Comparative study between intervention transcatheter direct thrombolysis and vein thrombolysis plus anti-coagulation therapy for treating lower extremity deep venous thrombosis / 心血管康复医学杂志

Objective: To compare the therapeutic effect of intervention transcatheter direct thrombolysis and vein thrombolysis and anti-coagulation drugs on lower extremity deep venous thrombosis (DVT). Methods: A total of 61 patients with lower extremity DVT accorded with inclusion standards were selected. They were randomly divided into intervention transcatheter direct thrombolysis group (n=30, intervention group) and vein thrombolysis and anti-coagulation group (n=31, thrombolysis + anti-coagulation group). Patients were treated for four weeks as a course. Results: Total effective rate of intervention group was significantly higher than that of thrombolysis + anti-coagulation group (93.33% vs. 64.52%), χ2=4.987, P=0.032. There were no significant differences in hemorheology indexes between two groups before treatment, P>0.05. Compared with before treatment, after treatment, there were significant reductions in high shear whole blood viscosity, low shear whole blood viscosity, plasma viscosity and fibrinogen level in intervention group, P<0.05 all; there were significant reductions in plasma viscosity and fibrinogen level in thrombolysis + anti-coagulation group, P<0.05 both. After treatment, compared with thrombolysis + anti-coagulation group, there were significant reductions in low shear whole blood viscosity [(12.10±2.13) mPa•s vs. (11.08±1.67) mPa•s] and plasma viscosity [(1.85±0.13) mPa•s vs. (1.31±0.09) mPa•s] in intervention group, P<0.05 both. After treatment, total effective rate of vessel open up in intervention group was significantly higher than that of thrombolysis + anti-coagulation group (90.00% vs. 61.29%), χ2=4.173, P=0.047. Conclusion: For patients with acute DVT and no operation contraindications, therapeutic effect of transcatheter direct thrombolysis is more significant. It can significantly improve hemorheology and vessel open up rate, it may be recommended as the preferred in clinic.

Effect of Tanreqing injection combined with cefoperazone sodium and Sulbactam sodium on C reactive protein in acute exacerbations of chronic bronchitis / 中国现代医生

Objective To explore the effect of Tanreqing injection combined with cefoperazone sodium and Sulbactam sodium in threatment of acute exacerbations of chronic bronchitis,and to explore the impact on C reactive protein. Methods From 2013 June to 2014 June in our hospital,100 cases of patients with acute exacerbation of chronic bron-chitis were selected as the object of study, all the patients were randomly divided into observation group and control group, 50 cases in each group, two groups were treated with cough, phlegm, relieving asthma and oxygen and other symptomatic treatment, while the observation group was treated with Tanreqing injection 20 mL into injection and in-travenous drip for 5% Glucose injection in 250 mL, once per day. Cefoperazone sodium and sulbactam sodium needle 3 g﹙a small number of patients with application of 2 g) with injection of saline 100 mL intravenous drip, 1 times/12 h. The course of treatment was 10 days. The clinical efficacy of the two groups and two groups of patients after sputum cough disappeared time change, vanishing lung wet rales disappearance time and PaO2, PaCO2, and changes of CRP before and after treatment in two groups of patients were compared. Results After treatment, the total effective rate in the observation group and the control was 94.0%, 80.0%, the effects of two groups were compared, the difference was statistically significant﹙P<0.05). The observation group patients’s sputum, cough disappeared time, the disappearance time of pulmonary rales disappearance time were faster than the control group, the difference was statistically signifi-cant ﹙P<0.05). PaO2 of observation group after treatment was significantly higher than the control group, while PaCO2 was significantly lower than the control group, the difference was statistically significant﹙P<0.05). The CRP level of ob-servation group decreased more significantly than the control group, the difference was statistically significant﹙P<0.05). Conclusion The therapeutic effect of Tanreqing injection combined with cefoperazone Sulbactam sodium injection in treatment of chronic bronchitis in acute attack period can improve the curative effect, decrease the level of CRP, im-prove the patient's clinical symptoms, signs, and is worthy of promotion and application.

Anatomic features and intra-operative protection of surface vasa vasorum on longissimus in thoracolumbar segments / 中华骨科杂志

Objective To study the anatomic features of surface vasa vasorum on longissimus in thoracolumbar segments,and its protection function during the internal fixation for thoracolumbar fracture via Wiltse approach.Methods From March 2010 to October 2012,a total of 97 patients with thoracolumbar fractures underwent posterior internal fixation with pedicle screw system.The trend and distribution of surface vasa vasorum on longissimus in thoracolumbar segments were observed in the operation,and the vessels were protected during the surgical procedures by using specific devices and techniques.Operative time and intra-operative blood loss were recorded.Visual analogue scale (VAS) values were evaluated after 3 days,1 month,6 months postoperatively,and 1 month after the removal of internal fixation.MRI images of longissimus in thoracolumbar segments were compared after preoperative and postoperative 6 months.Results Surface vasa vasorum distribution on 194 longissimus and 402 inter-pedicle areas of 97 patients were observed.In 402 areas,94.3％ of surface vasa vasorum presented sarciniform,while only 5.7％ of surface vasa vasorum presented tube shape.In 379 areas of sarciniform distribution,9.8％ of blood vessel bundles were located in vertebral pedicle area;76.0％ of blood vessel bundles were located in the upper inter-pedicle areas;12.4％ of blood vessel bundles were located in middle inter-pedicle areas;1.8％ of blood vessel bundles were located in lower inter-pedicle areas.In 379 areas,87.3％ of blood vessel bundles could be completely retained;12.7％ of blood vessel bundles were treated by electro coagulation and burning.Intra-operative blood loss was 21±9.3 ml.VAS values after 3 days,1 month,6 months postoperatively,and 1 month after the removal of internal fixation were 3.3± 1.6,2.1± 1.4,1.2±0.7 and 1.1±0.7.The longissimus treated with electro coagulation demonstrated pimelosis change on MRI after postoperative 6 months.Conclusion Surface vasa vasorum on longissimus in thoracolumbar segments are generally of sarciniform,and most of them are located in upper inter-pedicle areas.The protection of vasa vasorum can reduce the intra-operative lesion and postoperative pimelosis change of longissimus.

Precise locating fluoroscopy reduces radiation exposure during the surgical procdure for thoracolumbar fracture / 中华骨科杂志

Objective To study the effect of precise locating technique of C?arm fluoroscopy in order to reduce the radia?tion exposure during the surgical procdure for thoracolumbar fracture. Methods From March 2010 to Octorber 2012, a total of 92 cases with thoracolumbar fracture underwent postierior internal fixation procdures with pedicle instrumentation. C?arm fluoros?copy was used in 44 cases with precise locating technique, while in 48 cases with traditional methods. In precise locating group,C?arm fluoroscopy was used after anesthesia. Once an ideal view was got, the position parameters of C?arm fluoroscopy machine were recorded. The machine was positioned according to the recording for the secondary fluoroscopy. Pre?operative and intra?operative number of times of exposure, length of exposure time, time for fluoroscopy and total operating time were recorded and compared be?tween two groups. Results Pre?operative number of times of exposure, exposure time, and time for fluoroscopy in precise locating group were (5.51±2.47), (2.26±1.05) s and (9.83±3.67) min,which were higher than those of (4.02±2.42), (1.78±0.98) s and (8.29± 3.52) min in traditional group. However, intra?operative number of times of exposure, exposure time, and time for fluoroscopy in precise locating group were (5.26±3.64), (2.24±1.24) s and (10.39±4.82) min,which were lower than those of (9.74±4.38), (4.21± 2.38) s and (24.69±6.35) min in traditional group,and total number of times of exposure, exposure time, time for fluoroscopy and total operating time in precise locating group were(10.77±4.16), (4.50±1.83) s, (20.22±5.03) min and(70.52±18.33)min,which were also lower than those of (13.76±5.31), (5.99±3.27) s , (32.98±7.83) min and(81.86±21.57)min in traditional group. Conclu?sion Precise locating technique of C?arm fluoroscopy reduces the radiation exposure during the surgical procdure for thoracolum?bar fracture.

Percutaneous multiple K-wire fixation combined with skeletal traction through supracondyle of femur in treatment of intertrochanteric fracture in the elderly / 中华老年医学杂志

Objective To evaluate a minimally invasive procedure for intertrochanteric fracture treatment in elderly patients. Methods Total 46 elderly patients with intertrochanteric fracture were treated with a minimally invasive procedure from September 2008 to February 2010. The fractures were fixed with multiple K-wires combined with skeletal traction through supracondyle of femur. All procedures were undertaken under local anesthesia. Results All the patients were followed up for 8.8-months in average, and 42 patients recovered with independent walking, and the good rates was 91.3%, without severe complications in this group. Conclusions Minimally invasive procedure including fixation with multiple K-wires combined with traction through femoral supracondyle, is a safe and effective treatment for intertrochanteric fracture in elderly patients, avoiding high risks of intra-and post-operative complications.