Objective To investigate the efficacy and adverse reactions of azithromycin sequential therapy for the treatment of children with mycoplasma pneumonia.Methods 84 children with mycoplasma pneumonia were randomly divided into study group and control group according to the digital table,with 42 cases in each group.The study group was given azithromycin treatment,and the control group was given erythromycin treatment.The clinical curative effect and adverse reaction were compared between the two groups.Results The total effective rate of the study group (97.62％) was significantly higher than that of the control group (76.19％),and the difference was statistically significant (x2 =11.95,P ＜ 0.05).The pyretolysis time [(3.78 ± 1.57) d],cough improvement time [(3.29 ± 0.74) d],rate disappearance time[(5.88 ± 2.35) d],average hospitalization time [(8.89 ± 1.76) d] of the study group were significantly shorter than those of the control group [(4.49 ± 1.71) d,(4.28 ± 0.77) d,(7.69 ±2.54) d,(10.05 ± 2.27) d],and the differences were statistically significant (t =2.01,6.33,3.29,2.46,all P ＜0.05).The incidence rate of adverse reactions such as nausea,abdominal distention,abdominal discomfort,local injection pain,rash,elevated alanine aminotransferase of the study group (4.76％) was significantly lower than that of the control group (19.05％),and the difference was statistically significant (x2 =4.86,P ＜ 0.05).Conclusion Azithromycin sequential therapy is effective in the treatment of children with mycoplasma pneumonia.It can effectively shorten the disappearance time of clinical symptoms and signs,and average hospitalization time,and has low incidence rate of adverse reactions.It is worthy of clinical use.

Female ; Humans ; Middle Aged ; Postmenopause ; Trophoblastic Neoplasms ; pathology ; Uterine Neoplasms ; pathology

In recent years, the incidence of esophagogastric junction adenocarcinoma (AEG) has gradually increased. At present, radical surgery is still the most effective treatment for early AEG, and its surgical methods include proximal gastrectomy and total gastrectomy. Although proximal gastrectomy preserves part of the structure and function of the stomach, postoperative complications such as gastroesophageal reflux seriously affect the quality of life of patients. Although total gastrectomy reduces the incidence of complications such as gastroesophageal reflux, the surgical trauma is large, and the postoperative digestive function is severely reduced, leading to complications such as anemia. As the prognosis of early gastric cancer is good, how to choose the gastrointestinal reconstruction method and improve the patient′s postoperative quality of life has gradually become the focus of the surgeon′s attention. The postoperative quality of life of different digestive tract reconstruction methods for early esophagogastric junction adenocarcinoma is reviewed.

Objective:To explore the perioperative safety and postoperative short-and long-term efficacy of stomach-partitioning gastrojejunostomy (SPGJ) with distal selective vagotomy (DSV) for treating benign gastric outlet obstruction (GOO).Methods:The clinical data of 26 benign GOO patients treated by Beijing Friendship Hospital, Capital Medical University from January 2019 to July 2023 were retrospectively analyzed. There were 20 males (76.9%) and 6 females (23.1%), aged from 25 to 75 years, with an average age of (55.8±13.6) years, and an average body mass index (BMI) of (20.1±3.4) kg/m 2. There were 12 cases in SPGJ-DSV group and 14 cases in SPGJ group. The main outcome was the gastrointestinal quality of life index (GIQLI) 1 year after surgery in both groups. Independent sample t-test was used to test the difference between the continuous variables with normal distribution. The comparison between groups of non-normal distribution continuous variables was tested by Mann-Whitney U test. Counting data were compared using Chi-square test or Fisher exact test. Results:There were no significant differences between the two groups in terms of operative time ( P=0.071), intraoperative blood loss ( P=0.422), time to pass gas ( P=0.538), time to liquid intake ( P=0.386), postoperative hospitalization ( P=0.431), complications within 30 days after surgery ( P=0.999), and postoperative GOOSS grade ( P=0.483). Among them, postoperative DGE occurred in one patient in each of the two groups, both of which were grade A. In the follow-up results, compared with the SPGJ group, SPGJ-DSV group had a significant advantage in GIQLI score, and the difference was statistically significant ( P=0.028). The incidence of gastric ulcer, reflux esophagitis, bile reflux and gastritis in SPGJ-DSV group was 8.3%, 8.3%, 8.3% and 58.3%, while that in SPGJ group was 35.7%, 21.4%, 21.4% and 57.1%, respectively, but there was no statistical significance between groups. Conclusion:In the treatment of benign GOO patients, SPGJ with DSV did not significantly increase the difficulty of laparoscopic procedures, operative time and intraoperative blood loss. Moreover, it showed a significant advantage in gastrointestinal quality of life 1 year after surgery. In addition, the incidence rates of gastric ulcers and reflux esophagitis were lower in the SPGJ-DSV group 1 year after surgery, but further confirmation is needed in large sample studies.

Objective:To compare the clinical efficacy between robot-assisted and free-hand percutaneous cannulated screwing (PCS) in the treatment of femoral neck fractures in the middle-aged and young patients.Methods:A retrospective study was conducted to analyze the clinical data of 53 patients with femoral neck fracture who had been treated with PCS from May 2020 to May 2022 at Department of Traumatic Surgery, Maoming Hospital Affiliated to Southern Medical University. In the robot group of 25 patients subjected to robot-assisted PCS, there were 11 males and 14 females with an age of (48.2 ± 11.9) years; in the free-hand group of 28 patients subjected to free-hand PCS, there were 13 males and 15 females with an age of (48.5 ± 9.8) years. The 2 groups were compared in terms of operation time, intraoperative bleeding, intraoperative guide drills, intraoperative fluoroscopy frequency, fracture union time, Harris hip score at the last follow-up and postoperative complications. Postoperative imaging examination was performed to evaluate distribution accuracy of the cannulated screws in the femoral neck (deviation between the screws and the femoral neck axis, parallelism between the screws and distance between the screws and the neck cortex).Results:There was no statistically significant difference between the robot and free-hand groups in the general clinical data before operation, showing comparability ( P>0.05). The robot group showed significantly shorter operation time [(32.7 ± 4.8) min], significantly less intraoperative bleeding [(14.6 ± 4.8) mL], significantly less intraoperative guide drillings [(3.5 ± 0.7) times] and significantly less intraoperative fluoroscopy frequency [(7.9 ± 1.4) times] than the free-hand group [(56.9 ± 11.3) min, (27.0 ± 7.3) mL, (9.1 ± 1.8) times and (16.3 ± 6.0) times)] (all P<0.05). Postoperative imaging showed that the deviation between the screws and the femoral neck axis was 4.4° ± 1.1° on the anteroposterior X-ray film and 3.2° ± 0.8° on the lateral X-ray film, the parallelism between the screws 4.9° ± 0.8° on the anteroposterior X-ray film and 3.0° ± 0.7° on the lateral X-ray film, and the distance between the screws and the femoral neck cortex (10.4 ± 2.7) mm in the robot group, all significantly smaller than those in the free-hand group [10.5° ± 2.8°, 4.9° ± 1.1°, 12.1° ± 4.0°, 5.1° ± 1.3°, and (15.4 ± 3.2) mm] (all P<0.05). All the 53 patients were followed up for (22.2 ± 8.5) months. All fractures got united. The fracture union time in the robot group [(20.6 ± 4.6) weeks] was insignificantly shorter than that in the free-hand group [(23.7 ± 7.7) weeks] ( P>0.05). At the last follow-up, the Harris hip score in the robot group [(88.6 ± 5.6) points] was significantly higher than that in the free-hand group [(84.8 ± 6.3) points] ( P<0.05). Follow-ups revealed 2 cases of internal fixation loosening, 1 case of screw head cutting and 1 case of femoral head necrosis in the free-hand group but none of such complications in the robot group. Conclusion:In the treatment of femoral neck fractures in the middle-aged and young patients, compared with free-hand PCS, robot-assisted PCS shows advantages of shorter intraoperative time, less bleeding, less fluoroscopic radiation, higher accuracy of screw placement, a lower incidence of postoperative complications and better functional recovery of the hip joint.

There are four types of hiatal hernia, among which type Ⅰ sliding hernia is the most common and its incidence increases with age. At present, domestic and foreign scholars tend to treat hiatal hernia by surgery, but for this kind of functional surgery, both curative effect and neural protection are needed, so higher requirements are put forward for operators. Therefore, it is necessary for clinicians to master the vagus neuroanatomy and its relationship with the peripheral vascular system and identify the necessity of preserving vagus nerve, so as to provide a basis for accurate treatment of hiatal hernia. Therefore, this article reviews the protection and anatomy of vagus nerve in hiatal hernia during the operation.