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Objective: To evaluate the effects of different doses of naloxone combined with dezocine on postoperative analgesia in patients with breast cancer. Methods: One hundred and twenty patients with modified radical mastectomy were enrolled in the Tianjin Medical University Cancer Institute and Hospital, between May 2018 and January 2019. The patients were randomly assigned into group L, group M, group H, and group C (n=30). Patients in each group were administered 0.15 mg/kg of dezocine. Patients in group L, group M, and group H were intravenously instilled with naloxone (0.5, 1.0, and 1.5μg/kg, respectively), while patients in group C were administered equal volumes of normal saline. We recorded the time of awakening and removing the laryngeal mask in each group, and the blood pressure and heart rate of each patient around the time of removing the laryngeal mask. We determined the visual analog scale (VAS) scores of pain, Bruggrmann comfort scale (BCS) scores, and Ramsay sedation scores at 1h (T1), 6h(T2), 12h (T3), and 24h (T4) postoperatively, and the number of remedial analgesia and postoperative adverse reactions were recorded in each group after surgery. Results: The time of awakening and removing the laryngeal mask in group L, group M, and group H were shorter than that in group C, and group M had the shortest awakening time (P<0.05). The VAS scores of the patients in group M at T1, T2, and T3 were lower than those in the other three groups (P<0.05). The number of postoperative remedial analgesia and adverse reactions in group C were higher than those in the other three groups (P<0.05). Conclusions:Naloxone (1.0 μg/kg) combined with dezocine (0.15 mg/kg) can enhance the postoperative analgesic effect of dezocine, shorten the awakening time, and reduce the adverse reactions.
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Objective To analyze the imaging characteristics of 18 F-fluorodeoxyglucose ( FDG) PET/ CT in patients with multiple myeloma (MM). Methods Sixty-eight patients (41 males, 27 females, age (61.5±17.2) years) with pathologically proven MM were retrospectively reviewed between January 2011 and August 2016. Imaging characteristics of 18 F-FDG PET/ CT in patients were analyzed. Maximum stand-ardized uptake value (SUVmax ), score of the bone involvement (bones of whole body were classified into 10 groups, and when 1 group was involved, the score was 1), the number of bone lesions and soft tissue swell-ing around bone lesions were investigated. Results A total of 1310 lesions were detected in 68 MM pa-tients. The SUVmax varied widely and mild metabolic activity (2.5≤SUVmax<5.0) was observed in the high-est proportion of MM patients (49.8％, 652/ 1310). The SUVmax of MM patients was 6.63±3.02. The score of bone involvement was 4.49±3.01. The number of bone lesions was 10.50(3.00, 33.00), and soft tissue swelling around bone lesions was observed in 22 patients. Conclusions There are special imaging charac-teristics of 18 F-FDG PET/ CT in MM patients, such as multiple osteolytic lesions with mild to moderate met-abolic activity, clear boundary and extensive bone involvement, and lesions usually limit to the skeletal sys-tem. The characteristics are of certain value in the diagnosis and differential diagnosis of MM.
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Objective To evaluate the diagnostic role of 18 F-fluorodeoxyglucose (FDG) PET/ CT in female patients with ascites of unknown origin by analyzing the characteristics of PET/ CT images. Meth?ods From April 2011 to December 2016, 117 female (average age: 58 years) with ascites of unknown ori-gin who underwent 18 F-FDG PET/ CT or whose ascites were found by PET/ CT were retrospectively analyzed. The causes of ascites, level of ascites metabolism in PET/ CT, diagnostic efficacy of PET/ CT for localizing primary tumor and metastasis were analyzed. Two-sample t test was used to analyze the data. Results The most common cause of female ascites was ovarian cancer, accounting for 35.0％(41/ 117). The mean stand-ardized uptake value (SUVmean ) of malignant ascites was higher than that of benign ascites (1.41±0.40 vs 0. 94±0.47; t= 3.92, P<0.05). The total detection rate of 18 F-FDG PET/ CT for primary or metastatic tumor in malignant ascites was 89.4％(93/ 104), and 75.6％(31/ 41) for malignant ascites originating from ovari-an cancer. For patients with ovarian cancer, 18 F-FDG PET/ CT clearly localized the primary tumors in 24. 4％(10/ 41) patients and metastasis in 51.2％(21/ 41) patients. Conclusions Ovarian cancer is the most common cause of female ascites. 18 F-FDG PET/ CT has a high diagnostic value for qualitative and etio-logical diagnosis for ascites of unknown origin in females.
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Objective To explore the clinical application value of neutrophil gelatinase-associated lipocalin(NGAL)which were tested by immunity transmission turbidity in early kidney injury after elective percutaneous coronary intervention.Methods A case-control study was conducted.All 201 stable angina pectoris and acute coronary syndrome patients undergone percutaneous coronary intervention in TEDA International Cardiovascular Hospital,during April to August 2013,were enrolled in this study.Before and 2 h,4 h,8 h,24 h,48 h after the operation,the plasma creatinine of the patient samples were tested by enzymic method.Before and 2 h,4 h,8 h,24 h after the operation,the plasma NGAL was tested by immunity transmission turbidity method.Before and 8 h,24 h after the operation,the urinary NGAL was tested by immunoturdimetric method.The data were compared between contrast induced nephrpathy (CIN) and non-CIN groups.For normal distribution of quantitative data,t test were used and for non-normal distribution of quantitative data,nonparametric rank and inspection were used.Results CIN occurred in 8 of 201 enrolled patients,the incidence was 3.98％.Receiver operating characteristic curve (ROC) analysis confirmed the diagnostic accuracy of the plasma NGAL in CIN,and the area under the curve(AUC) of 2 h plasma NGAL was 0.928,95％ CI 0.800-0.985,with the cut-off value NGAL as 109 ng/ml,the diagnostic sensitivity and specificity for CIN were 87.5％ and 100％ ;the AUC of 8 h plasma NGAL was 0.945,95％ CI 0.824-0.992,with the cut-off value NGAL as 96 ng/ml,the diagnostic sensitivity and specificity for CIN were 87.5％ and 87.5％ ;the AUC of 8 h urinary NGAL was 0.969,95％ CI 0.859-0.999,with the cutoff value NGAL as 91 ng/ml,the diagnostic sensitivity and specificity for CIN were 87.5％ and 100％.Conclusions The change of plasma and urinary NGAL is earlier to that of serum creatinine for the early diagnosis of CIN.It can be used as the predictor of early renal damage after elective coronary artery interventional.
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Objective To explore the value of SUV in patients with ascites of unknown cause.Methods A total of 55 patients (24 males,31 females,average age 54.8 years,age range:23-82 years) with ascites of unknown cause who underwent 18F-FDG PET/CT scan were retrospectively enrolled in this study.SUVmax and SUVmean of ascites and liver were measured and their ratios (T/NT) were calculated and compared by two-sample t test.All patients were followed up and had final diagnoses.Sensitivity,specifici ty,accuracy,positive predictive value and negative predictive value were calculated respectively.The diagnostic efficiency was compared among 18F-FDG PET/CT tumor localization alone,ascites radioactivity and ascites cytology examination by x2 test or Fisher exact test.Results Besides the high metabolized primary lesions and/or metastasis,the liver and spleen swamped by ascites with high radioactivity were visualized on MIP images.The SUVmax and SUVmean of malignant ascites were 1.78±0.65 and 1.37±0.38 respectively,which were higher than those of benign ascites (1.11±0.36 and 0.72±0.22; t=4.13,6.82,both P＜0.05).T/NT of malignant ascites was higher than that of benign ascites (SUVmax:0.64±0.20 vs 0.48±0.12,t =3.27,SUVmeax:0.68±0.17 vs 0.38±0.10,t =7.21 ; both P＜0.05).The diagnostic sensitivity,specificity and accuracy of SUV in ascites were 75.0％ (27/36),94.7％ (18/19) and 81.8％ (45/55),respectively.The sensitivity and accuracy of SUV were higher than those of cytological examination (44.4％ (16/36) and 63.6％ (35/55) ; x2 =6.98,4.58,both P＜0.05).The specificity of SUV was higher than that of tumor localization by 18F-FDG PET/CT (63.2％,12/19; x2 =5.70,P＜0.05).Conclusion Significantly higher SUVmax and SUV in malignant ascites than benign ascites were noted,which might play an adjuvant role in patients with ascites of unknown cause.
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Objective To evaluate the the safety and efficiency of precise liver resection for patients with primary liver cancer. Methods 86 patients with primary liver cancer were randomized to receive conventional routine hepatectomy (n=44) or the precise liver resection (n=42). Outcomes were compared between the precise hepatectomy group and the routine group, including, the blood loss, operation time, morbidity and mortality. Results There were significant differences in morbidity rates (7.1% vs. 20.5%; P<0.001), the blood loss [(320±315) ml vs. (613±526) ml;P<0.001) , postoperative alanine aminotransferase (ALT) value (in postoperation 7 d, 82.7 U/L vs.321.7 U/L; P<0.001) and length of hospital stay (12.3 d vs. 18.6 d; P<0.001) between precise hepatectomy and routine groups. The 1 year tumor recurrence rate and 1 year survival rate were 26.2%(11/42) and 78.6% (33/42) in precise liver resection group, 38.6% (17/44) and 65.9%(29/44) in routine liver resection group,with significant difference (P=0.010;P=0.018). Conclusion Precise liver resection is safe and effective in the treatment of liver tumor without much injury to patients.