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Background/Aim. Surgery for developmental dysplasia of the hip (DDH) often needs acetabuloplasty and femoral osteotomy. This type of operation is characterized by long duration, major trauma, and severe postoperative pain. The aim of the study was to compare the analgesic effects of the caudal block (CB) and epidural block (EB) on the DDH surgery in children. Methods. A total of 100 children undergoing DDH surgery in our hospital from May 2018 to December 2021 were selected and randomly divided into two groups: an ultrasound-guided CB group and an EB group (each group consisting of 50 children). The dosage of ropivacaine, changes in blood pressure, heart rate, and intraoperative dosage of fentanyl were recorded. In addition, we recorded the values of several parameters after the surgery: the modified Face, Legs, Activity, Cry, and Consolability (FLACC) scale score at 2, 4, 6, 12, 24, 36, and 48 hrs after surgery; the time point of first-time request for aceta-minophen and proportion of patients using pethidine; the sedation degree within 12 hrs after the operation (assessed using the Ramsay Sedation Scale – RSS); the incidence of nausea, vomiting, and urinary retention; the satisfaction degree of family members with the applied methods of post-operative analgesia in children. Results. The ropivacaine dosage used in the CB group exceeded that of the EB group (p < 0.05). The CB group had lower FLACC scores 12 and 24 hrs after the operation and a longer postoperative time until the first-time request for acetaminophen than the EB group (p < 0.05). No block-related complications occurred; the two groups had similar incidence rates of nausea, vomiting, and urinary retention. The RSS score within 12 hrs after operation was higher in the CB group than in the EB group, and the family members of the children in the CB group were more satisfied (p < 0.05). Conclusion. Both CB and EB can provide satisfactory intraoperative and postoperative analgesia for pediatric hip surgery. However, CB pro-vides effective analgesia for 24 hrs after the operation and lasts longer than that accomplished by the EB.

In recent years, with the development of minimally invasive instruments,equipment and the progress of surgical techniques, minimally invasive pancreatic surgery has entered an era of rapid development. Function-preserving laparoscopic resection of pancreatic head and duodenal papilla tumors including laparoscopic duodenum-preserving pancreatic head resection (LDPPHR), laparoscopic pancreatic head tumor enucleation and laparoscopic transduodenal ampullary resection(LTDAR) have also been used in clinical practice. However, the anatomy and surgical procedures are extremely complicated. Many surgeons lack the experience in this field. So far, these procedures have rarely used in clinical practice. In this article, we introduced the current status, problems and countermeasures of these surgical procedures, to promote the development of function-preserving laparoscopic pancreatic head and duodenal papilla tumor resection surgery.

The advanced technique comprising an enhanced multi-W-shaped gauge and Taguchi-based analytical program of gamma camera (GC) spatial resolution optimization was proposed and successfully applied to the routine diagnosis of nuclear examination. The indigenous gauge was revised from a V-shaped gauge for computer tomography (CT) scanning. The multi-W-shaped slit had a gradually narrowing gap between two adjacent V-slits; once the gap was beyond the GC recognizable limit, the acquired imaging blurred, and the discrimination between V-slits was lost. The five factors of GC data collecting were assigned as A (detector to target distance), B (total counts), C (zoom of ROI), D (matrix size), and E (energy width). Taguchi's orthogonal array ( L 1 8 ) of factor combinations was adopted to arrange them into 18 groups. The reproducibility was ensured by the manual ranking of the acquired SPECT imaging quality by three seasoned radiology experts in three discrete periods. Next, Matlab and OriginPro software packages performed the SPECT analysis via the Poisson distribution program, identifying the peak center and FWHM of peaks of interest in SPECT imaging to quantify the spatial resolution and calculate the minimum detectable difference (MDD). The smallest MDD of 6.21 mm revealed the optimal combination of factors for GC data collecting: A1 (DTD 5 cm), B3 (TC 225), C3 (Zm 1.0), D1 (MS 2 5 6 × 2 5 6), and E2 (EW 10%). The conventional preset and group 7 (with the highest signal-to-noise ratio) had MDD values of 8.19 mm and 7.62 mm. [ABSTRACT FROM AUTHOR]