Randomized, controlled trial comparing respiratory and analgesic effects of interscalene, anterior suprascapular, and posterior suprascapular nerve blocks for arthroscopic shoulder surgery / 대한마취과학회지

Background@#Interscalene brachial plexus block (ISB) provides excellent analgesia for arthroscopic shoulder surgeries but is associated with adverse effects including hemidiaphragmatic paresis. We aimed to compare the respiratory effects, forced vital capacity (FVC), and forced expiratory volume in 1 second (FEV1) between suprascapular nerve block (SSB) and ISB. @*Methods@#Sixty patients were recruited and randomized into ISB, anterior SSB, and posterior SSB groups. FVC, FEV1, and diaphragmatic excursion were evaluated at baseline and 30 minutes after intervention. Blocks were performed under ultrasound guidance with 15 ml of 0.5% ropivacaine. Pain scores were assessed at 6, 12, and 24 hours postoperatively. @*Results@#The ISB group showed a reduced FVC of 31.2% ± 17.5% (mean ± SD), while the anterior and posterior SSB groups had less reduction of 3.6% ± 18.6% and 6.8% ± 6.5%, respectively (P < 0.001). The ISB group showed more reduction in diaphragmatic excursion than the anterior and posterior SSB groups (median [IQR]): −85.7% (−95.3% to −63.3%) vs. −1.8% (−13.1% to 2.3%) and −1.2% (−8.8% to 16.8%), respectively (P < 0.001). The median pain scores (IQR) in the ISB and anterior SSB groups were lower than those in the posterior SSB group at 6 hours on movement: 0 (0–2), 1.8 (0–4.5) vs. 5 (2.5–8), respectively (P = 0.002). There was no significant difference in oxycodone consumption postoperatively. @*Conclusions@#Anterior SSB preserves lung function and has a comparable analgesic effect as ISB. Thus, it is recommended for arthroscopic shoulder surgeries, especially in patients who have reduced lung function.

Effects of inner-heating acupuncture on apoptosis of chondrocytes and expression of Caspase-3 and Caspase-9 in rats with knee osteoarthritis / 中国针灸

OBJECTIVE@#To investigate the effect of inner-heating acupuncture on apoptosis of chondrocytes and expression of Caspase-3 and Caspase-9 in rats with knee osteoarthritis (KOA).@*METHODS@#A total of 32 rats were divided into a normal group, a model group, a control treatment group and a treatment group by random number grouping method, 8 rats in each one. The rats in the normal group received no intervention. The rats in the remaining three groups adopted modified Videman method to develop KOA model, the ankle joint of left posterior leg was fully extended and fixed with a resin bandage for 6 weeks. After successful modeling, the rats in the model group received no intervention. The rats in the control treatment group were treated with medium-frequency pulse electrotherapy. The rats in the treatment group were treated with inner- heating acupuncture, 30 min each treatment, once a day, five days per week, and totally 3-week treatment was given. After 3 weeks, the damaged cartilage tissue was collected, and HE staining was used to observe the pathological changes of the cartilage tissue of the knee joint. ELISA was used to detect the content of cytochrome-C in the tissue homogenate supernatant. The chondrocytes in damaged cartilage tissue were isolated, flow cytometer was used to detect the changes of apoptosis and mitochondrial membrane potential. The mRNA and protein expression of Caspase-3 and Caspase-9 in chondrocytes were detected by real-time quantitative PCR (qRT-PCR) and Western blot (WB), respectively.@*RESULTS@#Compared with the normal group, the damage of cartilage tissue in the model group was significant, and the expression level of Cyt-C in the homogenate supernatant of damaged cartilage tissue was increased (<0.01); the chondrocyte apoptosis was increased significantly (<0.01); the chondrocyte mitochondrial membrane potential was decreased significantly (<0.01); the mRNA and protein expression of Caspase-3 and Caspase-9 was increased significantly (all <0.01). Compared with the model group, the cartilage injury in the control treatment group and the treatment group was significantly relieved; the expression level of Cyt-C in the supernatant of damaged cartilage tissue homogenate was decreased (both <0.01); the chondrocyte apoptosis was significantly reduced (both <0.01); the chondrocyte mitochondrial membrane potential was increased significantly (both <0.01). Moreover, the mRNA and protein expression of Caspase-3 and Caspase-9 was significantly reduced (all <0.01). Compared with the control treatment group, the treatment group was more effective in the treatment of KOA.@*CONCLUSION@#The inner-heating acupuncture could significantly improve the pathological changes of KOA rats, inhibit the apoptosis of chondrocytes, which may be closely related to the suppression of Caspase-3 and Caspase-9 expression.

TNF-α inhibits SCF, ghrelin, and substance P expressions through the NF-κB pathway activation in interstitial cells of Cajal

Ulcerative colitis is a chronic inflammatory disease of the colon where intestinal motility is disturbed. Interstitial cells of Cajal (ICC) are required to maintain normal intestinal motility. In the present study, we assessed the effect of tumor necrosis factor-alpha (TNF-α) on viability and apoptosis of ICC, as well as on the expression of stem cell factor (SCF), ghrelin, and substance P. ICC were derived from the small intestines of Swiss albino mice. Cell viability and apoptosis were measured using CCK-8 assay and flow cytometry, respectively. ELISA was used to measure the concentrations of IL-1β, IL-6, ghrelin, substance P, and endothelin-1. Quantitative RT-PCR was used to measure the expression of SCF. Western blotting was used to measure the expression of apoptosis-related proteins, interleukins, SCF, and NF-κB signaling pathway proteins. TNF-α induced inflammatory injury in ICC by decreasing cell viability and increasing apoptosis and levels of IL-1β and IL-6. TNF-α decreased the levels of SCF, ghrelin, and substance P, but had no effect on endothelin-1. TNF-α down-regulated expressions of SCF, ghrelin, and substance P by activating the NF-κB pathway in ICC. In conclusion, TNF-α down-regulated the expressions of SCF, ghrelin, and substance P via the activation of the NF-κB pathway in ICC.

Case-control study on the treatment of Hawskins type II fractures of talar neck with minimally invasive or traditional approach / 中国骨伤

<p><b>OBJECTIVE</b>To compare the differences of radiographical and functional outcomes between traditional and minimally invasive approach in treating Hawskins type I fractures of the talar neck.</p><p><b>METHODS</b>From February 2000 to February 2008, 37 patients underwent reduction and internal fixation using two different approaches. In minimally invasive approach group, there were 16 males and 2 females, ranging in age from 20 to 47 years, averaged (35.2 +/- 3.1) years, and in traditional approach group, there were 15 males and 4 females, ranging in age from 22 to 44 years, averaged (35.3 +/- 2.3)years. All the patients had Hawskins type I fractures. The following data were compared between two groups: operation time, blood loss, length of incision and function of ankle joint. All the patients were graded by Hawkins points-scoring system after operation.</p><p><b>RESULTS</b>All patients were followed up. The duration ranged from 2 to 10 years, with an average of 5.6 years. The index such as operation time, blood loss and the length of incision of patients in minimally invasive approach group were significantly less than those of patients in traditional approach group. According to AOFAS points-scoring system, the score of minimally invasive group was higher than that of traditional approach group.</p><p><b>CONCLUSION</b>Compared with traditional approach, minimally invasive approach can protect blood supply better, get better clinical effects,which is worth of choosing to treat Hawskins type II fractures of talar neck.</p>

The clinical report of 21 cases of occlusion of atrial septal defect through right chest small incision / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the methods and efficacy of atrial septal defect (ASD) occlusion through right chest incision.</p><p><b>METHODS</b>The clinical data of 21 patients with ASD from July 2004 to May 2005 were analyzed retrospectively. Eight patients were male and 13 patients were female, aged from 1 to 70 years old, with the median age of 21 years old. The diameter of ASD was from 8 to 40 mm. All the 21 patients were under general anaesthesia. A 2 to 3 cm incision was made in the 4th intercostals of right side of sternum. With the help of transesophageal or normal transthoracic echocardiography, the occluder was released using monotube unit.</p><p><b>RESULTS</b>All cases were occluded successfully without death. The types of the occluder were from 14 to 46 mm. None failed and had to choose extracorporeal circulation operations. No transfusion and no serious complication such as the occluder dislocated occurred. And no evident of atrial shunt was found when in review echo.</p><p><b>CONCLUSIONS</b>The ASD occlusion through right chest minimal incision is safe, credit, minimal invasive and worth to use widely.</p>

Evaluation of Renal Function in Children with Hydronephrosis / 实用儿科临床杂志

Hydronephrosis is one of the most common urological diseases in children.Most of hydronephrosis caused by ureteropelvic junction obstruction.Whether these children need operations were being argued.The current tendency is when the renal function become worse,operation is suggested needed,in order to save the renal function.So the methods how to evaluate the renal function are especially important,this article related to the current research and review.