Supraclavicular block versus interscalene brachial plexus block for shoulder surgery: A meta-analysis of clinical control trials.

BACKGROUND: The ultrasound-guided interscalene block (ISB) has been considered a standard technique in managing pain after shoulder surgery. However, this method was associated with the incidence of hemi-diaphragmatic paresis. In contrast to ISB, supraclavicular block (SCB) was suggested to provide effective anaesthesia for shoulder surgery with a low rate of side-effects. Thus, we performed a meta-analysis of randomised controlled trials (RCTs) to compare SCB with ISB for evaluating the efficacy and safety. METHOD: The literature was searched from PubMed, Wiley Online Library, EMBASE, and the Cochrane Library by two reviewers up to April 2017. All available RCTs written in English that met the criteria were included. Two authors pulled data from relevant articles and assessed the quality with the Cochrane Handbook. Review Manager 5.3 software was used to analyse the data. RESULTS: Five RCTs and one prospective clinical study met the eligibility criteria and were included in the meta-analysis. We considered that there were no statistically significant differences between supraclavicular and interscalene groups in procedural time (P = 0.81), rescue analgesia (P = 0.53), and dyspnoea (P = 0.6). The incidence of hoarseness and Horner syndrome was statistically lower in the SCB group than in the ISB group (P = 0.0002 and P < 0.00001, respectively). CONCLUSION: The meta-analysis showed that ultrasound-guided SCB could become a feasible alternative technique to the ISB in shoulder surgery.

Determination of apparent diffusion coefficient to quantitatively study partial hepatic ischemia reperfusion injury in a rabbit model.

BACKGROUND: Animal models of partial hepatic ischemia-reperfusion injury (IRI) have potential benefits for decision making and clinical management after liver transplantation or massive hepatic resection. We evaluated changes in apparent diffusion coefficient (ADC) in rabbits with partial hepatic IRI using 3.0 T magnetic resonance diffusion-weighted imaging (DWI). METHODS: Rabbits underwent 60 minutes of left lobar ischemia followed by 0.5, 2, 6, 12, 24, or 48 hours of reperfusion (n = 6 each). DWI spin echo-echo planar imaging (SE-EPI) was performed with b values of 50, 100, 200, 300, 500, and 600 s/mm(2). RESULTS: There was a significant difference between the ADCs at 0.5 hour and sham groups when b values were <300 s/mm(2) and between the six hour and sham groups with b = 50 and 100 s/mm(2). The ADC values were lower in the 24-hour group with b values of 50, 100, 200, and 300 s/mm(2) (all P < .01) but significantly increased in the 48-hour group when b = 500 and 600 s/mm(2) compared with the sham group (all P < .01). ADC did not change significantly in the 2-hour and 12-hour groups compared with the control group. CONCLUSIONS: In this study 3.0 T DWI dynamically monitored the pathological processes of liver IRI, revealing the microvascular disorder with a perfusion-sensitive ADC at the lower b values (<300 s/mm(2)), particularly in the early stages.

[Research of disinfecting effect of SH-series (the equipment for secondary treatment of hospital sewage)].

In order to examine the effect of using SH-series (i.e. The equipment for secondary treatment of hospital sewage) in treating sewage, we have been engaged in a series of testing-study. The results were as follows: The pollution of organic matter and microbes in hospital sewage was very serious. Both kinds of pollution were considered, when we plan our scheme of conducting hospital sewage treatment. The temperature of water was raised to 23.7-24.2 degrees C and the value of pH 7.4-7.8, the hospital sewage was treated for 60 minutes through the SH-series equipment with increased oxygenation and digestion the coliform group increased rapidly in geometrical progression. The reducing rate of the major organic matter pollution index was 69-89%. After having gone further through the SH-series treatment (Disinfecting and oblique-tubes sedimentation) sewage containing intestinal pathogens and tubercle bacilli reach the index comparable with GBJ48-83 (trial edition) "The standard". "The Disinfecting contacting time" was 1/4.5-1/2.2 of "The Standard", its "Residual chlorine" was 105-110% of "The standard".