Clinical effectiveness of INSURE method in the treatment of neonatal respiratory distress syndrome / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To evaluate the clinical effectiveness and safety of intubation-surfactant-extubation (INSURE) method in the treatment of neonatal respiratory distress syndrome (NRDS), and to investigate its possible mechanisms.</p><p><b>METHODS</b>Sixty-four premature infants, who were admitted for NRDS and treated with pulmonary surfactant from March 2010 to March 2012, were enrolled in the study. They were randomly divided into INSURE (n=32) and conventional mechanical ventilation (CMV) groups (n=32). The two groups were compared in terms of respiratory function, ventilation time, duration of oxygen therapy, complications, and prognosis, as well as expression of interleukin-10 (IL-10), tumor necrosis factor-α (TNF-α) and serum ferritin (SF).</p><p><b>RESULTS</b>Oxygenation index in the INSURE group was significantly higher than in the CMV group at 48 hours after treatment (P<0.05). Compared with the CMV group, the INSURE group showed significantly lower incidence of ventilator-associated pneumonia (VAP) and significantly shorter duration of oxygen therapy (P<0.05 for all comparisons). There were no significant differences in ventilation time and the incidence of pneumothorax, intracranial hemorrhage, necrotizing enteroolitis, bronchopulmonary dysplasia, and pneumorrhagia between the two groups (P>0.05). The levels of TNF-α and SF were significantly lower in the INSURE group than in the CMV group at 6, 24, 48, and 72 hours after treatment (P<0.05), while the level of IL-10 was significantly higher in the INSURE group than in the CMV group (P<0.05).</p><p><b>CONCLUSIONS</b>INSURE method can improve the oxygenation function of the lung, decrease the incidence of VAP and shorten the duration of oxygen therapy in neonates with NRDS, which is probably due to the fact that this method can reduce the production of TNF-α and SF and inhibit the decrease of IL-10.</p>

Cranioplasty for large-area skull defect with computer aided design/manufacture non-model-multi-spot shaped titanium mesh / 中华神经医学杂志

Objective To evaluate the clinical application of titanium mesh for cranioplasty of large-area skull defect with CAD/ (Computer aided design/manufacture) CAM non-model-multi-spot shaping technique. Methods Eighty-five patients suffered from large-area skull defect were treated by CAD/CAM non-model-multi-spot shaping technique from July 2007 to February 2009. A retrospective analysis of clinical data on these patients was performed. Results The average time for cranioplasty was (13.00 ± 2.56) min, and the postoperative improvement rate of patients with skull defects syndrome was 85% without major complications. Three-dimensional reconstruction of the skull showed physiological original shape recovery. The post-operative satisfaction rate of patients reached 100%.Conclusion Cranioplasty of large-area skull defect with CAD/CAM non-model-multi-spot shaped titanium mesh enjoys short operative time, few postoperative complications and remarkably improved symptoms, and achieves perfect combination of science and aesthetics, which worths widely used in clinic.