Lung transplantation after paraquat poisoning in an adolescent: one case report and literature review / 器官移植

Objective To summarize the effect of the timing of lung transplantation and related treatment measures on clinical prognosis of patients with paraquat poisoning. Methods Clinical data of a patient with paraquat poisoning undergoing bilateral lung transplantation were retrospectively analyzed. Clinical manifestations, auxiliary examination, diagnosis and treatment of this patient were summarized and analyzed. Results A 17-year-old adolescent was admitted to hospital due to nausea, vomiting, cough and systemic fatigue after oral intake of 20-30 mL of 25% paraquat. After symptomatic support treatment, the oxygen saturation was not improved, and pulmonary fibrosis continued to progress. Therefore, sequential bilateral lung transplantation was performed under extracorporeal membrane oxygenation (ECMO). After postoperative rehabilitation and active prevention and treatment for postoperative complications, the patient was discharged at postoperative 50 d. Conclusions The timing of lung transplantation after paraquat poisoning may be selected when the liver and kidney function start to recover. Active and targeted prevention of potential pathogen infection in perioperative period and early rehabilitation training contribute to improving clinical prognosis of lung transplant recipients.

Construction and Application of Evaluation Index System for Clinical Specialty Capability of Traditional Chinese Medicine in Shandong Province / 中国医院管理

Objective Construct a scientific and reasonable evaluation index system for clinical specialties of tradi-tional Chinese medicine in Shandong Province to provide a scientific basis for improving the service capacity of clini-cal specia lties of traditional Chinese medicine.Methods Based on relevant policies and literature research,the analytic hierarchy process and Delphi expert consultation method were used to determine the index system and its weight,and 509 clinical specialties of traditional Chinese medicine capacity levels of 178 medical institutions in Shandong Province were evaluated.Results A scientific and effective evaluation index system for clinical specialty capacity of traditional Chinese medicine in Shandong Province was constructed,with 23 secondary indicators in 5 dimen-sions.It comprehensively evaluats the service capacity and management level of orthopedics and traumatology de-partments of traditional Chinese medicine class hospitals in Shandong Province,uses orthopedics and traumatology as an example.Conclusion Driven by the dynamic monitoring of the evaluation index system,improve the service ca-pacity for clinical specialties of traditional Chinese medicine,guide it to strengthen the internal construction of tradi-tional Chinese medicine,and give full play to the advantages of traditional Chinese medicine characteristics.Increase the support for clinical specialties of traditional Chinese medicine in Shandong Province,and then promote the high-quality development of traditional Chinese medicine.

Impact of Pringle’s maneuver on postoperative serum inflammatory mediator levels and prognosis of HBV-related HCC patients / 中华肝胆外科杂志

Objective@#To analyze the impact of Pringle’s maneuver on postoperative serum inflammatory mediator levels and prognosis in hepatitis B virus-related hepatocellular carcinoma (HBV related HCC) patients.@*Methods@#A retrospective study was conducted on 157 HBV related HCC patients who underwent treatment at the Chinese PLA General Hospital from January 2016 to December 2017. There were 128 males and 29 females. The mean age was (54.5±12.1) years. These patients were divided into 106 patients who underwent Pringle’s maneuver (the Pringle’s maneuver group). The remaining patients were in the Occlusion-free group. All patients were detected inflammatory mediator levels including the various interleukins (IL) and were regularly followed up. The recurrence-free survival was evaluated by the Kaplan-Meier method, and compared with the log-rank test. The relationship between the Pringle’s maneuver and risks of postoperative tumor recurrence of these patient were estimated by the univariate and multivariate Cox regression models.@*Results@#On postoperation day 1 and day 3, the serum IL-1 and IL-6 levels of the Pringle’s maneuver group were significantly higher than the Occlusion-free group [5.0(5.0, 12.0)ng/L vs. 5.0(5.0, 5.0)ng/L], [122.0(74.5, 173.8)ng/L vs. 80.0(40.0, 120.0)ng/L]; [5.0(5.0, 10.0)ng/L vs. 5.0(5.0, 5.0)ng/L], [78.3(42.8, 138.5)ng/L vs. 48.1(30.1, 75.0)ng/L]. On day 5, the serum IL-1 and IL-8 levels were also significantly higher than the Occlusion-free group [5.0(5.0, 5.3)ng/L vs. 5.0(5.0, 5.0)ng/L], [100.6 (44.2, 186.5)g/L vs. 68.0(36.3, 112.0)ng/L] (all P<0.05). There were 42 and 27 patients who did not develop recurrence in the Pringle’s Maneuver group and the Occlusion-free group, respectively. The recurrence-free survival rates of the Pringle maneuver group and the Occlusion-free group were 40.0% and 52.9%, respectively. There were no significant differences between the two groups (P>0.05). The multivariate Cox regression model suggested that there was no significant correlation between Pringle’s maneuver and recurrence free survival of these patients with HBV related HCC.@*Conclusions@#Pringle’s maneuver could significantly elevate the postoperative serum IL-1, IL-6, IL-8 levels, but it was not related with an increased risk of postoperative tumor recurrence.

Analysis of the diagnosis and treatment of biliary cystadenoma and cystadeno-carcinoma: report of 16 cases / 国际外科学杂志

Objective To analyze the clinical features of intrahepatic biliary cystadenoma and cystadenocarcinoma.Methods Sixteen patients from Dec.2008 to Dec.2013 were retrospectively reviewed to investigate their clinical manifestations,image features,treatment and prognosis.Results Intrahepatic biliary systadenoma and occured occurred primarily in middle-aged women with no typical clinical manifestations.Image examination is the key method in diagnosis.Surgery is the only method to cure the disease.The procedure depends on its location,and its prognosis is related to complete surgical resection.Conclusion Intrahepatic biliary cystadenoma and cystadeno-carcinoma is a rare tumor occuring mostly in middle-aged women.Image examination is the key method in diagnosis.Complete surgical resection contributes to its better prognosis.

Influence of three primers on the shear bond strength between cast titanium and composite resin / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To investigate the influence of three primers on the shear bond strength between cast titanium (Ti) and composite resin.</p><p><b>METHODS</b>The disks (n = 40) were cast by commercially pure (CP) Ti, which diameter were 8 mm and thick were 3 mm. The titanium surfaces were polished with silicon carbide sand papers under running water and then treated by sandblasting and acid (4%HF) etching. They were divided into four groups: control group (group A), treated with KH-570 (group B), treated with Alloy Primer (group C), treated with Metal photo primer (group D). After treatment, the specimens were evaluated for their shear bond strengths by universal testing machine. The values were statistically analyzed. The fractured surfaces were observed by scanning electron microscope (SEM).</p><p><b>RESULTS</b>The shear bond strengths of group A, B, C, D were (9.773 +/- 0.67), (11.463 +/- 0.82), (14.224 +/- 0.75), (13.157 +/- 0.73) MPa. There were significant differences in bond strength between A and B, C, D (P < 0.01). B and C, D had significant differences (P < 0.01). C and D had no significant differences (P>0.05).</p><p><b>CONCLUSION</b>KH-570, Alloy Primer, Metal photo primer significantly improve the bond strength of ceramage composite resin to cast titanium. KH-570 group bonding strength is lower than the the Alloy Primer group and Metal photo primer group.</p>

Effects of post-cure heat treatment on the bond strength of ceramage composite resins for titanium casting using different surface treatments / 华西口腔医学杂志

<p><b>OBJECTIVE</b>This study aims to investigate the effects of post-cure heat treatment (PCHT) on the bond strength of Ceramage composite resins for titanium casting using different surface treatments.</p><p><b>METHODS</b>Metal specimens (n=30) were randomly divided into following five groups: polishing (group A), sandblasting (group B), acid etching after sandblasting (group C), PCHT after sandblasting (group D), and PCHT after sandblasting and acid etching (group E). The specimens were then processed and coated with Ceramage composite resins according to the grouping. After treatment, the shear bond strengths and microhardness of the specimens were evaluated. The fracture surface morphology of the titanium-Ceramage composite resin was observed using a scanning electron microscope.</p><p><b>RESULTS</b>The shear bond strengths of groups A to E were (5.92 +/- 0.54), (10.25 +/- 0.55), (14.97 +/- 0.88), (14.41 +/- 0.63), and (19.95 +/- 0.52) MPa, respectively. No statistical difference was found between groups C and D, whereas the rest of the groups showed statistically significant differences (P < 0.01). Visible polymerization residues were found on titanium porcelain metal surface of groups B to E. The microhardness values of groups D and E were higher than those of groups B and C (P < 0.05).</p><p><b>CONCLUSION</b>PCHT significantly improves the bond strength and surface microhardness of Ceramage composite resins for titanium casting.</p>

Outcomes of open and minimally invasive esophagectomy for esophageal cancer / 中华消化内镜杂志

Objective To compare the safety,feasibility,and long-term outcomes between combined thoracoscopic and laparoscopic esophagectomy (TLE) and open three-field esophagectomy (OE) for esophageal cancer.Methods The data of 183 patients with esophageal cancer who accepted TLE (n =94) or OE (n =89) from February 2009 to December 2011 were retrospectively collected and compared.Results Demographics,pathologic data in each cohort were almost identical.No significant differences were observed in operative time,the number of lymph node harvested,rates of anastomotic leak,thoracic abscess,chyle chest,re-operation,vocal cord paralysis,gastric emptying dysfunction and morbidity.A significant difference was observed in blood loss (86.6 ±38.3 ml in TLE group vs.217.4 ±87.2 ml in OE group,P=0.000),rate of transfusion (1.1％ vs.6.7％,P =0.045),hospital stay (13.9 ±7.5 d vs.17.1 ±10.2 d,P =0.017),rate of overall surgical complications (23.4％ vs.38.2％,P =0.030),rate of pulmonary complications (9.6％ vs.27.0％,P =0.002) and rate of arythmia (4.1％ vs.12.4％,P =0.046).Median follow-up time was 28.0 ±2.0 months (95％ CI:24.2-31.8).No difference between the two groups concerning survival was observed (P =0.954).Conclusion The TLE for esophageal cancer is safe and feasible.Although it cannot improve the survival of long-term,it is worth spreading in intraoperative and postoperative advantages compared with OE group.

Clinical study of carboprost tromethamine combined with uterine strap suture in hemorrhage during cesarean section / 中国医师进修杂志

ObjectiveTo investigate the clinical effect ofcarboprost tromethamine combined with uterine strap suture in hemorrhage during cesarean section.MethodsSixty patients with hemorrhage during cesarean section were selected and divided by random digits table method into observation group and control group with 30 cases each.The patients in observation group were treated with carboprost tromethamine combined with uterine strap suture,while the patients in control group were treated with carboprost tromethamine alone.The clinical effect,blood loss,blood transfusion cases,transfusion volume and the occurrence of recurrent hemorrhage and complication of two groups were compared.ResultsCompared with control group,the efficiency in observation group was significantly higher [93.33％(28/30) vs.70.00％ (21/30),P＜ 0.05];blood loss,blood transfusion cases,transfusion volume and recurrent hemorrhage rate of observation group were obviously lower [ (603.35 ± 52.62) ml vs.(689.17 ± 50.36) ml,3 cases vs.10 cases,(640.21 ±63.58) ml vs.(726.17 ±68.74) ml,3.33％(1/30) vs.26.67％(8/30),P ＜0.05];the occurrence rate of complication of two groups had no statistical significance (P ＞ 0.05).ConclusionsCarboprost tromethamine combined with uterine strap suture can improve the clinical effect of patients with hemorrhage during cesarean section,decrease blood loss and transfusion volume,and reduce the recurrent hemorrhage rate.