简介：Coronaryarterybypassgrafting(CABG)isenteringaneweraasminimallyinvasivetechniques,off-pumpsurgeryandtotal'arterialrevascularizationhavefotmdrolesinthesurgicaltreatmentofpatientswithcoronaryarterydisease.Thecontinueddevelopmentofthetechniquesofpercutaneouscoronaryintervention(PCI)isalsohavinganimpactonthetypeofpatientreferredforCABG.

简介：瞄准：与良性的职业人员静电干扰增生(BPH)在病人为职业人员静电干扰发炎程度和感染调查风险因素以便更高效地管理职业人员静电干扰发炎。方法：有在四川大学的韦斯特中国医院里经历在2005年9月和2005年12月之间的TURP的BPH的六十个病人被学习。前列腺液体(PF)为能分泌的IgA(SIgA)的测量被收集并且补充3(C3)。前列腺织物为由即时PCR的严峻的细菌的16SrDNA是镇定的，检验在织物的SIgA并且检验发炎。为职业人员静电干扰发炎或感染的可能的临床、有免疫力的风险因素被使用逻辑回归方法分析。结果：在尿分析法，职业人员静电干扰感染和在PF的C3的高集中的反常的白血房间计数是为职业人员静电干扰发炎程度的风险因素(P=0.025，0.034和0.035，分别地并且机会比率[或]=18.269，8.284和1.508，分别地)。为职业人员静电干扰感染的风险因素在PF包括C3集中和SIgA的集中(P=0.003和0.013，分别地并且OR=1.645并且0.993，分别地)。结论：现在的学习建议那职业人员静电干扰发炎与泌尿道感染，职业人员静电干扰感染和激活的补充被联系，那职业人员静电干扰感染与BPH在病人的前列腺与激活的补充并且在调整粘膜免疫下面被联系。单个有免疫力的规定应该与BPH在职业人员静电干扰发炎的治疗和病人的感染被考虑，这也被建议。

简介：ＡｓｏｕｒｃｅｅｘｔｅｎｔａｎａｌｙｓｉｓｏｆｔｈｅＬａｎｃａｎｇｅａｒｔｈｑｕａｋｅ（Ｍｓ＝７．６）ｏｆ１９８８ＳＩ－ＨＵＡＺＨＥＮＧ（郑斯华）ＪＩＡＮＹＡＮＧ（杨健）ＣｅｎｔｅｒｆｏｒＡｎａｌｙｓｉｓａｎｄｐｒｅｄｉｃｔｉｏｎ，ＣｈｉｎａＳｅｉｓ...

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简介：静脉的thromboembolism(VTE)作为深静脉血栓(DVT)和肺的栓塞(PE)被表明，代表死亡，残疾，和不快的一个重要原因。他们是各种各样的外科的过程的经常的复杂并发症。变老的人口和更严重地受伤的病人的幸存可以在损伤病人建议thromboembolism的增加的风险。在风险挑战医生扩展了人口的理解小心地检验风险因素让VTE识别能得益于预防的高风险的病人。基于证据的风险因素的精确知识在预言并且阻止手术后的DVT是重要的，并且能为appropriatethromboprophylaxis使用被合并到一个决定支持系统。在一张高风险的损伤人口的DVT预防的标准使用在下导致DVT的发生。VTE的发生在亚洲是普通的。评估包括实验室测试，Doppler测试和phlebography。屏蔽Dopplersonography应该在所有非常受伤的病人上为监视被执行识别DVT。D暗淡是一个有用标记在损伤外科病人监视预防。开始预防的最佳的调子以前在2hours之间并且在外科以后的10个小时，而是PE的风险继续因为几weeks.Thromboprophylaxis为预防包括毕业压缩袜子和抗凝剂。抗凝剂包括Warfarin，它属于维生素K对手，unfractionatedheparin，低分子的重量肝磷脂，因素Xa间接禁止者Fondaparinux，和口头的IIainhibitorMelagatran和ximelagatran。Recombinant人的solublethrombomodulin是一个新、高度有效的antithrombotic代理人。在选择损伤病人的venacaval过滤器的预防放置可以减少PE的发生。为预防劣等的静脉cava过滤器插入的指示与多重损害，关上的头损害，骨盆的破裂，脊骨破裂，多重长骨头破裂，和出席谨慎包括延长固定。多重损伤的病人在为DVT的增加的风险，但是也在流血，和肝磷脂的使用的增加的风险可以被禁忌。连续压缩设备(SCD)是为DVT预防的一种选择。压缩设备向足够的DVTprophylaxis提供低失败率和没有设�

简介：ObjectivesTotestthefeasibilityoftheuseofhighthoracicepiduralanesthesiaasasoleanestheticinpatientsundergoingoffpumpcoronaryarterybypasssurgery,avoidinggeneralanesthesia.MethodsBetweenOctober2002toApril2003,twentyfivecasesunderwentbeatingheartcoronaryarteryrevascularizationwithoutendotrachealgeneralanesthesia,usinghighthoracicepiduralanesthesiaandanalgesia.Allthepatientsunderwentepiduralcatheterizationontheeveningbeforethesurgery.ResuitsThepatientsinallreceived71grafts(singlen=11,doublen=5,triplen=6,quadruplen=3).Sixpatientsunderwentrepeatcoronaryarterybypass.Exceptonewasconvertedtogeneralanesthesiaandcardiopulmonarybypass,theotherpatientsunderwentoff-pumpcoronaryarterybypassgraftsurgery,2patientsunderwentgraftingvialeftthoracotomy(MIDCAB)andtherestthroughmidsternotomy.Therewasnomortality.Meanlengthofstayintheintensivecareunitwas16.2(4.2hoursandhospitalwas3.0(1.2days.ConclusionsOurexperienceconfirmsthefeasibilityofperformingmuhiplecoronaryarterybypassesinconsciouspatientswithoutendotrachealgeneralanesthesia.

简介：ObjectivesToevaluateretrospectivelythepotentialbenefitsofcombinedutilizationofvariousassistedcirculationdevicesincardiacarrestpatientswhodidnotrespondtoconventionalcardiopulmonarycerebralresuscitation(CPCR).MethodsAssistedcirculationdevices,includingemergencycardiopulmonarybypass(ECPB),intra-aorticballoonpump(IABP),andleftventricularassistdevice(LVAD),wereappliedto16adultpatientswhohadcardiacarrest82min-56hafteropenheartsurgeryanddidnotrespondto20minorlongerconventionalCPCR.ECPBwasappliedto2patients,ECPBplusIABPto8patients,ECPBplusIABPandLVADto6patients.ResultsOnepatientrecoveredfullyandonepatientdied.Oftheother14patients,13resumedspontaneouscardiacrhythmandonedidnot;noneofthemcouldbeweanedfromECPB.Furthertreatmentofthe14patientswithcombinationsofassistedcirculationdevicesenabled6patientstorecover.Oneofthe7recoveredpatientsdiedofreoccurringcardiacarrestafter11days;theother6weredischargedingoodconditionandwerefollowedupfor3-49months(mean=22months).Ofthe6dischargedpatientsonesufferedcerebralembolismduringLVADtreatment,resultinginmildlimitationofmobilityoftherightlimbs;theother5nevermanifestedanycentralnervoussystemcomplications.Therewasnolatedeathsgivinga37.5%(6/16)long-termsurvivalrate.ConclusionsECPBcouldeffectivelyreestablishbloodcirculationandoxygensupply,rectifyacidosis,andimproveinternalmilieu.ThecombinedutilizationofECPB,IABP,andLVADreducesthedurationofECPB,improvestheincidenceofrecovery,andoffersbeneficialalternativestorefractorycardiacarrestpatients.

简介：Objective:Tocomparativelystudythedifferenteffectsofopenheartsurgeryonbraintissuesofpatientswithcongenitalandrheumaticheartdisease.Methods:Fortypatientswithcongenitalheartdisease(CHD,CHDgroup,n=20)orrheumaticheartdisease(RHD,RHDgroup,n=20)underwenton-pump(cardiopulmonarybypass,CPB)heart-beatingopenheartsurgery.BloodsamplesbeforeCPB,and20minutes,1hour,24hoursand7daysafterCPBwerecollected,andthelevelsofneuron-specificenolase(NSE)andproteinS-100bintheplasmaweredeterminedwithenzyme-linkedimmunoadsorbentassay(ELISA),respectively.Allthepatientswereexaminedwithelectroencephalogram(EEG)beforeand1weekafteroperation.ThechangesofNSE,S-100bandEEGcomparedtoverifythedifferenceofpostoperativecerebralinjurybetweenCHDcasesandRHDcases.Results:TheplasmalevelofS-100bincreasedsignificantly20minutesafterCPBandwasstillhigherthanthepreoperativelevelat24hoursafteroperationinbothgroups(P<0.01).TheplasmalevelofNSEincreasedmoresignificantlyintheCHDgroupthanintheRHDgroup20minutesafterCPBanditreturnedtothenormallevel24hoursafterCPBintheCHDgroupbutremainedatahighlevelintheRHDgroup(P<0.01).ThelevelsofNSEandS-100breturnedtothenormallevelsonthe7thdayafterCPB.AbnormalEEGwasfoundin75%ofthepatientsintheCHDgroupand60%intheRHDgroup.Conclusions:On-pumpheart-beatingopenheartsurgerycancausecertaincerebralinjuryinthepatientswithCHDorRHD.TheinjurywasmoresevereandrecoveredmorequicklyintheCHDgroupthanintheRHDgroup.

简介：Thisisareportofanonrandomizedcomparisonoftreatmentresultsof139patientswithstageIB,HAandproximalIIBcarcinomaoftheuterinecervixtreatedbyradiationaloneand113treatedwithacombinationofradiationandsurgery.Thefive-yeartumorfreeacturialsurvivalforthepatientswithstageIBeitherwithirradiationalone(RT)orcombinedwithsurgery(RS)wasapproximately87%.ForstageⅡthetumorfreeactuarialfive-yearsurvival79%withpatientsofRS,and76%withRT.Inthe113patientstreatedwithRStherewere18(16%).Inthe139patientstreatedbyRTtherewere18(13%)recurrencesofpelvic,4localrecurrences,11combinedwithparametrial,andfreeparametrialrecurrences.Therewasnosignificantdifferenceinthesurvivalandrecurrencerateofthepatientstreatedwitheithermethod.Majorcomplicationswerecomparableinbothgroups(RTapproximately25%andRSapproximately10%),but2/3ofthosecomplicationsrecoveredwithoutsequelae.Themostfrequentminor

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