The course of chronic pancreatitis is prolonged, and pain is the main symptom, which seriously affects the quality of life and work ability of patients. Its treatment is the most important and complex problem. This article systematically describes the theoretical basis, indications, efficacy, selection and balance of drugs, endoscopy, surgery and other measures related to pain treatment.
Postoperative cognitive dysfunction (POCD) is a common and important complication after cardiac surgery. The pathological reactions caused by cardiac surgery, such as traumatic stress reaction, inflammation, hemodynamics disorders, and blood coagulation dysfunction, by triggering central inflammation, ischemia, hypoxia and ischemia-reperfusion injury and other mechanisms, leading to brain function-impairment, causing the development of POCD. According to the above mechanisms, taking corresponding protective measures, reducing the development of POCD, and improving the quality of life after cardiac surgery are of great importance.
The single ventricular circulation is notable for coexisting systemic venous hypertension and pulmonary arterial hypotension. The use of mechanical circulatory support (MCS) devices is a viable therapeutic treatment option for patients with congestive heart failure. Ventricular assisted devices, cavopulmonary assisted devices, and total artificial heart pumps continue to gain acceptance as viable treatment strategies for single ventricular physiology patients as bridge-to transplantation, bridge-to-recovery, and longer-term circulatory support alternatives. Patients with single ventricular physiology had the lower survival rates compared with those with biventricular circulation. We present a review of the current and future MCS devices for patients with univentricular circulations.
This paper introduced definition of right care, presented the evidences of overuse and underuse in the world and pointed out the importance of dissemination of evidence-based medicine to right care. Not only evidence production but also concepts of evidence-based practical are important. It is important to disseminate evidence-based medicine not only among academic societies but also among the public. These are critical for achieving right care and preventing overuse and underuse of medical care.
Objective To measure the paraspinal muscle parameters, explore the characteristics of paraspinal muscles, and investigate the influence factors of paraspinal muscle degeneration in healthy people. MethodsEighty-two healthy Chinese people were prospectively recruited between February 2020 and November 2020, including 36 males and 46 females. The age ranged from 21 to 75 years, with a mean of 48.0 years. The height ranged from 150 to 183 cm, with a mean of 165.6 cm. The body mass ranged from 43 to 100 kg, with a mean of 65.4 kg. The body mass index (BMI) ranged from 16.7 to 32.4 kg/m2, with a mean of 23.7 kg/m2. Parameters of the paraspinal muscles (multifidus muscle, erector spinae muscle, and psoas major muscle) at L3, L4, and L5 levels were measured by MRI, including the relative total cross-sectional area (rtCSA), relative fatty cross-sectional area (rfCSA), relative signal intensity (rSI), and fatty infiltration (FI). The differences of paraspinal muscle parameters at different genders and different measurement levels were compared; Pearson or Spearman correlation analysis was used to explore the relationship between paraspinal muscle parameters and age, height, body mass, BMI. Results From L3 to L5 level, the rtCSA and rfCSA of multifidus muscle and psoas major muscle as well as the rfCSA of erector spinae muscle increased, while rtCSA of erector spinae muscle decreased. The FI and rSI of paraspinal muscles increased gradually. The parameters of paraspinal muscles at L4 and L5 levels were significantly different from those at L3 levels (P<0.05). There were significant differences in rtCSA and rfCSA of multifidus muscle, rtCSA, FI, and rSI of erector spinae muscle as well as rtCSA, rfCSA, and FI of psoas major muscle between L4 and L5 levels (P<0.05). Compared with males, the rfCSA and FI of multifidus muscle, FI of erector spinae muscle, and FI of psoas major muscle were significantly higher in females, while the rtCSA of psoas major muscle was significantly lower (P<0.05). Age was significantly negatively correlated with rtCSA of paraspinal muscles (P<0.05), but significantly positively correlated with FI of paraspinal muscles, rfCSA and rSI of multifidus and erector spinae muscles (P<0.05). Height was significantly negatively correlated with rfCSA and FI of paraspinal muscles (P<0.05). ConclusionThe degree of paraspinal muscle degeneration increases gradually along the spine axis from head to tail. Paraspinal muscle degeneration is related to age, height, and gender. The relationship between the body mass, BMI and paraspinal muscle degeneration needs further study.
ObjectiveTo investigate the protective mechanism of prostaglandin E1 against hepatic ischemia reperfusion injury.MethodsUsing 45minute ischemiareperfusion rat model in normal temperature, PGE1 was injected into portal vein before ischemia. An hour later blood was taken from portal vein to examine the enzyme levels, including GOT, GPT, LDH and TNFα, ET1. The alteration of pathological morphology of the ischemia lobe was observed.ResultsThe three enzemes, TNFα, ET1 levels of ischemiareperfusion group were significantly higher than those of the control group (P＜0.01). The indices of the PGE1 group were much lower than those of the ischemiareperfusion group (P＜0.01), but little higher than those of the control group (P＞0.05). The control group had obvious alteration in pathological morphology, but only slight alteration in PGE1 group, compared with the control group. ConclusionPGE1 protects against ischemiareperfusion injury of the liver.