Objective To compare milrinone （MIN）, Phenoxybenzamine （PHE），and mixture of nitroglycerin and verapamil(NVC) for the prevention and treatment of human radial artery spasm. Methods Residuary radial arteries from 30 patients undergoing coronary artery bypass grafting （CABG） using autologous radial artery from March to September of 2012 in General Hospital of Shenyang Military District were collected. All the artery specimens were cut into 60 vessel rings of 3 mm in width and hanged in the Organ-Bath. Using a random number table，all the vessel rings were divided into 4 groups：PHE group，NVC group，MIN group and blank group （control group）. Firstly，20 vessel rings were used for spasm relaxation experiment with 5 rings in each group. Phenylephrine was added into the Organ-Bath to reach final concentration of 10-3 mol/L in order to cause vessel rings spasm. PHE of 1 mmol/L，NVC of both 30 μmol/L，MIN of 30 μmol/L and Krebs-Ringer’s solution were added respectively into above groups to compare the relaxant effect of these vasodilators on radial artery spasm. Secondly，the other 40 vessel rings were used for spasm prevention experiment with 10 rings in each group. All the 40 vessel rings were dipped in above 4 groups. After 30 minutes，phenylephrine was added to the Organ-Bath to reach final concentration of 10-3 mol/L. Time-dependent constriction of the vessel rings were compared to examine the prevention effect of these vasodilators on radial artery spasm. Results In the spasm relaxation experiment, vessel ring spasm relaxed most quickly in NVC group （P＜ 0.01）. Vessel rings in MIN group relaxed more slowly but steadily （P＜ 0.05）. Vessel rings in PHE group relaxed most slowly （P＜0.01）. And there was no relaxation in the control group. In the spasm prevention experiment，vessel rings in the control group contracted （spasm） 100% immediately after phenylephrine administration. Vessel rings in MIN group contracted immediately after phenylephrine administration too，but slower than the control group（P＜0.01）. Vessel rings in NVC group did not contract right after phenylephrine administration，but the sedentary tension of these vessel rings gradually increased 120 minutes after phenylephrine administration，and vessel ring contraction reached 46.89% 240 minutes after phenylephrine administration. There was no vessel ring contraction in PHE group. Conclusions All the vasodilators in our experiment are effective for the prevention and treatment of radial artery spasm to different degree，but each medication has its own characteristics，vasodilatation result and time-dependent effect. NVC is most effective to dilate radial artery which has been in spasm state, while radial artery pretreated by PHE is least to become spasm after being stimulated.
Objective To assess the results of microvascular decompression (MVD) in treating cranial nervehyperactive dysfunction. Methods From October 2002 to January 2007, 106 patients with cranial never hyperactivedysfunction were treated with MVD. Among them, there were 47 males and 59 females with an average age of 62 years (42-85 years), including 56 cases of trigeminal neuralgia, 33 cases of hemifacial spasm and 17 cases of spasmodic torticoll is. MRI showed obvious nerve root compression in 60 patients (56.6%), suspected nerve root compression in 33 patients (31.1%) and no nerve root compression in 13 patients (12.3%). The disease course was 2-300 months with median course of 54 months. The typical manifestations before operation were pain and myospasm in corresponding innervation region. Results The superior cerebellar artery was the most common offending vessel in trigeminal neuralgia (44.6%, 25/56), the anterior inferior cerebellar artery in hemifacial spasm (33.3%, 11/33), and the vertebra-basilar artery in spasmodic torticol is (82.4%, 14/17). Compl ications of facial paralysis, hypoacusia, facial numbness, dizziness, pain of neck and shoulder, muscles weakness of neck and subcutaneous dropsy occurred in 31 patients (29.2%). All patients were followed up for 6-42 months. The total response rate was 90.6%. The curative rate of MVD was 83.9% (47/56) in trigeminal neuralgia, 81.8% (27/33) in hemifacial spasm and 41.2% (7/17) in spasmodic torticol is, respectively. Five patients failed to response (4.7%), 2 of them were cured after re-operation and 3 abandoned further treatrment. Five patients suffered recurrence 3-8 months after operation (4.7%), 2 of them recovered after re-operation, 1 got rel ief by Gamma-knife treatment, and 2 abandoned further treatment. Conclusion MVD has a good therapeutic effect on the disease caused by vascular compression of cranial nerve. Comprehensive preoperative evaluation, skillful operational technique and intraoperative electrophysiological monitoring should be implemented to enhance the therapeutic effects of MVD and to prevent possible compl ications.
In search of a new method for treating venous crisis after replantation of the finger, the effect of instantaneous, quick and forceful squeezing on the belly of replanted finger (the so-called SQUEEZINGG TECHNIQUE) was studied. In the animal experiment, 20 SD rats were used. The femoral veins and arteries were separated in order to measure the venous pressure. The result showed that the venous pressure was (8.33 +/- 1.29) x 10(-2) kPa in normal condition, (20.61 +/- 2.34) x 10(-2) kPa in the condition simulating venous crisis and (73.9 +/- 5.74) x 10(-2) kPa on carrying out the squeezing technique. The second part of the experiment was performed on ten human fingers which were amputated because of trauma or other diseases. One of the arteriae digitales palmares propriae and two of its accompanied veins were disected, and all other blood vessels were ligated. The artery was irrigated with normal saline at a pressure of 12 kPa. When both veins were left open, the venous pressure was (1.32 +/- 0.17) kPa; (4.29 +/- 0.49) kPa, when both were ligated; and (16.88 +/- 5.25) kPa when the squeezing technique was applied at the time venous crisis developed. From May 1991 to May 1996, this method was used for 43 times in 25 cases (35 fingers) with venous crisis after replantation. It was successful for 39 times in 21 cases (30 fingers). It was very important that the performer should use the thumb and the index finger to squeeze just the belly of the involved finger, and that every squeeze should be forceful, quick and instantaneous. It was suggested that if this method was properly performed it could improve the survival rate of replanted fingers. The mechanism of squeezing technique in the treatment of venous crisis following replantation of finger was proposed.