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Objective:To investigate the clinical efficacy of conservative and surgical treatment of testicular appendage torsion in children and to summarize the experience.Methods:The clinical data of 106 children with testicular appendage torsion admitted in Tengzhou Central People's Hospital Affiliated to Xuzhou Medical University from January 2012 to December 2018 were retrospectively analyzed. According to different therapeutic methods, all the children were divided into conservative group (25 cases) and surgical group (81 cases). The clinical efficacy was compared between the two groups.Results:106 children with testicular appendage torsion were cured. The hospitalization time [(5.61±1.04)d vs (11.32±1.89)d], pain relief time [(9.11±2.56)d vs (68.5±19.87)d], disappearance time of scrotal edema [(5.11±1.08)d vs (10.56±1.50)d] and the utility time of antibiotic [(4.89±1.32)d vs (7.06±1.26)d] in the surgical group were shorter than those in the conservative group, with statistically significant difference(all P<0.05). After 6 months of follow-up, there were no cases of recurrence and discomfort in the two groups. Conclusions:Children with testicular appendage torsion should be actively treated with surgery, which can not only significantly shorten the course of disease, but also reduce the incidence of complications and missed diagnosis. For children who with testicular appendage torsion, surgeries should be performed actively. It can significantly shorten the duration of symptoms, but also reduce the occurrence of complication and the occurrence probability of misdiagnosis.
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Objective@#To explore the changes of helper T lymphocytes 17 (Th17) and regulatory T lymphocytes (Tregs) in peripheral blood of patients with extensive burn at early stage in August 2nd aluminum dust explosion accident in Kunshan factory (hereinafter referred to as Kunshan explosion accident) and the significance.@*Methods@#Twenty patients with extensive burn in Kunshan explosion accident admitted to our department of burns and plastic surgery were enrolled in burn group, and 10 healthy adult volunteers with no history of smoking were enrolled in healthy control group. Five mL of peripheral venous blood samples were collected from patients in burn group at admission (≤post injury hour 6, PIH 6) and PIH 24, and on post injury day (PID) 7, and from volunteers in healthy control group respectively. The percentages of CD64+ T lymphocytes, human leukocyte antigen-DR positive (HLA-DR+ ) T lymphocytes, CD3+ CD8- Th17, and CD4+ CD25+ Tregs in peripheral blood T lymphocytes were determined by flow cytometer.@*Results@#(1) The percentages of CD64+ T lymphocytes in peripheral blood T lymphocytes of patients in burn group at admission and PIH 24 [(2.35±0.32)% and (4.02±0.15)%] were higher than (0.67±0.11)% of healthy volunteers in healthy control group. The percentage of CD64+ T lymphocytes in peripheral blood T lymphocytes of patients in burn group on PID 7 [(0.39±0.25)% ] was lower than that of healthy volunteers in healthy control group. The percentages of HLA-DR+ T lymphocytes in peripheral blood T lymphocytes of patients in burn group at admission and PIH 24 [(54±18)% and (72±17)%] were higher than (38±14)% of healthy volunteers in healthy control group. The percentage of HLA-DR+ T lymphocytes in peripheral blood T lymphocytes of patients in burn group on PID 7 [(28±15)% ] was lower than that of healthy volunteers in healthy control group. (2) The percentages of CD3+ CD8-Th17 in peripheral blood T lymphocytes of patients in burn group at admission and PIH 24 [(4.21±0.46)% and (7.38±0.39)%] were higher than (0.98±0.09)% of healthy volunteers in healthy control group. The percentage of CD3+ CD8-Th17 in peripheral blood T lymphocytes of patients in burn group on PID 7 [(0.81±0.05)% ] was lower than that of healthy volunteers in healthy control group. (3) The percentages of CD4+ CD25+ Tregs in peripheral blood T lymphocytes of patients in burn group at admission and PIH 24, and on PID 7 [(1.78±0.26)%, (1.26±0.37)%, and (0.38±0.03)%] were lower than (3.24±0.52)% of healthy volunteers in healthy control group.@*Conclusions@#The percentage of Th17 in peripheral blood T lymphocytes of patients with extensive burn at early stage in Kunshan explosion accident increased at first and then decreased compared with that of healthy volunteers, indicating that the patients′ immune function increased first and then weakened. The percentages of Tregs in peripheral blood T lymphocytes at each time point were lower than the percentage of healthy volunteers, indicating that the patients′ immunomodulation gradually weakened after extensive burns.
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Objective To test the protective effect of a new Ringer's malate solution on intestine's apoptosis caused by hemorrhagic shock in rats.Methods Forty-eight Sprague-Dawley male rats, weighing 280-320 g, were randomly assigned into four groups: sham shock group (group SS), normal saline group (group NS), Ringer's lactate group (group RL) and Ringer's malate (group RM), n=12 each.The group SS was served as control group, the other groups were subjected to 60 min of hemorrhagic shock followed by crystalloid resuscitation.Those rats were sacrificed 3 h after resuscitation.Intestinal tissue was harvested to detect Bcl-2/Bax protein level, the bioactivity of superoxide dismutase (SOD) and malondialdehyde (MDA) level.The level of intestinal cell apotosis was measured using TUNEL method and apoptosis index was calculated.The intestinal histopathology was examined.Results Compared with group SS, the expression of Bcl-2 and the bioactivity of SOD were lower, the level of Bax protein, MDA and apoptotic index were higher in groups NS, RL and RM (P<0.05).Compared with groups NS and RL, the expression of Bcl-2 and the bioactivity of SOD was higher, the level of Bax protein, MDA and apoptotic index were lower in group RM (P<0.05).Histopathological examination showed that group RM was better than group NS and group RL.Conclusion Ringer's malate alleviated intestinal apoptosis caused by hemorrhagic shock in rats.The study suggests that Ringer's malate solution could be a potential new therapeutic agent for fluid resuscitation.
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Objective To compare the degree of liver injury during resuscitation with different crystalloid solutions in a rat model of hemorrhagic shock.Methods Forty-eight SPF healthy male SpragueDawley rats,aged 7-9 weeks,weighing 280-320 g,were assigned into 4 groups (n=12 each) using a random number table:sham operation group (group S),normal saline group (group NS),Ringer's lactate solution group (group RL) and Ringer's malate solution group (group RM).Hemorrhagic shock was induced by withdrawing blood from the right internal jugular vein until mean arterial pressure was reduced to 35-45 mmHg which was maintained for 1 h.The internal jugular vein and artery were cannulated after anesthetization,but no animals were subjected to hemorrhage in group S.The crystalloid solution (2 times the volume of blood loss) was infused intravenously over 30 min starting from 1 h of shock.The animals were resuscitated with 0.9％ sodium chloride solution in group NS,with Ringer's lactate solution in group RL,and with Ringer's malate solution in group RM.Mean arterial pressure was continuously monitored and recorded during the experiment.Before shock (T1),at 1 h of shock (T2) and at 4 h after resuscitation (T3),blood samples were collected from the right internal jugular vein for determination of serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) concentrations by enzyme-linked immunosorbent assay.Rats were sacrificed at T3,and livers were removed for measurement of malondialdehyde (MDA) content and superoxide dismutase (SOD) activity in liver tissues (using colorimetric method) and for examination of pathological changes of liver tissues (with light microscope).Results Compared with group S,the serum ALT and AST concentrations at T2.3 and SOD activity and MDA content at T3 were significantly increased in NS,RL and RM groups (P＜0.05).Compared with group NS or group RL,the serum ALT and AST concentrations were significantly decreased,the SOD activity was increased,and the MDA content was decreased at T3 (P＜0.05),and the pathological changes of liver tissues were significantly attenuated in group RM.Conclusion Ringer's malate solution produces better efficacy than normal saline and Ringer's lactate solution when used for resuscitation and mitigating liver injury in a rat model of hemorrhagic shock.
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Objective:To investigate the clinical effects of stellate ganglion block(SGB) on the stress ulcer in burn patients and explore the underlying mechanisms.Methods:40 patients with burn injury induced stress ulcer were randomized to two groups:SGB group (n=20) and Control group (n=20).SGB group was treated with conventional symptomatic therapy,SGB group underwent SGB every two days for 1 week on the basis of Control group.And the levels of plasma ET-1 and NO were detected using ELISA before and after therapy.And the clinical efficacy of the two groups was observed after the treatment.Results:Compared with the Control group,the levels of plasma ET-1 and NO were markedly lower in the SGB group (P＜0.05),while the clinical efficacy was higher(P＜0.05).Conclusion:SGB could enhance the clinical efficacy stress ulcer in bum patients,which might be related to the decrease of plasma ET-1 and NO levels.
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Objective To study the effects of two types of crystalloids on postoperative inflam-matory reaction during the process of cesarean section.Methods Sixty patients undergoing cesarean section were randomly divided into Ringer lactate solution group (RL)and Ringer acetate solution group (RA)with 30 cases in each group.Before anesthesia,10 ml/kg crystal solution was infused, the infusion rate was 1 5-20 ml·kg-1 ·h-1 .The patients were performed epidural anesthesia in left lateral position.Crystal solution was infused to maintain the blood pressure during the operation.Ve-nous blood was drawn at the beginning of the operation (T1 ),the end of the operation (T2 ),four hours after operation (T3 ),twenty-four hours after operation (T4 )in order to measure the blood plasma value of IL-6,TNF-α,CRP.Results The blood plasma value of IL-6,TNF-α,CRP had no significant differences at T1 ,T4 ;but the value of group RA was significantly higher than that of group RL (P <0.05)at T2 ,T3 .Conclusion Ringer acetate solution causes more significant postop-erative inflammatory cytokine release than Ringer lactate solution does during the process of cesarean section.
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Objective To investigate the effects of different doses of dexmedetomidine combined with propofol and remifentanil target controlled infusion (TCI) on postanesthesia recovery of patients in functional endoscopic sinus surgery. Methods Eighty ASA Ⅰor Ⅱ grade patients, scheduled for the endoscopic sinus surgery, were divided into control group (20 cases) and dexmedetomidine group (60 cases) according to the random digits table method. The patients in dexmedetomidine group were given loading dose dexmedetomidine 0.6 μg/kg, then were given dexmedetomidine of different maintenance doses:0.3 μg/(kg·h) in D1 group, 0.6 μg/(kg·h) in D2 group and 0.9 μg/(kg·h) in D3 group. The patients in dexmedetomidine group were given TCI propofol and remifentanil during the maintenance of general anesthesia, rocuronium was administrated intermittently during operation, and bispectral index (BIS) was controlled at 40 - 50. The changes of hemodynamics 5 - 10 min after entering operation room (T0), before induction (T1), 1 min after intubation (T2), 5 min after intubation (T3), before extubation (T4) and 5 min after extubation (T5) were observed. The spontaneous breathing recovery time, call of eye-opening time, extubation time and adverse reaction after surgery were recorded. Moreover, the visual analogue score (VAS) and Ramsay sedation score were used to evaluate the comfort level of patients. Results The mean arterial pressure (MAP) at T5 in control group and D1 group were significantly higher that in D2 group and D3 group, and there were statistical differences (P0.05). The VAS 15 min after extubation in D1 - D3 group were significantly lower than that in control group: (3.7 ± 0.3), (3.1 ± 0.4) and (3.0 ± 0.5) scores vs. (6.2 ± 0.6) scores, and there were statistical differences (P<0.05). The Ramsay sedation scores in D1 - D3 group were significantly higher than that in control group:(2.5 ± 0.2), (2.7 ±0.2) and (5.3 ± 0.3) scores vs. (1.4 ± 0.3) scores. Moreover, Ramsay sedation score in D3 group was significantly higher than that in D1 group and D2 group, and Ramsay sedation score in D2 group was significantly higher than that in D1 group. There were statistical differences (P<0.05). Four and 2 patients occurred nausea vomiting respectively in control group and D1 group within 24 h after operation. Conclusions Dexmedetomidine combined with propofol and remifentanil TCI can maintain hemodynamic stability and improve anesthesia recovery quality.
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PURPOSE: Secondary hyperparathyroidism (SHPT) develops in patients with chronic renal failure. This study aimed to compare analgesic efficacy in SHPT patients who undergo subtotal parathyroidectomy after superficial versus deep cervical plexus block. METHODS: Sixty chronic renal failure patients with SPHT scheduled for subtotal parathyroidectomy were randomized to receive general anesthesia (group GA), general anesthesia plus bilateral superficial and deep cervical plexus block (group BD), or general anesthesia plus bilateral superficial cervical plexus block (group BS) (n = 20). Bilateral superficial cervical plexus block or combined superficial and deep cervical plexus block with 0.5% ropivacaine was administered. Postoperative pain was assessed using visual analogue scale (VAS). RESULTS: VAS score at 1 hour, 4 hours, and 8 hours after operation was 3.71 +/- 0.60, 2.72 +/- 0.54, 2.17 +/- 0.75 in BS group; 4.00 +/- 0.28, 2.89 +/- 0.21, and 2.46 +/- 1.01 in BD group, significantly lower than in GA group (6.50 +/- 0.50, 5.02 +/- 0.54, and 4.86 +/- 0.51, respectively). The dosage of tramadol was 109.0 +/- 35.2 mg in BS group and 93.0 +/- 24.52 mg in BD group, significantly lower than in GA group (300.0 +/- 27.13 mg). The incidence of complications in GA group (90%) was significantly higher than in BS group (30%) and BD group (15%). Serum glucose and norepinephrine levels were significantly higher at 1 hour, 4 hours, and 8 hours after operation, but returned to baseline levels at 24 hours after operation. CONCLUSION: Superficial cervical plexus block or combined superficial and deep cervical plexus block effectively reduces postoperative pain, stress response, and complications in SHPT patients who undergo subtotal parathyroidectomy.
Subject(s)
Humans , Anesthesia, General , Blood Glucose , Cervical Plexus , Hyperparathyroidism, Secondary , Incidence , Kidney Failure, Chronic , Norepinephrine , Pain, Postoperative , Parathyroidectomy , TramadolABSTRACT
The biomechanical properties of eight human corneas from four normal Chinese fresh corpses were investigated by use of one dimension tensile test, tensile stress relaxation and creep test. The destructive load, stretchy ratio, spreading stress, spreading strain and elastic modulus were determined. Also obtained were the stress relaxation and creep data and curves. After reduction of data, the reduced stress relaxation and creep data and curves were worked out. The regression method was used to get the regression coefficient. The least square method was employed to fit the data of stress and strain; then the stress-strain formula was expressed and the curves of human cornea were plotted. The constitutive equation is K (lambda,t) = G(t) T(e) (lambda) and some conclusions are drawn.
Subject(s)
Humans , Biomechanical Phenomena , Cornea , Physiology , Elastic Modulus , Stress, MechanicalABSTRACT
We have researched the viscoelastic properties of the cancellous bones of the os calcaneus, os lunatum and os capitalum. The compressing stress relaxation experiment and the creep experiment in the vertical, horizontal and 45 degree directions on the os calcaneus were performed. The data and curve of the compressing stress relaxation and creep were obtained. By masing regression analysis we worked out the compressing reduced stress relaxation and creep functions and curves. The results show that the quantities of compressing stress relaxation and creep of the calcaneus in the vertical direction are larger than those in the other two directions. The initial quantities of creep of the os capitalum are larger than those of the os lunatum, and there are no significant different between the quantities of stress relaxation of the cancellous bones of the os lunatum and os capitalum.
Subject(s)
Adult , Humans , Male , Calcaneus , Physiology , Elasticity , Linear Models , Lunate Bone , Physiology , Models, Biological , Regression Analysis , Skull , Physiology , Stress, Mechanical , Weight-Bearing , PhysiologyABSTRACT
Objective:To compare the anesthetic depth and postoperative recovery of propofol combined with remifentanil or fentanyl when administered through target-controlled infusion(TCI).Methods: Ninety patients receiving elective epigastric surgery were randomly divided into 3 groups: PF-A,PF-B and PR group.Through TCI,patients in PF-A group were administered with propofol(3 ?g /ml) and fentanyl(2 ?g/L),in PF-B group with propofol(3 ?g/ml) and fentanyl(4 ?g/L initially and 2 ?g/L after intubation),and in PR group with propofol(3 ?g/ml) and remifentanil(6 ?g/L).Vital signs(including mean aortic pressure and heart rate) and bispectral index values were recorded pre-anesthesia,pre-and post-intubation,post-incision and during operation in 3 groups.Results: In PF-A group,post-intubation MAP and HR were significantly higher than those of pre-intubation(P