Analgesic Effects of Ultrasound‐Guided Iliohypogastric/Ilioinguinal Nerve Block Combined with Lateral Femoral Cutaneous Nerve Block in Total Hip Arthroplasty via Direct Anterior Approach: A Retrospective Cohort Study

ObjectiveThis study aimed to explore the efficacy and safety of the combination of lateral femoral cutaneous nerve blocks (LFCNB) and iliohypogastric/ilioinguinal nerve blocks (IHINB) on postoperative pain and functional outcomes after total hip arthroplasty (THA) via the direct anterior approach (DAA).MethodsIn this retrospective cohort study, patients undergoing THA via the DAA between January 2019 and November 2019 were stratified into two groups based on their date of admission. Sixty‐seven patients received LFCNB and IHINB along with periarticular infiltration analgesia (PIA) (nerve block group), and 75 patients received PIA alone (control group). The outcomes included postoperative morphine consumption, postoperative pain assessed using the visual analogue scale (VAS), the QoR‐15 score, and functional recovery measured as quadriceps strength, time to first straight leg rise, daily ambulation distance, and duration of hospitalization. The Oxford hip score and the UCLA activity level rating were assessed at 1 and 3 months after surgery. In addition, postoperative complications were recorded. Patients were also compared based on the type of incision used during surgery (traditional longitudinal or “bikini” incision).ResultsPatients in the nerve block group showed significantly lower postoperative morphine consumption, lower resting VAS scores within 12 h postoperatively, lower VAS scores during motion within 24 h postoperatively, and better QoR‐15 scores on postoperative day 1. These patients also showed significantly better functional recovery during hospitalization. At 1‐month and 3‐month outpatient follow up, the two groups showed no significant differences in Oxford hip score or UCLA activity level rating. There were no significant differences in the incidence of postoperative complications. Similar results were observed when patients were stratified by type of incision, except that the duration of hospitalization was similar.ConclusionCompared to PIA alone, a combination of LFCNB and IHINB along with PIA can improve early pain relief, reduce morphine consumption, and accelerate functional recovery, without increasing complications after THA via the DAA.     

大肠癌“移行粘膜”病理变化研究——粘液组化、免疫组化及电镜观察

对200例大肠癌旁“移行粘膜”进行了粘液组化HID／AB及PAT／KOH／PAS检测,单克隆抗体MC3和CEA免疫组化标记,凝集素PNA、UEA－1及DBA受体测定,扫描电镜观察。其结果与10例正常直肠粘膜、130例癌组织、155例各型腺瘤型息肉及3－5个月胎儿大肠粘膜进行对照。结果表明大肠粘膜从良性到恶性的各阶段粘液组化及免疫组化的改变有显著差异（P＜0．05或P＜0．01）,癌旁“移行粘膜”也存在类似癌及胎儿大肠的不成熟性病理变化,异常范围88．0％的病例在2－3cm以内。     

The Effects of Permeation Enhancers on the Surface Morphology of the Rat Nasal Mucosa: A Scanning Electron Microscopy Study

A rat model has been developed to compare relative morphological changes in the nasal mucosa after exposure to potential membrane permeation enhancers. Scanning electron microscopy was used to characterize gross structural and specific cellular changes following exposure. Micrographs of the rat nasal mucosa were scored in four categories: (1) mucosal surface integrity, (2) ciliary morphology, (3) mucus/extracellular debris, and (4) presence of red blood cells. The order of increasing morphological damage resulting from a 5-min exposure to each surfactant was 0.5% Solulan C-24 0.5% Solulan C-24/0.5% sodium tauro-24,25-dihydrofusidate (STDHF) < 0.5% STDHF < 1.0% STDHF 1.0% Laureth-9 < 1.0% sodium taurodeoxycholate 1.0% sodium deoxycholate. The changes observed in the mucosal morphology after exposure to the various surfactants are in general agreement with data in the literature. This model is able to compare rapidly the relative morphological effects on the mucosal membrane of different nasal formulations.     

胆道梗阻的影像对比研究

目的：比较各种影像检查在胆道梗阻患者的诊断上的优劣。方法：分析89例年龄在12－75岁的胆道梗阻患者的CT、B超,胆道造影资料。结果：对胆管癌,胰头癌,炎性狭窄,肝癌,壶腹癌的诊断,胆道造影与病理的符合率较高,肿大淋巴结的诊断,CT与B超较胆道造影与病理的符合率高,对于梗阻部位,胆道造影,CT与手术的符合率较B超与手术符合率高。结论：胆道造影与CT对梗阻部位及原因的诊断准确率较高。B超的临床实用性较高。     

The clinical radiological and histological correlation of orbital assessment in malignant lesions of the maxillo-ethmoid complex

Twelve patients undergoing surgery between May 1995 and March 1999 for malignant tumours of the paranasal sinuses abutting or invading the orbital walls were studied for the need to remove orbital contents. Alt patients were evaluated clinically, radiologically (CT Scan) and per-operatively to delineate the extent of orbital invasion. Combined regimen (Surgery + Radiotherapy) were used in all patients. A biopsy from periorbita was taken when eye was spared. It was found that per-operative evaluation of the orbit is equally specific in comparision to clinical and CT Scan combined and eye may be preserved in selected patients with involvement of orbital periosteum provided there is no frank soft tissue mass in the orbit.     

Stellenwert von Computertomographie und Magnetresonanztomographie bei der Diagnostik von Malignomen der Mundh?hle und des Oropharynx

Problem: There is a lack of clear criteria for the use of MR and CT in the diagnosis of head and neck cancer – some of it is even contradictory. The results of this study should lead to the establishment of more clear criteria. Patients: 165 patients suffering from head and neck tumors were subjected to a total of 463 CT and 197 MRI examinations. Results: The CT and MRI staging corresponded in 67% and 60% of the oropharynx tumors, respectively, with the clinical findings. In the case of oral cavity tumors, the clinical TNM stages were identical with CT and MRI results in 50% and 43% of cases, respectively. In the case of lymphatic node staging, the frequency of error was slightly higher using MRI, at 27%, compared with the CT rate of 22%. In the evaluation of cervical lymphatic nodes, CT proved to be more sensitive attaining 78% compared to the MRI rate of 69%. Conclusion: The results provide clear indications as to the MRI and CT examinations. Primary preoperative screening and post-therapeutic aftercare should be assessed using CT, as should lymphatic node diagnosis in the neck area. In the case of special problems such as, for example, the relevant bone and periostium infiltration, MR should be considered as a supplementary examination at a second stage.      

改良CT扫描检查肺部小病灶

肺部ＣＴ扫描小病灶易遗漏 ,扫描前对定位图像观察细致 ,定位准确 ,则可达到检出病灶的目的 ,现报告如下。１临床资料１９９７年８月至１９９８年１月１０例肺部０．５～０．８ｃｍ小病灶 ,男７例 ,女３例 ,年龄１７～８３岁 ,平均年龄５７岁。病人仰卧于检查床上 ,双手抱紧头部 ,臀部垫高１５°～２５° ,定位线对准锁骨连线中心 ,先扫描全肺像 ,再根据病变情况 ,设定扫描程序。我科采用美国ＧＥｓｙｓｔｅｃ３０００型全身ＣＴ机 ,取ＸＹ轴线 ,从小病灶上缘 ,以３ｍｍ层厚 ,３ｍｍ层距 ,扫到病灶下缘为止。其他肺野 ,可用１０ｍｍ层厚 ,１…     

Survey on the use of pulmonary scintigraphy, spiral CT and conventional pulmonary angiography for suspected pulmonary embolism in the British Isles

AIM: To determine current clinical practice in the radiological diagnosis of acute pulmonary embolism and assess the use of spiral volumetric computed tomography. METHOD: A survey of 327 acute hospitals including cardiothoracic and orthopaedic tertiary referral centres was undertaken to assess current utilization of lung scintigraphy, spiral computed tomography and pulmonary angiography in the investigation of suspected pulmonary embolism. Responses were received from 215/327 (66%) centres. RESULTS: Lung scintigraphy was provided by 208 hospitals (144 on-site and 64 off-site). Spiral CT services were provided by 111 (52%) hospitals (on- or off-site), 142 (66%) units had access to angiographic facilities. Sixty-three centres out of 215 (29%) offered both on-site lung scintigraphy and spiral CT while only 41/215 (19%) hospitals were able to undertake all three tests on-site. On average, 501 perfusion (Q) or ventilation-perfusion (V/Q) scintigrams were performed per hospital per year with 26 spiral CT studies and just 4.6 pulmonary angiograms. CONCLUSION: These data suggest that lung scintigraphy is frequently the only imaging test in patients other than chest radiography, despite the large number of indeterminate results reported in most series.     

Die Magnetresonanztomographie in der Dentalradiologie (Dental-MRT)

Zusammenfassung Ziel dieses Beitrags ist die Vorstellung der Untersuchungsm?glichkeiten des Ober- und Unterkiefers mittels Magnetresonanztomographie (Dental-MRT) und ihre Anwendung bei der Diagnose zahnmedizinischer Erkrankungen. Sieben gesunde Probanden, 5 Patienten mit Pulpitis, 9 Patienten mit dentogenen Zysten, 5 Patienten nach Zahntransplantationen und 12 Patienten mit atrophem Unterkiefer wurden untersucht. Axiale T1- und T2-gewichtete Gradientenecho- und Spinecho-Sequenzen in 2D und 3D-Technik wurden durchgeführt. Nach der Untersuchung wurden zus?tzliche Panoramaschnitte und orhoradiale Rekonstruktionen des Ober- und Unterkiefers, unter Verwendung einer gebr?uchlichen Dental-Software, angefertigt. Der gesamte Ober- oder Unterkiefer, Z?hne, Pulpa und der Inhalt des Mandibularkanals k?nnen gut dargestellt werden. Patienten mit einer Entzündung der Zahnwurzel k?nnen ein deutliches Knochenmarks?dem in der Periapikalregion zeigen. Bei Patienten mit odontogenen Zysten ist die Beziehungen zu den umgebenden Kieferstrukturen gut darstellbar. Nach Kontrastmittelgabe zeigt sich ein Enhancement in der Zahnpulpa. Die Dental-MRT ist ein nützliches Verfahren zur anatomischen Darstellung des Kieferbereichs und zahnmedizinischer Erkrankungen.