ObjectiveTo introduce the hiatal hernia (HH) and to summarize the research development of relationship between HH and respiratory symptoms. MethodsLiteratures in recent years which about relationship between HH and respiratory symptoms at home and abroad were collected and reviewed. ResultsGastroesophageal reflux disease (GERD), which always be caused by laryngeal airway and other esophageal symptoms, was a common illness and easily be misdiagnosed. One common symptom of the GERD was the HH. For those patients with reflux-associated esophageal symptoms, many of them suffered from HH. The treatment results showed that the endoscopic surgery could relieve the reflux symptom and effectively control the respiratory symptoms. ConclusionsThe HH can increase the risk of respiratory symptoms; an active treatment on the HH can relieve the respiratory symptoms, which is caused by the reflux symptom.
ObjectiveTo systematically review the efficacy and safety of high-versus low-chloride content in fluid resuscitation during perioperative and critical care. MethodsDatabases including The Cochrane Library (Issue 5, 2015), Web of Science, PubMed, CNKI, VIP, CBM and WanFang Data were searched to collect relevant randomized controlled trials (RCTs) about high-versus low-chloride content in fluid resuscitation from inception to May 2015. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Then meta-analysis was performed by using RevMan 5.2 software. ResultsA total of 15 RCTs involving 772 participants were included. The results of meta-analysis indicated that there were no significant differences in mortality (RR=1.30, 95% CI 0.59 to 2.89, P=0.52), incidence of acute kidney injury (RR=1.66, 95% CI 0.83 to 3.31, P=0.15), the level of serum creatinine (MD=0.05, 95% CI-0.06 to 0.15, P=0.38), urine output (MD=0.61, 95% CI-1.11 to-2.33, P=0.48), transfusion volume (MD=86.01, 95% CI-37.80 to 209.82, P=0.17), hospital length of stay (LOS) (MD=-0.27, 95% CI-1.11 to 0.58, P=0.54) and ICU LOS (MD=-0.97, 95% CI-3.31 to 1.37, P=0.42) between the high-chloride content group and the low-chloride content group. While the level of serum chlorine in the high-chloride content group was higher than that in the low-chloride content group (MD=5.40, 95% CI 1.68 to 9.12, P=0.004). ConclusionCurrent evidence shows, there is no difference between high-versus low-chloride content in fluid resuscitation during perioperative and critical care. Due to the limited quality and quantity of the included studies, more high quality studies are need to verify the above conclusion.
ObjectiveTo systematically review the safety of propofol versus sevoflurane for pediatric surgery. MethodsEMbase, PubMed, The Cochrane Library, CSCD, CNKI, WanFang Data were searched to collect randomized controlled trials (RCTs) about propofol versus sevoflurane for pediatric surgery from inception to January 2015. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Then metaanalysis was performed by using RevMan 5.3 software. ResultsFifteen RCTs involving 1 065 children were included finally. Meta-analysis results showed that, compared with the sevoflurane group, the propofol group could reduce the incidence of emergence agitation (OR=0.23, 95%CI 0.16 to 0.34, P<0.000 01) and the incidence of postoperative vomiting (OR=0.32, 95%CI 0.20 to 0.51, P<0.000 01). There were no significant differences between the two groups in extubation time (MD=0.98, 95%CI -0.26 to 2.21, P=0.12), eye-opening time (MD=3.32, 95%CI -2.65 to 9.29, P=0.28) and postoperative analgesic requirements (OR=0.60, 95%CI 0.30 to 1.23, P=0.16). ConclusionIn reducing the incidence of emergence agitation and postoperative vomiting, propofol is superior to sevoflurane, so propofol is safer than sevoflurane for children's surgery.
According to the working principle of vertical ultrasonic vial washing machine, receiving respective force of small water droplets on the inside wall of vials and the minimum air velocity of blowing off water droplets can be obtained based on the analysis of water-droplet-related parameters. The inside wall model of 7 mL vial created by GAMBIT was divided into fine grids. Then the Realizable k-epsilon Two Equation Turbulence Model was adopted and the flow field of vial by FLUENT software was simulated when air was flushing inside the wall. In that case, the optimal position, inner diameter and the corresponding minimum air velocity of needle can be acquired to meet the needs of vial washing machine applied to 7 mL vial.
ObjectiveTo evaluate the applicability and the long-term outcomes of percutaneous transluminal balloon angioplasty (PTBA) in the management of Budd-Chiari syndrome (BCS) secondary to hepatic venous obstruction. MethodsClinical data of 94 patients with BCS secondary to hepatic venous obstruction who underwent PTBA of the hepatic vein from Jan. 2005 to Dec. 2013 in The First Affiliated Hospital of Zhengzhou University were analyzed retrospectively. ResultsPTBA were technically successful in 93 of the 94 patients (98.94%). Ninety-one of the 93 patients (97.85%) were treated with PTBA alone and 2 patients (2.15%) were treated with PTBA and stent. One patient with primary hepatocellular carcinoma (HCC) underwent resection of liver cancer after interventional therapy. Hepatic venous pressure value of 93 patients was significantly decreased after balloon interventional procedures. Symptoms were significantly improved in the 93 patients who had successful PTBA. Procedure-related complications occurred in 6 of the 93 patients (6.38%), and 1 patient (1.06%) died in 2 months after operation because of intra-abdominal bleeding. Two patients lost during follow-up with a follow-up loss rate of 2.15% (2/93), and the 91 patients were followed-up for 1-96 months [(49.72±28.60) months]. HCC occurred in 3 patients during follow-up period. Restenosis of targeted hepatic vein developed in 8 patients (11 times), and the overall recurrence rate was 11.83% (11/93). One patient of them underwent surgical operation, the remaining 7 patients underwent PTBA successfully. The 1-, 2-, 3-, and 5-year primary patency rates were 97.47% (77/79), 94.20% (65/69), 91.67% (55/60), and 91.67% (33/36), respectively. The 1-, 2-, 3-, and 5-year secondary patency rates were 98.73% (78/79), 98.55% (68/69), 98.33% (59/60), and 97.22% (35/36), respectively. ConclusionsPTBA is a safe and effective treatment for BCS with the hepatic vein obstruction and had good mild-term outcomes. The liver function of the patients improved after treatment, with few patients died from HCC caused by hepatic cirrhosis, so we must pay attention on it, as well as the targeted hepatic vein.
ObjectiveTo investigate therapeutic method, curative effect, and prognosis of inferior vena cava (IVC) blocking Budd-Chiari syndrome (BCS) with thrombosis. MethodsClinical data of 128 BCS patients with membranous or short-segment occlusion of IVC as well as IVC thrombosis, who accepted interventional treatment in The Affiliated Hospital of Zhengzhou University from Apr. 2004 to Jun. 2012, were retrospectively analyzed. Comparison of the difference on effect indicators between predilation group and stent filter group was performed. ResultsThereinto, 9 patients with fresh IVC thrombosis were treated with agitation thrombolysis (agitation thrombolysis group), 56 patients were predilated by small balloon (predilation group), for the rest 63 patients, a stent filter was deployed (stent filter group). Besides 1 stent filter fractured during the first removal attempt and had to be extracted surgically in the stent filter group (patients suffered with sent migration), in addition, the surgeries of other patients were technically successful without procedure-related complication. effect indicators were satisfactory in all patients, and there were no statistical differences between predilation group and stent filter group in dosage of urokinase, urokinase thrombolysis time, hospital stay, and incidence of complication (P > 0.05), but the cost of predilation group was lower than that of stent filter group (P < 0.01). All of the 128 patients were followed-up postoperation, and the duration range from 18 to 66 months with an average of 44.2 months. During the follow-up period, reobstruction of the IVC was observed in 13 patients without thrombosis, of which 1 patient in agitation thrombolysis group, 6 patients in predilation group, and 6 patients in stent filter group. There was no significant difference in recurrence rate between predilation group and stent filter group (P > 0.05). Patients with recurrence got re-expansion treatment, and no stenosis or thrombogenesis recurred. ConclusionsAgitation thrombolysis for fresh IVC trombosis in the patients with BCS is safe and effective. Predilation and stent filter techniques are all effective in the treatment of BCS with chronic IVC thrombosis, but the former technique seems to be more economic.