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Objective To study the effects of Huazhi Rougan granule in treatment of nonalcoholic fatty liver disease and its effect on level of adiponectin, interleukin-6 and tumor necrosis factor-α.Methods 88 patients with nonalcoholic fatty liver disease from October 2014 to September 2015 in our hospital were selected,and divided into observation group and control group according to the order of admission.The control group were taken silibinin meglumine tablets for treatment on the basis of aerobic exercise , dietary guidance.The observation group on the basis of aerobic exercise , dietary guidance were given Huazhi Rougan granule for treatment.The observation group were taken aerobic exercise and metformin for treatment.Two groups of patients with clinical efficacy were evaluated, blood parameters, adiponectin, interleukin-6 and tumor necrosis factor-αwere measured before and 30 days after treatment between the two groups of patients.Results After treatment, the total clinical efficacy of the observation group was significantly higher than the control group ( P<0.05 ) .The levels of adiponectin in the observation group were significantly higher than those in the control group (P<0.05).The level of IL-6, TNF-αin the observation group were significantly lower than those in the control group (P<0.05).Low density lipoprotein cholesterol and triglyceride in the observation group were significantly lower than those in the control group (P<0.05).Conclusion Huazhi Rougan granule can effectively reduce the levels of TNF-αand IL-6 and increase the level of adiponectin in nonalcoholic fatty liver patients, and the clinical curative effect is good.
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Objective To investigate the effect of dexmedetomidine added to ropivacaine administered locally on prevention of tourniquet?related hypertension in the patients undergoing total knee arthroplast. Methods Ninety patients of both sexes, aged 58-74 yr, weighing 60-78 kg, of American Society of Anesthesiologists physical statusⅠ?Ⅲ, scheduled for elective unilateral total knee arthroplast, were randomly divided into 3 groups ( n=30 each) using a random number table: ropivacaine group ( group R) , dexmedetomidine added to ropivacaine administered locally group ( group D + R ) , and dexmedetomidine administered intravenously + ropivacaine group ( group Div+R ) . Femoral nerve block:0.5% ropivacaine 15 ml was injected in group R; the mixture ( 15 ml) of 0. 5% ropivacaine 20 ml plus dexmedetomidine 60 μg was injected in group D+R; 0.5% ropivacaine 15 ml was injected in group Div+R. Lateral femoral cutaneous nerve block: 0.5% ropivacaine 5 ml was injected in group R; the mixture 5 ml was injected in group D+R; 0.5% ropivacaine 5 ml was injected in group Div+R. General anesthesia was induced after the end of nerve block. In group Div+R, dexmedetomidine was infused as a bolus of 0.5 μg∕kg over 10 min starting from anesthesia induction, followed by an infusion of 0.4 μg·kg-1 ·h-1 until 30 min before the end of surgery. A tourniquet was applied and inflated ( 266-304 mmHg) within 90 min. Before induction of anesthesia ( T0 ) , and at 0, 15, 30, 45, 60, 75 and 90 min after the tourniquet was inflated ( T1?7 ) , mean arterial pressure and heart rate were recorded. The occurrence of hypertension, hypotension, tachycardia and bradycardia was recorded when the tourniquet was inflated. Agitation was assessed and scored after removal of the endotracheal tube. The time for recovery of breathing, emergence time, and time for removal of the endotracheal tube were recorded. Results Compared with group R, the mean arterial pressure and heart rate were significantly decreased at T1?7 in D+R and Div+R groups, the incidence of hypertension and tachycardia was decreased, the incidence of bradycardia was increased, and agitation score was decreased in D+R and Div+R groups ( P0.05). There was no significant difference in the time for recovery of breathing, emergence time, and time for removal of the endotracheal tube between the three groups ( P>0.05 ) . Conclusion Dexmedetomidine added to ropivacaine administered locally can exert effect on prevention of tourniquet?related hypertension in the patients undergoing total knee arthroplast, and the effect is similar to that of dexmedetomidine administered intravenously.
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BACKGROUND:Epidural analgesia has been considered a gold standard for postoperative analgesia in the lower limbs. Its outcomes are accurate and adverse reactions are few, so it can be used in the clinic. However, this method has adverse reactions such as hypotension and urine retention. Low molecular weight heparin should be used after operation, which can increase the possibility of epidural hematoma, and limits its application to epidural analgesia in the clinic. At present, few studies concerned ultrasound guided continuous fascia iliaca compartment block technology. OBJECTIVE:To evaluate the efficacy of postoperative pain relief and the joint rehabilitation between a continuous fascia iliaca compartment block and a continuous epidural analgesia for patients undergoing total hip arthroplasty. METHODS:A total of 60 patients undergoing a selective total hip arthroplasty were assigned to continuous fascia iliaca compartment block group and continuous epidural analgesia group (n=30). Al patients in both groups received a pre-fluence before general anesthesia. Continuous fascia iliaca compartment block group were injected with 0.25%ropivacaine 30 mL via iliac fascia gap. Continuous epidural analgesia group received 0.20%ropivacaine 10 mL via epidural catheter, indwel ing catheter. When the analgesic effect was identified, anesthesia intubation was carried out. After operation, medicine was given via iliac fascia and epidural analgesia pump in both groups respectively. Postoperative analgesia in single dose was not given. If pain could not be endured, analgesia would be rescued (parecoxib 20-40 mg/time) according to pain degree. Visual analogue scale scores, supplemental analgesia of parecoxib, complication of anesthesia, Harris hip joint scores, day of first walk, and duration of hospital stay were recorded. RESULTS AND CONCLUSION:No significant difference in visual analogue scale scores, supplemental analgesia, Harris hip joint scores and duration of hospital stay was detected. Day of first walk was earlier in the continuous fascia iliaca compartment block group than in the continuous epidural analgesia group. The complications were apparently lower in the continuous fascia iliaca compartment block group than in the continuous epidural analgesia group. These data indicated that after total hip arthroplasty, two kinds of analgesia methods could provide satisfactory postoperative outcomes. Hip joint was perfectly recovered. However, the complications of continuous fascia iliaca compartment block were less, and helpful to patients’ early off-bed activities, and could be considered as a good choice for analgesia after total hip arthroplasty.