目的:观察相同剂量不同浓度的罗哌卡因用于腰丛坐骨神经联合阻滞的临床效果。方法:择期行单侧下肢手术的患者90例,年龄18~65岁,ASAⅠ或Ⅱ级,随机分为3组(n=30):A组给予0.3 ％的罗哌卡因腰丛36 mL、坐骨神经24 mL,B组给予0.36 ％的罗哌卡因腰丛30 mL、坐骨神经24 mL,C组给予0.4％罗哌卡因腰丛27 mL、坐骨神经18 mL。分别于给药后2、5、10、15、20、25、30、35 min测定下肢的感觉、运动评分以及感觉阻滞的时间和运动阻滞的时间。结果:三组患者阻滞起效时间无明显差别,高容量组完全阻滞的持续时间短于低容量组;高容量低浓度组患者完全阻滞率高于低容量组,但达到完全阻滞时间长于低容量组。结论:在剂量相同时罗哌卡因的浓度和容量会影响腰丛和坐骨神经的阻滞 效果;高容量罗哌卡因更有利于达到良好的感觉阻滞。
目的:探讨全直肠系膜切除术(total mesorectal excision,TME)结合双吻合器(DST)治疗低位直肠癌的效果及临床价值。方法:对我院85 例低位直肠癌患者采用 TME和DST联合治疗的方法,观察治疗后的排便功能及疗效.结果:所有患者手术均顺利,无吻合口瘘和狭窄,切割环均完整,无手术闭合失败及手术死亡。随访时间6 个月～5年,局部复发率4例(4.7%)。排便控制功能:优75 例(88.2%),良9 例(10.6%),差1 例(1.2%)。结论:TME和 DST联用治疗低位直肠癌,保肛效果满意,并发症少,提高了患者的生存质量,值得临床推广。
ObjectivesTo systematically review the efficacy and safety of hydrotalcite in the treatment of reflux esophagitis (RE).MethodsCBM, CNKI, WanFang Data, VIP, PubMed, EMbase, The Cochrane Library, Web of Science and Scopus databases were searched online to collect randomized clinical trials (RCTs) of hydrotalcite or hydrotalcite plus PPI versus PPI alone in the treatment of RE from inception to June 30th, 2017. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Meta-analysis was performed by RevMan 5.3 software.ResultsA total of 15 RCTs involving 1 655 patients were included. The results of meta-analysis showed that: after 4-8 weeks of treatment, there was no significant difference between hydrotalcite vs. PPI regarding RE healing rates (RR=0.87, 95%CI 0.76 to 1.00, P=0.05). However, there were significant increases in RE healing rate (RR=1.22, 95%CI 1.14 to 1.31, P<0.001) and symptom relief rate (RR=1.36, 95%CI 1.12 to 1.66,P<0.01) between hydrotalcite plus PPIvs. PPI alone. Similar increases of RE healing rate (RR=1.16, 95%CI 1.08 to 1.25, P<0.001) and symptom relief rate (RR=1.12, 95%CI 1.04 to 1.20,P<0.01) were seen in patients with refractory RE. No increase of adverse effect rate was shown with hydrotalcite or hydrotalcite plus PPI compared to PPI alone.ConclusionsCompared with PPI alone, hydrotalcite plus PPI confers a statistically significant improvement of healing rate and symptom relief rate, while it does not increase adverse effect rate. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusions.
Object ive To summa r i z e the advanc ement of cytoske l e ton and axon outgrowth of neuron. Methods The recent l iterature concerning cytoskeleton and axon outgrowth of neuron was reviewed and summarized. Results The actin filaments and microtubules in neuron were highly polarized and dynamic structures confined to the ti ps of axons and the reci procal interactions between these two major cytoskeletal polymers was also dynamic. Attractive or a repulsive cue whose final common path of action was the growth cone cytoskeleton mediated the growth of axons of neuron by intracellular signaling cascades. Regulating the actin filament and microtubule dynamics as well as their interactions in growth cones played a key role in neurite outgrowth and axon guidance. Rho-GTPases and glycogen synthase kinase 3β (GSK-3β), the two major intracellular signal ing pathways had emerged in recent years as candidates for regulating the dynamics of actin filaments and microtubules. Conclusion The axon outgrowth and guidance depend on well-coordinated cytoskeletal and reciprocal interaction dynamics which also mediate axon regeneration after spinal cord injury. Regulating activity of Rho-GTPases and GSK- 3β simultaneously may acts as key role to regulate the dynamics of cytoskeletal and to determine axon outgrowth.