目的比较水交换与常规注气进镜方式对结肠镜检查质量的影响。方法计算机检索PubMed、Web of Science、the Cochrane Library、中国生物医学文献数据库、中国知网和万方数据,搜集关于水交换与单纯注气的常规进镜方式对结肠镜检查质量影...目的比较水交换与常规注气进镜方式对结肠镜检查质量的影响。方法计算机检索PubMed、Web of Science、the Cochrane Library、中国生物医学文献数据库、中国知网和万方数据,搜集关于水交换与单纯注气的常规进镜方式对结肠镜检查质量影响的研究,检索时限为建库至2022年10月8日。由2名研究员独立完成对文献的筛选、数据提取和质量评价。采用RevMan 5.4.1软件对纳入文献进行Meta分析。结果共纳入23项研究,10654例患者,Meta分析结果显示,水交换虽延长了进镜时间(MD=1.81,95%CI:1.28~2.35,P=0.000),但其腺瘤检出率(ADR)(O^R=1.40,95%CI:1.26~1.55,P=0.000)、盲肠插管率(O^R=1.62,95%CI:1.24~2.10,P=0.000)和肠道准备质量评分(MD=0.61,95%CI:0.42~0.79,P=0.000)高于常规进镜方式,疼痛评分(MD=-1.07,95%CI:-1.39~-0.76,P=0.000)、腹部按压(O^R=0.42,95%CI:0.29~0.60,P=0.000)和体位变化(O^R=0.59,95%CI:0.42~0.82,P=0.002)低于常规进镜方式,差异均有统计学意义(P<0.05)。结论水交换进镜方式虽延长了进镜时间,但提高了ADR、盲肠插管率和肠道准备质量评分,减轻了疼痛,降低了腹部按压和体位改变的概率,其是进行高质量结肠镜检查的较佳选择。展开更多
目的探讨超声辅助气管插管深度定位的应用价值。方法选择2020年9月—2022年12月苏州大学附属太仓医院收治的要进行气管插管的50例患者,进行常规气管插管后,运用听诊结合呼气末二氧化碳(positive end expiratory pressure CO_(2),PetCO_(...目的探讨超声辅助气管插管深度定位的应用价值。方法选择2020年9月—2022年12月苏州大学附属太仓医院收治的要进行气管插管的50例患者,进行常规气管插管后,运用听诊结合呼气末二氧化碳(positive end expiratory pressure CO_(2),PetCO_(2))和超声辅助确认导管所处位置,记录以上不同方法下的导管位置确认结果及耗时。结果将听诊结合PetCO_(2)监测结果作为标准,超声辅助下确认气管导管位置的灵敏度、特异度、准确率、阴性及阳性预测值分别是97.62%(47/48)、100%(2/2)、98.00%(49/50)、66.67%(2/3)、100%(47/47)。超声和听诊结合PetCO_(2)监测在确认气管插管位置方面表现出较高的一致性(Kappa=0.86,P<0.01)。超声探测平均用时为(20.14±5.47)s,短于听诊结合PetCO_(2)监测(25.51±7.44)s,差异有统计学意义(P<0.05)。结论超声辅助评估气管内插管定位准确性较高,操作方便、迅速,可有效提升插管效率。展开更多
Background Animal models of myocardial infarction （MI） have been widely used to study the pathologi- cal and physiological changes that occur in MI, and to objectively evaluate the efficacy of new treatments. They a...Background Animal models of myocardial infarction （MI） have been widely used to study the pathologi- cal and physiological changes that occur in MI, and to objectively evaluate the efficacy of new treatments. They are an important tool in this procedure. However, the mortality rate of MI animal models has so far been higher than in real-life situations. The aim of this study was to explore the use of a modified retrograde traction tracheal intubation （MRTI） method for increasing the success rate of MI models in rats. Methods Sixty male Sprague-Dawley rats were used in the experiment. Using the MRTI method of artificial airway generation, we established the MI model by ligation of the left anterior descending branch of the coronary artery. We analyzed the effects of MRTI, the use of lidocaine, operative details, nursing considerations during the operation, and post-operative factors on the success rate of the MI model in rats. Results The success rate of generating an MI model in rats can be significantly increased using the following methods： 1） Setting up the artificial airway through the use of MRTI by using a single-lumen central venous catheter; 2） Selecting a ligation site 2 mm be- low the midpoint of the connection between the left atrial appendage and the pulmonary cone; 3） Adding a drop of lidocaine to the surface of the heart to slow down the heart rate, make the operation easier to perform, and prevent arrhythmias postoperatively; 4） Clearing up airway secretions timely both intra and postoperative- ly; 5） Making sure that rats are in a warm state both intra and postoperatively; 6） Preventing wound infection. Conclusions Use of the MRTI method can quickly establish an artificial airway in rats. Intraoperative use of lidocaine, selecting a precise vascular ligation site, and appropriate care both intra and postoperatively can in- crease the success rate of MI model generation.展开更多
文摘目的探讨超声辅助气管插管深度定位的应用价值。方法选择2020年9月—2022年12月苏州大学附属太仓医院收治的要进行气管插管的50例患者,进行常规气管插管后,运用听诊结合呼气末二氧化碳(positive end expiratory pressure CO_(2),PetCO_(2))和超声辅助确认导管所处位置,记录以上不同方法下的导管位置确认结果及耗时。结果将听诊结合PetCO_(2)监测结果作为标准,超声辅助下确认气管导管位置的灵敏度、特异度、准确率、阴性及阳性预测值分别是97.62%(47/48)、100%(2/2)、98.00%(49/50)、66.67%(2/3)、100%(47/47)。超声和听诊结合PetCO_(2)监测在确认气管插管位置方面表现出较高的一致性(Kappa=0.86,P<0.01)。超声探测平均用时为(20.14±5.47)s,短于听诊结合PetCO_(2)监测(25.51±7.44)s,差异有统计学意义(P<0.05)。结论超声辅助评估气管内插管定位准确性较高,操作方便、迅速,可有效提升插管效率。
基金supported by Guangdong Medical Scientific Research Funds(No.B2012304)Guangzhou Medical and Health Technology Projects(No.20141A011019)
文摘Background Animal models of myocardial infarction （MI） have been widely used to study the pathologi- cal and physiological changes that occur in MI, and to objectively evaluate the efficacy of new treatments. They are an important tool in this procedure. However, the mortality rate of MI animal models has so far been higher than in real-life situations. The aim of this study was to explore the use of a modified retrograde traction tracheal intubation （MRTI） method for increasing the success rate of MI models in rats. Methods Sixty male Sprague-Dawley rats were used in the experiment. Using the MRTI method of artificial airway generation, we established the MI model by ligation of the left anterior descending branch of the coronary artery. We analyzed the effects of MRTI, the use of lidocaine, operative details, nursing considerations during the operation, and post-operative factors on the success rate of the MI model in rats. Results The success rate of generating an MI model in rats can be significantly increased using the following methods： 1） Setting up the artificial airway through the use of MRTI by using a single-lumen central venous catheter; 2） Selecting a ligation site 2 mm be- low the midpoint of the connection between the left atrial appendage and the pulmonary cone; 3） Adding a drop of lidocaine to the surface of the heart to slow down the heart rate, make the operation easier to perform, and prevent arrhythmias postoperatively; 4） Clearing up airway secretions timely both intra and postoperative- ly; 5） Making sure that rats are in a warm state both intra and postoperatively; 6） Preventing wound infection. Conclusions Use of the MRTI method can quickly establish an artificial airway in rats. Intraoperative use of lidocaine, selecting a precise vascular ligation site, and appropriate care both intra and postoperatively can in- crease the success rate of MI model generation.
