Objective To evaluate the postoperative effects of different thoracoscopic sympathectomy on palmar hyperhidrosis patients. Methods We searched the Wanfang Database, CNKI, Weipu, CBM, PubMed, Cochrane Library (from inception to March 2016) to identify studies about thoracoscopic sympathectomy on palmar hyperhidrosis patients. Quality of the included studies was evaluated. The meta-analysis was performed by RevMan5.3 software. Results A total of 15 studies (9 randomized controlled trials, 3 cohort studies, and 3 retrospective studies) involving 2 542 patients were included. The result of meta-analysis suggested that there was statistical difference in postoperative compensatory hyperhidrosis (OR=4.88, 95% CI 1.88 to 12.68,P=0.001) between T2 sympathectomy and T3 sympathectom. Compared with T2-4 sympathectomy patients, the risk of postoperative compensatory hyperhidrosis in T2-4 sympathectomy group was significantly lower (OR=5.13, 95% CI 2.91 to 9.02,P<0.000 01). Compared with T3 sympathectomy group, the risk of postoperative compensatory hyperhidrosis and hand dry in the T4 sympathectomy group was significantly lower (OR=2.91, 95% CI 2.06 to 4.12,P<0.000 01;OR=14.60, 95% CI 3.06 to 69.63,P=0.000 8), respectively. Conclusion The rate of postoperative compensatory hyperhidrosis or hand dry is lower on T4 sympathectomy patients and supposed to be the best segment for the treatment of palmar hyperhidrosis patients.
Objective To evaluate the effect of remote ischemic perconditioning on inflammation and oxidative stress in patients undergoing cardiac valve replacement with cardiopulmonary bypass (CPB). Methods Sixty adult patients undergowent cardiac valve replacement under CPB. There were 29 males and 31 females with an age ranging from 40–60 years and weight from 45–70 kg. They were randomly divided into 2 groups (n=30 in each) by random number generator: a control group (group C, 14 males and 16 females) and a remote ischemic perconditioning group (group R, 15 males and 15 females). Anesthesia was induced with intravenous injection of midazolam, fentanyl, vecuronium. The patients were mechanically ventilated after endotracheal intubation. Anesthesia was maintained with intravenous injection of midazolam, fentanyl, vecuronium and inhalation of sevoflurane. Three cycles of 5-min ischemia and 5-min reperfusion were performed on the right lower extremity immediately after aortic occlusion by means of a tourniquet in group R. A tourniquet was only placed under the right lower extremity in group C. Before CPB and at 0, 1, 6 and 24 h after termination of CPB (T0-4), blood samples were obtained from the right internal jugular vein for determination of levels of serum IL-6, IL-10, SOD and MDA and the count of white blood cell and the percentage of monocytes. The bladder temperature was measured at T0-4 and SIRS score was evaluated on preoperative 1 d and postperative 1, 2 and 3 d. Tracheal extubation time and length of ICU stay were record. Results Compared with group C, the concentration of serum IL-6 at T1-3, the concentration of MDA at T1, the count of leukocyte T3, the bladder temperature at T4 and the SIRS scores on postperative 1 d were significantly decreased, while the concentration of serum IL-10 at T2-T3, the SOD activity at T1-T2, and the percentage of monocyte at T3-T4 were significantly increased in group R (P<0.05). Tracheal extubation time and length of ICU stay in group R were significantly shorter than those of group C (P<0.05). Conclusion Remote ischemic perconditioning can reduce inflammation and oxidative stress and improve post-operative recovery in patients undergoing cardiac valve replacement with CPB.