Objective:To investigate the predictive efficacy of global inhomogeneity (GI) index based on pulmonary electrical impedance tomography (EIT) in postoperative pulmonary infection of patients with craniocerebral trauma.Methods:A total of 90 patients with emergency craniocerebral trauma underwent surgery under general anesthesia in Suzhou Science & Technology Town Hospital. According to the complication of pulmonary infection at the 3rd day after operation, they were divided into the pulmonary infection group (P3 group) and non-pulmonary infection group (NP3 group), and according to the complication of pulmonary infection at the 7th day after operation, they were divided into the P7 group and NP7 group. The average GI index within 5 min before anesthesia induction (T 0) and 5 min after endotracheal intubation (T 1) and other clinical data in the perioperative period were collected. The prevalence of pulmonary infection at the 3rd and 7th days after operation was recorded. Receiver operating characteristic (ROC) curve was used to evaluate the predictive value of preoperative GI index for pulmonary infection at the 3rd and 7th days after operation. Results:A total of 88 patients were included. Among them, 26 patients developed pulmonary infection within 3 days after operation, and the prevalence rate was 29.5%. Pulmonary infection occurred in 38 patients within 7 days after operation, and the prevalence rate was 43.2%. Within 3 days after operation, the preoperative Glasgow Coma Scale score in the P3 group was significantly lower than that in the NP3 group ( P < 0.05). Within 3 days after operation, GI index in the P3 group increased significantly at T 1 when compared with the NP3 group ( P< 0.001). Within 7 days after operation, GI index in the P7 group increased significantly at T 1 when compared with the NP7 group ( P < 0.05). GI index at T1 accurately predicted pulmonary infection within 3 days after operation (AUC = 0.857, P < 0.001), and the best intercept value was ≥0.4225 (sensitivity: 0.846, specificity: 0.823). GI index at T 1 predicted pulmonary infection within 7 days after operation (AUC = 0.667, P < 0.005), and the best intercept value was ≥0.4225 (sensitivity: 0.579, specificity: 0.780), but the prediction efficiency was poor. Conclusions:The average GI index within 5 min after endotracheal intubation can be used as an effective predictor of pulmonary infection within 3 days after operation.

Objective:To investigate the clinical effect of laparoscopic assisted removal of greater omentum free transplantation combined with skin grafting for the repair of large area refractory wounds.Methods:From June 2013 to June 2018, 18 cases of lower extremity skin and soft tissue defects with multiple bone, joint, tendon and internal plants exposure were admitted to Hanzhong Central Hospital, including 12 males and 6 females, aged from 15 to 50 years old, with an average age of 32.6 years old. The area of skin and soft tissue defect: 30 cm×12 cm-53 cm×21 cm. The operation was divided into two stages. In the first stage, the greater omentum was acquired with the assist of laparoscope and free transplanted to cover the wound. After the greater omentum free transplantation was confirmed to survive, the split-thickness skin graft was applied for wound repair.Postoperative survival of the greater omentum and skin grafting, complications, appearance and function of lower limbs were observed and followed up.Results:The 18 operations were performed successfully, the area of omentum resection was 25 cm×10 cm-35 cm×15 cm, all the greater omentums survived after operation without complications such as intestinal adhesion, volvulus and peritonitis. The area of the skin grafting was 36 cm×8 cm-45 cm×22 cm. 16 cases skin grafting survived completely, 2 cases skin grafting were necrosis just local small area, and scar healed after dressing change. Postoperative follow-up of 6-12 months showed good appearance and function of lower limbs and satisfactory results.Conclusions:For the large area soft tissue defect wound of lower extremity, complicated with multiple deep tissues such as bone, joint and internal materials exposed, the greater omentum free transplantation under laparoscope combined with medium thick skin graft second stage has the advantages of good appearance and function after wound healing, less donor injury and fewer postoperative complications.

Objective:To investigate the clinical effect of laparoscopic assisted removal of greater omentum free transplantation combined with skin grafting for the repair of large area refractory wounds.Methods:From June 2013 to June 2018, 18 cases of lower extremity skin and soft tissue defects with multiple bone, joint, tendon and internal plants exposure were admitted to Hanzhong Central Hospital, including 12 males and 6 females, aged from 15 to 50 years old, with an average age of 32.6 years old. The area of skin and soft tissue defect: 30 cm×12 cm-53 cm×21 cm. The operation was divided into two stages. In the first stage, the greater omentum was acquired with the assist of laparoscope and free transplanted to cover the wound. After the greater omentum free transplantation was confirmed to survive, the split-thickness skin graft was applied for wound repair.Postoperative survival of the greater omentum and skin grafting, complications, appearance and function of lower limbs were observed and followed up.Results:The 18 operations were performed successfully, the area of omentum resection was 25 cm×10 cm-35 cm×15 cm, all the greater omentums survived after operation without complications such as intestinal adhesion, volvulus and peritonitis. The area of the skin grafting was 36 cm×8 cm-45 cm×22 cm. 16 cases skin grafting survived completely, 2 cases skin grafting were necrosis just local small area, and scar healed after dressing change. Postoperative follow-up of 6-12 months showed good appearance and function of lower limbs and satisfactory results.Conclusions:For the large area soft tissue defect wound of lower extremity, complicated with multiple deep tissues such as bone, joint and internal materials exposed, the greater omentum free transplantation under laparoscope combined with medium thick skin graft second stage has the advantages of good appearance and function after wound healing, less donor injury and fewer postoperative complications.

Kidney cancer usually requires multidisciplinary individualized treatments. No matter what kind of treatment, drugs are essential. According to the "six-step process" (prescription legitimacy review, patient basic information evaluation review, treatment protocol review, organ function and laboratory index review, pretreatment review, and unconventional prescription review) in prescription review proposed by the anti-tumor drug prescription review expert group and referring to domestic and foreign kidney cancer guidelines and drug instructions in recent years, this consensus selects 9 targeted drugs and 4 immunotherapeutic drugs that are currently commonly used in China and elaborates the key review points in patient basic information evaluation review, treatment protocol review, and organ function and laboratory index review of kidney cancer drug treatment, in order to provide reference for clinical front-line pharmacists to review prescriptions of kidney cancer patients and promote rational drug use in clinic.

Kidney cancer usually requires multidisciplinary individualized treatments. No matter what kind of treatment, drugs are essential. According to the "six-step process" (prescription legitimacy review, patient basic information evaluation review, treatment protocol review, organ function and laboratory index review, pretreatment review, and unconventional prescription review) in prescription review proposed by the anti-tumor drug prescription review expert group and referring to domestic and foreign kidney cancer guidelines and drug instructions in recent years, this consensus selects 9 targeted drugs and 4 immunotherapeutic drugs that are currently commonly used in China and elaborates the key review points in patient basic information evaluation review, treatment protocol review, and organ function and laboratory index review of kidney cancer drug treatment, in order to provide reference for clinical front-line pharmacists to review prescriptions of kidney cancer patients and promote rational drug use in clinic.

Objective To analyze the incidence of coronary myocardial bridge (MB) of the Uyghur and Han peoples with 64-slice CT. Methods A total of 1350 patients with suspected of coronary disease or other diseases underwent coronary angiography with 64-slice CT, among them 341 patients were diagnosed as MB, including 260 Han people, 70 Uyghur people, 7 Muslim people and 4 people of Kazak ethnic minority group. The incidence of MB of the Uyghur and Han people was calculated respectively; incidence of MB in proximal, middle and distal segment of left anterior descending (LAD), the first diagonal branch (D1), the second diagonal branch (D2), obtuse marginal (OM), left circumflex (LCX) and right coronary artery (RCA) between two races were compared with Chi-Square test. Results Totally 341 patients had 439 MB, 332 in Han people, 92 in Uyghur people, 9 in Muslim people and 6 in Kazak ethnic minority group with 64-slice CT. There was no statistical significance of MB incidence between the Uyghur and Han people in coronary artery (P＞0.05), including the proximal, middle and distal segment of LAD. Conclusion The 64-slice CT can effectively detect MB with a high special resolution. There is no statistical significance of MB incidence between the Uyghur and the Han people in each coronary artery.