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Post-induction hypotension is common and associated with postoperative complications. We hypothesised that pneumatic leg compression reduces post-induction hypotension in elderly patients undergoing robot-assisted laparoscopic prostatectomy. In this double-blind randomised study, patients were allocated randomly to the pneumatic leg compression group (n = 50) or control (n = 50). In the intervention group, pneumatic leg compression was initiated before induction of anaesthesia. In the control group, pneumatic leg compression was initiated 20 min after anaesthesia induction. The primary outcome was the incidence of post-induction hypotension in these groups. Post-induction hypotension was defined as systolic blood pressure < 90 mmHg during the first 20 min after induction. Haemodynamic variables and area under the curve of post-induction systolic blood pressure over time were assessed. Complications associated with pneumatic leg compression were recorded, including: peripheral neuropathy; compartment syndrome; extensive bullae beneath the leg sleeves; and pulmonary thromboembolism. The incidence of post-induction hypotension decreased in the pneumatic leg compression group compared with that in the control group; 5 (10%) vs. 29 (58%), respectively, p < 0.001. In the pneumatic leg compression group, the lowest systolic, diastolic and mean blood pressures 20 min after induction of anaesthesia were significantly greater than the control group. Pneumatic leg compression resulted in an increased area under the curve of systolic blood pressure in the first 20 min after induction, p = 0.001. There were no pneumatic leg compression-related complications. Pneumatic leg compression reduced post-induction hypotension in elderly patients undergoing robot-assisted laparoscopic prostatectomy, suggesting that it is an effective and safe intervention to prevent post-induction hypotension among elderly patients undergoing general anaesthesia. 相似文献
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Kyung-Suk Suh Suk Kyun Hong Sola Lee Su young Hong Sanggyun Suh Eui Soo Han Seong-Mi Yang YoungRok Choi Nam-Joon Yi Kwang-Woong Lee 《American journal of transplantation》2022,22(1):260-265
Minimally invasive approaches are increasingly being applied in surgeries and have recently been used in living donor hepatectomy. We have developed a safe and reproducible method for minimally invasive living donor liver transplantation, which consists of pure laparoscopic explant hepatectomy and pure laparoscopic implantation of the graft, which was inserted through a suprapubic incision. Pure laparoscopic explant hepatectomy without liver fragmentation was performed in a 60-year-old man with alcoholic liver cirrhosis and hepatocellular carcinoma. The explanted liver was retrieved through a suprapubic incision. A modified right liver graft, procured from his 24-year-old son using the pure laparoscopic method, was inserted through a suprapubic incision, and implantation was performed intracorporeally throughout the procedure. The time required to remove the liver was 369 min, and the total operative time was 960 min. No complications occurred during or after the surgery. The patient recovered well, and his hospital stay was of 11 days. Pure laparoscopic living donor liver transplantation from explant hepatectomy to implantation was performed successfully. It is a feasible procedure when performed by a highly experienced surgeon and transplantation team. Further studies with larger sample sizes are needed to confirm its safety and feasibility.
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目的基于人类免疫缺陷病毒Ⅰ型(HIV-1)感染者外周血单个核细胞(PBMCs)中HIV-1总DNA和RNA定量检测结果对感染细胞内病毒的转录活性进行区分。方法采集2017年10月至2018年12月于哈尔滨医科大学附属第四医院感染科就诊的HIV-1感染者血液样本,分离PBMCs细胞,采用PCR荧光探针法对PBMCs细胞内HIV-1总DNA和RNA进行定量检测,并计算两者比值(Ratio)。根据Ratio值筛选出HIV-1转录活跃组样本和相对非活跃组样本,另外选择健康人PBMCs样本作为对照组。对3组样本进行基因转录组表达谱检测以及人口特征差异性检验,并对基因表达谱检测结果进行主成分分析以验证对3组样本病毒转录活性区分的准确性。结果从60例感染HIV-1患者的PBMCs样本中筛选出HIV-1转录活跃组样本(10例)和相对非活跃组样本(11例),另外选择6例健康人PBMCs样本作为对照组。其中转录活跃组样本Ratio值为165.2~738.93,平均为(339.27±189.68);相对非活跃组Ratio值为4.67~42.39,平均为(17.65±11.78)。转录活跃组和相对非活跃组样本间的CD4+T细胞计数(P=0.049)和Ratio值(P<0.001)差异均具有统计学意义;3组样本年龄(P=0.989)和性别(P=0.650)分布差异无统计学意义。对3组样本的PBMCs基因表达谱主成分分析结果显示:对照组与HIV-1感染者(包括转录活跃组和相对非活跃组)间区分明显。转录活跃组和相对非活跃组间有部分样本重合,同时结果也显示当HIV-1感染者的CD4+T淋巴细胞计数与健康人无显著差异时,其细胞内的基因表达与健康人接近。结论基于HIV-1总DNA和RNA定量检测结果及两者间比值可以较好地区分PBMCs内病毒转录活性。HIV-1感染细胞内部病毒的不同转录激活状况可导致其基因表达谱的异质性。 相似文献
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目的 系统评价益气活血法联合西药治疗特发性肺纤维化(idiopathic pulmonary fibrosis,IPF)的疗效及安全性。方法 系统检索中国知网、维普网、万方数据库、EMbase、PubMed、Cochrane Library图书馆等数据库,检索时限从数据库建库至2021年1月,纳入益气活血法联合西药治疗特发性肺纤维化的随机对照试验(randomized controlled trial,RCT),由2名研究人员独立筛选并交叉核对纳入结果,提取有效数据后,应用RevMan 5.3软件进行Meta分析。结果 纳入16项随机对照试验共计1160例IPF患者。分析结果显示益气活血法联合西药组可提高临床总有效率(OR= 3.71,95% CI [2.68,5.14],P<0.00001);改善患者肺功能:用力肺活量(MD=0.31,95% CI [0.23,0.38],P<0.00001)(MD=3.59,95% CI [1.51,5.66],P=0.0007),一氧化碳弥散量(MD=2.54,95% CI [1.83,3.25],P<0.00001);提高生活质量,降低圣乔治评分:呼吸困难(MD=-12.70,95% CI [-21.07,-4.32],P=0.003),活动能力(MD=-8.38,95% CI [-13.66,-3.10],P=0.002),疾病影响(MD=-13.87,95% CI [-22.53,-5.22],P=0.002);并可降低患者中医症状积分:喘息(MD=-0.66,95% CI [-0.84,-0.49],P<0.00001),咳嗽(MD=-0.71,95% CI [-1.04,-0.37],P<0.0001);有效提高动脉血氧分压(MD=5.92,95% CI [4.61,7.22],P<0.00001);且不增加不良事件发生率(OR=0.55,95% CI [0.27,1.14],P=0.11)。结论 益气活血法联合西药治疗IPF可提高临床治疗有效率,改善患者生活质量,且不增加临床不良事件(便秘、嗜睡、口干、恶心呕吐、皮肤瘙痒、腹泻等)发生率。但本研究纳入文献质量参差不齐,仍需更多大样本、高质量、多中心的RCT试验验证结论。 相似文献
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Chalub Lucas Orbolato Nunes Gabriel Pereira Ferrisse Túlio Morandin Strazzi-Sahyon Henrico Badaoui Dos Santos Paulo Henrique Gomes-Filho João Eduardo Cintra Luciano Tavares Angelo Sivieri-Araujo Gustavo 《Clinical oral investigations》2022,26(4):3343-3356
Clinical Oral Investigations - The objective of this systematic review and meta-analysis (SRM) was to answer the question whether the use of ultrasonic irrigation (UI) results in less postoperative... 相似文献