Bile Duct Neoplasms ; pathology ; surgery ; Bile Ducts, Intrahepatic ; Cholangiocarcinoma ; pathology ; surgery ; Hepatectomy ; methods ; Hepatic Artery ; pathology ; surgery ; Humans ; Lymph Node Excision ; methods ; Portal Vein ; pathology ; surgery

Objective To compare the effect of oxycodone or sufentanil in preventing post-operative hyperalgesia induced by remifentanil.Methods One hundred and twenty patients scheduled for radical operation for carcinoma of stomach undergoing general anesthesia, 62 males and 58 females, aged 18-65 years, ASA physical status Ⅰ or Ⅱ, were randomly divided into 3 groups.Thirty minutes before the end of operation, oxycodone hydrochloride 10 mg was administered intravenously in oxycodone hydrochloride group (group O, n=42) while sufentanil 10 μg was injected in group S (group S, n=40) and equal normal saline was injected in control group (group C, n=38).The VAS score after waking up was recorded.VAS score>3 was defined as hyperalgesia, and sufentanil was injected when VAS score≥6.The BCS scores were recorded immediately after extubation (T1), 30 min (T1), 1 h (T3), 2 h (T4) and 4 h (T5) after extubation.Awakening time and extubation time and the incidence of nausea and vomiting 4 h after extubation were compared.Results At T1-T5, the BCS scores in group O were significantly higher than those in groups S and C (P<0.05).Group S has a higher adverse reaction (P<0.05).There was no significant differences of awakening time and extubation time in 3 groups.Conclusion Prophylactic injection of oxycodone 10 mg can reduce incidence rate of post-operative hyperalgesia, and increase BCS score with little side effects.

Hepatectomy ; Humans ; Liver Neoplasms ; surgery ; Preoperative Care ; Safety

Objective To evaluate the early therapeutic effect of flail chest with pulmonary contusion by using different mode of mechanical ventilation. Methods Twenty-nine patients of flail chest with pulmonary contusion were analysed retrospectively. All the patients were treated with the ventilator Bear1000. Two groups were established: invasion group was treated with SIMV+PEEP(8 cases) and CPAP+PSV (7 cases), noninvasion group was treated with NIPPV(14 cases). Results There was no death in all the patients. CPAP+PSV was more effective than SIMV+PEEP not only in decreasing breath rate and improving hypoxemia but also in decreasing peak inspiratory pressure(P

Bile Duct Neoplasms ; surgery ; Bile Ducts, Intrahepatic ; Cholangiocarcinoma ; surgery ; Humans

Objective To investigate the expressions of nitric oxide synthase (NOS) protein and mRNA in the lung of rats with hepatopulmonary syndrome. Methods Male Sprague-Dawley rats were divided into four groups: sham operation (SO), intrahepatic portal hypertension (IHPH), prehepatic portal hypertension (PHPH) and portasymstimic shunt (PCS). Two weeks after preparation of rat models, the following measurements were performed: arterial blood gas analysis; the concentrations of NO in lungs; in situ hybridization of ecNOS and iNOS mRNA expressions in lung tissue sections with digoxin-labeled ecNOS and iNOS oligonucleotide probes; expressions of ecNOS and iNOS proteins by immunohistochemisty; image and semiquantitative analysis of the expressions of ecNOS, iNOS and their mRNA. Results PaO_ 2 was (73.85?6.51) mmHg in IHPH rats, significantly lower than that in PHPH, PCS and SO rats97.39? 1.33, 95.23?2.22 and (99.05?0.75)mmHg, respectively.The level of lung NO of IHPH was(19.78?5.33)?mol per gram of protein,much higher than that of PHPH, PCS and SO 13.21?3.99,13.89?3.16 and (8.71?1.68)?mol per gram of protein,respectively. In capillary endothelia, positive expressions of ecNOS mRNA and ecNOS protein in IHPH(4.96?0.82,4.11?0.28) were significantly higher than those of PHPH (1.81? 0.39, 1.63?0.18), PCS (1.88?0.53,1.83?0.16)and SO(1.19?0.32,0.98?0.20). Conclusion The expressions of NOS protein and mRNA in the lung of rats with hepatopulmonary syndrome were increased, and the level of lung NO was elevated, which seems to play an important role in the pathogenesis of hepatopulmonary syndrome.

Antigens, CD19 ; analysis ; Asthma ; blood ; Child ; Child, Preschool ; Female ; Flow Cytometry ; Humans ; Immunoglobulin E ; blood ; Lymphocytes ; immunology ; Male ; Receptors, IgE ; analysis

Cysts ; complications ; Exophthalmos ; complications ; Frontal Sinus ; pathology ; Humans ; Male ; Middle Aged ; Paranasal Sinus Diseases ; complications

OBJECTIVETo study the applied value of double joystick technique in reduction-internal fixation for femoral shaft fracture in adults.

METHODSThirty-four patients (24 males and 10 females) with femoral shaft fractures were treated with reduction assisted by double joystick technique and internal fixation with interlocking intramedullary nail from September 2010 to June 2013. The average age of the patients was 41 years old, ranged from 17 to 65 years old. The duration of the disease course ranged from 3 to 7 days, with a mean of 5 days. The fractures belonged to AO types 32A (5 cases), 32B (20 cases) and 32C (9 cases) and located in left femur for 18 patients and right femur for 16 patients. The patients were followed up, and fracture healing and complications were observed. The curative effect were evaluated according to Thorsen femur fracture evaluation standard.

RESULTSThe operative time ranged from 40 to 110 min (mean 75 min) and intraoperative blood loss ranged from 200 to 300 ml (mean 250 ml). All the patients obtained a good fracture reduction and were followed up for 12 to 24 months (mean 18 months) after the surgery. All the fractures united between 4 and 8 months with a mean of 5 months. No complications such as breakage of nail, infection, osteofascial compartment syndrome, refracture and fracture malunion were found. According to Thorsen femur fracture evaluation standard, 30 patients obtained an excellent result, 3 good and 1 fair.

CONCLUSIONIn surgery of reduction-internal fixation for femoral shaft fracture in adults, the use of double joystick technique obtains good reduction result, short operative time, less injury, high healing rate of bone fractures, less complications and good limbs function, so it is worthy of popularizing in clinic.

Adolescent ; Adult ; Aged ; Bone Nails ; Female ; Femoral Fractures ; physiopathology ; surgery ; Fracture Fixation, Intramedullary ; instrumentation ; methods ; Fracture Healing ; Humans ; Male ; Middle Aged ; Young Adult

Hepatectomy ; methods ; Humans ; Liver ; blood supply