1.Diagnosis and treatment of grade Ⅴ liver trauma combined with hilar bile duct transection injury
Jiajia SHEN ; Fan PAN ; Xiaojin ZHANG ; Shaohua CHEN ; Yi JIANG
Chinese Journal of Digestive Surgery 2015;14(4):349-351
According to the Organ Injury Scale Grading System of the American Association for the Surgery of Trauma (AAST-OIS),grade Ⅴ liver trauma is always complicated with retrohepatic inferior vena cava injury and less bile duct injury,and it is extremely severe and difficult to be treated.Timely and fast judgment,emergent exploration and effective repair of the injured bile duct are the key points for the treatment of bile duct injury.One patient with grade Ⅴ liver trauma combined with hilar bile duct transection injury was admitted to the Fuzhou General Hospital of Nanjing Military Command on August 30,2013.The rupture of left and right liver junction was detected by preoperative multidisciplinary consultation and emergency open surgery at admission hour 4.There was left and right hepatic duct bifurcation rupture at the first hepatic hilum.Non-functional liver tissues were excised.Breakage left and middle hepatic vein were sutured by polymer suture line.Liver traumatic bleeding and bile duct were sutured and ligatured individually.Left and right hepatic duct laceration was sutured by 6-0 PDS suture line.A hole in the stomach wall was opened fist,and then most part of the gastric contents was removed and the gastric wall was reparied by stapler.Patient received the postoperative symptomatic treatment with gradual recovery,and was discharged from hospital at admission day 26.The patient was readmitted to the hospital at 31 days of discharge due to outflow of purulent fluid from abdominal cavity drainage tube,and was treated by ceftriaxone sodium and tazobactam sodium according to the results of drug sensitive test and continuous peritoneal lavage.The abdominal cavity drainage tube and left and right hepatic duct drainage tube were removed at postoperative day 83.The patient was discharged from hospital at readmission day 28,and was followed up till December 2014 with good recovery and without complication.
2.Development and Application of Multifunctional Laryngeal Mask
Zujin ZHANG ; Jun ZHONG ; Shaohua WEI ; Xueliang FAN
Chinese Medical Equipment Journal 1993;0(06):-
Objective To design a multifunctional laryngeal mask development and can be used in clinical tracheobronchial foreign body removal, surgical lung lavage, lung surgery to stop bleeding and lung biopsy. Methods Three-way Laryngeal Mask is improved base on the traditional laryngeal mask, it adds a three-way channel(adapter), one end(port) of the threeway channel connected with the laryngeal mask, another end covered the seal cap from which can insert the fiberoptic bronchoscope or endoscope, one another end is a 15mm standard interface for connecting with the respiratory machine or anesthetic machine. The fiberopticscope or other kinds of endoscope will be inserted from the end of seal cap through the laryngeal mask body, the glottis enters trachea to bronchus. The standard end can be connected with the respiratory machine, in the process of operation can adjust the ventilation by manual control or machine-controlled. Results Through the clinical application testing, the use of the multifunctional laryngeal mask for all lung diseases surgery is successful completely, the degree of satisfaction is 100% and the effect of ventilation is excellent. Conclusion The multifunctional laryngeal mask can be widely used in the clinical various lung disease operation with safe, reliable, effective and advantages of fewer complications, which significantly expand the traditional use of laryngeal mask and considerably increase the security of anesthesia and operation.
3.The correlation of human papillomavirus and EB virus infection in nasopharyngeal carcinoma in Fujian.
Fan YANG ; Shaohua HUANG ; Maoxin WANG ; Jianzhong LI ; Xianming CHEN
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2014;28(15):1122-1125
OBJECTIVE:
To investigate the prevalence of human papillomavirus in nasopharyngeal carcinomas of Fujian province in China.
METHOD:
Samples from 70 patients with NPC and 25 controls. All samples were detected HPV DNA by polymerase chain reaction (PCR) suing GP5+/6+ and MY09/11 primers and genotyped by surface plasmon resonance (SPR) and HPV 16/18 E6 and LMP-1 using immunohistochemistry and EBER using in situ hybridization.
RESULT:
Only 2 cases of 70 patients were showed evidence of HPV DNA by PCR, the 2 HPV positive cases subtype HPV-70 and HPV-18 were genotyped by SPR, both the 2 HPV positive cases are non-keratinizing carcinomas (the HPV-70 positive one is differentiated and the HPV-18 positive one is undifferentiated), both the 2 HPV positive cases do not show any evidence of EBV. Data showed that 57 of 70 NPC detected EBER positive, but only 25 out of 70 NPC samples were detected LMP-1 positive.
CONCLUSION
Our study showed a low prevalence of human papillomavirus in NPC patients of Fujian province in Southern China, there is no evidence about HPV and EBV co-infection.
Adolescent
;
Adult
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Aged
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Aged, 80 and over
;
Carcinoma
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China
;
epidemiology
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DNA, Viral
;
isolation & purification
;
Epstein-Barr Virus Infections
;
epidemiology
;
Female
;
Herpesvirus 4, Human
;
isolation & purification
;
Humans
;
Male
;
Middle Aged
;
Nasopharyngeal Carcinoma
;
Nasopharyngeal Neoplasms
;
epidemiology
;
virology
;
Papillomaviridae
;
classification
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isolation & purification
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Papillomavirus Infections
;
epidemiology
;
Young Adult
4.Observation of the curative effect of 125 I treatment to non-small cell lung cancer combined obstructive pneumonia
Wukui HUANG ; Hailin WANG ; Lina YOU ; Mo LIU ; Shaohua YUAN ; Xiwen FAN ; Shufa YANG
Journal of Practical Radiology 2015;(9):1518-1521
Objective To observe the curative effect of pure 1 25 I treatment to non-small cell lung cancer combined obstructive pneumonia.Methods 28 cases with non-small cell lung cancer combined obstructive pneumonia were enrolled.Treatment planning system was used to calculate the dosage of tumor and make up the therapeutic plan.CT-guided radiation treatment of particle im-plantation was then conducted.Follow-up was done to evaluate the curative effect one to two months after treatment.Results The total effective rate of therapeutic evaluation was 89.3%.Clinical symptoms including chest distress,hard breathing and fever were ameliorated remarkedly.Life quality score of appetite and fatigue was also improved.White blood cell reduced significantly in blood routine examination.Conclusion There is a definite curative effect of pure 1 25 I treatment to non-small cell lung cancer combined ob-structive pneumonia.
5.The Factors Affecting the Effects of Hearing Aids on Presbycusis Patients
Cuixia WANG ; Xianming CHEN ; Ping LUO ; Fan YANG ; Shaohua HUANG ; Shiyan CHEN ; Jianzhong LI
Journal of Audiology and Speech Pathology 2014;(5):456-460
Objective To analyze the factors affecting the effects of hearing aids in presbycusis patients . Methods One hundred and twenty cases with presbycusis were investigated by using general data and the Satisfac-tion with Amplification in Daily Life questionnaire(SADL) .The individual scores and total scores of all the subjects were collected together with the personal information ,including age ,gender ,degree of education ,pure-tone aver-age ,hearing aid type ,monaural/binaural status ,total hearing aid experience ,daily use time ,the time of perceived hearing difficulty .A single factor analysis and multiple stepwise regression analysis were used to filter out main fac-tors influencing the effect of hearing aids .Results The degree of education ,hearing aid type ,monaural/binaural status ,daily use time ,the time of perceived hearing difficulty were factors influencing the effect of hearing aids . The patients with higher level of education ,the longer daily use ,binaural status obtained more scores than those of the low degree of education ,the shorter daily use ,and monaural status( P< 0 .01) .The older people felt better than the youngers(P<0 .01) .The patients with long -time perceived hearing difficulty got more scores than those with short -time perceived hearing difficulty (P<0 .01) .In general ,the degree of education ,and the daily use time were the main factors influencing the effects of hearing aids .Conclusion There are many factors that influence the effects of hearing aids ,in which the degree of education ,daily use time are the main factors ,and the combination of the two factors obtain the effects of hearing aid maximization ,and the binaural status ,the short time of perceived hearing difficulty and the older obtain better satisfaction .The gender doesn't significantly influence the effects of the hearing aids .
6.Clinical Observation of Daily Vesiculating Moxibustion Combined with Cluster Immunotherapy for Treatment of Perennial Allergic Rhinitis
Qingwen XU ; Shaohua LI ; Huiyuan CHEN ; Zhijun FAN ; Lijuan WU ; Zhongmei WEN ; Weijiang CHEN
Journal of Guangzhou University of Traditional Chinese Medicine 2015;(3):441-444
Objective To explore a more effective way to enhance the clinical efficacy of cluster immunotherapy for perennial allergic rhinitis. Methods A total of 60 perennial allergic rhinitis patients were evenly randomized into treatment goup and control group. The two groups were given cluster immunotherapy, and the treatment group was given daily vesiculating moxibustion additionally . Before and after treatment, the scores of traditional Chinese medical constitution and the rhinitis quality of life ( QOL) were observed, and one year after treatment, the therapeutic effect and safety were evaluated. Results ( 1) One year after treatment, the treatment group showed better total clinical efficiency than the control group ( 96.67% vs 80.00%, P<0.05). ( 2) After treatment, the average scores of Qi deficiency constitution, yang deficiency constitution and special constitution were significantly lower than those before treatment in the treatment group ( P<0.01). The improvement of Qi deficiency constitution and yang deficiency constitution in the treatment group was superior to that in the control group ( P<0.05). ( 3) The total QOL scores and the scores of each dimension of QOL scale were improved in both groups, and the differences were significant except for the emotion dimension ( P<0.01). Insignificant differences were shown between the two groups after treatment ( P>0.05). ( 4) Two cases had grade 1 general adverse reaction and 5 cases had local adverse reaction during cluster immunotherapy. During vesiculating moxibustion, 3 cases had blistering and the blistering disappeared after symptomatic treatment. Conclusion Daily vesiculating moxibustion combined with cluster immunity therapy is effective for the treatment of allergic rhinitis, showing good effect on improving Qi deficiency constitution, yang deficiency constitution and special constitution as well as the quality of life of the patients.
7.Clinical significance and the expression of NT-proBNP and copeptin in patients with acute cerebral hemorrhage
Yongkai YANG ; Fan ZHANG ; Shaohua XUE ; Xiangzhong HE ; Wei GAO ; Dun LIU ; Xiaohui ZHOU
Chongqing Medicine 2015;(7):910-912
Objective To investigate the relationship of plasma concentration of NT-proBNP,copeptin and glasgow coma scale(GCS)scores,hematoma volumes in patients with acute cerebral hemorrhage.Methods 109 patients with acute cerebral hem-orrhage(the cerebral hemorrhage group)and 32 healthy individuals (the control group)admitted in our hospital from December 2011 to June 2013 were selected and detected for plasma NT-proBNP and copeptin.The levels of NT-proBNP,copeptin,glasgow co-ma scale(GCS)scores and hematoma volumes were compared between the two groups.Results The levels of plasma NT-proBNP and copeptin in the cerebral hemorrhage group were significantly higher than that in control group(P <0.05).The levels of plasma NT-proBNP and copeptin were significantly increased with the severity and the hematoma volume of the acute cerebral hemorrhage. The levels of NT-proBNP and copeptin are positively correlated with hematoma volumes(r=0.63,r=0.58,P <0.01)and negative-ly correlated with Glasgow Coma Scale(GCS)scores(r=-0.52,r=-0.46,P <0.01).Conclusion The levels of NT-proBNP and copeptin are positively correlated with hematoma volumes and negatively correlated with glasgow coma scale(GCS)scores.They are important clinical parameters to reflect the severity and hematoma volumes of the acute cerebral hemorrhage.
8.The value of detection of copeptin and procalcitonin in early diagnosis and prognosis of cerebral hemorrhage-associated pulmonary infection
Yongkai YANG ; Fan ZHANG ; Shaohua XUE ; Dun LIU ; Xiaohui ZHOU ; Xiangzhong HE ; Wei GAO
Chongqing Medicine 2015;(18):2483-2484,2487
Objective To investigate that the relationship of serum concentration of copeptin ,procalcitonin(PCT )and early diagnosis ,prognosis in patients with cerebral hemorrhage‐associated pulmonary infection .Methods One hundred and twenty pa‐tients with acute cerebral hemorrhage ,acute cerebral hemorrhage‐associated pulmonary infection and 60 healthy individuals (the control group) admitted in our hospital from January 2012 to December 2013 were selected and detected for serum copeptin and procalcitonin .The differences of serum copeptin ,procalcitonin levels were compared in controls ,in patients with cerebral hemor‐rhage and cerebral hemorrhage‐associated pulmonary infection and their correlation was analyzed .Results The levels of serum copeptin in the cerebral hemorrhage‐associated pulmonary infection were significantly higher than that in control group and the cer‐ebral hemorrhage (P<0 .05) .The levels of serum procalcitonin in control group and the cerebral hemorrhage were significantly lower than that in the cerebral hemorrhage‐associated pulmonary infection ,the levels of serum C‐reactive protein ,copeptin ,procalci‐tonin and the APACHEⅡ scores of the patients with survival group were significantly lower than those with non‐survival group (P<0 .05) .Conclusion The levels of serum copeptin and procalcitonin are correlated intimately with cerebral hemorrhage‐associat‐ed pulmonary infection .They are important clinical parameters to reflect the early diagnosis and prognosis of cerebral hemorrhage‐associated pulmonary infection .
9.Image analysis on corneal opacity: A novel method to estimate postmortem interval in rabbits.
Lan, ZHOU ; Yan, LIU ; Liang, LIU ; Luo, ZHUO ; Man, LIANG ; Fan, YANG ; Liang, REN ; Shaohua, ZHU
Journal of Huazhong University of Science and Technology (Medical Sciences) 2010;30(2):235-9
Corneal opacity is one of the most commonly used parameters for estimating postmortem interval (PMI). This paper proposes a new method to study the relationship between changes of corneal opacity and PMI by processing and analyzing cornea images. Corneal regions were extracted from images of rabbits' eyes and described by color-based and texture-based features, which could represent the changes of cornea at different PMI. A KNN classifier was used to reveal the association of image features and PMI. The result of the classification showed that the new method was reliable and effective.
10.Management of grade Ⅳ portal vein thrombosis in liver transplantation (report of 6 cases)
Lizhi LU ; Qiucheng CAI ; Fang YANG ; Xiaojin ZHANG ; Shaohua CHEN ; Fan PAN ; Ning MU ; Huanzhang HU ; Yi JIANG
Chinese Journal of Organ Transplantation 2012;33(3):152-155
Objective To investigate the methods for reconstructing portal vein in liver transplantation patients with grade Ⅳ portal vein thrombosis.Methods Clinical data of 6 patients with grade Ⅳ portal vein thrombosis who underwent liver transplantations were analyzed retrospectively.Different portal vein reconstructing approaches were applied: 4 patients underwent portal vein anastomosis with internal organ varicosis vein (group A),and 2 patients underwent portal vein arterialization (group B). Portal venous flow was monitored by intraoperative ultrasound and postoperative liver function was tested periodically during follow-up.Results In group A,one patient died of celiac infection 2 months post-transplantation.The remaining three patients were followed up for 14-17 months,and their portal veins remained smooth without thrombosis and with mitigated esophageal varicosity.In group B,one patient,with recurrent upper gastrointestinal bleeding,died of celiac infection 47 days after liver transplantation.The patient was followed up for 33 months with satisfactory liver and kidney functions although stomach esophagus varicosity was aggravated.Portal vein blood flow in groups A and B was 1258 ± 345 and 2275 ± 247 ml/min respectively after anastomosis by intraoperative color Dopplar ultrasound monitoring. Aspertate aminotransferase (AST) in group B was significantly lower on the fourth day after liver transplantation,and alanine aminotransferase (ALT) in group B was significantly lower on the 3rd,4th,5th and 6th day after liver transplantation than in group A (all P<0.05).Serum total bilirubin (TBIL) had no statistically significant difference during the 10 days post-operation (P>0.05).Conclusion Patients with grade Ⅳ portal vein thrombosis may achieve a satisfactory clinical effect by reconstructing portal vein through anastomosis of donor portal vein with internal organ? varicosis vein.PVA may be associated with early recovery of graft function and may be an effective remedial measure for patients with grade Ⅳ portal vein thrombosis who undergo liver transplantation.