RESUMEN
Objective To observe the effect of methylprednisolone on elderly patients undergoing percutaneous balloon kyphoplasty(PKP).Methods A total of 180 elderly patients with PKP due to thoracolumbar fractures under general anesthesia were selected,and randomly divided into methylprednisolone 1mg/kg group(group M)and normal saline control group(group C),with 90 cases in each group.The pain visual analogue scale(VAS),blood glucose,C-reactive protein(CRP),white blood cell(WBC),percentage of neu-trophils,nausea and vomiting scores were recorded before operation,Postanesthesia Care Unit(PACU),2h and 1 day after operation.confusion assessment method(CAM)was used to evaluate the occurrence of postoperative delirium(POD)within 3days after operation,and the quality of life and mortality were assessed at 3months after follow-up.Results The blood glucose level of patients in group M in PACU was significantly higher than that in group C(P＜0.05),and the degree of nausea and the incidence of nausea and vomiting in PACU and 2h after operation(8.86％vs 23.38％)were significantly lower than those in group C(P＜0.05),and the degree of vomi-ting at 2h after operation was also lower than that in group C(P＜0.05).There was no significant difference in the incidence of POD be-tween the two groups within 3days after surgery(11.7％vs 12.7％)(P＞0.05).There was no significant difference in CRP,WBC,and neutrophil percentage between the two groups before operation and 1day after operation(P＞0.05).There was no significant difference in hospital stay,anesthesia cost and total medical cost between the two groups(P＞0.05).There was no significant difference in the 3-month mortality and quality of life score(SF-36)between the two groups(P＞0.05).Conclusion The intraoperative application of methylprednisolone can reduce the degree and incidence of postoperative nausea and vomiting in elderly patients with PKP,but it does not reduce the incidence of POD,and can lead to a transient increase in blood glucose level.
RESUMEN
Objective To investigate the anatomical structure of the first plantar lumbrical muscle in the foot and to measure the relevant data which could provide anatomical basis for repairing thumb and finger defects with the transplantation of toes accompanied with the first lumbrical muscle,and to explore the marphological function of the first lumbrical muscle of the foot.Methods From March,2016 to January,2018,a systematic and detailed dissection of the 50 formalin-fixed feet was performed to observe the exact position of the starting and ending points of the first lumbrical muscle,and a Vernier caloper was used to measure the relevant record data.Results The first lumbrical muscle originates from the medial portion of the flexor digitorum lungus tendon of the second toe,and the length of the ventral muscle was [55.87±8.67(79.30-41.16] mm.There were 2 endpoints in the tendon.The first one was in the medial tubercle of the proximal phalanges.The second one was aponeurosis of the dorsal toe and the tendon was divided into proximal and distal segments with the medial tubercle as the mark point.The length of the proximal segment was [15.34±4.81(5.52-25.18] mm,the width of the proximal segment was [2.31±1.12(3.28-1.21)] mm,the thickness was [0.44±0.14(0.28-0.68)] mm;the length of the distal segment was [11.51±4.06(3.46-14.90)] mm,the width was [6.10±1.44(9.36-3.70)] mm,and the thickness was [0.18±0.09(1.10-0.38)] mm.The length and thickness of the proximal segment was signifantly larger than those of the distal segment (P＜0.05).Conclusion The first lumbrical muscle has the function of maintaining the balance and stability of both the toe and the arch during movement,flexuring the metatarsophalangeal joint,extending the interosseous joint of the extensor phalangeal,adducting the second toe;also the function of preventing the second toe from pronation during foots' movement.