In order to observe the curative effect and general reaction of locally used adriamycin (ADM)-loaded chitosan drug delivery system on giant cell tumor of bone after curettage. The cavities of 4 cases of giant cell tumor after curettage were filled with ADM-loaded chitosan drug delivery system with 4 times the dosage usually used for intravenous application. After operation, the concentration of ADM in plasma on the 1st, 2nd and 5th day, and the functions of liver and kidney on the 1st week, 1st month and 6th month were all investigated. The results were that the concentration of ADM in plasma was (143.05 +/- 27.55) ng/ml, (52.17 +/- 11.28) ng/ml and (4.25 +/- 3.07) ng/ml respectively, and the functions of liver and kidney were all normal in 6 months. After a follow-up of 7-19 months, no local or general reactions were observed and X-ray showed no recurrence. Therefore, it was concluded that the locally used ADM-loaded chitosan delivery system was safe and effective in treatment of giant cell tumor of bone after curettage.
【摘要】 目的 观察小剂量氯胺酮在健忘镇痛麻醉辅助局部麻醉（局麻）剖宫产中的应用。方法 选择1200例剖宫产的孕妇,随机分为单纯局麻组(L组)、氟芬强化局麻组(F组)和健忘镇痛麻醉组(J组),每组400例。L组单纯局麻;F组局麻术中辅以氟哌利多500 mg,芬太尼015 mg;J组在F组基础上辅以氯胺酮,观察各组患者麻醉诱导至胎儿娩出时间;新生儿1、5 min Apgar评分;手术中血压相对于基础值的波动情况;手术中及手术后出血情况及麻醉满意度。 结果 J组与L组和F组比较,胎儿娩出时间无显著差别;Apgar评分提高;手术中孕妇血压波动不明显;手术中及手术后出血量无明显增加,麻醉满意度明显提高。 结论 由小剂量氯胺酮辅助实施的健忘镇痛麻醉在局麻剖宫产中优于单纯局麻和氟芬强化局麻,在剖宫产中尤其急诊剖宫产中值得推广。【Abstract】 Objective To observe the application of lowdose ketamine during the local anesthesia in cesarean section assisted by analgestic and amnestic anesthesia. Methods A total of 1200 cases who need cesarean section were randomly divided into 3 groups (400 cases in each group): simple local anesthesia group (group L), droperidolfentanyl strengthen local anesthesia group (group F) and analgestic and amnestic anesthesia group (group J). Group L was only local anesthesia. Group F was local anesthesia supplemented by droperidol 500 mg, fentanyl 015 mg. Group J was supplemented with ketamine on the basis of group F. Then the time from anesthesia to the fetus delivery, Neonatal Apgar score of one and five minutes, the blood pressure fluctuations, amount of bleeding in or after surgery and the satisfaction of anesthesia were all observed. Results Compared with group L and F, the delivery time was no significant difference, Apgar score increased, blood pressure fluctuations in pregnant women was not obviously varied, amount of bleeding in or after surgery had no significantly increase, and the satisfaction of anesthesia improved markedly all in group J. Conclusions The analgestic and amnestic anesthesia assisted by lowdose ketamine, in cesarean section, is better than local anesthesia and strengthen local anesthesia by droperidolfentanyl, which is worthy to be popularized, especially in emergency caesarean section.
Objective We searched and reviewed medical evidence to find the guide of treatment for local advanced nasopharyngeal carcinoma. Methods Firstly, we put forward clinical questions. Secondly, we searched medical evidence from Medline (1985-2002), Embase (1984-2000), Cochrane library (2002.1) and ACP. And then we reviewed the results. The key words we used were "nasopharyngeal carcinoma, chemotherapy and radiotherapy randomized" and "meta analysis or randomized control trial". Results Through searching, we got 17 papers including 1 systematic review and 16 randomized control trials, in which there were 8 prospective randomized phase Ⅲ trials. Most of these trials concluded that combination chemo-radiotherapy were better than radiotherapy alone. We think these results were suitable for our patient’treatment decision. Conclusion To treat our patients,we choosed the method of the mutimodality of squeitial neoadjuvant chemotherapy, concurrent chemo-radiotherapy and adjuvant chemotherapy with the drug doses down-adjusted.
Toexploretheinfluenceoflocalmassiveexcisionbeforeradicalsurgeryonprognosisofpatientswithbreastcancer,wecomparedtheprognosisbetweenthegroupunderwentlocalresectionpriortoradicalsurgery(106cases)andthegorupwithdirectradicalresection(143cases).Theresultsshowedthatthelocalrecurrencerate,distancemetastasisrateandthesurvivalrateat3,5yearsofthegroupunderwentlocalexcisionpriortoradicalsurgerywere16.0%,26.4%,79.2%,71.7%respectivelyandofthegroupunderwentdirectradicalresectionwere4.9%,16.1%,89.5%,82.5%respectively,thedeferencewassignificant(Plt;0.01,0.05,0.05,0.05respectively).Theresultsindicatethatthelocalexcisionbeforeradicalsurgerycanaffecttheprognosisofpatientswithbreastcancer.
Objective To discuss the clinicopathologic risk factors related to local recurrence of rectal cancer after radical surgery. Methods The complete clinicopathologic data of 368 patients with rectal cancer from January 2004 to April 2011 in this hospital were retrospectively analyzed by univariate and multivariate analysis methods. Results There were 73 cases suffered from local recurrence and accounted for 19.84% （73/368） of rectal cancer during the same period. Univariate analysis results showed that gender， tumor from anal margin， tumor circumference， TNM staging， histology type， vessel infiltration， tumor perforation， stomal leak， and chemoradiotherapy were associated with postoperative recurrence （P＜0.05）. Multivariate analysis results showed that tumor from anal margin， tumor circumference， TNM staging， histology type， vessel infiltration， tumor perforation， and chemoradiotherapy were prognostic factor for local recurrence of rectal cancer （P＜0.05）. Conclusions There are many factors related to postoperative local recurrence， but the most dangerous factor is vessel infiltration.
OBJECTIVE: To conduct the in vitro test on drug release of rifampin encapsulated in a carrier made of porous phosphate glass ceramics and to analyze main factors which affect the drug release rate. METHODS: A certain quantitative of rifampin was sealed in a hollow cylindrical capsule which consisted of chopped calcium phosphate crystal fiber obtained from glass crystallization. The rifampin concentration was measured in the simulated physiological solution in which the capsule soaked. RESULTS: Rifampin could be released in a constant rate from the porous glass ceramic carrier in a long time. The release rate was dependent on the size of crystal fiber and the wall thickness of the capsule. CONCLUSION: This kind of calcium phosphate glass ceramics can be a candidate of the carrier materials used as long term drug therapy after osteotomy surgery.
ObjectiveTo compare the outcomes of local anesthesia and general anesthesia in transcatheter aortic valve replacement (TAVR).MethodsA total of 399 severe aortic stenosis patients were included, who underwent TAVR successfully in West China Hospital of Sichuan University between April 2012 and January 2019. The baseline characteristics, procedural details, postprocedural outcomes, and ultrasound data of those patients were collected. All patients were followed up and the end date of follow-up was June 20th 2020. According to anesthetic mode, the patients were divided into local anesthesia group and general anesthesia group. The differences between the two groups in incidence of postprocedural complications, hemodynamics, postprocedural 30-day mortality, and postprocedural 1-year mortality were retrospectively analyzed.ResultsOf the 399 patients, 206 (51.6%) received local anesthesia and 193 (48.4%) received general anesthesia. There was no statistical difference between the two groups in baseline characteristics. The symptoms of both groups were relieved. But the incidences of mild bleeding events (12.4% vs. 1.5%, P<0.001), severe bleeding events (10.4% vs. 0.5%, P<0.001), major vascular complications (0.5% vs. 3.6%, P=0.032), and postprocedural 30-day all causes mortality (1.9% vs. 6.7%, P=0.018) were significantly lower in the local anesthesia group than those in the general anesthesia group.ConclusionIn TAVR, compared with general anesthesia, local anesthesia is safer to use with lower incidence of postprocedural complications and postprocedural 30-day all causes mortality.
Objective To explore the cl inical effectiveness of debridement in treatment of Pes anserinus bursitis under arthroscopy by comparing the curative effect of three therapies: local block therapy, open operation and debridement under arthroscopy. Methods From January 2000 to January 2007, 90 cases of unilateral Pes anserinus bursitis were treated with debridement under arthroscopy (group A, n=30), local block therapy (group B, n=30) and open operation (group C, n=30),respectively. The group A included 18 males and 12 females, aged (40.0 ± 2.5) years old; the locations were left knee in 16 cases and right knee in 14 cases; 10 cases had injury history, 7 cases had tired history and 13 cases had no obvious inducement; the course of disease was (24.0 ± 3.2) weeks. The group B included 17 males and 13 females, aged (37.0 ± 2.5) years old; the locations were left knee in 15 cases and right knee in 15 cases; 10 cases had injury history, 8 cases had tired history and 12 cases had no obvious inducement; the course of disease was (26.3 ± 3.5) weeks. The group C included 16 males and 14 females, aged (39.8 ± 2.2) years old; the locations were left knee in 18 cases and right knee in 12 cases; 8 cases had injury history, 10 cases had tired history and 12 cases had no obvious inducement; the course of disease was (25.0 ± 3.9) weeks. There was no statistically significant difference in the general data among three groups (P gt; 0.05). Results All patients were followed up 15 months on average (12-24 months). In group C, the inflammatory reation occurred at wound in 9 cases (30%) at 3-10 days after operation and was cured after symptomatic management; other incision healed by first intention; and showing statistically significant differences when compared with other 2 groups (P lt; 0.05). In group C, joint swell ing occurred at 1 week after operation in 1 case, l imitation of joint motion in 2 cases at 10-12 weeks after operation and was recovered after symptomatic management. In group B, 21 cases (70%) had a recurrence at 6-12 months after operation, all patients of other 2 groups had no recurrence; showing statistically significant differences between group B and groups A, C (P lt; 0.05). At last follow-up, the pain remain rates were 3.3% (group A), 0 (group B) and 33.3% (group C), and the compl ication incidence rates were 3.3%, 26.7% and 70.0%, respectively; all showing statistically significant differences among three groups (P lt; 0.05). At last follow-up, there were statistically significant differences in the visual analogue scale (VAS) score, the HSS score, and range of motion (ROM) between preoperation and postoperation in group A (P lt; 0.05); there was no statistically significant difference in the VAS score, HSS score and ROM between preoperation and postoperation in group B (P gt; 0.05); the ROM of postoperation in group C was smaller than that of preoperation (P lt; 0.05). There were statistically significant differences in the VAS score and HSS score between group A and groups B, C (P lt; 0.05), and in ROM among three groups after operation (P lt; 0.05). Conclusion The treatment of Pes anserinus bursitis with debridement under arthroscopy has advantages of easy-to-do, less compl ication, low relapse rate and good functional rehabil itation.
Objective To summarize the current advancement of preoperative radiotherapy for rectal cancer. Methods Relevant literatures about current advancement of preoperative radiotherapy for rectal cancer published domesticly and abroad recently were collected and reviewed. Results The lower local recurrence rate and longer disease-free survival time were observed in preoperative radiotherapy， compared with postoperative radiotherapy for rectal cancer. The recurrence rate was higher in short-course radiotherapy， compared with conventionally radiotherapy for stageⅢrectal cancer， but there was no significant difference for stageⅡrectal cancer. The biology molecular such as p53， CEA， Cox-2， EGFR， and VEGF had shown to be radiosensitive. Conclusions The proposal of preoperative radiotherapy for rectal cancer， could be prone to conventionally radiotherapy. There are more screening targets for preoperative radiotherapy in extensive exploration of diverse radiosensitivity. Biology molecular， developed gene expression profiling， and gene chips for rectal cancer may contribute to the individualization treatment.
Objective To introduce the surgical technique and results of total mesorectal excision (TME) for rectal cancer. Methods Reviews.Results As a result of TME, local recurrence rates have declined from 20%-30% to 3%-8%, 5-year survival rate have risen to 75%, and the rates of sphincter preservation have risen too.Conclusion Total mesorectal excision reduces the local recurrence rates and raise the survival figures after excision of rectal cancer. Patients have a high quality of life.