Application of Nano-Carbon in lymph node dissection and protection of parathyroid glands in 3D laparoscopic thyroidectomy / 中国内镜杂志

Objective To explore the clinical significance of Nano-Carbon particles and 3D laparoscopy in central compartment lymph node dissection and parathyroid glands protection in treatment of cN0 thyroid cancer. Methods We conduct a retrospective analysis of sixty-five patients with cN0 thyroid cancer who were received 3D laparoscopic thyroidectomy in the last 3 years. All patients were received total resection of thyroid plus the affected side and (or) contralateral side central compartment lymph node dissection. All patients were allocated to control group (n = 32) and carbon nano-particles trace group (tracer group, n = 33). The lymph node-related indexes (including number of dissected lymph node at Ⅵ area, number of Metastatic lymph node and Frozen lymph node-positive rate at Ⅵ area), serum calcium (24 h after surgery) and PTH (48 h after surgery) were collected and compared between the 2 groups. Results Number of dissected lymph node at Ⅵ area, positive rates of intraoperative frozen-section examination of parathyroid glands and PTH (48 h after surgery) were found statistical higher in nanoparticles group than control (P < 0.05). No statistical difference were found in Number of Metastatic lymph node and serum calcium (24 h after surgery) (P < 0.05). Conclusion The clinical significance of carbon nanoparticles and 3D laparoscopy is effective and feasible for central compartment lymph node dissection and parathyroid glands protection in treatment of cN0 thyroid cancer.

Application of Nano-Carbon in lymph node dissection and protection of parathyroid glands in 3D laparoscopic thyroidectomy / 中国内镜杂志

Objective To explore the clinical significance of Nano-Carbon particles and 3D laparoscopy in central compartment lymph node dissection and parathyroid glands protection in treatment of cN0 thyroid cancer. Methods We conduct a retrospective analysis of sixty-five patients with cN0 thyroid cancer who were received 3D laparoscopic thyroidectomy in the last 3 years. All patients were received total resection of thyroid plus the affected side and (or) contralateral side central compartment lymph node dissection. All patients were allocated to control group (n = 32) and carbon nano-particles trace group (tracer group, n = 33). The lymph node-related indexes (including number of dissected lymph node at Ⅵ area, number of Metastatic lymph node and Frozen lymph node-positive rate at Ⅵ area), serum calcium (24 h after surgery) and PTH (48 h after surgery) were collected and compared between the 2 groups. Results Number of dissected lymph node at Ⅵ area, positive rates of intraoperative frozen-section examination of parathyroid glands and PTH (48 h after surgery) were found statistical higher in nanoparticles group than control (P < 0.05). No statistical difference were found in Number of Metastatic lymph node and serum calcium (24 h after surgery) (P < 0.05). Conclusion The clinical significance of carbon nanoparticles and 3D laparoscopy is effective and feasible for central compartment lymph node dissection and parathyroid glands protection in treatment of cN0 thyroid cancer.

Effects of intrathecal escin and clonidine in the treatment of neuropathic pain in rats / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the effects of intrathecal escin and clonidine, used alone or in combination, in the treatment of neuropathic pain in rats and the possible mechanism.</p><p><b>METHODS</b>Ninety-six male SD rats weighing 250-300 g were chronically implanted with lumbar intrathecal catheters. One week later, the left L5 and L6 spinal nerve roots were ligated to establish the model of spinal nerve ligation neuropathic pain (SNL). The rats were then randomly divided into 16 groups (n=6), including the control (saline), escin, clonidine, escin+clonidine, and the antagonist groups. Mechanical withdrawal threshold was assessed before and at 5, 10, 20, 30, 40, 50 and 60 min after intrathecal administration was evaluated. The maximal possible effect (MPE) was calculated and the effect of the treatments on the neuropathic pain. Isobolographic analysis was performed to characterize any potential interactions between the drugs.</p><p><b>RESULTS</b>MPE was significantly higher in escin group (20, 40 microg), clonidine group (2, 5, 10 microg) and escin+clonidine group [1/4, 1/2 (escin ED(50)+clonidine ED(50))] than in the saline group (P<0.05). Intrathecal escin (5-40 microg) or clonidine (1-10 microg) alone dose-dependently alleviated neuropathic pain. Isobolographic analysis suggested a synergistic effect between escin and clonidine. Intrathecal pretreatment with yohimbine (20 microg) antagonized the effects of clonidine (P<0.01) and attenuated the action of the combination treatment with escin and clonidine (P<0.05).</p><p><b>CONCLUSION</b>Intrathecal escin and clonidine alone can dose-dependently relieve neuropathic pain. Escin and clonidine produce a synergistic effect for pain relief, which may involve the actions of alpha(2) receptor and Ca(2+) channel.</p>

Comparison of target controlled propofol infusion and sevoflurane inhalational anesthesia in laparoscopic cholecystectomy / 南方医科大学学报

<p><b>OBJECTIVE</b>To compare the effects of propofol target controlled infusion (TCI) and sevoflurane inhalational anesthesia on the hemodynamics and postoperative recovery in patients undergoing laparoscopic cholecystectomy.</p><p><b>METHODS</b>Sixty ASA IorII patients scheduled for laparoscopic cholecystectomy were randomized into propofol TCI group (group P) and sevoflurane inhalational anesthesia group (group S). In group P, TCI propofol was maintained after intubation until incision closure with the target concentration at 3 microg/ml. In group S, sevoflurane (end-tidal concentration of 2%) was maintained with oxygen flow rate of 2 L/min until incision closure. Fentanyl and vecuronium were intravenously infused according to the depth of anesthesia during the operation. MAP and HR were measured before anesthesia (T(1)), immediately after intubation (T(2)), at skin incision (T(3)), 10 min after pneumoperitoneum (T(4)) and immediately after completion of the operation (T(5)) respectively. Awake time, postoperative nausea and vomiting of the patients were observed after operation.</p><p><b>RESULTS</b>There was significant difference in MAP and HR at T(4) between the two groups (P<0.05), but not at T(1), T(2), T(3) and T(5) (P>0.05). No significant difference was also found in the awake time between the two groups (P>0.05). The incidence of PONV, however, was significantly lower in group P than in group S (P<0.05).</p><p><b>CONCLUSION</b>Propofol TCI and sevoflurane inhalational anesthesia are all effective in inducing good anesthetic effect, maintaining hemodynamic stability and ensuring rapid recovery, but propofol TCI causes lower incidence of PONV in operations such as laparoscopic cholecystectomy.</p>

Acute normovolemic hemodilution combined with controlled hypotension in patients undergoing liver tumorectomy / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the effects of acute normovolemic hemodilution (ANH) combined with controlled hypotension on reducing heterogeneous transfusion and safety during liver tumorectomy.</p><p><b>METHODS</b>Thirty patients undergoing elective liver tumorectomy were randomly divided into 3 groups (10 each), namely ANH group (group A), ANH combined with controlled hypotension group (group B) and control group (group C). All the patients were anesthetized via endotracheal intubation. Before the operation, ANH was performed in groups A and B after anesthesia induction, and controlled hypotension was initiated in group B during tumorectomy. Blood transfusion and fluid infusion were carried out routinely in group C. Hb and Hct were measured before operation, after ANH, and immediately, 1 day and 7 days after the operation. The difference in intraoperative blood loss and heterogeneous blood transfusion volume in the 3 groups was observed.</p><p><b>RESULTS</b>In group A, heterogeneous blood transfusion was avoided in 6 cases and but given in the other cases for an average of 400 ml. In group C, every patient received heterogeneous blood transfusion (664.8-/+248.1 ml), but none of the patients received heterogeneous blood in group B. The difference in transfusion volume between the 3 groups was significant (P<0.01). Hemodynamics was basically stable during operation in the 3 groups.</p><p><b>CONCLUSION</b>ANH combined with controlled hypotension is safe and effective for decreasing and even avoiding homologous blood transfusion in liver tumorectomy.</p>