Objective:To investigate the effect of ultrasonic debridement combined with hyperbaric oxygen on bacterial clearance and microcirculation of diabetic foot ulcer wound.Methods:A total of 98 patients with diabetic foot ulcer who received conservative treatment in the Department of Vascular Surgery of Longkou People Hospital were selected as the research subjects and divided into three groups. The Group A (32 cases) received standard treatment; the Group B (30 cases) received standard treatment + hyperbaric oxygen therapy; the Group C (36 cases) received standard treatment + ultrasonic debridement + hyperbaric oxygen therapy. On the day 0, 7, 14, and 21, the changes of wound area were calculated by millimeter graph paper method, and the ulcer healing rates were also calculated. The bacterial clearance rates of ulcer wound were calculated by quantitative bacterial wound culture method. The microcirculation of ulcer wound was measured by Laser Doppler Perfusion Imaging (LDPI). The limb pains before and after treatment were evaluated by limb pain score and intermittent claudication score.Results:After 3 courses of treatment, the transcutaneous oxygen partial pressures and the wound blood flows of the 3 groups were significantly higher than those before treatment, and the percutaneous oxygen partial pressure and wound blood flow of the Group C after treatment were significantly higher than those of the Group A and the Group B, with statistically significant differences ( P<0.05). On the 14th and 21st day after treatment, the ulcer areas of the Group C were significantly lower than those of the Group A and the Group B, and the ulcer healing rate of Group C was significantly higher than those of the Group A and the Group B, with statistically significant differences ( P<0.05). On the 7th, 14th, and 21st day after treatment, the bacterial quantity in the ulcer tissue of the Group C was significantly lower than those in the Group A and the Group B ( P<0.05). After 3 courses of treatment, the scores of intermittent claudication and limb pain in the three groups were significantly lower than those before treatment, and the scores of limb pain and intermittent claudication in the Group C were significantly lower than those in the Group A and the Group B after treatment ( P<0.05). Conclusion:Hyperbaric oxygen combined with ultrasonic debridement can effectively remove bacteria in diabetic foot ulcer wound, promote microcirculation, and help ulcer wound healing. It is worthy of clinical application.

Objective:To investigate the effect of ultrasonic debridement combined with hyperbaric oxygen on bacterial clearance and microcirculation of diabetic foot ulcer wound.Methods:A total of 98 patients with diabetic foot ulcer who received conservative treatment in the Department of Vascular Surgery of Longkou People Hospital were selected as the research subjects and divided into three groups. The Group A (32 cases) received standard treatment; the Group B (30 cases) received standard treatment + hyperbaric oxygen therapy; the Group C (36 cases) received standard treatment + ultrasonic debridement + hyperbaric oxygen therapy. On the day 0, 7, 14, and 21, the changes of wound area were calculated by millimeter graph paper method, and the ulcer healing rates were also calculated. The bacterial clearance rates of ulcer wound were calculated by quantitative bacterial wound culture method. The microcirculation of ulcer wound was measured by Laser Doppler Perfusion Imaging (LDPI). The limb pains before and after treatment were evaluated by limb pain score and intermittent claudication score.Results:After 3 courses of treatment, the transcutaneous oxygen partial pressures and the wound blood flows of the 3 groups were significantly higher than those before treatment, and the percutaneous oxygen partial pressure and wound blood flow of the Group C after treatment were significantly higher than those of the Group A and the Group B, with statistically significant differences ( P<0.05). On the 14th and 21st day after treatment, the ulcer areas of the Group C were significantly lower than those of the Group A and the Group B, and the ulcer healing rate of Group C was significantly higher than those of the Group A and the Group B, with statistically significant differences ( P<0.05). On the 7th, 14th, and 21st day after treatment, the bacterial quantity in the ulcer tissue of the Group C was significantly lower than those in the Group A and the Group B ( P<0.05). After 3 courses of treatment, the scores of intermittent claudication and limb pain in the three groups were significantly lower than those before treatment, and the scores of limb pain and intermittent claudication in the Group C were significantly lower than those in the Group A and the Group B after treatment ( P<0.05). Conclusion:Hyperbaric oxygen combined with ultrasonic debridement can effectively remove bacteria in diabetic foot ulcer wound, promote microcirculation, and help ulcer wound healing. It is worthy of clinical application.

Objective:To investigate the clinical efficacy and mechanism of atorvastatin and Lipo-prostaglandin E1 (LipoPGE1) combined with hyperbaric oxygen (HBO) in the treatment of diabetic lower extremity vascular disease.Methods:A total of 194 patients with diabetic lower extremity ischemic disease received conservative treatment at the Department of Vascular Surgery of Longkou People’s Hospital from October 2016 to October 2019 were included into a retrospective analysis, who were divided into observation group ( n=102) and control group ( n=92) according to the treatment. The control group was treated with atorvastatin and LipoPGE1 on the basis of conventional symptomatic treatment, while the observation group was treated with HBO on the basis of that of the control group. The peak systolic velocity (Vmax), resistance index (RI), and ankle brachial index (ABI) of popliteal artery, anterior and posterior tibial artery, and dorsalis pedis artery were measured before and after treatment by color Doppler ultrasound. The skin temperature and transcutaneous oxygen partial pressure (TcPO 2) were recorded before and after treatment. The levels of inflammatory factor interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in serum were detected by enzyme-linked immunosorbent assay (ELISA) and that of C-reactive protein (CRP) was detected by fluorescence method. The whole blood high, low, and medium shear rate, plasma viscosity, and fibrinogen (Fib) of the two groups were detected by digital noninvasive hemodynamic detector. Results:After 3 courses of treatment, the skin temperature, TcPO 2, and ABI of the two groups were significantly higher than those before treatment, and the skin temperature, TcPO 2, and ABI of the observation group were significantly higher than those of the control group ( P<0.05). The limb pain score and intermittent claudication score of the two groups were significantly lower than those before treatment; and after treatment, the limb pain score and intermittent claudication score of the observation group were significantly lower than those of the control group ( P < 0.05). The Vmax of popliteal artery, anterior and posterior tibial artery, and dorsalis pedis artery of the two groups were significantly higher than those before treatment, and the RI was significantly lower than that before treatment; and after treatment, the Vmax of popliteal artery, anterior and posterior tibial artery, and dorsalis pedis artery of the observation group were significantly higher than those of the control group, and the RI was significantly lower than that of the control group ( P<0.05). The levels of serum TNF- α, IL-6, and CRP of the two groups were significantly lower than those before treatment; and after treatment, the levels of TNF-α, IL-6, and CRP of the observation group were significantly lower than those of the control group ( P < 0.05). The whole blood high, low, and medium shear rate, plasma viscosity, and Fib of the two groups were significantly lower than those before treatment; and after treatment, those of the observation group were significantly lower than those of the control group, the differences were statistically significant ( P< 0.05). Conclusion:Atorvastatin and LipoPGE1 combined with HBO can significantly improve the clinical symptoms of the patients with diabetic lower extremity vascular disease and restore the damaged neurovascular function, which is mainly achieved by reducing the inflammatory factors and improving the level of hemorheology of the patients with diabetic lower extremity vascular disease.

Objective:To investigate the clinical efficacy and mechanism of atorvastatin and Lipo-prostaglandin E1 (LipoPGE1) combined with hyperbaric oxygen (HBO) in the treatment of diabetic lower extremity vascular disease.Methods:A total of 194 patients with diabetic lower extremity ischemic disease received conservative treatment at the Department of Vascular Surgery of Longkou People’s Hospital from October 2016 to October 2019 were included into a retrospective analysis, who were divided into observation group ( n=102) and control group ( n=92) according to the treatment. The control group was treated with atorvastatin and LipoPGE1 on the basis of conventional symptomatic treatment, while the observation group was treated with HBO on the basis of that of the control group. The peak systolic velocity (Vmax), resistance index (RI), and ankle brachial index (ABI) of popliteal artery, anterior and posterior tibial artery, and dorsalis pedis artery were measured before and after treatment by color Doppler ultrasound. The skin temperature and transcutaneous oxygen partial pressure (TcPO 2) were recorded before and after treatment. The levels of inflammatory factor interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in serum were detected by enzyme-linked immunosorbent assay (ELISA) and that of C-reactive protein (CRP) was detected by fluorescence method. The whole blood high, low, and medium shear rate, plasma viscosity, and fibrinogen (Fib) of the two groups were detected by digital noninvasive hemodynamic detector. Results:After 3 courses of treatment, the skin temperature, TcPO 2, and ABI of the two groups were significantly higher than those before treatment, and the skin temperature, TcPO 2, and ABI of the observation group were significantly higher than those of the control group ( P<0.05). The limb pain score and intermittent claudication score of the two groups were significantly lower than those before treatment; and after treatment, the limb pain score and intermittent claudication score of the observation group were significantly lower than those of the control group ( P < 0.05). The Vmax of popliteal artery, anterior and posterior tibial artery, and dorsalis pedis artery of the two groups were significantly higher than those before treatment, and the RI was significantly lower than that before treatment; and after treatment, the Vmax of popliteal artery, anterior and posterior tibial artery, and dorsalis pedis artery of the observation group were significantly higher than those of the control group, and the RI was significantly lower than that of the control group ( P<0.05). The levels of serum TNF- α, IL-6, and CRP of the two groups were significantly lower than those before treatment; and after treatment, the levels of TNF-α, IL-6, and CRP of the observation group were significantly lower than those of the control group ( P < 0.05). The whole blood high, low, and medium shear rate, plasma viscosity, and Fib of the two groups were significantly lower than those before treatment; and after treatment, those of the observation group were significantly lower than those of the control group, the differences were statistically significant ( P< 0.05). Conclusion:Atorvastatin and LipoPGE1 combined with HBO can significantly improve the clinical symptoms of the patients with diabetic lower extremity vascular disease and restore the damaged neurovascular function, which is mainly achieved by reducing the inflammatory factors and improving the level of hemorheology of the patients with diabetic lower extremity vascular disease.

Objective: To compare the clinical effects of endoscopic laminectomy with traditional hemilaminectomy for lumbar spinal stenosis. Methods: From January 2016 to April 2017, 61 patients with lumbar spinal stenosis were treated surgi-cally. Percutaneous endoscopic laminectomy was performed in 32 patients (minimally invasive group), including 13 males and 19 females, aged 38-76 years, with an average age of 58.47±7.51 years. Twenty-nine patients (open group) underwent hemilaminecto-my, including 11 males and 18 females, aged 38-75 years, with an average age of 57.17±9.99 years. The operation time, bleeding, incision length, bedridden time and hospitalization time were recorded. Visual analogue scale(VAS), Oswestry disability index (ODI), dural sac cross-sectional area (DSCA), ventral intervertebral space height (VH), dorsal intervertebral space height (DH) and lumbar mobility (range of motion, ROM) were compared between the two groups. Results: All of 61 patients were followed up for 14 to 27 months, with an average of 19.2±2.95 months. The operation time was 60.88±6.49 min in the minimally invasive group, and 52.07±9.45 min in the open group (t=4.277, P=0.000). The blood loss of minimally invasive group was 55.63±10.14 ml, and that of open group was 78.79±12.58 ml (t=7.952, P=0.000). The incision length of minimally invasive group was 23.31±4.56 mm, and open group 82.59±7.66 mm (t=12.047, P=0.000). Bed rest time was 21.97±6.42 h in minimally invasive group and 78.79±12.58 h in open group (t=12.047, P=0.000). The hospitalization time of the minimally invasive group was 8.53±2.75 d and the open group 11.34±3.12 d (t=3.745, P=0.000). All these parameters had statistical significance (P<0.05). At the last follow-up, the VAS score of minimally invasive group was 1.06±0.56, and the open group was 1.14±0.74 (t=0.469, P=0.634). ROM of open group was 5.66±1.12 degree, and ROM of minimally invasive group was 5.56±1.13 degree (t=0.140, P=0.710), VH of minimally invasive group was 14.75±2.81 mm, and open group was 14.44±2.89 mm (t=0.181, P=0.672). There was no significant difference between the two groups for these parameters. At the last follow-up, ODI score was 13.25%±1.08% in the minimally invasive group and 14.28%±2.10% in open group (t=5.911, P=0.018). DSCA score was 108.56±8.69 mm² in the minimally invasive group, and 117.28±11.09 mm² in open group (t=11.774, P=0.001). There were significant differences between the two groups for ODI and DS-CA. Conclusion Both endoscopic and open laminectomy have excellent clinical effects on lumbar spinal stenosis. Endoscop-ic laminectomy has the advantages of less local trauma, less damage to the stability of the lumbar spine and faster recovery. However, there's a higher technical requirement for endoscopic spine surgery.

0.05).Traction reactions,the use of sedative and centrally acting anesthesia drugs during the operation were significantly less in group AEA than those in group EA(P

AIM: To observe the effect of small dose ephedrine on hypote ns ion as the lithotomy position in laying down legs after the aged in the operatio ns with epidural anesthesia. METHODS: Twenty-seven ASA Ⅰ-Ⅱma le patients, aged 65-83 (71? 6.5 ) years undergoing transurethral resection of prostate (TURP) with the lithotomy position were randomly assigned to two gro ups by double blind method: ephedrine group (n=13) and contrasti ve group (n=14). The continual epidural anesthesia was administe red in T 12 -L 1 and L 3-4 for all patients used 1.5 % lidocaine. W hen the operation was finished off, before thirty seconds of horizontal position laying down legs, 15 mg ephedrine was iv at ephedrine group and 3 ml saline wat er at control group. After legs were laid down on the lithotomy position, variab les of SBP, MBP and P were recorded in ten minutes. RESULTS: Dur ing ten minutes after double legs were laid down, the variables were lightly ris en about 8.7 % to 76.9 % in ephedrine group and were fallen about 7.8 % to 85.7 % in control group. The difference on variables of two groups was significant (P