Objective To investigate the value of continuous renal replacement therapy (CRRT) coupled with minimally invasive ultrasound-guided percutaneous transhepatic gallbladder drainage (PTGD) for the treatment of severe acute biliary pancreatitis.Methods Hospitalized patients with severe acute biliary pancreatitis were recruited from the intensive care unit (ICU) of the Mfiliated Hospital of Qingdao University from June 2010 to June 2015,and divided into conventional CRRT alone group (n =30) and CRRT + PTGD group (n =30).Comparisons of postoperatively symptoms (time required for abdominal pain relief,time consumed for,gastrointestinal decompression),laboratory findings (WBC,PLT,PCT,CRP,AMS,TBIL,ALT,ALB,Lac) and acute physiology and chronic health evaluation score (APACHE Ⅱ,Balthazar CT,MODS) were carried out between two groups.The occurrence of complications (ARDS,abdominal infection,bile leakage,abdominal hemorrhage,intestinal injury,catheter translocation,catheter dislocation) was observed.The differences in duration of ventilator support,the length of stay in ICU,and fatality rate were compared between the two groups.Results Compared with the conventional CRRT alone group,the postoperative symptoms were significantly relieved,and time required for abdominal pain relief and time consumed for gastrointestinal decompression were evidently shortened in the CRRT + PTGD group (P ＜ 0.05).There were statistically significant differences in laboratory findings (WBC,PLT,PCT,CRP,AMS,TBIL,ALT) between two groups (P ＜ 0.05).The differences in APACHE Ⅱ,Balthazar CT and MODS score between the two groups also presented statistical significance (P ＜ 0.05).The comparisons of the duration of ventilator support [(6.1 ± 1.3) d vs.(9.5 ± 1.4) d] andthe length of stay [(15.7 ± 1.1) dvs.(21.1 ± 2.5) d] between thetwo groups revealed statistical significance (P ＜ 0.05).Conclusions CRRT coupled with PTGD for the treatment of severe acute biliary pancreatitis can effectively eliminate the inflammatory mediators and toxins from patients.On this basis,the coupled therapy with gallbladder puncture and drainage is capable of decompressing the biliary tract,improving liver function,effectively relieving clinical symptoms,minimizing the changes of laboratory findings an,d APACHE Ⅱ score,and thereby optimizing the prognosis of patients.

Objective To explore the efficacy and safety of Kegel exercise combined with biofeedback electrical stimulation in the treatment of postpartum pelvic floor dysfunction(PFD).Methods A total of 100 postpartum PFD patients diagnosed and treated in Shaoxing Maternal and Child Health Care Hospital from January 2022 to May 2023 were selected and divided into KEG group and combination group according to random number table method,with 50 cases in each group.Patients in KEG group were given Kegel exercise,and patients in combination group were treated with Kegel exercise combined with biofeedback electrical stimulation.The clinical efficacy,pelvic floor electrophysiological indexes,bladder neck mobility,urethral rotation angle and sexual function were compared between two groups.Results The total effective rate of combination group was significantly higher than that of KEG group(x2=4.891,P=0.026).After treatment,the anterior resting average electromyogram value(aEMG),posterior resting aEMG,slow muscle aEMG and fast muscle maximum electromyogram value(mEMG)of pelvic floor muscles and sexual satisfaction scores in two groups were significantly higher than before treatment,bladder neck mobility and urethral rotation angle in combination group were significantly lower than before treatment,the duration of vaginal contraction in combination group was significantly longer than before treatment,and the pain score of coitus in combination group was significantly lower than before treatment(P＜0.05).The anterior resting aEMG,posterior resting aEMG,slow muscle aEMG and fast muscle mEMG of pelvic floor muscles and sexual satisfaction scores in combination group were significantly higher than those in KEG group,bladder neck mobility and urethral rotation angle were significantly lower than those in KEG group,the duration of vaginal contraction was significantly longer than that in KEG group,and the pain score of coitus was significantly lower than that in KEG group(P＜0.05).No complications occurred in both groups after treatment.Conclusion Kegel exercise combined with biofeedback electrical stimulation can significantly improve pelvic floor muscle function,sexual function and urinary function in patients with postpartum PFD with good safety,and its efficacy is better than Kegel exercise.

Objective: To evaluate the efficacy and safety of drug-coated balloons (DCB) for de novo large coronary vessels. Methods: One hundred and two patients were retrospectively enrolled in this study, there were 104 lesions with the reference lumen diameter of target vessel more than 2.8 mm and patients were treated with DCB in de novo lesions during May 2015 and July 2017 in our center. Coronary artery angiography and quantitative coronary angiography were performed in 82 (80.4%) patients at follow up period ((8.1±1.7) months post procedure). The endpoints were late lumen loss (LLL) at follow up,and major adverse cardiac events (MACE) including cardiac death, myocardial infarction (MI), target lesion revascularization (TLR) and stent or target lesion thrombosis at 12 months post procedure. Results: Ninety-eight lesions were treated with DCB only, 6 (5.9%) bailout drug-eluting stent (DES) were used because of severe coronary dissection, 2 patients (2.0%) received revascularization driven by acute ischemic events during hospitalization. Cutting balloons and NSE balloons were used in 65.4% (68/104) and 26.0% (27/104) lesions. The lesion length was (12.57±3.58) mm and the DCB length was (19.87±4.55) mm. The late lumen loss was (0.01±0.52) mm during angiographic follow up. The TLR rate and overall MACE rate was 3.9% (4/102) and 3.9% (4/102) and there was no death,MI and target lesion thrombosis at 12 months follow up. Conclusion DCB treatment for de novo large coronary vessels is effective and safe.