Objective To assess the left ventricular(LV)segmental function by velocity vector imaging(VVI)in uremic patients with diffferent quantity of parathyroid hormone(PTH).Methods Sixty patients with uremia were divided into 2 groups according to the value of PTH:group A with PTH less than 3 times of upper normal limit,group B with PTH more than 3 times of upper normal limit.Normal control group was 30 healthy subj ects.All people were evaluated by VVI.The parameters,including the longitudinal systolic strain rate(SSR),diastolic strain rate(DSR),were analysed among the three groups.Results Compared with normal group,in group A and B,SSR,DSR in all segments were lower.Compared with group A,in group B,DSR were all significantly lower(P＜0.05),SSR in apex of laternal wall,medium of anterior septum wall,posterior wall,medium and apex of posterior septum wall and superior wall,base,medium and apex of anterior wall were significantly lower(P＜0.05).There was no statistically significant difference of left ventricular ejection fraction between the two groups(P＞0.05).Conclusions VVI is a viable objective tool to quantitatively assess LV segmental function damaged by different quantity of PTH.

Objective To study the diagnosis and treatment of portal vein complications after orthotopic liver transplantation. Methods The clinical data of 173 patients receiving orthotopic liver transplantation in our hospital from 2002 to 2005 were retrospectively analyzed. Results The incidence of portal vein complications was 3.5% (6 cases). The incidence of portal vein stenosis was 1.2% and that of portal vein thrombosis was 2. 3%. Three cases had previously been treated for portal hypertension and three cases had had a history of portal vein thrombosis before liver transplantation. All the complicated patients recovered and were discharged after successful treatment. There was no complication related mortality. Conclusions A history of previous treatment for portal hypertension, portal vein thrombosis is a risk factor predisposing the patients to portal vein complications after orthotopic liver transplantation. Color Doppler sonography is a sensitive and specific method for monitoring the portal vein complications following orthotopic liver transplantation. The angiography of portal vein is essential for diagnosis of the complications. Thrombolysis treatment is unsatisfactory for advanced stage portal vein thrombosis. Balloon dilation and stenting are both a safe and effective management modality for simple portal vein stenosis.

Objectives To compare the effectiveness and safety of local anesthesia and epidural anesthesia with ureteroscopic pneumatic lithotripsy at distal ureteral stone. Methods A total of 160 patients with distal ureteral stone treated with ureteroscopic pneumatic lithotripsy from December 2013 to February 2014 were included. They were divided equally into 2 groups by method of random sampling. Patients in group A (n=80) treated with local anesthesia were compared to those in group B(n=80),who were dealt with epidural anesthesia. Results The statistical difference was significant in terms of hospital stay after operation and overall cost of therapy(P<0. 05) respectively,on the other hand,it was not significant in respect of the operation time,the operation successful rate,the stone clearance rate and the complications incidence rate (P>0. 05)respectively. Conclusion For the identified patients,the local anesthesia in ureteral ureteroscopic pneumatic lith-otripsy is a safe,effective and economical method for distal ureteral stone.

Objective To investigate the clinical manifestation,pathological characteristics,neurological imaging,indications,operative approach and microsurgieal technique of surgery for brain stem tumor.Methods 17 cases of brain stem tumor treated by applying microsurgical skills were retrospectively analyzed from Jan.2002 to Dec.2007.Ten cases were operated via the suboccipito-retromastoid approach,among which 5 situated in pons,3 in medulla oblongata and 2 invoved both pens and medulla oblongata;4 cases were performed via the posteromedian-suboccipital approach,among which 2 located in pens,1 in medulla oblongata and 1 involved both midbrain and pens;3 lesions situated in varying sites of mesencephalon were operated by the suboceipito-supratentorial,infratemporal approach and pterional approach respectively.Results In the series of the patients,lesion was totally excised in 6 cases,subtotally in one,without surgical mortality.All patients were followed up for years ranging from 5 months to 4 years.During the follow-up period,seven patients resumed work and normal life;4 patients could perform physical labor;3 patients obtained self care capability;2 patients needed to be taken care of,1 patient died from pneumonia after discharge.Conclusion Fine therapeutic efficacy and low disability rate could be obtained while applying microsurgical techniques to resect brain stem tumors with correct indication,appropriate approach and elaborate microneurosurgical skills.

Objective Medical ethical problems have become underlying risks since the introduce of Negative pressure wound therapy ( NPWT) in Wound Care Center .The article was to analyze ethical problems in applying new technology in wound care and take intervention countermeasures to investigate the effects . Methods Patients treated by NPWT from January 2009 to Decem-ber 2012 were collected as objectives of investigation from the indexes of compliance rate , cure rate and adverse event rate .The ethical problems related to efficacy ,safety and conflicts of patients′economic interests during the application of NPWT were analyzed .On the basis of the ethnical core principle which was harmless , beneficial, respectful and justifiable , the details of effectiveness and safety of NPWT technique , informed consent form and emergency response protocols of the adverse events were designed according to interna -tional guidelines .Nurses received standardized training to learn new technology . Results 78 cases with chronic wounds accepted negative pressure wound therapy and all cooperated to complete treatment , compliance rate was 100%, no adverse events , the average cure rate was 91 .03%.The treatment costs are less than international and national costs from 75%to 66%. Conclusion Following the ethical principle , informed consent , good communication , strict entry system and standardized operation process make sure the safety and effectiveness of new technology and optimize patients′benefits .

Objective To compare the clinical curative effect of percutaneous nephrolithotomy (PCNL) and flexible uretero‐scope lithotripsy (FURL) for the treatment of renal calculus ≤2 cm .Methods Totally 148 patients with kidney stone ≤2 cm whom have taken operation treatment in our hospital were chosen from January 2014 to December 2014 .Among them ,81 patients were taken PCNL treatment (PCNL group) and 67 patients were taken FURL treatment (FURL group) .Clinical curative effect were compared .Results There was no statistically significant difference in the comparison of stone clearance rate ,fever rate and postoperative WBC increase (P>0 .05);the operation time of PCNL group (64 .21 ± 11 .71)min was shorten than the FURL group (107 .32 ± 16 .35)min ,the postoperative hospital stay of PCNL group (6 .51 ± 1 .92)d was longer than the FURL group (3 .28 ± 1 .24)d ,the Hb decrease after operation of PCNL group (13 .31 ± 2 .71)g/L was higher than the FURL group (3 .88 ± 2 .10)g/L , the postoperative hs CRP increase of PCNL group (14 .21 ± 1 .62)mg/L was higher than the FURL group (5 .23 ± 1 .14)mg/L ,the differences were statistically significant (P<0 .05) .Conclusion For the treatment of renal calculus ≤2 cm ,the FURL has a great advantage on reducing postoperative complications ,decreasing the trauma of operation and shorten postoperative hospital stay .

Objective: To study the effect of moist therapy on dermal radio lesions. Methods:13 located dermal radio lesions about Ⅲ-Ⅳ stage from 12 cases were treated with moist therapy. Wound managing steps for each time: The first step was to measure the size of wounds and take photos, and then evaluate individual pain level by a numeric pain scale. The second step was to assess and analyze the factors affecting wounds healing, including nutrition, sleeping, activity, psychological condition. After that the individualized plans about nutrition, activity, and psychological care were made. While exchanging dressings, the implementation and effects of the plans must be evaluated and adjusted. The mechanical debridement combined with autolyzing debridement was used for wounds managing. Then the wounds were saturated with bFGF and normal saline, and wetly covered with occlusive dressings. Wounds were managed every two days until wounds healed. Results: All 13 wounds were cured. The average healing time was (10?6)d and the average cost was (202?48)yuan. The pain level after moist therapy was significantly lowered than before(P

Objective To reasonably confirm the target of 3-dimensional conformal radiation therapy (3DCRT) for lung cancer. Methods While a patient was breathing, the motion of the primary lesion in the lung was observed by fluoroscopy. The extent of motion of the primary lesion during irradiation was evaluated by portal films. Three 3DCRT plannings for lung cancer, in which gross tumor volume (GTV) decided by a group of radiation oncologists and implemented, were taken as the standard. The GTV delineated by five radiation oncologits was compared with the standard by computing the radial line measurement variation (RLMV). Results From fluoroscopic observation in fifty-nine patients, the extent of lesion motion was the largest in cephalo-caudal direction, with 14.3 mm for lesions in the lower and 7.1 mm (median) for middle part of the lung. In lateral and antero-posterior directions, it was within 4. 0 mm. The motion error during irradiation was 4. 2 mm in lateral direction and 4.6 mm in cephalo-caudal direction. The random error, system error and total error for set-up uncertainty were 3.4 mm, 6.0 mm, and 6.9 mm. Compared to the standard, the discrepancy of GTV could be as large as 150% . The largest RLMV was observed in the area of lung hilar nodes. Conclusions The target of 3-dimensional conformal radiation therapy for lung cancer should be confirmed individually and delineated by a group of radiation oncologists. A more efficient fixing device is needed owing to the large total error for set-up.

Objective:Pyoderma gangrenosum(PG) is regarded as a possibly immunity-mediated ulcerative skin disease,which is difficult to be managed and easy to relapse.Few cases of PG have been reported to be treated successfully in the world.This study aimed to investigate the clinical characteristics and difficulties and strategies in the management of mosquito bite-induced ulcer by PG.Methods: We analyzed the clinical characteristics and difficulties in the treatment of a case of mosquito bite-induced leg ulcer complicated by PG.Following the TIME(tissue removal,infection/inflammation control,moisture imbalance correction,and edge of wound revision) principles of wound bed preparation,we treated the ulcer by silver ion dressing + infrared rays,hypertonic saline dressing + infrared rays,hypertonic saline dressing + electrotherapy,and honey dressing + medication at different times.The ulcer size and scores on pain and healing were assessed before each wound care,and the results of each method were analyzed by the SPSS11.0 software.Results: The pain score was continuously reduced with the treatment and the ulcer size and healing score were gradually decreased in the later stage,while in the earlier stage,the ulcer size was even enlarged,with one ulcer becoming two,and the healing score obviously increased.The differences were statistically significant(P

Objective: Vacuum-assisted closure(VAC) is a new technique for wound treatment,whose clinical application at home is but at the initial stage.The aim of this study was to investigate the procedure,therapeutic course and the effectiveness of the technique in the treatment of chronic wounds.Methods: This study included 12 cases of chronic or infected wound,which were more than 100 cm2 in size,either undermined,or drainage-obstructed,or difficult to heal despite over a month of previous treatment.We used the Freedom Negative Pressure Wounds Therapy Machine and the Ten-Step Management Procedure for a regular course of 30-50 days.We recorded and analyzed the pre-and post-treatment PUSH(pressure ulcer scale for healing) scores,healing modes,healing time and cure rate of all the cases.Results: The 12 cases were treated by VAC for(27.7 ? 22.6) days,of which 9 were cured,1 improved and 2 healed after moisture therapy followed by further treatment in the surgical department.The average healing time was(59.36 ? 22.88) days and the total cure rate was 91.7%.Age is positively correlated with healing time,but other factors showed no significant correlation with healing time and cure rate.Conclusion: The VAC technique is applicable to chronic wounds in patients of all ages,and the best therapeutic course is 30-50 days,which helps to raise the cure rate of intractable wounds.