目的 探讨急性心肌梗死冠状动脉介入治疗（PCI）术后患者梗死区心肌存活性对左室重构及功能的影响。 方法 2006年2月－2010年12月208例急性心肌梗死急诊PCI术后的患者接受静息状态下18氟-脱氧葡萄正电子断层显像进行心肌代谢显像检查，根据基线梗死区心肌有无存活分为两组，同时进行超声心动图检查，评价左室壁运动、左室射血分数，左室舒张末内径、左房内径及舒张期二尖瓣血流速度峰值的比值。血运重建术后12个月随访超声心动图，观察梗死区心肌存活状态对于左室重构以及心功能的影响。 结果 PCI术后12个月，有存活心肌组左室射血分数（46.7 ± 6.98）%高于无存活心肌组（45.1 ± 7.12）%，两组差异有统计学意义（P＜0.01），有存活心肌组左室舒张末期内径（53.17 ± 3.89） mm小于无存活心肌组（55.46 ± 4.75） mm，两组差异有统计学意义（P＜0.05）。左房内径及舒张期二尖瓣血流速度峰值的比值两组随访时均无明显变化。 结论 急性心肌梗死行PCI治疗后的患者，在有存活心肌的情况下，心功能改善明显；而梗死区无心肌存活的患者，12个月后，心功能减低，左室重构更加明显。
Objective To assess the anesthetic efficacy of articaine versus lidocaine for irreversible pulpitis. Methods We electronically searched PubMed, EMbase, Cochrane Library (Issue 4, 2009), CNKI, VIP and CBM. The search was updated to December 2009. Randomized controlled trials (RCTs) and quasi-RCTs were indentified about articaine and lidocaine for irreversible pulpitis. Study selection and meta-analysis were conducted according to the Cochrane Handbook for systematic reviews. And RevMan5.0 was applied for statistical analysis in success rate. Results Nine trials involving 985 pulpitis patients were included. Meta-analysis indicated that, both the anesthetic success rate (RR=1.33, 95%CI 1.23 to1.44) and maxillary anesthetic success rate (RR=1.65, 95%CI 1.38 to 1.98) of articaine were superior to that of lidocaine, but there was no statistical significance in mandibular anesthetic success rate between two groups (RR=1.28, 95%CI 0.97 to 1.69). Conclusion The current evidence shows that articaine is superior to lidocaine in anesthetic efficacy, and is good at maxillary anesthesia.
Objective To investigate the effect and clinical significance of 3 d and 1 d bowel preparation method for colorectal carcinoma surgery on preoperative gut mucosal barrier function. Methods Plasma levels of D-lactate (D-LAC), diamine oxidase (DAO) and endotoxin (ET) were measured at 2 h before operation in 3 d bowel preparation group (50 cases) and 1 d bowel preparation group (50 cases), 25 cases of inguinal hernia were included as control group. D-LAC, DAO and ET were detected by using enzymatic spectrophotometric assay, spectrophotometric assay and limulus lysate test with azo chromogenic substrate, respectively. Results Preoperative plasma levels of D-LAC, DAO and ET in 3 d bowel preparation group were (10.25±1.43) mg/L, (5.82±0.80) U/ml and (10.11±1.41) ng/L respectively. In 1 d bowel preparation group the corresponding values were (10.19±1.35) mg/L, (5.80±0.81) U/ml and (9.82±1.35) ng/L respectively. There were no significant differences between 3 d and 1 d bowel preparation group (Pgt;0.05), compared with hernia group, 1 d and 3 d bowel preparation group were also no statistically significant differences (Pgt;0.05). Conclusions There are no significant preoperative gut mucosal barrier function damages in patients with 1 d and 3 d bowel preparation for colorectal carcinoma surgery, 1 d bowel preparation for colorectal carcinoma surgery can be performed in colorectal carcinoma patients, and 3 d bowel preparation can be used for certain special colorectal carcinoma patients.