial infarction size, the contents of TNF-α, ROS and the expression of p-p38MAPK in Ad-p38mapk+I/R+rh-BNP group were higher than those in Ad-NC+I/R-rh-BNP group (P<0.05). Conclusion rh-BNP can alleviate myocardial I/R injury, which is related to inhibiting p38MAPK pathway, reducing inflammation response and oxidative stress response.
ObjectiveTo observe the effect of Baduanjin on the motor function and balance function in patients within 6 months after stroke.Methods Between July 2018 and March 2019, a total of 40 stroke patients were randomly divided into the Baduanjin group and the control group. Twenty patients in the Baduanjin group received the treatment of Baduanjin training and conventional rehabilitation, while the other 20 patients in the control group were treated with conventional rehabilitation only. The duration of the treatment was 3 weeks; then the motor function, balance ability and the ability of daily life in the two groups were assessed by the Fugl-Meyer Assessment (FMA), the 6-minute Walking Test (6MWT), the Berg Balance Scale (BBS), the balance tester and the Barthel Index (BI) respectively before and after treatment.ResultsAfter the 3-week treatment, the motor function, balance ability and the ability of daily life assessed by FMA, 6MWT, BBS, the balance tester, and BI were improved significantly in both groups (P<0.05). The post-treatment scores of FMA, BI, BBS and 6MWT distance in the Baduanjin group were more than those in the control group [72.25±20.91 vs. 57.90±20.25, 89.75±12.08 vs. 77.75±15.68, 53.25±5.74 vs. 47.80±9.77, (251.03±79.43) vs. (186.92±100.09) m; P<0.05]. In the sit-to-stand balance test, compared with those in the control group, the total trajectory length of center of gravity, average swing speed of center of gravity, and unit area trajectory length of center of gravity in standing stance in the Baduanjin group reduced significantly [(235.86±76.08) vs. (303.60±123.01) cm, (11.67±3.37) vs. (15.76±7.05) cm/s, (2.53±0.99) vs. (3.40±1.28) cm/cm2; P<0.05], and the total trajectory length of center of gravity, average swing speed of center of gravity, and unit area trajectory length of center of gravity in sitting stance in the Baduanjin group also reduced significantly [(246.59±98.79) vs. (334.05±155.87) cm, (7.69±2.29) vs. (11.13±6.41) cm/s, (4.10±1.38) vs. (6.25±4.21) cm/cm2; P<0.05].ConclusionConventional rehabilitation with or without Baduanjin can improve the motor function, balance function and the ability of daily life in patients after stroke, but the effect of rehabilitation with Baduanjin is better than conventional rehabilitation.
Objective To evaluate the correlation between benign prostatic hyperplasia (BPH) and metabolic syndrome (MS). Methods Total 666 elderly male patients admitted to West China Hospital for routine physical examination in May, 2010 were included in this study. The related laboratory tests of BPH and MS were taken. The correlation among BPH, lower urinary tract Symptoms (LUTS), prostate volume (PV), MS and its component diseases were analyzed. Results Hypertension was an important risk factor for BPH (OR=1.309, 95%CI 1.033 to 1.661), low HDL-C hyperlipidemia was a risk factor for IPSS scored over 7 points (OR=1.573, 95%CI 0.330 to 0.997), and the score of PV was positively correlated to obesity, hypertension, low HDL-C hyperlipidemia and MS (all Plt;0.05). Conclusion For the patient with BPH, MS and its component diseases mainly exert their effects on PV changes rather than LUTS.
Objective To compare vein graft patency after endoscopic great saphenous vein harvesting (EVH) and conventional open saphenous veinharvesting (OVH) in coronary artery bypass grafting (CABG), and to identify risk factors for vein graft stenosis. Methods The great saphenous vein was harvested using an EVH method in 60 patients, 34 males and 26 females, who underwent CABG in the General Hospital of PLA between May 2006 and May 2009. The mean patient age was 66.6±9.2 years in the EVH group.The OVH group had 60 patients (40 males and 20 females with a mean age of 65.7±10.6 years), chosen to match the clinical characteristics of the EVH group. 64multislice computed tomography (64MSCT) was used to evaluate vein graft patency at six months and two years postoperatively. We also collected and analyzeddata on possible risk factors for vein graft stenosis. Results The harvesting time was longer in the EVH group than in the OVH group (52.5±13.3 minutes vs. 36.1±18.0 minutes, t=2.13, P＜0.05). The EVH group requireda greater number of repairs to veins than did the OVH group (2.2±13 vs. 0.9±0.6,t=2.60, P＜0.05). There were no statistically significant differences invein length, number of vein grafts, or vein graft flow between the two groups. There was also no significant difference in vein graft patency between the EVH and OVH groups at six months postoperatively (96.2% vs. 94.5%) or at two years postoperatively (90.2% vs. 91.5%). The average of vein graft blood flow was a riskfactor for vein graft stenosis(t=2.61, P=001). Conclusion The EVH vein graft had a good patency rate at six months and two years after the surgery.
Objective To investigate the efficacy and prognostic risk factors of high flow nasal cannula (HFNC) in elderly patients with respiratory failure. Methods Clinical data of 172 elderly patients with respiratory failure admitted to 363 Hospital from April 2020 to August 2022 were retrospectively collected. The patients were divided into an observation group (n=86) and a control group (n=86) according to treatment method. The observation group (54 males, 32 females), mean 68.67±2.36 years old, received HFNC oxygen therapy. The control group (52 males, 34 females), mean 68.12±2.14 years old, received conventional oxygen therapy. According to the prognosis after HFNC treatment, the observation group was subdivided into a poor prognosis group (n=21) and a good prognosis group (n=65). The clinical effects of different treatment methods in the two groups were analyzed, and the risk factors affecting prognosis of elderly patients with respiratory failure treated by HFNC were analyzed by multivariate logistic regression. A line graph model was constructed, and the model was verified by receiver operator characteristic curve and cumulative gain graph. Results Repeated measures ANOVA was conducted on the oxygen therapy indicators of the two groups of patients. The results showed that pH, PaO2, PaCO2, and respiratory rate all have statistical significance in terms of time effect (F=423.25, P<0.001; F=326.25, P<0.001; F=128.79, P<0.001; F=323.16, P<0.001), inter-group effect (F=128.79, P<0.001; F=205.46, P<0.001; F=310.52, P<0.001; F=123.15, P<0.001), and interactive effect (F=111.06, P<0.001; F=198.76, P<0.001; F=134.28, P<0.001; F=112.47, P<0.001). This indicated that the impact of time on pH, PaO2, PaCO2, and respiratory rate differs depending on the treatment method. The scores of acute physiology and chronic health evaluation Ⅱ (APACHEⅡ), the level of brain natriuretic peptide (BNP), the heart rate before treatment, the posterior root of tongue fall, the initial HFNC flow and the duration of HFNC in the poor prognosis group were significantly higher than those in the good prognosis group. Initial PaO2/FiO2 was significantly lower than that in the good prognosis group (P<0.05). Multiple factor analysis showed that APACHEⅡ score>17 points, BNP level>150 ng/L before treatment, heart rate >105 times/min before treatment, posterior root of tongue drop, initial HFNC flow>55 L/min, initial PaO2/FiO2<150 mmHg were independent influencing factors for poor prognosis of elderly patients with respiratory failure treated by HFNC. The histogram model showed that the total score of the above 6 indicators is 284, corresponding to a probability of poor prognosis of 71.6%, which proved that the prediction ability of this model is good. Conclusions The application of HFNC in elderly patients with respiratory failure has a significant effect. APACHEⅡ score, BNP level before treatment, heart rate before treatment, posterior root of tongue fall, initial HFNC flow, initial PaO2/FiO2 are all risk factors affecting the prognosis, which should be paid attention to in clinic to improve the therapeutic effect.