Objective:To analysis the clinical characteristics of pulmonary hypertension (PH) complicating pregnancy, then to explore the delivery time and the monitodng as well as the treatment during perinatal peri-od.Methods:The data of 10 cases with PH treated in our hospital from June 2005 to January 2009 were retro-spectively analyzed.Reaults:1 case was primary pulmonary hypertension(PPH) ; 9 cases were secondary PH (SPH), in which 4 cases were rheumatic heart disease and 5 cases were congenital heart diseases.3 cases were slight PH,6 cases were moderate PH, and 1 were severe group.4 cases NYHA class were Ⅰ～Ⅱ and 6 cases NYHA class were Ⅲ～Ⅳ.4 cases were term delivery,5 cases were premature delivery, and 1 got artifi-cial abortion.8 cases were cesarean section, and 1 was vaginal delivery.2 cases were very low birth weight infants, 1 infant was death and 1 mother was death.Conclusions:The patient of PPH should avoid concei-ving.For SPH patients whether to conceive depends on cardiac function, the level of pulmonary arterial pres-sure and should better get pregnancy after surgery or medication.It should terminate pregnancy in the first tri-mester for moderate or severe patients.Cesarean section is more suitable for those in the second or third tri-mester.The prognosis of the mother and neonate depends on several factors.

Objective To compare the outcomes of 23G and 25G plus (25G+) vitrectomy in treatment of proliferative diabetic retinopathy (PDR).Methods This is a prospective randomized study.Fifty-seven PDR patients (75 eyes) with symptoms requiring vitrectomy were randomly divided into 23G vitrectomy group (30 patients,39 eyes) and 25G+ vitrectomy group (27 patients,36 eyes).Visual acuity,intraocular pressures,ophthalmoscopy,B-scan ultrasound was examined before surgery.The follow-up period was 10.0 (23G group) and 8.5 months (25G+ group) respectively.Intraoperative complications,operation time,postoperative visual acuity,intraocular pressure,postoperative complications and postoperative ocular conditions were analyzed.Results The mean surgical times were (53.35± 7.42)minutes and (49.16±5.17) minutes in 23G and 25G+ group respectively,and the difference was significant (t=4.37,P＜0.05).Iatrogenic injuries occurred in 11 eyes (28.21％) and 5 (13.89％) eyes in 23G and 25G + group respectively,and the difference was significant (x2 =4.93,P＜0.05).The postoperative visual acuity of 23G and 25G+ group were improved compared to before surgery (x2=16.81,18.29; P＜0.05).At last follow-up,there was 25 eyes and 24 eyes with visual acuity ≥ 0.05 in 23G and 25G+ groups respectively,and the difference was not significant (x2 =0.13,P＞0.05).Hypotony was detected in 7 and 3 eyes at the third postoperative day in 23G and 25G+ group respectively,and the difference was significant (x2 =5.67,P＜0.05).Conclusion 25G+ vitrectomy is a safe and effective treatment for PDR with shorter surgery time and fewer surgical complications.

Objective To observe the therapeutic efficacy of 6% hydroxyethyl starch 130/0.4 (trade name: voluven) and polygeline on dog with hemorrhagic shock and their effect on immune function of red blood cells (RBC). Methods Eighteen dogs were randomized into three groups (n=6 in each group): normal sodium group, voluven group and polygeline group. Hemorrhagic shock models were set up according to Wiggers’ method. The mean arterial pressure value was bled to (45.56?3.69) mmHg within 10 min and maintained at this level for 60 min. Subsequently the dogs were resuscitated with normal saline or voluven or polygeline. The hemodynamics were measured before and 60 min after shock and 10, 30 and 60 min after infusion. The concentrations of MDA in plasm, C3b receptor garland rate (RBC-C3bRR) and RBC immune complexes garland rate (RBC-ICR) were measured. Results At 60 min after shock, MAP and CO were significantly lower than these before shock (P

This article analyzed the present situation of development of TCM prevention and health care services in Nanning area of Guangxi Province, put forward a new mode of constructing regional TCM Prevention and health care service system: strengthen, clear and standardization, expounded the key points of implementation of construction of three-level health service system of TCM prevention and health care in Nanning area, practical significance of the construction of regional medical prevention and health care service system, and the advantages of three-level health service system of TCM prevention and health care. Finally, it summarized the experience in preliminary construction of three-level health service system of TCM prevention and health care services in Nanning area.

Objective To evaluate the clinical effect of intervertional devascularization and surgical devascularization in treatment of patients with upper gastrointestinal hemorrhage .Methods Ninety-nine cases treated with intervertional devaacularization or surgical devascularization were retrospectively studied including 48 cases in intervertional group and 51 cases in surgical group.The postoperative resection, complications and rebleeding time were compared by X2 test and t test between two methods.Results The 12 months, 24 months and 36 months cumulative rebleeding rates after intervertional devascularization were 12.5% (6/47) ,24.5% (11/45), 27.9% (12/43) respectively.The rate after surgical devaacularization were 29.2% (14/48) ,44.7% (21/47), 48.9% (22/45) respectively.There were statistically significant differences between the intervertional and surgical groups (X2=3.843,4.150,4.083, P < 0.05).The complications of intervertional devascularization included fever 85.4% (41/48), bellyache 81.3% (39/48), portalvein thrombosis 4.2% (2/48), intraabdominal hemorrhage 2.1% (1/48), infection 2.1% (1/48) and death 2.1% (1/48).The complications of surgical devaacularization included fever 68.6% (35/51), bellyache 62.7% (32/51), generous hydroperitoneum 25.5% (13/51), portalvein thrombosis 37.3% (19/51), splenic vein thrombosis 11.8% (6/51), hepatic encephalopathy 3.9% (2/51), hepatorenal syndrome 2.0% (1/51), intraabdominal hemorrhage 2.0% (1/51), death 3.9% (2/51) and infection 15.7% (8/51).There were statistically significant differences of fever, bellyache, generous hydroperitoneum, portalvein thrombosis, splenic vein thrombosis between the intervertional and surgical groups(X2=4.174,3.098,16.199,6.011,5.536,14.085,P <0.05).Conclusions The intervertional devascularization procedure is simple, safe and effective method for treating upper gastrointestinal hemorrhage for portal hypertensive.The clinical effect is better than that of surgical devascularization.

OBJECTIVE To evaluate the rationality of teicoplanin for the empirical treatment of severe community-acquired pneumonia(CAP) in the aged.METHODS Totally 179 hospitalized cases of severe CAP were enrolled and divided into two groups,teicoplanin treatment group(67 cases) and non-teicoplanin treatment group(112 cases),whose clinical data and antibiotic empirical treatment were analyzed respectively,compared their PSI scores and clinical outcomes after 5 day′s therapy.RESULTS The PSI scores had no significant difference of two groups.The total treatment failure rate in teicoplanin treatment group was 23.9%,lower than that in non-teicoplanin treatment group.The treatment failure rate of teicoplanin combining the third generation cephalosporin treatment cases was 19.4%,lower than that in single use of cephalosporin(50.0%),also less than that in the cases of cephalosporin combining other antibiotics therapy,which accounted for 32.1%.CONCLUSIONS The use of teicoplanin may reduce treatment failure rate of severe CAP among aged.

The present paper was aimed to study the security of burning during the continuous monitoring of transesophageal arterial oxygen saturation. 20 rabbits were randomly divided into two groups: control group and high-frequency electrotome group. All rabbits were implanted with the oxygen saturation detection probes into the lower esophageal after anesthesia. The probes were made up with two light-emitting diode (LED) and then connected with oxygen saturation sensor to monitoring for 2h and 6h, respectively. We then intercepted two luminous points as esophageal specimens and dist the esophageal tissue detection device headend 1cm gastric side esophageal specimens (self-contr01) after monitoring, and carried out pathological examination. The pathological results of the LED-1, LED-2 esophageal biopsy and self-control section were mucous integrity, submucosal mildedema, hyperemia, a small number of lymphocytes and mononuclear cell infiltration. All the score of the esophageal tissue histologic was 2. The results showed that montioring the SteO2 not more than 6h was safe with montiored using a matching of oxygen saturation sensor and monitoring esophageal arterial oxygen saturation.
Animals ; Esophagus ; pathology ; Female ; Male ; Mucous Membrane ; pathology ; Oximetry ; adverse effects ; methods ; Rabbits ; Safety

Objective To investigate the prostecdtive efficacy of one-stage bone grafting in man-aging chronic osteomyelitis after debridement.Methods From March 1999 to May 2003, 79 patients with chronic osteomyelitis including 28 patients with nonunion underwent one-stage autogenous bone graft-ing, allografts or mixed bone grafting after debridement in Nanjing General Hospital of Nanjing Military Command.All patients were followed up for a mean period of 77 months (60-111 months).Results Six patients (8%) , including two with autogenous bone grafting, three with allografts and one with mixed bone grafting, were confirmed with recurrence of infection, with no statistical difference among three methods of bone grafting.Of 28 patients with nonunion, 23 patients with autogenous bone grafting and two with allografting obtained union, the other three patients with mixed bone grafting obtained union in two patients but resulted in recurrence of infection with nonunion in one, with cure rate of 96% (27/28).Conclusions One-stage bone grafting after debridement for infection and bone union can reach cure rate of over 90%.The recurrence of infection mostly occurs within the first year after operation, with stable long-term curative effect.

Objective To investigate the curative effect of granulated cancellous bone autograft in treatment of refractory bone nonunion after limited contouring of bone ends. Methods Between 2003 and 2006, 13 patients with refractory bone nonunion were treated with external fixation and granulated cancellous bone autograft after limited contouring of bone ends. Results The mean follow-up period was 22.6 months (19-30 months), which showed that all patients gained bone union and resumed com-plete weight loading or previous job at final follow-up. The mean fixation time of external fixators was 10.6 months (7-18 months). The intermittent or persistent pin-track infection occurred in eight patients and relieved by pin-track care and oral or parenteral antibiotics, with no infection after removing external fixator. Conclusion The granulated cancellous bone autograft after limited contouring of bone ends is an effective method for treatment of refractory bone nonunion.

The clinical features of posterior circulation dissecting aneurysm are complex, and microsurgical clipping is more difficult. Endovascular therapy is the main treatment method at present. Flow diverter (FD) has higher metal coverage rate. Compared with the traditional endovascular therapy, especially when the parent artery needs to be retained during procedure, FD has a lower complication rate after treatment of posterior circulation dissecting aneurysm, and it has gradually become an effective treatment method for such aneurysms. This article reviews the efficacy and safety of FD in the treatment of posterior circulation dissecting aneurysms.