Objective To investigate the efficacy and safety of continuous local anesthetic wound infiltration following open abdominal partial hepatectomy. Methods We performed a prospective, non-randomized, concurrent and con...Objective To investigate the efficacy and safety of continuous local anesthetic wound infiltration following open abdominal partial hepatectomy. Methods We performed a prospective, non-randomized, concurrent and controlled study. Patients undergoing open abdominal partial hepatectomy, according to their willingness, accepted one of the following managements for the postoperative pain： continuous wound catheter （CWC） infiltration, patient-controlled epidural analgesia （PCEA）, patient-controlled intravenous analgesia of morphine （PCIAM）, and patient-controlled intravenous analgesia of sufentanil （PCIAS）. The primary outcome was postoperative visual analogue scale （VAS） scores at rest and on movement. Secondary outcomes included consumption of rescue medication, side effects, and complications associated with postoperative pain management. Results From August 2013 to December 2013, 80 patients were allocated to receive CWC （n=10）, PCEA （n=22）, PCIAM （n=29）, or PCIAS （n=19）. After adjusting for age, sex, body mass index, percentage of resected liver, operation time, and Amsterdam Preoperative Anxiety and Information Scale, there was no significant difference in the VAS scores at rest or on movement between Group CWC and the other groups, namely PCEA, PCIAM, and PCIAS, at 4, 12, 48, and 72 hours postoperatively （all P〉0.05）. The need for rescue medication was not significantly different between Group CWC and the other three groups at 48 and 72 hours postoperatively （all P〉0.05）. There was no significant difference in the incidence of postoperative nausea and vomiting or anal exsufflation time between group CWC and the other three groups （all P〉0.05）. No severe adverse effects associated with continuous wound infiltration were observed during the study period. Conclusions CWC has a comparable analgesic effect compared with traditional analgesia methods at most time points postoperatively. CWC is a safe alternative for the postoperative analgesic management of open liver surgery.展开更多
AIM： To investigate whether manual acupuncture at representative acupoints in different parts of the body can modulate responses of gastric motility in rats and regular effects in different acupoint stimulation. METH...AIM： To investigate whether manual acupuncture at representative acupoints in different parts of the body can modulate responses of gastric motility in rats and regular effects in different acupoint stimulation. METHODS： The gastric motor activity of rats was recorded by the intrapyloric balloon. The changes of gastric motility induced by the stimulation were compared with the background activity in intragastric pressure and/or waves of gastric contraction recorded before any stimulation. Morphological study was also conducted by observing the Evans dye extravasation in the skin after mustard oil injection into the intragastric mucous membrane to certify cutaneous innervations of blue dots related to gastric segmental innervations. RESULTS： In all six rats that received mustard oil injections into intragastric mucosa, small blue dots appeared in the skin over the whole abdomen, but mainly in peri-midline upper- and middle- abdomen and middle-back, a few in thigh and groin. It may speculate that cutaneous innervations of blue dots have the same distribution as gastric segmental innervations. Acustimulation in acupoints of head-neck, four limbs, upper chest-dorsum and Iower-dorsum induced markedly augmentation of gastric motility （acupoints on headneck such as St-2： n = 16, 105.19 ± 1.36 vs 112.25 ± 2.02 and St-3： n = 14, 101.5 ± 1.75 vs 109.36 ± 1.8; acupoints on limbs such as Sp-6： n = 19, 100.74 ± 1.54 vs 110.26 ± 3.88; St-32： n = 17, 103.59 ± 1.64 vs 108.24 ± 2.41; St-36： n = 16, 104.81 ± 1.72 vs 110.81 ± 2.74 and U-11： n = 17, 106.47 ± 2.61 vs 114.77 ± 3.77, P 〈 0.05-0.001）. Vigorous inhibitory regulations of gastric motility induced by acu-stimulation applied in acupoints on whole abdomen and middle-dorsum were significantly different as compared with the controls before acu-stimulation （abdomen acupoints such as Cv-12： n = 11, 109.36 ± 2.09 vs 101 ± 2.21; Cv-6： n = 18, 104.39 ± 1.42 vs 91.83 ± 3.22 and St-21： n = 12, 107 ± 2.97 vs 98.58 ± 2.81; acupoints on middledorsum such as BI-17： n = 19, 100.63 ± 1.4 vs 92.21 ± 2.07 and BI-21： n = 19, 103.84 ± 1.48 vs 97.58 ± 2.16, P 〈 0.05-0.001）. CONCLUSION： Regular regulatory effects of facilitation and inhibition on gastric motility appear to be somatotopically organized in the acupoints of whole body, and the effective regularity of site-special acupoints on gastric motility is involved in segmental innervations between stomach and acupoints.展开更多
Background:Hormone sensitive lipase(HSL) is an enzyme that regulates adipose tissue lipolysis and plays an important role in chronic exerciseinduced changes in adipose tissue metabolism.The purpose of this study was t...Background:Hormone sensitive lipase(HSL) is an enzyme that regulates adipose tissue lipolysis and plays an important role in chronic exerciseinduced changes in adipose tissue metabolism.The purpose of this study was to determine whether aerobic exercise intensity influences abdominal adipose tissue HSL gene expression in obese women under weight loss. Methods:Thirty women(body mass index(BMI) = 33.0±0.7 kg/m^2,age = 58±1 years) completed one of three 20-week interventions: caloric restriction alone(CR only,n = 8),CR plus moderate-intensity exercise(CR + moderate-intensity,45%—50%heart rate reserve(HRR). 3 day/week,n = 9),or CR plus vigorous-intensity exercise(CR + vigorous-intensity,70%—75%HRR,3 day/week,n = 13).Each group had a similar prescribed energy deficit comprised of underfeeding alone(2800 kcal/week for CR only) or underfeeding(2400 kcal/week) plus exercise(400 kcal/week).Body composition and maximal aerobic capacity(VO_2max) were measured,and subcutaneous abdominal adipose tissue samples were collected before and after the interventions.Adipose tissue HSL gene expression was measured by real time reversetranscriptase polymerase chain reaction. Results:All three interventions reduced body weight,fat mass,percent fat.and waist to a similar degree(all p < 0.01).In addition,all interventions did not change absolute VO_2 max,but increased relative VO_2 max(p < 0.05 to P < 0.01).Compared to pre-intervention.neither CR only nor CR + moderate-intensity changed adipose tissue HSL gene expression,but CR + vigorous-intensity significantly increased adipose tissue HSL gene expression(p < 0.01).The changes of HSL gene expression levels in the CR + vigorous-intensity group were significantly different from those in the CR only(p < 0.05) and CR + moderate-intensity(p < 0.01) groups.In the whole cohort,changes in adipose tissue HSL gene expression correlated positively to changes in absolute(r = 0.55,p < 0.01) and relative(r = 0.32,p = 0.09) VO_2 max. Conclusion:These results support a potential effect of aerobic exercise training intensity on hormone sensitive lipase pathway in adipose tissue metabolism in obese women under weight loss.展开更多
文摘Objective To investigate the efficacy and safety of continuous local anesthetic wound infiltration following open abdominal partial hepatectomy. Methods We performed a prospective, non-randomized, concurrent and controlled study. Patients undergoing open abdominal partial hepatectomy, according to their willingness, accepted one of the following managements for the postoperative pain： continuous wound catheter （CWC） infiltration, patient-controlled epidural analgesia （PCEA）, patient-controlled intravenous analgesia of morphine （PCIAM）, and patient-controlled intravenous analgesia of sufentanil （PCIAS）. The primary outcome was postoperative visual analogue scale （VAS） scores at rest and on movement. Secondary outcomes included consumption of rescue medication, side effects, and complications associated with postoperative pain management. Results From August 2013 to December 2013, 80 patients were allocated to receive CWC （n=10）, PCEA （n=22）, PCIAM （n=29）, or PCIAS （n=19）. After adjusting for age, sex, body mass index, percentage of resected liver, operation time, and Amsterdam Preoperative Anxiety and Information Scale, there was no significant difference in the VAS scores at rest or on movement between Group CWC and the other groups, namely PCEA, PCIAM, and PCIAS, at 4, 12, 48, and 72 hours postoperatively （all P〉0.05）. The need for rescue medication was not significantly different between Group CWC and the other three groups at 48 and 72 hours postoperatively （all P〉0.05）. There was no significant difference in the incidence of postoperative nausea and vomiting or anal exsufflation time between group CWC and the other three groups （all P〉0.05）. No severe adverse effects associated with continuous wound infiltration were observed during the study period. Conclusions CWC has a comparable analgesic effect compared with traditional analgesia methods at most time points postoperatively. CWC is a safe alternative for the postoperative analgesic management of open liver surgery.
基金Supported by the National Natural Science Foundation of China, No. C30100245 and National Basic Research 973 Program, No. 2005CB523308
文摘AIM： To investigate whether manual acupuncture at representative acupoints in different parts of the body can modulate responses of gastric motility in rats and regular effects in different acupoint stimulation. METHODS： The gastric motor activity of rats was recorded by the intrapyloric balloon. The changes of gastric motility induced by the stimulation were compared with the background activity in intragastric pressure and/or waves of gastric contraction recorded before any stimulation. Morphological study was also conducted by observing the Evans dye extravasation in the skin after mustard oil injection into the intragastric mucous membrane to certify cutaneous innervations of blue dots related to gastric segmental innervations. RESULTS： In all six rats that received mustard oil injections into intragastric mucosa, small blue dots appeared in the skin over the whole abdomen, but mainly in peri-midline upper- and middle- abdomen and middle-back, a few in thigh and groin. It may speculate that cutaneous innervations of blue dots have the same distribution as gastric segmental innervations. Acustimulation in acupoints of head-neck, four limbs, upper chest-dorsum and Iower-dorsum induced markedly augmentation of gastric motility （acupoints on headneck such as St-2： n = 16, 105.19 ± 1.36 vs 112.25 ± 2.02 and St-3： n = 14, 101.5 ± 1.75 vs 109.36 ± 1.8; acupoints on limbs such as Sp-6： n = 19, 100.74 ± 1.54 vs 110.26 ± 3.88; St-32： n = 17, 103.59 ± 1.64 vs 108.24 ± 2.41; St-36： n = 16, 104.81 ± 1.72 vs 110.81 ± 2.74 and U-11： n = 17, 106.47 ± 2.61 vs 114.77 ± 3.77, P 〈 0.05-0.001）. Vigorous inhibitory regulations of gastric motility induced by acu-stimulation applied in acupoints on whole abdomen and middle-dorsum were significantly different as compared with the controls before acu-stimulation （abdomen acupoints such as Cv-12： n = 11, 109.36 ± 2.09 vs 101 ± 2.21; Cv-6： n = 18, 104.39 ± 1.42 vs 91.83 ± 3.22 and St-21： n = 12, 107 ± 2.97 vs 98.58 ± 2.81; acupoints on middledorsum such as BI-17： n = 19, 100.63 ± 1.4 vs 92.21 ± 2.07 and BI-21： n = 19, 103.84 ± 1.48 vs 97.58 ± 2.16, P 〈 0.05-0.001）. CONCLUSION： Regular regulatory effects of facilitation and inhibition on gastric motility appear to be somatotopically organized in the acupoints of whole body, and the effective regularity of site-special acupoints on gastric motility is involved in segmental innervations between stomach and acupoints.
基金supported by NIH grants R01-AG/ DK20583,P30-AG21332,and M01-RR07122
文摘Background:Hormone sensitive lipase(HSL) is an enzyme that regulates adipose tissue lipolysis and plays an important role in chronic exerciseinduced changes in adipose tissue metabolism.The purpose of this study was to determine whether aerobic exercise intensity influences abdominal adipose tissue HSL gene expression in obese women under weight loss. Methods:Thirty women(body mass index(BMI) = 33.0±0.7 kg/m^2,age = 58±1 years) completed one of three 20-week interventions: caloric restriction alone(CR only,n = 8),CR plus moderate-intensity exercise(CR + moderate-intensity,45%—50%heart rate reserve(HRR). 3 day/week,n = 9),or CR plus vigorous-intensity exercise(CR + vigorous-intensity,70%—75%HRR,3 day/week,n = 13).Each group had a similar prescribed energy deficit comprised of underfeeding alone(2800 kcal/week for CR only) or underfeeding(2400 kcal/week) plus exercise(400 kcal/week).Body composition and maximal aerobic capacity(VO_2max) were measured,and subcutaneous abdominal adipose tissue samples were collected before and after the interventions.Adipose tissue HSL gene expression was measured by real time reversetranscriptase polymerase chain reaction. Results:All three interventions reduced body weight,fat mass,percent fat.and waist to a similar degree(all p < 0.01).In addition,all interventions did not change absolute VO_2 max,but increased relative VO_2 max(p < 0.05 to P < 0.01).Compared to pre-intervention.neither CR only nor CR + moderate-intensity changed adipose tissue HSL gene expression,but CR + vigorous-intensity significantly increased adipose tissue HSL gene expression(p < 0.01).The changes of HSL gene expression levels in the CR + vigorous-intensity group were significantly different from those in the CR only(p < 0.05) and CR + moderate-intensity(p < 0.01) groups.In the whole cohort,changes in adipose tissue HSL gene expression correlated positively to changes in absolute(r = 0.55,p < 0.01) and relative(r = 0.32,p = 0.09) VO_2 max. Conclusion:These results support a potential effect of aerobic exercise training intensity on hormone sensitive lipase pathway in adipose tissue metabolism in obese women under weight loss.
