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Introduction: Cholelithiasis is one of the most commonsurgical diseases. Laparoscopic cholecystectomy has beenuniversally accepted as gold standard for treatment ofcholelithiasis. Although many studies have shown postoperative changes in liver function tests after high pressurepneumoperitoneum during laparoscopic cholecystectomy,but very few studies have investigated the effects of lowpressure pneumoperitoneum on hepatic functions.The presentstudy was designed to compare post-operative changes inliver function tests among patients randomized to either lowpressure laparoscopic cholecystectomy(LPLC) (i.e.8 mmHg)or high pressure laparoscopic cholecystectomy(HPLC) (i.e.14mmHg).Material and methods: After taking a well informed writtenconsent,150 cases undergoing laparoscopic cholecystectomywere enrolled in the study and randomised preoperatively intotwo groups (LPLC and HPLC). Liver function tests (LFTs)including Total Bilirubin, Conjugated Bilirubin, AspartateTransaminase (AST), Alkaline Phosphatase(ALP), AlanineTransaminase (ALT), Gamma-glutamyl Transferase (GGT),Total Serum Protein, Total Serum Albumin) were done onpost-operative day (POD) 1 and day 7 and compared withpreoperative LFTs in both groups.Results: The study demonstrated significant increase inConjugated bilirubin on POD 1(p < .001), AST on POD1 (p: .005), ALT on POD 1 (p <.001), ALP on POD 1(p < .001) in HPLC as compared to LPLC patients. LFTsin both groups were found to be normal on POD 7 withoutsignificant difference between the two groups.Conclusion: Low pressure laparoscopic cholecystectomy hasless adverse effects on liver functions as compared to the highpressure laparoscopic cholecystectomy
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Background: With the establishment of laparoscopic cholecystectomy as gold standard management of cholelithiasis, the current stress is being given on increasing patient safety and reducing the post-operative morbidity associated with this procedure. An emerging trend is to use of low-pressure pneumoperitoneum in an attempt to lower the impact of pneumoperitoneum while providing adequate working space.Methods: In this prospective randomized study 66 participants were allocated into two arms i.e. low-pressure pneumoperitoneum (LPP) and standard pressure pneumoperitoneum (SPP). The necessary data were collected using laboratory investigations, clinical examination and perioperative findings. Data were analyzed using suitable statistical software.Results: Mean duration of surgery, surgical difficulty and field visualization difficulty were insignificantly greaterin LPP group than SPP group. CO2 consumption was significantly less in LPP. Incidence of bile spillage, usage of drain was insignificantly increased in LPP. Post-operative pain was significantly greater in SPP group. Time for per oral tolerance of food and incidence of nausea were significantly greater in SPP group. Standard pressure group needed significantly more tramadol injection than LPP. There were no significant haemodynamic changes in SPP group compared to LPP group. Length of hospital stay was significantly greater in SPP.Conclusions: Laparoscopic cholecystectomy in low pressure pneumoperitoneum is safe and feasible. Intra-operative complications like operative field visualization, operative difficulties, conversion rates, duration of surgery are not affected moreover, low-pressure pneumoperitoneum, decreases consumption of intra-operative CO2, post-operative pain, shoulder tip pain, need of analgesia, nausea and promotes early per oral feeding, thus reduces hospital stay.
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Introduction: This study proposes to compare the use of thelow pressure pneumoperitoneum/LPLC (< 9 mm Hg) with theuse of standard pressure pneumoperitoneum/SPLC (14 mmHg) in patients undergoing laparoscopic cholecystectomy ina prospective randomized manner in an attempt to lower theimpact of pneumoperitoneum on human physiology.Method and Materials: The study was carried out with asample size of 50 patients randomised into two groups, onewith 25 patients - SPLC while the other group with 25 patientsLPLC. To compare post-operative pain incidence of shouldertip pain, average operation duration, need of additionalanalgesia post-operatively, duration of hospital stay, change inPulse rate, SBP & DBP in both groups.Result: Incidence and intensity of post-operative pain, postoperative pain referred to the tip of the right shoulder weresignificantly lower in LPLC group compare with SPLC group.The average change in SBP in patients who underwent LPLCwas an increase of 0.83 ± 8.66 mm Hg and in SPLC groupwas an increase of 0.91 ± 14.67 mm Hg. Average change inDBP in patients who underwent LPLC was increase of 1.75± 8.33 mm Hg and in SPLC group was an increase of 2.64 ±8.34 mm Hg and in LPLC group was a decrease of 0.8 ± 12.01beats per minute and in SPLC group was an increase of 1.8± 5.33 beats per minute. The average change in SBP, DBP &heart rate in patients who underwent LPLC & SPLC was notstatistically significant. Average hospital stay for LPLC groupare 1.92 days and for SPLC group its 2.48 days.Conclusion: An uncomplicated gall stone disease can betreated by low pressure laparoscopic cholecystectomy withreasonable safety by an experienced surgeon. It is significantlyadvantageous in terms of post-operative pain, use ofanalgesics, less shoulder tip pain and hospital stay.
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Pneumoperitoneum of 12-16mmHg is created by instillation of carbon dioxide during laparoscopic cholecystectomy .Nowadays low pressure pneumoperitoneum of 8-10 mmHg is used to decrease the side effects. In our study we have compared the two methods. Methods: Eighty patients with gallstones admitted in Government Hospital Gandhinagar (district hospital Jammu) for laparoscopic cholecystectomy were divided into two groups of forty each. Forty patients were subjected to standard pressure pneumoperitoneum during the procedure and forty patients to low pressure pneumoperitoneum. Results: Very slight difference in operating time of two groups was seen. No significant change in postoperative blood pressure and heart rate seen. Only two patients had shoulder tip pain and required more analgesics. Conclusion: High pressure pneumoperitoneum has no effect on intra operative and post operative hemodynamics but can lead to increase in post operative pain.
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Objective To investigate the clinical effect of low/low pressure drainage radical resection in the treatment of high perianal abscess.Methods Eighty-six patients with high perianal abscess treated in Tangshan Traditional Chinese Medicine Hospital from Octorber 2014 to Octorber 2016 were selected and randomly divided into the observation group(44 cases)and the control group(42 cases).The observation group was treated with decompression and drainage radical surgery,while the control group was treated with one-stage incision and thread drawing radical surgery.The postoperative conditions of the two groups were observed, including pain,anal function,healing time and clinical effect,and statistical analysis was made on the quantitative scores of the above indexes.Results The cure rate of the observation group was 100%(44/44), significantly higher than that in the control group(90.47%(38/42)),and the difference between the two groups was statistically significant(χ2=4.395,P=0.036).The postoperative pain score of the observation group was(1.681±0.945)points,significantly lower than that in the control group((3.328±1.300)points),and the difference was statistically significant(t=-4.504,P=0.000); The number of recurrence(0 cases)was significantly lower than that in the control group(4 cases)(P=0.036).The healing time of the observation groups was(22.08± 2.12)d, significantly lower than that in the control group((37.552± 2.61)d),and the difference between the two groups was statistically significant(t=29.0411,P=0.000);The anal function score of the observation group was(1.681±0.838)points,significantly lower than that in the control group((2.809 ±0.928)points),and the difference between the two groups was statistically significant(t = -3.217,P=0.000).Conclusion Low pressure drainage radical is an effective surgical method for sphincter preserving radical treatment of high perianal abscess,which not only preserves the sphincter and anus straight ring,but also reduces the postoperative anal function and the degree of morphological damage and the surgery the pain and length of hospital stay and cost saving.
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Objective To develop a kind of rapid decompression equipment replacing the toughened glass simulating the state of aircraft cabin glass bursting on the fly.Methods The metallic membrane was used to isolate both chambers with different air pressures.The areas of decompression membrane and path were determined by calculating on the basis of aircraft decompression altitude,cabin pressure differential and decompression time.The structural strength was determined according to enduring force of the metallic membrane.The membrane was ejected by high pressure air using the ejection launch technology of aircraft missile.The result of simulating aircraft cabin glass bursting on the fly was achieved.Results The rapid decompression equipment ejected by air pressure in low-pressure chamber could achieve the state of simulating aircraft cabin glass bursting on the fly,and the best decompression time was 0.16 s.Conclusion The rapid decompression equipment ejected by air pressure accomplishes the decompression preparative in short time with easy operation,and can satisfy the desired requirements for the performance and precision.
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Objective: To establish a method for separation of isochlorogenic acids A, B, and C from Lonicerae Flos. Methods: Isochlorogenic acids A, B, and C in Lonicerae Flos were isolated and purified by macroporous resin and medium-low-pressure preparative chromatography. Their structures were identified on the basis of the spectral data and physicochemical property. Results: The contents of prepared isochlorogenic acids A, B and C were 98.7%, 99.2%, and 97.6%, respectively. Conclusion: This method is economic, simple, rapid, and effective for the preparation of isochlorogenic acids A, B, and C with high purity.
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This study was aimed to establish a separation method for neochlorogenic acid reference substances from Lonicera japonica. Refined neochlorogenic acid inL. japonica water extract was separated and concentrated by HPD200A macroporous resin, which was isolated and purified by medium-low-pressure preparative chromatography and determined by HPLC. The structure was identified by various spectroscopic data including ESI-MS,1H-NMR and13C-NMR. The results showed that the optimal purification technology conditions were as follows: washed with 5BV of water, collected elution, concentration, drying; neochlorogenic acid crude products were eluted with acetonitrile-0.5% formic acid solution (10:90) with the flow rate of 20 mL·min-1; and the detection wavelength was 326 nm. The contents of the prepared neochlorogenic acid reached to 98.86% and the yield was 89.1%. It was concluded that the method was effective for the preparation of neochlorogenic acid with high purity. It can be used to prepare the reference substances for quantitative analysis and content determination of Chinese materia medica.
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Objective: To put forward the problems in applying portable disposable low pressure vacuum drainage system for modified radical mastectomy and to propose the solutions. Methods: We retrospectively analyzed the clinical data of 268 breast cancer patients who were treated with portable disposable low pressure vacuum drainage system after receiving modified radical mastectomy in Changhai Hospital, from January 2013 to. September 2013. Based on the use of ordinary vacuum ball, the patients were divided into dual-chamber group and single-chamber group. The incidence of bleeding at the puncture sites, volume of post-operation drainage, indwelling time of drainage tube, and hospitalization stay were recorded for the two groups. Results: A total of 23 cases had puncture site bleeding, including 22 early bleeding and one delayed bleeding. For the duat-chamber group, the indwelling time of parasternal drainage tube was significantly shorter than that of axillary drainage tube median: 5.0d vs 9.0d, Z=-10. 713, P = 0.000). The drainage time (median: 9.0d vs 10.0 d) and hospitalization stays (median: 9. 0d vs 9.0d) of the two groups were not significantly different. It was found that 97.8% (262/268) of the patients in this study were discharged early with a drain, but with lack of discharge guidance. Conclusion: Disadvantages of portable disposable low pressure vacuum drainage system include puncture site bleeding, drainage tube cannot be extubated independently and measurement cannot be done independently, and insufficient discharge guidance. Improvement of puncture device, use of double-lumen tube independent drainage, and improvement of discharge guidance should be made to improve the system.
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The build-in low-pressure monolithic column combined with hydride generation atomic fluorescence spectrometry ( HG-AFS ) was employed for speciation analysis of fish meat. The sample pretreatment and separation approach could be accomplished within 30 min. The proper amount of fish sample was weighed and smashed into puree. The extraction solution composed of 10% HCl, 1% thiourea, and 0. 15% KCl was added before loaded into the automatic temperature controlled vertex system with 2000 r/min. The sample solution was separated through Merck monolithic column, with 3% ( V/V) acetonitrile, 30 mmol/L amonium acetate and 0. 03%(V/V) 2-mercaptoethanol (2-ME) as the eluent. The after-column eluent was digested by novel UV digestion device with pipeline sintered into the lamp, and then detected by hydrid-generation AFS. The rapid LC separation enabled fast mercury speciation of fish sample within 10 min. The different UV lamp digestion effects, eluent components, carrier gas, shield gas, lamp current, as well as PMT working power was optimized. Under the optimal conditions, the robust system achieved detection limits (DL) of 0. 15 μg/L and 0. 14 μg/L for methylmercury and HgⅡ, respectively. The RSD (n=7) was less than 5%, the linear correlation coefficient was 0 . 999 , and the matrix spiked recovery was in the range of 85%-110% for Hg speciation. This method was used for the determination of Hg speciation in fish and soil samples, and was proofed to be a reliable, easy approach for daily inspection.
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Objective: To establish a separation method for naringin and neohesperidin reference substances from Citrus aurantium. Methods: Naringin and neohesperidin monomers in C. aurantium were isolated and purified by macroporous resin and medium-low- pressure preparative chromatography. Results: The contents of the prepared naringin and neohesperidin reached to 98.76% and 99.50%, respectively. Conclusion: This method is effective for the preparation of naringin and neohesperidin with high purity. It could be used to prepare the reference substances for the qualitative and quantitative analyses of Chinese materia medica.
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Pulmonary artery (PA) aneurysm is a rare finding in the thoracic cavity, accompanied by pulmonary hypertension. Clinical presentation of PA aneurysms is usually asymptomatic. The guideline for PA aneurysm treatment is unclear. We report an unusual case of low pressure PA aneurysm associated with atrial septal defect in a 69-year-old man.
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Aneurysm , Heart Septal Defects, Atrial , Hypertension, Pulmonary , Pulmonary Artery , Thoracic CavityABSTRACT
OBJECTIVE: To establish a new chromatography technique to, separate and purify naphthaquinone components from rhizoma of Arnebia euchroma(Royle). METHODS: Medium and low pressure preparative chromatography and Flash column were used to separate and purify the constituents, and their structures were elucidated by physicochemical properties, IR, MS, 1H-NMR and C-NMR. RESULTS: Six monocases were obtained, which were deoxyshikonin, shikonin, isobutylshikonin, acetylshikonin, β-ace-toxyisovalerylshikonin, and β, β-dimethylacrylshikonin. The purities of the 6 compounds analyzed by HPLC were 99.62%, 99.02%, 99.5%, 99.31%, 99.3% and 99.2%, respectively. CONCLUSION: A medium and low pressure preparative chromatography method has been established for the first time which can accurately and rapidly separate monocases from herbs.
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Objective To investigate the value of low-pressure laparoscopic technique for appendicitis surgery during early and mid-term pregnancy.Methods The clinical data of 13 pregnant women underwent low-pressure laparoscopic appendectomy from July 2007 to December 2010 were analyzed retrospectively.Results All the 13 cases were performed laparoscopic appendectomy successfully without laparotomy and cured completely before discharged from hospital No intestinal fistula,wound infection,abortion and other complications occurred.During follow-up,9 cases of full-term pregnancy patients gave birth to healthy babies,and there was no abortion and premature delivery on 4 patients still in their pregnancy.Conclusion For women at early or mid-term pregnancy with acute appendicitis,low-pressure laparoscopic appendectomy could reduce the stimulus of surgical operation on uterus and decrease the risk of abortion.
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ObjectiveTo explore the application value of low pressure flushing in minimally invasive percutaneous nephrolithotomy lithotripsy.MethodsClinical data of 38 patients,who adopted the low pressure flushing therapy for curing the renal or upper ureteral calculi in the percutaneous nephrostolithotomy lithotripsy were retrospectively arakyzed.ResultsAming 38 patients after operation,stone-free rate of stage 1 was obtained in 25 cases and the stones were completely removed after secondary operation in 2 cases.5 patients had partial residual stones and two cases were most of the residual stones.The mean operation time was 1 ～ 2.5h.The average duration of hospitalization was 8d.There were no intraoperative and postoperative complications,such as the spread of infection due to the surgery.ConclusionThe low pressure flushing could improve clinical efficacy of percutaneous nephrostolithotomy lithotripsy and it had high security.
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PURPOSE: To evaluate the types of glaucoma in patients with pseudoexfoliation syndrome (PXS) and analyze the glaucomatous changes in patients with normal intraocular pressure (IOP). METHODS: A retrospective chart analysis of patients diagnosed with PXS was performed. The types of glaucoma were classified based on the IOP, optic disc examination, visual field test results, and optical coherence tomography (OCT) results. Other than those with pseudoexfoliative glaucoma (PXG), the normal IOP patients with PXS were divided into glaucomatous and non-glaucomatous groups. Later, the glaucomatous group was clinically compared to the non-glaucomatous group. RESULTS: The records of 40 patients with PXS were evaluated. Among the 48 PXS eyes, high pressure glaucoma was found in 21 eyes (43.75%), low pressure glaucoma in 5 eyes (10.42%), and non-glaucoma in 19 eyes (39.58%). However, in the 32 fellow eyes without PXS, 2 eyes (6.25%), 8 eyes (25%), and 20 eyes (62.5%) showed the above diseases, respectively. In result, PXS affected the glaucomatous change (odds ratio = 2.544, p = 0.045). By contrast, in PXS patients with normal IOP, PXS did not affect the glaucomatous change (p = 0.519). CONCLUSIONS: Diverse types of glaucoma including low pressure glaucoma may exist in patients with PXS. Considering the possibility of low pressure glaucoma in patients with PXS is necessary.
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Humans , Exfoliation Syndrome , Eye , Glaucoma , Intraocular Pressure , Retrospective Studies , Tomography, Optical Coherence , Visual Field TestsABSTRACT
Objective: To investigate the effects of ischemic postconditioning and controlled low-pressure reperfusion on ischemia and reperfusion-induced spinal cord injury. Methods: Spinal cord ischemia was induced by occlusion of the descending thoracic aorta combined with maintaining systemic hypotension (40 mmHg,1 mmHg=0.133 kPa) in rats. Rats were randomly divided into three groups (n = 103), namely, control group, postconditioning group (Post-con group) and low-pressure reperfusion group (LR group). Rats in control group underwent an abrupt increase to 100 mmHg in mean arterial pressure (MAP) after reperfusion. Those in the Post-con group underwent 3 cycles of 30-second reperfusion and 30-second occlusion after 30-second full reperfusion with MAP of 100 mmHg. The MAP maintained 40 mmHg for the initial 3 min of reperfusion in the animals of the LR group, then increased to 100 mmHg. The relative spinal cord blood flow (rSCBF) was monitored simultaneously during the ischemia and 30 min after reperfusion. The activities of superoxide dismutase (SOD),catalase (CAT) and myeloperoxidase (MPO) and malondialdehyde (MDA) content in lumbar spinal cord tissue were measured at 1,4,12 and 24 h after reperfusion,and the neurologic function of hind-limb was also evaluated at the same time. The samples of lumbar spinal cord were collected in all groups at the end of observation for histological examination. Results: Postconditioning and low-pressure reperfusion both improved the hyperperfusion after reperfusion. In Post-con group the activities of SOD and CAT was markedly increased 1 and 4 h after reperfusion (P<0.01) compared with control group, and no marked increase in MDA and MPO was observed. The MDA in the spinal tissue of LR group was significantly lower than that of the control group (P< 0.01), but no significant increases were observed in the activities of SOD and CAT. The MPO activity in LR group peaked from the 1st to 4th hour of reperfusion and then gradually reduced. Postconditioning and low-pressure reperfusion both improved the neurologic function during reperfusion, but behavioral scores of animals in LR group were lower than that in the Post-con group. The pathological results had a similar pattern to the behavioral scores in all 3 groups 24 h after reperfusion. Conclusion: Ischemic postconditioning and controlled low-pressure reperfusion can both attenuate ischemia and reperfusion injury in spinal cord, and the neuroprotection of ischemic postconditioning is superior to controlled low-pressure reperfusion, probably because postconditioning can enhance activities of antioxidant enzymes and decrease neutrophil accumulation.
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O uso de sistemas de irrigação por gotejamento à baixa pressão tem como objetivo oferecer uma técnica de irrigação viável para pequenas propriedades. Foram dimensionados oito sistemas de irrigação, um com os seguintes acessórios: 210 metros de tubo gotejador com diâmetro interno (DI) de 10,4 mm, sete conectores de 12 mm, e seis metros de tubo de polietileno, um adaptador para tubo de polietileno, uma curva de 90º e três metros de tubo de PVC com DI igual a 20,6 mm. Quatro sistemas foram montados com um filtro de tela de 130 μm e os demais com um filtro de disco de 200 μm. Em todos os sistemas foram utilizados um reservatório de 1 m³ localizado a 3 m acima do nível do solo. Irrigou-se 1296 m² de uma cultura de tomate, em canteiros com dimensões de 1,20 m por 60 m. Para avaliação técnica do projeto foi obtida a uniformidade de aplicação de água através do coeficiente de uniformidade de emissão (UE) e coeficiente de uniformidade de distribuição (UD), durante um período de 90 dias. Os resultados indicaram que o UE e o UD foram excelentes e que os valores de grau de entupimento aumentaram com o uso da irrigação. Assim, de acordo com os resultados, comprova-se a viabilidade técnica da utilização de sistemas de irrigação por gotejamento funcionando a baixa pressão para pequenas áreas.
A low pressure drip irrigation gravity feed system may be a viable technique to small farms. So, according with it, eight irrigation systems with 10.4 mm internal diameter driptubing 210 m long, seven 12 mm adapters, 20.6 mm polyethylene pipe 6 m long, polyethylene adapter, 20.6 mm 90º elbow, 20.6 mm PVC pipe 3 m long and 1 m³ water reservoir at 3 m height, were designed and assembled to irrigate 1.296 m² with tomato cultivated in 0.8 x 60 m beds. One 130 mm screen filter was used to four systems and one 200 mm disc filter for the other ones. Emission uniformity coefficients (UE) and distribution uniformity coefficients (UD) were obtained throughout 90 days. UE and UD were excellent and the degree of clogging at the emitters increased with time. Therefore, according to the results, the low pressure drip irrigation systems tested are technically viable to small areas.
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Objective To develop a prototype of low pressure plant-cultivating facility, for studying the growing technique of higher plants under low pressure in manned deep space exploration, so as to lay foundations for establishing controlled ecological life support system (CELSS) in low pressure environment. Methods According to detailed demonstration of technical plan, blueprint design and machining of components, facility installment, debugging, trial operations and verification experiments were carried out. Results Two sets of low pressure plant-cultivating facilities were manufactured, both of them could be used to cultivate higher plant under low or normal pressure. They worked stably and their technical parameters such as temperature, relative humidity, air pressure, O2 partial pressure, CO2 partial pressure and water content of matrix were all monitored and controlled effectively. Conclusion Their main technical indexes meet design and experimental requirements, low pressure plant-cultivating experiments can be carried out with the facilities effectively.
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Objective To study the cultivating technique of wheat under low pressures as to establish the basis of developing hypobaric controlled ecological life support system.Methods Wheat growing experiments under normal and low pressure(101 kPa,50 kPa) were carried out with low pressure plant-cultivating facilities,and the growing indexes of wheat under low pressure,such as photosynthetic rate,transpiration rate,growing status,yield and nutrient contents in seeds were compared with those under normal pressure.Results Wheat grew normally under low pressure as compared with those grown under normal pressure,but low pressure curled leaves of the wheat and caused them to turn yellow at prophase;after 15 d treatment under hypobaric condition,the average rates of photosynthesis and transpiration increased by 9.23%and 11.54% respectively;shoot height of wheat decreased,both tiller number of each plant and the ratio of root in whole plant increased,but harvest time was delayed for about 5 d under low pressure;the biomass and the yield of wheat increased by 5.46% and 4.39% respectively,the contents of protein and total saccharide in seeds also enhanced at reduced pressure,but other nutrient contents in seeds had no significant difference between 101 kPa and 50 kPa.Conclusion Growth of wheat is promoted in certain degree by low atmospheric pressure.