Laparoscopic end-to-end aortobifemoral bypass with reimplantation of the inferior mesenteric artery

Background: Colic ischemia is a serious complication that can occur after abdominal aortic surgery. It has been described in two patients after laparoscopic aortic surgery. The goal of the current experiment was to determine the feasibility of inferior mesenteric artery (IMA) reimplantation during laparoscopic aortobifemoral bypass (LAFB). Methods: Six piglets were submitted to the laparoscopic approach according to the ``apron' technique previously described. The infrarenal aorta was clamped and an LAFB was performed using a dacron graft. The IMA was reimplanted in the body of the graft with a running 5-0 polypropylene suture. Results: Mean operation and dissection times were 282.5 min (range, 270–310 min) and 123 min (range, 110–140 min), respectively, with a mean blood loss of 108 ml (range, 80–150 ml). Aortic clamping and anastomotic times were 123 min (range, 110–135 min) and 33 min (range, 24–45 min), respectively. The IMA reimplantation took 55 min (range, 45–70 min). At autopsy, all anastomoses were patent with no stenosis nor leak. Conclusion: Laparoscopic IMA reimplantation during laparoscopic aortobifemoral bypass is feasible. Received: 10 July 1998/Accepted: 15 November 1998     

Negative influence of maternal smoking during pregnancy on infant outcomes

BackgroundAccording to the INPES 2014 health barometer, the prevalence of smoking in pregnant women in France is the highest in Europe : 17.8% of expectant mothers who smoke continue to do so during pregnancy. Several epidemiological studies have confirmed multiple risks for tobacco-exposed infants (low birth weight; digestive, respiratory, neurological, and psychological disorders; obesity; type 1 diabetes).PurposeThis study compared a cohort of infants exposed to tobacco in utero (T + ) with those unexposed (T−). Birth weight, diet, presence of colic (ROME III criteria) and regurgitations (Vandenplas scale) were specifically analyzed.MethodsThis observational, cross-sectional, and multicenter survey was conducted in France by pediatricians and general practitioners from September 2016 to February 2017. Infants with a chronic pathology and those with parents under 18 years of age were excluded. The data were collected by the physician and by the mother through a self-administered questionnaire.ResultsA total of 452 physicians recruited 759 T+ and 741 T- infants in the study. The mean birth weight of T+ infants was significantly lower (3.1 ± 0.5 kg [WHO z-score -0.476 ± 1.081]) than that of T− infants (3.3 ± 0.5 kg [0.033 ± 0.965]; P < 0.001). At the time of leaving the maternity facility, 47.7% of T+ infants were breastfed by their mother compared with 70.1% of T− infants. The median reported duration of breastfeeding was 1 month vs. 2 months for T+ and T− infants, respectively. Colic was significantly more common in T+ than in T− infants: 25.6% vs. 12.3% according to the ROME III criteria, and 45.7% vs. 29.7% according to the doctor's opinion (P < 0.001 for both). In the T+ group, cases of regurgitation (63.6% vs. 56.5%; P = 0.005), respiratory disorder (6.3% vs. 2.4%, P < 0.001), and bronchiolitis (6.5% vs. 3.0%; P = 0.001) were also more frequent.ConclusionThis study confirms that maternal smoking during pregnancy is associated with health risks; exposed infants had significantly more digestive/respiratory symptoms and lower birth weight than unexposed infants. Preventive and educational actions need to be further strengthened in the face of this public health problem.     

Chemical composition and mechanisms underlying the spasmolytic and bronchodilatory properties of the essential oil of Nepeta cataria L.

Aim of the study

The study was aimed to investigate the chemical composition and pharmacological basis for traditional use of essential oil of Nepeta cataria L. (Limiaceae) (Nc.Oil) in gastrointestinal and respiratory disorders.

Materials and methods

Chemical analysis was carried out through GC-EIMS, ¹³C NMR and Kovats Retention Indices while pharmacological study was carried out in isolated tissues preparations.

Results

Four major components; 1,8-cineol (21.00%), α-humulene (14.44%), α-pinene (10.43%) and geranyl acetate (8.21%) were identified among the 27 compounds in Nc.Oil. In isolated rabbit jejunum, Nc.Oil, papaverine and verapamil inhibited spontaneous and high K⁺(80 mM) precontractions, as well as shifted the Ca⁺⁺ concentration–response curves (CRCs) to right, indicating calcium channel blocking activity. In isolated guinea-pig trachea, Nc.Oil and papaverine inhibited carbachol (1 μM) and K⁺ precontractions with similar potency, while verapamil was more potent against K⁺. Nc.Oil also potentiated isoprenaline inhibitory CRCs, similar to papaverine, indicating papaverine-like PDE inhibitor activity. In isolated guinea-pig atria, Nc.Oil caused cardiodepression at around 25–80 times higher concentrations, similar to papaverine.

Conclusions

These data indicate that Nepeta cataria possesses spasmolytic and myorelaxant activities mediated possibly through dual inhibition of calcium channels and PDE, which may explain its traditional use in colic, diarrhea, cough and asthma.     

Infantile colic, prolonged crying and maternal postnatal depression

Aim:  To study if infant crying is associated with maternal postnatal depression.
Methods:  Data from 1015 mothers and their children participating in a prospective European multicentre study were analysed. Infantile colic and prolonged crying were defined as excessive crying as reported by the mothers 2 and 6 months after delivery, and at the same time the mothers completed the Edinburgh Postnatal Depression Scale (EPDS).
Results:  In cross-sectional analyses, infant crying was associated with high EPDS scores both 2 (OR: 4.4; 95% CI: 2.4–8.2) and 6 months postpartum (OR: 10.8; 95% CI: 4.3–26.9). More than one-third of the others of infants with prolonged crying had high EPDS scores 6 months postpartum. Longitudinal analyses showed that mothers of infants with colic had increased odds of having high EPDS scores 6 months after delivery even if crying had resolved (OR: 3.7; 95% CI: 1.4–10.1).
Conclusion: Both infantile colic and prolonged crying were associated with high maternal depression scores. Most noteworthy, infantile colic at 2 months of age was associated with high maternal depression scores
4 months later.     

输尿管镜气压弹道碎石术治疗输尿管结石

目的评价输尿管镜气压弹道碎石术（URSL）治疗输尿管结石的临床疗效。方法使用输尿管镜下气压弹道碎石术治疗输尿管结石170例，输尿管上段结石10例，输尿管中段结石42例，输尿管下段结石118例，结石最大直径2．2cm，平均1．0cm，合并患侧肾积水80例，伴肾绞痛77例，平均病史为24周。结果一次性碎石成功率90．5％（154例）；10例输尿管壁残留小结石，术后1个月复查静脉肾盂造影（IVU），残石已排净；2例较大残余结石上移至肾盂行体外冲击波碎石（ESWL），1个月内结石排净；4例改开放手术，2例为结石被息肉严重包裹碎石失败，2例结石远端严重狭窄；均无输尿管穿孔、撕裂、假道、撕脱等并发症；随访9—12个月，肾积水病例积水情况明显改善；伴肾绞痛病例症状消失；未见结石复发病例。结论输尿管镜气压弹道碎石术治疗输尿管结石疗效确切、安全。     

针刺和杜冷丁对输尿管结石绞痛镇痛和排石作用121例临床分析

目的观察电针与药物对输尿管结石绞痛的镇痛作用和排石效果。方法121例输尿管结石绞痛患者随机分成电针组和药物组（用杜冷丁、解痉药治疗）。结果电针疗法能促进排石和缓解绞痛的作用。两组对绞痛缓解时间和镇痛持续时间作用相似，电针组治疗后绞痛缓解时间和镇痛作用的持续时间分别为（16．33±6．37）min、（4．60±1．42）h，药物组分别为（15．44±6．01）min、（4．54±1．40）h。两组比较，差异无显著性意义（P〉O．05）。电针组2周内排石率为60．32％，药物组（43．10％），电针组排石率高于药物组，两组比较，差异无显著性意义（P〈0．05）。结论电针疗法有明显的排石和镇痛作用。     

腰夹脊穴针刺疗法治疗肾绞痛疗效观察

目的观察腰夹脊穴针刺术治疗泌尿系结石引起肾绞痛的疗效及可靠性。方法肾绞痛患者1∞例,随机抽出50例接受腰夹脊穴针刺术治疗的资料进行回顾性分析,并与对照组阿托品注射治疗的50例进行疗效对比。结果腰夹脊穴针刺镇痛显效率76％（38／50例）,总有效率94％（47／50例）。对照组显效率36％（18／50例）,总有效率84％（42／50例）,P〈0．05。结论该疗法治疗肾绞痛比解痉药效果好,起效快,疗效确切,方法简便,无毒副作用,并可反复使用。     

奥尔芬-75、杜冷丁及盐酸曲马多治疗肾绞痛的疗效观察

目的研究奥尔芬-75、杜冷厂和盐酸曲马多对肾绞痛的镇痛效果,评价奥尔芬-75治疗肾绞痛的可行性。方法108例肾绞痛患者随机分为奥尔芬．75（甲,n=36）组、杜冷丁（丙,n=36）和盐酸曲马多（丙,n=36）．tg,分别给予奥尔芬-75、杜冷丁和盐酸tb马多镇痛。采用VRSs．4和NRS分析3种药物的镇痛效果,同时观察药物不良反应。结果甲组和乙组镇痛效果和起效时间优干丙组（P〈0．05）,甲与乙组无差异;但甲组持续时间和不良反应优于乙组和丙组（P〈0．01）。结论奥尔芬．75对肾绞痛镇痛效果与杜冷丁无差异、但优于曲马多;奥尔芬-75镇痛持续时间和不良反应优于杜冷丁、且无成癌性,对肾绞痛临床疗效优点杜冷丁和曲马多,值得提倡使用。     

结肠粘膜重建尿道的实验研究

目的：探讨结肠粘膜重建尿道的可能性。方法：选择6条雌性杂种成年犬，在全麻下切开尿道，剥离全段尿道粘膜，取相等长度的结肠粘膜替代尿道粘膜，12周后将犬处死，取其尿道作病理检查。结果：犬尿道病理组织学检查示移植于尿道的结肠粘膜全部成活，大部分腺上皮已转变为移行上皮。结论：应用结肠粘膜重建尿道是一种新的方法，这种技术可应用于包皮或膀胱及颊粘膜不适合时的尿道重建。     

肾绞痛急诊治疗方法的前瞻性研究

目的 通过对几种急性肾绞痛治疗方法的效果进行对比分析,探讨急诊科治疗肾绞痛的首选方法.方法 选取急诊科340例肾绞痛患者,按就诊顺序随机分为4组:A(哌替啶)组;B(双氯芬酸钠)组;C(间苯三酚)组;D(双氯芬酸钠+间苯三酚)组.观察各组的平均起效时间及用药30min后的疗效.结果 哌替啶组、双氯芬酸钠+间苯三酚组、双氯芬酸钠组的平均起效时间分别为(9.53±3.34)min、(10.49±2.54) min、(10.51±2.27)min,均少于间苯三酚组(18.51±4.86) min,差异有统计学意义(P＜0.01);而前三者间差异无统计学意义(P＞0.05).4组的有效率差异无统计学意义(P＞0.05).复发率比较,间苯三酚组(11.43％)和双氯芬酸钠+间苯三酚组(9.00％)均低于哌替啶组(24.59％)和双氯芬酸钠组(23.75％).间苯三酚组无不良反应,双氯芬酸钠组和双氯芬酸钠+间苯三酚组的不良反应率(2.27％、2.78％)均低于哌替啶组(27.27％).结论 双氯芬酸钠+间苯三酚是目前值得推荐的肾绞痛治疗方法.