Search

Objective: To investigate the effect of preoperative ultrasound-guided quadratus lumborum block (QLB) combined with general anesthesia on serum stress response and pain related indexes in patients with renal transplantation. Methods: 82 patients undergoing renal transplantation in our hospital from September 2019 to August 2021 were selected as the observation objects. According to the random number table method, they were divided into group A and group B, 41 cases respectively. Group A was given general anesthesia, and group B was given preoperative ultrasound-guided QLB combined general anesthesia. The resting visual pain simulation (VAS) score, the dosage of sufentanil in patient-controlled intravenous analgesia, the number of effective compressions were compared between the two groups, the changes of serum stress response and pain related indexes were compared between the two groups, and the incidence of adverse reactions were compared between the two groups. Results: The resting VAS scores at 6 h, 12 h, 24 h and 48 h after operation in group B were lower than those in group A(P<0.05). The dosage of sufentanil in patient-controlled intravenous analgesia in group B was less than that in group A, and the number of effective compressions was less than that in group A (P<0.05). Blood glucose (Glu) and cortisol (Cor) in group B after extubation and 24 h after operation were lower than those in group A (P<0.05). Substance P (SP), prostaglandin E2 (PGE2) and serotonin (5-HT) increased 24 h after operation in the two groups, but group B was lower than group A (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P<0.05). Conclusion: Preoperative ultrasound-guided QLB combined with general anesthesia for patients with renal transplantation can effectively reduce pain and stress response, reduce the dosage of sufentanil in patient-controlled intravenous analgesia and the number of effective compressions, and do not increase the incidence of adverse reactions. [ABSTRACT FROM AUTHOR]

This study explored the value of MRI texture analysis in the preoperative T staging diagnosis of rectal cancer and its relationship with the degree of tumor differentiation. Seventy-two patients with rectal cancer were selected as the research objects, and MRI texture analysis was performed. The results showed that the mean value of MRI texture parameters, contrast, autocorrelation, entropy, variance, and preoperative T staging of rectal cancer were all influencing factors. The preoperative T staging AUC of each parameter in the combined diagnosis of rectal cancer was 0.951, which was significantly higher than that of a single parameter. The MRI texture parameters of patients with different tumor differentiation levels are significantly different. The mean, autocorrelation, entropy, variance and the tumor differentiation are negatively correlated, and the contrast is positively correlated with the tumor differentiation (P<0.05). The mean value of MRI texture parameters, contrast, autocorrelation, entropy, and variance are the influencing factors of preoperative T stage of rectal cancer, which can be used for the diagnosis of T stage and are related to the degree of tumor differentiation. [ABSTRACT FROM AUTHOR]

Objective To investigate the reasonable treatment effect of perioperative hydrocephalus in patients with posterior fossa tumor. Methods The clinical data of 241 patients who underwent resection of posterior fossa tumors were analyzed retrospectively, of which 14 patients were excluded because of postoperative complications with other systemic infections. The patients with posterior fossa tumor complicated with hydrocephalus were divided into preoperative lumbar cistern drainage 1（ PLCFD1） group（ 22 cases） and no preoperative lumbar cistern drainage 1（ NPLCFD1） group（ 45 cases）. 227 patients with posterior fossa tumors were divided into preoperative lumbar cistern drainage 2（ PLCFD2） group（ 43 cases） and no preoperative lumbar cistern drainage 2（ NPLCFD2） group（ 184 cases）. The clinical data of the two groups were compared and analyzed. Results In this group,67 patients with posterior cranial fossa tumor complicated with hydrocephalus, and the remission rate of hydrocephalus was 94. 0%.The remission rate of early postoperative hydrocephalus in PLCFD1 group（ 86. 4%） was significantly higher than that in NPLCFD1 group（ 62. 2%）（ P = 0. 043）. The postoperative intracranial infection rate in PLCFD2 group（ 23. 3%）was significantly lower than that in NPLCFD2 group（ 41. 3%）（ P = 0. 028）. There was no significant difference in antibiotic use time between PLCFD2 group[14（ 10. 75-20. 50） d]and NPLCFD2 group [17（ 13. 25-22. 75） d]（ P = 0. 134). Conclusions Surgical treatment of hydrocephalus is not recommended in patients with posterior cranial fossa tumors complicated with hydrocephalus, except for obvious acute intracranial hypertension and ineffective drug treatment; In the patients with subtotal resection or above, only a small number of patients with hydrocephalus need further surgical treatment. Proper lumbar cistern drainage during and after operation can promote the early clearance of inflammatory and bloody cerebrospinal fluid in patients with posterior fossa tumor complicated with hydrocephalus after tumor resection, so as to reduce the incidence of postoperative hydrocephalus and reduce the incidence of intracranial infection after posterior fossa tumor resection. [ABSTRACT FROM AUTHOR]

Copyright of West China Journal of Stomatology is the property of Sichuan University, West China College of Stomatology and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective To evaluate the application value of head CT angiography for preoperative evaluation of patients with skull base meningioma. Methods The clinical data of 28 patients with skull base meningioma were analyzed retrospectively. To learn the relationship between tumor and blood vessels, preoperative head CTA examination was taken. The appropriate surgical resection was taken to protect the blood vessels. Results Preoperative head CTA showed the size of the tumor, the base, and the source of blood supply. It showed the third-level structure of the intracranial artery. It clearly showed the three-dimensional image relationship of tumors, blood vessels, and skulls, and can distinguish between tumors and nearby blood vessels. The results of the operation showed that 8 cases of Simon II stage resection, 16 of III stage resection, and 4 of IV stage resection. No cerebral infarction, no vascular damage after operation. Karnofsky scored 17.5 points higher than the preoperative average, followed up 6 to 36 months. 25 patients had no recurrence, and 3 had residual tumor growth recurrence. Conclusion The preoperative CTA can distinguish the relationship between the skull base tumor and the adjacent blood vessel, which is beneficial to the protection of blood vessels, and provides intuitive information for the operation of skull base meningioma. [ABSTRACT FROM AUTHOR]

Objective: To investigate the diagnostic value of preoperative serum thyroid stimulating hormone (TSH) level combined with Doppler ultrasonography for differentiated thyroid carcinoma (DTC). Methods: 528 patients with thyroid nodules who were treated in Beijing First Hospital of Integrated Chinese and Western Medicine from January 2015 to June 2017 were selected as the subjects. 268 patients with DTC who were diagnosed by pathologically were recorded as the observation group, another 260 patients with benign thyroid nodules were recorded as the control group. The ultrasonic indexes, level of TSH in the two groups were detected and compared. The relationship between serum TSH level, lymph node metastasis and tumor diameter in the observation group was analyzed. and the diagnostic value of preoperative serum TSH combined with Doppler ultrasound in DTC was observed. Results: The number of lesions was single, the size of the lesion was small nodules, and the rate of sand like calcificationin the observation group were significantly higher than those of the control group, the differences were statistically significant (P<0.05). The proportion of patients with TSH level ranged from 2.20 to 4.20 μIU/mL and > 4.20 μIU.mL in the observation group were significantly higher than those in the control group, and the proportion of patients with TSH level ranged from<0.27 IU/mL, 0.27 to 1.44 mu IU.rnL and 1.45 to 2.19 IU/mL were significantly lower than those of the control group, the differences were statistically significant (p<0.05). The TSH level of the patients with cervical lymph node metastasis in the observation group were significantly higher than those in the non metastasis group.the TSH level of patients with tumor diameter ranged from 2 to 4 cm and > 4 cm were significantly higher than those patients with < 2 cm, and the diameter of tumor >4 cm of patients was significantly higher than those patients with 2 to 4 cm, the differences were statistically significant (P<0.05). The sensitivity of preoperative TSH combined with Doppler ultrasonography for DTC diagnosis was 73.88% (198/268), specificity was 82.31% (214/260), and accuracy was 78.03% (412/528), which were significantly higher than those of pure ultrasound diagnosis of 57.46% (154/268), 75.77% (197/260), 66.48% (351/528), the differences were statistically significant (P<0.05). The area under the ROC curve of combined diagnosis was 0.847, in which the critical diagnostic value of TSH was 3.153 mlU/L. Conclusion: The DTC patients can be diagnosed by preoperative serum TSH level combined with Doppler ultrasonography effectively, this combined diagnosis can be popularized in clinical practice, so as to play a guiding role in the diagnosis, treatment and disease evaluation of patients with DTC, which is worth to be pay attention. [ABSTRACT FROM AUTHOR]

Objective To investigate the effect of preoperative hyperbaric oxygen therapy upon the incidence of hypoxemia in patients after renal transplantation. Methods In the experimental group, 55 patients received hyperbaric oxygen therapy prior to renal transplantation, and 66 counterparts in the control group underwent conventional renal transplantation. Postoperatively, the incidence of hypoxemia, pulmonary infection, time of in-bed oxygen inhalation and length of hospital stay were statistically compared between two groups. Results In the experimental group, 12 among 55 patients (22%) presented with hypoxemia after renal transplantation, and 20 of 66 (30%) in the control group. In the experimental group, 4 cases suffered from pulmonary infection with an incidence of 7%, and 14 (21%) in the control group. In the experimental group, the incidences of hypoxemia and pulmonary infection were lower than those in the control group (both P<0.05). In the experimental group, the time of in-bed oxygen inhalation and length of hospital stay were (5.9±2.0) d and (17.7±3.7) d, significantly shorter compared with (6.8±2.6) d and (20.5±4.2) d in the control group (both P<0.05). Conclusions Prior to renal transplantation, hyperbaric oxygen therapy can significantly reduce the risk of hypoxemia and pulmonary infection after renal transplantation, which can be served as a conventional preventive measure against the incidence of hypoxemia following renal transplantation. [ABSTRACT FROM AUTHOR]

Objective: To analyze the risk factors of preoperative upper respiratory infections in children with cleft lips and palate (CLP) and investigate preventive measures to reduce infections and improve the quality of treatments., Methods: A total of 510 children with CLP of ages 3 years old or younger were selected from hospital cases from June to December 2017. The test group comprised 50 children with upper respiratory infections, whereas the control group comprised 460 children without upper respiratory infections. A t-test and a multivariate logistic analysis were utilized to analyze the risk factors and to investigate the preventive measures., Results: Feeding patterns, the presence of infected companions during hospitalization, and ventilation at night were statistically significant. The feeding patterns and the presence of infected companions during hospitalization were independent risk factors for upper respiratory infections in children with CLP., Conclusions: Bottle feeding, infected companions during hospitalization, and the absence of window ventilation at night are risk factors for preoperative upper respiratory infections in children 3 years old or younger with CLP. Among the risk factors identified, feeding patterns and the presence of infected companion during hospitalization were the most influential. Medical staff members should streng-then corresponding health education and nursing measures to control the risk factors.

Objective: This study explored the preoperative prognostic factors of patients with glioblastoma multiforme (GBM) in order to propose a preoperative prognosis estimation model. Methods: The clinical data of 416 patients diagnosed with GBM in Beijing Tiantan Hospital affiliated to Capital Medical University from 2008 to 2015 were retrospectively reviewed.A total of nine factors: gender, age, duration of symptoms, preoperative epilepsy, preoperative muscle weakness, preoperative headache, preoperative KPS score, tumor location and tumor diameter were enrolled in the survival analysis.The significant factors identified by Kaplan-Meier plot were further collected in the multivariate Cox regression analysis.On the basis of multivariate analysis results, a preoperative prognosis estimation model was founded. Results: Univariate analysis showed that Age ≥50 years, without preoperative epilepsy, tumor located in non-frontotemporal lobe, tumor diameter ≥6 cm and preoperative KPS score <70 were prognostic risk factors ( P <0.05). Multivariate analysis revealed that Age ≥50 years, without preoperative epilepsy, tumor located in non-frontotemporal lobe were independent risk factors ( P <0.05). The prognostic estimation model based on the independent risk factors divided the whole cohort into three subgroups with different survival ( P <0.001). Conclusions: The more risk factors, the higher score but poorer prognosis. Patients in the high-risk group had lower gross total resection degree but higher rate of postoperative complications, which suggested that aggressive resection was not suitable for high-risk patients.