A total of 65 patients were included in the final analysis with 31 patients in Group G + E and 34 patients in Group G. The quality life scores for social, emotional, and global health were higher in Group G + E than in Group G (P < 0.05). We found that EP may improve short-term QoL in elderly patients undergoing esophagectomy. EP, epidural anesthesia; Group G, patients only received general anesthesia; Group G + E, patients received general anesthesia combined with epidural anesthesia; QLQ, Quality of life Questionnaires; QoL, quality of life.
Previous archaeological mapping work on the successive medieval capitals of the Khmer Empire located at Angkor, in northwest Cambodia (∼9th to 15th centuries in the Common Era, C.E.), has identified it as the largest settlement complex of the preindustrial world, and yet crucial areas have remained unmapped, in particular the ceremonial centers and their surroundings, where dense forest obscures the traces of the civilization that typically remain in evidence in surface topography. Here we describe the use of airborne laser scanning (lidar) technology to create high-precision digital elevation models of the ground surface beneath the vegetation cover. We identify an entire, previously undocumented, formally planned urban landscape into which the major temples such as Angkor Wat were integrated. Beyond these newly identified urban landscapes, the lidar data reveal anthropogenic changes to the landscape on a vast scale and lend further weight to an emerging consensus that infrastructural complexity, unsustainable modes of subsistence, and climate variation were crucial factors in the decline of the classical Khmer civilization. 相似文献
The antiplasmodial effect of a single dose treatment with a sulfadoxine/pyrimethamine combination as compared to a sulfalene/pyrimethamine combination against falciparum malaria was assessed in semi-immune populations in Burma in early 1980. Parasite clearance rates on Day 7 after treatment were 99.2% for the sulfadoxine/pyrimethamine combination and 98.6% for the sulfalene/pyrimethamine combination for all age-groups. The earlier recrudescence rates within one month were 3.7% and 9.2% respectively, while the later recrudescence rates between 1 and 2 months were 9% and 8.3% respectively. Hence, both combinations were equally effective for treatment of falciparum malaria as no significant difference in the parasite clearance rates was observed. However, the earlier recrudescence rates showed a significant difference with a higher rate for the sulfalene/pyrimethamine combination. This is thought to be due to the shorter half-life of sulfalene compared to sulfadoxine and to its being unable therefore to suppress the falciparum infections for as long a period as sulfadoxine. But there was not much difference in the later recrudescence rates. These combinations have a stimulating effect on the production of falciparum gametocytes; and, in order to minimize transmission, an effective gametocytocide such as primaquine should be given along with them, as well as with the chloroquine/pyrimethamine combination, in areas with efficient malaria vectors. Recrudescence rates and gametocyte rates were highest among children in the 1-4 years age-group and this could be attributed to their lower level of acquired immunity compared to the older children and adults. Vivax malaria was also found to be effectively suppressed for about 4 weeks with both combinations.(ABSTRACT TRUNCATED AT 400 WORDS) 相似文献
Hearing loss has been reported with valproic acid (VPA) use. However, this is the first case of VPA‐induced hearing loss that was tested and confirmed with a VPA rechallenge, supported by serial audiometry and pharmacokinetic modelling. A 39‐year‐old truck driver with temporal lobe epilepsy was treated with VPA at 400 mg, twice daily, and developed hearing loss after each dose, but recovered within three hours. Hearing loss fully resolved after VPA discontinuation. Audiometry performed five hours after VPA rechallenge showed significant improvement in hearing thresholds. Pharmacokinetic modelling during the VPA rechallenge showed that hearing loss occurred at a level below the therapeutic range. Brainstem auditory evoked potential at three months after VPA discontinuation showed bilateral conduction defect between the cochlear and superior olivary nucleus, supporting a pre‐existing auditory deficit. VPA may cause temporary hearing threshold shift. Pre‐existing auditory defect may be a risk factor for VPA‐induced hearing loss. Caution should be taken while prescribing VPA to patients with pre‐existing auditory deficit. 相似文献
We report a patient with juvenile myoclonic epilepsy who subsequently developed temporal lobe epilepsy, which gradually became clinically dominant. Video telemetry revealed both myoclonic seizures and temporal lobe seizures. The temporal lobe seizures were accompanied by a focal recruiting rhythm with rapid generalisation on EEG, in which the ictal EEG pattern during the secondary generalised phase was morphologically similar to the ictal pattern during myoclonic seizures. The secondary generalised seizures of the focal epilepsy responded to sodium valproate, similar to the myoclonic epilepsy. In this rare case of coexistent Juvenile Myoclonic Epilepsy and Temporal lobe epilepsy, the possibility of focal epilepsy recruiting a generalised epileptic network was proposed and discussed. 相似文献
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