沈阳市红十字会医院

Objective To analyze the effect of the alar contour grafts on the postoperative alar retraction in rhinoplasty. Methods Forty female patients attending the author’s hospital for first time rhinoplasty from December 2018 to December 2020 were selected. A random number table method was used to divide the group into the experimental group and the control group of 20cases each. In the experimental group, the alar grafts were routinely placed, while in the control group, the alar grafts were not used. The long axis of the nostrils and the distance between the highest point of the alar rim and the long axis of the nostrils were observed by taking a lateral view photograph of the patient to evaluate the relationship between the columella and the alar rim. In comparison of patients’ nostril axis ratios preoperatively and one year postoperatively. Results Post-operative follow-up one year and 12 cases were lost to follow up. There were 15 cases in the final experimental group and 13 cases in the control group. The difference between the preoperative nostril axis ratio of the experimental group and the control group was not statistically significant（P＞0.05）.The postoperative nostril axis ratio of the experimental group was smaller than that of the control group, and the difference was statistically significant. The difference between the preoperative and postoperative nostril axis ratio in the experimental group was not statistically significant（P＞0.05）.In the control group, there was a statistically significant difference between the preoperative and postoperative nostril axis ratios（P＜0.01）.There were no post-operative complications in two groups. Conclusion General applications of the alar contour grafts in rhinoplasty could significantly prevent the alar retraction postoperation.

Objective To explore the clinical effect of clopidogrel and aspirin in the treatment of acute ST segment elevation myocardial infarction,and to provide reference for clinicians to choose rational drug use regimen.Methods From January 2018 to July 2019,select 102 cases of patients with acute ST elevation myocardial infarction in Shenyang,divide all patients by the digital method,namely 51 controls and trial group,the former using conventional thrombolytic therapy,the latter in the combination of clopidogrel and aspirin in control group,comparing the clinical total effective rate,the incidence of adverse cardiovascular events and cardiac function index of the two groups.Results The overall clinical response rate of the patients in the trial group was 94.12%,higher than that in the control group(80.39%),P＜0.05.The incidence of adverse cardiovascular events in the trial group was 3.92%,lower than that in the control group(15.69%),P＜0.05.Differences between LVDED,L vsED and LVEF levels between the two groups,P＞0.05,after the above treatment,both LVDED and L vsED levels in the control and trial groups were lower than before treatment,and the trial group was lower than the control group,LVEF levels in both groups after treatment higher than before treatment,and the trial group is higher than the control group,P＜0.05.Conclusion In the treatment of patients with acute ST elevation myocardial infarction,clopidogrel and aspirin can promote the recovery of disease,improve their cardiac function,prevent adverse cardiovascular events,and promote the improvement of clinical symptoms and therapeutic effect of patients,which is worthy of recommendation.

Objective:To explore the clinical efficacy and safety of verapamil hydrochloride combined with prednisone in the preventive treatment of cluster headache.Methods:A total of 43 patients with cluster headache in Shenyang Red Cross Hospital from March 2020 to March 2021 were randomly divided into an observation group (22 cases) and a control group (21 cases) with the random number table method. There were 17 males and 5 females in the observation group, aged (42.26±12.75) years; there were 14 males and 7 females in the control group, aged (39.26±11.38) years. The observation group was treated with verapamil combined with prednisone, while the control group was treated with verapamil. After two weeks of treatment, the durations of cluster period, headache frequencies, and adverse reactions of the two groups were recorded. Independent sample t test was used for inter-group comparison of measurement data, paired t test was used for intra-group comparison of measurement data, and χ 2 test was used for count data. Results:Compared with that before the treatment, the pain degree of patients in the observation group and the control group relieved after the treatment, with the total effective rate of 90.91% (20/22) in the observation group and 61.90% (11/21) in the control group, with a statistically significant difference between the two groups ( P<0.05). Compared with those before the treatment, the frequencies of headache attack and the durations of cluster period in the two groups decreased after the treatment, and the differences of the two groups before and after the treatment were statistically significant (all P<0.05), and there were statistically significant differences between the observation group and the control group after the treatment (both P<0.05). No serious adverse reactions occurred in both groups during the treatment. Conclusions:Verapamil combined with prednisone can prevent cluster headache, and can obviously reduce the duration of cluster period and the frequency of pain attack, and improve the clinical symptoms. Meanwhile, it has good safety and better effect than verapamil alone.

To explore the effect of VSD negative pressure drainage combined with limited fixation on infection control in patients with third-degree open tibia and fibula fractures. Methods:A total of 100 patients with third-degree open tibia and fibula fractures were selected and divided into the control group ( n=50 ) who received conventional fracture reduction and fixation intervention and the experimental group ( n=50 ) who received VSD neg-ative pressure drainage combined with limited fixation. The effects of different methods on clinical outcomes, pain science ( VAS ) scores, infection control and complications were compared. Results: Compared with the control group, the infection control time, wound healing time, hospital stay and fracture healing time were shorter in the ex-perimental group, and the difference was statistically significant (P<0. 05). There was no statistical significance (P>0. 05);the VAS scores of the two groups were significantly decreased after operation, and the VAS score of the ex-perimental group was significantly lower than that of the control group, with significant differences (P < 0. 05). One month after the operation, the effective rate of infection control in the experimental group was 96. 00%, which was significantly higher than 80. 00% in the control group, and the difference between the groups was statistically signifi-cant ( P < 0 . 05 ) . The incidence of complications in the experimental group was 12%, which was significantly lower than that in the control group ( 26%) , and the difference between the groups was statistically significant ( P < 0 . 05 ) . Conclusion:The clinical treatment effect of VSD negative pressure drainage combined with limited fixation forⅢ degree open tibia and fibula fracture is significant, which can reduce the pain degree of patients and reduce the occurrence of complications, which is worthy of clinical application.

Objective To observe the clinical efficacy of extracorporeal shock wave lithotripsy(ESWL with different energy and frequency in the treatment of upper ureteral calculi. Methods A total of 80 patients with upper ureteral calculi were randomly divided into a low-frequency low-energy group and a high-frequency high-energy group according to the order of consultation, with 40 cases in each group. The low-frequency lowenergy group was treated with low-energy low-frequency extracorporeal shock wave lithotripsy, and the highfrequency high-energy group was treated with high-frequency high-energy extracorporeal shock wave lithotripsy.The therapeutic effect and the occurrence of adverse events were compared between the two groups. Results The total effective rate of treatment was 90.0% in the high-frequency high-energy group, which was higher than 70.0%in the low-frequency low-energy group, and the difference was statistically significant（P＜0.05）. The difference was not statistically significant when comparing the incidence of adverse events between the two groups（P＞0.05）.Conclusion In the treatment of upper ureteral calculi, the clinical effect of high-frequency high-energy extracorporeal shock wave lithotripsy is better than that of low-energy low-frequency extracorporeal shock wave lithotripsy, and will not increase the occurrence of adverse events.