The relationship between hyperlactatemia and metabolic acidosis, which may involve shock resuscitation,homoiostasis, and nutritional support, remains a hot topic. On one hand, increased production of lac-tate due to anaerobic glycolysis during tissue hypoperfusion can aggravate metabolic acidosis; on the other hand,the utilization of lactate at organ and cell levels may lower blood lactate level, and thus alleviate metabolic acidosis.The ultimate blood lactate level depends on the balance of these two action mechanisms.

OBJECTIVE: To investigate the therapeutic effects of 768 coblation treatment in children with obstructive sleep apnea-hypopnea syndrome. METHOD: A review of 768 coblation treatment in children with obstructive sleep apnea-hypopnea syndrome was presented with respect to the sleep monitoring results, therapeutic effects and complications. RESULT: The time of pseudomembrane ablate was 10-14 d after operation. There were 11 patients occurred Secondarily bleeding within 1 week and 21 patients lymphatic tissue hyperplasia compensatorily within half a year after operation. After operation 3 months, the sleep Monitoring results were improved remarkably (P < 0.01) and the symptoms of snore and choke improved. CONCLUSION Coblation treatment in children with obstructive sleep apnea-hypopnea syndrome can reduce bleeding volume and improve obstruct syndrome apparently. The treatments of tonsils and adenoids differ with the characteristics of children and tympanotomy was fit for chil dren with secretory otitis media.
Catheter Ablation ; Child ; Child, Preschool ; Female ; Follow-Up Studies ; Humans ; Male ; Retrospective Studies ; Sleep Apnea, Obstructive ; surgery

OBJECTIVE: To investigate the efficacy and safety of nasal septal suture in septoplasty. METHOD: Sixty patients who had undergone septoplasty were allocated into two groups: packing group and suturing group. Post-operative signs and symptoms (visual analogue scale) were compared between the two groups. RESULT: The patients of packing group experienced significantly more postoperative pain, epiphora, tinnitus, ear fullness, sleep disturbance and nasal congestion(P<0. 05). No statistically significant difference between two groups in hemorrhage (P>0. 05). CONCLUSION Nasal septum continuous suture is a feasible method to replace nasal packing after septoplasty.
Bandages ; Humans ; Nasal Septum ; surgery ; Pain Measurement ; Pain, Postoperative ; Postoperative Period ; Rhinoplasty ; Suture Techniques ; Sutures ; Tinnitus

Objective To investigate the therapeutic outcome and its influencing factors after laparoscopic conservative surgery in treatment of tubal pregnancy. Methods From January 2003 to December 2008, 226 cases with tubal pregnancy were treated by laparoscopic conservative surgery. The tubal pateacy was evaluated in 152 cases given by hysterosalpingography (HSG) and 6 cases given by second laparoscopic exploration at 3-6 months after surgery. In their first laparoscopic surgeries, 209 got successful treatment and 19 underwent fail treatment. At 3-6 months after surgery, 89 cases with tubal patency among 207 cases with successful treatment were enrolled in group A. Nineteen cases who were failed in their first laparoscopic conservative surgery and treated by salpingectomy and 63 cases with tubal obstruction were enrolled in group B. The rate of tubal patency was calculated on patients with characteristics of gestational sac less or more than 5 era, the level serum human chorionic gonadotropin (hCG) less than 2000 IU/L,2000 IU/L to 5000 IU/L, and more than 5000 IU/L Results There was no significant difference in age,parity, amenorrhea, location of tubal pregnancy, rupture, pelvic adhesion between group A and group B.Two hundred and seven cases (91.6%, 207/226) were successfully treated at initial laparescopy. One hundred and fifty-two cases got follow up and 55 cases lost follow up at 3 to 6 months after surgery. There was statistical difference in preoperative hCG value which median were 980 (55-12 000) IU/L in group A,3150 (570-40 000) IU/L in group B(P<0.01); the diameter of tubal gestational sac were (3.4±1.3)cm in group A and (5.0±1.7) cm in group B(P<0.01); respectively, the volume of peritoneal bleeding were 200 (0-1500) ml and 300 (0-1600) ml, the rate of live tubal embryo was 2% (2/89) in group A and 11% (9/82) in group B, which all reached statistical difference (P<0. 05). Among 171 cases in both group A and 8, the rate of tubal patency were 65% (67/103) in 103 cases with maximal diameter of tubal gestational sac less than 5 cm and 32% (22/68) in 68 cases with maximal diameter of tubal gestational sac more than 5 cm, which reached statistical difference (P < 0.01). The rate were 72% (73/102) in patients with serum level of hCG less than 2000 IU/L, 29% (12/42)in patients with 2000 IU/L to 5000 IU/L and 15% (4/27)in patients with more than 5000 IU/L, which also showed statistical difference (P <0.05). It was observed that preoperative serum hCG level (OR=0.277, P<0.01), the maximal diameter of gestational sac (OR=0.577, P<0.01) and the volume of peritoneal bleeding (OR=0.999, P < 0.05) were significant factors influencing successful laparoscopy treatment by logistical regression analysis.Conclusion In order to preserve fertility, laparoscopic conservative surgery was a safe and feasible approach in treatment of tubal pregnancy. Preoperative serum hCG levels, size of tube gestational sac were significant factors influencing successful laparoscopic surgery.

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

Many pediatric surgeons have little training in laparoscopic application.The major problem in clinical practice of laparoscopic technician is without regularly training,unsuitable indication,and ignoring peroperation management.so that there are much more serious complications.For these reasons,it is a prerequisite that surgon and anesthetist must be trained before clinical practice,and the qualification of admission should be strictly controlled.

Objective To study and compare the effects and mechanisms between the Xuebijing injection and Danshen injection on ischemic-reperfusion injury of rabbit limb .Methods 30 New Zealand rabbits were randomly divided into control group ,Xuebi-jing group and Danshen group ,with 10 in each group .The Crinnion model of ischemic-reperfusion injury of rabbit limb was used . Each group was treated correspondingly after the blood flow was restored .Xuebijing group and Danshen group were treated with 4 mL/kg Xuebijing injection 2 mL/kg Danshen injection in saline with 10 mL total volume .Control group was treated with 10 mL sa-line .Before releasing clip and 1 h ,2 h and 4 h after reperfusion ,the blood samples were collected for detecting clotting function (APTT ,FIB ,PT-INR ,PT) ,biochemistry items (ALB ,LDH ,CK) ,MDA level and SOD level .Results Compared with control group ,the APTT of Xuebijing group in 1 h and 2 h and Danshen group in 4 h after reperfusion improved significantly (P<0 .05) . The PT of Xuebijing group after reperfusion extended significantly compared with the PT before reperfusion (P<0 .05) .The FIB level of Xuebijing group and Danshen group in 4 h after reperfusion was much higher than before (P<0 .05) .The LDH and CK level of Xuebijing group after reperfusion was much lower than that of control group (P< 0 .05) .The MDA level of Xuebijing group in 2 h and Danshen group in 1 h ,2 h after reperfusion was much lower than that of control group (P<0 .05) .The SOD activ-ity of Xuebijing group in 1-4 h and Danshen group in 2 h after reperfusion was much higher than that of control group (P<0 .05) .Conclusion Xuebijing injection and Danshen injection have the relieving effect on the limb ischemic-reperfusion injury by ad-justing clotting function and decreasing free oxygen radicals .In terms of relieving the injury of muscle tissue ,the effect of Xuebijing injection might be better than Danshen .

Objective To compare the clinical efficacy of postoperative analgesia between intercostal nerve freezing and con‐trolled intravenous analgesia in patients of thoracic surgery .Methods 80 patients of thoracic surgery from January 2012 to June 2013 were randomly divided into two groups :Intercostal nerve cryotherapy group (frozen group n=40) and intravenous analgesia group(control group n=40) .Frozen group :the intercostal incision and down each one intercostal and chest tube placement of inter‐costal nerve roots were frozen before sternal closure ;control group :intravenous analgesia pump were used postoperative .According to VAS method to evaluate pain level and observe adverse reactions ,complications and analgesic drug usage of postoperative pa‐tients .Results The analgesic effect of frozen group was better than that of control group within five days after thoracotomy .Com‐pared with the control group ,the incidence of adverse reactions ,postoperative complications ,and analgesic drug usage was signifi‐cantly reduced in frozen group ,there was a significant difference between the two groups (P<0 .05) .Postoperative follow‐up dis‐play :intercostal nerve area in some patients may appear numbness ,dysesthesia ,etc .,but the above situation can return to normal gradually .Conclusion The analgesic effect of intercostal nerve cryotherapy for thoracotomy patients is excellent ,and with few side effects and good safety ,and it is worthy of promotion .

Teaching method of grouping and numbering the experimental animals refers to management of laboratory animals by marking them with numbers. In an experimental group, the same marked experimental animal is performed surgery operation by each group member. As a whole, each group member gets the same score according to the evaluation of operation performance of that group and the score is recorded as usual performance score. This method is simple and easy to implement. It is the optimizing of traditional basic operative surgery teaching methods which is conducted not only to improve medical students' sense of responsibility and animal protection awareness, to make full use of teaching resources and reduce waste, to cultivate medical students' team cooperation awareness, but also to deepen medical students' knowledge about surgical complications and improve the quality of teaching.