亚甲蓝切缘封闭在环状混合痔手术中的应用

为探讨亚甲蓝切缘封闭在环状混合痔手术中的临床应用价值,将72例手术治疗的环状混合痔患者随机分为治疗组和对照组,各36例,对照组采用保留齿状线、分段外切内扎术治疗,治疗组在对照组手术的基础上加行亚甲蓝切缘封闭注射。观察两组治愈率、创面愈合时间、术后肛门疼痛、肛缘水肿、术后早期排尿及排便功能等情况。结果显示,在治愈率方面,两组差异无统计学意义,P〉0．05;但在创面愈合时间、术后肛门疼痛、肛缘水肿、排尿困难及排便困难等方面,治疗组明显优于对照组,P〈0．05。结果表明,在环状混合痔手术中加行亚甲蓝切缘封闭注射,可以显著减少术后并发症的发生,减轻患者痛苦,缩短创面愈合时间。     

Comparison between continuous posterior and lateral interscalene brachial plexus blockades for major shoulder surgery

Background

Postoperative pain relief after major shoulder surgery is extremely challenging. Continuous interscalene blockade is considered a well suited pain management technique for this type of surgery, but with technical difficulties. The aim of this study was to compare the efficacy and safety of continuous posterior and conventional lateral interscalene brachial plexus blockades.

Methods

This prospective randomized study included 40 patients who were radomally allocated into two equal groups (n = 20 patients), in the first group, continuous lateral interscalene blockade was done (Lateral Group), while continuous posterior interscalene was performed in the second group (Posterior Group). The measurement data were patient characteristics and surgical data, easiness of catheter insertion, onset of blockade, catheter insertion and total blockade times. Side effects encountered during blockade and postoperative efficacy of analgesia as well as patients satisfaction were also measured.

Results

There was no significant difference as regards the onset of anesthesia in both groups. Block procedure time and catheter placement times were faster in the posterior group (6.6 ± 0.64 vs 9.6 ± 1.1 min; P < .05 and 1.6 ± 0.7 vs 4.3 ± 0.7 min; P < 0.05 respectively). Successful catheter insertion was higher in the posterior group (19 patients vs 15 patients in the lateral group). Easy catheter insertion were significantly higher in the posterior group (16 patients vs eight patients In the lateral group; P < 0.05).Technical adverse effects related to catheter insertion were significantly higher in the lateral group (nine patients vs only one patient in the posterior group; P < 0.05). Complications were comparable in both groups. Postoperative efficacy of analgesia and Patient’s satisfaction about catheter placement was higher in the posterior group.

Conclusion

In conclusion, we demonstrated a high success rate, low systemic and technical adverse effects, and better catheter compliance with continuous posterior interscalene blockade.     

Cardiac resynchronization therapy for left ventricular dysfunction induced by chronic right ventricular pacing in a child

Cardiac resynchronization therapy (CRT) has been proven its value in adult patients with congestive heart failure of low ejection fraction and wide QRS duration. Contrast to adult patients, CRT has been rarely applied for young patients. We report on a 9-yr-old boy with progressive left ventricular (LV) dilatation and dysfunction following chronic VVI pacemaker therapy for congenital complete atrioventricular block associated with maternal anti-SSA/Ro and SSB/La antibody. His LV dysfunction was improved after epicardially established CRT.     

Block copolymer stabilized nonaqueous biocompatible sub-micron emulsions for topical applications

Polyethylene glycol (PEG) 400/Miglyol 812 non-aqueous sub-micron emulsions were developed due to the fact that they are of interest for the design of drug-loaded biocompatible topical formulations. These types of emulsions were favourably stabilized by poly (2-vinylpyridine)-b-poly (butadiene) (P2VP-b-PBut) copolymer with DP_But > DP_2VP, each of these sequences being well-adapted to the solubility parameters of PEG 400 and Miglyol 812, respectively. This type of block copolymers, which might limit the Ostwald ripening, appeared to be more efficient stabilizers than low molecular weight non-ionic surfactants. The emulsion characteristics, such as particle size, stability and viscosity at different shear rates were determined as a function of the phase ratio, the copolymer concentration and storage time. It was further shown that Acyclovir, as a model drug of low water solubility, could be incorporated into the PEG 400 dispersed phase, with no significant modification of the initial emulsion characteristics.     

紫杉醇衍生物GT对人喉癌细胞系Hep-2的临床价值分析

目的探讨紫杉醇衍生物GT对人喉癌细胞系Hep-2的临床价值。方法 GT对Hep-2细胞的增殖抑制作用应用MTT法进行测定,通过流式细胞术及细胞形态学考察GT对Hep-2细胞诱导凋亡的作用。结果在光镜下,GT作用细胞之后能观察到较为典型的细胞凋亡的形态学变化,如染色质断片化、细胞核固缩、核碎裂、染色质凝集成新月型紧贴于核膜周边、凋亡小体形成等。明显增加G2/M期的细胞比例,典型的亚二倍体"凋亡小峰"出现。结论紫杉醇衍生物GT能够明显抑制Hep-2细胞的生长,使细胞分裂阻滞于G2/M期,对肿瘤细胞凋亡有诱导作用,值得临床进一步对其进行研究开发。     

玻璃酸钠关节腔注射配合封闭治疗膝骨性关节炎疗效观察

目的探讨玻璃酸钠关节腔注射配合封闭治疗效果。方法对120例患者随机分为治疗组和对照组。治疗组60例采取玻璃酸钠关节腔注射配合封闭疗法;对照组60例口服非甾体抗炎药物,双氯芬酸钠缓释片,局部外涂扶他林乳胶剂。结果5周为1疗程评定。治疗组60例,治愈28,显效26例。有效5例,无效1例,治愈率46．67％总有效率98．33％。对照组60例,治愈12例,显效15例,有效13例,无效20例,治愈率20％,总有效率66．67％。结论玻璃酸钠关节腔注射,局部痛点封闭能明显改善膝关节功能,疗效优于口服药物,是治疗膝关节骨性关节炎的有效方法。     

中医药治疗慢性肾功能衰竭研究概况

慢性功能肾衰竭(chronic renal failure,CRF)病机为脾肾虚损,导致湿浊、瘀血等浊毒潴留于体内,弥漫于三焦。本虚标实为其致病特点。从病因病机、治则、方药、综合治疗等方面,介绍中医药治疗慢性肾功能衰竭研究概况。中医药能有效延缓病情进展,延长患者寿命,防治早中期肾功能不全有独特优势。指出应重视古代文献研究,全面掌握有关本病论述,验证于临床,辅助现代科技,中西医结合,扩展中医药治疗CRF临床研究思路,提高疗效及生存质量,使中医药治疗该病发挥更大优势。     

螺旋CT扫描技术在梗阻性黄疸的临床应用探讨

目的 探讨螺旋CT扫描技术在梗阻性黄疸的临床应用,提高病变信息在图像中的展现率。方法 对73例梗阻性黄疸扫描前准备,扫描技术方法、病变显示结果进行统计,分析影响图像的相关因素。结果 高密度对比剂干扰胆道结石诊断3例。10mm重建间隔显示病变53例(53／73)：5mm重建间隔显示病变69例(69／73)。三期强化扫描中,动脉期无强化7例(7／16),病灶浅淡不均匀强化9例(9／16);门脉期和延迟期病灶高密度不均匀强化13例(13／16),等密度3例(3／16)。结论 螺旋CT检查梗阻性黄疸,胃、肠对比剂以清水为首选。图像重建以小间隔薄层减少漏诊误诊。CT强化三期扫描对胆管癌诊断与鉴别诊断很有价值。