Search

Malignant hyperthermia (MH) is a rare life threatening inherited disorder that is triggered by drugs used for general anesthesia in susceptible persons. The symptoms include rapid increase of body temperature and severe muscle contractions. The present study includes 3 cases of MH and highlights the timely identification of symptoms for rescuing the patient. In case I, a 7-year-old male child underwent surgery with ketamine at a dose of 250 mg. After 4 h of operation, the child went through convulsions, high fever and succumbed within a few hours. High fever was not detected in a timely manner, which is one of the main symptoms of MH. In case II, a 12-year-old male child had convulsions and high fever after simple surgery caused by MH. Once confirmed, immediate measures were taken to lower the body temperature and the child was rescued. In case III, a male 57-year-old was admitted to hospital due to paraplegia. The patient underwent more critical conditions once symptoms of MH appeared. Additionally, antidote dantrolene was unavailable in the first and third case; thus, the progression of disease was not alleviated although active symptomatic and supportive treatment were employed. [ABSTRACT FROM AUTHOR]

Bacterial infections are common but have become increasingly resistant to drugs. The aim of the present study was to examine the combined treatment of traditional Chinese and Western medicine in 30 cases of pulmonary infection with multidrug resistant Acinetobacter baumannii. Patients were divided into groups A and B according to drug treatments. Cefoperazone or sulbactam and tanreqing were administered in group A, and cefoperazone or sulbactam in group B. The curative effect and prognosis of the two groups were recorded and the remaining treatments were performed routinely in the clinic. For the combined therapy group, which was administered sulperazone and tanreqing, 8 patients were recovered, 6 patients had significant effects, 3 patients exhibited some improvement and 1 patient had no response. One of the patients did not survive after 28 days. By contrast, there were 4 patients that were successfully treated, 3 patients with significant effects, 2 patients with some improvement and 2 patients had no response in the sulperazone group, and 4 patients did not survive after 28 days. In conclusion, the combined therapy of cefoperazone or sulbactam supplemented with tanreqing was identified to be more effective than cefoperazone or sulbactam as monotherapy, for treating multidrug resistant Acinetobacter baumannii. [ABSTRACT FROM AUTHOR]

Esophageal foreign body impaction is a notable clinical emergency. If the high-risk esophageal foreign bodies are not removed in time, life-threatening complications, such as perforation, infection and injury to the vessels, may occur. In the present study, the case of a patient experiencing a foreign body sensation in the throat after ingesting a fish bone by mistake is presented. A high risk of impending arterial puncture was confirmed using thoracic CT and thoracic aorta CT angiography scanning. The ends of the fish bone were first confirmed using a fibro-bronchoscopy light source passing through the bronchial and esophageal walls, before biopsy forceps were used to successively free the thoracic aorta and bronchial ends under gastroscopy. Finally, the fish bone was safely removed using a combination of gastroscopy and the rarely used fibro-bronchoscopy, and the patient recovered well after standard care. In certain cases of foreign bodies, it is necessary to use multiple strategies in a timely manner according to the type and location of the ingested foreign body. [ABSTRACT FROM AUTHOR]

Neoadjuvant chemotherapy is the preferred treatment of advanced gastric cancer. However, the choice of an optimal regimen remains controversial. The present study aimed to assess the effectiveness of preoperative chemotherapy with EOX and FOLFOX in Chinese patients with advanced gastric cancer. A total of 87 and 26patients underwent FOLFOX and EOX regimens, respectively, for advanced gastric cancer between July2004 and September2012. Clinicopathological characteristics, pathological T stage, N stage and pathological response to tumour regression were retrospectively compared between the two groups. Following neoadjuvant chemotherapy, a higher number of patients manifested deeper invasive cancer in the FOLFOX group than those in the EOX group (P=0.047). In addition, a higher number of patients also exhibited metastatic lymph nodes in the FOLFOX group (67.8%) than in the EOX group (57.7%) (P=0.000). In the FOLFOX and EOX groups, 4 (4.6%) and 3 (11.5%) cases of complete regression were observed, respectively. A higher number of patients (38.5%) also exhibited tumour regression grades of 3 and 4 in the EOX group than in the FOLFOX group (19.5%) (P=0.047). Results of the present study suggest that the EOX regimen may be more effective than the FOLFOX regimen as preoperative chemotherapy for Chinese patients with advanced gastric cancer. The EOX regimen may be suitable for younger patients subjected to individual neoadjuvant chemotherapy. [ABSTRACT FROM AUTHOR]

The aim of the present study was to investigate the use and effectiveness of a selective, partial, pedunculated (tongue-shaped) conjunctival flap (CF) for the treatment of refractory fungal keratitis (FK) with or without perforation. A total of 31 cases of corneal diseases treated by CF surgery between April 2014 and October 2015 were evaluated. Among the 31 cases, 16 cases (male:female, 11:5) with FK were selected. Logistic regression analysis was used to investigate factors associated with complications of CF surgery. A higher prevalence of FK was identified among male farmers compared with female farmers, in which plant trauma was the most prevalent cause of the disease. Only 4 patients had experienced corneal perforation prior to CF surgery. Patients aged 61-80 years had a higher prevalence of FK (50%) compared with other age groups; however, there was no statistically significant correlation between the prevalence of FK and sex or age. It was also demonstrated that age, sex, combined surgery and surgery duration were not significantly associated with post-surgical complications. All CF surgeries were performed following corneal ulcer scraping; however, 4 patients (12.5%) required additional surgery. The visual acuity of participants post-surgery decreased in 4 cases and remained unchanged in 12 cases. A total of 3 study patients experienced post-surgical complications of corneal perforation (1 patient) and purulent exudate spreading (2 patients). The post-surgical outcome was good for all study participants as the surgeries were able to control infection and preserve the eyeball, with the potential of future corneal transplant. These results suggest that CF surgery may be a useful alternative treatment for refractory FK in countries such as China where there is lack of cornea donors. [ABSTRACT FROM AUTHOR]

Septic shock, also known as infectious or toxic shock, is a medical condition caused by severe infection and sepsis. Early identification, timely diagnosis and effective treatments are imperative to prevent this medical condition. The aim of the present study was to examine the application of pulse index continuous cardiac output (PiCCO) technique in the treatment of septic shock patients. Fifty septic shock patients were randomly divided into the conventional detection group (group C, n=25) and the PiCCO detection group (group P, n=25). A central venous catheter and radial artery catheter were placed into the patients of group C and a central venous catheter and PiCCO catheter (through femoral artery) were placed in the patients of group P to detect haemodynamics, which was managed and treated according to early goal-directed therapy (EGDT). PiCCO was applied to monitor and guide the application of fluid resuscitation, vasoconstriction drugs (dopamine) and positive inotropic drugs (dobutamine). The EGDT qualified rate of patients from the two groups at the 6th h of treatment, changes of post-resuscitation relevant parameters [blood lactate level, central venous oxygen saturation (ScvO2), central venous pressure (CVP), mean arterial pressure (MAP) and urine volume], positive fluid balance quantity and the dosage of dopamine and dobutamine at the 6th, 24th and 48th h were observed. In comparison to group C, group P showed an increase in the EGDT qualified rate and ScvO2 at the 6th h of treatment while the blood lactate level was decreased. The positive fluid balance quantity at the 6th and 24th h and the dosage of dobutamine were increased while the dosage of dopamine was reduced (P<0.05). There was no statistical significance in terms of the differences of positive fluid balance quantity and the dosage of dopamine and dobutamine in the two groups at the 48th h of treatment (P>0.05). There was also no statistical significance in terms of the differences of CVP, MAP and urine volume in the two groups (P>0.05). In conclusion, under the monitoring and guidance of the PiCCO technique, EGDT treatment should be applied to septic shock patients together with early fluid resuscitation and positive inotropic drugs instead of using only vasoconstriction drug, which cause elevation of blood pressure. [ABSTRACT FROM AUTHOR]

Diffuse lamellar keratitis (DLK) is a sterile inflammation of the cornea, which may occur after laser-assisted in situ keratomileusis (LASIK) surgery. Little is known about the association of DLK with permanent eyeliner tattoo. The present case report describes the case of a 37-year-old Chinese woman who developed severe foreign body sensation in both eyes 1 week after receiving bilateral permanent eyeliner tattoo treatment. The patient had received bilateral LASIK surgery 10 years previously. Slit-lamp biomicroscopy revealed diffused granular infiltrates precipitated around the edge of the corneal flaps in both eyes. After topical treatment, DLK persisted. Therefore, the patient underwent surgery to remove the corneal epithelium around the DLK lesion. There was no recurrence of the disease during the 3-month observation period. To our knowledge, this is the first case report describing a case of late-onset of DLK that was triggered by permanent eyeliner tattoo. Doctors should be aware of the diagnosis and treatment of this complication associated with the application of permanent eyeliner tattoo as the popularity of this cosmetic procedure increases. [ABSTRACT FROM AUTHOR]

Sepsis is a systemic inflammatory response of the body to an antigen and can become a life-threatening condition by triggering a cascade of changes leading to multiple organ failure such as heart failure. The aim of the present study was to examine the changes of the plasma levels of N-terminal of the prohormone brain natriuretic peptide (NT-proBNP) and cardiac troponin T (cTnT) in patients with sepsis and to analyze their prognostic significance. A total of 38 hospitalized patients with sepsis were included in the present study. The patients were divided into the survival and death groups, based on their prognosis. The plasma levels of NT-proBNP and cTnT for the two groups were measured for all the patients on the 1st, 3rd and 7th day of admission. The plasma levels of NT-proBNP and cTnT between the two groups were compared and their association with prognosis were analyzed. The plasma levels of NT-proBNP and cTnT in the death group were significantly higher than those in the survival group (P<0.05). Additionally, a positive assocciation of the plasma levels of NT-proBNP and cTnT was identified (P<0.05). In conclusion, the plasma levels of NT-proBNP and cTnT may be used as routine clinical biomarkers to assess the prognosis of patients with sepsis. [ABSTRACT FROM AUTHOR]