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Objective:To investigate the impact of multidisciplinary diagnosis and treatment on postoperative 30-day mortality and complications in elderly patients with hip fracture.Methods:A retrospective analysis was conducted of the 260 elderly patients with hip fracture who had been treated by the mode of multidisciplinary diagnosis and treatment at Department of Orthopedics, Shenzhen Second People's Hospital from June 2018 to October 2019. The multidisciplinary group consisted of 66 males and 194 females with an age of 78.7 years ± 5.1 years, and 141 femoral neck fractures, 114 intertrochanteric fractures and 5 subtrochanteric fractures. They were compared with the 242 elderly patients with hip fracture (traditional group) who had been treated by the traditional mode from January 2017 to May 2018. The 2 groups were compared in terms of preoperative waiting time, 48-hour operation rate, 30-day mortality, and incidences of postoperative pneumonia and pressure ulcer.Results:There were no statistically significant differences in the preoperative general data or operative procedures between the 2 groups, showing comparability ( P>0.05). For the multidisciplinary group, preoperative waiting time was 41.9 h ± 36.5 h, significantly shorter than that for the traditional group (71.4 h ± 13.9 h), 48-hour operation rate 66.5% (173/260), significantly higher than that for the traditional group(8.7%, 21/242), incidence of postoperative pneumonia 3.1%(8/260), significantly lower than that for the traditional group(9.9%, 24/242), incidence of postoperative pressure ulcer (5.4%, 14/260), significantly lower than that for the traditional group(11.2%, 27/242), and 30-day mortality(2.3%, 6/260), significantly lower than that for the traditional group(5.8%, 14/242) (all P<0.05). Conclusions:Establishment of a mode of multidisciplinary diagnosis and treatment can significantly reduce the prolonged preoperative waiting time for elderly patients with hip fracture, thereby greatly reducing postoperative complications and postoperative 30-day mortality.
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OBJECTIVE The short-term efficacy of endoscopic adenoid hypothermic plasma ablation and its effect on Eustachian tube function. METHODS 75 patients with obstructive sleep apnea hypopnea syndrome who were treated in our hospital from March 2013 to March 2015 were divided into two groups according to the different operative methods: nasal power cutting group(30 cases) and low temperature plasma ablation group(45 cases), comparison of the two groups of patients with surgery time, intraoperative blood loss and follow-up after 6 months of clinical efficacy and Eustachian tube function. RESULTS The time of resection, operation time and intraoperative blood loss were significantly better in the low-temperature plasma ablation group than that in the rhinectomy group, the difference was statistically significant(P0.05). CONCLUSION The clinical efficacy of low-temperature plasma ablation is close to nasal dynamic cutting, but low-temperature plasma ablation surgery in the amount of bleeding was significantly less than the nasal excision. This surgical approach is minimally invasive and safe, but its postoperative secondary infection and secondary bleeding is high, so this need for further study.
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Objective To study the extraction,registration and fusion of the image contour of liver CT scan sequence.Methods Filtering method was used to remove the noise and enhance the edge of the image,and then the contour of the CT image was extracted.According to the optimal registration parameters,the hepatic arterial phase and venous phase images were registered,and the corresponding relationship between the arterial and venous images was determined.At last,the CT images of the arterial and venous phase were fused.Results After fusing the corresponding arterial and venous images,condition of liver artery and vein of the same cross section in different phase periods could be observed.Conclusions Fused image can offer richer image information to doctors for diagnosis.
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Objective To research the endometrial receptivity by established the endometriosis rat model in intimal window period.Methods The autologous endometrial tissues of 22 sexually mature SD rats were transplanted into the homonymy abdomi-nal wall and offside uterine mesometrium.After four weeks,we randomly dissected two rats and observed the growth of etopic en-dometrium.The EMs rats were mated with male rats in the same cage and vaginal plug was observed in the next day.The histomor-phology of eutopic and ectopic endometrial was observed in the fifth day of pregnancy.Results Ectopic endometrium was grown in the abdominal wall and mesometrium,which formed a small bulge cystic mass in 20 rats.All foci was showed adhesion to the sur-rounding tissues in a different extent.In the light microscope,the morphology of ectopic endometrial was as the same as nomal en-dometrium.The establishment of the endometriosis rat mode is successful.Vaginal plug was positive the next day.Nonoperative side uterine was full of fluid in the fifth day of pregnancy.Eutopic and ectopic endometrium were in the secretory phase..Conclusion It is a successful method to establish a rat model of endometriosis by autotransplantion of endometrium.The endometrium of EMs model rats is in embryo implantation window period,and it provides a convenient model for studying endometrial receptivity.
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Objective To study the relationship between ischemic mitral regurgitation and geometric angles of the mitral valve leaflets in patients with coronary artery disease and papillary muscle dysfunction by transesophageal echocardiography(TEE) ,and to evaluate anatomy and pathophysiology mechanicm of the ischemic mitral regurgitation with left ventricular papillary muscle dysfunction .Methods A total of 84 subjects were enrolled in this study .All of the subjects were divided into group A (healthy volunteers constituted the control group ,n =40) ,group B (chronic inferior or posterior myocardial infarction patients with papillary muscle dysfunction group ,n =44) ,group C(patients from group B after mitral valvuloplasty surgery ,n = 20) .The relationship between mitral regurgitation and geometric angles of the mitral valve leaflets and mitral annulus were studied by TEE .Results Geometric angle between the mitral valve leaflets and mitral annulus were significantly larger in group B ,and geometric angles of the mitral valve leaflets and mitral annulus was positive correlated with degree of mitral regurgitation .Degree of mitral regurgitation significantly reduced in group C ,no significant difference was found at the geometric angles of the mitral valve leaflets and mitral valve annular compared with group A .Conclusions The degree of mitral regurgitation were highly correlated with geometric angles of the mitral valve leaflets and mitral valve annular in patients with left ventricular papillary muscle dysfunction caused by coronary heart disease .Repair of the mitral valve leaflets surgery can significantly reduce geometric angles of the mitral valve leaflets and mitral valve annular ,and reduce the degree of mitral regurgitation significantly .
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Objective To evaluate the localization of mitral valvular(MV)prolapse by transthoracic echocardiography(TTE),transesophageal echocardiography(TEE)and explore the interrelationship between the different subregions of MV prolapse and mitral regurgitation(MR).Methods Total of thirtythree patients with MV prolapse and more than moderate MR were included.TEE was used to further judge the location of scallop lesions and the result of both TTE and TEE were compared with the surgical findings respectively.The relationship between the different subregions of MV prolapse and MR was analyzed.Results Compared with the surgery findings,the accuracy rate of TTE and TEE in diagnosis of MV prolapse was 100％ qualitatively,80％ for TTE and 94％ for TEE in localizing the diseased region with the anterior and posterior MV,the result of TEE was significantly different from TTE(P＜0.05).MR level was related to the location of MV prolapse.Conclusions Compared with the TTE,TEE had more advantages in localizing the position of the MV prolapse.Mitral regurgitation is related to the location of MV prolapse.
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OBJECTIVE: In order to study the mechanism of the aqueous humor circulation and its relationship to the glaucoma macroscopically with engineering methods. METHODS: A dynamistic model was presented, which can be used to simulate the situation and the treatment of the primary open angle glaucoma (POAG). The frame of the model was built based on the ophthalmically accepted feedback mechanism between the aqueous humor circulation and the intraocular pressure (IOP). The transfer functions and the parameters were educed from the analysis of physiological theories, the basic elements of hydrodynamics, and the clinical parameters. The relation between the parameters of the system and the episode mechanism of POAG was discussed. A digital method was used to simulate the Challenge test and some medicines' treatment of POAG, and the results were consistent with clinical observations. RESULTS: The results of simulation illuminate that the model can simulate the mechanism of the aqueous humor circulation and the curative mechanism of some medicines under the physiological condition and the pathological condition of the POAG. CONCLUSION: A few parameters which can hardly be captured with clinical method could be obtained from the model. These parameters can be helpful for the diagnosis and prediction of the curative effect.