Infectious pancreatic necrosis (IPN) is a challenging complication of acute pancreatitis and can lead to poor prognosis.Over the years,open necrosectomy has become the main treatment modality for IPN,but it will cause high incidence rate of complications and mortality rate.In recent years,with the rapid development of minimally invasive surgery,many scholars have performed minimally invasive treatment for IPN patients and achieved good outcomes.This article introduces five minimally invasive treatment techniques,i.e.,percutaneous catheter drainage,minimally invasive retroperitoneal necrosectomy,endoscopic drainage + necrosectomy,laparoscopic necrosectomy,and advanced therapeutic strategy,pointed out that different minimally invasive techniques had different indications,and minimally invasive therapies should be selected based on IPN patients' general conditions to improve their outcome.

ObjectiveTo evaluate the effect of surgical treatment of distal tibial facture with minimally invasive perutaneous locking compression plate osteosynthesis.Methods38 patients with distal tibial fracture were treated with minimally invasive percutaneous locking compression plate(LCP) osteosynthesis.According to AO classification,twelve patients belonged to type A,fifteen type B,and eleven type C.ResultsAll patients were followed up for 6 to 19 months,with an average time of 9 months.The X-ray pictures showed that one-stage union was achieved in the patients,with a mean healing time of 16 weeks.No complications such as infection,non-union were found.The clinical outcomes were evaluated according to Mazur ankle joint function scoring.Twenty-nine were rated as excellent,six as good and three as fair,with the good-excellent rate of 92.1％.ConclusionMinimally invasive peteosynthesis is a kind of a good fixation in treatment of accelerating bone and soft tissue healing.

Objective To evaluate the risk factors for carotid atherosclerosis in patients with cerebral infarction.Methods A total of 180 patients with cerebral infarction were divided into no-plaque group (38cases) and plaque group (142 cases) on the results of Color ultrasonography.Plaque group was further divided into stable plaque subgroup (46 patients) and no-stable plaque subgroup (96 patients).Total cholesterol (TC),high density lipoprotein cholesterol (HDL-C),low density lipoprotein cholesterol (LDL-C),triglyceride (TG),fibrinogen (FIB) and oxidized low density lipoprotein cholesterol (OXLDL) were recorded.The risk factors for carotid atherosclerosis in patients with cerebral infarction were analyzed.Results The percentage of hypertension,diabetes,stroke history,smoking were 88.7％(126/142),43.7％(62/142),53.5％(76/142),50.7％ (72/142) in plaque group and 52.6％(20/38),21.1％(8/38),31.6％(12/38),13.2％(5/38) in no-plaque group.The percentage of hypertension,diabetes,stroke history,smoking in plaque group were higher than those in no-plaque group,and there were significant differences (P ＜ 0.05).The age,TC,LDL-C,OXLDL,FIB were (65 ± 10) years old,(5.3 ±0.8) mmol/L,(3.4 ±0.8) mmol/L,(0.75 ±0.34) mmol/L,(4.8 ± 1.1) g/L in plaque group,and (56 ± 7) years old,(4.6 ± 0.7) mmol/L,(2.8 ± 0.7) mmol/L,(0.45 ± 0.21) mmol/L,(3.8 ± 0.9) g/L in no-plaque group.The age,TC,LDL-C,OXLDL,FIB in plaque group were higher than those in no-plaque group,and there were significant differences (P ＜ 0.05).The percentage of diabetes,stroke history,smoking and LDL-C,OXLDL were 50.0％(48/96),62.5％(60/96),56.2％(54/96),(3.7 ± 0.9) mmol/L,(0.84 ± 0.36)mmol/L in no-stable plaque subgroup,and 30.4％(14/46),34.8％(16/46),39.1％(18/46),(3.1 ± 0.7) mmol/L,(0.60 ± 0.32) mmol/L in stable plaque subgroup.The percentage of diabetes,stroke history,smoking and LDL-C,OXLDL in no-stable plaque subgroup were higher than those in stable plaque subgroup,and there were significant differences (P ＜ 0.05).Multivariate Logistic regression analysis showed that LDL-C (OR =1.724,95％ CI 1.326-2.285),OXLDL (OR =2.464,95％ CI 1.502-5.676) and diabetes (OR =1.484,95％ CI 1.005-1.739) were the independent risk factors for carotid atherosclerosis in patients with cerebral infarction.Conclusion LDL-C,OXLDL and diabetes are the independent risk factors for carotid atherosclerosis in patients with cerebral infarction.

Objective To sum up the nursing experience of injection of sulphur hexafluoride microbubbles as contrast agent for thyroid contrast-enhanced ultrasound (CEUS).Methods The clinical data of 413 cases who injected sulphur hexafluoride microbubbles as a contrast agent for CEUS were retrospectively analyzed.Nursing observation and coordination were done on the CEUS examination process,venous puncture technique,the correct configuration and use of sulphur hexafluoride microbubbles as contrast agents,operating process,the correct treatment of adverse reactions.Results The success rate of thyroid CEUS in 413 cases was 100％.After completion of the CEUS procedure,2 cases revealed slight dizziness,1 case with the contrast agent extravasation,others did not have adverse reactions such as dizziness,the contrast agent extravasation,skin rashes,itching,pain at the injection site.Conclusion The key nursing points including mastery of the whole CEUS process,operator's qualified venous puncture technique,the correct configuration and use of sulphur hexafluoride microbubbles for injection as contrast agent,careful nursing observation in the operating process and correctly treatment of adverse reactions are significant for enhancing success rate of thyroid CEUS and relieving relevant adverse effects.

OBJECTIVE:To systematically review the efficacy and safety of Deproteinised calf blood serum injection in the treatment of cerebral infarction,and to provide evidence-based reference for clinical treatment.METHODS:Retrieved from Co-chrane Library,EMBase,Medline,CBM,CJFD,VIP and Wanfan database,randomized controlled trials(RCT)about theeffica-cy and safety ofDeproteinised calf blood serum injection(test group)based on basic treatment(control group)in the treatment of cerebral infarction were collected.Meta-analysis was performed by using Rev Man 5.2 software after data extraction and quality eval-uation with Cochrane system evaluation manual 5.1.0.RESULTS:A total of 18 RCTs were included,involving 2 111 patients.Re-sults of Meta-analysis showed the total effective rate [OR=3.30,95%CI(2.48,4.39),P<0.001],National Institutes of Health Stroke Scale (NIHSS) score[MD=-1.47,95%CI(-2.06,-0.88),P<0.001] and activities of daily living(ADL) score[MD=9.09,95%CI(6.46,11.72),P<0.001] in test group were significantly better than control group,there were significant differences be-tween the 2 groups;and there was no obvious adverse reactions during treatment. CONCLUSIONS:Both efficacy and safety of De-proteinised calf blood serum injectionin the treatment of cerebral infarction are good.

Objective To evaluate operative methods and the clinical effect of closed reduction and percuta-neous locking compression titanium plate internal fixation in treatment of distal tibial fractures.Methods The clinical data of 21 patients with fracture who received closed reduction technology through the subcutaneous tunnel of fracture end,minimally invasive percutaneous treatment of tibial locking titanium plate fixation were retrospectively analyzed. Results All 21 patients were followed up from 6 to 18 months(11 months in average).All patients recovered with good healing of fracture.According to criteria of Johner -Wruhs score,the results were excellent in 12 cases,good in 6 cases,fair in 3 cases,and poor in 0 case.The excellent and good rate was 85.71%.Conclusion The method of closed reduction and percutaneous locking compression titanium plate internal fixation in treatment of distal tibial frac-tures can protect skin soft tissue,reduce the damage to the blood -supply of the fracture,promote the healing of the fracture and reduce complications.

Objective:To review the progress in vaginal mucoadhesive drug delivery systems. Methods:Based on the recently published papers,the research on the application of vaginal mucoadhesive drug delivery systems was classified and summarized. Re-sults:Vaginal mucoadhesive drug delivery systems not only showed safety,effectiveness and strong permeability but also avoided the first pass effect,prolonged drug residence time and improved bioavailability and compliance of patients. Conclusion:Vaginal mucoad-hesive drug delivery systems are becoming research hotspots and exhibit broad application prospects to replace the traditional delivery systems.

Objective To analyze clinical characteristics of migraine complicated with cerebral edema.Methods We first time reported a case of familiar hemiplegic migraine complicated with diffuse cerebral edema in China,another 19 cases of migraine complicated with cerebral edema were reported in literature.The clinical characteristics of these 20 cases were analyzed.Results In 20 cases,the male:female ratio was 1.2∶ 1,the mean age of onset was (16.0 ± 10.2) years.All 20 cases were complicated with cerebral edema,among whom 8 (40％) were familiar hemiplegic migraine,8 (40％) were sporadic hemiplegic migraine,4 (20％) were migraine with aura.Common neurological symptoms and signs included paralysis (75％),aphasia (65％),disturbance of consciousness (60％),disordered vision (40％),Paresthesia (35％).Eleven cases (55％) had permanent neurological deficit.Conclusions The clinical manifestations of migraine with cerebral edema are complicated,the neurological disturbance is severe and usually has a long duration.The early diagnosis and treatment is beneficial,and preventive treatment in intermittent period is recommended.

Objective To evaluate the relationship between myocardial perfusion and diastolic function with velocity vector imaging (VVI) combined with myocardial contrast echocardiography (MCE) in dog models of coronary artery stenosis at rest and stress. Methods Different stenoses in anterior descending branch were made in 8 dogs. Before and after coronary artery stenosis, VVI evaluation was made on short axis image, then MCE were performed in the left ventricular mastoid muscle section at rest and in the peak dose of dobutamine. The myocardial blood flow A·β value and peak diastolic strain rate (SR_(dia)) on the direction of the circumference of the short view were measured, and the relationship between them was analyzed. Results At rest, no significant difference of A·β value nor SR_(dia) was found between the stenotic bed and normal bed when coronary stenosis was mild or moderate. However, A·β value and SR_(dia) of the stenotic bed were smaller than those in the normal bed when coronary stenosis was severe (P<0.05). At dobutamine stress, A·β value and SR_(dia) of the stenotic bed were already less than those in the normal bed when coronary stenosis was mild or moderate. A·β values and SR_(dia) of the stenotic bed decreased further compared to the normal bed (P<0.05) when coronary artery was severe. At both rest and stress, the standard A·β value was strongly correlated with SR_(dia) (r_(rest)=0.57,r_(stress)=0.72,P<0.01). Conclusion VVI can not only evaluate the diastolic function of myocardial segments on the short axis view, but also reflect changes of myocardial perfusion to a certain extent.