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Objective To analyze the factors affecting diagnosis and morbidity of upper gastrointestinal cancer.Methods Clinical data of 17 830 patients who were performed with upper gastrointestinal endoscopy between January 2020 and January 2022 was collected.Combined with questionnaire and pathological examination,the diagnosis and morbidity of upper gastrointestinal cancer was analyzed.Results There were 88,33 and 119 cases of carcinoma of esophagus,cardia and stomach respectively.Among them,57,27 and 91 cases of early carcinoma of esophagus,cardia and stomach were found.They were divided into the observation group(240 cases)and control group(17 590 cases).Univariate analysis showed significant differences between the two groups in education,drinking,pickled food,atrophic gastritis,intraepithelial neoplasia,painless gastroscopy,standard gastroscopy,and anxiety.Multivariate unconditional Logistic regression analysis and propensity score matching showed that drinking,atrophic gastritis,pickled food,intraepithelial neoplasia and anxiety were risk factors influencing the diagnosis and morbidity of upper gastrointestinal cancer.Conclusion Drinking,atrophic gastritis,pickled food,intraepithelial neoplasia and anxiety are risk factors influencing the diagnosis and morbidity of upper gastrointestinal cancer.Adjust the diet and life style,enhance the awareness of early cancer screening,can control the risk factors influencing the diagnosis and morbidity of upper gastrointestinal cancer.
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Objective To analyze the impact of patients ages on propofol dosage in painless gastroscopy.Methods A retrospective analysis was conducted on the clinical data of 158 painless gastroscopy patients from January 2017 to June 2020.They were divided into the young group(18～44 years old,n = 57),the middle-aged group(45～59 years old,n = 51),and the elderly group(≥60 years old,n = 50)based on their age.The anesthesia status and safety of each group were compared.Results The results showed that the dosage of propofol,average total dosage of propofol,MAP,HR,RR,SpO2 levels in the young group were higher than those in the middle-aged and elderly groups when consciousness disappeared,and the middle-aged group was higher than the elderly group;The onset time,anesthesia recovery time,orientation recovery time,and departure time in the young group of patients were shorter than those in the middle-aged and elderly groups,and the middle-aged group was shorter than the elderly group(P<0.05).The incidence of airway obstruction,hypoxemia,mandible support,mask ventilation,adverse cardiovascular events,sedation related adverse events,and incidence of obstructed endoscopy in the elderly group were higher than those in the young and middle-aged groups.The incidence of smooth endoscopy was lower than that in the young and middle-aged groups(P<0.05).Conclusion Aging may increase the dosage of propofol in patients underwent painless gastroscopy under anesthesia,prolong the onset time,anesthesia recovery time,orientation recovery time,and departure time,increase stress reactions and adverse reactions,and strengthen monitoring for elderly patients in clinical practice.
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Objective To explore the effect of remimazolam combined with remifentanil on painless bronchoscopy in elderly patients and observe its impact on hemodynamics.Methods Collect 80 elderly patients underwent bronchoscopy examination from October 2021 to October 2022 as research subjects,and divide them into remifentanil group and combination group according to anesthesia methods.Remifentanil group was given remifentanil assisted painless bronchoscopy,and the combined group was given remimazolam assisted painless bronchoscopy based on remifentanil group.The hemodynamics and operation conditions of the two groups at different time points[before anesthesia induction(T1),at the time of transglottis(T2),1 min after transglottis(T3),5 min after transglottis(T4),at the end of the inspection(T5)]were compared,and the changes of intraoperative and postoperative adverse reactions of patients with different anesthesia methods were observed,and satisfaction analysis was conducted.Results Compared with remifentanil group,the heart rate(HR)in the combined group at T2,T3,and T4 was slower,percutaneous arterial oxygen saturation(SpO2)was lower at T3,T4,diastolic blood pressure(DBP)and systolic blood pressure(SBP)were higher in T2,T3,T4,and the differences were statistically significant(P<0.05).The onset time of drugs was shorter,the recovery time of patients was long,the incidence of hypoxemia,hypotension and HR slowdown was lower,the incidence of HR increased was higher,and the postoperative satisfaction was higher,with statistical significance(P<0.05).There was no statistically significant difference in the incidence of postoperative nausea,vomiting,dizziness,headache,and drowsiness between the two groups of patients(P>0.05).Conclusion Remimazolam combined with remifentanil for painless bronchoscopy in elderly patients may have a good application effect,which can maintain hemodynamic stability,rapid onset,long duration of efficacy,reduce the rate of intraoperative adverse reactions,have a good safety,and can improve patient satisfaction.
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Objective To compare the anesthetic effect and safety of Ciprofol and Propofol combined with Fentanyl in painless bronchoscopy for conscious patients in intensive care unit(ICU).Methods 60 conscious patients who underwent painless bronchoscopy from October 2022 to January 2023 were selected.According to the random number table method,30 cases were divided into the control group(Propofol 1.5 mg/kg + Fentanyl 1 μg/kg)and 30 cases were divided into the experimental group(Ciprofol 0.4 mg/kg + Fentanyl 1 μg/kg).Systolic blood pressure,diastolic blood pressure,heart rate,respiratory frequency,and percutaneous arterial oxygen saturation(SpO2)were recorded before anesthesia(T1),during the examination(T2),and at the completion of the examination(T3)in the two groups,and the success rate of induction of general anesthesia,the time of induction of anesthesia,the time of bronchoscopy,the time of eye-opening,the total dosage of medications used,the incidence of injection pain,and the incidence of intraoperative adverse reactions(hypotension,respiratory depression,bradycardia,and bucking)in the two groups were compared.Results Analysis of the data revealed significant group,time,and interaction effects for systolic blood pressure,diastolic blood pressure,heart rate,and respiratory frequency at different time points(P<0.05).The experimental group had a shorter induction time of anesthesia[1.40(1.10,1.62)min]in comparison to the control group[1.60(1.30,2.10)min](P<0.05),and the experimental group required a less amount of drug to achieve the desired outcome[(21.40±1.82)mg]compared to the control group[(78.75±6.71)mg](P<0.05).Furthermore,the incidence of injection pain(3.33%)and respiratory depression(6.67%)was significantly reduced in the experimental group compared to the control group(36.67%)and(30.00%)(P<0.05).Conclusion The use of Ciprofol in combination with Fentanyl has been found to provide effective anesthesia during bronchoscopy,while also increasing safety and decreasing the incidence of adverse events.It is worthy of clinical application.
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OBJECTIVE To investigate the effects of dexmedetomidine （DEX）-assisted general anesthesia on hemodynamics and cognitive function in elderly patients undergoing painless enteroscopy. METHODS From July 2020 to February 2022， 180 elderly patients undergoing painless enteroscopy in the outpatient operating room of the Second People’s Hospital of Jiaozuo were selected and divided into a control group （n＝90） and an observation group （n＝90） according to the random number table method. The control group was given routine general anesthesia （induced with sufentanil and propofol anesthesia， maintained with propofol anesthesia）， while the observation group was given DEX-assisted general anesthesia after preoperative preparation. The hemodynamic indexes [mean arterial pressure （MAP）， heart rate （HR）]， dosage of general anesthesia， awakening time， cognitive function [minimized mental status examination （MMSE）]， and the incidence of adverse drug reactions were compared between the two groups. RESULTS There was no significant difference in various indicators before anesthesia （T0） between 2 groups （P＞ 0.05）. Compared with T0， MAP and HR of the two groups were reduced significantly 10 minutes after anesthesia （T1）， at the time of enteroscope reaching the ileum and cecum （T2）， enteroscope withdrawal after the examination （T3）， and 10 minutes after surgery （T4）； but MAP and HR of the observation group at T1， T2， T3， and T4 were all higher than those of the control group （P＜0.05）. Compared with the control group， the dosage of general anesthesia and the recovery time in the observation group were significantly reduced or shortened， the MMSE scores at 1， 2 and 3 days after the operation were significantly increased， while the incidence of cognitive dysfunction and adverse reactions were significantly reduced （P＜0.05）. CONCLUSIONS DEX can effectively improve the hemodynamics and cognitive function of elderly patients undergoing painless enteroscopy， which is beneficial to reduce the dosage of general anesthesia， shorten recovery time， and has better safety.
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Objective To investigate the effect of remimazolam on anesthetic effect and postoperative cognitive function during painless bronchoscopy in elderly patients.Methods A total of 90 patients with painless bronchoscopy admitted to Wenzhou People's Hospital were selected.And randomly dividing into 45 patients in control group,45 patients in observation group.The control group was given propofol,and the observation group was given remimazolam.Mean arterial pressure(MAP),heart rate(HR),and blood oxygen saturation(SpO2)were monitored.Effective time after induction,recovery time after withdrawal and discharge time were compared.Patient's cognitive function was assessed using the mini-mental state examination(MMSE),auditory word learning test(AVLT),shape connection test(STT),and animal language fluency test(AFT).Enzyme linked immunosorbent assay(ELISA)was used to determine substance P(SP),C-reactive protein(CRP),noradrenaline(NE),tumor necrosis factor-α(TNF-α)in serum,interleukin(IL)-6 and prostaglandin E2(PGE2)concentrations.Results Compared with the control group,the MAP of the observation group patients at time points T2 and T3 showed statistically significant differences(P<0.05);HR was especially significant at T2,T3 and T6 periods(P<0.05).SpO2 at T2 and T3(P<0.05).The awakening time,discharge time of the observation were shorter than control(P<0.05).At 1 day after surgery,the MMSE score,STT score,AFT score were significantly higher(P<0.05);The serum levels of SP,PGE2 and NE and IL-6,TNF-α and CRP were decreased in the control(P<0.05).The incidence of adverse reactions was 17.78％in control group and 8.89％in observation group(χ2=7.654,P=0.031).Conclusion Remazolam is used in painless bronchoscopy in elderly patients,intraoperative hemodynamics is stable,having little impact on postoperative cognitive function,and inhibits the release of inflammatory factors and the secretion of pain mediators,which is worthy of clinical use.
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@#Objective To explore the application of painless diagnosis and treatment technology in children's peripherally inserted central catheter(PICC)guided by ultrasound.Methods Totally 82 children who planned to undergo PICC in the hospital from January 2021 to January 2023 were selected and randomly divided into a control group and an observation group using a random number table method,with 41 cases in each group;The control group underwent conventional ultrasound guided PICC catheterization,while the observation group underwent painless diagnostic and therapeutic techniques using ultrasound guided PICC catheterization;Compare the success rate of catheterization,completion time of catheterization,degree of pain in the child pain[children's pain behavior scale(FLACC)],tolerance[Houpt behavior scale(HBS)],compliance[Frankl scale(FCS)],and family satisfaction between the two groups.Results The success rate of catheterization in the observation group was higher than that in the control group,and the catheterization time was shorter than that in the control group,with a statistically significant difference(P<0.05).The FLACC score of the observation group was lower than that of the control group,while the HBS score and FCS score were higher than those of the control group,with a statistically significant difference(P<0.05);The total satisfaction of family members in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).Conclusion The use of painless diagnosis and treatment technology in ultrasound-guided PICC catheterization in children can improve the success rate of catheterization,shorten the catheterization time,reduce the degree of pain in children,enhance tolerance and compliance,and improve family satisfaction.
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@#Objective To explore predictive value of modified STOP-BANG questionnaire(MSBQ)for hypoxemia during painless gastroscopy.Methods A total of 300 patients were selected as the study subjects who underwent painless gastroscopy in Zhejiang Cancer Hospital from October to December 2021.The MSBQ and STOP-BANG questionnaire(SBQ)were used for assessment before the examination,and patients were divided into high risk group(total score≥3 points)and low risk group(total score<3 points)according to their scores.The incidence of hypoxemia in high risk group and low risk group of the two scales was observed.The predictive value of MSBQ and SBQ for the risk of hypoxemia during painless gastroscopy was evaluated by receiver operating characteristic(ROC)curve.Results The incidence of hypoxemia in high risk group was significantly higher than that in low risk group(P<0.05).The sensitivity of MSBQ and SBQ to predict the occurrence of hypoxemia in painless gastroscopy was 81.01%and 83.54%,the specificity was 78.28%and 66.06%,and the area under the curve was 0.81 and 0.79,respectively.The prediction efficiency of MSBQ was better.Conclusion MSBQ has a high predictive value for the risk of hypoxemia in painless gastroscopy.
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Objective:To explore the application research of isolated esophageal ventilation device in painless gastroscopy.Methods:A total of 200 patients who underwent painless gastroscopy requiring esophageal isolation were selected,and they were randomly divided into an observation group(isolated esophageal ventilation device + gastroscopy)and a control group(ordinary mask ventilation + gastroscopy),with 100 cases in each group.The heart rates,blood pressures,the numbers of breaths and blood oxygen saturation(SpO2)of 5 time points of two groups were recorded at entering time(T0),pre installing ventilation device(T1),post installing ventilation device(T2),during gastroscopy(T3)and post gastroscopy(T4).And then,the incidence of complications,occurrence of adverse events,total dosages of Propofol,operation times of gastroscopy,wake-up times and observation times of two groups were compared.Patients'satisfactions for the examination were evaluated by self-designed satisfaction survey and evaluation scale.Results:The differences of SpO2 between the two groups of patients at T1-T4 time points were statistically significant(t=23.150,t=14.720,t=17.900,t=18.520,P<0.05),respectively,and the difference of that between two groups at T0 time point was not statistically significant.There were no significant differences in blood pressure,heart rate and respiratory frequency between the two groups of patients at different time points.The total incidences of complications in the control group and the observation group were respectively 68.00％ and 13.00％.The total incidence of complications in the control group was significantly higher than that in the observation group,and the difference was statistically significant(x2=62.766,P<0.05).The total dosage of Propofol,time of gastroscopy examination and observation time of the observation group were significantly lower than those of the control group,and the differences were statistically significant(t=4.977,t=20.040,t=6.486,P<0.05),respectively.There was no statistically significant difference in the wake-up time between the two groups of patients.The satisfaction rates of the control group and observation group were respectively 79.00％ and 95.00％for painless gastroscopy,and the satisfaction rate of the control group was significantly lower than that of the observation group,and the difference was statistically significant(x2=11.317,P<0.05).Conclusion:In the application of the isolated esophageal ventilation device in painless gastroscopy,the SpO2 decrease of preventive operation can improve the oxygenation state of patients,and decrease the incidence rate of chocking cough and other adverse reactions,and reduce the occurrence of gastric reflux,and shorten the time of gastroscopy examination,and enhance the satisfaction of patients for examination,which has better safety.
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Objective:To analyze the intestinal preparation effect of dimethicone oil combined with polyethylene glycol electrolyte powder in painless gastrointestinal endoscopy.Methods:The study included 380 patients undergoing painless gastrointestinal endoscopy in Nanjing Qixia District Hospital from January 2020 to June 2021. They were randomly grouped into observation group and control group, with 190 patients in each group. The control group was given polyethylene glycol electrolyte powder + 0.9% sodium chloride for intestinal preparation before gastrointestinal endoscopy, and the observation group was given polyethylene glycol electrolyte powder + dimethicone silicone oil. The intestinal cleanliness, antifoam effect, colonoscopy index, detection rate of polyps, adenomas and advanced adenomas, and adverse drug reactions were compared between the two groups.Results:The satisfaction rates of intestinal cleaning and defoaming in the observation group were 92.11% (175/190) and 90.53% (172/190) respectively, which were obviously higher than those in the control group: 84.71% (161/190) and 83.16% (158/190) ( P>0.05). The entering time of colonoscopy and the time of colonoscopy inspection in the observation group were obviously shorter than those in the control group: (3.35 ± 1.05) min vs. (6.02 ± 1.68) min, (11.86 ± 1.93) min vs. (15.22 ± 2.10) min. The rinsing amount of 0.9% sodium chloride was obviously reduced: (35.68 ± 7.64) ml vs. (50.34 ± 10.30) ml ( P<0.05). The detection rate of <5 mm polyps in the observation group was obviously higher than that in the control group: 15.79% (30/190) vs. 5.79% (11/190) ( P<0.05). The detection rate of adenomas in the observation group was obviously higher than that in the control group: 24.74% (47/190) vs. 15.79% (30/190) ( P<0.05). The detection rate of advanced adenomas in the observation group was obviously higher than that in the control group: 20.53% (39/190) vs. 9.47% (18/190) ( P<0.05). The total incidences of abdominal distension and adverse reactions in the observation group were obviously lower than those in the control group: 1.05% (2/190) vs. 5.26% (10/190), 9.47% (18/190) vs. 18.42% (35/190) ( P<0.05). Conclusions:The application of polyethylene glycol electrolyte powder combined with dimethicone oil in painless gastrointestinal endoscopy can effectively improve the intestinal cleanliness, the satisfaction of removing bubbles and the detection rate of polyps and adenomas, reduce the incidence of adverse reactions, and have high clinical application value.
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Subacute thyroiditis (SAT) is an inflammatory disease of the thyroid gland with multiple etiologies and clinical features, often challenging to recognize. The classic presentation is the painful, granulomatous thyroiditis (DeQuervain's) characterized by diffuse swelling of the gland, usually preceded by an upper respiratory tract infection. A painless variant, also referred to as autoimmune subacute thyroiditis, has been documented and is strongly linked to postpartum state, reported following ~10% of pregnancies. It can be differentiated from the former by the presence of anti-thyroid antibodies, which classifies it as an autoimmune thyroiditis. Any spontaneous development of painful swelling of the thyroid gland warrants a complete work up that includes thyroid hormones, thyroid autoimmune panel, acute phase reactant titers, and, if available, imaging that may lead to the diagnosis of an inflammatory or infectious cause of thyroiditis.
Tiroiditis Subaguda, es una enfermedad inflamatoria de la glándula Tiroides que tiene muchas etiologías y características clínicas, y frecuentemente difícil de reconocer. La presentación clásica es: tiroiditis granu-lomatosa dolorosa caracterizada de hinchazón difusa de la glándula del Tiroides, usualmente precedida de una infección respiratoria de las vías áreas superior (como una infección viral). Existe una variante sin dolor, tam-bién referida como tiroiditis subaguda autoinmune, ha sido documentado y es muy ligada al estado postparto, en un 10% de los embarazos. La Tiroiditis postparto Puede ser diferenciada de la anterior por la presencia de anticuerpos lo que la clasifica como una tiroiditis auto-inmune. Cualquier desarrollo espontaneo de una hin-chazón dolorosa de la tiroides garantiza su evaluación de una manera formal, que incluye las hormonas del tiroides, panel tiroideo de autoinmunidad títulos de los factores que reaccionan agudamente, y si está disponible imágenes como una ultrasonografía que conlleva al di-agnóstico de una Tiroiditis inflamatoria o de origen in-feccioso.
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Humans , Female , Adolescent , Thyroiditis, Subacute , Goiter, Nodular , Postpartum ThyroiditisABSTRACT
OBJECTIVE To obser ve the efficacy and safety of rimazo lom for painless gastroscopy sedation in outpatients. METHODS Totally 84 patients who underwent painless gastroscopy were collected from the outpatient department of the Central Hospital of Enshi Tujia and Miao Autonomous Prefecture from March to June in 2021. By random number table method combined with envelope allocation concealment method ，they were randomly divided into observation group and control group ，with 42 cases in each group. The patients in the observation group were slowly injected with Sufentanil citrate injection 0.1 μg/kg+Rimazole toluenesulfonate for injection 0.2 mg/kg. Patients in the control group were slowly injected with Sufentanil citrate injection 0.1 μg/kg+ Propofol emulsion injection 2 mg/kg. Gastroscopy was performed after the patient ’s consciousness disappeared. The sedative efficiency，sedative onset time ，recovery time and the occurrence of adverse drug reaction were observed in 2 groups. The heart rate（HR），mean arterial pressure （MAP），pulse oxygen saturation （SpO2），modified observer ’s assessment of alertness/sedation （MOAA/S）score and Narcotrend score were recorded in 2 groups after entering the room （T0），after anesthesia induction （T1）， when gastroscope entered the throat （T2），at the end of gastroscope withdrawal （T3），5 min after gastroscopy （T4）. RESULTS There was no significant difference in the effective rate of sedation （100％），the incidence of respiratory depression ， nausea and vomiting between the two groups （P＞0.05）. The qq.com onset time of sedation in the observation group was longer than control group ，and the recovery time and the incidence ofhypotension，hypotension to be tre ated，injection pain and bradycardia in observation group were significantly shorter or lower than control group （P＜0.05）. At T 0，there was no significant difference in HR ，MAP，SpO2，MOAA/S score or Narcotrend score between two groups （P＞0.05）. From T 1 to T 4，the HR of control group was significantly lower than that of the same group at T 0，and significantly lower than observation group at the same time（P＜0.05）. From T 1 to T 3，the MAP of two groups were significantly lower than the same group at T 0（P＜0.05），but there were no significant differences between two groups and between T 4 and T 0（P＞0.05）. There was no significant difference in SpO 2 at different time points between two groups and HR at different time points in observation group （P＞0.05）. From T 1 to T 3，MOAA/S score and Narcotrend score of two groups were significantly lower than the same group at T 0，while the MOAA/S score and Narcotrend score at T 1 and T 3 and Narcotrend score at T 3 of observation group were significantly higher than control group at the same time （P＜0.05），and the Narcotrend score of observation group at T 2 was significantly lower than control group at the same time（P＜0.05）；at T 4，there were no significant differences in MOAA/S score and Narcotrend score between two groups （P＞ 0.05）. CONCLUSIONS Remazolam shows good sedative effect and safety for painless gastroscopy.
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AIM: To investigate the effective dose of esketamine for prevention on propofol injection pain in painless abortion. METHODS: From November 2021 to December 2021, thirty patients undergoing painless abortion, aged 20 to 40 years old, ASA physical status or Ⅱ, BMI 19-26 kg/m
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Objective:To evaluate the effect of laryngopharyngeal reflux on sedation-related adverse events in the patients undergoing painless gastroscopy.Methods:Two hundred and eighty-nine American Society of Anesthesiologists physical status Ⅰ-Ⅲ patients of both sexes, aged 18-75 yr, with body mass index 18.5-28.0 kg/m 2, scheduled for elective painless gastrocopy, were selected.Specimens of glottic secretions before and after gastroscopy were collected, and the concentration of human pepsin was measured by enzyme-linked immunosorbent assay.The patients in whom the concentration of pepsin was positive before the examination were excluded (the concentration ≥ 31.34 pg/ml was considered as positive). The patients were divided into laryngopharyngeal reflux group (R group, the concentration of pepsin was positive after gastroscopy) and non-laryngopharyngeal reflux group (N group, the concentration of pepsin was negative after gastroscopy) according to the concentration of pepsin in the secretion samples before and after gastroscopy.The occurrence of hypoxemia, hypotension, bradycardia, bucking and body movement during operation was recorded.The patients were followed up by telephone on the 1st, 3rd and 7th days after operation.The sore throat, hoarseness, nausea and vomiting, cough and expectoration and use of antibiotics were recorded. Results:Compared with group N, the incidence of bucking and hypoxemia was significantly increased, the incidence of sore throat and hoarseness was increased on the 1st day after operation, and the incidence of cough and expectoration was increased on the 1st and 3rd days after gastroscopy in group R ( P<0.05). Conclusion:Laryngopharyngeal reflux can increase the development of intraoperative and postoperative sedation-related adverse events in the patients undergoing painless gastroscopy.
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Objective:To assess the influence of age on the safety of propofol mono-sedation for adult patients undergoing painless gastroscopy.Methods:A retrospective study was conducted on data of 321 patients scheduled for painless gastroscopy with propofol mono-sedation. According to the age, patients were divided into youth group (116 cases, 18-44 years), middle-aged group (103 cases, 45-59 years) and elderly group (102 cases, 60-80 years). The procedure time, the total dosage of propofol, the occurrence of airway obstruction or hypoxemia, the use of airway interventions including airway opening maneuvers and facemask ventilation, lowest SpO 2, adverse cardiovascular events (including hypertension, hypotension, tachycardia, and bradycardia), and the use of ephedrine during painless gastroscopy were observed. Results:There was significant difference regarding the total dosage of propofol among youth group (173.2±47.0 mg), middle-aged group (158.8±41.3 mg) and elderly group (137.8±26.3 mg) ( F=21.761, P<0.001). The total dosage of propofol was significantly lower in the elderly group compared with the middle-aged group ( P<0.017) and youth group ( P<0.017), and that in the middle-aged group was significantly lower than that in the youth group ( P<0.017). The incidence of hypoxemia was 12.9% (15/116) in the youth group, 15.5% (16/103) in the middle-aged group and 25.5% (26/102) in the elderly group, with significant difference among three groups ( χ2=5.711, P=0.017). Moreover, the incidence of hypoxemia was significantly higher in the elderly group compared with the middle-aged group ( P<0.017) and youth group ( P<0.017). The incidences of hypotension, bradycardia and total adverse cardiovascular events were 5.2% (6/116), 4.9% (5/103) and 11.8% (12/102), 1.7% (2/116), 2.9% (3/103) and 7.8% (8/102), and 11.2% (13/116), 10.7% (11/103) and 20.6% (21/102) respectively in youth, the middle-aged and the elderly group. There were no significant differences in the above indicators among the three groups ( P>0.05). However, compared with those of the young and the middle-aged patients, the occurrence of hypotension, bradycardia and total adverse cardiovascular events in the elderly patients were on the rise. There were no significant differences among the three groups in other indices( P>0.05). Conclusion:Total dosage of propofol may need to be decreased gradually with the increase of age of patients undergoing gastroscopy with propofol mono-sedation. Compared with young and middle-aged patients, elderly patients have a significantly higher incidence of hypoxemia, with a tendancy of total adverse cardiovascular events increase, so the safety of painless gastroscopy is reduced for these patients.
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Objective:To evaluate the effect of virtual painless ward management based on mobile internet on pain management of patients after craniotomy. Methods:From May to October, 2019, 117 patients who accepted virtual painless ward management based on mobile Internet after craniotomy were selected as painless ward group. From December, 2018 to April, 2019, 117 patients previously hospitalized in the same department after craniotomy were selected as control group. The regression equation was established to compare the Numerical Rating Scale (NRS), nursing satisfaction and anxiety rate between two groups, and the general data, such as age, were taken as independent variables into the regression equation. Partial regression coefficient (B), odds ratio (OR) and 95% confidence interval (CI) of the painless ward management after adjustment compared with that of the non-painless ward management were calculated. Results:Multivariate regression analysis showed that, compared with the control group, the score of NRS within four days significantly decreased (B = -2.700, 95%CI -3.167 to -2.232, P < 0.001), the nursing satisfaction significantly increased (B = 0.542, 95%CI 0.289 to 0.795, P < 0.001), and the anxiety rate significantly decreased (B = -2.119, OR = 0.120, 95%CI 0.053 to 0.271, P < 0.001) in the painless ward group. However, the improvement of the anxiety rate might not completely depend on the decrease of NRS score (B = -0.112, OR = 0.894, 95%CI 0.727 to 1.100, P > 0.05). Conclusion:The procedure of virtual painless ward based on mobile internet could obviously improve the management level of analgesia for patients after craniotomy.
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Microneedles have been developed rapidly in the field of transdermal administration in the past few decades. In recent years, the development of microelectronics technology has expanded the applications of microneedles by combining with microelectronic systems, especially in biological diagnosis and treatment. Different types of microneedles have been designed to extract blood and tissue fluids for detection, or as electrodes to directly detect blood sugar, melanoma and pH in real-time in vivo, both show good prospects for real-time detection applications. In this paper, we review the design of materials and structure of microelectronic-based microneedles, and discuss their advances in biological diagnosis.
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Administration, Cutaneous , Drug Delivery Systems , Electrodes , Microinjections , NeedlesABSTRACT
@#A healthy 4-year-old boy presented with a painless lump on his upper lip for three years duration with no significant changes in size. Clinical examination revealed the presence of firm and mobile lump on the labial mucosa measuring approximately 15 mm × 10 mm, slightly pale yellowish compared to the surrounding tissues. The covering mucosa was intact and was non-tender upon palpation. Excisional biopsy was performed under general anaesthesia and the histopathological results revealed the presence of a partially encapsulated pleomorphic adenoma with variable epithelial and stromal components.
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Background: Optimum surgical intervention for low-grade haemorrhoids is unknown. Haemorrhoidal artery ligation (HAL) has been proposed as an efficacious, safe therapy while rubber band ligation (RBL) is a commonly used Out patient treatment.Methods: We compared recurrence after HAL versus RBL in patients with grade II-III haemorrhoids. The diagnosis of hemorrhoids is primarily based on the proctoscopic examination. The study evaluates comparative results of rubber band ligation (RBL) and hemorrhoidectomy. This study was conducted over a period of 1 year from January 2017 to December 2017. It includes 50 patients having second- or third-degree primary hemorrhoids who attended surgical OPD of Tertiary Care Hospital in Gujarat. These 50 patients were selected randomly and divided into two groups of 25 patients each (hemorrhoidectomy group and RBL group). Patients of fissure, fistulae, and malignancy were excluded. All parameters were recorded and finally analysed.Results: Hemorrhoidectomy and RBL are equally effective especially in second-degree hemorrhoids. However, RBL should be considered the first-line treatment in second-degree hemorrhoids because being an outpatient procedure, it is cost effective for the patients, saves many hospital beds for more sick patients, and takes the pressure off the surgical waiting list. Although RBL is not as effective as hemorrhoidectomy in third-degree hemorrhoid, it does improve bleeding and prolapse and is highly recommended for patients who are unfit for surgery.Conclusions: RBL should be considered as the first-line treatment for second-degree hemorrhoid. However, in the third-degree hemorrhoids, hemorrhoidectomy achieves better results, and RBL is recommend as the first-line treatment for those patients in whom there is contraindication for surgery or anesthesia.
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Introduction: Subdural hematoma is a rare but seriouscomplication of accidental dural puncture during epidural orspinal anesthesia. This case report emphasizes the importanceof close follow-up of patients with post dural punctureheadache following accidental dural puncture and methods toidentify development of subdural hematoma in such patients.Case report: a 23-year-old healthy primigravida developedaccidental dural puncture while trying to locate epiduralspace using a Tuohy needle for painless labor. The patientcomplained of headache on the 2nd post-operative day that wassignificantly relieved by analgesics, bed rest and hydration.Later she presented with severe headache that becamepersistent and lost its correlation with change of posture.Other than feeling nauseated she had no other additional signsand symptoms. Diagnosis of the SDH was confirmed via CTand treated surgically. The patient recovered completely.Conclusion: One should consider the possibility of subduralhematoma in patients when postdural puncture headache isprolonged or has a change in the character of headache withor without neurological symptoms for an early successfulintervention.