ObjectiveTo study effect of different surgical treatments for patent ductus arteriosus in children.MethodA total of 38 patients with patent ductus arteriosus who underwent surgical treatment of cardiothoracic surgery between January 2016 and December 2017 in our hospital were as an observation group (12 patients with severing suture, 26 patients with ligation, 14 males and 24 females, aged 0.08–8.67 years). In the same period, 38 patients with patent ductus arteriosus who underwent interventional closure in the Department of Cardiology were as a control group (17 males and 21 females, aged 0.50–5.42 years). The clinical effectiveness of the two groups was compared.ResultsThe operation time, postoperative hospital stay, and blood transfusion rate in the observation group were higher than those in the control group with statistical differences (P<0.05). There was no statistical difference in intraoperative blood loss and complications between the two groups.ConclusionsIn patients with a single patent ductus arteriosus or a small catheter, interventional closure of the patent ductus arteriosus is less trauma and faster recovery. But in patients with lower weigh, premature, other intracardiac malformations, large catheter, moderate or severe pulmonary hypertension, the surgery is better.
目的 探討應用經皮接骨板固定技術（MIPPO）結合鎖定鋼板（LCP）固定治療脛腓骨骨折的療效。 方法 2009年11月－2012年1月應用MIPPO技術結合LCP固定治療脛腓骨干骨折62例。其中男42例，女20例；年齡16～85歲，平均45歲。骨折按AO分型：A1型10例，A2型3例，A3型3例，B1型18例，B2型8例，B3型4例，C1型10例，C2型5例，C3型1例。閉合骨折47例；開放骨折15例，根據Gustilo-Anderson分型，Ⅰ型8例，Ⅱ型6例，ⅢA型1例。傷后內固定時間3 h～10 d，平均6 d。 結果 開放骨折有3例傷口Ⅱ期愈合，其中1例傷口皮緣壞死，1例鋼板部分外露經換藥和清創減張縫合后傷口愈合，1例骨外露經皮瓣轉移愈合；其余患者術后傷口均Ⅰ期愈合。62例均獲隨訪，隨訪時間6～16個月，平均9個月。無感染、神經損傷、骨筋膜室綜合征發生。術后2～4個月骨折均愈合。根據Johner-Wruhs療效評價，優48例，良14例；開放性骨折15例中優10例，良5例。 結論 MIPPO技術結合LCP固定治療脛腓骨干骨折，具有創傷小、骨折愈合快等優點。
目的 探討鎖骨鉤鋼板并改良Weaver-Dunn技術治療Tossy Ⅲ型陳舊性肩鎖關節脫位的療效。 方法 2007年１月－2011年１月，對12例Tossy Ⅲ型陳舊性肩鎖關節脫位采用鎖骨鉤鋼板并改良Weaver-Dunn技術治療。其中3例為肩鎖關節脫位手術后再次發生脫位，2例合并鎖骨遠端骨折采用保守治療無效，余7例單純性陳舊性肩鎖關節脫位未經任何檢查治療。 結果 術后患者切口均Ⅰ期愈合，無神經血管損傷、無切口感染等并發癥。12例均獲隨訪，隨訪時間12～30個月。X線片示鎖骨復位情況良好，去除內固定后未見肩鎖關節脫位復發。肩鎖關節功能好，局部畸形消失，無肩周肌肉萎縮及肩周炎出現，鎖骨位置良好。手術療效評價：獲優10例，良2例，優良率100%。 結論 鎖骨鉤鋼板并改良Weaver-Dunn技術治療Tossy Ⅲ型陳舊性肩鎖關節脫位，復位固定滿意，韌帶重建易成功，肩關節功能恢復好，是一種治療陳舊性肩鎖關節脫位較理想的方法。
Objective To investigate the effects of lycium barbarum polysaccharide (LBP) on the formation of traumatic neuroma and pain after transection of sciatic nerve in rats. Methods Forty Sprague-Dawley (SD) rats, weighing 200-220 g, half male and half female, were allocated into 2 groups randomly: LBP group and control group (n=20 per group). The right sciatic nerves were transected and 2 cm sciatic nerve were removed in all rats of the 2 groups. LBP were intraperitoneally injected in a volum of 10 mg/(kg·d) in the LBP group, while the same volum normal sal ine (NS) in the control group for 28 days. The deficiency of toenail and toe were observed to estimate the autophagy of the operated l imb. Light microscope and transmission electron microscope were used to observe the formation of traumatic neuroma aftertransection of sciatic nerve. Results Autophagy was observed in 5 rats (25%) of LBP group and in 12 rats (60%) of controlgroup at 4 weeks, showing significant difference (P lt; 0.05). Neuroma formed in 8 rats (40%) of LBP group and in 16 rats(80%) of control group, showing significant difference (P lt; 0.05). The observation of l ight microscope showed that there were unorganized growth cells in the neuroma, infiltrated muscle cells, the regeneration of axons and ensheathing cells to form small patch and funicular structure in the control group, while in the LBP group there were less prol iferation of nerve fibers with a regular arrangement. Transmission electron microscope showed that there were lots of axons in nerve tumour, more fusoid fibroblasts, more collagen fiber, and hyperplasia and degenerated myel in sheath in the control group, while in the LBP group there were less myel in sheath in the proximal end of injuring nerves, less Schwann cells and fibroblasts, and sparsed collagen fibers. Conclusion LBP can inhibit autophagy and the formation of traumatic neuroma after transection of sciatic nerve in rats.
Objective To summarize and analyze the clinical efficacy of negative pressure suction bell in the treatment of young children (≤6 years) with pectus excavatum. Methods The relevant clinical medical records of the children with pectus excavatum who received negative pressure suction bell treatment in the Outpatient Department of Children’s Hospital of Chongqing Medical University from May 2019 to January 2023 were collected. The age, sex, type, severity, depth of depression, duration of use and prognosis of children with pectus excavatum were retrospectively analyzed. Results A total of 100 pediatric patients were ultimately included in the study, comprising 74 males and 26 females. The age distribution was 57 patients aged 0-3 years and 43 patients aged 3-6 years. All patients were prescribed and used a negative pressure suction device for at least 3 months, after which they returned to our department's outpatient clinic for follow-up. The treatment demonstrated clinical effectiveness in 99 patients, yielding an efficacy rate of 99.00%. The excellent/good rate was 52.00%, and the complication rate was 8.00%. After treatment, the Haller index and the depth of sternal depression were reduced compared with those before treatment (P<0.001), and there was no statistical difference in the effective rate and excellent/good rate between different genders, different ages, different types of pectus excavatum, or different severity (P＞0.05). Conclusion Negative pressure suction bell is safe and effective in the treatment of young children (≤6 years) with pectus excavatum, and the correction effect has nothing to do with gender, type and severity .
ObjectiveTo compare and analyze the treatment effect of thoracoscopic surgery and traditional open surgery on infants with congenital diaphragmatic eventration, and summarize the experience of thoracoscopic surgery in infants with congenital diaphragmatic eventration.MethodsWe retrospectively analyzed the clinical data of 105 children with congenital diaphragmatic eventration who received operation in the Department of Cardiothoracic Surgery of Children’s Hospital of Chongqing Medical University from January 2010 to January 2019. The patients were divided into an open group and a thoracoscopic group according to the operation methods. There were 41 patients in the thoracoscopic group, including 30 males and 11 females, with an average of 13.42±11.08 months (range: 1 d to 3 years). There were 64 patients in the open group, including 44 males and 20 females, with an average age of 8.21±9.33 months (range: 15.0 d to 1.6 years). The operation time, intraoperative bleeding volume, postoperative mechanical ventilation time, hospital stay and other operation indexes as well as the mortality, recurrence rate and complication rate of the two groups were observed.ResultsThe operation indexes such as operation time, intraoperative bleeding volume, postoperative mechanical ventilation time, thoracic drainage time, CCU stay and hospital stay of the thoracoscopic group were better than those in the open group (P<0.05). There was no statistical difference between two groups in postoperative diaphgram muscles descent, postoperative feeding time or patients needing thoracic drainage (P>0.05). The incidence of postoperative complications in the thoracoscopic group (19.51%) was lower than that in the open group (23.44%, P>0.05), and the difference in mortality and recurrence rate between the two groups was not statistically significant (P>0.05).ConclusionBoth thoracoscopic diaphragmatic plication and traditional open surgery can effectively treat congenital diaphragmatic eventration, but compared with traditional open surgery, thoracoscopic diaphragmatic plication has the advantages of shorter operation time, less trauma, more rapid recovery and fewer complications, so it should be the first choice for children with congenital diaphragmatic eventration.