Objective To evaluate sevoflurane inhalation and propofol combined with ketamine total venous anesthesia in pediatric laparoscopic surgery of oblique inguinal hernia.Methods Seventy ASA Ⅰ children were randomly divided into two groups,35 children in every group.Children in group S were appliedsevoflurane inhalation[the minimum alveolar concentration(MAC)of sevoflurane was 1.0-1.5],children in group PK were applied ketamine inhalation and total venous anesthesia of propofol[80μg/(kg·min)]with ketamine[20μg/(kg·min)].Compared the time of anesthesia induction,tracheal catheter extubation,anesthesia recovery between the two groups.The mean arterial pressure(MAP),heart rate,pulse oxygen saturation(SpO_2)during anesthesia were compared.During 2 days after operation,the adverse effects such as nausea and vomit,lower grade of sleep quality were also compared.Results Compared with group PK,the time of anesthesia induction,tracheal catheter extubation and anesthesia recovery in group S were shorter (P<0.05),the incidence of emergence agitation in group S was higher(20.0%,7/35 vs 2.9%,1/35)(P<0.05).But nausea(17.1%,6/35),vomit(31.4%,11/35)and lower grade of sleep quality(54.3%,19/35)were higher in group PK than those in groups(all 2.9%,1/35)at 1 day after operation(P<0.05).The incidence of lower grade of sleep quality at2 days after operation in group PK(14.3%,5/35)was higher than that in group S(0)(P<0.05).Cardiovascular effects of children,such as MAP and heart rate during the period of tracheal catheter extubation in group S was higher than that in group PK.Conclusion Sevoflurane inhalation and propofol combined with ketamine total venous anesthesia in pediatric laparoscopic surgery of oblique inguinal hernia still has some disadvantages,the anesthesia technology is selected by anesthesia method and medicine combination.

Airway Obstruction ; complications ; diagnosis ; etiology ; surgery ; Bronchoalveolar Lavage Fluid ; microbiology ; Bronchoscopy ; Child, Preschool ; Colony Count, Microbial ; Female ; Foreign Bodies ; surgery ; Gram-Positive Bacteria ; isolation & purification ; Humans ; Infant ; Male ; Respiratory Tract Infections ; diagnosis ; etiology ; microbiology ; Staphylococcus aureus ; isolation & purification

Objective To evaluate the safety and efficacy of photoselective vaporization of prostate (PVP) for the treatment of benign prostatic hyperplasia (BPH). Methods A total of 161 patients with symptomatic bladder outlet obstruction due to BPH underwent PVP via transurethral with Niagara PV TM system.The therapeutic results were assessed using following variables:the safety and efficacy of sacral anesthesia,blood loss,operative time,indwelling catheterization,mean Qmax,IPSS,QOL and the sexual function. Results The PVP was successfully performed on all the 161 patients with BPH.There were 160 patients under sacral anesthesia and only 1 under epidural anesthesia.The mean operative time was (44.5?22.4)min (range,15～210 min).All patients had minimal or no blood loss and no patients required blood transfusion.No postoperative catheterization was needed in 21 patients. The mean catheterization time was (34.4? 20.8 )h (range,24-72 h).Postoperatively 2 cases had transient dysuria and 2 experienced delayed hematuria.All cases were followed up for 3 to 6 months after treatment.The mean Qmax increased from (6.5? 2.4 )ml/s to (19.8?2.1)ml/s;mean IPSS and QOL decreased to 5.8?1.6 and 1.7?0.4,respectively,which showed significant improvement,compared with those before operation( P

C-Reactive Protein ; analysis ; Calcitonin ; blood ; Calcitonin Gene-Related Peptide ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Pneumonia ; blood ; diagnosis ; Protein Precursors ; blood

Objective To explore the efficacy and safety of greenlight photoselective vaporization of prostate(PVP) in high-risk older patients with benign prostatic hyperplasia(BPH).Methods A total of 96 high-risk older patients with BPH underwent PVP.The operative time,blood loss,indwelling catheterization and operative complications were observed.The variables such as IPSS,QOL,uroflowmetry,post-void residual urine volume(RUV) were recorded and calculated pre-and post-operatively.Results All the 96 patients safely got through perioperative period.The mean operative time was(24.8?6.5)min,intraoperative blood loss was(55.4?16.8)ml and postoperative indwelling catheterization was(1.6?0.7)d.IPSS and QOL scores decreased form preoperative 29.8?5.2 and 5.2?0.8 to postoperative 8.4?2.3 and(1.4?)0.5,respectively.Qmax increased from(5.6?2.8)ml/s to(16.7?3.2)ml/s,and RUV decreased from(168.0?22.5)ml to(24.6?5.81)ml.There were significant differences of these parameters between pre-and post-operation(P

Objective To explore CT features of thin-wall cavity change of pulmonary metastases from renal clear cell carcinoma after molecular targeted treatment and its clinical significance.Methods Clinical and imaging data of 2 patients with thin-wall cavity of pulmonary metastases originating from renal clear cell carcinoma after molecular targeted drug Pazopanib were reported and analyzed retrospectively.Results After resection of primary renal tumors,multiple solid metastatic lesions in the lung were detected and the lesions showed ring enhancement on the post-contrast images.After 3-month Pazopanib treatment,most of the lesions presented thin-wall cavity change.Case 1 showed slowly disease progression while case 2 suffered from spontaneous pneumothorax and died 2 months later.Conclusion Necrosis of pulmonary metastases originated from renal carcinoma can be impelled by molecular targeted Pazopanib treatment,which helped to the formation of cystic thin-wall cavity,but the influence on the prognosis still remains uncertain.

Abnormalities, Multiple ; Bronchial Diseases ; complications ; Bronchoscopy ; Child ; Child, Preschool ; Female ; Foreign Bodies ; complications ; Humans ; Infant ; Lung ; diagnostic imaging ; pathology ; Male ; Radiography ; Respiratory System Abnormalities ; complications ; Respiratory Tract Diseases ; etiology ; pathology

Adenocarcinoma ; metabolism ; secondary ; Adult ; Aged ; CDX2 Transcription Factor ; Carcinoma, Signet Ring Cell ; metabolism ; pathology ; Colonic Neoplasms ; metabolism ; pathology ; Cystadenocarcinoma, Mucinous ; metabolism ; pathology ; Cystadenocarcinoma, Serous ; metabolism ; pathology ; Diagnosis, Differential ; Female ; Homeodomain Proteins ; metabolism ; Humans ; Keratin-20 ; metabolism ; Keratin-7 ; metabolism ; Middle Aged ; Ovarian Neoplasms ; metabolism ; pathology ; secondary ; Trans-Activators ; metabolism ; Young Adult

This study aims to investigate the preparation process and in vitro release behavior of artesunate polylactic acid microspheres, in order to prepare an artesunate polylactic acid (PLA) administration method suitable for hepatic arterial embolization. With PLA as the material and polyvinyl alcohol (PVA) as the emulsifier, O/W emulsion/solvent evaporation method was adopted to prepare artesunate polylactic acid microspheres, and optimize the preparation process. With drug loading capacity, encapsulation efficiency and particle size as indexes, a single factor analysis was made on PLA concentration, PVA concentration, drug loading ratio and stirring velocity. Through an orthogonal experiment, the optimal processing conditions were determined as follows: PLA concentration was 9. 0% , PVA concentration was 0. 9% , drug loading ratio was 1:2 and stirring velocity was 1 000 r x min(-1). According to the verification of the optimal process, microsphere size, drug loading and entrapment rate of artesunate polylactic acid microspheres were (101.7 +/- 0.37) microm, (30.8 +/- 0.84)%, (53.6 +/- 0.62)%, respectively. The results showed that the optimal process was so reasonable and stable that it could lay foundation for further studies.
Artemisinins ; chemistry ; Calibration ; Drug Compounding ; methods ; Lactic Acid ; chemistry ; Microspheres ; Polyesters ; Polymers ; chemistry ; Polyvinyl Alcohol ; chemistry

Objective To evaluate the effectiveness of ultrasound (US) volume navigation technology in guiding the lum?bar transforaminal puncture with full?endoscopic technique through posterolateral approach. Methods From June 2011 to June 2013, 60 patients (37 males and 23 females;mean age:32.9 years) with single?level lumbar disc herniation who had undergone lumbar transforaminal puncture with full?endoscopic technique through posterolateral approach were enrolled in this retrospective study, and they were randomly divided into 2 groups according to whether the assistance of ultrasound volume navigation technolo?gy was used. They received the minimally invasive surgery on L4, 5 (47 cases) and L5S1 (13 cases). In the US?guidance group (29 cas?es), ultrasound volume navigation was used to guide puncture process, and in the C?arm guided group (31 cases), C?arm was ap?plied to guide the puncture process The total puncture time and C?arm fluoroscopy times were recorded. Parameters including Os?westry disability index (ODI) and visual analogue scale (VAS) were selected to evaluate the clinical efficacy. Results Patients had no obvious discomfort during the puncture procedure and no postoperative complications. In US?guidance group, the preopera?tive time was 13.7 ± 2.1 min (range, 11-16 min), and the whole process took 20.6 ± 3.1 min (range, 16-28 min), while the average time of C?arm exposure were 4.9 ± 0.8 times (range, 4-7 times). In C?arm guided group, the average time for puncture procedure was 27.9±1.7 min (range, 25-32 min), and the average times of C?arm exposure were 14.3±1.2 times (range, 13-17 times). There were significant differences between two groups. Compared with C?arm guided group, US?guidance group had the same accuracy rate of puncture (the puncture needles all reached the target area), but the fluoroscopy times and puncture timewere decreased sig?nificantly. There’s no significant difference among the pre and postoperative ODI and VAS indexes. Patients were followed?up at 3 months and 1 year postoperation. The mean follow?up period was 16.4 months (range, 12-26 months). The ODI score of the US?guidance group were 72.9%±5.9%, 17.1%±3.6%and 15.9%±3.3%before operation, 3 months postoperation and 1 year postopera?tion respectively. The ODI score of the C?arm guided group were 73.2%±4.9%, 17.3%±3.3%and 16.1%±2.9%respectively. The VAS were 7.4±0.9, 2.2±0.7 and 1.9±0.8 in US?guidance group, and were 7.2±0.9, 2.1±0.7, 1.8±0.8 in C?arm guided group. Con?clusion The ultrasound volume navigation can guide the lumbar transforaminal puncture with full?endoscopic technique through posterolateral approach accurately, reducing the puncture time and the amount of X?ray radiation significantly. Its puncture accura?cy and efficacy have no significant differences, which could be broadly used in clinical application.