Objective To compare the fascia iliaca compartment block versus femoral nerve 3-in-1 block for postoperative analgesia in elderly patients undergoing hip surgery.Methods A total of 160 patients with hip fracture,of American Society of Anesthesiologists physical status Ⅱ or Ⅲ,aged 70-101 yr,weighing 30-93 kg,scheduled for elective total hip replacement or artificial femoral head replacement under general anesthesia,were divided into 2 groups (n =80 each) using a random number table:fascia iliaca compartment block group (FIB group) and femoral nerve 3-in-1 block group (FNB group).Ultrasound-guided fascia iliaca compartment and 3-in-1 blocks were performed with 0.2％ ropivacaine 40 ml in FIB and FNB groups,respectively.Patient-controlled analgesia (PCA) with 0.2％ ropivacaine 275 ml was used for postoperative analgesia until 72 h after operation in both groups.The PCA pump was set up with a 5 ml bolus dose,a 60 min lockout interval and background infusion at a rate of 5 ml/h,and the visual analog scale score was maintained≤4.When the visual analog scale score＞4,tramadol 50-100 mg was taken orally or injected intramuscularly for rescue analgesia.Before implanting the catheter,at 15 min after the initial administration and at 12 h after operation,temperature sensation and light touch sensation tests were performed in the anterior regions of thigh (innervated by femoral nerve),lateral region of thigh (innervated by lateral femoral cutaneous nerve) and superior part of the anterior region of thigh (innervated by obturator nerve).Successful sensory block was defined as the occurrence of a decline in temperature sensation or in light touch sensation in any area,and the successful sensory block was recorded.The requirement for rescue analgesia and patient's satisfaction with analgesia were recorded within 72 h after operation.The development of adverse reactions such as nerve damage,nausea and vomiting,dizziness and palpitation was also recorded within 48 h after operation.Results Compared with group FIB,the rate of successful analgesia in lateral thigh area was significantly decreased at 15 min after the initial adminstration and 12 h after operation,the requirement for rescue analgesia after operation was increased,the rate of satisfactory analgesia after operation was decreased (P＜0.05),and no significant change was found in the incidence of postoperative nausea and vomiting or dizziness in group FNB (P＞0.05).Conclusion Ultrasound-guided continuous fascia iliaca compartment block provides better efficacy for postoperative analgesia than 3-in-1 block in elderly patients undergoing hip surgery.

OBJECTIVE: To analyze the genotype and clinical phenotype of a 3-month-old female infant featuring unresponsiveness. METHODS: The infant was subjected to genetic testing, and her clinical features were compared with syndromes associated with variants of the candidate gene. RESULTS: The patient has featured long fingers, long and overlapped toes, musk-like face, blepharophimosis, ptosis, and lacrimal duct anomaly. She was found to harbor a heterozygous de novo variant NM_012330.3: c.3040C>T (p.Gln1014*) in exon 16 of the KAT6B gene. Her clinical phenotype and genotype have both conformed to Say-Barber-Biesecker-Young-Simpson syndrome (SBBYSS). CONCLUSION The child was diagnosed with SBBYSS syndrome due to the c.3040C>T (p.Gln1014*) variant of the the KAT6B gene. Discovery of the unique features has expanded the phenotypic spectrum of this syndrome.
Female ; Humans ; Blepharophimosis/genetics* ; Blepharoptosis ; Genotype ; Histone Acetyltransferases ; Infant

Objective To investigate the remodeling of atrial fibrosis in rheumatic heart disease (RHD) patients with atrial fibrillation and its possible mechanism.Methods The clinical data and right atrial tissue specimens were obtained from patients who had undergone mitral valve replacement for rheumatic valvular disease or who had undergone thoracotomy for congenital heart disease in the Second People's Hospital of Yibin from Oct.2013 to Oct.2015.According to the heart rhythm characteristics,the specimens obtained from these patients were divided into sinus rhythm group (RHD-SR group,18 cases),paroxysmal atrial fibrillation group (RHD-pAF group,21 cases) and persistent atrial fibrillation group (RHD-cAF group,42 cases).The right atrial tissue specimens obtained from those who had undergone thoracotomy for congenital heart disease with sinus rhythm were taken as the control group(CHD-SR group,21 cases).The structures of atrial tissues were observed under a light microscope.The picric acidsirius red staining was used to detect collagen volume fraction (CVF) of type Ⅰ and Ⅲ collagen and the type Ⅰ /Ⅲ collagen CVF ratio.The expressions of TGF-β1 protein and mRNA were detected by using Western blot and reverse transcription polymerase chain reaction (RT-PCR).Results The left atrial diameter (LAd) in the RHD-cAF group was significantly higher than that in the RHDSR group (P＜0.05),but no statistically significant difference was found in other clinical data among these groups (P＞0.05).The results of picric acid-sirius red staining demonstrated that the volume fraction of type Ⅰ and type Ⅲ1 collagen and the ratio of type Ⅰ /Ⅲ collagen were increased in CHD-SR group,RHD-SR group,RHD-pAF group and RHD-cAF group,gradually,there were statistically significant differences (P＜0.05),The expression levels of TGF-β1 protein and mRNA were increased gradually in CHD-SR,RHD-SR,RHD-pAF and RHD-cAF groups (P＜0.05).Conclusion Atrial fibrosis remodeling is an important mechanism of atrial fibrillation in patients with RHD.High expression of TGF-β1 may be involved in the remodeling of atrial fibrosis.