Objective: To observe the effects of Lulutong injection on microcirculation disturbance after burns. Methods: Eighty-eight patients with mild burn were randomly divided into two groups. From the first day after burn, the treatment group received 500 mg Lulutong injection intravenously injected in 5% glucose, once a day for 14 days as a therapeutic course. The control group was treated with 5% glucose. No large amount of solution was infused because the burned patients were mild and no shock was found. Both groups were received anti-infection treatment using 0.6 g of clindamycin. The morphology of nail-fold microcirculation , the state around the nail-fold microcirculation, hemorrheological parameters, changes in coagulation function 3, 7 and 14 days after burn and the side effects of drugs were observed. Results: Compared to the control group, in the treatment group, the arterioles dilated more markedly, the blood flow of micro-vessels became faster, the flowing score of nail-fold microcirculation decreased obviously, the state around the nail-fold microcirculation changed significantly, the total score declined faster, but no obvious changes were found in erythrocyte aggregation index, the number of leukocyte adhesion and coagulation function . There were 2 cases with dizziness. Conclusion: Lulutong injection may improve the microcirculation in patients with burn, and has little side effect.

At present, the research regarding repair of spinal cord mainly focuses on tissue engineering. Neural tissue engineering materials provide three-dimensional template for tissue regeneration and also environment for synthesis of extracellular matrix. This paper summarizes the types of nerve transplant materials and the research progress in application for treatment of spinal cord injury, so as to provide theoretical evidence for repair of spinal cord injury. But some problems exist in application of nerve cell scaffold materials for repair of spinal cord injury: poor mechanical properties lead to slow degradation speed, causing difficulties in tissue reconstruction with respect to velocity and in subsequent reconstruction of porous three-dimensional scaffold. In recent years, novel biomaterials with specific repair function have been made by the engineering method through combining the biological molecule with specific signal identification function and available materials, which is an advanced projeot in the current field of biomaterials.

OBJECTIVE To evaluate the effect of vacuum drainage for deep neck infection.METHODS There were 35 patients with deep neck infection in the First Central Hospital of Tianjin from January 2009 to February 2016. These patients were treated by abscess incision and drained with vacuum.RESULTS After treatment, the symptoms of the general fever and pharyngalgia were significantly turned better. The local inflammatory reaction was controlled within one to 3 days and the wounds were most primary healed in 7 days. CONCLUSION The deep neck inflammatory abscess was mostly able to be cured by incision and vacuum drainage of the abscess. The method can significantly reduce the pain of patients and the workload of the physician, and the effect of the method is better than the traditional treatment method.

ObjectiveTo investigate the effect of dexmedetomidine on tracheal extubation response in patients undergoing thyroid surgery after general anesthesia.Methods Forty-two patients who ASA classification Ⅰ - Ⅱ,were performed thyroid surgery under total intravenous anesthesia.They were divided into dexmedetomidine group and control group by random number table with 21 cases each.Both groups patients anesthesia induction and maintenance with the same methods,dexmedetomidine group patients at 15 min before anesthesia induction with venous infusion dexmedetomidine 0.6 μ g/kg(finished 10 min infusion),followed by 0.4 μ g/(kg · h) continuous infusion,control group patients with pump equivalent in 0.9％ sodium chloride injection in the same way.Systolic blood pressure (SBP),diastolic blood pressure (DBP) and heart rate (HR),surgery time,recovery time,extubation time,orientation recovery time,modified Aldrete score ≥9 scores time,rate of recovery from restlessness,tolerance score and recovery from any adverse effects were recorded.ResultsThere were no significant differences between two groups in surgery time,recovery time,extubation time,orientation recovery time,modified Aldrete score ≥ 9 scores time (P ＞0.05).SBP,DBP,HR at immediately and after extubation with 1,3,5 min of dexmedetomidine group were lower than those of control group(P ＜ 0.05 or ＜ 0.01 ).Tolerance score excellent rate of dexmedetomidine group was higher than that of control group[95.2％ (20/21) vs.28.6％ (6/21)] (P ＜ 0.05),the rate of recovery from restlessness of dexmedetomidine group was lower than that of control group[0 vs.28.6％(6/21 ) ] (P ＜ 0.05).ConclusionBefore anesthesia induction in patients with venous infusion dexmedetomidine 0.6 p g/kg(finished 10 min infusion),followed by 0.4 p g/(kg·h) continuous infusion can effectively reduce the patients' cardiovascular response to extubation,strengthen the patients' tolerance to endotracheal tube,reduce the patients' agitation and recover consciousness comfortable.

Objective To conduct the molecular epidemiologic analysis of Staphylococcus aureus (S.aureus) in the intensive care units(ICUs) and general wards and to compare their clinical characteristics.Methods Ninety-six clinically isolated strains of S.aureus(43 strains from the emergency intensive care unit(EICU) and neurosurgical intensive care unit(NICU) and 53 strains from the general wards) collected from Sepetember 2015 to April 2016 were performed the bacterial identification and antibiotic susceptibility test.The molecular typing was performed by adopting staphylococcal protein A (spa) typing method.Results Among 96 strains of S.aureus,the detection rate of methicillin-resistant S.aureus(MRSA) was 40.6%(39/96),which among 43 strains in ICU was 62.8%(27/43) and which among 53 strains in the general words was 22.6%(12/53).The resistance rates of strains from ICUs to gentamicin,levofloxacin,clindamycin,fosfomycin and minocycline were 23.3%,48.8%,46.5%,32.6% and 32.5% respectively,while which from the general wards were 7.5%,24.5%,18.9%,2.1% and 0% respectively.The Spa typing results showed that the main types of ICUs were t002,t091 and t311.The major epidemic strain was t002(n=16,37.2%) and mainly isolated from EICUs(12 strains),26 spa types were identified among the general wards trains,mainly were t189,t377,t571,t034,t091,t127.Conclusion The detection rate of MRSA in ICUs is higher than that in the general wards,these strains have high resistant rate to routine antibacterial drugs.t002 is the major epidemic strain.The general wards have more spa types with higher genetic diversity.

Objective To investigate the implementation of the surgical safety checklist in the hospital.Methods The investigation covered the participants of 560 surgical operations of a tertiary hospital,including the surgeons,surgical assistants,scrub nurses and anesthetists,to learn their compliance and awareness of the content of the surgical safety checklist.Results Poor compliance and unawareness of some items of surgical safety checklist in surgical team members were found,plus insufficient understanding of some the items on the checklist.This checklist can improve the quality and safety awareness of the team.Conclusion The implementation of the surgical safety checklist is feasible and effective for avoidance of risks in selective operations,and conducive to promoting communication among the surgical team and preventing surgical errors.

Objective: To preliminarily evaluate coronary heart disease (CAD) by dual-source CT vascular functional imaging in relevant patients. Methods: A total of 200 patients with suspected non-ST elevation acute coronary syndrome (NSTE-ACS) in our hospital from 2014-09 to 2015-10 were enrolled, 57 of them received dual-source CT angiography (DSCTA) and diagnosed for critical value of left anterior descending (LAD) stenosis; the patients were further examined by selective coronary angiography (SCA) within 1 week to conifrm the degree of stenosis. Meanwhile, fractional lfow reserve (FFR) was measured and taking FFR 0.8 as cut off point, the patients were divided into 2 groups: FFR<0.8 group,n=27 and FFR≥0.8 group,n=30. The values of left ventricular anterior wall, side wall, left ventricular cavity and the segmental thickness in diastolic and systolic stages were measured; relative CT value between ventricular anterior wall and side wall was compared, myocardium thickness at the end-diastolic stage was also compared. Results:①In FFR<0.8 group, compared with the side wall, anterior wall had decreased relative CT value (P=0.000), myocardium thickness at the end-diastolic stage (P=0.000) and myocardial wall thickening rate (P=0.001).②In FFR≥0.8 group, compared with the side wall, anterior wall had decreased relative CT value (P=0.000), myocardium thickness at the end-diastolic stage (P=0.018), while similar myocardial wall thickening rate (P=0.186).③Compared with FFR≥0.8 group, the patients in FFR<0.8group presented reduced relative CT value in anterior wall (P<0.05) and myocardial wall thickening rate (P<0.001), while similar myocardium thickness at the end-diastolic stage (P=0.964). Conclusion: CT information may provide the reference value for treating patients in clinical practice.

This paper is aimed to evaluate the biomechanism of monosegmental and bisegmental anterior fixation for thoracolumbar burst fracture. Twenty-four fresh porcine spines (T13-L3) were used in this study. Three of the fresh porcine spines were randomly selected as intact group, and the others were made into L1 burst fracture models. Fifteen of the twenty one fracture models fitting to the experimental requirements were divided randomly into five groups. Each of the specimens in the five groups and in the intact group underwent the tests of load-strain, load-displacement, stiffness and extreme limit bisegmental fixation group (P<0.05) loading. Data for the monosegmental fixation were insignificantly different on the load- strain and load-displacement tests from those for the bisegmental fixation (P>0.05), but were significantly different from those of the bisegmental fixation on the stiffness test, torsion test and limit loading test. Anterior monosegmental fixation is more stable and has stronger strain of axial compression than the bisemental fixation group. Resect pedicle group is insignificantly different from the monosegmental fixation group,so it is important to keep the pedicle integrity of injured vertebral body in surgery. The biomechanical stability of monosegmental fixation is feasible for thoracolumbar burst fracture.
Animals ; Biomechanical Phenomena ; Fracture Fixation, Internal ; methods ; Lumbar Vertebrae ; injuries ; surgery ; Spinal Fractures ; surgery ; Swine ; Thoracic Vertebrae ; injuries ; surgery

Objective: To analysis the clinical efficacy of dorsal digital nerves fasciocutaneous pedicle flap (DDNFPF) with superficial vein anastomosis in the treatment of the type III and type IV of fingertip defect, and the relationship between the incidence of vein crisis and superficial vein anastomosis. Methods: A total of 85 patients with 92 fingers, treated by DDNFPF from February, 2017 to December, 2018, were retrospectively analyzed. The superficial veins of 30 patients with 32 fingers were anastomosed, and 55 patients with 60 fingers were not. The difference of the superior rate and the incidence of venous crisis between superficial vein anastomosis and non-superficial vein anastomosis was compared by Chi-square test. The difference was considered as statistically significant when P<0.05. The regular postoperative followed-up was performed. Results: The average followed-up time was (7.0±2.9) months. The incidence of venous crisis in anastomosis group (1/32) was lower than that in non-anastomosis group (13/60). The difference was statistically significant (χ²=4.217, P<0.05) . There was no significant difference in the superior rate between the 2 groups after operation (96.8% and 90.0% respectively, χ²=0.596, P>0.05) . The repaired fingertips of the 2 groups were in good appearance, wear-resistant, stable holders and two-point discrimination was 5 to 8 mm. Conclusion DDNFPF for the type III and IV type of fingertip defect is safe and effective. A anastomosis of superficial veins in recipient area can significantly reduce the incidence of venous crisis.

Objective To report our first clinical experience with a novel modified culotte technique for the treatment of true coronary bifurcation lesions. Methods The novel modified culotte technique (the mono-ring culotte) stenting was done in which the side branch (SB) stent was deployed firstly followed by ex vivo wiring of a most proximal cell of SB stent with the hard end of main branch (MB) wire. Secondly, the MB stent was deployed through the most proximal cell of SB stent. The procedure was ended with kissing balloon dilation. From June 2014 to March 2015, 15 patients with true coronary bifurcation lesion were treated with mono-ring culotte stenting in our center. Results The procedures were successful in all cases without procedural complication and in-hospital major adverse cardiovascular events. The procedural time was (34. 3 ± 9. 6) min, fluoroscopic time was (18. 1 ± 3. 8) min, and contrast volume was (112. 0 ± 24. 5) ml, respectively. Post-procedurally, the residual stenosis of the main and the side branch were (10. 0 ± 2. 5)% and (10. 2 ± 5. 3)% , respectively. Conclusions The mono-ring culotte stenting is safe and feasible for treatment of true coronary bifurcation lesions, and may be superior to the conventional culotte stenting.