Objective To study the safety and efficacy of fast track program in anorectal surgery perioperative period. Methods One hundred and sixty-nine cases of rectal cancer were divided into the study group of 86 patients with fast track program, and the control group of 83 patients with traditional programs by random digits table. Both groups were compared from the time out of bed, the first intestinal discharge time,intravenous fluids stopping time,length of hospital stay,total cost of treatment and the incidence of postoperative complications. Results The study group compared with the control group: the first intestinal discharge time [(33.6 ± 12.9) h vs. (81.7 ± 20.1) h], intravenous fluids stopping time [(4.5 ±1.3) d vs.(7.4 ± 1.6) d],and length of hospital stay [(5.6 ± 1.2) d vs.(8.9 ±2.7) d],the total cost of treatment [(15 000 ± 3000) yuan vs. (16 000 ± 4000) yuan], the differences were statistically significant (P ＜ 0.01 or ＜ 0.05),and had less incidence of postoperative complications in study group than that in control group [5.8% (5/86) vs. 16.9% (14/83)], the difference was statistically significant (P ＜ 0.05).Conclusions Fast track program in anorectal surgery perioperative period is safe and effective, beneficial,conducive to rehabilitation of patients.

Objective To introduce an augmentation technique with 4-strand semitendinesus ten-don in treatment of partial anterior cruciate ligament (ACL) injury of under arthroscope and investigate the clinical outcome of the technique. Methods A total of 26 patients with posterolateral bundle rup-tures of ACL were treated arthroscopically with 4-strand semitendinosus tendon augmentation. The Inter-nationnal Knee Documentation Committee (IKDC) and Lysholm knee score scale were used for evaluation of knee function. The side-to-side difference in anterior knee laxity was examined by KT-1000 (25 de-grees flexion and 301b). Results There was no knee extension limitation, with knee flexion of 130°-150 °(average 142°). The patients were followed up for 12-18 months, which showed grade A in 25 pa-tients (96%) and grade B in one (4%) according to IKDC grade at final follow-up. The subjective IK-DC score was increased from preoperative (71.4±3.7) points to (95.8±3.4) points at final follow-up (t =9.836,P <0.01). The average side-to-side difference in maximal manual test with KT-1000 ar-thrometer at 25° flexion decreased from preoperative (5.1±1.2) mm to (2.1±1.3)mm at final follow-up (t = 10.48 ,P < 0.01). The Lysholm score of all patients was (76.7±3.2) preoperatively and (95. 7±2.4) at final follow-up (t =7.356,P<0.01). Conclusion Augmentation with 4-strand semiten-dinosus tendon under arthroscope can attain excellent clinical results and good anterior stability in treat-ment of partial tears of posterolateral bundle of ACL.

Objective To comparO thO Officacy and safOty of concurrOnt chOmoradiothOrapy and sOquOntial chOmoradiothOrapy in thO trOatmOnt of locally advancOd non -small cOll lung cancOr ( NSCLC). Methods From SOptOmbOr 2016 to FObruary 2018, 88 patiOnts with locally advancOd NSCLC admittOd to Li Huili East Hospital wOrO randomly dividOd into synchronous group ( 45 casOs) and sOquOntial group ( 43 casOs). ThO synchronous group rOcOivOd concurrOnt radiothOrapy and chOmothOrapy, whilO thO sOquOntial group was givOn radiothOrapy aftOr 4 cyclOs of chOmothOrapy. Both two groups took thO samO radiothOrapy and chOmothOrapy prOscription. ThO clinical Officacy, advOrsO rOactions and quality of lifO of thO two groups wOrO comparOd.Results ThO total OffOctivO ratO in thO synchro-nous group was significantly highOr than that in thO sOquOntial group (6.22% vs. 39.53% , χ2 =4.530,P<0.05). ThO incidOncO ratO of Ⅰ ~Ⅱ gradO radiation lung injury and radiation Osophagitis in thO synchronous group wOrO significantly highOr than thosO in thO sOquOntial group (26.67% vs. 9.30% ;17.78% vs. 2.32% , χ2 =4.457, 4.159,all P<0.05).ThOrO was no statistically significant diffOrOncO in quality of lifO scorO bOtwOOn thO two groups bOforO trOatmOnt (P>0.05).ThO body hOalth and total hOalth status of thO synchronous group wOrO significantly lowOr than thosO of thO sOquOntial group at thO Ond of trOatmOnt [(66.48 ± 9.28) points vs.(70.95 ± 11.68) points;(51.48 ± 10.26)points vs.(55.42 ± 9.84)points, t=2.010,2.144,all P<0.05], but thO scorO of total hOalth status in thO synchronous group was significantly highOr than that in thO sOquOntial group at thO Ond of trOatmOnt [(61.28 ± 6.48)points vs.(57.83 ± 7.93)points, t=2.239,P<0.05].Conclusion ConcurrOnt chOmoradiothOrapy has bOttOr clinical Officacy than sOquOntial radiothOrapy and chOmothOrapy in thO trOatmOnt of locally advancOd NSCLC. Although it can incrOasO thO incidOncO of radiation pnOumonitis and Osophagitis, thO patiOnts arO wOll tolOratOd and thO quality of lifO is improvOd gradually at thO Ond of thO trOatmOnt. It is worthy of clinical promotion.

OBJECTIVE: To explore the cause of cardiac perforation and tamponade during cardiac catheterization and intervention and to evaluate the effectiveness of the emergency treatment for tamponade in our hospital. METHODS: The clinical data from 23, 319 patients who received diagnostic catheterization or therapeutic procedures were analyzed retrospectively. RESULTS: Cardiac perforation and cardiac tamponade were observed in 22 of the 23, 319 patients during catheter procedures. It includes 1 in coronary artery angiography, 9 in percutaneous balloon mitral valvuloplasty, 3 in diagnosis, 2 in congenital heart disease intervention, 2 in pacemaker implantation, 2 in atrial fibrillation ablation and the other 3 in coronary revascularization. The occurrence of cardiac perforation in 11 patients was related to puncture of the interatrial septum and/or the procedure in the left atrial procedure and 2 were related to high pressure injection. Seventeen patients were found cardiac tamponade in the process of catheterization, and 5 were found at 2-14 h after operation. Pericardiocentesis and pericardial catheter drainage were performed in 20 patients and 11 of them succeeded. Among the other 11 patients, 7 were successfully saved by thoracotomy and 4 died. CONCLUSION Cardiac tamponade is a severe and fatal complication that may occur in different catheter procedures. Early prevention and diagnosis and performingperi cardiocentesis and drainage timely are critical to reduce the mortality.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Angioplasty, Balloon, Coronary ; adverse effects ; Cardiac Catheterization ; adverse effects ; Cardiac Tamponade ; etiology ; Child ; Child, Preschool ; Female ; Heart Injuries ; epidemiology ; etiology ; Humans ; Infant ; Infant, Newborn ; Male ; Middle Aged ; Pacemaker, Artificial ; adverse effects ; Retrospective Studies ; Young Adult

Objective To observe the clinical effect of arthroscopic repair of isolated degenerative medi-al meniscus injury in patients over 45 years old and to evaluate the healing after more than two years of fol-low-up through MRI.Methods A retrospective study was conducted on the clinical effects of 51 patients with isolated degenerative medial meniscus injury who underwent arthroscopic repair from January 2016 to Decem-ber 2020.The meniscus was sutured by total internal suture or total internal suture combined with internal-to-external technique.IKDC score,Tegner score and Lysholm score were recorded before operation and at the last follow-up(at least 24 months).The type and location of meniscus injury during operation,and the microscopic classification and location of cartilage injury were recorded.At the same time,MRI was used to observe the healing of meniscus and ICRS cartilage injury grading.On MRI,0-2 degree injury was defined as meniscus healing,and 3 degree injury was defined as nonunion.The clinical repair failure was judged according to the Barrett evaluation criteria.Results The average age of the patients was(57.3±8.4)years,and the average follow-up time was(55.0±15.3)months.There were 47.1％complex fissures,31.3％horizontal fissures and 21.6％other types.The Lysholm score increased from 53.5±6.4 preoperative to 87.6±7.9 postoperative,the IKDC score increased from 33.6±4.7 preoperative to 72.8±5.3 postoperative,and the Tegner score increased from 1.0±0.1 preoperative to 4.0±0.5 postoperative.Three patients were judged as clinical repair failure,and five patients had progressed cartilage injury after surgery.At the last follow-up,the meniscus healing was observed on MRI:0 degree in two cases(3.9％),1 degree in 17 cases(33.3％),2 degree in 11 cases(21.6％),3 degree in 21 cases(41.2％).Conclusion For middle-aged and elderly patients with isolated de-generative medial meniscus injury,if conservative treatment is not effective or there are mechanical obstruc-tion factors,arthroscopic meniscus repair can achieve good clinical results and low clinical repair failure rate.

Objective: To study the clinical efficacy of biological ceramics (iRoot BP Plus ) and mineral trioxide aggregate (MTA) in direct pulp capping of mature permanent teeth, to provide referrence for clinical application. Methods : Seventy-four patients with pulp exposure due to deep caries or reversible pulpitis in 75 mature permanent teeth were selected and were randomly divided into two groups. iRoot BP Plus were used as pulp capping agents in the treatment group and MTA were used as pulp capping agents in the control group respectively. The clinical efficacy and imaging analysis were performed at 1, 3, 6 and 12 months after operation. Treatment success rate of the two groups were calculated, and the influence of various factors including gender, age, tooth position, cavity, number and size of pulp exposure on the efficacy of direct pulp capping were analyzed. Results : Sixty patients with 61 mature permanent teeth were selected. Twelve mouths after treatment, 61 teeth of 60 patents were completely investigated (iRoot group: 31 teeth 30 patients; MTA group: 30 teeth 30 patients). The success rates of the 2 groups were 90.3% (iRoot BP Plus) and 90.0% (MTA), respectively. There was no statistical difference between 2 groups (P>0.05). Statistical analysis also showed that gender, age, tooth position, cavity, number and size of pulp exposure had no significant difference between the two groups (P>0.05). Conclusion Both iRoot BP Plus and MTA are effective in direct pulp capping of mature permanent teeth with carious pulp exposure, while the operation of iRoot is simple and convenient.