Objective: To evaluate the efficacy and safety of percutaneous microwave coagulation therapy (PMCT) for patients with primary and metastatic hepatic tumors.Methods: The enrolled 100 patients with 186 tumor nodules who...Objective: To evaluate the efficacy and safety of percutaneous microwave coagulation therapy (PMCT) for patients with primary and metastatic hepatic tumors.Methods: The enrolled 100 patients with 186 tumor nodules who underwent PMCT included 79 cases of primary or recurrent liver cancers and 21 cases of metastatic liver cancer. The tumors were divided into two groups according to the tumor size in diameter: group A, 0.5 cm?<3 cm; group B, ≥3 cm?<5 cm. Under local and/or epidural anesthesia, a single percutaneous microwave antenna (or two antennas array applicator) was inserted directly into the tumor in the liver for thermo-coagulation with the aid of ultrasound guidance.Results: Among the 186 lesions in 100 patients with primary and metastatic liver cancers, in group A, 123 (66%) were coagulated once. A Follow-up of 6–12 months demonstrated that 112 lesions (91%) showed no local recurrence by CT or MRI; In group B, of the 63 lesions (33.87%) coagulated twice, 31 (49%) showed no local recurrence by CT or MRI during a follow-up of 6 months. There were no serious clinical side effects or complications in all the PMCT patients.Conclusion: PMCT gives satisfactory curative effect on tumors with <3 cm in size. It is partly effective on lesions ≥3 cm?<5 cm in size. It is a minimally invasive and effective therapy, can be used safely in the field of percutaneous hepatis surgery, and carried out even in patients with poor liver function. Key words hepatocellular carcinoma - microwave - coagulation - therapy展开更多
AIM:To provide a specifi c review and meta-analysis of the available evidence for continuous wound infusion of local anaesthetic agents following midline laparoto-my for major colorectal surgery. METHODS: Medline, Emb...AIM:To provide a specifi c review and meta-analysis of the available evidence for continuous wound infusion of local anaesthetic agents following midline laparoto-my for major colorectal surgery. METHODS: Medline, Embase, trial registries, conference proceedings and article reference lists were searched to identify randomised, controlled trials of continuous wound infusion of local anaesthetic agents following colorectal surgery. The primary outcomes were opioid consumption, pain visual analogue scores (VASs), return to bowel function and length of hospital stay. Weighted mean difference were calculated for continuous outcomes. RESULTS: Five trials containing 542 laparotomy wounds were eligible for inclusion. There was a sig- nificant decrease in post-operative pain VAS at rest on day 3 (weighted mean difference: -0.43; 95% CI: -0.81 to -0.04; P = 0.03) but not on post-operative day 1 and 2. Local anaesthetic infusion was associated with a signifi cant reduction in pain VAS on movement on all three post-operative days (day 1 weighted mean difference: -1.14; 95% CI: -2.24 to -0.041; P = 0.04, day 2 weighted mean difference: -0.97, 95% CI: -1.91to -0.029; P = 0.04, day 3 weighted mean difference: -0.61; 95% CI: 1.01 to -0.20; P = 0.0038). Local an- aesthetic wound infusion was associated with a signifi - cant decrease in total opioid consumption (weighted mean difference: -40.13; 95% CI: -76.74 to -3.53; P = 0.03). There was no signifi cant decrease in length of stay (weighted mean difference: -20.87; 95% CI: -46.96 to 5.21; P = 0.12) or return of bowel function (weighted mean difference: -9.40; 95% CI: -33.98 to 15.17; P = 0.45). CONCLUSION: The results of this systematic re- view and meta-analysis suggest that local anaesthetic wound infusion following laparotomy for major color- ectal surgery is a promising technique but do not pro- vide conclusive evidence of benefi t. Further research is required including cost-effectiveness analysis.展开更多
AIM:To determine the efficacy and success of percutaneous aspiration irrigation and reaspiration(PAIR) in the management of hepatic hydatidosis.METHODS:Twenty-six patients with 32 hepatic hydatid cysts had PAIR.Twenty...AIM:To determine the efficacy and success of percutaneous aspiration irrigation and reaspiration(PAIR) in the management of hepatic hydatidosis.METHODS:Twenty-six patients with 32 hepatic hydatid cysts had PAIR.Twenty-two patients received at least 2 wk of drug therapy before the procedure was carried out to reduce the risk of recurrence from spillage during the procedure.The procedure was performed under local anesthesia with a 19-gauge 20 cm long needle,the cyst was punctured,cystic content(approximately 30 mL) was aspirated by a 12-14 F pigtail catheter and aspirated fluids were sent for analysis.Once the cyst was almost empty,two-thirds of the net amount of material aspirated was replaced by hypertonic saline and left in the cavity for about 30 min,with the catheter left in place for reaspiration of most of the fluid.When the amount of fluid drained was less than 10 mL per 24 h,the drainage catheter was removed.RESULTS:All 32 cysts showed evidence of immediate collapse after completion of the procedure,and before discharge from hospital,ultrasound examination showed fluid reaccumulation in all cysts.Serial follow-up showed a progressive decrease in the size and change in the appearance of cysts.To confirm the sterility of these cystic cavities,seven cysts were reaspirated on average 3 mo after the procedure.Investigations revealed no viable scolices.CONCLUSION:PAIR using hypertonic saline is very effective and safe with proper precautions.展开更多
Objective: There is a remarkable lack of scientific evidence to support the option to use alpha-stat or pH-stat management, as to which is more beneficial to brain protection during deep hypothermic CPB. This study ex...Objective: There is a remarkable lack of scientific evidence to support the option to use alpha-stat or pH-stat management, as to which is more beneficial to brain protection during deep hypothermic CPB. This study examined cortical blood flow (CBF), cerebral oxygenation, and brain oxygen consumption in relation to deep hypothermic CPB with alpha-stat or pH-stat management. Methods: Twenty-two pigs were cooled with alpha-stat or pH-stat during CPB to 15℃ esophageal temperature. CBF and cerebral oxygenation were measured continuously with a laser flowmeter and near-infrared spec-troscopy, respectively. Brain oxygen consumption was measured with standard laboratory techniques. Results: During CPB cooling, CBF was significantly decreased, about 52,2%±6.3% (P<0.01 vs 92.6%±6.5% of pH-stat) at 15℃ in alpha-stat, whereas there were no significant changes in CBF in pH-stat. While cooling down, brain oxygen extraction (OER) progressively decreased, about 9.5%±0.9% and 10.9%±1.5% at 15℃ in alpha-stat and pH-stat, respectively. At 31℃ the decreased value in pH-stat was lower than in alpha-stat (29.9%±2.7% vs 22.5%±1.9%; P<0.05). The ratio of CBF/OER were 2.0±0.3 in alpha-stat and pH-stat, respectively; it was kept in constant level in alpha-stat, and significantly increased by 19 ℃ to 15℃ in pH-stat (4.9±0.9 vs 2.3±0.4; P<0.01). In mild hypothermia, cerebral oxyhemoglobin and oxygen saturation in alpha-stat were greater than that in pH-stat (102.5%±1.4% vs 99.1%±0.7%; P<0.05). In deep hypothermia, brain oxygen saturation in pH-stat was greater than that in alpha-stat (99.2%±1.0% vs 93.8%±1.0%; P<0.01), and deoxyhemoglobin in pH-stat decreased more greatly than that in alpha-stat (28.7%±6.8% vs 54.1%±4.7%; P<0.05). Conclusions: In mild hypothermic CPB, brain tissue oxygen saturation was greater in alpha-stat than in pH-stat. However, cerebral oxygenation and brain tissue oxygen saturation were better in pH-stat than in alpha-stat during profound hypothermia. PH-stat strategy provided much more oxygen to brain tissue before deep hypothermic circulatory arrest.展开更多
Drink tests are advocated as an inexpensive, nonivasive technique to assess gastric function in patients with a variety of upper digestive symptoms. Many patients with dyspeptic complaints will achieve satiation or de...Drink tests are advocated as an inexpensive, nonivasive technique to assess gastric function in patients with a variety of upper digestive symptoms. Many patients with dyspeptic complaints will achieve satiation or develop symptoms at ingested volumes below those typically required to achieve these endpoints in controls. Substantial variation in test performance exists and a greater degree of standardization is required. Additionally, it remains unclear exactly what drink tests measure as correlations with measures of gastric sensation, accomodation and emptying are modest at best. Finally, results of drink tests do not guide therpay. At present, these tests are best reserved for research studies and are not advocated for use in clinical practice.展开更多
Objective: To observe the influence of local infiltration anesthesia at the scalp point on acupuncture stimulation induced changes of cerebral blood perfusion in the brain. Methods: Experiments were conducted in 10 he...Objective: To observe the influence of local infiltration anesthesia at the scalp point on acupuncture stimulation induced changes of cerebral blood perfusion in the brain. Methods: Experiments were conducted in 10 healthy volunteer subjects (8 males and 2 females) who were ordered to take a lying position on a specific bed with their heads keeping in a fixed position. Scalp point used was Motor Area (MS 6). The first syringe needle (gauge 5) was inserted into the scalp from the upper 1/5 of MS 6 and the second syringe needle inserted into the scalp from the middle 2/5 of MS 6 and advanced downward, with the two needles connected to a HAN’s Therapeutic Apparatus. Images of the brain were then taken before and after electroacupuncture (EA) stimulation, and after local injection of 1% lidocaine [mixed with epinephrine (1∶200,000, 3 mL)] plus EA by using Siemens ECAM/ICON Single Photo Emission Computed Tomography (SPECT). Intravenous injection of Ethyl cysteinate dimmer 555 MBq was performed before displaying cerebral images. Data of blood functional changing rat (BFCR%) were analyzed quantitatively using a mathematic model. Results: Before EA stimulation, the blood perfusion and function of cerebral cortex, thalamus, basal ganglion and cerebellum on both sides of the brain were basically symmetry. Following EA of MS 6, BFCR% of the contralateral thalamus, parietal lobe and the frontal lobe increased significantly. Following local infiltration anesthesia, BFCR% of the contralatral thalamus declined markedly (P<0.05). The results of quantitative analysis were in agreement with those of visual observation. Conclusion: Local infiltration anesthesia of the scalp point can significantly weaken or block EA stimulation induced changes of BFCR%.展开更多
AIM:To investigate the effect of pain relief after infu-sion of ropivacaine at port sites at the end of surgery.METHODS:From October 2006 to September 2007,72 patients undergoing laparoscopic cholecystectomy(LC) were ...AIM:To investigate the effect of pain relief after infu-sion of ropivacaine at port sites at the end of surgery.METHODS:From October 2006 to September 2007,72 patients undergoing laparoscopic cholecystectomy(LC) were randomized into two groups of 36 patients.One group received ropivacaine infusion at the port sites at the end of LC and the other received normal saline.A visual analog scale was used to assess postoperative pain when the patient awakened in the operating room,6 and 24 h after surgery,and before discharge.The amount of analgesics use was also recorded.The demographics,laboratory data,hospital stay,and perioperative complications were compared between the two groups.RESULTS:There was no difference between the two groups preoperatively in terms of demographic and lab-oratory data.After surgery,similar operation time,blood loss,and no postoperative morbidity and mortality were observed in the two groups.However,a significantly lower pain score was observed in the patients undergo-ing LC with local anesthesia infusion at 1 h after LC and at discharge.Regarding analgesic use,the amount of meperidine used 1 h after LC and the total used during admission were lower in patients undergoing LC with local anesthesia infusion.This group also had a shorter hospital stay.CONCLUSION:Local anesthesia with ropivacaine at the port site in LC patients signif icantly decreased post-operative pain immediately.This explains the lower meperidine use and earlier discharge for these patients.展开更多
Blood-letting therapy is extensively used in acupuncture clinic. In recent years, the author has applied blood-letting therapy to treat various kinds of diseases, with satisfactory therapeutic results reported in the ...Blood-letting therapy is extensively used in acupuncture clinic. In recent years, the author has applied blood-letting therapy to treat various kinds of diseases, with satisfactory therapeutic results reported in the following.展开更多
In the present paper, the authors make a review on the progresses of acupuncture anesthesia (AA) from ① historical development, ② research on acupuncture combined with local anesthesia; ③ research on acupuncture co...In the present paper, the authors make a review on the progresses of acupuncture anesthesia (AA) from ① historical development, ② research on acupuncture combined with local anesthesia; ③ research on acupuncture combined with epidural anesthesia; and ④ research on acupuncture combined with general anesthesia. Compound acupuncture anesthesia provides a new anesthetic measure for surgical operations and has a definite analgesic effect and many advantages, and should be investigated further.展开更多
Postoperative enteroparalysis refers to dysfunction of the intestinal tract after abdominal surgery, which is manifested by abdominal distension, failure of aerofluxus from the anus etc.
Paraplegia is a disastrous complication after operations of descending and thoracoabdominal aortic aneurysm. Re- gional hypothermia protects against spinal cord ischemia although the protective mechanism is not well k...Paraplegia is a disastrous complication after operations of descending and thoracoabdominal aortic aneurysm. Re- gional hypothermia protects against spinal cord ischemia although the protective mechanism is not well know. The objective of this study is to examine whether hypothermia protects the spinal cord by preventing apoptosis of nerve cell and also investigate a possible mechanism involved in hypothermia neuroprotection. Cell apoptosis with necrosis was evident in the spinal cord 24 h after 30 min of ischemia. Moderate hypothermia decreased the incidence of apoptotic nerve cells. Both cell apoptosis and necrosis were attenuated by hypothermia. p53 expression increased and bcl-2 expression declined after ischemia, while hypothermia mitigated these changes. This study suggests that apoptosis contributes to cell death after spinal cord ischemia, and that moderate hypothermia can prevent nerve cell apoptosis by a mechanism associated with bcl-2 and p53 genes.展开更多
The basic granulite of the Altay orogenic belt occurs as tectonic lens in the Devonian medium- to lower-grade metamorphic beds through fault contact. The Altay granulite (AG) is an amphibole plagioclase two-pyroxene ...The basic granulite of the Altay orogenic belt occurs as tectonic lens in the Devonian medium- to lower-grade metamorphic beds through fault contact. The Altay granulite (AG) is an amphibole plagioclase two-pyroxene granulite and is mainly composed of two pyroxenes, plagioclase, amphibole and biotite. Its melano-minerals are rich in Mg/(Mg+Fe2+), and its amphibole and biotite are rich in TiO2. The AG is rich in Mg/(Mg+Fe2+), Al2O3 and depletion of U, Th and Rb contents. The AG has moderate ∑REE and LREE-enriched with weak positive Eu anomaly. The AG shows island-arc pattern with negative Nb, P and Ti anomalies, reflecting that formation of the AG may be associated with subduction. Geochemical and mineral composition data reflect that the protolith of the AG is calc-alkaline basalt and formed by granulite facies metamorphism having peak P-T conditions of 750 °C?780 °C and 0.6?0.7 Gpa. The AG formation underwent two stages was suggested. In the early stage of oceanic crustal subduction, calc-alkaline basalt with island-arc environment underwent granulite facies metamorphism to form the AG in deep crust, and in the late stage, the AG was thrust into the upper crust.展开更多
Objective:To search for an effective therapy in treating peripheral facial paralysis. Methods: One hundred and eight patients were randomly divided into treatment group (n = 68) and control group (n = 40). The m...Objective:To search for an effective therapy in treating peripheral facial paralysis. Methods: One hundred and eight patients were randomly divided into treatment group (n = 68) and control group (n = 40). The multi-directional needling technique was used by selecting Jiache (颊车 ST 6), Yangbai (阳白 GB 14) and Dicang (地仓 ST 4) in the treatment group, and the traditional acupuncture technique with conventional needle selection was used in the control group. The treatment was given once daily with 10 treatments constituting a therapeutic course, and 2 courses of treatment were given in both the groups. Results: After the treatment, of the 68 and 40 cases in treatment and control groups, 56 (82.3%) and 28 (70.0%) were cured, 11 (16.2%) and 8 (20.0%) improved in clinical symptoms and signs, 1 (1.5%) and 4 (10.0%) failed, with the total effective rate being 98.5% and 90.0% respectively, and the therapeutic effect of treatment group was significantly superior to that of control group ( P 〈 0.05). Conclusion: The multi-directional needling is an effective therapy for treating peripheral facial paralysis.展开更多
In the present paper, the therapeutic effect of acupoint application of Chinese Materia Medica in the treatment of allergic asthma was observed. The results revealed that topical application of drug paste [mixture of ...In the present paper, the therapeutic effect of acupoint application of Chinese Materia Medica in the treatment of allergic asthma was observed. The results revealed that topical application of drug paste [mixture of powder of Mahuang (Herba Ephedrae), Xixin (Herba Asari), Baijiezi (Semen Sinapis Albae), etc.] at the acupuncture points could improve symptoms and signs of allergic asthma patients, with the total effective rate being 69.57% (16/23) for the short term effect, and 52.17%(12/23) for the long term effect. In medication (Aminophylline) group, of the 25 cases of allergic asthma, 16 (64.0%) were effective after 4 weeks of treatment, while 6 (24.0%) were still effective that was shown by 6 months’ follow up. The therapeutic effect of acupoint application group was significantly better than that of medication group in the long term effect. Results also showed that no obvious interrelation between the short term therapeutic effect and the duration or the severity of the disease. Results also display that acupoint application therapy is an effective, safe and handy method with fewer side effects for asthma.展开更多
Objective: To observe the therapeutic effect of the integrated acupuncture-moxibustio n and herbal therapies for facial paralysis. Methods: A total of 68 cases of facial paralysis were treated by integration of acupun...Objective: To observe the therapeutic effect of the integrated acupuncture-moxibustio n and herbal therapies for facial paralysis. Methods: A total of 68 cases of facial paralysis were treated by integration of acupunct ure-moxibustion and herbal therapies. For acu-moxibustion, Yifeng (翳风 TE 17) , Dicang (地仓 ST 4), Jiache (颊车 ST 6), Yangbai (阳白 GB 14), Hegu (合谷 LI 4), etc. were used. In addition, for facial palsy patients with wind-phlegm blockin g meridian-collaterals and wind-stirring due to yin defi ciency types in the acute stage, Modified Qian Zheng San (牵正散 Powder for Treating Wry-mouth) and Modi f ied Zhen Gan Xi Feng Tang (镇肝熄风汤 Tranquilizing Liver-wind Decoction) were u sed respectively; and for those in convalescent stage and sequela stage, Modifie d Danggui Bu Xue Tang (当归补血汤 Ghinese Angelica Decoction for Replenishing Bl ood) + Qian Zheng San (Powder for Treating Wry-mouth) and Modified Bu Yang Hu an Wu Tang (补阳还五汤 Decoction Invigorating Yang for Recuperation) were employed. Results: After the treatment, the curative rate of the 68 cases a ccounted for 90 % of the total cases, the remarkably effective 6%, the improved 3% and the poor 1% respectively. Conclusion: The therapeutic effectiveness of the integrated tre atment of acupuncture-moxibustion and herbal therapies for facial paralysis is certain.展开更多
Objective: To probe the best therapy for peripheral facial paralysis. Methods: A total of 122 cases of facial paralysis patients were randomized into treatment group (n=62, treating the disease by stages) and control ...Objective: To probe the best therapy for peripheral facial paralysis. Methods: A total of 122 cases of facial paralysis patients were randomized into treatment group (n=62, treating the disease by stages) and control group (n=60). For patients at the acute stage in treatment group, main point Yifeng (TE 17) was pricked first, followed by performing cupping and moxibustion, for patients at the resting stage, main point Hegu (LI 4) was punctured with reducing needling method, combined with other acupoints in the light of the concrete situations. For patients at the restoration stage, main point Zusanli (ST 36) was punctured with reinforcing method in combination with seven-star-needle tapping at the local affected region. Patients of control group were treated with routine method by puncturing Fengchi (GB 20), Yifeng (TE 17), Jiache (ST 6), Hegu (LI 4), Taichong (LR 3), etc.. The treatment was conducted once daily, with 10 days being a therapeutic course. Results: Following 3 courses of treatment, of the 62 cases in treatment group, 44 (70.9%) were cured, 12 (19.4%) had remarkable improvement in their symptoms and signs, 6 (9.7%) had amelioration, with the cure plus markedly effective rate being 90.3%; of the 60 cases in control group, 30 (50.0%) were cured, 12 (20.0%) had apparent improvement, 16 (26.7%) had amelioration, and the rest 2 (3.3%) failed in the treatment, with the cure plus markedly effective rate being 70.0%. Ridit analysis showed that the cure rate and cure plus markedly effective rate of treatment group were significantly higher than those of control group (P<0.05). Conclusion: Stage-aided acupuncture treatment is superior to routine treatment for facial palsy.展开更多
Objective.To study the speciality of orbicularis oculi muscles, nerves and oris muscles, nerves and mechanism of difference of faclal muscular injury in facial paralysis deeply.Methods. The conductive velocity of the ...Objective.To study the speciality of orbicularis oculi muscles, nerves and oris muscles, nerves and mechanism of difference of faclal muscular injury in facial paralysis deeply.Methods. The conductive velocity of the efferent nerves of orbicularis oculi and oris muscles of the health human beings and guinea pigs is measured with electromyogram (EMG) apparatus.Results. The conductive velocity of orbicularis oculi nerve is quicker and oris muscles are controlled by facial nerves on both sides. Measuring the threshold of Strength-Duration (S-D) curves of the motor point of orbicularis oculi and oris muscles shows the threshold of the former is lower. Measuring the diameter of orbicularis oculi and oris nerve fibers on the guinea pigs and rabbits shows the diameter of orbicularis oculi nerve fiber is bigger. The area of secondary synapse space of orbicularis oculi motor end plate is larger than that of oris under scanning electromicroscope.Conclusions. Orbicularis oculi muscles,orbicularis oculi nerves and oris muscles,oris nerves all have their own characteristic on physiology and anatomy. It elucidated the mechanism that orbicularis oculi muscle is easy to be injuried.展开更多
In the framework of biodiversity's studies of animal's genetic resources in general and especially camels, the authors focused, in the case of biodiversity, on the phenotypic and genetic variability of each camel po...In the framework of biodiversity's studies of animal's genetic resources in general and especially camels, the authors focused, in the case of biodiversity, on the phenotypic and genetic variability of each camel populations studied in southwestern of Algeria. The objective of the present study is to describe the conditions of dromedaries breeding, to analyze their phenotypic diversity, redefine the range flocks, highlight the perspectives of exploitation and use their products in livestock systems sustainablely. Knowing that the camel occupies a vital place in the socioeconomic development of breeders, owing to the multiple functions and services it provides. However, the pressures of diverse origins including population growth and recurrent droughts take serious threats to the development of the species. This survey was conducted during 2 years over 2500 animals owned by 60 farmers were studied. These animals were analyzed in terms of phenotypic and ethno-geographical evolution of breeding. A large number of blood samples (200) were collected, which allowed us to be the first DNA bank of camels in Algeria.展开更多
文摘Objective: To evaluate the efficacy and safety of percutaneous microwave coagulation therapy (PMCT) for patients with primary and metastatic hepatic tumors.Methods: The enrolled 100 patients with 186 tumor nodules who underwent PMCT included 79 cases of primary or recurrent liver cancers and 21 cases of metastatic liver cancer. The tumors were divided into two groups according to the tumor size in diameter: group A, 0.5 cm?<3 cm; group B, ≥3 cm?<5 cm. Under local and/or epidural anesthesia, a single percutaneous microwave antenna (or two antennas array applicator) was inserted directly into the tumor in the liver for thermo-coagulation with the aid of ultrasound guidance.Results: Among the 186 lesions in 100 patients with primary and metastatic liver cancers, in group A, 123 (66%) were coagulated once. A Follow-up of 6–12 months demonstrated that 112 lesions (91%) showed no local recurrence by CT or MRI; In group B, of the 63 lesions (33.87%) coagulated twice, 31 (49%) showed no local recurrence by CT or MRI during a follow-up of 6 months. There were no serious clinical side effects or complications in all the PMCT patients.Conclusion: PMCT gives satisfactory curative effect on tumors with <3 cm in size. It is partly effective on lesions ≥3 cm?<5 cm in size. It is a minimally invasive and effective therapy, can be used safely in the field of percutaneous hepatis surgery, and carried out even in patients with poor liver function. Key words hepatocellular carcinoma - microwave - coagulation - therapy
文摘AIM:To provide a specifi c review and meta-analysis of the available evidence for continuous wound infusion of local anaesthetic agents following midline laparoto-my for major colorectal surgery. METHODS: Medline, Embase, trial registries, conference proceedings and article reference lists were searched to identify randomised, controlled trials of continuous wound infusion of local anaesthetic agents following colorectal surgery. The primary outcomes were opioid consumption, pain visual analogue scores (VASs), return to bowel function and length of hospital stay. Weighted mean difference were calculated for continuous outcomes. RESULTS: Five trials containing 542 laparotomy wounds were eligible for inclusion. There was a sig- nificant decrease in post-operative pain VAS at rest on day 3 (weighted mean difference: -0.43; 95% CI: -0.81 to -0.04; P = 0.03) but not on post-operative day 1 and 2. Local anaesthetic infusion was associated with a signifi cant reduction in pain VAS on movement on all three post-operative days (day 1 weighted mean difference: -1.14; 95% CI: -2.24 to -0.041; P = 0.04, day 2 weighted mean difference: -0.97, 95% CI: -1.91to -0.029; P = 0.04, day 3 weighted mean difference: -0.61; 95% CI: 1.01 to -0.20; P = 0.0038). Local an- aesthetic wound infusion was associated with a signifi - cant decrease in total opioid consumption (weighted mean difference: -40.13; 95% CI: -76.74 to -3.53; P = 0.03). There was no signifi cant decrease in length of stay (weighted mean difference: -20.87; 95% CI: -46.96 to 5.21; P = 0.12) or return of bowel function (weighted mean difference: -9.40; 95% CI: -33.98 to 15.17; P = 0.45). CONCLUSION: The results of this systematic re- view and meta-analysis suggest that local anaesthetic wound infusion following laparotomy for major color- ectal surgery is a promising technique but do not pro- vide conclusive evidence of benefi t. Further research is required including cost-effectiveness analysis.
文摘AIM:To determine the efficacy and success of percutaneous aspiration irrigation and reaspiration(PAIR) in the management of hepatic hydatidosis.METHODS:Twenty-six patients with 32 hepatic hydatid cysts had PAIR.Twenty-two patients received at least 2 wk of drug therapy before the procedure was carried out to reduce the risk of recurrence from spillage during the procedure.The procedure was performed under local anesthesia with a 19-gauge 20 cm long needle,the cyst was punctured,cystic content(approximately 30 mL) was aspirated by a 12-14 F pigtail catheter and aspirated fluids were sent for analysis.Once the cyst was almost empty,two-thirds of the net amount of material aspirated was replaced by hypertonic saline and left in the cavity for about 30 min,with the catheter left in place for reaspiration of most of the fluid.When the amount of fluid drained was less than 10 mL per 24 h,the drainage catheter was removed.RESULTS:All 32 cysts showed evidence of immediate collapse after completion of the procedure,and before discharge from hospital,ultrasound examination showed fluid reaccumulation in all cysts.Serial follow-up showed a progressive decrease in the size and change in the appearance of cysts.To confirm the sterility of these cystic cavities,seven cysts were reaspirated on average 3 mo after the procedure.Investigations revealed no viable scolices.CONCLUSION:PAIR using hypertonic saline is very effective and safe with proper precautions.
文摘Objective: There is a remarkable lack of scientific evidence to support the option to use alpha-stat or pH-stat management, as to which is more beneficial to brain protection during deep hypothermic CPB. This study examined cortical blood flow (CBF), cerebral oxygenation, and brain oxygen consumption in relation to deep hypothermic CPB with alpha-stat or pH-stat management. Methods: Twenty-two pigs were cooled with alpha-stat or pH-stat during CPB to 15℃ esophageal temperature. CBF and cerebral oxygenation were measured continuously with a laser flowmeter and near-infrared spec-troscopy, respectively. Brain oxygen consumption was measured with standard laboratory techniques. Results: During CPB cooling, CBF was significantly decreased, about 52,2%±6.3% (P<0.01 vs 92.6%±6.5% of pH-stat) at 15℃ in alpha-stat, whereas there were no significant changes in CBF in pH-stat. While cooling down, brain oxygen extraction (OER) progressively decreased, about 9.5%±0.9% and 10.9%±1.5% at 15℃ in alpha-stat and pH-stat, respectively. At 31℃ the decreased value in pH-stat was lower than in alpha-stat (29.9%±2.7% vs 22.5%±1.9%; P<0.05). The ratio of CBF/OER were 2.0±0.3 in alpha-stat and pH-stat, respectively; it was kept in constant level in alpha-stat, and significantly increased by 19 ℃ to 15℃ in pH-stat (4.9±0.9 vs 2.3±0.4; P<0.01). In mild hypothermia, cerebral oxyhemoglobin and oxygen saturation in alpha-stat were greater than that in pH-stat (102.5%±1.4% vs 99.1%±0.7%; P<0.05). In deep hypothermia, brain oxygen saturation in pH-stat was greater than that in alpha-stat (99.2%±1.0% vs 93.8%±1.0%; P<0.01), and deoxyhemoglobin in pH-stat decreased more greatly than that in alpha-stat (28.7%±6.8% vs 54.1%±4.7%; P<0.05). Conclusions: In mild hypothermic CPB, brain tissue oxygen saturation was greater in alpha-stat than in pH-stat. However, cerebral oxygenation and brain tissue oxygen saturation were better in pH-stat than in alpha-stat during profound hypothermia. PH-stat strategy provided much more oxygen to brain tissue before deep hypothermic circulatory arrest.
文摘Drink tests are advocated as an inexpensive, nonivasive technique to assess gastric function in patients with a variety of upper digestive symptoms. Many patients with dyspeptic complaints will achieve satiation or develop symptoms at ingested volumes below those typically required to achieve these endpoints in controls. Substantial variation in test performance exists and a greater degree of standardization is required. Additionally, it remains unclear exactly what drink tests measure as correlations with measures of gastric sensation, accomodation and emptying are modest at best. Finally, results of drink tests do not guide therpay. At present, these tests are best reserved for research studies and are not advocated for use in clinical practice.
文摘Objective: To observe the influence of local infiltration anesthesia at the scalp point on acupuncture stimulation induced changes of cerebral blood perfusion in the brain. Methods: Experiments were conducted in 10 healthy volunteer subjects (8 males and 2 females) who were ordered to take a lying position on a specific bed with their heads keeping in a fixed position. Scalp point used was Motor Area (MS 6). The first syringe needle (gauge 5) was inserted into the scalp from the upper 1/5 of MS 6 and the second syringe needle inserted into the scalp from the middle 2/5 of MS 6 and advanced downward, with the two needles connected to a HAN’s Therapeutic Apparatus. Images of the brain were then taken before and after electroacupuncture (EA) stimulation, and after local injection of 1% lidocaine [mixed with epinephrine (1∶200,000, 3 mL)] plus EA by using Siemens ECAM/ICON Single Photo Emission Computed Tomography (SPECT). Intravenous injection of Ethyl cysteinate dimmer 555 MBq was performed before displaying cerebral images. Data of blood functional changing rat (BFCR%) were analyzed quantitatively using a mathematic model. Results: Before EA stimulation, the blood perfusion and function of cerebral cortex, thalamus, basal ganglion and cerebellum on both sides of the brain were basically symmetry. Following EA of MS 6, BFCR% of the contralateral thalamus, parietal lobe and the frontal lobe increased significantly. Following local infiltration anesthesia, BFCR% of the contralatral thalamus declined markedly (P<0.05). The results of quantitative analysis were in agreement with those of visual observation. Conclusion: Local infiltration anesthesia of the scalp point can significantly weaken or block EA stimulation induced changes of BFCR%.
文摘AIM:To investigate the effect of pain relief after infu-sion of ropivacaine at port sites at the end of surgery.METHODS:From October 2006 to September 2007,72 patients undergoing laparoscopic cholecystectomy(LC) were randomized into two groups of 36 patients.One group received ropivacaine infusion at the port sites at the end of LC and the other received normal saline.A visual analog scale was used to assess postoperative pain when the patient awakened in the operating room,6 and 24 h after surgery,and before discharge.The amount of analgesics use was also recorded.The demographics,laboratory data,hospital stay,and perioperative complications were compared between the two groups.RESULTS:There was no difference between the two groups preoperatively in terms of demographic and lab-oratory data.After surgery,similar operation time,blood loss,and no postoperative morbidity and mortality were observed in the two groups.However,a significantly lower pain score was observed in the patients undergo-ing LC with local anesthesia infusion at 1 h after LC and at discharge.Regarding analgesic use,the amount of meperidine used 1 h after LC and the total used during admission were lower in patients undergoing LC with local anesthesia infusion.This group also had a shorter hospital stay.CONCLUSION:Local anesthesia with ropivacaine at the port site in LC patients signif icantly decreased post-operative pain immediately.This explains the lower meperidine use and earlier discharge for these patients.
文摘Blood-letting therapy is extensively used in acupuncture clinic. In recent years, the author has applied blood-letting therapy to treat various kinds of diseases, with satisfactory therapeutic results reported in the following.
文摘In the present paper, the authors make a review on the progresses of acupuncture anesthesia (AA) from ① historical development, ② research on acupuncture combined with local anesthesia; ③ research on acupuncture combined with epidural anesthesia; and ④ research on acupuncture combined with general anesthesia. Compound acupuncture anesthesia provides a new anesthetic measure for surgical operations and has a definite analgesic effect and many advantages, and should be investigated further.
文摘Postoperative enteroparalysis refers to dysfunction of the intestinal tract after abdominal surgery, which is manifested by abdominal distension, failure of aerofluxus from the anus etc.
基金This work was supported in part by National Natural Science Foundation of China(90208011,30300174,30470856 and 30421005)National Basic Research Program(973 Program)(2002CB713802)Shanghai Key Project of Ba-sic Science Research(04DZ14005 and 04DZ05608).
文摘Paraplegia is a disastrous complication after operations of descending and thoracoabdominal aortic aneurysm. Re- gional hypothermia protects against spinal cord ischemia although the protective mechanism is not well know. The objective of this study is to examine whether hypothermia protects the spinal cord by preventing apoptosis of nerve cell and also investigate a possible mechanism involved in hypothermia neuroprotection. Cell apoptosis with necrosis was evident in the spinal cord 24 h after 30 min of ischemia. Moderate hypothermia decreased the incidence of apoptotic nerve cells. Both cell apoptosis and necrosis were attenuated by hypothermia. p53 expression increased and bcl-2 expression declined after ischemia, while hypothermia mitigated these changes. This study suggests that apoptosis contributes to cell death after spinal cord ischemia, and that moderate hypothermia can prevent nerve cell apoptosis by a mechanism associated with bcl-2 and p53 genes.
文摘The basic granulite of the Altay orogenic belt occurs as tectonic lens in the Devonian medium- to lower-grade metamorphic beds through fault contact. The Altay granulite (AG) is an amphibole plagioclase two-pyroxene granulite and is mainly composed of two pyroxenes, plagioclase, amphibole and biotite. Its melano-minerals are rich in Mg/(Mg+Fe2+), and its amphibole and biotite are rich in TiO2. The AG is rich in Mg/(Mg+Fe2+), Al2O3 and depletion of U, Th and Rb contents. The AG has moderate ∑REE and LREE-enriched with weak positive Eu anomaly. The AG shows island-arc pattern with negative Nb, P and Ti anomalies, reflecting that formation of the AG may be associated with subduction. Geochemical and mineral composition data reflect that the protolith of the AG is calc-alkaline basalt and formed by granulite facies metamorphism having peak P-T conditions of 750 °C?780 °C and 0.6?0.7 Gpa. The AG formation underwent two stages was suggested. In the early stage of oceanic crustal subduction, calc-alkaline basalt with island-arc environment underwent granulite facies metamorphism to form the AG in deep crust, and in the late stage, the AG was thrust into the upper crust.
文摘Objective:To search for an effective therapy in treating peripheral facial paralysis. Methods: One hundred and eight patients were randomly divided into treatment group (n = 68) and control group (n = 40). The multi-directional needling technique was used by selecting Jiache (颊车 ST 6), Yangbai (阳白 GB 14) and Dicang (地仓 ST 4) in the treatment group, and the traditional acupuncture technique with conventional needle selection was used in the control group. The treatment was given once daily with 10 treatments constituting a therapeutic course, and 2 courses of treatment were given in both the groups. Results: After the treatment, of the 68 and 40 cases in treatment and control groups, 56 (82.3%) and 28 (70.0%) were cured, 11 (16.2%) and 8 (20.0%) improved in clinical symptoms and signs, 1 (1.5%) and 4 (10.0%) failed, with the total effective rate being 98.5% and 90.0% respectively, and the therapeutic effect of treatment group was significantly superior to that of control group ( P 〈 0.05). Conclusion: The multi-directional needling is an effective therapy for treating peripheral facial paralysis.
文摘In the present paper, the therapeutic effect of acupoint application of Chinese Materia Medica in the treatment of allergic asthma was observed. The results revealed that topical application of drug paste [mixture of powder of Mahuang (Herba Ephedrae), Xixin (Herba Asari), Baijiezi (Semen Sinapis Albae), etc.] at the acupuncture points could improve symptoms and signs of allergic asthma patients, with the total effective rate being 69.57% (16/23) for the short term effect, and 52.17%(12/23) for the long term effect. In medication (Aminophylline) group, of the 25 cases of allergic asthma, 16 (64.0%) were effective after 4 weeks of treatment, while 6 (24.0%) were still effective that was shown by 6 months’ follow up. The therapeutic effect of acupoint application group was significantly better than that of medication group in the long term effect. Results also showed that no obvious interrelation between the short term therapeutic effect and the duration or the severity of the disease. Results also display that acupoint application therapy is an effective, safe and handy method with fewer side effects for asthma.
文摘Objective: To observe the therapeutic effect of the integrated acupuncture-moxibustio n and herbal therapies for facial paralysis. Methods: A total of 68 cases of facial paralysis were treated by integration of acupunct ure-moxibustion and herbal therapies. For acu-moxibustion, Yifeng (翳风 TE 17) , Dicang (地仓 ST 4), Jiache (颊车 ST 6), Yangbai (阳白 GB 14), Hegu (合谷 LI 4), etc. were used. In addition, for facial palsy patients with wind-phlegm blockin g meridian-collaterals and wind-stirring due to yin defi ciency types in the acute stage, Modified Qian Zheng San (牵正散 Powder for Treating Wry-mouth) and Modi f ied Zhen Gan Xi Feng Tang (镇肝熄风汤 Tranquilizing Liver-wind Decoction) were u sed respectively; and for those in convalescent stage and sequela stage, Modifie d Danggui Bu Xue Tang (当归补血汤 Ghinese Angelica Decoction for Replenishing Bl ood) + Qian Zheng San (Powder for Treating Wry-mouth) and Modified Bu Yang Hu an Wu Tang (补阳还五汤 Decoction Invigorating Yang for Recuperation) were employed. Results: After the treatment, the curative rate of the 68 cases a ccounted for 90 % of the total cases, the remarkably effective 6%, the improved 3% and the poor 1% respectively. Conclusion: The therapeutic effectiveness of the integrated tre atment of acupuncture-moxibustion and herbal therapies for facial paralysis is certain.
文摘Objective: To probe the best therapy for peripheral facial paralysis. Methods: A total of 122 cases of facial paralysis patients were randomized into treatment group (n=62, treating the disease by stages) and control group (n=60). For patients at the acute stage in treatment group, main point Yifeng (TE 17) was pricked first, followed by performing cupping and moxibustion, for patients at the resting stage, main point Hegu (LI 4) was punctured with reducing needling method, combined with other acupoints in the light of the concrete situations. For patients at the restoration stage, main point Zusanli (ST 36) was punctured with reinforcing method in combination with seven-star-needle tapping at the local affected region. Patients of control group were treated with routine method by puncturing Fengchi (GB 20), Yifeng (TE 17), Jiache (ST 6), Hegu (LI 4), Taichong (LR 3), etc.. The treatment was conducted once daily, with 10 days being a therapeutic course. Results: Following 3 courses of treatment, of the 62 cases in treatment group, 44 (70.9%) were cured, 12 (19.4%) had remarkable improvement in their symptoms and signs, 6 (9.7%) had amelioration, with the cure plus markedly effective rate being 90.3%; of the 60 cases in control group, 30 (50.0%) were cured, 12 (20.0%) had apparent improvement, 16 (26.7%) had amelioration, and the rest 2 (3.3%) failed in the treatment, with the cure plus markedly effective rate being 70.0%. Ridit analysis showed that the cure rate and cure plus markedly effective rate of treatment group were significantly higher than those of control group (P<0.05). Conclusion: Stage-aided acupuncture treatment is superior to routine treatment for facial palsy.
文摘Objective.To study the speciality of orbicularis oculi muscles, nerves and oris muscles, nerves and mechanism of difference of faclal muscular injury in facial paralysis deeply.Methods. The conductive velocity of the efferent nerves of orbicularis oculi and oris muscles of the health human beings and guinea pigs is measured with electromyogram (EMG) apparatus.Results. The conductive velocity of orbicularis oculi nerve is quicker and oris muscles are controlled by facial nerves on both sides. Measuring the threshold of Strength-Duration (S-D) curves of the motor point of orbicularis oculi and oris muscles shows the threshold of the former is lower. Measuring the diameter of orbicularis oculi and oris nerve fibers on the guinea pigs and rabbits shows the diameter of orbicularis oculi nerve fiber is bigger. The area of secondary synapse space of orbicularis oculi motor end plate is larger than that of oris under scanning electromicroscope.Conclusions. Orbicularis oculi muscles,orbicularis oculi nerves and oris muscles,oris nerves all have their own characteristic on physiology and anatomy. It elucidated the mechanism that orbicularis oculi muscle is easy to be injuried.
文摘In the framework of biodiversity's studies of animal's genetic resources in general and especially camels, the authors focused, in the case of biodiversity, on the phenotypic and genetic variability of each camel populations studied in southwestern of Algeria. The objective of the present study is to describe the conditions of dromedaries breeding, to analyze their phenotypic diversity, redefine the range flocks, highlight the perspectives of exploitation and use their products in livestock systems sustainablely. Knowing that the camel occupies a vital place in the socioeconomic development of breeders, owing to the multiple functions and services it provides. However, the pressures of diverse origins including population growth and recurrent droughts take serious threats to the development of the species. This survey was conducted during 2 years over 2500 animals owned by 60 farmers were studied. These animals were analyzed in terms of phenotypic and ethno-geographical evolution of breeding. A large number of blood samples (200) were collected, which allowed us to be the first DNA bank of camels in Algeria.