Advanced Emergency Medicine (E-Journal)
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Computer-assisted surgery navigation of pedicle screw insertion by standardized trainees
Get PDFObjective: To assess the precision and efficiency computer-assisted surgery navigation of pedicle screw insertion by standardized trainees. Methods From September 2013 to June 2016, 360 thoracic pedicle screws were inserted into 100 patients by standardized trainees (n = 30). Screws on the left side were inserted by hands (control group), while the other side were inserted under the guidance of computer-assistant navigation system (guided group). The insertion time and volume of blood lost by each screw were retrospectively analyzed. The precision ratio was assessed by computerized tomography (CT) scan after operation. Results The time consumed in screw insertion was significantly shorter in the guided group than that in the control group. The blood lost volume was lesser in the guided group. Post-operation CT scan revealed higher precision in the guided group than that in the control group. Conclusion Computer-assistant navigation system facilitates the learning of standardized trainees, and reduces the time-consuming and bleeding in thoracic pedicle screw insertion. Orthodontics training is the most important low-grade physician training in the orthopedic department1,2. Due to the complexity of spinal anatomy, professional required and high risk of spinal surgery, thoracic pedicle screw implantation has become a very demanding technique. Furthermore, the spine surgery learning is not conducive to the trainees. Since 2013, our department started to use the computer-assisted three-dimensional navigation technology to guide the implantation of screws3. We found that the computer-assisted navigation technology has greater advantage when compared with the traditional hand-implanted technology
Clinical study of endoscopic mucosal resection for digestive tract early cancer and precancerous lesions treatment
Get PDFThe clinical effect of endoscopic mucosal resection (EMR) on the digestive tract of early cancer and precancerous lesions was analyzed. 63 patients with early gastrointestinal cancer and precancerous lesions treated in our hospital from January 2013 to May 2015 were recruited for this study. Patients were randomly divided into the observation group (32 cases) and the control group (31 cases). The control group underwent conventional surgical treatment, while the observation group underwent EMR treatment. Both groups were observed for the clinical effect. The curative resection rate was 100.0% (P > 0.05). The postoperative complication rate in the observation group was 3.1% (1/32) and 25.8% (8/31) in the control group. The operative time for the observation group was significantly shorter than the control group (P < 0.05). Study subjects were followed up for 1 year. Both groups showed no primary tumor metastasis and recurrence (P > 0.05). EMR treatment showed good effect and significantly fewer complications in patients with early gastrointestinal cancer and precancerous lesions
Present Situation and Progress of Pancreatic Cancer Radiotherapy
Get PDFPurpose: The research purpose is to effectively improve treatment effect of postoperative pancreatic cancer.Approaches: Adjuvant radiotherapy and chemotherapy; Palliative radiotherapy is adpoted for patients whose pancreatic cancer cannot be removed through excision. Comprehensive treatment approach is adopted where gemcitabine is added during radiotherapy. Result: The treatment effect of palliative operation is a little bit better than the traditional operative treatment, adoption of comprehensive treatment is obviously superior to the aforesaid two treatment approaches.Conculsion: Comprehensive treatment effectively improves survival rate of patients, and the survival time is greatlyextended.Operation is generally adopted for pancreatic cancer treatment, but the effect is unsatisfactory. The averagelifetime of patients after palliative operation treatment is only 5 to 76 months, and the survival rate after five years only reaches 8% to 15%, while the curative effect of radical resection is a little bit better, but the survival rate after five years also only reaches 12% to 24%, and the average lifetime is about 10 to 19 months. In recent years, with gradual progress of medical treatment level, clinical cases of adopting radiotherapy for pancreatic cancer are increasing, but its main effect is palliative or auxiliary. This article refers to plenty of documentation, makes thorough study of present situation and progress of pancreatic cancer radiotherapy, put forward its own suggestions and opinions, and have certainreference value
Detection of HBV DNA by PCR and its application in clinical transfusion
Get PDFThis study was done in order to detect the hepatitis B virus (HBV) DNA copies in patients through blood transfusions; recessive carriers with HBsAg negative but HBV DNA positive were further studied to see the content and distribution of HBV in patients, and provide evidence for the clinical treatment. A total of 532 blood samples collected from July 2014 to July 2015 were tested for HBV-DNA viral load and hepatitis B serological markers using quantitative Polymerase Chain Reaction (qPCR) and serologic test (the five serological markers of hepatitis B). The results showed that, 3 cases were HBV serology negative and the HBV-DNA viral load was in the range of 250–500 whereas only 1 case was HBsAb positive and the HBV-DNA viral load was in the range of 500 and above. Quantitative PCR, for detecting HBV DNA, together with serological routine test can effectively reduce the risk of transfusion and prevent medical disputes
Progress in the treatment of sudden deafness
Get PDFIn recent years, the incidence of sudden deafness has a tendency to rise. Most scholars believe that the cause of the disease are virus infection, lymph fluid and cochlear circulation dysfunction and so on. The above several etiology may play a role in the process of sudden deafness, it is hard to isolate one of the causes, so there is no definite treatment of sudden deafness, the treatments of sudden deafness are based on the conjectural cause, lacking pertinence. This paper summarize the treatments of sudden deafness, in order to explore better ways to treat sudden deafness and to promote the development of clinical research
Infection Analysis and Control Strategy of Intravenous Drug Config-uration Central Hospital
Get PDFPurpose: Conducting analysis mainly on the infection situation of intravenous drug configuration central hospital and take appropriate infection control strategies in order to reduce its infection rates. Method: 300 cases of transfusion patients were randomly divided into experimental and control group of 150 cases respectively. Experimental group of patients took systemic infection prevention and control measures, while control group of patients took merely the traditional nursing intervention. Comparative analysis of infection factors and rate of incidence were conducted on both groups of patients. Results: the main causes of infection in the drug configuration central hospital were operator personnel and storage of drugs etc.. Infection rate of the experimental group was lower than that of the control group, which the difference was statistically significant (P < 0.05). Conclusion: Strengthening attention towards the relevant factors in order to achieve minimum incidence of infections in the hospital
Research and Analysis for Cancerous Perianal Disease
Get PDFObjective To analyze cancerous perianal disease. This study summed up the effective measures for prevention and treatment of perianal cancer patients. Methods Twelve perianal cancer patients were recruited from June 2011 to June 2016. Retrospective analysis was carried out for the 12 patients and further discussed for the factor of cancerous and effective treatment. Results Systematic analysis found out that six patients had hemorrhoids cancer (only two patients received treatment, one patient had metastasis and received chemotherapy; 1 patient had good prognosis after colon diversion; the rest of the patients were discharged from the hospital and received conservative treatment but treatments were ineffective and the condition worsen), two patients had anal fistula cancer (one patients underwent surgery, one patient gave up treatment), two patients had anal cancer (both underwent surgery), one patient had perianal skin squamous cell carcinoma (patients were transfer to other hospital for treatment), one patient had perianal melanoma (inpatient due to perianal neoplasm, histopathology confirmed melanoma and patient gave up for treatment).Conclusion Perianal cancerous phenomenon is unfavorable for the quality of life and health of patients. The relevant medical institutions must actively take measures against the perianal cancer, which has significant effect to survival of patients
Observation on the Curative Effect of Madopar Combined with Pramipexole in the Treatment of Parkinson’s Diseases
Get PDFParkinson’s disease is a common neurological degenerative disease in the elderly. The clinical manifestations are static tremor, increased muscle tone, slow movement, abnormal posture gait, and severe symptoms of loss of self-care. Parkinson’s disease has become a burden to not only patient, but also to his family and to the society. Normal human brain neurotransmitter dopamine and acetylcholine are in a balanced state, the two antagonism can maintain normal body function. The pathological changes of patients with Parkinson’s disease is degeneration and apoptosis of dopaminergic neurons in striatum, resulting in a significant reduction in dopamine levels, and thus lead to an imbalance in the effects of dopamine and acetylcholine, and a decrease in dopamine resistance to acetylcholine Parkinson’s disease symptoms. As such, this article will focus on the analysis of the Madopar and pramipexole in the treatment of Parkinson’s disease symptoms
Uncommon Variant of Wellens’ Syndrome: A Case Report and Review of Literature
Get PDFA 48-year-old male was admitted to the emergency department because of intermittent chest pain of 2 days duration. At the time of examination, he was pain-free. An electrocardiogram (ECG) showed biphasic T waves in leads V2 to V6. Troponin-I level was negative. During his transfer to the cardiac catheterization laboratory, he had a short episode of chest pain. His ECG was normal. Despite the unusual extension of biphasic T waves to the lateral precordial leads, the condition was recognized as Wellens’ syndrome, which typically associates biphasic or deep symmetric T wave inversion in leads V2 and V3 during pain-free periods with a critical stenosis in the proximal left anterior descending artery. The syndrome is uncommon to medical practice but should be recognized immediately in the emergency department because it represents a pre-infarction stage and carries a high risk of mortality.Â
Synergistic effect of scavenger receptor A and low-density lipoprotein receptor on foam cell formation
Get PDFThe aim of the study is to investigate the effect of LPS on the expression of scavenger receptor A (SR-A) and low-density lipoprotein receptor (LDL-R) genes and proteins in RAW264.7 cell line. RAW264.7 cells were incubated in serum-free medium randomly in the absence or presence of low-density lipoprotein (LDL) alone, LDL+LPS and LPS alone. Intracellular cholesterol contents were assessed by Oil Red O staining cholesterol enzymatic assay, tumor necrosis factor α levels in the supernatants were measured by enzyme-linked immunosorbent assay (ELISA), mRNA and protein ex-pressions of SR-A and LDL-R in the treated cells were assessed by semi-quantitative polymerase chain reaction and western blot, respectively. LPS was able to up regulate SR-A mRNA and protein expressions, override LDL-R suppression induced by a high dose of LDL and increase LDL uptake by enhancing receptor expression, leading to foam cell formation in Raw264.7 cells. Synergistic effect of the upregulation of SR-A and dysregulation of LDL-R under inflammatory stress may contribute to macrophage-derived foam cell formation.Â