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find Author "王丽娜" 7 results
  • Use of Decision Tree in Treating an Emergency Patient with Upper Gastrointestinal Hemorrhage

    Objective To apply the method of evidence-based medicine to identify the best therapy option for an emergency patient with upper gastrointestinal hemorrhage. Methods According to time and logical sequence of clinical events, a complete decision tree was built after the following steps to find the best treatment: clear decision-making, drawing decision tree graphics, listing the outcome probability, giving appropriate values to the final outcome, calculating and determining the best strategies. Results The performance of endoscopic therapy for the patient with upper gastrointestinal hemorrhage within the first six hours had little effect on the prognosis. Interventional therapy after the failure of endoscopic therapy had less mortality than direct surgical exploration. Conclusion Making clinical decision analyses via drawing the decision tree can help doctors clarify their ideas, get comprehensive views of clinical problems, and ultimately choose the best treatment strategy for patients.

    Release date:2016-09-07 11:04 Export PDF Favorites Scan
  • 先天性心脏病合并重度肺动脉高压的诊断及外科治疗

    目的总结先天性心脏病合并重度肺动脉高压患者的诊断及治疗经验。方法2000年1月~2005年8月,收治87例先天性心脏病合并重度肺动脉高压患者,其中室间隔缺损(VSD)58例,房间隔缺损(ASD)4例,VSD合并动脉导管未闭(PDA)6例,VSD合并ASD16例,PDA3例。82例患者行手术治疗,其中75例行常规心脏畸形矫治手术,VSD采用间断缝合涤纶补片修补,7例室间隔水平双向分流平衡的患者进行了单向活瓣VSD修补术;5例因艾森门格综合征放弃手术治疗。结果行手术治疗的82例中共死亡4例,均死于术后低心排血量综合征,其中单向活瓣VSD修补者死亡2例。手术后呼吸机辅助呼吸时间38~178h(56±8h),血管活性药物使用时间58~244h(117±43h)。术后发生并发症3例,均为肺不张,经雾化吸入、吸痰和拍背等治疗后治愈。随访78例,随访时间6个月,气促症状明显减轻,超声心动图提示2例心脏补片处有少量分流,其余患者均恢复良好。结论非有创性检查方法能对肺动脉高压的性质作出准确的判断,采取合适的治疗方法能获得满意的疗效。术前对肺动脉高压性质的准确判定、心肺功能调整以及围手术期处理是此类患者安全康复的关键。

    Release date:2016-08-30 06:23 Export PDF Favorites Scan
  • EXPERIENCE OF APPLICATION OF SKIN FLAP IN REPAIRING 112 PATIENTS WITH SEVERE THERMO PRESSURE INJURY OF HAND

    OBJECTIVE: To investigate the clinical effect of skin flaps repairing severe thermopressure injury of hand. METHODS: From January 1989 to December 1998, 112 patients with severe thermopressure injury of hand were repaired by various skin flaps transfer, the size of skin flaps was 6 cm x 8 cm to 12 cm x 18 cm. Postoperative patients were treated by combined rehabilitation in early stage. RESULTS: All the flaps were survived with satisfactory effect. Sixty-six patients were followed up 6 to 12 months, skin flaps all showed better colour and texture, and function of the hand was satisfactory. CONCLUSION: Different skin flaps are adopted to repair severe thermopressure injury of the hand according to different skin defects of the hand, combined early rehabilitation treatment, to achieve good recovery of function and appearance of the hand to the greatest extent.

    Release date:2016-09-01 10:27 Export PDF Favorites Scan
  • 病理性近视伴脉络膜新生血管患者抗血管内皮生长因子单克隆抗体bevacizumab治疗后视物变色一例

    Release date:2016-09-02 05:40 Export PDF Favorites Scan
  • Effectiveness of Shenmai Injection for Leukopenia after Tumor Radiation and Chemotherapy: A Meta-Analysis

    ObjectiveTo systematically review the effectiveness of Shenmai injection for leukopenia after the tumor radiation and chemotherapy. MethodsSuch databases as PubMed (1966 to June 2013), The Cochrane Library (Issue 5, 2013), Web of Science (1980 to June 2013), VIP (1989 to June 2013), WanFang Data (1990 to June 2013), CNKI (1980 to June 2013) and CBM (1981 to June 2013) were searched to collect randomized controlled trials (RCTs) on Shenmai injection in treating leukopenia after the tumor radiation and chemotherapy. Literature selection, data extraction and methodological quality assessment of the included studies was conducted by two reviewers independently. Then meta-analysis was performed using RevMan 5.2 software. ResultsA total of 11 studies involving 1 009 patients were included. The results of meta-analysis showed that when Shenmai injection and normal oral drugs for rising leucocyte were used in the treatment of leukopenia after the tumor radiation and chemotherapy, significant differences were found in significant effectiveness (RR=1.57, 95%CI 1.39 to 1.78, P < 0.000 01), and total effectiveness (RR=1.27, 95%CI 1.19 to 1.36, P < 0.000 01), but no significant difference was found in effectiveness (RR=0.90, 95%CI 0.74 to 1.09, P=0.27). ConclusionIn the treatment of leucopenia through tumor radiation and chemotherapy, Shenmai injection is superior to normal oral drugs in effectiveness. However, the above conclusion should be further confirmed by conducting more large-scale and welldesigned RCTs due to the limited quantity and quality of the included studies.

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  • The image characteristics of multispectral scanning laser imaging and optical coherence tomography in patients with pregnancy induced hypertension syndrome

    ObjectiveTo observe the image characteristics of multispectral scanning laser imaging (MSLI) and OCT in patients with pregnancy induced hypertension syndrome (PIHS).MethodsA total of 112 patients (224 eyes) of PIHS patients diagnosed in Obstetrics Department of Tianjin First Central Hospital from May 2016 to May 2017 were included in this study. The average age of the patients was 27.00±2.14 years. The average course of the disease was 15.00±8.27 days. There were 174 eyes in 87 patients of blurred vision, dazzling and visual fatigue consciously. All patients performed BCVA, direct ophthalmoscope, B ultrasound, confocal scanning laser Ophthalmoscope (cSLO) and spectral-domain OCT (SD-OCT). SD-OCT was performed with Spectralis HRA+OCT from Heidelberg Company in Germany to acquire tomographic images. Using Herdelberg's colorful program (MultiColor) based on cSLO and operating in accordance with standard methods, one scan simultaneously obtained blue light reflection based on 488 nm, green light reflection based on 515 nm, and infrared reflection based on 820 nm, synthesis to MSLI. Fundus abnormalities were classified into arterial spasm (stage Ⅰ), arteriosclerosis (stage Ⅱ), and retinopathy (stage Ⅲ). OCT examination was divided into normal and abnormal cases according to the abnormality of retinal morphology and thickness.ResultsOf the 224 eyes, 68 eyes (30.36%) showed normal fundus examination and 156 eyes (69.64%) showed abnormal fundus performance. Among them, 28 eyes were stage Ⅰ (17.95%); 40 eyes were stage Ⅱ (25.64%); 88 eyes were stage Ⅲ (56.41%). Thirty-six eyes (16.07%) showed normal fundus and 188 eyes (83.93%) showed abnormal performance with OCT. Of the 188 eyes with abnormal fundus performance, 86 eyes (45.74%) had retinal neuroepithelial serous detachment; 56 eyes (29.79%) had RPE detachment; optic disc edema, bulge, and local reflexes in the retinal nerve fiber layer were enhanced and/or the thickness increased in 46 eyes (24.47%). In MSLI, 48 eyes (21.43%) showed normal fundus; 176 eyes (78.57%) showed abnormal performance. Retinal edema was showed in green on MSLI, serous retinal neuroepithelial layer detachment, RPE layer detachment, retinal nerve fiber layer thickening, accompanied by changes in local retinal structure. The higher the degree of bulge, the darker the color. Consistent with the range of retinal edema revealed by SD-OCT.ConclusionsMSLI and SD-OCT images show highly consistent lesions in PIHS patients. MSLI can more clearly show superficial and deep retinal lesions.

    Release date:2020-02-18 09:28 Export PDF Favorites Scan
  • PREPARATION OF PERSONALIZED BRAIN CAVITY SCAFFOLD WITH THREE-DIMENSIONAL PRINTING TECHNOLOGY BASED ON MAGNETIC RESONANCE IMAGING

    ObjectiveTo explore a method of three-dimensional (3D) printing technology for preparation of personalized rat brain tissue cavity scaffolds so as to lay the foundation for the repair of traumatic brain injury (TBI) with tissue engineered customized cavity scaffolds. MethodsFive male Sprague Dawley rats[weighing (300±10) g] were induced to TBI models by electric controlled cortical impactor. Mimics software was used to reconstruct the surface profile of the damaged cavity based on the MRI data, computer aided design to construct the internal structure. Then collagen-chitosan composite was prepared for 3D bioprinter of bionic brain cavity scaffold. ResultsMRI scans showed the changes of brain tissue injury in the injured side, and the position of the cavity was limited to the right side of the rat brain cortex. The 3D model of personalized cavity containing the internal structure was successfully constructed, and cavity scaffolds were prepared by 3D printing technology. The external contour of cavity scaffolds was similar to that of the injured zone in the rat TBI; the inner positive crossing structure arranged in order, and the pore connectivity was good. ConclusionCombined with 3D reconstruction based on MRI data, the appearance of cavity scaffolds by 3D printing technology is similar to that of injured cavity of rat brain tissue, and internal positive cross structure can simulate the topological structure of the extracellular matrix, and printing materials are collagen-chitosan complexes having good biocompatibility, so it will provide a new method for customized cavity scaffolds to repair brain tissue cavity after TBI.

    Release date:2016-11-14 11:23 Export PDF Favorites Scan
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