10.3969/j.issn.1008-9691.2013.03.014

Objective:To study the Clinical efficacy of combined therapy of adenosylcobalamin and transcutaneous eletrical nerve stimulation(TENS)in the treatment of postherpetic neuralgia(PHN).Method:Sixty patients with PHN were randomly divided into 3 groups:group A treated with TENS.group B treated with adenosylcobalamin,group C treated with adenosylcobalamin and TENS based on the management of groups A and B.The three groups had all been treated for 10d.Result:In observation,visual analogue scale(VAS)and 5 grade pain scores of group C were lower than those of groups A and B;VAS and 5 grade pain scores differences of group C were higher than those of groups A and B:The effective rate of group C(100%)was higher than that of groups A and B respectively.The differences were significant(P<0.05).Conclusion:Combined therapy of adenosylcobalamin and TENS is effective for the treatment of PHN and can alleviate pain and improve sleep.

Objective To investigate the influence of bradycardia in patients of acute cervical cord injury. Methods A total of 184 patients with acute cervical cord injury were included. The influences of position and severity of cervical cord injury, combination with cerebral injury or not, with/without hyponatremia and with/without respiratory failureⅡon bradycardia incidence were analyzed by using single factor analysis and logistic regression analysis. Results In 184 patients, 102 patients with bradycardia were enrolled in bradycardia group and 82 patients without bradycardia were enrolled in control group. The position of cervical cord injury and rate of hyponatremia in two groups had no significant differences (P > 0.05). The severity of cervical cord injury, rate of brain trauma and rate of respiratory failureⅡ between two groups had significant differences (P < 0.05). Conclusions The severity of cervical cord injury is important influencing factor of bradycardia after cervical cord injury.With/without respiratory failureⅡand with/without cerebral injury are influencing factors of bradycardia after acute spinal cord injury,which may relate with the severity of cervical cord injury.

Objective:To explore the clinical efficacy of retzius-sparing robot-assisted laparoscopic radical prostatectomy with retrograde release of the neurovascular bundle.Methods:From January 2021 to January 2022, the clinical data of 113 patients with retzius-sparing robot-assisted laparoscopic radical prostatectomy (RS-RARP) was retrospectively analyzed. The ages of the optimized group and the standard group were (67.5±6.4) years and (67.7±6.1) years, and the body mass index (BMI) was (25.0±3.2) kg/m 2 and (24.9±3.1) kg/m 2, respectively. The prostate volume was (42.8±15.4) ml and (41.0±17.9) ml, the preoperative PSA was (13.5±13.1) ng/ml and (11.9±16.0) ng/ml, and the preoperative IIEF-5 score was (15.0±4.0) and (14.8±4.2) points, respectively. Gleason scores were (7.2±0.8) points and (7.1±0.9) points, respectively, with no statistical significance ( P>0.05). The clinical stages of cT 2 and cT 3 were 35 and 40 cases in the optimized group and 16 and 22 cases in the standard group, respectively. There were 5 and 11 cases of preoperative neoadjuvant therapy, respectively, with no statistical significance ( P>0.05). The optimized RS-RARP is the blunt dissection of the denonvilliers fascia and forward to the apex of prostate, and retrograde release of the NVB. The operation time, intraoperative blood loss, drainage tube retention time, days of hospital stay, positive rate of pathological margin and incidence of complications were compared. The recovery of urinary continence was evaluated at 2 weeks after the catheter was removed, and the postoperative IIEF-5 score and PSA were followed up at 1 month after the surgery. Immediate urinary continence was defined as the use of 1 pad on the day of radical prostatectomy. Follow-up intervals were no more than 3 months. The log-rank test compared urinary incontinence rates between the two modalities. Results:All 113 cases of surgery were completed, and median follow-up was 16 months. The operation time was (79.7±26.6) min and (149.8±40.1) min, and the intraoperative blood loss was (54.9±24.7) ml and (110.0±83.2) ml, respectively, and the difference was statistically significant ( P<0.01). The retention time of postoperative drainage tube was (5.3±2.1) d and (5.5±2.1) d in the optimal group and the standard group, and the days of hospital stay was (7.6±2.1) d and (8.5±2.3) d, respectively. The positive rate of postoperative pathological margin was 19.6% (10/51) and 24.2% (15/62), respectively. There was no significant difference ( P>0.05). immediate urinary continence was 86.3% (44/51) and 69.4% (43/62) in the optimized group and the standard group, respectively, and the difference was statistically significant ( P=0.033). Postoperative IIEF-5 scores were (13.2±3.3) and (11.0±4.3), respectively, and the difference was statistically significant ( P=0.012). Kaplan-Meier analysis showed that the risk of urinary incontinence was lower in the optimized group ( P=0.02). Conclusions:The optimized RS-RARP might shorten the operation time, reduce intraoperative bleeding, and help the recovery of urinary continence and sexual function to a great extent.