目的:探讨新生儿高未结合胆红素血症病因构成、发生规律及防治。方法:对340例新生儿高未结合胆红素血症进行病因综合分析。结果:(1)病因以感染因素占首位,其次是溶血因素及围产因素;(2)病因与发病时间的关系:溶血因素及围产因素均发生在日龄lt;3 d内,发病日龄gt;3 d以感染因素为主,还有母乳性黄疸。结论:早期新生儿高未结合胆红素血症以溶血因素及围产因素为主,中晚期新生儿高未结合胆红素血症则以感染因素为主。故加强围生期保健,加强预防及抗感染,减少孕期及产时并发症的发生可有效减少新生儿黄疸的发生。
ObjectiveTo summarize the prevention and treatment of iatrogenic medial collateral ligament (MCL) injuries in total knee arthroplasty (TKA).MethodsThe relevant literature about iatrogenic MCL injuries in TKA was summarized, and the symptoms, causes, preventions, and treatments were analyzed.ResultsPreventions on the iatrogenic MCL injuries in TKA is significantly promoted. With the occurrence of MCL injuries, the femoral avulsion can be fixed with the screw and washer or the suture anchors; the tibial avulsion can be treated with the suture anchors fixation, bone staples fixation, or conservative treatment; the mid-substance laceration can be repaired directly; the autologous quadriceps tendon, semitendinosus tendon, or artificial ligament can be used for the patients with poor tissue conditions or obvious residual gap between the ligament ends; the use of implant with greater constraint can be the last alternative method.ConclusionNo consensus has been reached to the management of iatrogenic MCL injuries in TKA. Different solutions and strategies can be integrated and adopted flexibly by surgeons according to the specific situation.
Objective To determine whether antibiotic prophylaxis can reduce the risk of postoperative bacteriuria in men undergoing transurethral resection of prostate (TURP) who have sterile preoperative urine. Method MEDLINE, EMBASE and Cochrane Library were searched for RCTs comparing antibiotic prophylaxis and placebo/blank controls for men undergoing TURP with preoperative sterile urine. The search strategy was established according to the Cochrane Prostatic Diseases and Urologic Cancers Group search strategy. Data was extracted by two reviewers using the designed extraction form. RevMan were used for data management and analysis. Results Fifty three relevant trials were searched, of which 27 trials were included and 26 were excluded. Antibiotic prophylaxis significantly decreased the rate of post-TURP bacteriuria.The pooled relative risk (RR) and 95% confidence interval were 0.36 (0.28, 0.46). Conclusions Prophylactic antibiotics could significantly decrease the incidence of post-TURP bacteriuria. Further comparative RCTs and cost-effective should be performed analysis to establish the optimal antibiotic regimes for the benefit of patients undergoing TURP.
Objective To review various kinds of therapeutic methods for restenosis after reconstructive vascular operation. Methods The literatures about prevention and treatment for restenosis after reconstructive vascular operation were reviewed. Results Therapeutic methods for vascular restenosis include gene therapy, drug treatment, placing external stent around the vein graft and physical therapy. The methods of gene therapy include transferring genes that inhibit the proliferation of vascular smooth muscle cell (VSMC) and inactivating genes that promote the proliferation of VSMC through technology of antisensenucleic acids or RNA interference. Conclusion Current treatment for restenosis after reconstructive varscular operation have both advantages and disadvantages, some of which are still being disputed. With the development of the technology of molecular biology, gene therapy would be the most effective therapy method for vascular restenosis.
ObjectiveTo summarize the prevention and treatment strategies and their effects on lymphatic leakage following transoral endoscopic thyroid cancer lateral neck lymph node dissection. MethodsA retrospective review was conducted, we collected clinical data from 47 patients with papillary thyroid carcinoma who underwent transoral endoscopic thyroidectomy and lateral neck lymph node dissection at our hospital from January 2021 to May 2023. A stepwise sequential treatment plan was adopted for patients with postoperative lymphatic leakage: low-fat, low-protein diet, continuous strong negative pressure suction, subcutaneous injection of Group A streptococcus in the surgical cavity, and ligation of the thoracic duct or lymphatic vessels through a small incision. The effectiveness of the sequential treatment plan was summarized. ResultsOut of the 47 patients, lymphatic leakage occurred in 5 cases postoperatively. Patient No.1 was cured of lymphatic leakage after sequential treatments including pectoralis major muscle flap occlusion of the jugular venous angle, low-fat, low-protein diet, continuous strong negative pressure suction postoperatively, subcutaneous injection of Group A streptococcus in the surgical cavity, and finally ligation of the thoracic duct or lymphatic vessels through a small incision. Patient No.20 was conservatively cured of lymphatic leakage with an initial surgical procedure involving pectoralis major muscle flap occlusion of the jugular venous angle, low-fat, low-protein diet, continuous strong negative pressure suction postoperatively, and subcutaneous injection of Group A streptococcus in the surgical cavity. Patient No.28 recovered after only pectoralis major muscle flap occlusion of the jugular venous angle, low-fat, low-protein diet and continuous strong negative pressure suction postoperatively. Treatment process of patient No.30 was the same as Patient No.1, Patient No.36 was the same as Patient No.20. Through the stepwise sequential treatment measures, all 5 patients successfully recovered from lymphatic leakage; the postoperative hospital stay ranged from 3 to 17 days, with an average of 8.6 days. ConclusionsThe stepwise sequential treatment plan used in this study can effectively prevent and treat lymphatic leakage after transoral endoscopic thyroid cancer lateral neck lymph node dissection. Given the small sample size of this study, we believe that it is necessary to conduct long-term studies to confirm the durability and stability of these measures.