Pectus excavatum is the most common chest wall deformity. Severe pectus excavatum can significantly impact both the physiological and psychological health of patients, necessitating timely therapeutic intervention. The Nuss procedure is currently the preferred surgical approach for treating moderate to severe pectus excavatum. However, in cases of severe pectus excavatum, the placement of the corrective steel bar through the anterior mediastinum poses a substantial risk of injury to the heart, major blood vessels, and lung tissue. This article reports a case of a 17-year-old patient with severe pectus excavatum combined with Marfan syndrome. CT examination revealed a Haller index of 14.07, with severe sternal depression leading to significant narrowing of the anterior mediastinal space and complete displacement of the heart into the left thoracic cavity, resulting in an extremely high surgical risk. We employed a simplified sternal elevation technique in conjunction with the Nuss procedure for treatment. During the operation, a sternal retractor was used to elevate the sternum, thereby enlarging the retrosternal space and facilitating the successful completion of the Nuss procedure. This approach effectively avoided damage to the heart and major blood vessels, resulted in no surgical complications, and achieved a satisfactory corrective outcome.
ObjectiveTo study the method of rapid and accurate measurement of body temperature in dense population during the coronavirus disease 2019 pandemic.MethodsFrom January 27th to February 8th, 2020, subjects were respectively measured with two kinds of non-contact infrared thermometers (blue thermometer and red one) to measure the temperature of forehead, neck, and inner side of forearm under the conditions of 4–6℃ (n=152), 7–10℃ (n=103), and 11–25℃ (n=209), while the temperature of axillary was measured with mercury thermometer under the same conditions. Taking the mercury thermometer temperature as the gold standard, the measurement results with non-contact infrared thermometers were compared.ResultsAt 7–10℃, there was no statistical difference among the forehead temperatures measured by the two non-contact infrared thermometers and the axillary temperature (P>0.05); there was no difference among the temperature measured by blue thermometer on forehead, neck, and inner side of forearm (P>0.05); no difference was found between the temperature measured by the red thermometer on forehead and inner side of forearm (P>0.05), while there was statistical difference between the temperatures measured by the red thermometer on forehead and neck (P<0.05). Under the environment of 11−25℃, there was no statistical difference among the forehead temperatures measured by the two infrared thermometers and the axillary temperature (P>0.05); the difference between the temperatures of forehead and inner side of forearm measured by the blue thermometer was statistically significant (P<0.05), while no difference appeared between the forehead and neck temperatures measured by the blue thermometer (P>0.05); there was no statistical difference among the temperatures of three body regions mentioned above measured by the red thermometer (P>0.05). According to the manual, the allowable fluctuation range of the blue thermometer was 0.3℃, and that of the red one was 0.2℃. The mean differences in measured values between different measured sites of the two products were within the allowable fluctuation range. Therefore, the differences had no clinical significance in the environment of 7–25℃. Under the environment of 4–6℃, the detection rate of blue thermometer was 2.2% and that of the red one was 19.1%.ConclusionsThere is no clinical difference between the temperature measured by mercury thermometer and the temperature measured by temperature guns at 7–10 or 11–25℃, so temperature guns can be widely used. In order to maintain the maximum distance between the measuring and the measured persons and reduce the infection risk, it is recommended to choose the inner forearm for temperature measurement. Under the environment of ambient temperature 4–6℃, the detection rate of non-contact electronic temperature gun is low, requiring taking thermal measures for the instrument.