Objective To investigate the possibility of interventional treatment of placenta accreta. Methods One patient with placenta accreta was treated with uterine arterial infusion of cef and MTX followed by embolization. Results Her placenta discharged through vagina at the 27th day after uterine aterial embolizayiea. No remnant was found in the uterine by Doppler imaging. The patient uneventfully recovered.Conclusions Intervetional therapy with uterine arterial embolization is a new and reliable method for treatment of placenta accheta.

Grounding impedance measurement is a traditional proficiency testing programs, 2014 proficiency testing program on the basis of original ability to verify, combined with actual detection need, innovation introduced two verification point of the power input socket and metal plane testing. This paper analyzes and discusses the results of the ability verification in 2014, and puts forward the points of attention and the recommended method of metal plane test.
Laboratories ; standards ; Laboratory Proficiency Testing

Objective Experimentally to investigate the changes in vasospastic canine basilar arteries. Methods Vasospasm of basilar arteries was induced by double-injecting autologous blood into the brain cisterns. 28 adult mongrel dogs of both genders served as the subjects, of them 20 involved in experimental group and accepted the PTA treatment and the other 8 doges were in negative control group without any treatment. PTA was performed by a single inflation of balloon for 10 seconds at a peak pressure of 2.0 atmospheres. Angiography was re-performed at 30 day, 90 day and 300 day following PTA, respectively. The histologic changes were then evaluated using light and electron microscopy. Results Caliber of basilar arteries of all canines decompressed obviously, from 1.3 mm to 0.8 mm. In test group, PTA succeeded in 15 ones, with caliber of vasospastic basilar arteries enlarged obviously after PTA ( P

OBJECTIVE: To discuss the clinical characteristics of bilateral bronchial foreign body in children, increase the curative rate and reduce the complications. METHOD: The clinical data of 35 cases with bilateral bronchial foreign body in children were retrospectively analysed, including surgery, key surgery points, and postoperative combined therapy. RESULT: The foreign bodies of all cases were removed under intravenous general and tropical anesthesia without complications. CONCLUSION The bilateral bronchial foreign body is a serious case, the timely and effective treatment can lower the mortality rate and postoperative complications. The children lack of oxygen for a long time before and in operation should be give comprehensive therapy, for example: sedation and hyperbaric oxygen.
Anesthesia ; Bronchi ; pathology ; Bronchoscopy ; Child ; Foreign Bodies ; diagnosis ; surgery ; Humans ; Oxygen ; Postoperative Period ; Retrospective Studies ; Treatment Outcome

Objective To investigate the safety and feasibility of laparoscopic pylorus-preserving pancreaticoduodenectomy.MethodsThe data of 59 patients with laparoscopic pancreaticoduodenectomy in Shangjin hospital of West China hospital of Sichuan University from January 2014 to December 2015 were analyzed retrospectively.The general data,operative time,estimated blood loss,conversion rate,time to liquid diet,postoperative hospital stay and complications were analyzed.Results The laparoscopic pylorus-preserving pancreaticoduodenectomy were successfully performed in 56 cases,the successful rate was 94.9%,the other 3 patients were converted to laparotomy for superior mesenteric vein/portal vein involvement.The operative time was 255~510 minutes,with mean operative time (384±145) minutes,the intraoperatve blood soss was 50~800 mL,with mean estimated blood loss (148±28)mL,the time to liquid diet was 1.0~4.0 days,with average time (3.2±1.1)days,the postoperative hospital stay was 5.0~53.0 days,with average time (10.3±2.6)days.After surgery,16 cases suffered from complication,the rate was 27.1%.The most common complication was pancreatic fistula which occurred in 13 cases including 12 cases of grade A and 1 case of grade pancreatic fistula.No grade C pancreatic fistula occurred in this series.Six patients suffered from delayed gastric emptying.One patient suffered from bile leakage.Conclusion Laparoscopic pylorus-preserving pancreaticoduodenectomy was safe and feasible.Pylorus-preserving does not increase the incidence of delayed gastric emptying.

Objective To investigate the effect of trimetazidine postconditoning on myocardial cell apoptosis in acute ischemia-reperfusion injury in rats.Methods 40 healthy adult Wistar rats were randomly assigned to Sham-operated group,MIRI group(I/R group),trimetazidine group and ischemic postconditioning group(IPOC group).The left anterior descending coronary artery of rat was ligated and the acute myocardial ischemia-reperfusion injury model was established.After that,ultrastructural changes of apoptotic myocardial cells were observed under electron microscope,and apoptotic cells were detected under optical microscope.The expressions of the Bcl-2,caspase-3 apoptosis related proteins were determined.Results ① The degree of ultrastructural injury of apoptotic myocardial cells was mild and basically the same in trimetazidine group versus IPOC group,and had a significant improvement as compared with I/R group.② The degree of myocardial apoptosis was basically the same in trimetazidine versus IPOC group,and lighter than in I/R group.③ Bcl-2 protein expression levels were(61.9 ± 2.9) ％,(21.4 ± 3.2) ％,(46.8 ± 3.5) ％ and (49.7 ± 3.1) ％,and caspase-3 protein expression levels were(38.1±4.5) ％,(72.8±5.7) ％,(47.2±5.1) ％ and(39.8 ±4.6)％ in Sham-operated group,I/R group,trimetazidine group and IPOC group respectively.Compared with I/R group,the expression of Bcl-2 protein was increased obviously,while the expression of easpase-3 protein was decreased in trimetazidine group and IPOC group.But there were no significant differences in the protein levels of Bcl-2 and caspase-3 between trimetazidine group and IPOC group(both P＞0.05).Conclusions Trimetazidine postconditoning can inhibit the myocardial cell apoptosis in acute ischemia-reperfusion injury in rats,and has a protective effect on myocardial cells.

Objective To study the experiences of severe acute pancreatitis (SAP) treated by combmation of traditional Chinese and western medicine.Methods Two hundred and forty patients with SAP were divided into A and B groups randomly,140 patients of group B were treated by combination of traditional Chinese and western medicine;100 patients of group A were treated by western medicine.Results After treatment in group B, the serum and urine amylase, and c-reactive protein,signiflcantly decreased.The complication rate of group A and group B was 55.00 % and 12.86 %(P

In the era of digital information,internet plus mode provides new opportunities for the development of traditional medical education.This paper introduces the application patterns of internet plus mode in the medical education,including the following aspects,such as the construction of medical quality resources sharing class,the implementing of medical massive open online courses and other kinds of open online courses,making comprehensive construction of textbooks,using social interactive software and some new wearable devices such as Google glass,distance education and so on.And from the construction of autonomy,sharing,dynamic teaching atmosphere and building a new relationship between teachers and students,it explores the application advantage of Internet plus in medical education,emphasizes thatInternet plus mode and traditional medical education should be organically integrated and financed.At the same time,we should improve the evaluation of information quality,study the integrity test,and the application of big data processing,so as to provide some ideas for the sustainable development.

Objective:To present our initial experience with robot-assisted laparoscopic prostatectomy (RALP) for complicated cases.Methods:Clinical and pathological data from 4 complicated prostate cancer cases,who underwent RALP from October to November in 2015,were analyzed retrospectively.All the cases were conducted transurethral plasmakinetic enucleation of prostate and hormonal therapy before RALP.Results:All surgeries were done successfully.The age,baseline prostatic special antigen,clinical tumor stage,operation time and estimated blood loss were 58-70 years,6.04-70.15 ng/mL,T2bT3b,210-360 min and 50-250 mL,respectively.No blood transfusion was needed.All surgical margin were negative.Conclusion:Although previous transurethral surgeries and hormonal therapies may increase the difficulty for operations,RALP is still appropriate for the complicated cases of prostate cancer.

ObjectiveTo evaluate the long-term outcomes of carotid endarterectomy versus carotid artery stenting for carotid stenosis.MethodsPubMed, EMBASE, and the Cochrane databases were retrieved.The randomized controlled trials of comparing CEA with CAS in patients with carotid artery stenosis were enrolled.The data such as the research basic characteristics and the long-term outcomes including stroke or death combined endpoints, any stroke or any death were extracted.The Stata software was used to conduct statistical analysis.ResultsA total of 7 randomized controlled trials and 8 210 patients were included.The median follow-up time was 2-7.4 years.The overall quality of the included studies was high and the risk of bias was low.The meta-analysis showed that the risks of the combined endpoint of stroke or death (hazard risk [HR] 1.21, 95% confidence interval [CI] 1.04-1.39), any stroke (HR 1.32, 95% CI 1.15-1.51) and ipsilateral stroke (HR 1.26, 95% CI 1.02-1.55) in the CAS group were significantly higher than those in the CEA group;the risks of death (HR 1.06, 95% CI 0.95-1.18), disabling stroke (HR 1.23, 95% CI 0.95-1.60), non-ipsilateral stroke (HR 1.12,95% CI 0.81-1.55) and restenosis (HR 1.18,95% CI 0.91-1.52) were not significantly different between between the CAS group and the CEA group.Conclusions CAS and CEA are associated with similar risks of long-term death, disabling stroke, non-ipsilateral stroke and restenosis.The risks of long-term combined endpoint of stroke or death, any stroke and ipsilateral stroke significantly higher with CAS.These results suggest that CEA remains the treatment of choice for carotid stenosis.