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Objective To evaluate the effect of different techniques of hepatic artery reconstruction on postoperative hepatic artery complications and clinical prognosis in liver transplantation. Methods Clinical data of 140 liver transplant recipients were retrospectively analyzed. All recipients were divided into the conventional hepatic artery reconstruction group (n=123) and special hepatic artery reconstruction group (n=17) according to hepatic artery reconstruction methods. Intraoperative and postoperative clinical indexes, the incidence of postoperative hepatic artery complications and survival rate were compared between two groups. Results The alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels at postoperative 1 d, total bilirubin (TB) at postoperative 7 d and prothrombin time international normalized ratio (PT-INR) at postoperative 30 d in special hepatic artery reconstruction group were higher than those in conventional hepatic artery reconstruction group, and the differences were statistically significant (all P < 0.05). There were no significant differences in the operation time, anhepatic phase, intraoperative blood loss, intraoperative transfusion volume of red blood cells, cold or warm ischemia time, the length of intensive care unit (ICU) stay, the length of hospital stay and postoperative blood flow of liver allograft between two groups (all P > 0.05). In the conventional hepatic artery reconstruction group, 5 recipients developed hepatic artery complications, whereas no hepatic artery complications occurred in the special hepatic artery reconstruction group, with no significant difference between two groups (P > 0.05). In the special hepatic artery reconstruction group, the 1-, 3- and 5-year cumulative survival rates were equally 82.4%, compared with 85.0%, 78.9% and 75.6% in the conventional hepatic artery reconstruction group, respectively. There was no significant difference between two groups (all P > 0.05). Conclusions When hepatic artery variations and (or) lesions are detected in donors and recipients, use of special hepatic artery reconstruction may effectively restore the hepatic arterial blood flow of liver allograft after liver transplantation, and will not affect the incidence of hepatic artery complications and survival rate of the recipients following liver transplantation.
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Objective To determine the median effective concentration (EC50) of remifentanil inhibiting responses to tracheal extubation in patients of Uygur nationality.Methods The patients of Uygur nationality,aged 18-60 yr,of ASA physical status Ⅰ or [Ⅱ,scheduled for elective surgery,were enrolled in this study.After the end of surgery,remifentanil was given by target-controlled infusion until tracheal extubation.The initial target plasma concentration (Cp) of remifentanil was 2.0 ng/ml.The response was defined as positive when MAP and/or HR increased by ＞ 15％ of the level at the end of operation and the duration ＞ 15 s during extubation.Each time the target Cp increased/decreased if the cardiovascular response was positive or negative.The ratio between the two successive concentrations was 1.1.The EC50 and 95 ％ confidence interval of remifentanil blunting responses to extubation was calculated by Probit method.Results Twenty-eight patients completed the study.The EC50 and 95 ％ confidence interval of remifentanil required for inhibiting the responses to extubation was 1.75 ng/ml and 1.45-2.01 ng/ml.Conclusion The EC50 of remifentanil inhibiting the responses to tracheal extubation is 1.75 ng/ ml in patients of Uygur nationality.
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Objective To determine the median effective target effect-site concentration (EC50) of sufentanil inhibiting cardiovascular response to tracheal intubation when combined with propofol in patients of Uygur nationality.Methods Thirty-one ASA Ⅰ or Ⅱ Uighurs of both sexes,aged 21-59 yr,with body mass index 18-28 kg/m2,undergoing elective surgery,were enrolled in this study.Anesthesia was induced and maintained with propofol and sufentanil target-controlled infusion and iv injection of cisatracurium 0.2 mg/kg.The target effect-site concentration (Ce) of propofol was set at 3.0 μg/ml.Tracheal intubation was performed after the target Ce and plasma concentrations were balanced.The target Ce was set at 0.8 ng/ml in the first patient.Each time Ce increased/decreased by 10％ in the next patient depending on whether or not the cardiovascular response to tracheal intubation occurred.The positive cardiovascular response was defined as increase in systolic blood pressure by 15％ and/or HR＞ 90 bpm lasting for ＞ 15 s.The EC50(95％ confidence interval) of sufentanil blunting cardiovascular responses to trancheal intubation was calculated by Probit analysis.Results EC50 (95 ％ confidence interval) of sufentanil inhibiting cardiovascular response to tracheal intubation when combined with 3.0 μg/ml propofol was 0.46 (0.43-0.49) ng/ml.Conclusion EC50 of sufentanil inhibiting cardiovascular response to tracheal intubation is 0.46 ng/ml in patients of Uygur nationality when combined with propofol.
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Objective To observe effect of aerobic exercise combined with inhalation of tiotropium on patients with stable chronic obstructive pulmonary disease (COPD) complicated with pulmonary hypertension.Methods A total of 98 patients with stable COPD and grade Ⅱ or Ⅲ pulmonary function complicated with pulmonary hypertension were recruited.They were divided into an observation group (n =31) and two control groups (n =30 and 37).Patients in control group 1 inhaled shahmette and fluticasone powder,and antibiotics as well as apophlegmatisant were also used in accordance with the demands of the patient's condition.Patients of in control group 2 inhaled tiotropium dry powder and accepted other therapeutic measures equivalent to those of control group1.The patients in the observation group were given aerobic exercise in addition to other therapeutic measures equivalent to those of control group 2.Six-minute walk test distances,pulmonary arterial systolic pressure and chronic obstructive pulmonary disease assessment test scores were compared after 6 months of treatment,among the groups and against the baseline values before treatment.Results After 6 months of treatment the average 6-minute walk distance,chronic obstructive pulmonary disease assessment score and pulmonary arterial systolic pressure of the observation group were all significantly better than for either of the control groups.Conclusions Inhaling tiotropium dry powder combined with aerobic exercise can reduce pulmonary artery systolic pressure and improve the symptoms as well as the quality of life for patients with stable COPD complicated by pulmonary hypertension.
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Objective:To evaluate the clinical effects of clindamycin injection on respiratory tract infections. Methods:Clindamycin injection was used in 50 respiratary tract infections patients aged over 18 years by intravenous drip with a dosage of 1.2 g once a day for a consecutive of 10 days. The symptoms and signs of the patients were observed, and the laboratory tests made. Results: The numbers of patients who were cured, remarkably improved, improved and without any improvement were 25, 19, 5 and 1, respectively. The total effectiveness rate was 98.0%. Conclusion: Clindamycin injection is significantly effective for treating the mild to moderate respiratory tract infections, especially for those caused by haemolytic streptococcus, streptococcus pneumoniae and lamellar bacillus. It has very little and mild side effects and is suitable for those allergic to penicillin.