Objective To explore the clinical characteristics and influencing factors of acute colonic pseudo-obstruction(ACPO)after emergency cesarean section.Methods A total of 22 parturients with ACPO after emergency cesarean section who were admitted to Hebei Children's Hospital from January 2019 to June 2023 were retrospectively selected and assigned to the ACPO group,and 110 parturients without ACPO after emergency cesarean section during the same period were selected as the non-ACPO group,according the ratio of 5∶1.The clinical characteristics of the ACPO group were observed.The clinical data of the two groups were collected and compared.Multivariate logistic regression methods were used to analyze the risk factors of ACPO after emergency cesarean section.Results All the patients with ACPO after emergency cesarean section presented with progressive abdominal dull pain,nausea and vomiting,abdominal distension,cessation of defecation and exhaust or a small amount of defecation and exhaust.Physical examination showed abdominal bulge,especially in the upper and right abdomen,with mild tenderness and with no rebounding pain.Univariate analysis showed that there were no significant differences in the maternal age,gestational weeks,embryo number,gravidity,parity,prenatal body mass index(BMI),cause of emergency cesarean section,pregnant complications,general anesthesia,preoperative albumin level or postoperative analgesia between the two groups(all P>0.05);the proportions of operation time≥60 min,blood loss≥800 ml,history of abdominal surgery,cocurrent chronic pelvic inflammatory disease,and intraoperative removal of uterine fibroids in the ACPO group were significantly higher than those in the non-ACPO group(all P<0.05).Multivariate logistic regression analysis showed that operation time≥60 min(OR=5.761),concurrent chronic pelvic inflammatory disease(OR=3.241),and intraoperative removal of uterine fibroids(OR=4.319)were the risk factors of ACPO after emergency cesarean section(all P<0.05).Conclusion Operation time≥60 min,concurrent chronic pelvic inflammatory disease,and intraoperative removal of uterine fibroids are the risk factors of ACPO after emergency cesarean section.More attention should be paid to the parturients with the above-mentioned risk factors after emergency cesarean section,and preventive measures should be taken in advance to effectively reduce the risk of postoperative ACPO.

Background:Dissolution therapy is used as an alternative to surgery in patients with gallbladder stone and contraindication for surgery.Finding medicines with optimal litholysis effect and low cytotoxicity is of great importance in clinical practice.Aims:To study the litholysis effect and biological safety of different ethers for gallbladder stones.Methods:Methyl tertiary-butyl ether (MTBE),ethyl tertiary-butyl ether (ETBE),ethylene glycol mono-tert-butyl ether (ETB),and di (ethylene glycol) tert-butyl ether (DETB),arranged by the order of relative molecular weight,were used to dissolve the gallbladder stones in vitro.Normal human liver cell line LO2 was treated with the above mentioned four ethers,and the cell viability was assessed by CCK-8 assay for analyzing the proliferative toxicity.Thirty Sprague-Dawley rats were administered intragastrically with the four ethers for 2 weeks,and then the serum biochemical indices and histopathology of liver,lung,kidney,stomach,duodenum and jejunum were examined.Results:The litholysis effect of MTBE was the most prominent (P ＜ 0.05);that of ETB and DETB were weaker than ETBE (P ＜ 0.05) but still had a substantial effect.CCK-8 assay showed that ETBE was the most toxic ether (P ＜ 0.05),and the proliferative toxicity of ETB and DETB was similar (P ＞ 0.05).Except for the slightly increased serum AST in MTBE,ETBE and ETB groups (P ＜ 0.05),the four ethers had no significant impact on serum biochemical indices and histopathology of multiple organs of the model rats.Conclusions:The increase of relative molecular weight of ether may reduce its litholysis effect,but meanwhile its biological safety is increased.

Objective To evaluate the diagnostic value of multi-slice three-dimensional computed tomographic angiography(MS 3D-CTA)for vertebrobasilar dolichoectasia(VBD).Methods MS 3D-CTA of 10 patients with VBD were retrospectively analysed.Source images were got by GE Lightspeed pro scanner.Volume rendering(VR)and maximum intensity project (MIP) were adopted to reconstruct 3D images in all cases.Twenty patients were selected as the control group by suspected cerebra[vascular diseases and underwent MS 3D-CTA at the same period.Enumeration data between the patient group and the control group was assessed by Wilcoxon.test.Results There were 2 types of 10 cases with VBD,including simple type(n=4)and saddle type(n=6).Compared with the control group of the length of the basilar artery(B 1,25.60 mm),the deviant degree(Bc,1.20 mm),the height(Bh,1.90 am),the length of the vertebral artery (V1,17.55 mm),the deviant degree(Vc,2.05 mm),and the diameter of BA and/or VA (Bw/Vw,3.05 mm),there is significant difference in the B1 30.20 mm,Bc 7.10 mm,Bh 8.80 mm,V1 23.00 mm,Vc 5.95 mm,and Bw/Vw 5.05 mm(P＜0.01,all).Conclusion The clinical performances of VBD is different,MS 3D-CTA is a very effective method for the diagnosis of VBD.

Objective To explore the evolution and treatment of traumatic subdural effusion(TSE).Methods The clinicsl materials of 66 patients with TSE were analyzed retrospectively.Results 53 patients were cured with comervative therapy,and other patients were evolved into chronic subdural hematoma(CSDH).8 patients with CSDH were cured with surgery and others with conservative therapy.Conclusion Patients with TSE don't need surgery,and then patients with clinical characteristics will be operated when TSE evolves into CSDH.