Critical Care ; methods ; trends ; Critical Illness ; therapy ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Integrative Medicine ; Multiple Organ Failure ; therapy

Objective To evaluate the safety and effectiveness of balloon kyphoplasty combined with physiotherapy in the treatment of osteoporotic vetcrbral compression fractures (OVCFs). Methods A retrospective review was of 12 OVCF cases ( including 16 fracture vertebrae) treated with balloon kyphoplasty was performed. Each patient had also been treated with anti-osteoporotic medication and the Rehabilitation of Osteoporosis Program-Exercise (ROPE) protocol, and each had received a six-month follow-up visit. The following parameters were recorded before the operation and 1 day and 6 months afterward : fracture recurrence, the severity of pain before and after treatment, and the change of vertebral height. The severity of pain was evaluated by using a visual analogue scale (VAS). Results During the treatment, no complication or adverse event was found. The average VAS values preoperation, postoperation and at the 6-month follow-up were 7.6±1.3, 2.1±1.2 and 2.6±1.4, respectively. The average changes in vertebral height preoperation, postoperation and at the 6-month follow-up were 49.2±18% , 74.3 ±14% and 69.8±16% respectively. All of the measures evaluated improved noticeably after the combined treatment. Conclusion Balloon kyphoplasty combined with anti-osteoporotie medication and physiotherapy showed good effects in the treatment of osteoporotic veterbral compression fractures.

Objective To observe the curative effect and adverse reactions of intercostals nerve block combined with fentanyl transdermal system in treatment of post-thoracotomy pain syndrome (PTPS). Methods Intercostals nerve block combined with fentanyl transdermal system was used for treatment of 141 patients with PIPS. The degree of pain relief was evaluated by numerical rating scale (NRS),the quality of life of patients was evaluated by the quality of life score standard,and the adverse reactions were also observed. Results The overall remission rate was 97.85%,there were 51 cases (36.43%)with complete remission, 80 cases (57.14%)with significant remission,and 6 cases (42.85%) with moderate remission. The adverse reactions included nausea,vomiting, constipation,dizziness,skin pruritus and dysuria,no serious liver and kidney function damage and respiratory inhibition. The quality of life of all patients was improved. Conclusion Multimodal analgesia has better curative effect and less adverse reactions in treatment of PTPS,so it deserves clinical promotion.

·AIM:To report a case of entry of antibiotic ointment into the anterior chamber following sutureless clear corneal incisions phacoemulsification.·METHODS:A 62-year-old man had uneventful phaco-emulsification with clear corneal incisions with intraocular lens(IOL) implantation. Postoperative medication included antibiotic/steroid ointment; the eye was firmly patched at the end of the procedure. On the first postoperative day, the patient was seen an oily droplet floating in the anterior chamber. Immediate surgical removal of the ointment without IOL exchange was performed.·RESULTS:During follow-up for six months after irrigation/aspiration of the anterior chamber and removal of the oily droplet, visual acuity and intraocular pressure (IOP) were unchanged and anterior segment was formed and quiet.·CONCLUSION:Ophthalmic ointment may ingress into the anterior chamber through unstable clear corneal incisions. The case highlights the importance of appropriate wound construction and integrity, as well as the risk of tight eye patching following placement of ointment.

Objective To explore the method of endovascular therapy for complicated aortic dissections.(Methods) The clinical data of 25 patients with complicated aortic dissections were analysed retrospectively.Results The patients′ ages ranged from 31-72 years with a mean of 50.2 years.Among the 25 cases,6 cases had severe ischemia of mesenteric artery,5 cases had renal artery ischemia,4 cases had severe(ischemia) of both legs,3 cases had renal arteries ischemia combined with superior mesenteric artery ischemia,2 had complicated aortic dissection combined with AAA,and in 5 cases the true aortic lumen was totally(compressed) by the false aneurysmal lumen.All patients underwent endovascular therapy,and the instant(technique) was successfully performed in all patients.Endoleak occurred in 3 cases after the stent-graft(deployment),it stopped spontaneously in 2 of them 7 days later,and 1 case with endoleak waiting for(treatment).In the other 22 patients,angiography after the operation showed that all the diseased area were sealed completely,and the viscera arterial blood supply was restored mainly via the true lumen.All the(patients) were cured and discharged.Conclusions In the management of complicated aortic dissections,(endoluminal) technique is simple,less traumatic,safe and has less complications as compared to the traditional operation.Improvement of the endoluminal technique is essential for successful treatment of these complicated cases.

Objective To study the effect of administration of transient receptor potential vanilloid 1 (TRPV1) antagonist capsazepine (CPZ) into the nucleus accumbens (NAc) on the regulation of body weight and fat accumulation in rats, and evaluate the therapeutic effect of CPZ on neuropathic obesity. Methods Forty rats were randomly divided into 5 groups (n=8), namely, control group (without giving any treatment),group A (performed intra-NAc injection of 1 nmol/mL CPZ),group B (performed intra-NAc injection of 10 nmol/mL CPZ),group C (performed injection of 10 nmol/mL CPZ via the areas adjacent to NAc) and group D (performed injection of 10 nmol/mL CPZ via the dorsal striatum); rats of the later 4 groups were given 1 μL CPZ daily for a consecutive 3 d.The body weight of rats from different treatment groups 1 and 3 weeks after the injection was measured and compared them to that of the control group.Then,the animals were sacrificed,the body fat content of each group was evaluated. Results The body weight in rats of group A 1 week after the injection increased (126.31± 10.25)％ as compared with their original weight, and that in rats of control group increased (148.78±6.98)％ as compared with their original weight, which showed significant difference between the 2 increment (P＜0.05); the body weight in rats of group B 1 week after the injection increased (115.87± 13.90)％ as compared with their original weight, which showed significant decrease as compared with that in the control group (P＜0.05); The body weight in rats of group B 3 week after the injection increased (132.82±15.8)％ as compared with their original weight, and that in rats of control group increased (164.86±6.34)％ as compared with their original weight,which showed significant difference between the 2 increment (P＜0.05).Furthermore,the body fat content in group B was significantly lower than that of other groups (P＜0.05). Conclusion Blockade of NAc TRPV1 receptor by CPZ has significant inhibitory central adjusting effect on body weight and fat content in rats; and TRPV1 antagonist may potentially serve as a specific drug for neuropathic obesity.

Aged ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Cyclophosphamide ; therapeutic use ; Doxorubicin ; therapeutic use ; Epstein-Barr Virus Infections ; Female ; Herpesvirus 4, Human ; Humans ; Lymphoma, Large B-Cell, Diffuse ; drug therapy ; pathology ; virology ; Lymphoma, T-Cell, Peripheral ; drug therapy ; pathology ; Neoplasms, Second Primary ; drug therapy ; pathology ; Prednisone ; therapeutic use ; Vincristine ; therapeutic use

OBJECTIVETo investigate the correlation between articulation, velopharyngeal function, and surgical age by comparing the changes in articulation after velopharyngeal closure is performed. This study is also conducted to investigate the influencing factors of omission change between pre- and post-operation.

METHODSA total of 48 patients, including 18 males and 30 females, mean age (13.3 ± 5.8) years, with non-syndromic cleft lips and palates were selected from January 2011 to December 2011. Their speech data and articulation between pre- and post-operation were retrospectively analyzed using non-parametric tests. Correlation study was performed to analyze the influencing factors of the changes in articulation. P < 0.05 was considered statistically significant.

RESULTSThe difference in articulation after velopharyngeal closure occurred was significant (Z = -3.796, P = 0.000). A negative correlation between the ratio of post-operative normal articulation and surgical age (R = -0.487, P = 0.000) was observed. The change in omission was positively correlated with surgical age (R = 0.589, P = 0.000) and gender (R = 0.404, P = 0.047). By comparison, the change in omission was negatively correlated with follow-up time (R = -0.235, P = 0.040).

CONCLUSIONArticulation and intelligibility are significantly improved after velopharyngeal closure is performed. These parameters are negatively correlated with surgical age to some extent. In addition, the change in omission is positively correlated with surgical age and gender, whereas the change in omission is negatively correlated with follow-up time.

Adolescent ; Articulation Disorders ; Child ; Cleft Lip ; Cleft Palate ; Female ; Humans ; Male ; Retrospective Studies ; Velopharyngeal Insufficiency ; Young Adult

Objective To investigate the clinical prognostic value of neutrophils to lymphocyte ratio(NLR)in patients with ST-segment elevation myocardial infarction(STIMI)who underwent percutaneous coronary intervention(PCI). Meth?ods A total of 326 patients with acute ST segment elevation myocardial infarction were enrolled. According to the neutro?phils to lymphocyte ratio, patients were divided into group T1(≤3.46), group T2(3.47-6.75)and group T3(>6.75). Basic clinical data,laboratory indexes,coronary angiography results, TIMI grading and left ventricular ejection fraction(LVEF) were collected in all groups. Incidence of adverse events in hospital such as acute heart failure, thrombosis, ventricular tachy?cardia and ventricular fibrillation, atrial fibrillation, atrioventricular block and cardiogenic shock, were recorded. Major ad?verse cardiac events(MACE), death of all causes, non-fatal MI, ischemic stroke and readmission due to heart failure at the 6-month follow-up were also noted. Results The incidence of heart failure, atrial fibrillation, ventricular tachycardia/ven?tricular fibrillation and cardiogenic shock was higher in group T3 than those in the other two groups(P < 0.05).The inci?dence of multivessel coronary artery disease was significantly higher in group T3 than that in group T1 (54.1% vs 37.0%, P<0.05). The percentage of TIMI grade 3 in post-operative infracted artery was significantly lower than that in group T1 (83.5%vs 94.4%). Left ventricular ejection fraction was significantly lower in group T3 than that of group T1 during hospital?ization (0.48 ± 0.10 vs 0.52 ± 0.10). There was no significant difference in the incidences of death, non-fatal MI, ischemic stroke at 6 month follow up. But the rate of readmission due to heart failure was significantly higher in group T3 than that in the group T1(P<0.05). Conclusion Neutrophils to lymphocyte ratio may be a useful marker to predict the prognosis of pa?tients with heart failure due to acute myocardial infarction.

Objective To analyze the clinicopathologic data and operative parameters of 209 elderly co-lon cancer patients treated by radical resection between January 2002 and December 2011 ,and to investigate the factors related to recurrence and metastasis after colon cancer radical resection in elderly patients .Methods We used univariate and multivariate analysis of Cox regression ,including 14 variables:age,gender,disease duration, hospitalization duration,surgeon experience,operation duration,laparoscopicsurgery,tumor location,tumor size, gross morphology ,differentiate degree ,depth of bowel wall invasion ,lymph node involvement and obstruction .The survival curve was obtained by Kaplan -Meier method.Results Univariate analysis showed that tumor size (RR=2.658,P<0.0001),gross morphology(Infiltrating type,RR=3.407,P=0.0054),degree of differentiation (RR=0.32,P<0.0001) were associated with tumor relapse and metastasis .Multivariate analysis showed that gender(RR=0.585,P=0.0359),tumor size(RR=2.364,P<0.0001),degree of differentiation (Infiltrating type,RR=0.246,P=0.0437),gross morphology(RR=0.31,P<0.0001)were the significant factors.Conclu-sion Gender,tumor size,degree of differentiation,gross morphology were the independent factors of recurrence and metastasis of colon cancer after radical resection in elderly patients .Targeted follow -up for high -risk groups will improve patients′life quality and prolong their survival time .