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简介：AbstractPenetrating head injury is rare, and thus management of such injuries is non-standard. Early diagnosis and intraoperative comprehensive exploration are necessary considering the complexity and severity of the trauma. However, because of the lack of microsurgical techniques in local hospitals, the possible retained foreign bodies and other postoperative complications such as cerebrospinal fluid (CSF) leak usually require a rational design for a secondary operation to deal with. We present a case of a 15-yearold boy who was stabbed with a bamboo stick in his left eye. The chopsticks passed through the orbit roof and penetrated the skull base. In subsequent days, the patient sustained CSF leak and intracranial infection after an unsatisfied primary treatment in the local hospital and had to request a secondary operation in our department. Computed tomography including plain scan, three dimension reconstruction and computed tomographic angiography are used to determine the course and extent of head injury. A frontal craniotomy was performed. Three pieces of stick were found residual and removed with the comminuted orbit bone fragments. A pedicled temporalis muscle fascia graft was applied to repair the frontier skull base and a free temporalis muscle flap to seal the frontal sinus defect. Aggressive broadspectrum antibiotics of vancomycin and meropenem were administrated for persistent fever after operation. CSF external drainage system continued for 12 days, and was removed 10 days after temperature returned to normal. The Glasgow coma scale score was improved to 15 at postoperative day 7 and the patient was discharged at day 22 uneventfully. We believe that appropriate preoperative surgical plan and thorough surgical exploration by microsurgery is essential for attaining a favorable outcome, especially in secondary operation. Good postoperative recovery depends on successfully management before and after operation for possible complications as well.

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简介：Objective:Toevaluatetheshort-termoutcomesofvideo-assistedthoracicsurgery(VATS)forthoracictumors.Methods:Thedataof1,790consecutivepatientswereretrospectivelyreviewed.ThesepatientsunderwentVATSpulmonaryresections,VATSesophagectomies,andVATSresectionsofmediastinaltumorsorbiopsiesattheCancerInstitute&Hospital,ChineseAcademyofMedicalSciencesbetweenJanuary2009andJanuary2012.Results:Therewere33patientsconvertedtoopenthoracotomy(OT,1.84%).Theoverallmorbidityandmortalityratewas2.79%(50/1790)and0.28%(5/1790),respectively.TheoverallhospitalizationandchesttubedurationwereshorterintheVATSlobectomygroup(n=949)thanintheopenthoracotomy(OT)lobectomygroup(n=753).Therewerenosignificantdifferencesinmorbidityrate,mortalityrateandoperationtimebetweenthetwogroups.Intheesophagealcancerpatients,nosignificantdifferencewasfoundinthenumberofnodaldissection,chesttubeduration,morbidityrate,mortalityrate,andhospitallengthofstaybetweentheVATSesophagectomygroup(n=81)andopenesophagectomygroup(n=81).However,theoperationtimewaslongerintheVATSesophagectomygroup.Inthethymomapatients,therewasnosignificantdifferenceinthechesttubeduration,morbidityrate,mortalityrate,andhospitallengthofstaybetweentheVATSthymectomygroup(n=41)andopenthymectomygroup(n=41).However,theoperationtimewaslongerintheVATSgroup.ThemediantumorsizeintheVATSthymectomygroupwascomparablewiththatintheOTgroup.Conclusions:Inearly-stage(I/II)non-smallcelllungcancerpatientswhounderwentlobectomies,VATSiscomparablewiththeOTapproachwithsimilarshort-termoutcomes.Inpatientswithresectableesophagealcancer,VATSesophagectomyiscomparablewithOTesophagectomywithsimilarmorbidityandmortality.VATSthymectomyforMasaokastageIandIIthymomaisfeasibleandsafe,andtumorsizeisnotcontraindicated.Longerfollow-upsareneededtodete

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简介：目的：观察电针治疗宫颈癌术后尿潴留的疗效。方法：治疗组按辨证分型采用电针治疗，对照组采用常规方法治疗，5d为1个疗程。结果：治疗组有效率为96．7％，治愈率为76．7％；对照组有效率为70．0％，治愈率为36．7％。两组间有效率、痊愈率比较，差异均有显著性意义（P〈0．01）。结论：电针疗法是治疗宫颈癌术后尿潴留的较佳方法。

简介：Objective:ToinvestigatewhetherGli1expressionisimportantinrelapseafterradicaloperationofbreastcancer.Methods:Usingimmunohistochemistry,Gli1expressionwasanalyzedinhumanprimarybreastcancer(n=284)andparacanceroustissues(n=20),andalsoinlocallymphnodes(n=28)andmetastaticlymphnodes(n=28).Results:InitialanalysisofGli1expressioninasmallcohortof20breasttumorsandtheirparacanceroustissuesshowedatendencytowardsGli1overexpressioninbreastcancertissues(P<0.001).Further,Gli1expressionin284breastcancertissuesampleswasanalyzedandasignificantcorrelationwasfoundbetweenincreasedexpressionofnuclearGli1andunfavorablerecurrence-freesurvival(RFS)(P<0.05).ThenuclearexpressionofGli1inmetastaticlymphnodesfollowingrelapseafterradicaloperationwasmuchhigherthanthatinthelocallymphnodesofprimarycarcinoma(P<0.05).Mostinterestingly,theexpressionofGli1wasmuchhigherintheinterstitialtissuesoftherelapsedgroupthanofthenon-relapsedgroup(P<0.001).Conclusions:BreastcancershowsahighprevalenceofGli1expression,whichissignificantlycorrelatedwithaggressivefeaturesandunfavorableRFS.NuclearGli1overexpression,especiallyintheinterstitialtissues,signifiedearlyrelapseafterradicaloperationofbreastcancer.

简介：BackgroundThevideo-assistedthoracoscopicsurgicaltechniquesarewidelyusedinthetreatmentofpatientswithcongenitalheartdiseaseswithgoodoutcomes.However,thefeasibilityandsignificanceofnursebasedearlycardiacrehabilitationincardiacintensivecareunit(ICU)forpatientswithtotallythoracoscopiccardiacoperationhasbeenseldomstudied.MethodsThirty-sixpatientswithtotallythoracoscopiccardiacoperationundertheconditionofthecardiacICUinGuangdongGeneralHospitalwererandomallocatedtotheinterventiongroupandthecontrolgroupbetweenJanuary2012toDecember2014.Thecontrolgroupreceivedstandardnursingcare,andtheinterventiongroupreceivedearlycardiacrehabilitationnursingcareinadditiontostandardcare.Theoutcomemeasuresincludedtheoxygensaturation(SpO2%),vitalcapacity,forcedexpiratoryvolumein1second(FEV1),andpaininthethoracicwound(visualanaloguescale,VAS),whichweremeasuredatthebaselineandwithin2-dayafter4-weeknursingcare.Forsafetyreason,wealsomonitoredtherateofperceivedexertion(RPE),heartrate,systemicbloodpressure.ResultsTherewerenon-significantdifferencesbetweenthegroupsinage,sex,totalnumberofcomorbidconditions,totalnumberofmedications,surgicaltime,andanesthetictime(P>0.05).Following4weekstreatment,thecardiopulmonaryfunctionsandVASscorewereimproved(P<0.05)inallgroups.Inaddition,theimprovementsweremoreintheearlycardiacrehabilitationnursecaregroupthaninthecontrolgroup(P<0.05).ConclusionTheearlycardiacrehabilitationnursingcareincardiacICUissafe,feasibleandbeneficialforpatientswithtotallythoracoscopiccardiacoperation.

简介：Objective:Laryngealreconstructionisneededtopreservelaryngealfunctioninpatientswhohaveundergoneextensiveverticalorfrontalpartiallaryngectomy.However,theprocedureremainsadifficultchallenge.Severalreconstructiontechniqueshavebeendescribed,butthesetechniquesposerisksofcomplicationssuchaslaryngealstenosis.Thisstudyaimedtoevaluatethepostoperativecourseandfunctionaloutcomesofanewtechniquethatcombinedamuscle-pediclehyoidboneandathyrohyoidflapduringlaryngealreconstructionaftertumorresection.Methods:Fourpatientsunderwentextensiveverticalpartialorfrontalpartiallaryngectomyforcancer.Aftertumorresection,laryngealreconstructionwasperformedusingtheproposedtechnique.Postoperativerecoverytime,complications,andoncologicresultswereevaluated.Results:Thefourpatientsweresuccessfullytreatedwiththeproposedtechnique.Nodyspnea,dysphagia,ordeathoccurredduringthepostoperativecourse.Decannulationwasperformedafteramedianof3days.Theaveragepostoperativehospitalstaywas7days.Short-termpostoperativefunctionalrecoverywasnormal.Nolaryngealstenosisortumorrecurrencewasobservedinanyofthefourpatientsafterafollow-upperiodofmorethan24months.Conclusion:Thecombinationofthemuscle-pediclehyoidboneandthethyrohyoidflapisareliableprocedureforlaryngealreconstructionafterextensiveverticalpartialorfrontalpartiallaryngectomy.

简介：摘要：目的 对某地区药店质量管理经营现状进行研究，优化药品监管模式。方法 结合药店质量管理经营实际状况,在对药店许可验收和日常检查监管环节存在的问题进行分析基础上,提出药品监管模式优化策略。结论 从引入新型监管模式、加强法律法规及日常质量管理培训和提高企业人员积极性以及效率有效性等方面对做好药店质量管理提出对策建议。 

简介：摘要：目的 对某地区药店质量管理经营现状进行研究，优化药品监管模式。方法 结合药店质量管理经营实际状况,在对药店许可验收和日常检查监管环节存在的问题进行分析基础上,提出药品监管模式优化策略。结论 从引入新型监管模式、加强法律法规及日常质量管理培训和提高企业人员积极性以及效率有效性等方面对做好药店质量管理提出对策建议。 

简介：摘要：目的 分析一例胆总管囊肿患儿二次术后出现Wernicke脑病的原因及护理对策。方法 ​2020年6月我院收治一例胆总管囊肿患儿，因术后出现肠梗阻症状行二次手术后患儿出现神志淡漠、反应迟钝、四肢活动欠佳、言语不清，症状逐渐加重甚至意识模糊，通过循证查询Wernicke脑病发生原因及机制，回顾性分析患儿的临床资料、辅助检查结果、临床表现、治疗及护理措施等，总结该特殊病例的发病原因及护理要点、难点。结果 此例患儿二次手术后第二天逐渐出现意识障碍，言语不清，共济失调症状，经维生素