الملخص
Objective To investigate the development and application of a simple one-time cricothyroid membrane fast trocar.Methods The cricothyroid membrane puncture ventilation device can be divided into two parts.Respectively was the casing column stabber parts,parts of the cutter head was an isosceles triangle,the column part slightly flat column arc,the rear end was provided with a cylindrical handle,it was also casing inner core.The second was casing parts.Corresponding for columnar needle knife,the rear end of the sleeve had a cylindrical breathing tube interface,can be connected with the breathing bag or ventilator breathing.Material thyrocricoid puncture sleeve was ABS engineering plastic,the first trial was made of three D printer technology.After technology finished the plastic injection machine or machine production were used to make it.Using this instrument 6 healthy dogs were in the cricothyroid membrane puncture.Respectively after operation with 2 days,4 days,7 days,drug treatment did not be taken during this period after they were observed after 6-12 months.Results 6 dogs were thyrocricocentesis cannulation success only once,with no infection.For 6-12 months after extubation,the dogs bark and systemic activity were normal,no abnormal shortness of breath,breathing difficulties and complications were taken placed.Conclusion The research and production of this instrument has been successful,through animal experiments illustrate the use of this device is safe and effective.It has the advantages of convenient operation and no complications.
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Objective To study the validity of RAND-UCLA (Rand Corporation and University of California at Los Angeles) consensus panel method in developing guidelines of referral indications for low back pain (LBP).Methods Evidence-based clinical guidelines for LBP management at community level and its referral guidelines published since 2001 and other tools were retrieved with varied tools.All clinical guidelines met inclusion criteria were evaluated with clinical studies and evaluation tools (AGREE).An pool of indication items was established based on evidence for developing referral indications for LBP, which were added by RAND-UCLA consensus panel method, and alternative referral indications were selected and clinical guidelines for LBP referral were established.Results A total of 15 copies of clinical guidelines from nine countries or regions were included in it after critical appraisal.Four copies of referral guidelines from two countries were included.Referral indications for LBP were derived directly from the RAND-UCLA consensus panel process, consisting of 44 referral indications for three groups (immediate, urgent and routine referral).Conclusions The RAND-UCLA consensus panel method is a more useful and practical tool in developing clinical guidelines, referral guidelines, which is worthwhile being recommended and spread.
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Objective To evaluate the feasibility and therapeutic effect of kyphoplasty in treating severe osteoporotic vertebral compressive fractures. Methods Thirty-five patients (48 vertebral bodies) with severe osteoporotic compressive fractures were included. There were 33 females and 2 males with the mean age of 74.2 years. The average compressive rate of the affected vertebral bodies was 77.0%. The thoracolumbar vertebrae were treated with kyphoplasties. Percutaneous puncture direction was adjusted according to compressive rate and shape of the vertebral bodies. The inflatable bone tamp was inserted into the fractured vertebral body. The balloon was inflated with low pressure and dilate-relieve-dilate method was applied. The balloon was deflated and withdrawn, leaving a cavity within the vertebral body, which then fulfilled with visualized bone cement. Preoperative and postoperative symptom level, complications and radiographic findings were recorded. Results All 35 patients tolerated procedure well. The mean heights of the anterior, mid and posterior vertebral body had improved from (0.8±0.1) cm, (0.8±0.2) cm, (2.1 ±0.8) cm preoperatively to (1.2±0.3) cm, (1.3±0.2) cm, (2.3±1.0) cm respectively after operation (P <0.05). There was significance difference between preoperative and postoperative heights of the anterior and mid vertebral body. The mean kyphosis was improved from 28.2°±5.2° before operation to 19.1°±4.9° after operation. Conclusion Kyphoplasty is feasible and effective for severe osteoporotic vertebral compressive fractures.
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Objective To observe the clinical therapeutic outcomes and the radiographs changes of lumbar degeneration disease treated by dynamic stabilization device (Wallis). Methods Eighty-four cases of lumbar degeneration disease were treated by threaded fusion cage, from May 1997 to May 2002. The JOA scores, the rate of fusion,cage sink and adjacent segment degeneration were observed. Results The average hospitalizotion was 23.59 days. The mean operation time was 3.00 hours. The mean JOA scores were 13.93 before the operation,while 26.69 on the end of the following time respectively; there was statistical significant. The mean motion of operative segment was 5.22 before operation, while 2.44 on the end of the following time respectively. The mean extension of operative segment was 3.32 before operation ,while 1.39 on the end of the following time respectively. The mean motion of adjacent segment was 3.68 before operation, while 6.54 on the end of the following time respectively. The mean extension of adjacent segment was 1.95 before operation,while 3.95 on the end of the following time respectively. There were all statistical significant on those changes of Cobbs angel. Conclusions The long-term therapeuptic effect of WALLIS treatment for lumbar degeneration disease is reliable. The motion of operative segment was significant decreased, especially on extension. The motion of adjacent segment was significant increased, the degree extension of adjacent segment was also significant increased.
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AIM The quality standard of Tongmai Jiangzhi Capsules (Rhizoma Curcumae Longae, Radix et Rhizoma Rhei, Fructus Ligustri Lucidi, Rhizoma Alismatis) has been established. METHODS TLC was used to identify curcumin, rhein, emodin, chrysophanol and aloe-emodin. HPLC was used to determine the content of curcumin, free-chrysophanol and free-emodin. RESULTS[WTBZ]: The linear relation was excellent for determination with ODS column and methanol-water-acetic acid(77∶ 22∶ 1)as mobile phase. The average recoveries of curcumin, free-emodin, free-chrysophanol were 101.8 % , 97.55 % and 97.64 % , respectively. The curcumin content in capsule was 2.27 mg, free-emodin 0.162 mg, free-chrysophanol 0.291 mg. CONCLUSION The methods are available with a good reproducibility and can be used to control the quality of Tongmai Jiangzhi Capsules.