ABSTRACT
Objective:To observe the anatomical characteristics of the semispinalis capitis plane (SCP) to provide a reference for clinically effective implementation of ultrasound-guided SCP block.Methods:Ultrasound scanning was performed in six certain districts of SCP in 30 healthy volunteers (60 sides). The key point was to examine and describe the anatomical characteristics of semispinalis capitis (SCA), deep space of SCA and structures within the space.Results:(1) Transverse scanning at the posterior arch of atlas revealed that the SCA was separated into medial and lateral head by an oblique thick septum; in the space between SCA and obliquus capitis inferior (SCA-OCI), the third occipital nerve (TON) and the greater occipital nerve (GON) were separated by a fascia.There was often a branch of occipital vein between them.The distance from TON to GON was (12.9±0.6) mm.(2) Transverse scanning at the lamina of axis revealed that the axial image of SCA and the structures in SCA-OCI space were similar to the results previously described in (1). The distance from TON to GON was (12.1±0.5) mm.(3) Sagittal scanning beside the spinous process of axis revealed that SCA was separated into superior and inferior belly by a septum which connected to the end of axis spinous process.(4) Sagittal scanning at the C 2, 3 facet joint revealed that in the space between OCI and C 2, 3 facet joint (OCI-C 2, 3) beneath SCA, there was no septum between TON and GON.The distance from TON to GON was (8.0±0.5) mm.(5) Transverse scanning at the lamina of C 4 revealed that in the space between SCA and semispinalis cervicis, the deep cervical artery and vein were observable except medial branch of C 4, and the characteristics of the short axis of the SCA belly were similar to the results previously described in (1). (6) Transverse scanning at the lamina of C 5 revealed that the view was similar to the results previously described in (5). The posterior branch of C 5 nerve was not found. Conclusions:SCP is rich in fascia, and blood vessels often pass through the deep surface space of SCA under ultrasound.The anatomical structure is complex, and there is individual variation.Grasping its ultrasonic anatomical characteristics is helpful in safely and effectively implementing ultrasound-guided SCP block.
ABSTRACT
Objective To observe the long-term toxicity of sustained-release dropping pills of Rhynchophylla total alkaloids in rats.Methods 80 Wistar rats were randomly divided into high dose group, middle dose group, low dose group and normal group. The rats were consecutively drenched for 12 weeks. The general status of the animals was observed daily in medication duration and body weight, daily appetite, quantity were recorded every 2 weeks. All animals were sacrificed on drenched 12 weeks and 2 weeks after discontinuation, then the content of WBC, RBC, Hb, PLT, LYM, NEU and ALT, AST, ALP, BUN, Cr were detected. Ratio of viscera was measured and the major organs were examined by the pathology.Results Continuous intragastric administration for 12 weeks after high dose group rats, poor diet, weight growth was slow;no significant changes of Hematology was found;The ALT, AST and ALP of high dose group rats increased[respectively(77.5±11.9)U/L,(210.4±21.7)U/L,(220.6±19.8)U/L], compared with the blank control group[respectively(55.2±12.1)U/L,(180.4±21.3)U/L,(190.3±22.6)U/L], the difference was statistically significant(P<0.05). The ratio of liver body in high dose group(3.86±0.29)was higher than the control group(3.52±0.25), the difference was statistically significant(P<0.05). And liver degeneration, focal necrosis was found.Conclusion The main chronic toxic damage is liver damage caused by sustained-release dropping pills of Rhynchophylla total alkaloids of long-term large delivery.
ABSTRACT
Objective: Blue dye was one of the methods for sentinel lymph node biopsy in breast cancer, but the success rate was affected by multiple factors. This study was to determine the related factors contributing to the success of sentinel lymph node biopsy in breast cancer using blue dye method. Method:From Jan. 2007 to Aug.2008, sentinel lymph node biopsy was performed by periareolarly injecting 1% methylene blue in 141 breast cancer patients followed by axillary clearance. Pathological diagnosis was performed for all of the lymph nodes by conventional HE staining. Unconditional logistic regression was applied to make both univariate and multiva-riate analysis. Results:Sentinel lymph node was successfully detected in 126 patients. But the biopsy was failed in the 15 patients. The success rate was 89.4% and the false negative rate was 6.82%. Univariate analysis showed that success rate of biopsy was in association with patients' age, body mass index (BMI), tumor size, preoperative axillary node's status, pathological grade as well as ≥4 positive axillary lymph nodes involved. Multivariate analysis indicated that the patients'age (OR=4.587, P=0.024), BMI (OR=4.882, P=0.011) as well as 4 or more of the axillary nodes involved (OR=3.143, P=0.013) were independent predicting factors for the success of sentinel lymph node biopsy. Conclusions:Methylene blue dyeing is a reliable method for sentinel lymph node biopsy. The rate of success is associated with patients' age, BMI as well as the number of metastases in axillary lymph nodes.