One-time Success Rate Research Articles

Development and clinical application of a new type of intramedullary nail tail cap

To develop a new type of tail cap for closing the tail of the central hole of the interlocking intramedullary nail so as to reduce difficulty in implantation of the tail cap into intramedullary nail, and ensure the accuracy of implantation, as well as reduce unnecessary operation time. In 2014, the new type of intramedullary nail tail cap ("new tail cap" for short) was successfully developed, and has been granted national utility model patent. A randomized controlled clinical trial was conducted in 34 patients with non pathological femoral shaft fractures treated between August 2014 and March 2016. The patients were randomly divided into groups A and B, 17 patients each group. There was no significant difference in gender, age, side, body mass index, cause of injury, injury to operation time, and fracture AO classification between groups ( P>0.05), with comparability. All patients underwent fixation with interlocking intramedullary nail, and the new tail cap and original tail cap were used in groups A and B respectively. The blood loss and operation time during tail cap implantation, fracture healing time, and complications were recorded and compared between 2 groups; the limb function was evaluated by Klemm function evaluation standard. The blood loss and operation time during tail cap implantation of group A [(3.5±0.8) mL and (10.57±3.15) s] were significantly less than those of group B [(5.5±1.7) mL and (21.99±6.90) s] ( t=-8.281, P=0.010; t=-10.743, P=0.009). All new tail caps were successfully implanted by one-time in group A, and the one-time success rate was 100%; the original tail cap exfoliation occurred in 3 cases of group B, and the one-time success rate was 82.4%. All the patients were followed up 6-16 months (mean, 9.7 months); there was no deep infection, loosening or breakage of internal fixation, and other serious complications. The time of fracture healing was (16.4±3.2) weeks in group A and (15.8±3.5) weeks in group B, showing no significant difference ( t=0.514, P=0.611). At last follow-up, according to the Klemm function evaluation standard, the results were excellent in 14 cases and good in 3 cases in group A, and were excellent in 11 cases and good in 6 cases in group B, showing no significant difference between 2 groups ( χ2=0.142, P=0.707). The new type of femoral intramedullary nail tail cap can simplify operation, shorten operation time, and reduce blood loss, and it has satisfactory effectiveness.

Application of three-dimensional wire localization and orientation in the resection of non-palpable breast lesions.

The aim of the present study was to compare the application value of the 3D stereo wire localization technique guided by a full digital breast X-ray machine, and general location technique in the resection of breast non-palpable lesions. A retrospective analysis of the clinical data of 80 patients with abnormal findings for non-palpable breast molybdenum target X-ray was conducted between June, 2011 and July, 2014. The patients were divided into two groups: 40 cases with a general location of lesions identified by perturbation axial + standard lateral radiograph to guide the clinical operation biopsy (group A); and 40 cases with a general location of lesions identified by the 3D stereo wire localization method to guide the clinical operation biopsy (group B). The one-time success rate of the resection of breast lesions of the two groups of patients was compared. Both groups of patients completed the operation. Of the 40 cases in group A, 33 cases had one-time complete resection of lesions, 5 cases had incomplete resection with the second resection, and the lesions of 2 cases were not excised and the one-time success rate of the breast lesion resection was 82.5%. Of the 40 cases in group B, lesions of 38 cases were one-time complete resection and 2 had vagal reaction; thus, the one-time success rate of breast lesion resection being 95%. Compared to group A, the one-time success rate of breast lesion resection of group B was statistically and significantly higher (χ2=3.638, P<0.05). In conclusion, the 3D stereo wire localization technique guided by the full digital breast X-ray machine for the excision of non-palpable breast lesions has high positioning accuracy with small operation excision scope. It is therefore an effective method that can be utilized for the qualitative diagnosis of non-palpable breast lesions.

Design and application of new portable vein visualizer

Objective To investigate the application of new portable vein visualizer in venous indwelling needle puncture in children. Methods A total of 432 children from January 2016 to June 2016 in pediatric department were randomly divided into observation group (n=224) and control group (n=208) . Children in observation group received self-designed new portable vein visualizer in superficial venous indwelling needle puncture, while children in control group received traditional needle puncture. The one-time puncture success rate, puncture time, pain in children and family satisfaction were compared between two groups. Results The success rate of observation group (95.1%) was significantly higher than control group (73.1%) (χ2=39.881, P<0.05) . The puncture time of observation group was shorter (3.400±0.615) than control group (4.850±0.873) , with statistically significant difference (t=9.608, P<0.05) . The family satisfaction in observation group (96.1%) was significantly higher than control group (85.2%) (χ2=7.037, P<0.05) . Conclusions Application of new portable vein visualizer in superficial venous indwelling needle puncture in children improves the success rate, decreases the puncture time, reduces the pain of children and improves family satisfaction. Key words: Innovation and promotion; New portable vein visualizer; Design; Application

Application effect of homemade visible stomach tube guiding device in patients with gastric canal implantation under general anesthesia

Objective To evaluate the application effect of homemade visible stomach tube guiding device in patients with gastric canal implantation under general anesthesia. Methods From January to December 2015, 90 patients who would undergo gastrointestinal or hepatobiliary surgery under general anesthesia with indwelling gastric tube were selected as the research object by purpose sampling method. 90 cases were divided into group A (conventional catheter) , group B (guidewire guided) and group C (homemade visible stomach tube guiding device guided) , with 30 cases in each group. All patients received gastric canal implantation immediately after endotracheal intubation under general anesthesia. We recorded the time of one-time successful gastric tube implantation, the times of implantation, the number of successful cases that implanted at a time, the total number of cases with successful implantation and the number of cases with throat mucosal injury. Results The intubation time of group A and group B were longer than that of group C (P<0.05) . The time in group A was the longest. Only 10 cases in group A were successful implanted in one time, 19 cases in group B were successfully implanted in one time, and all the cases in group C were successfully implanted in one time. The one-time success rate of gastric canal implantation of group C (100.0%) was higher than that of group A (33.3%) and group B (63.3%) (P<0.05) . The total success rate of gastric canal implantation of group A (53.3%) was lower than that of group B (90.0%) and group C (100%) (P<0.05) . The incidence of throat mucosal injury of group C (3.3%) was lower than that of group A (33.3%) and group B (26.7%) (P<0.05) . Conclusions The homemade visible stomach tube guiding device can quickly improve the one-time success rate of gastric canal implantation in patients under general anesthesia, reduce the time of implantation and decrease the incidence of throat mucosal injury. Key words: Innovation and promotion; Anesthesia, general; Gastric canal implantation; Visible stomach tube guiding device

The pilot study of radiology nursing intervention in abdominal 3-T Magnetic Resonance examination.

The aim of this study was to investigate the effect of radiology nursing intervention in abdominal examination at 3-T MRI. 60 patients with abdominal diseases were divided into two groups randomly: MR nursing intervention group and control group. All the patients underwent abdominal MR examination at 3-T. The MR nursing interventions were performed in nursing intervention group. The outcomes, including one-time success rate, the ratio of diagnosable MR images and the points of image quality, were compared between these two groups. The one-time success rates in control group and MR nursing intervention group were 66.67% and 96.67% with significant difference ( χ2 =9.017, P<0.05). The ratios of diagnosable images in the two groups were 76.67% and 96.67% with significant difference (χ2 =5.192, P<0.05). The points of MR image quality in the two groups were 1.87±0.86 and 2.33±0.55, respectively. There was significant difference between these two groups (t=-2.508, P<0.05). The effective nursing intervention can make the patients cooperation better in abdominal MR examination and improve the image quality significantly.

Optimized Axillary Vein Technique versus Subclavian Vein Technique in Cardiovascular Implantable Electronic Device Implantation: A Randomized Controlled Study.

Background:The conventional venous access for cardiovascular implantable electronic device (CIED) is the subclavian vein, which is often accompanied by high complication rate. The aim of this study was to assess the efficacy and safety of optimized axillary vein technique.Methods:A total of 247 patients undergoing CIED implantation were included and assigned to the axillary vein group or the subclavian vein group randomly. Success rate of puncture and complications in the perioperative period and follow-ups were recorded.Results:The overall success rate (95.7% vs. 96.0%) and one-time success rate (68.4% vs. 66.1%) of punctures were similar between the two groups. In the subclavian vein group, pneumothorax occurred in three patients. The subclavian gaps of three patients were too tight to allow operation of the electrode lead. In contrast, there were no puncture-associated complications in the axillary vein group. In the patient follow-ups, two patients in the subclavian vein group had subclavian crush syndrome and both of them received lead replacement. The incidence of complications during the perioperative period and follow-ups of the axillary vein group and the subclavian vein group was 1.6% (2/125) and 8.2% (10/122), respectively (χ2 = 5.813, P = 0.016).Conclusion:Optimized axillary vein technique may be superior to the conventional subclavian vein technique for CIED lead placement.Trial Registration:www.clinicaltrials.gov, NCT02358551; https://clinicaltrials.gov/ct2/show/NCT02358551?term=NCT02358551& rank=1.

The influence of different sites of catheterization of PICC on the incidence of complications for the infants after catheterization

Objective To explore the influence of different sites of catheterization of PICC on the incidence of complications for the infants after catheterization. Methods A total of 130 cases of infant patients hospitalized in our hospital from April 2015 to April 2016 were selected and divided into experimental group and control group according to the sites of catheterization.The children of the experimental group were placed PICC through the venous, while the children of the control group were placed PICC through the upper extremity venous.The incidence of complications, the one-time success rate of puncture, the time for operation, the amount of bleeding and the time for catheterization of the two groups were compared. Results The one-time success rate and time for operation of the children of the experimental group was better than that of the control group, and the differences were statistically significant(P 0.05). Conclusion Placement of PICC through the venous can significantly improve the success rate and can reduce the time for operation, meanwhile it has less impact on the complications after catheterization.PICC placement through the venous can be choosen preferably. Key words: Peripherally inserted central catheter; Catheter site; Complication; Success rate of catheterization; Time for operation

Discussion about the effects of using PlCC for low birth weight infant during the course of parenteral nutrition

Objective Study of peripherally inserted central catheter (PICC) for low birth weight infant parenteral nutrition effect. Methods A total of 100 low birth weight infants were selected, and then divided into the study group and the control group with 50 cases in each group according to random number table method. The study group used PICC for intravenous nutrition support treatment, the control group using external support for the treatment of indwelling needle for nutrition week vein. Comparing the two groups of one-time success rate of catheterization, average operation time, indwelling time, incidence of complications and nutritional support before and after the treatment, the children of weight. Results The one- time success rate of catheterization between the two groups had no significant difference (P > 0.05). The operation time and the indwelling time in the study group was(30.65±9.87) d, (23.47±6.38) d respectively, while in the control group was (3.26±1.09) d, (4.15±1.52) d respectively, the difference was significant between the two groups (t=19.054 and 20.829, P 0.05). Conclusions Parenteral nutritional support by PICC for low birth weight infant is a more ideal way with longer indwelling time and fewer complications. Key words: Catheterization, central venous; Low birth weight infants; Intravenous nutrition

The usage of HC visual laryngoscope for emergency tracheal intubation by unskilled junior emergency resident doctors

Objective To investigate the usefulness of HC visual laryngoscope designed for unskilled junior emergency resident doctors in respect of increasing the efficiency and success rate of emergency tracheal intubation. Methods A total of 80 patients needed the emergency tracheal intubation were at first divided into two groups randomly(random number). Patients in group A were operated by junior emergency resident doctors and patients in group B were operated by well experienced attending doctors. Then, the two groups of patients above were divided into two groups randomly(random number). Patients in group N were operated with conventional laryngoscope and patients in group HC were managed with HC visual laryngoscope. Then comparisons of the success rate of glottis exposure, the one-time success rate of tracheal intubation, the success rate of tracheal intubation, the complications, the number of attempt in successful intubation cases and the operative time consumed for successful intubation cases among the groups were done. Results (1) The success rate of glottis exposure, the one-time success rate and the success rate of tracheal intubation in group A-HC were 90%, 70% and 90%, respectively which were significantly higher than those (50%, 20% and 45%) in group A-N (P 0.05). Conclusions HC visual laryngoscope used by unskilled junior emergency resident doctors for emergency tracheal intubation, could increase success rate of glottis exposure, decrease the number of attempt of intubation, decrease rate of complication, shorten operative time required for intubation thus improving efficiency and success rate of emergency tracheal intubation, and maybe narrow the skill gap between unskilled junior resident doctors and well experienced attending doctors in respect of emergency tracheal intubation. Key words: HC visual laryngoscope; Emergency department; Junior resident doctors; Emergency tracheal intubation

SHORT-TERM EFFECTIVENESS OF PERCUTANEOUS PEDICLE SCREW GUIDED WITH PHOTOELECTRIC NAVIGATION FOR THORACOLUMBAR FRACTURES

To investigate the short-term effectiveness of percutaneous pedicle screw (PPS) guided with photoelectric navigation for thoracolumbar fractures. Between May 2013 and June 2015, the clinical data of 39 patients with thoracolumbar fractures in accordance with the selection criteria were retrospectively analyzed. The patients were divided into photoelectric navigation PPS group (trial group, 20 cases) and C-arm X-ray guidance PPS group (control group, 19 cases). There was no significant difference in gender, age, injury cause, fracture vertebrae, AO classification, operation time after injury, visual analogue scale (VAS) score, and vertebral compression ratio (VCR) between 2 groups (P &gt; 0.05). The operation time, bleeding amount, perspective times, VAS score, and one-time success rate (OSR) of screw placement were recorded; VCR and endplate-screw angle (ESA) were measured; and pedicle-screw relationship (PSR) was assessed by Ringel's method in radiographic result. Differences in operation time and bleeding amount were not significant between 2 groups (P &gt; 0.05); perspective times of control group was significantly more than t hat of trial group (t=-15.658, P=0.000). The OSR of trial group (95.60%, 87/91) was significantly better than that of control group (86.75%, 72/83) (χ2=4.323, P=0.038). The patients were followed up 6-11 months (mean, 7.6 months) in trial group, and 7-11 months (mean, 7.8 months) in control group. No neurovascular complications associated with screw insertion occurred. Difference was not significant in VAS score at 7 days and 6 months after operation between 2 groups (P &gt; 0.05), but VAS scores at 7 days and 6 months were significantly improved when compared with preoperative score in 2 groups (P &lt; 0.05), and significant difference in VAS score was shown between at 7 days and 6 months in 2 groups (P &lt; 0.05). VCR of trial group and control group were significantly improved to 94.75%±5.10% and 92.40%±5.09% at 6 months after operation from preoperative 71.97%±5.66% and 73.50%±5.97% (t=11.865, P=0.000; t=11.359, P=0.000), but there was no significant difference between 2 groups (t=1.442, P=0.158). ESA of trial group and control group were (1.82±1.13)° and (3.36±2.43)° at 6 months after operation, showing significant difference (t=5.421, P=0.000). At 6 months after operation, according to PSR classification, 83 screws rated as grade I, 6 as grade II, and 2 as grade III, and excellent and good rate of screw replacement was 97.80% in trial group; 54 screws were rated as grade I, 19 as grade II, 7 as grade III, and 3 as grade IV, and excellent and good rate of screw replacement was 87.95% in control group; difference was significant between 2?groups (χ2=18.347, P=0.000). Application of photoelectric navigation can guide screws placement by the two-dimensional multi pl ane dynamic image, has better accuracy of screws position in thoracolumbar fractures, reduces the introperative X-ray perspective times, maintains good reduction of vertebral body, and achieves satisfactory effectiveness.

小儿静脉穿刺时家属干预对穿刺成功率的影响研究

目的：比较小儿静脉穿刺时，家属是否在现场与穿刺护士压力大小的关系，以及家属因素对静脉穿刺成功率的影响。方法：应用自行设计的调查问卷和评估量表，搜集2015年9月至2015年12月所有来我院就诊患儿静脉穿刺的情况，和每次穿刺时护士的心理压力大小情况。将2015年9月至2015年10月来我院就诊的450例患儿设为试验组，穿刺时不允许家属在身边；2015年11月至2015年12月的450例患儿设为对照组，穿刺时允许家属在身边。对比静脉穿刺时，家属是否在现场对护士压力大小、穿刺次数的影响程度。结果：在工作年限1年、2年的低年资护士的穿刺一次性成功率中，试验组与对照组存在显著性差异(p 0.05)；在压力评分中，工作年限在1年、2年的低年资护士试验组主要变现在轻中度压力，而对照组表现为中、偏重度压力，两组间有统计学差异(p 0.05)。结论：护士为患儿进行静脉穿刺时，家属不在现场可提高静脉穿刺成功率；随工作年限延长，抗压能力增强。 Objective: To compare the relationship between the presence of family members and the pres-sure of the nurses in pediatric puncture, and the influence of family intervention on the success rate of puncture. Methods: A self-designed questionnaire and evaluation scale was used in the cases from September 2015 to December 2015. 450 patients from September to October were set as the experimental group which the families were not allowed in the children side when puncturing; 450 cases of November to December were set as the control group which the fami-lies were in the side. The influence of family members on the pressure of nurses and the number of times of puncture is compared. Results: There is a significant difference between the experi-mental group and the control group in the working life of 1 year, 2 years of junior nurses punc-ture one-time success rate (p 0.05); mild to moderate pressure was realized in junior nurses in experimental group, while severe degree pressure was showed in the control group (p 0.05). Conclusions: The success rate of venous puncture can be improved without the family members in the field, resistance of pressure can be strengthened with the working experience.

Clinical effect of peripherally inserted central catheters based on modified seldinger technique under guidance of vascular ultrasound.

Objective:To observe and analyze the application effect of ultrasound-guided modified Seldinger technique (MST) in Peripherally Inserted Central Catheter (PICC) catheterization.Methods:Two hundred patients treated with PICC catheterization from January 2013 to December 2015 were selected and randomly divided into two groups, namely, observation group and control group. The observation group adopted ultrasound-guided MST for catheterization while the control group applied traditional puncture technique for catheterization. Then efficacy of catheterization, success rate of catheterization and incidence rates of complications were compared between two groups.Results:Various indicators of catheterization effects of the observation group were better than those of the control group, and the differences were statistically significant (P<0.05); one-time success rate of puncture and catheterization of the observation group was both higher than the control group (P<0.05);. Moreover, the incidence of puncture points bleeding, phlebitis and thrombus were all lower than those of the control group (P<0.05).Conclusion:Implementing PICC catheterization based on ultrasound-guided modified Seldinger puncture technique can increase success rate of puncture, improve the effect of catheterization, lower incidence rate of adverse effects of catheterization and improve satisfaction and comfort level of patients.

Effects of improved nursing method in the insertion of transesophagus atrial pacing electrode catheter

Objective To observe the effects of modified inserting method in improving one-time success rate of transesophagus atrial pacing. Methods A total of 87 patients who needed for transesophagus atrial pacing were randomly divided into observation group (45 cases)and control group (42 cases); conventional inserting method was used in the control group while modified inserting method was used in the observation group. The success rate and the level of comfort of two groups were evaluated. Results The cases that cannot stand for the pain of insertion were 10 in the observation group and 22 in the control group, the level of comfort between two groups was found to be statistically significant(Z=-3.742, P<0.01). Th one-time success rate in observation group was 86.7%, and 66.7% in the control group, the difference has statistical significance (χ2=4.908, P<0.05). Conclusions Modified inserting method can effectively increase one-time success rate of inserting electrode catheter and reduce discomfort produced during the process, therefore improving patients′compliance. Key words: Nursing of catheter; Transesophagus atrial electrode catheter; Inserting method

Application of stereotactic surgical planning system in foramen ovale puncture for the treatment of trigeminal neuralgia

Objective To investigate the practical application value of stereotactic surgical planning system in the foramen ovale puncture for the treatment of idiopathic trigeminal neuralgia. Methods A total of 112 patients with trigeminal neuralgia admitted at the Department of Neurosurgery, the Second Hospital, Shandong University from October 2008 to March 2013 were enrolled. Using stereotactic techniques to complete the radiofrequency treatment of trigeminal neuralgia after foramen ovale puncture of gasserian ganglion. Different from the traditional mounting of the stereotactic frame, this study used reversed mounting frame. The simulation puncture was conducted after the CT scan dicom data were inputted into the stereotactic surgical planning system. The target coordinates, percutaneous puncture point coordinates, and puncture paths were ultimately determined. Results Using the above methods, 112 patients completed foramen ovale punctures. Twenty-five puncture paths were corrected by the stereotactic surgical planning system before procedure (the correction rate was 22.3%). The one-time success rate of foramen ovale puncture was 100% after setting the paths. No serious complications occurred, such as internal carotid artery injury and bleeding, diplopia, and keratitis. The immediate effective rate was 100%, one-year effective rate was 95.5%%, and two-year effective rate was 90.2%. Conclusion Preoperative setting puncture paths using the stereotactic surgical planning system for the treatment of trigeminal neuralgia is accurate, safe, and effective. Key words: Trigeminal neuralgia; Foramen ovale; Punctures; Stereotaxic techniques; Neuronavigation

Comparison of three intubation methods in patients with restricted cervical movement

The clinical data of 96 intubated inpatients with restricted cervical movement from June 2012 to June 2014 were retrospectively reviewed.They were divided into fiberoptic bronchoscope, Shikani optical stylet and McCoy laryngoscope groups (n=32 each). Identical anesthesia induction was applied.Compared with McCoy laryngoscope group, the total success rate and one-time success rate of tracheal intubation was higher in Shikani optical stylet group, tracheal intubation time was shorter and postoperative complications were fewer (P 0.05). Shikani optical stylet intubation has a less impact on hemodynamics and intubation time is short so that it is ideal for surgical patients with restricted cervical spine. Key words: Intubation, intratracheal; Spondylosis, cervical vertebrae

Development and clinical application effect of venipuncture auxiliary devices under special conditions

Objective To design and develop a kind of venipuncture auxiliary device to use in the absence of light condition or patients with poor vein condition, and validate its clinical effect. Methods A total of 70 patients with shock were divided into experimental group (venipuncture auxiliary device group with 37 cases) and control group (non-device group with 42 cases) by random digits table method. The one-time puncture success rate and operating time were compared between two groups. Results The one-time puncture success rate was 94.59%(35/37) in experimental group and 78.57%(33/42) in control group, and there was significant difference,χ2=4.214,P<0.05. The time of establishing a single vein passage was (73.63±29.35) s in experimental group and (107.61±45.94) s in control group, and there was significant difference,t=3.656,P<0.05. Conclusions The device is small in size, low cost, easy to carry, the screen is clear, is a rapid infusion with explore vascular equipment. It can guide nurses accurately on vascular puncture, fast, smooth and effective transfusion puncture process. Key words: Infrared rays; Infusions intravenous; Nursing care; Equipment design

Study on the accuracy of thoracolumbar pedicle screw installation assisted by O-arm navigation

Objective To evaluate the accuracy and reliability of O-arm-based thoracolumbar pedicle screw installation. Methods A retrospective review was conducted on 75 patients who had undergone thoracolumbar pedicle screw fixation assisted with O-arm navigation (navigation group, n=32) and C-arm fluoroscopy ( fluoroscopy group, n=43) from March to October 2014. All the patients were assessed with X-ray and CT images after operation. Accuracy of screw installation in both groups was compared. In navigation group, screw directions were measured on the sagittal and axial images of intra-operative navigation and post-operative CT scanning to evaluate the concordance. Results In fluoroscopy group, a total of 206 pedicle screws were placed with the one-time success rate of 93.2% and accuracy of 90.8% for screw placement, and one misplaced screw (grade Ⅲ) led to L3 nerve root symptom. In navigation group, a total of 226 pedicle screws were placed with the one-time success rate of 100% and accuracy of 96.9% for screw placement, and no screw was grade Ⅲ. Further, there were no significant differences in screw directions on the sagittal and axial images between intraoperative navigation and post-operative CT scanning (P>0.05). Conclusion O-arm navigation that provides high-resolution images and high precision improves the accuracy of thoracolumbar pedicle screw installation, and possesses good reliability. Key words: Spinal fractures; Surgery, computer-assisted; Thoracic vertebrae; Lumbar vertebrae; Pedicle screws

Application of improved indwelling needle puncture on infant patients with congenital heart disease complicated with pneumonia

Objective To investigate the application of improved indwelling needle puncture on infants of congenital heart disease complicated with pneumonia, and account the rate of successful puncture in one time. Methods A total of 120 congenital heart disease complicated with pneumonia infants in the pediatric intensive care unit were selected and randomly divided into observation group and control group with 60 cases in each. Improved puncture method was used in the observation group and conventional puncture method in the control group. The number of one-time successful puncture cases was compared in two groups. Results The number of one-time successful puncture was 47 with 13 unsuccessful one-time puncture in the observation group and 34 comparing with 26 cases in the control group (χ2=6.469, P<0.05). Conclusions Using the improved puncture method could improve one-time success rate in the infants of congenital heart disease complicated with pneumonia, it is worthy to popularize in pediatric nursing. Key words: Children; Congenital heart disease; Venous indwelling needle; Improved puncture method

Clinical research on the use of flexible laryngeal mask, classic laryngeal mask and supreme laryngeal mask in breast surgery under general anesthesia

Objective Randomized controlled research on the safety of the use of flexible laryngeal mask,classic laryngeal mask and Supreme laryngeal mask in breast surgeries under general anesthesia.Methods Sixty ASA Ⅰ-Ⅱpatients aged 27 y-77 y weighing 51 kg-82 kg scheduled for breast surgery under general anesthesia were randomly divided into 3 groups (n=20),according to random number table:flexible laryngeal mask group (group A),classic laryngeal mask group (group B) and Supreme laryngeal mask group (group C).After induction of anesthesia,laryngeal mask insertion was performed,respectively.Noninvasive blood pressure (BP),heart rate (HR) and bispectral index(BIS) were recorded at the time before induction,the time before and just the time of laryngeal mask insertion,at 1,2,3,5,10 min after laryngeal mask insertion was complete.Observe the hemodynamic response and complications of laryngeal mask insertion.Results Patients of three groups had high one-time success rate above 90％,and short intubation time(＜1 min).BIS of three groups all decreased significantly[group A (93±5) vs (39±7),group B (96±3) vs (39±9),group C (95±5) vs (39±9),P＜0.05].In group A,BP was significantly decreased after induction [systolic blood pressure (SBP)(134±13) mmHg vs (109±12) mmHg (1 mmHg=0.133 kPa),diastolic blood pressure (DBP) (77±10) mmHg vs (64±9) mmHg,mean artery pressure (MAP) (90±11) mmHg vs (74±9) mmHg,P＜0.05].In group B,there was no significant change in BP and HR.While in group C,there was significant change in HR and BP [HR (77±10) bpm vs (68±9) bpm,SBP (127±28) mmHg vs (107±15) mmHg,DBP(72±14) mmHg vs (58±11) mmHg,MAP (85 ±15) mmHg vs (70±10) mmHg,P＜0.05].Insertion and extubation of laryngeal mask didn't cause violent hemodynamic responses.There were no significant differences among the hemodynamic responses of three groups,during the period of induction of anesthesia and laryngeal mask insertion.And the intubation time,recovery time and extubation time were not different among three groups.There were less complications of intubation and extubation observed in group A,compared with other two groups.Conclusions Flexible laryngeal mask,classic laryngeal mask and Supreme laryngeal mask can all prevent hemodynamic responses to intubation,and flexible laryngeal mask has advantage in reducing complications produced by intubation than other two kinds of laryngeal mask. Key words: General anesthesia; Breast surgery; Laryngeal mask ; Hemodynamic response ; Complications

Experiments of Blast Furnace Slag as a Mud Cake Modifier and Its Trial in Horizontal Well I306H

Blast furnace slag (BFS) was added into drilling fluid as a mud cake modifier (MCM) for the reuse of BFS. The effects of MCM on drilling fluid rheology and shear strength of cement- formation interface (SSCFI) were evaluated. The experimental results showed that the optimized formula of the drilling fluid has 1.0 wt% MCM. The simulation re- sults showed that SSCFI increased significantly with the addition of MCM. Based on the mechanism analysis of BFS as an MCM to improve SSCFI, it is found that the transformation of mud cake to agglomerated cake (MTA) can be the main reason. The trial result of horizontal well I306H in Laojunmiao oilfield in China showed that the one-time success rate of cementing operation was 100% and the high quality rate was 79.78%. This horizontal well is flowing well after perfora- tion with oil production of 11.5t/d and the water cut is only 9%. Compared to the adjacent horizontal wells after fractur- ing, the oil production rate is increased by 228.57%-259.38%. Obviously, the effect of BFS as an MCM is self-evident. Meanwhile, this research provides a new way for the recycling of BFS. established (17) and the synergism of MCM with the form- ing agent of agglomerated cake (18) was studied (19). The application effects of six oilfields in China showed that the MTA method improves significantly the qualified rate and high quality rate of well cementing (20, 21). But, this method is not used in horizontal well. Based on the drilling fluid and cement slurry from Laojunmiao oilfield in China, the effects of BFS as an MCM on the drilling fluid rheology were investigated. The relationship of SSCFI with the addi- tion of MCM and curing time was evaluated. The mecha- nism of BFS as an MCM to improve SSCFI was analyzed. The trial effect of horizontal well I306H was introduced in Laojunmiao oilfield in China. 2. MATERIALS BFS is from Shengda Material Co., Ltd., Wuhan, China.