Objective To explore the effects of early enteral nutrition therapy combined with micro-ecologicalpreparation on early intestinal function recovery in patients with severe acute pancreatitis (SAP). Methods The clinical data of 48 patients with SAP treated from January 2012 to January 2015 were retrospectively analyzed. Out of the 48 cases, 23 were treated with early enteral nutrition therapy (the control group), and 25 were treated with early enteral nutrition therapy combined with micro-ecologicalpreparation (the observation group). The counts of white blood cells (WBC), the levels of blood amylase, serum lipase, lactic dehydrogenase (LDH), and the scores of gastrointestinal function 1 day before treatment and on the 7th and 14th day of treatment were observed. The incidences of complications, case fatality rates, and lengths of hospital stay were recorded. Results One day before treatment, the differences in the counts of WBC, the levels of blood amylase, lipase, and LDH between the two groups were not statistically significant (P>0.05). On the 7th day of treatment, the counts of WBC, the levels of blood amylase, lipase, and LDH in the two groups decreased in varying degrees, and the decreasing in the observation group was more obvious (P<0.05). On the 14th day of treatment, the levels of blood amylase in the two groups were almost normal, and the difference between the two groups was not statistically significant (P>0.05); the levels of lipase, LDH and the counts of WBC in the observation group were lower than those in the control group (P<0.05). One day before treatment, the difference in the scores of gastrointestinal function between the control group (1.34±0.76) and the observation group (1.46±0.62) was not statistically significant (P>0.05); on the 7th and 14th day of treatment, the scores of gastrointestinal function in the observation group (0.37±0.18, 0.29±0.06) were lower than those in the control group (0.63±0.32, 0.47±0.08), and the differences were statistically significant (P<0.05). There were significant differences between the two groups in terms of the incidence of total complications and length of hospital stay (P<0.05), while the difference in the case fatality rate between the two groups was not statistically significant (P>0.05). Conclusion Early enteral nutrition combined with micro-ecological preparation is benefit to the intestinal function recovery in patients with SAP.
Purpose To evaluate the therapeutic effect of laser-induced chorioretinal venous anastomosis for retinal vein occlusion (RVO)． Methods The investigation included 28 consecutive patients (28 eyes) with RVO．The non-ischemic group 18-cases (18 eyes) we re tre ated with the krypton red laser to induce chorioretinal venous anastomosis， the ischemic group underwent the same therapy and the grid or scattertype photoco agulation at the same time． All of the eyes were followed up for more than 5 mo nths， and with an average period of 6.6 months． Results Seven cases (7 eyes， 38．9%) of the non-ischemic group created successful chorioretinal venous anastomosis， with mean improvement of 4．43plusmn;0．7 8 standard deviation lines of best corrected visual acuity compared to0.19plusmn;0.67 lines for 11 eyes with unsuccessful anastomosis (Plt;0.001)．None of the seven eyes developed to ischemic state． Four of the 11 eyes with unsuccessful anastomosis converted to ischemic type (36.4%) ．Two cases of the ischemic group created successful anastomosis with improvement in visual acuity． The other cases had no change in visual acuity． Conclusion Laser-induced chorioretinal venous anasto mosis is a new therapeutic method for RVO， especially for nonischemic type and successful anastomosis can decrease the conversion rate of the vein occlusion to an ischemic state． (Chin J Ocul Fundus Dis, 2001,17:8-11)
ObjectiveTo evaluate the changes of the flow parameters before and after the anastomotic port exploration and dredging during coronary artery bypass grafting by using the transit time flow measurement (TTFM).MethodsA total of 167 patients who underwent continuous coronary artery bypass grafting and anastomotic port exploration and dredging surgery in Beijing Anzhen Hospital from 2018 to 2019 were enrolled in this study. There were 136 male and 31 female patients aged 41-82 (58.35±17.26) years. If the probe entered and exited the anastomotic port smoothly, it was recorded as a non-resistance group; if the resistance existed but the probe could pass and exit, it was recorded as a resistance group; if the probe could not pass the anastomotic port for obvious resistance, it was recorded as the stenosis group. In the stenosis group, the grafts were re-anastomosed and the flow parameters were re-measured by TTFM.ResultsA total of 202 anastomotic ports were carried out by exploration and dredging. Among them, 87 anastomosis (43.1%) were in the non-resistance group, and there was no significant change in the blood flow volume (BFV) and pulsatility index (PI) before and after exploration and dredging (6.16±3.41 mL/min vs. 6.18±3.44 mL/min, P=0.90; 7.06±2.84 vs. 6.96±2.49, P=0.50). Sixty-four anastomosis (31.7%) were in the resistance group, the BFV was higher after exploration and dredging than that before exploration and dredging (17.11±7.52 mL/min vs. 4.96±3.32 mL/min, P<0.01), while the PI was significantly smaller (3.78±2.20 vs. 8.58±2.97, P<0.01). Fifty-one anastomosis (25.2%) were in the stenosis group, and there was no significant change in the BFV and PI before and after exploration and dredging (3.44±1.95 mL/min vs. 3.48±2.11 mL/min, P=0.84; 10.74±4.12 vs. 10.54±4.11, P=0.36). After re-anastomosis, the BFV was higher (16.48±7.67 mL/min, P<0.01) and the PI deceased (3.43±1.39, P<0.01) than that before exploration and dredging.ConclusionThe application of anastomotic exploration and dredging can reduce the occurrence of re-anastomosis, and promptly find and solve the stenosis of the distal coronary artery, improve the poor perfusion of distal coronary, and thus improves the prognosis of patients.
目的探讨乳腺腺肌上皮瘤临床特点、诊断及治疗方法。方法回顾性分析乳腺腺肌上皮瘤6例。结果6例均表现为乳腺包块，直径在1.5～3 cm之间，对其均行乳腺包块切除术。术后随访6个月～6年，无复发。结论乳腺腺肌上皮瘤为良性肿瘤，首选治疗为包括肿瘤组织的局部扩大切除术。
ObjectiveTo evaluate the effectivness of using high porous polyethylene lower eyelid spacers (Medpor LES) combined with the lateral tarsal-strip procedure for reconstruction of the eyelid closure function in paralytic lagophthalmus after facial palsy. MethodsBetween March 2008 and December 2012, 32 patients (32 eyelids) with hypophasis in facial palsy which all sorts of causes lead to were treated with Medpor LES combined with the lateral tarsal-strip procedure. Of 32 cases, 20 were male and 12 were female, aged from 20 to 72 years (mean, 46.8 years). The left eye was involved in 18 cases and the right eye in 14 cases with a disease duration of 1.5 months to 2 years (mean, 4.4 months). All the patients were shown as lower eyelid ectropion, lower eyelid retraction, exposure keratitis, and corneal ulcer, but no obvious upper eyelid retraction was observed. ResultsPrimary healing of incision was obtained in all patients. The edema time of the eyelid was from 5 days to 3 weeks (mean, 2 weeks). Conjunctival edema appeared in 4 cases after 2 weeks of operation, which was cured after expectant treatment. The patients were followed up 5-8 months (mean, 6 months). At 1 week, 3 and 6 months after operation, the height of palpebral fissure was reduced, and the degree of lagophthalmus and low eyelid retraction were significantly corrected (P<0.05), but no significant difference among different time points after operation (P>0.05). Outer canthus displacement occurred in 3 cases at 1 month postoperatively, and was cured after the lateral tarsal strip procedure. No lower eyelid ectropion, corneal exposure, or Medpor LES displacement and exposure occurred during follow-up. ConclusionMedpor LES combined with the lateral tarsal-strip procedure has good effectiveness for reconstruction of eyelid closure function in most cases of paralytic lagophthalmus after facial palsy.
ObjectivesTo provide a reference for the evaluation procedures of genetic testing technology applicable to China by combining the existing evaluation frameworks and procedures for genetic testing techniques globally, and also put forward design suggestions for the construction of evaluation procedures in China.MethodsThe literature research method was primarily used to summarize different evaluation progress, as well as put forward design suggestions.ResultsAt present, numerous developed countries have organized genetic testing technology evaluation projects. The various evaluation frameworks developed were based on the ACCE or HTA framework. The evaluation and decision-making procedures were similar in general, including topic selection, evaluation implementation, results reporting and making recommendations. However, there still remained difficulties such as limited evidence and uncertainty in decision-making.ConclusionsTo establish the procedures of genetic testing technology applicable in China, the following specific procedures are recommended: selecting target genetic testing technology topics; analyzing necessity and feasibility of target testing technology evaluation; evaluating and reviewing the evidence; applying results and decision-making transformation; developing regular review and revision mechanisms.