1.Effect of oxycodone combined flurbiprofen ester in the treatment of postoperative analgesia after thoracic surgery
Chabing LI ; Feng XU ; Wei WANG ; Kesong ZHENG
The Journal of Clinical Anesthesiology 2016;32(12):1183-1185
Objective To observe the efficacy of oxycodone or fentanyl combined with flurbi-profen esters (FA)for postoperative analgesic after thoracic surgery.Methods Eighty patients,53 males and 24 females,aged 40-65 years,ASA physical status Ⅰ-Ⅲ,undergoing elective thoracotomy surgery,randomly divided into two groups (n =40 each).Oxycodone 0.1 mg/kg (group O)or fenta-nyl 1 μg/kg (group F)were intravenously injected 1 5 minutes before the end of surgery.Each patient was given PCIA,with solution including oxycodone 0.8 mg/kg plus FA 4 mg/kg plus ondansetron 8 mg plus 0.9% NaCl (1 50 ml)in group O and fentanyl 8 μg/kg plus FA 4 mg/kg plus ondansetron 8 mg plus 0.9% NaCl (1 50 ml)in group F.The coughing and resting visual analogue scale (VAS), Ramsay score at 2,6,12,24,36 and 48 hours after operation,complications,the times of patient controlled pressing and requirement for rescue analgesic were evaluated.Results Compared with group F, the resting and coughing VAS at 2, 6, 12, 24, 36 and 48 hours after operation, requirement for rescue analgesic,the incidence of nausea and vomiting and the times of patient con-trolled pressing were significantly lower in group O (P <0.05).There was no significantly difference in the Ramsay score.Conclusion It is effective that the patients undergoing thoracic surgery used the PCIA of oxycodone combined FA to control the postoperative pain, and analgesic effect more excellent than fentanyl combined FA,and with fewer side effects.
2.Evaluation of the CaV1 1-R528 H gene knock-in mouse model of thyrotoxic hypokalemic periodic paralysis
Hongye ZHI ; Hongyan XU ; Yingying CHEN ; Yaning CHEN ; Lijun ZHOU ; Dawei ZHAN ; Kesong YAN ; Hebin YAO
Acta Laboratorium Animalis Scientia Sinica 2016;24(4):369-374
Objective To establish and evaluate the CaV1?1?R528H gene knock?in mouse model of thyrotoxic hy?pokalemic periodic paralysis. Methods Thirty?six 8?week?old male CaV1?1?R528H gene knock?in mice and thirty?six 8?week?old wild?type male C57BL/6J mice were used in this study. Using three?factor two?level 2 × 2 × 2 factorial design ( the three factors including mutation, thyroxine and insulin, and two levels were with or without) , the mice were divided into 8 groups. The thyroxine groups were intraperitoneally injected with levothyroxine in a dose of 350 μg/kg once per day for 12 consecutive days to produce thyrotoxicosis. The insulin groups were intraperitoneally injected with short?acting insulin in a dose of 0?8 U/kg after the last administration of levothyroxine, and the potassium levels of different groups were meas?ured and recorded before (0 min) and after insulin injection (30 min, 60 min). Results (1) Compared with the control group, the following phenomena including irritability, dull coat, increased diet and water intake, and slow body weight gain, were observed in the thyrotoxic mice. Thyroid function tests showed that the levels of T3 and T4 in the thyrotoxic mice were significantly higher than those in the corresponding control mice (P<0?05), and the TSH level was significantly low?er than that of the corresponding control mice (P<0?05 ). (2) After administration of insulin or thyroxine alone, the po?tassium levels in the mutant and wild?type mice were not significantly different. However, after combined administration of thyroxine and insulin, the potassium levels in the mutant group were significantly lower than those in the wild?type mice at 30 min and 60 min ( P<0?05 for both). (3) The main effects and interactions:Mutation factor or thyroxine factor alone did not influence on the potassium level, only insulin showed hypokalemic effect (P<0?05). There were interactions be?tween thyroxine and mutation, and between insulin and mutation (P<0?05), but no interaction between thyroxine and in?sulin. Conclusions (1) A thyrotoxicosis state in mice is successfully developed in this study. (2) An CaV1?1?R528H gene knock?in mouse model of thyrotoxic hypokalemic periodic paralysis is successfully established.
3.Application of orthopedic metal artifact reduction technology in CT examination of arthroplasty
Kesong ZHANG ; Xiaolin XU ; Qing HAN ; Yun ZOU ; Bingpeng CHEN ; Kerong YANG ; Hao JIANG ; Jincheng WANG
Journal of Jilin University(Medicine Edition) 2019;45(1):179-183,后插4
Objective:To investigate the metal artifact reduction effect of orthopedic metal artifact reduction (O-MAR) techonology and its improvement effect on the image quality in CT examination in the patients with arthroplasty, and to elaborate the significance of the technology in clinical diagnosis and treatment of arthroplasty.Methods:The CT data of 20patients with hip or knee prostheses was collected.There were two tube voltages in each group of CT data:120and 140Kev.There were also two groups of CT data in each tube voltage group:nonO-MAR group and O-MAR group;there were four subgroups of CT data of each case:120 Kev/-O-MAR, 120Kev/+O-MAR, 140Kev/-O-MAR, 140Kev/+O-MAR.After data collection, Mimics software was applied to conduct three-dimensional (3D) reconstruction for purpose of the qualitative and quantitative analysis of CT data.Qualitative analysis mainly included the grade of severity of metal artifact and quality of data.Quantitative analysis included the volume of metal artifact, the average CT value and standard deviation (SD) in region of interest (ROI) .ROI 1and ROI 2were chosen at the location of beam hardening artifact (radial high-density metal artifact) and photon starvation artifact (band low-density metal artifact) , respectively.Results:According to the result of3D measurement, the volumes of artifact had no significant difference between 120 Kev/-O-MAR group and140Kev/-O-MAR group (P=0.062) , but there were siginificant differences in the volumes of artifact between other groups (P<0.05) ;O-MAR technology decreased the volume of beam-hardening artifact obviously (P<0.05) .According to the results of two-dimensional (2D) measurement, there was no significant difference in the average CT values in ROI 2between 120Kev/-O-MAR group and 140Kev/-O-MAR group (P=0.069) , but there were significant differences in the average CT values between other groups (P<0.05) ;O-MAR technology decreased the high-density beam-hardening metal artifact and the low-density photon-starvation metal artifact in 2D measurement.Conclusion:O-MAR technology could significantly reduce the CT metal artifact of hip and knee prostheses and increase the clinical value of CT data.
4.Long-term curative effects of suture plus proximal gastric vagotomy or triad-therapy for duodenal ulcer with acute perforation.
Ruiyun XU ; Li FANG ; Xiaochun JIANG ; Yueping WAN ; Shaowei HUANG ; Kesong JIANG ; Nan LIN ; Weidong PAN
Chinese Journal of Surgery 2002;40(9):647-649
OBJECTIVETo study the long-term curative effects of suture plus proximal gastric vagotomy (PGV) and suture plus triad-therapy (omeprazole, amoxycillin and flagyl taken orally) for the treatment of duodenal ulcer with acute perforation.
METHODSThree hundred and twenty-nine patients with duodenal ulcer and acute perforation were treated with 2 different methods, respectively. Method A was suture plus PGV (group A, 153 cases), and method B was suture plus triad-therapy (group B, 176 cases). Follow-up was made by means of correspondence, outpatient reexamination and cooperation with local hospitals in 5 to 8 years after operation. The contents of follow-up included symptom acquisition (such as upper abdominal pain or distention, pyrosis, belch, acid regurgitation, vomiting, diarrhea and conditions of living or working), gastroscopy and Helicobacter pylori (HP) detection. The curative effects were evaluated by the Visick scale.
RESULTSThree hundred and one patients were followed up (group A 142 and group B 159). According to the Visick scale, 97 (68.3%), 19 (13.4%), 13 (9.15%) and 13 (9.15%) patients in group A, and 31 (19.5%), 28 (17.6%), 24 (15.1%) and 76 (47.8%) in group B were classified as Visick I, II, III and IV respectively (Z = -9.818, P < 0.01). As for HP detection, there were 130 (91.5%) patients in group A and 94 (59.1%) in group B (chi(2) = 41.438, P < 0.01).
CONCLUSIONSThe long-term curative effects of suture plus PGV were superior to those of suture plus triad-therapy for duodenal ulcer with acute perforation although HP positive rate was higher in group A than in group B. HP infection is one of the etiological factors of duodenal ulcer. The increased excitability of the vagus nerve remains to play an important role in duodenal ulcer.
Acute Disease ; Adolescent ; Adult ; Aged ; Amoxicillin ; administration & dosage ; Drug Therapy, Combination ; Duodenal Ulcer ; drug therapy ; etiology ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Metronidazole ; administration & dosage ; Middle Aged ; Omeprazole ; administration & dosage ; Peptic Ulcer Perforation ; drug therapy ; surgery ; Suture Techniques ; Vagotomy, Proximal Gastric ; methods
5.Accuracy verification and reliability analysis of three-dimensional printing model in orthopedics and maxillofacial surgery
Yun ZOU ; Qing HAN ; Xiaolin XU ; Yingying YANG ; Kesong ZHANG ; Kerong YANG ; Yanguo QIN ; Yongwei ZOU ; Jincheng WANG ; Shouyi ZHANG
Journal of Jilin University(Medicine Edition) 2017;43(5):996-1001,后插6
Objective:To discuss the accuracy of stereolithography (SLA)-3D printing model in orthopedics and maxillofacial surgery,and to clarify the reliability of its clinical application.Methods:A total of 33 cases of SLA-3D printing models were randomly included (10 long bones,13 irregular bones and 10 prostheses),and the CT scanning and three-dimensional reconstruction were performed.According to the clinical application characteristics of the models,the max height (MH),max length (ML),max width (MW),width of the trochlear (WT),length of the trochlear (LT),length of the glenoid cavity (LGC),width of the glenoid cavity (WGC),distance of pubic tubercle-anterior superior iliac spine (DPI),diameter of the acetabulum (DA),diameter of the marrow cavity (DMC),anterior height of right ramus (AHRR) and posterior height of right ramus (PHRR) were selected to measure the original data and model data,respectively.The absolute / relative errors were calculated.Intraclass correlation coefficient (ICC) was used to evaluate the consistency of the data.The three-dimensional error analysis of the prosthesis model was carried out.Results:There were no significant differences in the anatomical parameters except MW of irregular bone (P>0.05) in 33 cases of SLA-3D printing model.The values of ICC were all greater than 0.950;the maximum values of absolute / relative errors were-0.58 mm and-1.37%,respectively;the maximum 3D error of prosthesis model was 0.237 mm,and the average value was 0.132 mm.Conclusion:The CT data of SLA-3D model is highly consistent with the original data,and it is accurate and reliable in the diagnosis and treatment of the diseases in orthopedics and maxillofacial surgery.
6.The Effect from Elastic Modulus of Vessels on Fractional Flow Reserve of Carotid Artery Stenosis
Long YU ; Kesong XU ; Jun WAN ; Shengzhang WANG ; Haiyan LU
Journal of Medical Biomechanics 2020;35(4):E397-E402
Objective To explore the feasibility of applying fractional flow reserve (FFR) into the assessment of carotid stenosis, and analyze the effects from elastic modulus of vessel wall on hemodynamic parameters of carotid artery stenosis model and FFR calculation results. Methods The standard models of carotid bifurcation and stenosis models with different stenosis rates were established by computer-aided design software. Assuming that the vessel wall was linear elastic material and the blood was incompressible Newtonian fluid, the fluid-structure coupling simulation of blood flow in carotid artery stenosis model under the pulsating flow was carried out by finite element analysis, and the relevant hemodynamic parameters were obtained, and the corresponding FFR was calculated. Results When the elastic modulus was fixed, the FFR for narrow part of the model decreased gradually with the increase of the stenosis rate, and the relative difference between the FFR of elastic wall and rigid wall increased with the increase of the stenosis rate; when the stenosis rate was fixed at 70%, the FFR decreased gradually with the increase of elastic modulus. Conclusions The effect of vascular wall elasticity should be considered in the process of functional assessment on carotid stenosis with FFR; the larger stenosis rate will lead to the greater influence from elastic modulus of vessel wall on FFR.