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Objective:To investigate the effect of acupoint stimulation assisted anesthesia on the agitation during recovery and the levels of serum opioids (Opiorphin) and amyloid A (SAA) in elderly patients after hip fracture surgery.Methods:Eighty-six older patients who underwent hip fracture surgery in Shaoxing Second Hospital from February 2020 to September 2021 were randomly divided into the routine group and the research group, each with 43 patients. They were given acupoint sham stimulation and acupoint stimulation respectively, and the general indexes of the two groups, recovery quality, cognitive function and changes in serum Opiorphin and SAA levels were compared.Results:There were no differences in operation time, anesthesia time, recovery time and intraoperative blood transfusion between the two groups ( P>0.05). The dosage of remifentanil in the research group was significantly lower than that in the routine group: (270.64 ± 17.62) μg vs. (291.82 ± 23.34) μg, P<0.05. The incidence of agitation during the recovery period in the research group was significantly lower than that in the routine group: 13.95% (6/43) vs. 48.84% (21/43), P<0.05. The mini-mental state examination (MMSE) scores in the research group at 12, 24 and 48 h after operation were significantly higher than those in the routine group: (22.80 ± 2.04) scores vs. (19.31 ± 3.61) scores, (24.92 ± 2.44) scores vs. (21.49 ± 3.58) scores, (26.73 ± 2.57) scores vs. (24.23 ± 3.95) scores, there were statistical differences ( P<0.05). The serum Opiorphin level at 24 h after operation in the research group was higher than that in the routine group: (32.74 ± 8.57) mg/L vs. (25.40 ± 6.36) mg/L; and the SAA level was lower than that in the routine group: (157.36 ± 10.24) mg/L vs. (204.37 ± 15.56) mg/L, there were statistical differences ( P<0.05). Conclusions:Acupoint stimulation adjuvant anesthesia can reduce the occurrence of agitation during the recovery period of elderly patients with hip fracture, reduce the dosage of anesthetics, reduce postoperative cognitive impairment, regulate serum Opiorphin and SAA levels, and help early postoperative recovery.
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Objective To investigate the effect of genetic factors on the occurrence of chronic post-thoracotomy pain syndrome ( PTPS) from the perspective of genetic polymorphisms. Methods Two hun-dred patients of both sexes, of American Society of Anesthesiologists physical statusⅠ or Ⅱ, aged 18-80 yr, scheduled for elective video-assisted thoracoscopic radical lung cancer surgery, were enrolled in this study. Blood samples were taken before operation for genotype analysis of 20 SNP loci, such as rs4073 and rs3774932, after DNA extraction. Postoperative multimodal analgesia was applied to maintain the visual an-alogue scale score ＜3. All the patients were followed up for 2-4 months after operation to record the occur-rence of PTPS. The patients were divided into 2 groups according to whether PTPS occurred: non-PTPS group (group N) and PTPS group (group P). Results The incidence of PTPS was 38. 7％ after surgery, and there were 114 patients in group N and 72 cases in group P . There was significant difference in A/T al-lele and genotype frequency at interleukin-8 rs4073 site and NF-κB1 rs3774932 site between the two groups (P＜0. 05). Conclusion Interleukin-8 and NF-kappa B1 genetic polymorphisms are associated with the occurrence of PTPS.
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Background and purpose: Docetaxel plus prednisone chemotherapy can improve the patients' survival for castrate-resistant prostate cancer. Angiogenesis inhibitors can also inhibit the growth of tumor. The curative effect of combined treatment is still not clear. This study aimed to evaluate the efficacy of docetaxel plus prednisone combined with thalidomide in treating castrate-resistant prostate cancer (CRPC) patients with bone metastasis. Methods:A total number of 78 CRPC patients were selected in Fuzhou General Hospital from Dec. 2008 to Jun. 2015. Seventy-eight patients were divided into two groups: 40 patients in chemotherapy group (docetaxel plus prednisone) and 38 patients in combined treatment group (docetaxel plus prednisone combined with thalidomide). A total number of 78 subjects were evaluated by the effective rate, the remission rate of bone pain, the prostate specific antigen (PSA) progression-free surviv-al, the overall survival and adverse effect. Results: The response rate (65.79%) and the remission rate of bone pain (86.84%) in combined treatment group were both higher than those in chemotherapy group (40.00% and 60.00%, P0.05). The rates of adverse effects including peripheral neuritis and lethargy in combined treatment group (26.32% and 55.26%) were higher than those in chemotherapy group (5.00% and 17.50%, P<0.05). Conclusion: Thalidomide combined with docetaxel plus prednisone in CRPC patients with bone metastasis can prolong the PSA progression-free survival and overall survival. The adverse effects are mild. It may become a new choice of treatment for CRPC.
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Objective To study curative efficacy of dezocine in treatment of receiving laparoscopic appendectomy and its effects on white blood cell count and c reactive protein.Methods 90 patients of laparoscopic appendectomy who received therapy from January 2015 to October 2016 in our hospital were selected as research objects,according to random number table,those patients were divided into the observation group and the control group,45 cases in each group.The control group was treated with sufentanil, while the observation group was treated with dezocine.Then operation index, T0 (preoperative),T1(extubation),T2(after extubation) mean arterial pressure(MAP),heart rate(HR), respiration rate(RR),isual analogue scale/score ( VAS) , ramsay score ( RSS) , white blood cell count and c reactive protein of two groups after treatment were compared .Results After treatment, MAP,HR in the observation group were significantly lower than control group [(78.30 ±6.20)mmHg vs.(86.08 ±6.09)mmHg,(76.45 ±5.90)mmHg vs.(80.48 ±5.80)mmHg,(90.82 ±9.50)time/min vs.(96.73 ±9.83)time /min,(87.21 ±8.15)time /min vs.(93.59 ±9.90)time /min](P<0.05); VAS, RSS score were significantly lower than the control group[(2.60 ±0.70)score vs.(5.29 ±0.83)score,(3.53 ±0.92)score vs.(6.38 ± 1.21)score](P<0.05); White blood cell count, c reactive protein were significantly lower than the control group[(7.92 ±2.01) ×109/L vs.(14.98 ±2.11) ×109/L,(7.90 ±2.30)mg/L vs(12.46 ±3.10)mg/L](P<0.05).Conclusion Dezocine is well for receiving laparoscopic appendectomy, obvious analgesic effect, can significantly reduce the white blood cell count and c reactive protein.
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Objective To explore the effect of ultra-early hyperbaric oxygenation (HBO) on bone calcium, biomechanical properties and bone collagen of femur in rats with complete spinal cord transaction. Methods A total of 75 Sprague-Dawley rats were randomly divided in-to sham group (n=15), model group (n=20) and HBO group (n=40). HBO group was divided into three hours group (HBO1 group, n=20) and twelve hours group (HBO2 group, n=20). All groups underwent laminectomy at T10, while the model group, HBO1 group and HBO2 group underwent complete spinal cord transection at the same level. Three hours and twelve hours after surgery, HBO1 group and HBO2 group received HBO, respectively, for three courses with ten days in a course. After treatment, the femoral biomechanical properties, bone calcium and hydroxyproline (Hyp) were determined. The morphology of bone trabecula and the bone collagen was observed with HE stain-ing and Masson triad color staining, respectively. Results After treatment, compared with the sham group, the femoral biomechanical proper-ties, the content of bone calcium and Hyp decreased in the model group (P<0.05);compared with the model group and HBO2 group, they in-creased in HBO1 group (P<0.05). The number of bone trabecula and the bone collagen decreased, and derangement and sparseness were ob-served in the model group;however, the changes were substantially mild in HBO1 group. Conclusion Ultra-early HBO could increase the content of bone calcium and Hyp of femur, improve the morphology of the femur bone collagen, and improve the femoral biomechanical properties in rats with complete spinal cord transection.
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Objective To investigate the efficacy of dexmedetomidine-assisted topical anesthesia in patients undergoing bronchoalveolar lavage ( BAL). Methods Twenty-four ASA Ⅱ or Ⅲ patients in ICU, aged 24-64 yr, weighing 50-80 kg, scheduled for BAL, were randomly divided into 2 groups ( n = 12 each) : topical anesthesia group (group A) , topical anesthesia + dexmedetomidine group (group B) . In group A, 0.9% normal saline 5 ml was injected intravenously 30 min before operation, 2% lidocaine 5-10 ml was given via a tracheal tube or cannula 5 min before operation and then an increment of 2% lidocaine 5 ml was given using fibreoptic bronchoscope every 15-30 min as required (the total amount was within 20 ml) . In group B, dexmedetomidine 0.5-1.0 μg/kg was injected (time of injection≥ 10 min) followed by infusion at 0.1-0.5 μg·kg-1 ·h-1 and the topical anesthesia was performed as the method described in group A. The time of lavage, adverse reactions and adverse cardiovascular events were recorded. Blood samples were taken 20 min before lavage, 20 min after the start of lavage and 20 min after the end of lavage (T1-3 ) for determination of the concentrations of plasma catecholamine and serum cortisol. Results The incidences of adverse reactions and adverse cardiovascular events were significantly lower and the operation time was significantly shorter in group B than in group A ( P < 0.05). The concentrations of plasma catecholamine and serum cortisol were significantly higher at T2，3 in group A, while lower at T2，3 in group B than at T1 ( P < 0.05) . The concentrations of plasma catecholamine and serum cortisol were significantly lower in group B than in group A ( P < 0.05). Conclusion Dexmedetomidine-assisted topical anesthesia can be used safely and effectively in BAL.