Journal Detail Information

1

Cite

Share

To compare the traditional anterior transposition and anterior subcutaneous with blood supply of the ulnar nerve for the treatment of cubital tunnel syndrome

Tongming XIE ; Wenjun LUO ; Qiqun XIE ; Hanjie ZHANG

Chinese Journal of Postgraduates of Medicine.2014;37(32):13-15. doi:10.3760/cma.j.issn.1673-4904.2014.32.005

Objective To compare the traditional anterior transposition and anterior subcutaneous with blood supply of the ulnar nerve for the treatment of cubital tunnel syndrome.Methods Eighty cases with cubital tunnel syndrome were enrolled in the retrospective study from January 2009 to March 2013,40 cases (control group) were treated by traditional anterior transposition while the others (observation group) were treated by anterior subcutaneous with blood supply.According to the evaluation criteria of ulnar nerve,evaluated the function of patients and compared the scores of two groups and the improved rate of different level patients.Results The scores of two groups before surgery were (3.6 ± 0.4),(3.7 ± 0.5) scores,after surgery were (7.5 ± 0.9),(7.4 ± 0.6) scores respectively,there was significant difference between two groups before and after surgery (P ＜ 0.05),but there was no significant difference between two groups (P ＞0.05).The improved rate of observation group was 87.5％ (35/40),which was higher than that of control group [85.0％ (34/40)],but without statistical difference (P ＞ 0.05).In two groups the patients with middle scores showed no statistical significance in improved rate [90.0％ (27/30) vs.96.4％ (27/28)] (P ＞ 0.05).Two treatments showed a significant difference for the low scores patients 8/10 vs.7/12 (P ＜0.05).Conclusion Anterior subcutaneous with blood supply of the ulnar nerve is better than traditional anterior transposition for the gross cubital tunnel syndrome patients.

2

Cite

Share

The clinical analysis of single operation hole for thorascopic surgery in treatment of encapsulated effusion with atelectasis after thoracic injury for 56 cases

Xuesong DING ; Nan LUO ; Xia ZHAO

Chinese Journal of Postgraduates of Medicine.2014;37(32):15-17. doi:10.3760/cma.j.issn.1673-4904.2014.32.006

Objective To explore the surgical methods and clinical applications of single operation hole for thorascopic surgery in treatment of encapsulated effusion with atelectasis after thoracic injury.Methods From October 2011 to October 2013,using single operation hole for thorascopic surgery treating encapsulated effusion with atelectasis in 56 cases after thoracic injury,35 males and 21 females,aged 21-68,mean 34 years old.The left encapsulated effusion with atelectasis in 31 cases,the right of encapsulated effusion with atelectasis in 25 cases,atelectasis in 43 cases,partial atelectasis in 9 cases,total atelectasis in 4 cases.Before thorascopic surgery,routine thoracentesis or (and) closed thoracic drainage were performed,but ineffective.Surgical approach for anesthesia with the thorascopic surgery encapsulated effusion dissection + suction drum lung surgery.Thorascopic surgery were completed in single operation hole,postoperative chest tube into the hole from observation.Results The operation time was 55-120 min,average 75 min; blood loss was 25-150 ml,average 65 ml.All patients underwent in single operation hole.The postoperative hospital stay was 7-19 d,average 11.2 d.There were no perioperative mortality and major complications.Conclusions The single operation hole for thorascopic surgery in treatment of encapsulated effusion with atelectasis after thoracic injury is exactly effective and simple.It can be used as an effective treatment.

3

Cite

Share

The effect of respiratory mechanics in airway humidification with ambroxol during mechanical ventilation

Jiling XIE ; Huiping HUANG ; Guosheng HUANG ; Xiaotai HUANG ; Junling ZHANG ; Shangying TANG ; Fulan LIANG

Chinese Journal of Postgraduates of Medicine.2014;37(33):5-7. doi:10.3760/cma.j.issn.1673-4904.2014.33.002

Objective To observe effect of using ambroxol to humidify of airway during mechanical ventilation to treat severe pneumonia in infants,and to explore dynamic changes of respiratory mechanics.Methods Sixty-five infants with severe pneumonia need ventilator treatment according the diagnosis criterion were divided into 2 groups by random digits table method:experimental group (33 cases) and control group (32 cases).Experimental group was used ambroxol and control group was used 0.9％ sodium chloride,each 2 ml intratracheal instillation,and then took the balloon pressurized oxygen 30 s,followed by ventilator,after 24 h.Changes of respiratory mechanics indexes were observed before and after treatment,including:mean airway resistance,lung dynamic compliance,work of breathing,airway plateau pressure.Respiratory mechanics values were recorded before and after treatment.Results After treatment for 24 h,the index in experimental group were better than those in control group.Mean airway resistance were (0.68 ± 0.04) cmH2O/ (L·s) and (0.57 ± 0.05) cmH2O/ (L·s),1 cmH2O =0.098 kPa,lung dynamic compliance were (3.17 ± 0.81) ml/kPa and (2.56 ± 0.69) ml/kPa,work of breathing were (0.54 ± 0.08) J/L and(0.41 ± 0.06) J/L,airway plateau pressure were (2.23 ± 0.58) cmH2O and (2.12 ± 0.63) cmH2O.There were significant differences (P ＜ 0.05).The mechanical ventilation time in experimental group was significantly shorter than that in control group [(64.08 ± 13.92) h vs.(79.57 ± 19.64) h] (P ＜0.05).Conclusion Airway humidification using ambroxol can better treat severe pneumonia,reduce airway resistance and improve alveolar ventilation,shorten time on the machine.

4

Cite

Share

Perinatal outcome of monochorionic diamniotic twins with selective intrauterine growth restriction

Xiaoli ZHAO ; Ling LI ; Qing GAO ; Li SUN

Chinese Journal of Postgraduates of Medicine.2014;37(33):34-37. doi:10.3760/cma.j.issn.1673-4904.2014.33.012

Objective To evaluate the perinatal outcome of three types of monochorionic diamniotic (MCDA) twins with selective intrauterine growth restriction (sIUGR).Methods From January 2010 to June 2013 clinical data of 37 pairs of MCDA twins (74 fetuses)with sIUGR and 40 pairs of normal MCDA twins (80 fetuses) in the same period were analyzed retrospectively.Fetuses with sIUGR were classified into three groups based on umbilical artery Doppler flow.There were 20 cases of type Ⅰ,11 cases of type Ⅱ and 6 cases of type Ⅲ.The perinatal outcome was compared between sIUGR and normal MCDA twins,and among the three types of sIUGR as well.Perinatal outcomes included gestational age at delivery,rate of intrauterine fetal death (IUFD),birth weight,twins discordance of birth weight,neonatal death and survival rate at 6 months.Results The gestational age of sIUGR group at delivery was significantly earlier than that of control group [(33.1 ± 3.0),(36.9 ± 3.2) weeks,respectively],and the rate of IUFD of both fetuses of sIUGR group was significantly higher [5.4％ (4/74),0,respectively],there was significant difference(P ＜ 0.05).In sIUGR group,the average birth weight of large or small twins [(2 030.8 ± 353.4),(1 529.0 ± 432.9) g] was smaller than those in control group [(2 471.5 ± 500.9),(2 346.0 ± 460.3) g],there was significant difference (P ＜ 0.05).The twins discordance of birth weight in sIUGR group was significantly larger [(27.2 ± 2.6)％] than that in control group [(8.0 ± 1.6)％] (P ＜0.05).The gestational age at delivery in type Ⅱ and type Ⅲ [(33.1 ± 5.0),(34.3 ± 2.8) weeks] was significantly earlier than that in control group (P ＜ 0.05).The rate of IUFD of both fetuses in type Ⅱ (18.2％,4/22) was significantly higher than that in type Ⅰ (0) and control group (0) (P ＜ 0.05).In sIUGR group,the average birth weight of small twins in type Ⅰ,type Ⅱ and type Ⅲ was (1 646.0 ± 433.5),(1 332.8 ± 310.5),(1 504.5 ± 382.2) g respectively,all of which was significantly smaller than that in control group (P ＜ 0.05).The average birth weight of small twins in type Ⅱ was smaller than type Ⅰ and the difference was statistically significant (P ＜ 0.05).In sIUGR group,the twins discordance of birth weight in type Ⅰ,type Ⅱ and type Ⅲ was (26.3 ±5.1)％,(31.0 ±1.6)％,(31.4 ±3.3)％ respectively,all of which was significantly larger than that in control group (P ＜0.05).There were no significant difference of the twins discordance of birth weight among the three types of sIUGR (P ＞ 0.05).Survival rate at 6 months in type Ⅱ (63.6％,14/22) was significantly lower than type Ⅰ (95.0％,38/40) and control group (92.5 ％,74/80) (P ＜ 0.05).Conclusions The perinatal outcome of MCDA twins with sIUGR is poor.The outcome is different among the three types of sIUGR,and type Ⅱ is the worst.Type Ⅱ is associated with a high risk of intrauterine fetal demise.It is important to monitor the intrauterine situation closely.

5

Cite

Share

The application of lidocaine in cervical cancer postoperative urinary retention

Yuanyuan TANG

Chinese Journal of Postgraduates of Medicine.2014;37(33):38-40. doi:10.3760/cma.j.issn.1673-4904.2014.33.013

Objective To analyze the therapeutic effect of lidocaine in cervical cancer postoperative urinary retention.Methods Sixty-five patients with cervical cancer postoperative urinary retention were divided into two groups by random digits table method:treatment group 32 cases,immediately after the urethral catheter to infiltrate 1 ml of 2％ lidocaine cotton ball placed urethral opening more than 20 minutes again urine; control group 33 cases,routine for patients with urethral catheter.The incidence of urinary retention and adverse drug reactions were compared between two groups.Results Treatment group residual urine volume was(53 ± 22) ml,1 case(3.12％,1/32) of urinary retention,control group was (163 ± 32) ml and 8 cases (24.24％,8/33),there was significant difference (P ＜ 0.05).Conclusion Lidocaine for cervical cancer postoperative urinary retention has good prevention effect,can be popularized in clinical application.

6

Cite

Share

Neonatal effects and efficacy of dexmedetomidine on haemodynamics during cesarean section under general anesthesia

Chuanbao HAN ; Xiuhong JIANG ; Xia WU ; Zhengnian DING

Chinese Journal of Postgraduates of Medicine.2014;37(33):40-43. doi:10.3760/cma.j.issn.1673-4904.2014.33.014

Objective To explore the neonatal effects and efficacy of dexmedetomidine on haemodynamics during cesarean section under general anesthesia.Methods Thirty-eight ASA Ⅰ or Ⅱ parturients with a single baby at full term in vertex presentation,scheduled for cesarean section under general anesthesia,were randomly divided into 2 groups (each group of 19 patients) by random digits table method:dexmedetomidine group and normal saline group.The patients in dexmedetomidine group received an intravenous infusion loading dose of 0.6 μ g/kg of dexmedetomidine,starting 10 min before induction of anesthesia,following with an intravenous infusion 0.4 μ g/ (kg ·h) of dexmedetomidine until peritoneal closure.The patients in normal saline group received an intravenous infusion of isovolumic of normal saline.Recording the systolic blood pressure (SBP),diastolic blood pressure (DBP) and heart rate (HR) before infusion (T0) and 10 min after the start of infusion (T1),at tracheal intubation (T2),at delivery of the baby (T3),15 min after delivery (T4),at end of operation (T5),at extubation (T6) and 15 min after extubation (T7).The blood of umbilical vein and umbilical artery was drawn for gas analysis,and the Apgar scores at 1 and 5 min were also recorded after delivery.Results The level of SBP,DBP and HR at T0 had no significant difference between two groups (P ＞ 0.05).In dexmedetomidine group,the level of SBP,DBP and HR were significantly higher at T2 than those at T0 [(136 ± 12) mmHg (1 mmHg =0.133 kPa) vs.(124 ± 9) mmHg,(83 ± 10) mmHg vs.(72 ± 6) mmHg,(93 ± 11) times/min vs.(81 ± 8) times/min] (P ＜ 0.05).In normal saline group,the level of SBP,DBP and HR at T2-6 [(151 ± 14),(137 ± 11),(132 ± 10),(132 ±9),(142± 13)mmHgvs.(125 ±9)mmHg;(94±13),(85±9),(80±8),(80±9),(86±11)mmHgvs.(74 ±7) mmHg; (122 ±15),(105 ±12),(90 ±9),(89 ± 10),(97 ±11) times/min vs.(81 ±9) times/min] were significantly lower (P ＜ 0.05).Compared with normal saline group,the level of SBP,DBP and HR were lower in dexmedetomidine group at T2-6(P ＜ 0.05).There were no significant difference not only about the blood gas analysis of umbilical vein and umbilical artery,but also about the Apgar scores at 1 and 5 min after delivery (P ＞ 0.05).Conclusion Administration of dexmedetomidine is effective in maintaining the maternal haemodynamic during the cesarean section under general anesthesia without adverse neonatal effects.

7

Cite

Share

Effects of butorphanol pretreatment on myocardial injury induced by limb ischemia/reperfusion

Wenwei WANG ; Keping YE ; Min TAO ; Lishu WANG ; Qigang YE ; Huaqing WANG

Chinese Journal of Postgraduates of Medicine.2014;37(34):17-19. doi:10.3760/cma.j.issn.1673-4904.2014.34.006

Objective To investigate the effects of butorphanol pretreatment on myocardial injury induced by limb ischemia/reperfusion.Methods Forty patients with distal lower extremity orthopedic surgery (ASA Ⅰ or Ⅱ) were divided into two groups by random digits table method with 20 cases each:butorphanol group and control group.Epidural anesthesia was selected in all patients.In butorphanol group,patients were given butorphanol 0.04 mg/kg intravenously 15 min before tourniquet.In control group,equal volume of normal saline was infused at the same time.Blood samples were taken from jugular vein before tourniquet (T0),then 5 min(T1),2 h (T2),6 h (T3),12 h (T4) and 24 h (T5) after the second reperfusion of tourniquet.The serum creatine kinase isoenzyme MB (CK-MB),cardiac troponin Ⅰ (cTnI),tumor necrosis factor-α (TNF-α) and malondialdehyde (MDA) levels were determined.Results Compared with those at T0,the serum C K-MB levels were increased at T2-T5,the serum cTnI,MDA,TNF-α levels were increased at T1-T5 in control group,and there were significant differences (P ＜ 0.05).Compared with those at T0,the serum CK-MB levels were increased at T3,T4,the serum TNF-α levels were increased at T1-T3,the serum cTnI levels were increased at T1-T5 in butorphanol group,and there were significant differences (P ＜ 0.05).Compared with those in control group,the serum CK-MB levels were decreased at T2-T5 [(20.2 ± 5.0) U/L vs.(35.3 ±6.8) U/L,(32.3 ±3.7) U/L vs.(48.6 ±8.5) U/L,(29.5 ±5.4) U/L vs.(51.5 ±8.0) U/L,(22.2 ±4.8) U/L vs.(33.7 ±6.7) U/L],the serum cTnI,TNF-α levels were decreased at T1-T5 [(0.158 ± 0.016) μg/L vs.(0.278 ±0.021) μg/L,(0.169 ±0.036) μg/L vs.(0.332 ± 0.062) μg/L,(0.357 ±0.049) μg/L vs.(0.623 ±0.083) μg/L,(0.178 ±0.045) μg/L vs.(0.383 ±0.059) μg/L,(0.138 ±0.016) μg/L vs.(0.263 ±0.023) μg/L; (1.63 ±0.13) μg/L vs.(2.12 ±0.08) μg/L,(1.69 ± 0.08) μ g/L vs.(2.28 ± 0.09) μ g/L,(1.63 ± 0.09) μ g/L vs.(2.25 ± 0.07) μ g/L,(1.23 ± 0.14) μμg/Lvs.(1.93±0.12) μg/L,(1.13±0.15) μμg/Lvs.(1.79±0.07) μμg/L],theserumMDAlevelswere decreased at T1-T4 [(4.82 ±0.53) nmol/L vs.(6.68 ±0.67) nmol/L,(4.99 ±0.61) nmol/L vs.(7.59 ±0.72) nmol/L,(5.02 ±0.43) nmol/L vs.(7.54 ±0.63) nmol/L,(4.52 ±0.55) nmol/L vs.(6.52 ±0.47) nmol/L] in butorphanol group,and there were significant differences (P ＜0.05).Conclusion Butorphanol pretreatment can improve the serum CK-MB,cTnI levels,and has a protective role for myocardial injury induced by limb ischemia/reperfusion.

8

Cite

Share

Comparative efficacy between arterial thrombolysis with urokinase and intravenous thrombolysis with recombinant tissue plasminogen activator in treatment of ischemic stroke

Xianlin GAO

Chinese Journal of Postgraduates of Medicine.2014;37(34):20-22. doi:10.3760/cma.j.issn.1673-4904.2014.34.007

Objective To compare the effect of arterial thombolysis with urokinase and intravenous thrombolysis with recombinant tissue plasminogen activator(rt-PA) in treatment of ischemic stroke.Methods One hundred patients with ischemic stroke were divided into intravenous thrombolysis (with rt-PA) group and arterial thrombolysis (with urokinase) group with 50 cases each by random digits table method.The thrombolytic recanalization rate,mortality rate and complications after treatment were observed and compared between two groups.Results The thrombolytic recanalization rate in intravenous thrombolysis (with rt-PA) group was higher than that in arterial thrombolysis (with urokinase) group [88.0％ (44/50) vs.66.0％ (33/50)],the complication rate in intravenous thrombolysis (with rt-PA) group was lower than that in arterial thrombolysis (with urokinase) group [6.0％ (3/50) vs.28.0％ (14/50)],and there was significant difference (P ＜ 0.05).There was no significant difference in mortality between two groups (P ＞ 0.05).There was no significant difference in the National Institutes of Health Stroke Scale (NIHSS) scores before treatment between two groups (P ＞ 0.05).The NIHSS scores 1,3,10,30 d after treatment were lower than those before treatment in two groups,and there were significant differences (P ＜ 0.05).There was no significant difference in NIHSS scores at different times and modified Rankin Scale 30 d after treatment between two groups (P＞ 0.05).Conclusions The efficacy of rt-PA in ischemic stroke patients is significantly better than that of the arterial thrombolysis with urokinase,with higher recanalization rate and fewer complications.It is safe and effective,and can be as the first choice for the treatment of ischemic stroke thrombolysis.

9

Cite

Share

Clinical analysis of radiofrequency catheter ablation in treatment of 127 atrial fibrillation patients

Yunqing LIU ; Tiejun LI ; Shumei MA ; Di ZHANG

Chinese Journal of Postgraduates of Medicine.2014;37(34):23-25. doi:10.3760/cma.j.issn.1673-4904.2014.34.008

Objective To investigate the clinical efficacy,safety and the correlation factors of recurrence of radiofrequency catheter ablation in treatment of atrial fibrillation.Methods The clinical data of 127 patients with atrial fibrillation having underwent circumferential pulmonary vein ablation guided by 3-D mapping system were analyzed retrospectively.Then they were followed up for 12 months.The status of patients after ablation and the success rate of ablation was recorded,then the relationship between the factors and the recurrence after ablation of atrial fibrillation was analyzed.Results After a follow up of 12 months,94 patients maintained sinus rhythm,and atrial fibrillation recurred in 33 cases.The first clinical success rate was 74.02％(94/127).Thirty-three patients with recurred atrial fibrillation received ablation again and 11 patients got success.The total clinical success rate was 82.68％ (105/127).The success rate of paroxysmal atrial fibrillation was 88.46％ (92/104) and success rate of persistent atrial fibrillation was 56.52％ (13/23).Univariate analysis showed that the type,the course,the diameters of left atrial,the early recurrence,the body mass index were related to the recurrence of atrial fibrillation,and multivariable Logistic analysis revealed only the type and the diameters of left atrial were independent risk factors responsible for the recurrence of atrial fibrillation (P ＜ 0.05).Conclusion Radiofrequency catheter ablation in treatment of atrial fibrillation is effective and safe,and the type and the diameters of left atrial are independent risk factors responsible for the recurrence of atrial fibrillation.

10

Cite

Share

Clinical observation of ozone therapy combined with gemcitabine and cisplatin regimen in patients with advanced non-small cell lung cancer

Jingfeng GUO ; Yankun HE ; Feng WU ; Hui XING ; Bo ZHANG ; Bing WANG ; Jing PENG

Chinese Journal of Postgraduates of Medicine.2014;37(34):38-41. doi:10.3760/cma.j.issn.1673-4904.2014.34.013

Objective To observe the efficacy and adverse reaction of ozone therapy combined with gemcitabine and cisplatin (GP) regimen in patients with advanced non-small cell lung cancer.Methods Fifty-five patients with advanced non-small cell lung cancer were enrolled and allocated to treatment group (28 cases) and control group (27 cases).The patients in treatment group received ozone therapy combined with GP regimen,and the patients in control group received GP regimen only.The efficacy,quality of life,adverse reaction and cellular immune function after treatment was compared between two groups.Results There was no significant difference in the efficacy between two groups (P ＞ 0.05).The quality of life after treatment in treatment group was better than that in control group (P ＜ 0.05).The liver function damage in treatment group was lower than that in control group (P ＜ 0.05).The cellular immune function in treatment group was stronger than that in control group (P ＜ 0.05).Conclusion Ozone therapy combined with GP regimen can effectively alleviate adverse induced by GP regimen chemotherapy and significantly improve the quality of life in patients with advanced non-small cell lung cancer.

DISPLAY OPTIONS

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share