Lipoabdominoplastia con definición anatómica. Actualización / Lipoabdominoplasty with anatomical defi nition. Update

Existe en la práctica diaria de los cirujanos plásticos una búsqueda continua de mejores alternativas técnicas para el tratamiento de las deformidades del contorno abdominal. La LADE (Lipoabdominoplastia con defi nición anatómica) da un paso más adelante de la técnica LAP tradicional. Esta técnica incorpora los principios de resaltar la defi nición de la musculatura abdominal, consiguiendo resultados más naturales y con menos estigmas de una intervención quirúrgica. Los resultados estéticos son mucho más armoniosos, con un verdadero aspecto abdominal rejuvenecido. Logramos reducir la morbilidad preservando los vasos sanguíneos perforantes y suspendiendo la fascia de Scarpa. Una correcta selección del paciente asociado a la estandarización de esta técnica hace que el procedimiento sea seguro y reproducible

There is a continuous search for better technical alternatives for the treatment of abdominal contour deformities in the practice of plastic surgeons. LADE ­ Lipoabdominoplasty with Anatomical Defi nition ­ is a step ahead of the traditional LAP technique. This technique incorporated the principles of highlighting the defi nition of the abdominal musculature, achieving more natural results with fewer reminders of a surgical intervention. The aesthetic results are much harmonious, with a true abdominal rejuvenated appearance. We can reduce morbidity by preservation of perforating blood vessels and suspension of Scarpa's fascia. The correct selection of the patient associated with the standardization of this technique makes the procedure safe and reproducible

Effects of fascia gun versus stretching on exercise-induced muscle fatigue / 中国组织工程研究

BACKGROUND:There are increasing scientific and technological ways to promote the recovery of muscle fatigue after sports,such as vibrating foam shaft,fascia gun relaxation,and ultra-low temperature cold therapy.Fascia gun relaxation has been widely used in practice,but there is still relatively little research on fascial guns. OBJECTIVE:To compare the effects of three relaxation methods(fascia gun,stretching,fascia gun+stretching)on muscle status and muscle strength during the recovery of exercise-induced muscle fatigue,and to provide scientific basis for the application of the three methods in practice. METHODS:Forty college students were randomly divided into control group(n=10),stretching group(n=10),fascia gun group(n=10),and fascia gun+stretching group(n=10).All subjects completed leg flexion and extension training at 60%1 RM,15 times per set,for 10 sets in total,to make exercise fatigue models.After modeling,the subjects were intervened with supine rest,static stretching,fascia gun relaxation,fascia gun+stretching relaxation respectively.Muscle status and muscle strength indexes were tested before exercise,immediately after exercise,immediately after relaxation,24 and 48 hours after exercise. RESULTS AND CONCLUSION:The muscle tension and dynamic hardness of the control group and the stretching group immediately after relaxation were significantly higher than those before training(P<0.01).However,there was no significant difference in the fascia gun group and fascia gun+stretching group before and after training(P>0.05).At 24 hours after training,the peak torque of the control group and fascia gun group was significantly lower than that before training(P<0.01),and there was no significant difference in the stretching group and fascia gun+stretching group before and 24 hours after training(P>0.05).To conclude,the fascia gun can immediately and effectively improve the muscle state of sports fatigue and stretching can promote the effective recovery of muscle strength within 24 hours after sports fatigue.Relaxation using fascia gun plus stretching can achieve the superposition of the two effects.

Application and mechanism of tissue flossing in sports and rehabilitation / 中国组织工程研究

BACKGROUND:Tissue flossing is a new injury prevention tool and auxiliary exercise training strategy.Tissue flossing can increase joint range of motion,improve athletic performance,and relieve pain,and is increasingly widely used in the field of sports and rehabilitation. OBJECTIVE:To review the mechanism of tissue flossing and its application in sports and rehabilitation to provide a reference for follow-up research. METHODS:"Tissue flossing;compression tissue flossing;floss band;voodoo flossband;blood flow restriction;shearing of fascia;musculoskeletal rehabilitation;sport injury"were used as Chinese and English search terms to search on the databases of CNKI,WanFang,VIP,PubMed and EBSCO databases.Relevant articles from January 2000 to October 2022 were retrieved,and 86 articles were finally included according to inclusion and exclusion criteria. RESULTS AND CONCLUSION:Tissue flossing intervention can improve lower limb joint motion,improve sprint and jump performance,promote joint injury rehabilitation,and relieve pain subjectively.However,tissue flossing intervention did not improve the range of motion of the upper limb.There is still controversy on the acute enhancement of lower limb muscle strength.It has a good tendency to improve lower limb balance and stability and improve mental state,but more studies are needed to confirm.The possible mechanisms of tissue flossing intervention are mainly fascia shear,pain gating,blood flow restriction and reperfusion,and compression.Tissue flossing is a useful treatment option that can provide important contributions in the future in the areas of sports training,sports injury prevention and rehabilitation,but more long-term in-depth studies are needed.

Therapeutic efficacy of massage versus instrument-assisted soft tissue mobilization in patients with lateral epicondylitis of the humerus / 中国组织工程研究

BACKGROUND:Instrument-assisted soft tissue mobilization is often used as a noninvasive treatment for soft tissue(skeletal muscle,ligament,and fascia)injuries and postoperative recovery to improve pain and enhance strength in the range of joint motion. OBJECTIVE:To compare the clinical efficacy of instrument-assisted soft tissue mobilization and massage therapy in patients with lateral epicondylitis of the humerus. METHODS:A total of 25 athletes with lateral epicondylitis of the humerus were enrolled in this study and randomized into two groups:13 subjects receiving instrument-assisted soft tissue mobilization as the experimental group and 12 subjects receiving massage therapy as the control group.The treatment period was 4 weeks,with two sessions per week.Elbow joint visual analog scale,Mayo elbow performance index,elbow range of motion measurement,and forearm strength were measured and recorded in both groups before and after treatment. RESULTS AND CONCLUSION:Both treatments significantly reduced visual analog scale score of the elbow joint after the first and last treatments(P＜0.05),but the visual analog scale score showed no significant difference between the two groups(P＞0.05).The Mayo elbow performance index showed a significant increase in both groups after the first and last treatments(P＜0.05),but there was no significant difference between the two groups(P＞0.05).In the maximum grip strength test,the maximum grip strength of the experimental group in the vertical direction and during internal and external rotations after treatment was better than that before treatment(P＜0.05),while the control group only showed improved maximum grip strength during internal rotation(P＜0.05),with no significant improvement in maximum grip strength in other states.There was also no significant difference in the maximum grip strength in all the three states between the two groups(P＞0.05).After the last treatment,the range of motion of the elbow joint and the angle of forearm pronation and supination were significantly improved in both intervention groups(P＜0.05).The maximum angle of the elbow joint for flexion was smaller than that before treatment(P＜0.05),and there was no significant difference in each angle of motion between the two groups(P＞0.05).The range of motion of the forearm and elbow joint in both groups were significant improved after the first and last treatment(P＜0.05)and there was no significant difference in difference in the range of motion of the forearm and elbow joint between the two groups(P＞0.05).To conclude,both instrument-assisted soft tissue mobilization and massage therapy significantly reduce pain,improve elbow flexibility and increase joint range of motion in patients with lateral epicondylitis of the humerus.However,instrument-assisted soft tissue mobilization is better than massage therapy to improve the maximum grip strength.

Clinical effects of free superficial temporal fascia flap combined with split-thickness thin skin graft in repairing refractory wounds in the anterior tibia / 中国医师杂志

Objective:To observe the clinical effect of free superficial temporal fascia flap combined with split thickness skin transplantation in repairing refractory wounds in the anterior tibia.Methods:Data on 19 patients with soft tissue defects in the anterior tibial region who were admitted to the First Affiliated Hospital of Air Force Medical University from September 2019 to October 2023 and met the inclusion criteria were collected and summarized. Among them, 11 were males and 8 were females, aged 19-70 years old. The wound area was 4.3 cm×5.0 cm-6.8 cm×9.5 cm, and all wounds were accompanied by tendon exposure. 5 patients also had local bone exposure, and 10 patients had varying degrees of local infection. All patients were treated with wound debridement and continuous closed negative pressure drainage to control infection. After controlling the wound infection, an equally large temporal superficial fascia tissue flap was designed and cut according to the size of the wound to repair the wound. At the same time, a scalp split thick skin was taken to cover the fascia flap.Results:All 19 patients with superficial temporal fascia flaps survived, while 2 patients had poor skin flap survival due to subcutaneous hematoma. After re-grafting, the wound healed. After follow-up for 6-24 months, all patients were satisfied with the appearance of the anterior tibial region and had good recovery of ankle joint function. The supply valve area was concealed, without obvious scars, hair loss, baldness and other complications.Conclusions:The use of free superficial temporal fascia flap combined with split thick skin transplantation for repairing anterior tibial wounds has the advantages of strong anti infection ability, thin fascia flap, concealed donor site, and reconstruction of supporting ligaments. It is an ideal repair method for repairing difficult to heal wounds in the anterior tibial area.

Efficacy of arthroscopic superior capsular reconstruction using composite autologous patch graft combined with tenodesis of the long head of the biceps tendon in the treatment of irreparable massive rotator cuff tears / 中华创伤杂志

Objective:To investigate the efficacy of arthroscopic superior capsular reconstruction using composite autologous patch graft combined with tenodesis of the long head of the biceps tendon in the treatment of irreparable massive rotator cuff tears (IMRCT).Methods:A retrospective case series study was performed on 11 IMRCT patients who were admitted to Affiliated Fuyang Hospital of Bengbu Medical University (Fuyang People′s Hospital) from May 2020 to June 2022, including 7 males and 4 females, aged 54-74 years [(62.6±7.3)years]. All the patients were treated with arthroscopic superior capsular reconstruction using composite patch graft combined with tenodesis of the long head of the biceps tendon. The Visual Analogue Scale (VAS), Acromiohumeral Distance (AHD), Constant-Murley score and University of California Los Angeles (UCLA) score and active range of motion of the shoulder joint before, at 6 months after surgery and at the last follow-up were compared. At the last follow-up, the integrity of reconstructed superior capsule and the long head of the biceps tendon was evaluated using MRI of the shoulder joint. Postoperative complications were observed.Results:All the patients were followed up for 13-39 months [16(13, 36)months]. The VAS score, AHD, Constant-Murley score, and UCLA score were 2(2, 3)points, (9.1±1.1)mm, (56.1±5.4)points, and (19.7±2.8)points respectively at 6 months after surgery, which were all significantly improved from those before surgery [6(5, 7)points, (5.1±1.2)mm, (37.9±2.2)points, and (11.8±1.2)points] ( P<0.05). The VAS score, AHD, Constant-Murley score, and UCLA score were 0(0, 1)points, (8.4±0.9)mm, (83.6±3.8)points, and (28.2±2.3)points respectively at the last follow-up, which were all significantly improved from those before surgery ( P<0.05). At the last follow-up, the VAS score or AHD were not significantly improved from those at 6 months after surgery ( P>0.05); Constant-Murley score and UCLA score were both significantly improved from those at 6 months after surgery ( P<0.05). At 6 months after surgery, shoulder active ranges of motion in forward flexion, abduction and external rotation were (134.6±13.5)°, (124.6±18.6)° and 45(40, 50)° respectively, which were all significantly improved compared with those before surgery [(63.2±36.1)°, (65.0±23.1)°, and [30(20, 40)°] ( P<0.05). At the last follow-up, shoulder active ranges of motion in forward flexion, abduction and external rotation were (144.1±12.6)°, (139.6±15.4)° and 60(45, 65)° respectively, which were all significantly improved compared with those before surgery ( P<0.05). There were no significant differences in active range of motion of the shoulder in forward flexion, abduction and external rotation between 6 months after surgery and the last follow-up ( P>0.05). At the last follow-up, MRI revealed integrity of the reconstructed superior joint capsule and the long head of the biceps tendon in 10 patients. One patient developed resorption of the greater tuberosity and 1 showed a partial tear of the supraspinatus tendon at 1 year after surgery. Conclusion:Arthroscopic superior capsular reconstruction using composite autologous patch graft combined with tenodesis of the long head of the biceps tendon can relieve shoulder pain, decrease upward displacement of the humerus head, improve the function and range of motion of the shoulder joint, and reduce complications in the treatment of IMRCT.

Fascia is the"sensor"for the coupling response of manipulative therapies / 针灸推拿医学（英文版）

Fascia,the initial response site for mechanical stimulation in manipulations,is also the target of the effect of manipulations.As the essence of manipulation is"force",how mechanical stimuli are transduced into neuroelectric and biochemical signals in the fascia and how physical and chemical signals of the fascia initiate the mechanical stimulation effect are the common key questions in the study of the principle of manipulation.The physical changes in the fascial connective tissue caused by the manipulation,such as the deformation and displacement of the fascial tissue,can act on the nerve end receptors in the fascial layer and generate neural electrical signals;they can also activate the mechanoreceptors on the fascial cell membrane and convert mechanical signals into chemical signals via mechanosensitive ion channel transduction,triggering a physicochemical coupling response in the fascial microenvironment and producing mechanical stimulation through neuro-endocrine-immune system pathways.The"mechanical force of manipulation"in the fascia is transmitted through the meridian to facilitate the body's perception and transmission of mechanical stimulation signals,indicating that the fascia is the"sensor"of coupled response to the physicochemical information of mechanical stimulation of manipulation.

A new type of hydrocelectomy under trans-interfascial plane surgical technique: 15 cases of experience / 现代泌尿外科杂志

【Objective】 A new type of testicular hydrocele reversal resection is described under the concept of trans-interfascial plane surgery, in order to improves the understanding of the anatomical level of testicular hydrocele surgery and to optimize the surgical approach. 【Methods】 During Jan. and June 2021, 15 patients with primary testicular hydrocele were treated with hydrocelectomy and gubernaculum preservation.Demographic information, indications of treatment, success rate and complications were collected.The anatomical structures were analyzed using intraoperative findings and photographs. 【Results】 All operations of 15 patients were successful, with the surgery time of 25-48 minutes, with an average of (34.0±6.2) minutes.No patients experienced scrotal hematoma or incision infection.There were no relapses during the 3-month follow-up after surgery.The anatomical points observed during surgery were as follows: we further confirmed that the internal spermatic fascia completely surrounded the testis, epididymis, and the spermatic cord; this layer was an avascular plane, the cremaster muscle and fascial layer between the internal and external spermatic fasciae were absent; intraoperative preservation of the gubernaculum helped to fix the testicles in its natural position. 【Conclusion】 Our novel technique of hydrocelectomy is reliable, and the precise anatomical description of the concept of trans-interfascial plane surgery can help to improve the related surgical techniques.

Clinical efficacy study of transvaginal ischia spinous fascia fixation in the treatment of pelvic organ prolapse / 安徽医科大学学报

Objective @#To explore the safety and effectiveness of transvaginal ischia spinous fascia fixation for pelvic organ prolapse.@*Methods @#The retrospective analysis of 124 patients who underwent surgical treatment for stage III - IV pelvic organ prolapse was conducted. Among them , 53 cases of transvaginal ischia spinous fascia fixation (IS⁃ FF) were performed as a study group (ISFF group) while 71 cases of transvaginal sacrospinous ligament fixation (SSLF) were performed as a control group (SSLF group) . The operation time , postoperative hospitalization days , preoperative and postoperative hemoglobin values , indwelling urinary catheter time , postoperative pain scores , and the occurrence of complications were compared between the two groups , and the efficacy of the operation was objectively evaluated by using the staging method of pelvic organ prolapse (POP⁃Q) . Also the scores of the pelvic floor impact questionnaire⁃7 (PFIQ⁃7) , the pelvic floor dysfunction questionnaire⁃20 (PFDI⁃20) , and the questionnaire of quality of life 12 (PISQ⁃12) were used to evaluate the patients ′ postoperative quality of life.@*Results @#The operation time and postoperative hospitalization days of patients in the ISFF group were less than those in the SSLF group , and the differences were statistically significant (P < 0. 05) . The preoperative and postoperative hemoglobin values , retention time of urinary catheter, postoperative pain scores , and hospitalization costs of patients in the two groups were compared , and the differences were not statistically significant. At the 3 ⁃month postoperative outpatient follow⁃up , the objective success rate was 100% in two groups. The median follow⁃up time of patients in both groups was 24 months ( 12 - 41 months) , and there were 2 cases of recurrence in the ISFF group , with a recurrence rate of 3. 77% and a subjective success rate of 96. 23% . While there were 3 cases of recurrence in the SSLF group and 2 cases of loss of visit , with a recurrence rate of 4. 34% and a subjective success rate of 95. 65% . 1 patient in the SSLF group presented with a pelvic hematoma with a diameter of about 5 cm after surgery. The hematoma disappeared after hemostasis and other symptomatic treatment. There was no organ injury or blood transfusion in both groups.@*Conclusion @#Transvaginal ischia spinous fascia fixation is a safe and effective treatment for pelvic organ prolapse , and it has the advantages of short operation time , fast postoperative recovery , fewer complications , and improvement of patients ′ quality of life.

Outcomes after elevation of serratus anterior fascia flap versus serratus muscle flap in direct-to-implant breast reconstruction following mastectomy: a prospective study

Abstract Objective: The purpose of this study was to compare postoperative pain between SF flap and serratus anterior muscle (SM) in direct-to-implant breast reconstruction. Methods: This is a prospective cohort study that included 53 women diagnosed with breast cancer who underwent mastectomy and one-stage implant-based breast reconstruction from January 2020 to March 2021. Twenty-nine patients (54.7%) had SF elevation, and 24 patients (45.3%) underwent SM elevation. We evaluated patient-reported early postoperative pain on the first day after surgery. Also, it was reported that all surgical complications in the first month and patient reported outcomes (PROs) were measured with the BRECON 23 questionnaire. Results: The serratus fascia group used implants with larger volumes, 407.6 ± 98.9 cc (p < 0.01). There was no significant difference between the fascial and muscular groups regarding the postoperative pain score reported by the patients (2 versus 3; p = 0.30). Also, there was no difference between the groups regarding early surgical complications and PROs after breast reconstruction. Conclusion: The use of SF seems to cause less morbidity, which makes the technique an alternative to be considered in breast reconstruction. Although there was no statistical difference in postoperative pain scores between the fascia and serratus muscle groups.

Efeito da auto liberação miofascial na flexibilidade de escolares: uma proposta acessível / Effects of self myofascial release on the flexibility of students: an accessible proposal

RESUMO Diversas pesquisas têm avaliado a aplicabilidade da técnica de auto liberação miofascial (ALM) na melhora aguda da flexibilidade em inúmeros esportes e/ou populações diferentes. No entanto, torna-se difícil sua inserção nas aulas de educação física escolar pelo elevado custo dos materiais. Dessa forma, buscou-se investigar o efeito da ALM em escolares por meio da utilização de rolos de espumas originais e com rolos confeccionados com materiais adaptados de baixo custo. Participaram da pesquisa 30 escolares, que foram aleatoriamente agrupados em: Grupo Controle (GCT), Grupo Rolo Original (GRO) e Grupo Rolo Adaptado (GRA). A flexibilidade foi avaliada antes e após a aplicação da ALM. A ALM foi realizada em músculos alvos uma vez por 30 segundos com intervalos de 15 segundos entre os estímulos. As comparações na flexibilidade pré e pós ALM foram avaliadas utilizando o teste de t student, com nível de significância adotado de p<0,05. Verificou-se que a ALM no GRO e GRA aumentaram agudamente a flexibilidade dos escolares em 7,53 e 16,5%, respectivamente. Assim, a utilização de rolos confeccionados com material alternativo (adaptado) para aplicação da ALM se mostra uma forma mais acessível financeiramente para ser utilizada nas aulas de educação física e abre possibilidades para sua aplicação para além das escolas.

ABSTRACT Several studies have assessed the applicability of the Myofascial Self-Release Technique (MSRT) in the acute improvement of flexibility in various sports and/or different populations. However, its integration into school physical education classes becomes challenging due to the high cost of materials. Therefore, the aim was to investigate the effect of MSRT on schoolchildren using both original foam rollers and rollers made from low-cost adapted materials. Thirty schoolchildren participated in the study and were randomly grouped into: Control Group (CG), Original Roller Group (ORG), and Adapted Roller Group (ARG). Flexibility was evaluated before and after the application of MSRT. MSRT was performed on target muscles once for 30 seconds with intervals of 15 seconds between stimuli. Comparisons in pre- and post-MSRT flexibility were assessed using the Student's t-test, with a significance level adopted of p <0.05. It was found that MSRT in ORG and ARG significantly increased schoolchildren's flexibility by 7.53% and 16.5%, respectively. Therefore, the use of rollers made with alternative (adapted) material for applying MSRT appears to be a more financially accessible way to be used in physical education classes and opens possibilities for its application beyond schools.

Pericapsular Nerve Group (PENG) block versus fascia iliaca compartment (FI) block for hip surgery: a systematic review and meta-analysis of randomized controlled trials

Abstract Background: This study compares Fascia Iliaca compartment (FI) block and Pericapsular Nerve Group (PENG) block for hip surgery. Methods: Pubmed, Embase and Cochrane were systematically searched in April 2022. Inclusion criteria were: Randomized Controlled Trials (RCTs); comparing PENG block versus FI block for hip surgery; patients over 18 years of age; and reporting outcomes immediately postoperative. We excluded studies with overlapped populations and without a head-to-head comparison of the PENG block vs. FI block. Mean-Difference (MD) with 95% Confidence Intervals (CI) were pooled. Trial Sequential Analyses (TSA) were performed to assess inconsistency. Quality assessment and risk of bias were performed according to Cochrane recommendations. Results: Eight RCTs comprising 384 patients were included, of whom 196 (51%) underwent PENG block. After hip surgery, PENG block reduced static pain score at 12h post-surgery (MD = 0.61 mm; 95% CI 1.12 to -0.09; p = 0.02) and cumulative postoperative oral morphine consumption in the first 24h (MD = -6.93 mg; 95% CI -13.60 to -0.25; p = 0.04) compared with the FI group. However, no differences were found between the two techniques regarding dynamic and static pain scores at 6 h or 24 h post-surgery, or in the time to the first analgesic rescue after surgery. Conclusion: The findings suggest that PENG block reduced opioid consumption in the first 24 h after surgery and reduced pain scores at rest at 12 h post-surgery. Further research is needed to fully understand the effects of the PENG block and its potential benefits compared to FI block. PROSPERO registration: CRD42022339628 PROSPERO registration: https://www.crd.york.ac.uk/prospero/display_record.php? RecordID=339628

Primer caso comunicado en el Perú de cabestrillo de fascia lata en incontinencia urinaria de esfuerzo / First reported case of fascia lata sling in stress urinary incontinence in Peru

RESUMEN La incontinencia urinaria de esfuerzo es frecuente en las mujeres desde la adultez media. La técnica más frecuente para tratar estos casos es el cabestrillo sintético. Sin embargo, el cabestrillo autólogo tiene buenos resultados comparables con el material sintético en los diversos estudios publicados. Presentamos un caso tratado con cabestrillo de fascia lata, describiendo la técnica y evolución.

ABSTRACT Stress urinary incontinence is common in women from middle adulthood onwards. The most frequent technique to treat these cases is the synthetic sling. However, the autologous sling has good results comparable with the synthetic material in the various studies published. We present a case treated with fascia lata sling, describing the technique and evolution.

Ultrasound Guided Fascia Iliaca Compartment Block Using Either Bupivacaine Or Bupivacaine With Dexmedetomidine For Postoperative Analgesia In Patients With Femur Fractures.

Background: Femur fractures are extremely painful due to the lowest pain threshold of the periosteum among the deep somatic structures. Perioperative Fascia Iliaca Compartment Block (FICB), when administered using a local anesthetic agent, bupivacaine, can reduce morbidity by providing satisfactory pain relief. Dexmedetomidine, an alpha-2 agonist, is known to prolong the local anesthetic effects without causing any significant side effects. We compared analgesic duration of ultrasound guided FICB with bupivacaine alone and bupivacaine with dexmedetomidine for postoperative analgesia. A prospective, randomized, double blinded study was conducted on 50 patientsMaterials And Method: aged 18 to 65 years undergoing femur fracture surgeries. Patients were divided into 2 groups of 25 each. Both groups received USG guided FICB. Group A received 28 ml 0.25% bupivacaine and 2 ml normal saline (NS). Group B received 28 ml 0.25% bupivacaine and 30 mcg dexmedetomidine in NS. Pain scores were assessed every 5 minutes until 15 minutes post FICB, during positioning for subarachnoid block and every 2 hours until 24 hours post-operatively. Total duration of analgesia, cumulative analgesia requested in 24 hours, Ramsay sedation and patient satisfaction scores were recorded. Results: The mean duration of analgesia in Group A was 419.4 ± 115.35 minutes (95%CI: 374.2 – 464.6) and in Group B was 656.6 ± 137.99 minutes (95%CI: 602.5 –710.7), p <0.001. Mean VAS score during positioning for SAB in Group A was 1.60 ± 0.50 and in Group B was 0.96 ± 0.68. USG guided FICB with dexmedetomidine is superior inConclusion: providing prolonged post-operative analgesia in comparison to bupivacaine alone

Dacryocystectomy: A fibrin glue-assisted subfascial excision

This article describes a technique of dacryocystectomy involving dissection within the subfascial plane, in which the lacrimal sac fascia is preserved and the orbital fat remains undisturbed. The lacrimal sac cavity was directly injected with Tisseel fibrin glue mixed with trypan blue. This led to sac distension and facilitated its separation from surrounding periosteal and fascial attachments. Staining the lacrimal sac epithelium improved definition of the mucosal lining. Transverse sections of the lacrimal sac specimen were histologically analyzed, which confirmed that dissection was completed within a subfascial plane. The technique herein described facilitates en bloc excision of the lacrimal sac without breaching the fascial plane that separates the sac from orbital fat.

(In)tensões em fluxo no corpo vivo / (In)tensions influx in the living body / (In)tensiones que fluyen en el cuerpo vivo

Este artigo traz reflexões sobre o sistema fascial na aproximação com os estudos somáticos e a Educação Física. Deste escopo, apresenta-se um caminho de sensibilização que pretende dar visibilidade para a perspectiva facial na orientação do trabalho corporal. Tal caminho chama a atenção para o fato de que somos seres de natureza viscoelástica, e, enquanto tais, embora sejamos amplamente sujeitos à lógica biomecânica newtoniana, pulsamos nas entrelinhas dessa leitura calculista de compreensão da vida, de modo a afirmar a linguagem das (in)tensões, de onde se evidencia o sistema fascial. Neste sentido, as fáscias oferecem possibilidades interessantes para ingressarmos a fundo na linguagem e na compreensão do movimento humano, ao oportunizar a composição de visões mais amplas e conectivas acerca do corpo, que se apresentam à percepção como um universo fluído (aquoso), no qual irrompem as energias sutis, no ebulir das sensações, das emoções e dos sentimentos que preenchem de sentidos a experiência de movimento.

This article brings reflections about the fascial system in the approach to somatic studies and Physical Education. From this scope, a path of awarenessis presented, which aims to give visibility to the fascial perspective on bodywork orientation. This path draws our attention to the fact that we, as human beings, have viscoelastic properties, and, as such, although we are widely prone to the Newtonian biomechanical logic, we pulse in between the lines from its calculating classical literature of life comprehension, in such a way as to reaffirm the language of (in)tensions. In this sense, the qualification of the Physical Education intervention, which involves the need to seek greater attention and awareness of this (in)tensions flow, without which we do not ascend into the language and comprehension of the human movement, by providing the opportunity for the composition of broader and more connective views about the body, that are presented to the perception as a fluid (watery) universe, in which erupt the subtle energies, in the ebullition of sensations, emotions and feelings that fill of meaning the movement experience.

Este artículo trae reflexiones sobre sistema fascial en la aproximación con el estudios somáticos y la Educación Fisica. Desde este ámbito, se presenta um caminho de sensibilización, que pretende dar visibilidad a la perspectiva fascial en la orientación del trabajo corporal. Este caminho llama la atención sobre el hecho de que somos seres de naturaleza viscoelástica y, como tal, aunque estamos en gran parte sujetos a la lógica biomecânica newtoniana pulsamos entre las líneas de esta comprensión calculadora de la vida para afirmar el linguaje de las (in)tensiones. En este sentido, la calificación de la intervención en Educación Fisica implica la necesidade de buscar una major atención y conciencia de este (in)tensionalidades, sin las cuales lo llegaremos al fondo em el linguaje y comprensión del movimiento humano, al brindar oportunidades para la composición de miradas más amplas y conectivas sobre el cuerpo que se presentan a la percepción como un universo fluido (acuoso), en el que irrumpen energias sutiles, en la ebullición de sensaciones, emociones y sentimentos que llenan de sentidos la experiencia del movimiento.

Analysis of the curative effect of triple surgery under endoscope in the treatment of intractable heel pain / 中国骨伤

OBJECTIVE@#To investigate the clinical effect the treatment of arthroscopy-assisted calcaneal spur resection combined with plantar fascia release and calcaneal decompression in the treatment of the patients with intractable calcaneal pain.@*METHODS@#The clinical data of 50 patients with intractable heel pain from January 2016 to January 2019 were retrospectively analyzed, including 20 males and 30 females;aged from 40 to 68 years old with an average of (50.12±7.35)years old, the medical history ranged from 1 to 4 years. All patients underwent arthroscopy-assisted calcaneal spur resection combined with plantar fascia release and calcaneal decompression, and were followed up, the duration ranged from 24 to 60 months with an average of(42.00±3.28) months. All patients had obvious heel pain before surgery, and X-ray examinations often showed the presence of calcaneal spurs. In addition to the routine foot examination, the changes in the height and angle of the arch of the foot were also measured pre and post-operatively by X-ray, for the evaluation of clinical effect. The VAS system was used to evaluate the degree of foot pain;the AOFAS scoring system was used to comprehensively evaluate the foot pain, voluntary movement, gait and stability.@*RESULTS@#The VAS decreased from (8.75±1.24) before surgery to (5.15±2.35) at 3 months after surgery, (4.07±2.53) at 6 months after surgery, and (3.95±2.44) at the last fllow-up(P<0.05). The AOFAS score increased from (53.46±4.17) before surgery to(92.46±2.53) at 3 months after surgery, (96.33±2.46) at 6 months after surgery, and (97.05±2.37) at the last follow-up(P<0.05). The arch height was (41.54±1.15) mm before operation and (41.49±1.09) mm after the operation, the difference was not statistically significant(P>0.05). The internal arch angle of the foot arch was (121±6)° before operation and (122±7)° after operation. The difference was not statistically significant(P>0.05).@*CONCLUSION@#Arthroscopy-assisted calcaneal bone spurs resection combined with plantar fascia release and calcaneal decompression exhibited great clinical effect for treating intractable heel.

Butorphanol intravenous analgesia combined with transversal abdominis plane block in postoperative analgesia after cesarean section / 重庆医学

J Objective To investigate the efficacy of butorphanol intravenous analgesia combined with transversus abdominal plane block in postoperative analgesia after cesarean section.Methods A total of 120 cases of cesarean section performed in Jinjiang Hospital from August 2021 to January 2022 were selected for the study.The cases were divided into three groups,according to the different methods of maternal postopera-tive analgesia,the group A was treated with intravenous analgesia(100 mL normal saline containing 3 μg/kg butorphanol+25 mg dolasetron,2 mL/h,continuous analgesia for 48 h);the group B received intravenous analgesia(100 mL normal saline containing 3 pg/kg butorphanol+25 mg dolasetron,2 mL/h,continuous an-algesia for 48 h)combined with transverse abdominal plane block(0.5％ropivacaine given bilaterally on each side).2 μg/kg butorphanol+25 mg dolasetron,2 mL/h,continuous analgesia for 48 h)combined with trans-versus abdominis plane block(10 mL of 0.5％ropivacaine was given bilaterally),and intravenous analgesia in the group C(100 mL of saline containing 2 pg/kg butorphanol+25 mg dolasetron,2 mL/h,continuous anal-gesia for 48 h)combined with transversus abdominis plane block(0.5％ropivacaine 10 mL was given bilater-ally),and the three groups were compared in terms of the VAS scores of postoperative analgesia at 4,8,12,24 and 48 h,the occurrence of the incidence of adverse reactions,such as dizziness,drowsiness,nausea,and vomi-ting,and the satisfaction with the analgesia.satisfaction of analgesia.Results Comparison of analgesic effect between groups,the VAS of group B and group C were significantly lower than those of group A at 4,8 and 12 h after surgery(P＜0.05),but there was no significant difference between group B and group C in pain scores(P＞0.05),and postoperative 24,48 h pain scores of the three groups are not statistically different(P＞0.05).In terms of the incidence of adverse reactions such as dizziness,drowsiness,nausea and vomiting,there was no significant difference in the incidence of adverse reactions between the group A and the group B,and they were all higher than that of the group C.Satisfaction with analgesia at 4,8,12,24,48 h after surgery:group C＞group B＞group A.Conclusion The multi-mode analgesia program of butorphanol intravenous an-algesia combined with transversal abdominis plane block can be safely and effectively used for postoperative analgesia after cesarean section,and appropriate reduction of butorphanol dosage when combined can alleviate the adverse reactions brought by opioids,thus improving the satisfaction of patients with postoperative analge-sia.

Pharmacodynamics of ropivacaine for ultrasound-guided pericapsular nerve group block in hip surgery / 中华麻醉学杂志

Objective:To evaluate the pharmacodynamics of ropivacaine for ultrasound-guided pericapsular nerve group (PENG) block in hip surgery.Methods:American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ patients of either sex with hip trauma (femoral neck or trochanteric fracture), aged 18-64 yr, with body mass index of 18-30 kg/m 2, scheduled for elective hip surgery under general anesthesia, with VAS score>4 points at 15 degrees of hip flexion, were selected. PENG block was performed at 30 min before anesthesia, and 0.375% ropivacaine was injected with an initial dose of 15 ml and the successive volume gradient of 1.2 ml after successful localization. VAS score was assessed at 30 min after injection. When the VAS score was 3, the block was considered effective, a lower volume gradient was given in the next patient, otherwise a higher volume gradient was given in the next patient, which was repeated until 7 up-and-down cross waveforms were obtained. Probit analysis was used to calculate the median effective volume (EV 50) and 95% effective volume (EV 95) and 95% confidence interval ( CI) of 0.375% ropivacaine for PENG block. Results:The EV 50 (95% CI) of 0.375% ropivacaine for PENG block was 11.36 ml (9.41-12.64 ml), and the EV 95 (95% CI) of 0.375% ropivacaine for PENG block was 14.19 ml (95% CI 12.80-25.07 ml). Conclusions:The EV 50 of 0.375% ropivacaine is 11.36 ml when used for ultrasound-guided PENG block in hip surgery.

Preliminary study on anatomy and clinical significance of the superficial region of lateral femoral muscle / 中华显微外科杂志

Objective:To explore the feasibility in reconstruction of the muscular power with the superficial part of lateral femoral muscle through anatomical study on the superficial region of lateral femoral muscle.Methods:Studies on 4 sides of lower limbs of 2 cadaver specimen were conducted in the Department of Hand and Foot Microsurgery of Xi'an Fengcheng Hospital. Intraoperative observations and measurements were further carried out on 21 sides of 21 patients. Muscular fascia in superficial region, muscular gross morphology, thickness, length and width of muscles, length of muscle fibres and pinnate angles of muscle surface were observed and measured. Both blood vessels and nerves in the muscle were separated to measured.Results:The superficial region of lateral femoral muscle was in a shape of fusiform and started from the greater trochanter and ended at the patella and rectus femoris, with the fascia at proximal end and the muscle of distal end. The inferior muscle fibres of the fascia were arranged in sequence and ended at the deep fascia from proximal to distal. Mean muscle thickness was measured at 1.96 cm±0.48 cm, and mean pinnate angle was of 18.9°±3.3°. The superficial region was found being distributed by the descending branches of lateral circumflex femoral artery(LCFA) and the second branch of femoral nerve, and they accompanied each other. At 5.0 cm from the point of entry to the muscle, the diameter of the vessels was measured at 2.39 mm±0.52 mm, and the diameter of nerves was at 2.64 mm±0.61 mm. Both of arteries and nerves further branched out anteriorly and posteriorly in 1.0-1.5 cm intervals after having entered the muscle. At 0 - 2.5 cm away from the muscle entry point, a larger branch was often running posteriorly into the muscle, and this branch appears on all 4-sided specimens. While the occurrence rate in the 21 sides of patients observed in operations was of 90.5%, with a transverse diameter at 1.23 mm±0.28 mm.Conclusion:The superficial region of lateral femoral muscle is dominated by independent vessels and nerves and there are many branches from superior vessels and nerves, which form an anatomical basis for one or more muscular flaps.