Comparison of intravenous butorphanol vs. tramadol for post-spinal anesthesia shivering: a meta-analysis and systematic review.

Background: Patients often experience shivering after spinal anesthesia. In recent years, more and more studies have compared the efficacy and side effects of intravenous butorphanol and tramadol in the treatment of shivering after spinal anesthesia. Therefore, we conducted a MATE analysis and systematic review to compare the efficacy and side effects of butorphanol vs. tramadol in the treatment of shivering after spinal anesthesia. Methods: PubMed, Cochrane Library, and Embase databases were searched for randomized controlled trials (RCTs) from inception to 30 December 2022, comparing the effects of butorphanol vs. tramadol for the control of shivering after spinal anesthesia. Data assessment and collection were analyzed using the Review Manager 5.4 software. Results: Five randomized controlled trials involving 302 adult patients were included in this meta-analysis. The results showed that butorphanol has a shorter time to cease shivering (standardized mean difference (SMD) = -0.53; 95% confidence interval (CI) [-0.89, -0.17], P = 0.004, I2 = 0%), a higher rate of cessation of shivering within 1 min after administering the study drugs (relative risk (RR), 1.69; 95% CI [1.15,2.48], P = 0.008, I2 = 0%), and higher incidences of sedation (RR, 2.98; 95% CI [2.11, 4.21], P <0.00001, I2 = 0%), compared with tramadol. Conclusion: In the treatment of shivering after spinal anesthesia, butorphanol has a shorter onset time and a higher rate of cessation of shivering within 1 min after the study drugs were administered than tramadol. Therefore, butorphanol is superior to tramadol in the treatment of shivering after spinal anesthesia.

[Diagnosis and treatment of prostatic abscess: Report of 11 cases and review of the literature].

OBJECTIVE: To analyze the clinical features, imaging characteristics, treatment options and prognosis of prostatic abscess (PA), and provide some new ideas for the diagnosis and treatment of the disease. METHODS: This retrospective study included 11 cases of confirmed PA treated in the Fifth Medical Center of PLA General Hospital. We analyzed the clinical data obtained from the electronic medical records, including basic demographic statistics, risk factors, clinical symptoms, laboratory results, imaging findings, treatment methods, treatment-related complications and outcomes. RESULTS: The 11 patients diagnosed with PA between May 2016 and August 2022 were aged (64.18 ± 7.19) years and all had at least 1 comorbidity, including 5 cases of diabetes mellitus (45.5%) and 8 cases of dysuria (72.8%). PA was confirmed in 3 cases by CT and in 8 cases by MRI, 6 (54.5%) multifocal and 10 (90.9%) >2 cm in diameter, with a median size of 3.84 cm. After admission, positive urine culture was found in 3 cases, positive blood culture in 1, Klebsiella pneumoniae in 2 and Enterococcus Faecalis in 1. Three of the patients were treated by intravenous administration of antibiotics alone, and the other 8 by transurethral PA unroofing in addition. Antibiotics medication lasted for a median of (12.9 ± 3.88) d and hospital stay averaged (19.18 ± 8.20) d. The patients were followed up for 3 months, which revealed the presence of PA in 2 of the cases treated with antibiotics alone, but not in any of the cases treated by surgery. CONCLUSION: PA is relatively rare and has no specific symptoms clinically. Imaging examination is very important for accurate diagnosis, and transurethral PA unroofing plus antibiotics administration could be considered as an optimal management of the disease.

Clinical application and accuracy analysis of 3D printing guide plate based on polylactic acid in mandible reconstruction with fibula flap.

BACKGROUND: Due to the special anatomy morphology and physiological function of the mandible, it has always become a challenge to accurately reconstruct the mandibular defect in maxillofacial surgery. Digital three dimensions (3D) printing surgical guide, as the effective method for individual and accurate surgery, is a hotspot of clinical research at present. In this study, 3D printing PLA surgical guide plate was applied to reconstruct the mandibular defect with fibula flap, its clinical effect and accuracy were evaluated, which aimed to improve the accurate reconstruction of mandibular defects. METHODS: After sterilization, the dimension deformation of the PLA standard specimen were measured. Eighteen patients diagnose with mandibular tumor were collected as observation objects. Then partial mandible resection and simultaneous mandible reconstruction with fibula graft were implemented according to the computer-aided design plan. The clinical effects of 3D printing PLA guide plates application were evaluated by facial contours, occlusal stability and chewing function. Through registering the postoperative computed images reconstruction with preoperative designed shape, the reconstruction accuracy was evaluated by detecting the maximum difference including the distance between lateral convex point of the condyles, the distance between medial convex point of the condyles and the horizontal contained angle between long axis of the condyles. RESULTS: After high temperature steam sterilization, the curvature of the PLA specimen with 100% filling rate and 4.8 mm thickness were the smallest and their dimension deformation had no statistical significance (P>0.05). The minimally deformed 3D printing PLA guide plate were smoothly placed in the right place during the operation. After surgery, the face was symmetrical, the occlusal relationship was restored well and no deviation of the mandibular movement were found. The spiral computed tomography (SCT) scanning showed that the distance between lateral/medial convex points of the condyle and the horizontal contained angle were 128.34±8.68 mm, 88.69±6.75 mm and 145.87°±12.01°. Compared with preoperative design, the maximum deviation of the actual postoperative registration was 1.67±0.63, and the difference was not statistically significant (P>0.05). CONCLUSIONS: The application of 3D printing PLA guide plate in the segmental section and reconstruction of the mandible can effectively simplify the operation, and better reconstruct the continuity of the mandible. The surgical accuracy can fully meet clinical needs with relatively low prices.

An early experience of the robot-assisted laparoscopic nephroureterectomy without re-docking in a single position.

OBJECTIVE: This study aims to evaluate the execution of robot-assisted laparoscopic nephroureterectomy without repositioning the patient. METHODS: The clinical data of 9 patients who underwent robot-assisted laparoscopic nephroureterectomy between May 2017 and November 2018 were analyzed, proceeding in a single position, without repositioning the patient. This involved 5 men and 4 women, with an average age of 61.67 ± 10.37 years and an average body mass index (BMI) of 24.78 ± 3.84. We considered the duration of the intervention, the blood loss, the duration of the hospital stay, the duration of maintenance of the drainage and the follow-up on all patients, with or without complications and recurrence of the tumor. RESULTS: The intervention was completed in all 9 cases. The average duration of the intervention was 242.89 ± 13.37 minutes, the average blood loss was 166.67 ± 70.71 ml, the average hospitalization time was 2 ± 0.71 days, the average time drainage maintenance was 5.11 ± 1.05 days and the average follow-up times without complications and tumor recurrence were 12.56 ± 6.19 months. CONCLUSION: Robot-assisted laparoscopic nephroureterectomy without repositioning the patient during the procedure simplifies the procedure and shortens the duration of the procedure. It is also a safe, effective and feasible minimally invasive treatment method. KEY WORDS: Nephroureterectomy, Robot-assisted laparoscopic, Tumor recurrence, Single position, Upper tract urothelial carcinoma.

Biological roles of filamin a in prostate cancer cells

ABSTRACT Objective This study aims to investigate the association of filamin A with the function and morphology of prostate cancer (PCa) cells, and explore the role of filamin A in the development of PCa, in order to analyze its significance in the evolvement of PCa. Materials and Methods A stably transfected cell line, in which filamin A expression was suppressed by RNA interference, was first established. Then, the effects of the suppression of filamin A gene expression on the biological characteristics of human PCa LNCaP cells were observed through cell morphology, in vitro cell growth curve, soft agar cloning assay, and scratch test. Results A cell line model with a low expression of filamin A was successfully constructed on the basis of LNCaP cells. The morphology of cells transfected with plasmid pSilencer-filamin A was the following: Cells were loosely arranged, had less connection with each other, had fewer tentacles, and presented a fibrous look. The growth rate of LNCap cells was faster than cells transfected with plasmid pSilencer-filamin A (P <0.05). The clones of LNCap cells in the soft agar cloning assay was significantly fewer than that of cells stably transfected with plasmid pSilencer-filamin A (P <0.05). Cells stably transfected with plasmid pSilencer-filamin A presented with a stronger healing and migration ability compared to LNCap cells (healing rate was 32.2% and 12.1%, respectively; P <0.05). Conclusion The expression of the filamin A gene inhibited the malignant development of LNCap cells. Therefore, the filamin A gene may be a tumor suppressor gene.

Biological roles of filamin a in prostate cancer cells.

OBJECTIVE: This study aims to investigate the association of filamin A with the function and morphology of prostate cancer (PCa) cells, and explore the role of filamin A in the development of PCa, in order to analyze its significance in the evolvement of PCa. MATERIALS AND METHODS: A stably transfected cell line, in which filamin A expression was suppressed by RNA interference, was first established. Then, the effects of the suppression of filamin A gene expression on the biological characteristics of human PCa LNCaP cells were observed through cell morphology, in vitro cell growth curve, soft agar cloning assay, and scratch test. RESULTS: A cell line model with a low expression of filamin A was successfully constructed on the basis of LNCaP cells. The morphology of cells transfected with plasmid pSilencer-filamin A was the following: Cells were loosely arranged, had less connection with each other, had fewer tentacles, and presented a fibrous look. The growth rate of LNCap cells was faster than cells transfected with plasmid pSilencer-filamin A (P<0.05). The clones of LNCap cells in the soft agar cloning assay was significantly fewer than that of cells stably transfected with plasmid pSilencer-filamin A (P<0.05). Cells stably transfected with plasmid pSilencer-filamin A presented with a stronger healing and migration ability compared to LNCap cells (healing rate was 32.2% and 12.1%, respectively; P<0.05). CONCLUSION: The expression of the filamin A gene inhibited the malignant development of LNCap cells. Therefore, the filamin A gene may be a tumor suppressor gene.

Controllable Optical Bistability and Four-Wave Mixing in a Photonic-Molecule Optomechanics.

We theoretically investigate the nonlinear optical phenomena including optical bistability and four-wave mixing (FWM) process in a composite photonic-molecule cavity optomechanical system. The photonic-molecule cavity consisted of two whispering gallery mode (WGM) microcavities, where one WGM cavity is an optomechanical cavity with high-cavity dissipation κ and the other WGM cavity is an auxiliary ordinary optical cavity with high-quality factor (Q). Controlling the parameters of the system, such as the coupling strength J between the two cavities, the decay rate ratio δ of the two cavities, and the pump power P, the optical bistability can be controlled. Furthermore, the FWM process which presents the normal mode-splitting is also investigated in the FWM spectrum under different parameter regimes. Our study may provide a further insight of nonlinear phenomena in the composite photonic-molecule optomechanic systems.

Physical mechanism of order between electric and magnetic dipoles in spoof plasmonic structures.

It has been recently shown that a solid-textured metal cylinder can support electric and magnetic dipolar resonances simultaneously [Phys. Rev. X4, 021003 (2014)PRXHAE2160-330810.1103/PhysRevX.4.021003] which are almost degenerate in a two-dimensional (2-D) structure and non-degenerate in a three-dimensional (3-D) structure, and with the magnetic dipole appearing at higher frequency. They are described as spoof localized plasmonic modes analogous to localized plasmonic resonances in optical frequencies. Here, we consider a hollow metal cylinder corrugated by periodic cut-through slits. Our results indicate that the magnetic dipole can be separated from the electric dipole in a 2-D structure, and magnetic dipolar resonance appears at lower frequency, rather than electric resonance in both 2-D and 3-D structures. In order to clarify the physical mechanism behind the abnormal phenomenon, we study the influence of the core material on the electric- and magnetic-dipole modes based on theoretical analysis and numerical simulation. It is discovered that there is a threshold of an imaginary part of permittivity for switching the order between electric and magnetic dipoles. These results may provide fundamental understanding and physical insight for spoof plasmonic modes supported in designer structures.

Clinical characteristics and electroencephalogram analysis of levetiracetam in the treatment of children with febrile seizure recurrence.

Febrile seizure is the most common neurologic disorder in infants and children. This study aimed to elaborate safe and effective therapy for preventing FS recurrence by levetiracetam (LEV). A prospective study was performed in two groups of children, the no treatment group (n=51, 24.1±9.0 months) and the LEV treatment group (n=45, 23.3±8.9 months). The findings demonstrated that a significant difference (P<0.01) was observed between the no treatment group 51.0% (26/51) and LEV treatment group 15.5% (7/45) in terms of FS recurrence after 50 weeks. FS recurrence/fever episode was 12.4% (12/97) in the LEV treatment group and 51.8% (57/110) in the no treatment group. Furthermore, LEV administration significantly improved (P<0.001) epileptiform + nonspecific EEG abnormalities (17.8%; 8/45), as compared with the no treatment group (68.6%; 35/51). In conclusion, LEV could function as an effective therapeutic agent for the prevention of FS recurrence and reducing the frequency of fever episodes. Furthermore, LEV administration significantly improved nonspecific EEG abnormalities, which may be used as a clinical monitoring index for LEV treatment in patients with FS.

Experience of treating high risk prostate hyperplasia patients with a HPS120 laser.

BACKGROUND: The aim of this study was to investigate the effects and safety of 120 watt PVP surgery for the high risk prostate hyperplasia patients. METHODS: 120 watt PVP surgery was performed on 120 cases of high risk prostate hyperplasia patients. The assessment included the operation time, energy consumed, hemoglobin changes, and serum salt concentration, whether to keep urinary catheter, hospitalization time, and complications after the operation. International Prostate Symptom Scoring (IPSS), the maximum urine flow rate (Qmax) and residual urine volume (RUV) were conducted preoperatively and postoperatively for the patients. RESULTS: There were 30% of patients taking oral anti-coagulant drug (n = 36), 88 cases with abnormal ECGs. All the patient's internal diseases, include the cardiovascular disease (42/120), the hypertension (56/120), the respiratory system diseases (51/120), the cerebrovascular diseases (39/120), anemia (24/120), liver or kidney dysfunction (16/120), diabetes (18/120), hypoproteinemia (15/120) were under controlled. The average age, prostate volume and energy consumed was 82.8 ± 8.6 (70-96) years, 66.1 ± 25.3 (30-160) ml, and 224 ± 85 (31-596) kJ respectively. The average follow-up time was 20.8 ± 3.2 (18-24) months. The incidence of bladder neck contracture and urethral stricture were 1.7% and 0.8% respectively, no prostate cancer occurred during the subsequent follow-up period. CONCLUSIONS: 120 watt PVP surgery can safely and effectively alleviate the urination parameters of high risk prostate hyperplasia patients. The surgical process is safe and effective, and is not affected by the various internal diseases or the use of oral anti-coagulant drugs.

[The recent clinical efficacy study of photoselective vaporization of prostate (120 W) for treatment of large gland benign prostatic hyperplasia].

OBJECTIVE: To explore the recent clinical safety and efficacy of photoselective vaporization of prostate (120 W) for the treatment of large gland benign prostatic hyperplasia. METHODS: The clinical data of 112 cases who accepted photoselective vaporization of prostate (120 W) for the treatment of severe benign prostatic hyperplasia (the weight of prostate > 75 g) from July 2010 to January 2012 was statistical analyzed. Relief symptoms and complications were observed around surgery, and the recent clinical efficacy was analyzed. RESULTS: All the operations were smooth. There were not transurethral resection syndrome. No cases need transfusion intraoperative and postoperative. The operation average time was (52.6 ± 12.1) minutes, and the average amount of bleeding was (27.4 ± 18.5) ml. The postoperative bladder irrigating time was (19.4 ± 7.3) hours, the mean postoperative indwelling catheter time was (3.2 ± 0.6) days, and the mean postoperative hospital stay was (4.8 ± 1.3) days. Postoperative international prostate symptom score (t = 52.24 - 59.10), quality of life (t = 48.42 - 53.63), maximum flow rate (t = -31.01 - -24.23) and residual urine volume (t = 9.85 - 12.53) compared with preoperative are significantly improved (P < 0.01). CONCLUSIONS: With the safe operation of photoselective vaporization of prostate (120 W) for the treatment of large gland benign prostatic hyperplasia, it is less bleeding, recent efficacy is significant, and it is especially appropriate to elderly patients at high risk of large gland.

[Effect of probiotics on respiratory tract pathogen colonization in neonates undergoing mechanical ventilation].

OBJECTIVE: To study the effect of mouth-fed probiotics on pathogenic bacteria colonization of the oropharynx and lower respiratory tract in neonates undergoing mechanical ventilation. METHODS: Randomized control method was employed to divide the neonates undergoing mechanical ventilation into probiotics (n=82) and control groups (n=83). The control group received routine treatment. The probiotics group was administered with oral probiotics in addition to routine treatment. The number of pathogenic bacteria colonized on the oropharynx and lower respiratory tract, and the number of the bacterial strain of ventilator-associated pneumonia (VAP) in the two groups were examined. The timing of the bacteria colonization and VAP occurrence were also examined. RESULTS: The probiotics group presented a lower bacterial strain colonization rate of the oropharynx pathogenic bacteria than the control group (35% vs 51%; P<0.05). The colonization time of pathogenic bacteria of the oropharynx and lower respiratory tract, and the time of VAP occurrence lagged behind in the probiotics group compared with that the control group (P<0.05). No adverse reaction caused by probiotics was found. CONCLUSIONS: Probiotics administration is effective in decreasing pathogenic bacteria colonization on the oropharynx, in postponing the pathogenic bacteria colonization on the oropharynx and lower respiratory tract and in delaying the occurrence of VAP in neonates undergoing mechanical ventilation.

[Comparative study of pneumatic lithotripsy and holmium laser lithotripsy for ureteral stones].

OBJECTIVE: To compare the efficacy and safety of endoscopic laser lithotripsy (LL) and endoscopic pneumatic lithotripsy (PL) for ureteral stones. METHODS: We retrospectively analyzed the clinical data of 415 patients with ureteral calculi treated with endoscopic laser lithotripsy (n = 214 ) and pnumatic lithotripsy (n = 201 ). RESULTS: The overall successful fragmentation rate of all ureteral stones in a single session of the LL group was higher than that of the PL group (95% vs. 69%, P < 0.01). The average stonefree time of the LL group was shorter than that of the PL group (18 days vs. 31 days, P < 0.01). No complications such as perforation during the operation were observed in the LL group whereas 3 perforations occurred in the PL group. CONCLUSION: LL has its advantage over PL in its better clinical effect for the stone fragmentation and low complication rate and is an effective and safe treatment for ureteral stones.