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Objective To investigate and evaluate the feasibility and analgesic effect of ultrasound guided intercostobrachial nerve (ICBN) blockade in patients with persistent pain after radical mastectomy with ICBN preservation.Methods In a total of 53 following-up female cases,aged 18-55 years,ASA Ⅰ or Ⅱ,receiving radical mastectomy with ICBN preservation during January,2014 to February,2016,19 patients complained persistent pain in the lateral chest,axilla and/or upper arm more than 3 months after the surgery were enrolled.ICBN blockade was performed using 0.5% ropivacine 10 mL injected in the potential space between the superior of pectoralis minor muscle and the inferior of serratus anterior muscle in the second intercostal space guided by ultrasound.Visual analogue scale (VAS) was applied to assess the pain intensity at rest,on movement,and with 100 kPa pressure before blockage and 30 min thereafter,and then the pain intensity (SPI) was calculated.All nerve blockade-related adverse events including local anesthetic-related allergy,central nervous system and cardiovascular toxicity were recorded.Seven-day follow-ups were required in all patients to assess the pain intensity.Results All 19 cases completed ICBN blockade guided by ultrasound,of which 17 cases completed the seven-day follow-ups.The mean difference in SPI was-9.19 VAS points (95%CI-11.24--7.14,P<0.01).Compared with each mean VAS and SPI before block,all that after block at day 1-6 were significantly decreased (P<0.01 or P<0.05).There were 14(82.4%),13(76.5%),7(41.2%) and 3(17.6%)cases that SPI was decreased over 5 points after block at day 1-4.No nerve blockade-related adverse event was observed.Conclusion Ultrasound guided ICBN blockade can relieve persistent post-mastectomy pain safely and effectively.
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OBJECTIVE@#To explore a method for locating the area of lacrimal sac in dacryocystorhinostomy under endoscopy.@*METHOD@#Sixty-eight patients were performed dacryocystorhinostomy under endoscopy. Take light spot of ocular optic fiber as the lacrimal sac projection to the lateral wall of the nasal cavity position.@*RESULT@#With the guiding of ocular optic fiber, lacrimal sac can be located accurately. The operating time of dacryocystorhinostomy under endoscopy was shortened significantly, and the operation procedure was simplified. All patients were followed up for 2 years, only 2 recurrent cases were found. The success rate reach to 97.06% (66/68).@*CONCLUSION@#Ocular optical fiber used in locating the lacrimal sac in dacryocystorhinostomy under endoscopy is simple and feasible, and can be widely used.
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Dacryocystitis , General Surgery , Dacryocystorhinostomy , Methods , Endoscopy , Fiber Optic Technology , Nasolacrimal Duct , General Surgery , Recurrence , Treatment OutcomeABSTRACT
OBJECTIVE@#To get a method of dacryocyst allocation for dacryocystorhinostomy per nasal endoscope.@*METHOD@#The dacryocyst of 7 chronic dacryocystitis cases(8 eyes) were located through nasal cavity guided by endo-ophthalmic optical fiber.@*RESULT@#All the 7 patients got successful operations, the bleeding was 10-20 ml during the operation , postoperative recovery was good, no infection occurred. Five patients received operations twice, all of them were detained anaesthetic tubes for 3 to 6 months, dacryocyst rinsing were conducted once per month after extubation. No obstructions and complications occurred after one year follow up.@*CONCLUSION@#Endo ophthalmic optical fiber can be used to locate dacryocyst in dacryocystorhinostomy per nasal endoscope.
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Dacryocystitis , General Surgery , Dacryocystorhinostomy , Methods , Eye , Nasolacrimal Duct , General Surgery , Nose , General Surgery , Optical Fibers , Treatment OutcomeABSTRACT
Objective To study the influence of furosemide on the currents of the delayed rectification potassium channel and sodium channel of mice's spiral ganglion neurons.Methods Postnatal mice(P1～P6) spiral ganglion neurons were obtained by mechanical dissociation and enzymolysis.Delayed rectification potassium channels' currents and sodium channels' currents were recorded with whole-cell patch clamp techniques.Observed was the influence of furosemide on potassium channels and sodium channels.Results When furosemide was added around the spiral ganglion neurons,the delayed rectification potassium currents were inhibited to around +200～+300 pA,and sodium currents were inhibited to about 30% of peak current.Furosemide was washed away after working steadily for 1 minute,5 and 10 minutes.The delayed rectification potassium currents could recover to 98%,64%,and 25% of the peak currents before and sodium currents could recover to 96%,76% and 54% of the peak currents accordingly.Conclusion The currents of delayed rectification potassium channels and sodium channels could be inhibited by furosemide to different degrees.The longer furosemide was used,the greater damage could occur in the ion channels.
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Objective:To study on mechanisms of wrist-ankle acupuncture for prevention and treatment of peripheral neuritis complicated by diabetes.Methods:Ninety cases of peripheral neuritis complicated by diabetes were treated respectively by wrist-ankle acupuncture and body acupuncture,with western medicine routine treatment used as control group,30 cases in each group.The therapeutic effects and laboratory results were compared.Results:Therapeutic effects in wrist-ankle acupuncture group and body-acupuncture group were significantly superior to that in control group,with no significant difference between wrist-ankle acupuncture and body-acupuncture group.Conclusion:Wrist-ankle acupuncture can improve blood glueose and metabolism blood lipids,decrease blood viscosity and recover function of peripheral nerve cells and it has a definite effect on diabetic peripheral neuritis.