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find Author "周阳" 5 results
  • The application of enhanced recovery after surgery in pain management after total knee arthroplasty

    Objective To explore the application of enhanced recovery after surgery (ERAS) in pain management after knee arthroplasty (TKA). Methods Doctor-nurse pain management team was established based on ERAS between June and July 2016, and the pain management was carried out after training the doctors and nurses. According to the formula of two-sample mean comparison and inclusion and exclusion criteria, 60 TKA patients admitted to the hospital from March to May 2016 were assigned into the control group (before intervention) and 60 TKA patients admitted from August to October 2016 were assigned into the trial group (after intervention). The patients in the control group received routine pain management. In the trial group, preventive analgesia was performed, pain health education paths were built and ISBAR communication mode was made preoperatively; anesthesia protocols were optimized intraoperatively; multimodal analgesia based on time-demand was used postoperatively; continuing analgesia program was provided at the discharge. The pain score, Hospital for Special Surgery (HSS) knee score, average length of stay (ALOS) and average hospitalization cost (excluding materials) were compared between the two groups. Results The pain scores between the two groups at the admission and 6 hours after surgery were not statistically different (P>0.05), and the pain scores in the trial group 24, 48, 72 hours after surgery were significantly lower than those in the control group (P<0.05). The HSS scores between the two groups at the admission were not statistically different (P>0.05), and the HSS scores in the trial group 3 days, 1 week, and 1 month after surgery were significantly higher than those in the control group (P<0.05). And ALOS and average hospitalization cost (excluding materials) in the trial group were significantly lower than those in the control group (P<0.05). Conclusion The application of ERAS in pain management after TKA can effectively alleviate the postoperative pain, improve the patients’ knee function, shorten the ALOS, and decrease the average hospitalization cost.

    Release date:2017-09-22 03:44 Export PDF Favorites Scan
  • Short-term efficacy of purse-string Ivor-Lewis approach in minimally invasive esophagectomy for middle and lower esophageal cancer: A case control study

    Objective To compare the short-term efficacy of Ivor-Lewis via hand-sewn purse-string approach and purse-string forceps approach in minimally invasive esophagectomy for middle and lower esophageal cancer, and to discuss the safety and feasibility of hand-sewn purse-string anastomosis technique for minimally invasive Ivor-Lewis esophagectomy (MIILE). Methods The clinical data of 151 patients undergoing thoracoscopic and laparoscopic esophageal cancer surgery from January 2014 to January 2017 in our hospital were retrospectively analyzed. According to the different methods of purse string making, the patients were divided into a purse-string forceps group including 49 males and 16 females with a mean age of 67.98±7.07 years ranging from 51 to 80 years treated with forceps to make purse-string and a handcraft group including 61 males and 25 females with a mean age of 67.76±8.18 years ranging from 52 to 83 years using hand-sewn way. The perioperative data of two two groups were compared. Results The purse-string making time and postoperative total volume of chest drainage were less in the handcraft group than those in the purse-string forceps group (P<0.05). There was no significant difference between the two groups in hemorrhage during operation, the operation duration or postoperative hospital stay (P>0.05). There was also no statistical difference between the two groups in the rate of anastomotic or gastric tube fistula, anastomotic stenosis, pulmonary infection or incision infection (P>0.05). Conclusion In minimally invasive esophagectomy for middle-lower section, MIILE by hand-sewn purse-string is as safe as purse-string forceps, with no more complications, needing no professional equipments, and easy to learn, master and promote.

    Release date:2018-05-02 02:38 Export PDF Favorites Scan
  • The effect of PKD1 gene on autophagy in aortic smooth muscle cells

    ObjectiveTo explore the effects of PKD1 gene on mouse aortic smooth muscle (MOVAS) cells autophagy.MethodsThe shRNA and over-expression lentiviral vectors for the target gene of PKD1 were constructed. MOVAS cells were infected by a number of successful packaging shRNA (PKD1 knockdown) or ETS-1 (PKD1 over-expressing) lentiviral vectors, and qPCR was used to test interference and over-expressing effects. Then qPCR and Western blotting were used to detect the expression levels of autophagy markers including Atg5, Beclin1 and LC3 in control group, shPKD1 group and ETS-1 group.ResultsCompared with the control group, PKD1 mRNA level was decreased in the shPKD1 group (P<0.05); ETS-1 and PKD1 mRNA levels were increased in the ETS-1 group (P<0.05). In contrast with the control group, the mRNA levels of autophagy markers including Atg5 (P<0.05) and Beclin1 (P<0.01) were obviously decreased in the shPKD1 group, but they were obviously increased in the ETS-1 group (P<0.001). Protein levels of Atg5, Beclin1 and LC3 were significantly decreased in the shPKD1 group (P<0.05), but they were increased obviously in the ETS-1 group (P<0.05) in contrast with the control group.ConclusionPKD1 gene is involved in MOVAS cells autophagy, low expression of PKD1 gene can inhibit autophagy and high expression of PKD1 promotes autophagy in vascular smooth muscle cells.

    Release date:2020-05-28 10:21 Export PDF Favorites Scan
  • 改进后的腓肠神经营养血管皮肤筋膜蒂逆行岛状皮瓣应用总结

    目的探讨腓肠神经营养血管逆行岛状皮瓣改进前后皮瓣成活情况及静脉回流障碍的差异以及两种方法手术操作的难易程度。 方法回顾性分析2000年1月-2015年12月收治的79例因各种原因行腓肠神经营养血管筋膜蒂逆行岛状皮瓣修复患者的病历资料。根据患者手术方法,将79例患者分为传统手术组(n=44)和改进手术组(n=35)。观察对比两组患者术后的皮瓣成活率及静脉回流障碍的差异。 结果共纳入患者79例,传统手术组和改进手术组分别剔除2例和1例患者。传统手术组皮瓣均出现中、重度静脉回流障碍,而改进手术组静脉回流障碍以轻、中度为主(χ2=13.447,P<0.001);且两组患者皮瓣经相应处理后静脉回流障碍均缓解,未出现因静脉回流障碍皮瓣坏死的情况。术后,传统手术组2例皮瓣坏死,成活率95.2%;改进手术组皮瓣全部成活(χ2=70.205,P<0.001)。 结论改进后的腓肠神经营养血管皮肤筋膜蒂逆行岛状皮瓣无损伤供血动脉血管之虞,术后静脉回流障碍轻,操作简单,术者无需具备显微血管解剖经验,可向基层单位推广。

    Release date:2016-12-27 11:09 Export PDF Favorites Scan
  • 自体脂肪移植在整形与修复重建外科领域应用的指南

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