1.Application of magnetic compression anastomosis in one-stage repair of the intestinal leakage
Haijun MA ; Shanpei WANG ; Chao FAN ; Shiqi LIU ; Yafei SHANG ; Xiaopeng YAN ; Xiangming CHE ; Yi Lü
Chinese Journal of Digestive Surgery 2011;10(1):64-67
Objective To explore a new method for one-stage repair of the intestinal leakage based on the principle of magnetic compression anastomosis. Methods Twenty-four dogs were randomly divided into experimental group (n = 12) and control group (n = 12) according to random number table. The model of upper and multiple intestinal leakages was established by making transverse incisions of 1 cm in length on the jejunum wall about 50 cm and 100 cm away from the Treitz ligament. Forty-eight hours later, two NdFeB magnetic rings with the magnetic flux of 2500 G were put into the intestine from the leak sites. The leak sites were pressed between the two rings. The ventages in the control group were sutured. The condition of the dogs was observed after the repair of the leakage. The excreting time was recorded, and the leakage pressures of the anastomotic stoma were detected.The positions of the magnetic rings in the experimental group were detected by X ray. Tissues of the anastomotic stoma were processed by hematoxylin eosin and Masson staining. All data were analyzed using the two-sample t test. Results Severe abdominal infection occurred 48 hours after the establishment of the model. All the intestinal leakages in the experimental group were successfully repaired and the dogs survived for a long time. The magnetic rings were excreted six or seven days after the repair. Eight dogs of the control group survived. The leakage pressure of the anastomotic stoma seven days after the repair was (134 ±23)mm Hg (1 mm Hg =0. 133 kPa) in the experimental group and (91 ± 18)mm Hg in the control group, respectively, with a significant difference between the two groups (t = 3.225, P < 0.05). The leakage pressure of the anastomotic stoma 14 days after the repair was (281 ±7)mm Hg in the experimental group and (271 ±21) mm Hg in the control group, respectively, with no significant difference between the two groups (t =0. 988, P > 0.05). Histological observation showed that after the magnetic compression anastomosis, the intestinal muscle and mucosa recovered well, inflammatory reaction was slight and less collagen fiber and scar was formed. Conclusions Application of magnetic ring with the magnetic flux of 2500 G in one-stage repair of the intestinal leakage in the state of severe abdominal infection is safe and reliable.
2.Effect of dexmedetomidine on quality of intraoperative wake-up test in patients undergoing balloon occlusion test of the internal carotid artery
Miao CHEN ; Xueping HAN ; Xuedong SHANG ; Yafei CHEN ; Yong WANG ; Qi FU ; Haiming GUO ; Zheng SUN
Chinese Journal of Anesthesiology 2017;37(5):601-605
Objective To evaluate the effect of dexmedetomidine on the quality of intraoperative wake-up test in the patients undergoing balloon occlusion test of the internal carotid artery.Methods Forty-two patients of either sex with intracranial aneurysm,aged 57-78 yr,weighing 53-86 kg,of American Society of Anesthesiologists physical status Ⅱ or Ⅲ,scheduled for elective balloon occlusion test of the internal carotid artery under general anesthesia,were assigned into 2 groups (n =21 each) using a random number table:propofol conbined with remifentanil group (group PR) and dexmedetomidine combined with propofol and remifentanil group (group DPR).In group DPR,dexmedetomidine was intravenously infused over 15 min in a loading dose of 0.5 μg · kg-1 before induction of anesthesia,followed by an infusion of 0.3 μg · kg-1 · h-1 throughout surgery.Propofol and remifentanil were given by target-controlled infusion (TCI) after infusion of the loading dose.The patients were mechanically ventilated after placement of the laryngeal mask airway.Maintenance of anesthesia was as follows:propofol and remifentanil were given by TCI with the target plasma concentrations of 0.5-1.0 μg/ml and 1-3 ng/ml,respectively,in group DPR;propofol and remifentanil were given by TCI with the target plasma concentrations of 3-5 μg/ml and 3-6 ng/ml,respectively,in group PR.Bispectral index (BIS) value was maintained at 40-60.Before wakeup test,propofol infusion was stopped and the target plasma concentration of remifentanil was decreased to 0.5 ng/ml in two groups,and the infusion rate of dexmedetomidine was decreased to 0.1 pg · kg-1 · h-1 in group DPR.The wake-up time was recorded and the wake-up quality was assessed.After admission to the operating room (T0,baseline),at 10 min before wake-up test (T1),immediately after patients were wakened (T2),at 10 min after patients were wakened (T3) and at the end of wake-up test (T4),the mean blood pressure (MAP),heart rate,respiratory rate (RR),SpO2 and BIS values were recorded.The development of intraoperative awareness,emergence time,postoperative agitation,nausea and vomiting,regurgitation and aspiration and severe pain was recorded.Results MAP,heart rate,SpO2 and RR were all within the normal range during wake-up period in two groups.Compared with the baseline at To,MAP was significantly decreased at Ti,3,4 in group PR,and BIS value was decreased at T1-4 in DPR and PR groups (P<0.05).Compared with group PR,MAP was significantly increased at T1.3,BIS value was decreased at T24,the wake-up time was shortened,Ramsay sedation score and wake-up quality were increased,the emergence time was shortened,and the incidence of agitation was deceased (P<0.05),and no significant change was found in verbal rating scale scores assessed after extubation in group DPR (P > 0.05).No cardiovascular events,respiratory depression,intraoperative awareness,postoperative nausea and voniting,regurgitation and aspiration or severe pain was found in two groups.Conclusion Dexmedetomidine can raise the quality of intraoperative wake-up test in the patients undergoing balloon occlusion test of the internal carotid artery.
3.Multifunctional Cervical Health Care Pillow.
Zhaolan YANG ; Zengtao HOU ; Dazhong XU ; Yafei CAO ; Weidong LIU ; Peng SHANG
Chinese Journal of Medical Instrumentation 2018;42(5):341-344
Cervical spondylosis is due to degenerative cervical disc and its stimulation or oppression of the adjacent nerves, spinal cord, spinal artery and other tissue caused by clinical symptoms. The cervical spine is an anatomical structure with activity, while the pillow has a certain plastic fixation effect on the cervical spine anatomy. Therefore, the pillow not only plays a health role in the cervical spine, but also plays an important role in restoring the normal physiological curvature of the cervical spine. Based on this, a multi-functional cervical vertebra treatment pillow is designed, which not only has the functions of traction, maintaining different positions of the cervical spine, correcting the cervical curvature and equipment exercises, but also has the functions of voice broadcast and network data terminal.