RÉSUMÉ
Objective:To analyze the effect of ultrasound-guided stellate ganglion block combined with dexmedetomidine on Narcotrend index and pain degree after hip replacement.Methods:Seventy patients who underwent hip replacement in the Third People′s Hospital of Dalian City from January 2018 to June 2019 were selected. The patients were divided into control group and experimental group by random digits table with 35 cases in each group. Before induction of anesthesia, the patients in control group were given dexmedetomidine 0.25 μg/(kg·h) venous pump injection; the patients in experimental group were anesthetized by ultrasound-guided stellate ganglion block combined with dexmedetomidine 0.25 μg/(kg·h). The anesthesia recovery, Narcotrend index pain degree and adverse reaction were compared between 2 groups.Results:The postoperative finger-pointing-nose time, spontaneous breath recovery time, head up time and eye opening time in experimental group were significantly shorter than those in control group: (17.78 ± 2.33) min vs. (22.07 ± 2.59) min, (2.50 ± 0.51) min vs. (3.61 ± 0.58) min, (12.01 ± 1.33) min vs. (18.01 ± 2.05) min and (7.35 ± 1.18) min vs. (9.53 ± 1.46) min, and there were statistical differences ( P<0.01). There was no statistical difference in the Narcotrend index at the time of going into the operating room between 2 groups ( P>0.05); the Narcotrend index at the time of intubation, 5 min after intubation and 10 minutes before conclusion of the surgical procedure in experimental group was significantly higher than that in control group (95.15 ± 3.66 vs. 89.77 ± 4.39, 90.36 ± 3.71 vs. 86.44 ± 4.28 and 88.50 ± 4.06 vs. 82.22 ± 4.17), and there was statistical difference ( P<0.01). The static and dynamic visual analogue score 4, 8, 12, 24 and 48 h after operation in experimental group was significantly lower than that in control group, and there was statistical difference ( P<0.01). No adverse reaction associated with ultrasound-guided stellate ganglion block was observed in the experimental group. Conclusions:Ultrasound-guided stellate ganglion block combined with dexmedetomidine has a significant anesthetic effect in hip replacement patients, which can promote postoperative recovery, as well as improve Narcotrend index and pain level.
RÉSUMÉ
Objective More early esophageal cancers are treated by endoscopy.However,whether submucosal patients are suitahle for endoscopic treatment is still controversial,and few domestic researches were conducted in this area.The present study investigated the impact of submucosal invasion depth on lymph node metastasis.Methods A total of 258 patients who underwent esophagectomy from November 2009 to March 2014 were studied.Submucosal invasion was equally categorized into inner one-third(sml),middle one-third(sm2),and deep one-third(sm3) invasion by pathologists.Demographics of patients,tumor characteristics,and surgical information were retrospectively collected through medical records.They were compared according to different submucosal invasions.Cancer characteristics and its association with LNM were analyzed by univariate and multivariate analysis.Results The study included 75 sml (29.1％),73 sm2(28.3％),and 110 sm3(42.6％) patients,and the rates of LNM were 12.0％ (9/75),11.0％ (8/73),20.9％ (23/110),respectively.sm3 might be associated with regional LN M (univariate analysis,P =0.041).Tumor volume ＞ 1.856 cm3 (P =0.022) and lymphovascular invasion (P =0.004) predicted LNM using multivariate analysis.Conclusion Submucosal ESCC showed a substantial rate of LNM and it seems that they are not suitable for endoscopic treatment.Depth of invasion was not an independent risk factor for LNM.
RÉSUMÉ
Objective To detect the effect of a new bioactive bone screws composed of nanohydroxyapatite/polyamid 66/glass fiber (n-HA/PA66/GF) biomaterial on biological behavior of osteoblasts with a view to a later clinical application of the screws.Methods Mice osteoblasts were co-cultured with n-HA/PA66/GF biomaterial or its extract.Cell growth was detected under a microscope,cell proliferation using MTT assay,apoptosis by flow cytometry,osteocalcin by ELISA method,cell migration using Transwell invasion assay,cell adhesion and growth by scanning electron microscope,and cytoskeleton and actin filament distribution using immunofluorescene.Results Direct contact test demonstrated n-HA/PA66/GF material had no obvious cytotoxicity to osteoblasts.Extract of n-HA/PA66/GF material stimulated osteoblast proliferative activity over time with absorbance value of 0.96 ± 0.14,1.54 ± 0.15,and 2.39 ±0.27 respectively after 2,4,and 6 hours of coculture (P ＜ 0.05).The n-HA/PA66/GF material induced more osteoblasts to entering S period without obvious influence on apoptosis rate and promoted osteocalcin secretion.Migrated cells in medium supplied with n-HA/PA66/GF material or FBS was 8.73 ± 3.26 and 9.47 ± 3.29 in each visual field,but there was no significant difference (P ＞ 0.05).Osteoblasts had a regular form on the surface of n-HA/PA66/GF material,closely adhered to the surface,and reproduced and aggregated with each other to form stratified cell layers.However,nHA/PA66/GF material exhibited no obvious influence on distribution of cytoskeleton and actin filament.Conclusion The new n-HA/PA66/GF screws has excellent cytocompatibility with positive regulatory effect on cell growth,proliferation,secretion,adhesion,cycle,and osteocalcin secretion.