Objective To analyze the application effects of endoscopic optic nerve decompression in patients with traumatic optic neuropathy and its effect on visual acuity.Methods From January 2014 to January 2016,100 patients (100 eyes) with traumatic optic neuropathy in our hospital were selected as observation objects.According to different treatment methods,the patients were divided into observation group and control group,50 cases in each group.The control group was treated with drugs,and the observation group with endoscopic sinus decompression of optic nerve on the basis of the control group after the stability of the disease.The patients in two groups were followed up at least 1 year.The clinical efficacy,visual acuity,VEP findings and incidence of adverse reactions were compared between the two groups.Results The effective rates in the observation group and control group were 76.0％ and 36.0％,there was significant difference between two groups (P ＜ O.05).In the observation group,the visual acuity of 16 eyes were improved in 22 eyes with no light perception,9 eyes in 13 eyes with light perception,9 eyes in 11 eyes with hand movement,and 4 eyes with finger counting were all improved;In the control group,the visual acuity of 6 eyes were improved in 20 eyes with no light perception,6 eyes in 14 eyes with light perception,5 eyes in 12 eyes with hand movement,1 eye in 4 eyes with finger counting.After treatment,the incubation period and amplitude of P1O0 in the observation group were (116.85 ±7.96) ms and (5.11 ± 1.16) μV,which were better than the control group (105.62 ±6.82) ms,(4.31 ± 1.25) μV.The incidence of adverse reaction in the observation group was significantly lower than that in the control group (P =O.000).Conclusion The endoscopic optic nerve decompression has a good application effect and safety in patients with traumatic optic neuropathy,can effectively improve the patient's visual acuity,help to improve the quality of life of patients,is worthy of clinical application.

Objective To assess the clinical efffects off Ipratropium bromide combined with atomization inhalation of budesonide via a ventilator with a Y-shaped connector on acute exacerbation off chronic obstructive pulmonary disease (AECOPD).Methods A total off 62 AECOPD patients treated at our hospital from June 2013 to September 2014 were randomly divided into the experimental group (n=31,treated with ipratropium bromide combined with atomization inhalation of budesonide) and the control group (n =31,treated with the same amount of saline).Results The airway pressure of mechanical ventilation,the time of mechanical ventilation and the time of staying in the intensive care unit all showed significant differences between the experimental and control groups [(25.4±5.2) cmH2O vs.(38.1±3.4) cmH2O,(6.5±1.3) d vs.(6.8±1.4) d,(8.9±2.1) d vs.(9.5±1.5) d,t=10.934,0.960,1.108,respectively,P＜0.05 for all].The rate of tracheotomy was lower in the experimental group than in the control group (17/31 or 54.8％ vs.20/31 or 64.5％,x2 =0.603,P＜0.05).Conclusions Ipratropium bromide combined with budesonide inhalation under mechanical ventilation via a Y-shaped connector has ffavorable clinical effects on AECOPD.

OBJECTIVETo investigate the effects of perioperative intestinal microecological treatment on postoperative complications and gastrointestinal function in patients with refractory functional constipation by nonrandomized controlled trial.

METHODSA total of 198 patients with refractory functional constipation who underwent Jinling procedure in our department from 2014 to 2015 were prospectively enrolled, and were divided into conventional treatment group (n=100, routine intestinal preparation was used before operation; probiotics and prebiotics were applied if diarrhea or abdominal distention occurred after operation) and microecological treatment group (n=98, routine perioperative management was applied; probiotics, prebiotics and enteral nutrition were administered since 2 weeks before operation; probiotics and prebiotics were given again when exhaust and defecation recovered after operation). The general clinical data, postoperative complications, gastrointestinal quality of life index (GIQLI), Wexner constipation score, the incidence of abdominal distension and diarrhea during follow-up were collected.

RESULTSThe baseline information was not significantly different between two groups (all P>0.05) as well as the morbidity of postoperative complication [27.6% (27/98) vs 37.0% (37/100), P=0.155]. Compared with conventional treatment group, microecological treatment group had obviously lower incidence of enteritis [2.0%(2/98) vs. 9.0% (9/100), P=0.034] and shorter postoperative hospital stay [(7.2±3.1) d vs. (9.8±3.6) d, P=0.040]. The incidences of diarrhea and abdominal distension in microecological treatment group were obviously lower than those in conventional treatment group [30.9% (29/94) vs. 46.9% (45/96), P=0.024; 44.7%(42/94) vs. 60.4%(58/96), P=0.030] at postoperative 1-month. Compared with conventional treatment group, microecological treatment group had obviously higher GIQLI (52.36 vs. 43.55, P=0.026) at postoperative 1-month. At postoperative 12-month, the incidences of diarrhea and abdominal distension decreased obviously in both two groups but without significant differences [diarrhea: 3.4% (3/89) vs. 3.3%(3/90), P=0.989; abdominal distention: 6.7% (6/89) vs. 5.6% (5/90), P=0.742]. GIQLI and Wexner score were improved but without significant differences as well (all P>0.05).

CONCLUSIONPerioperative intestinal microecological treatment can obviously reduce the incidences of postoperative enteritis, early abdominal distension and early diarrhea, improve the postoperative early GIQLI, and shorten postoperative hospital stay.

Objective: To investigate the key issues in the diagnosis and treatment of foreign body aspiration in children with tracheobronchial variations. Methods: A retrospective study was performed for 11 pediatric patients who were treated in Department of Otorhinolaryngology and Head and Neck Surgery, Henan Province People′s Hospital after a diagnosis of foreign body aspiration with tracheobronchial variations between January 2015 and December 2017. There were 7 males and 4 females among the 11 cases of foreign body aspiration with tracheobronchial variations, ranging between 9 months and 11 years of age. Results: Among 11 cases, the types of variationswere tracheal bronchus in 9 cases, bridging bronchus in 1 case and simple tracheal stenosis in 1 case. All of the pediatric patients were under general anesthesia, and the foreign bodies were removed by bronchoscopy successfully with no significant complications. Conclusions The possibility of tracheobronchial variations should be considered in children with recurrent wheezing and poor efficacy of regular treatment before foreign body aspiration. Removal of foreign body via rigid bronchoscope under general anesthesia is a safe and effective treatment. These children are needed to combine the situation oftracheobronchial variations and the location of foreign bodies to guide the operation, and strengthened the perioperative treatment.