【摘要】 目的 探讨癫痫患者注意功能受损的特点。 方法 2008年12月-2009年12月选取69例癫痫患者作为病例组，35例正常人作为对照组，分别用持续操作任务实验（continuous performance test，CPT）、斯特鲁普实验（Stroop）和双任务实验测查持续注意、选择注意和分散注意功能。 结果 与对照组相比，病例组CPT反应时延长，漏报率增加（Plt;0.05）；Stroop实验冲突条件下反应时延长，冲突、一致和中性条件下错误率增加，冲突和中性条件下的反应时干扰量和错误率干扰量增加（Plt;0.05）；双任务比单任务划销方格数目减少，字符串正确率减少，双任务减退程度增加（Plt;0.05）。 结论 癫痫患者的持续注意、选择注意和分散注意功能均受损。【Abstract】 Objective To observe the damages of attentive function in the patients with epilepsy. Methods From December 2008 to December 2009, 69 patients with epilepsy and 35 healthy people were selected as the patients group and control group. All the selected ones underwent continuous performance test (CPT), Stroop test and dual task, respetviely, to assess their sustained attention, selected attention and divided attention. Results In CPT, the reaction time prolonged and the omission rate increased significantly in the patient group compared with those in the control group (Plt;0.05). In Stroop test, the reaction time in the patients group prolonged under incongruous condition, and error rate increased under incongruous, congruous and neutral conditions. The reaction time interfered effects and error interfered effects increased under incongruous and neutral conditions (Plt;0.05); the boxes crossed and right rate of digit strings decreased and decrement increased during dual task than single task in the patient group (Plt;0.05). Conclusion The sustained attention, selected attention and divided attention of patients with epilepsy are impaired.
Objective To explore the early prevention measures of severe acute pancreatitis （SAP） complicated with infection. Methods The foreign and native related literatures of SAP complicated with infection in recent 10 yearswere retrieved， and the effect of sooner measures for SAP complicated with infection were discussed. Results It was beneficial to reduce the incidence of infection and improve the outcome in SAP by using antibiotics of apt through the blood-pancreatic barrier， using proton pump inhibitor properly， and using enteral nutrition， hemofiltration， and hyperbaric oxygen as soon as possible， and then combined with traditional Chinese medicine. Conclusions SAP complicated with infection is the one of the main reasons of death. It is a must to take effective and comprehensive measures in the early stage in order to reduce the rate of infection. However， there are several unclear problems to probe in the future on this issue.
Regional cerebral oxygen saturation cerebral oxygen saturation(rScO2) monitoring by using near-infrared spectroscopy(NIRS) is a simple, sensitive, continuous and noninvasive method, which can detect the change in oxygen supply and demand. It has already draw attentions and applications during perioperative in recent years. The technique was firstly used in cardiac surgery, thereafter some studies found thoracic surgery which mostly used one-lung ventilation also was necessary to monitor rScO2. A series of studies confirmed there were correlations among perioperative adverse events and rScO2. In this paper, we reviewed the basic principle of rScO2, summarized the applications of rScO2 in cardiac and thoracic surgery, discussed the existing problems.
Objective To evaluate the effects of low-dose epinephrine on cerebral oxygen saturation (rScO2) and awakening time during one-lung ventilation (OLV) for thoracic surgery. Methods Thirty consecutive patients undergoing lobectomy from March to July 2016 in our hospital were randomly divided into an epinephrine group (n=15, 8 males and 7 females at an average age of 58.70±11.40 years) or a saline group (n=15, 7 males and 8 females at an average age of 57.00±11.40 years). They were continuously infused with 0.01 μg/(kg·min) epinephrine or saline after general induction. Hemodynamics was maintained ±20% of the baseline value. All patients were ventilated by a pressure control mode during OLV with tidal volume of 5-8 ml/kg and end-tidal carbon dioxide tension (EtCO2) of 35-45 mm Hg. Regional cerebral oxygen saturation (rScO2) was monitored using near-infrared spectroscopy (NIRS) continuously. Results Compared with the saline group, the epinephrine group had a high rScO2 during OLV, with a statisitical significance at OLV 40 min and 50 min (67.76%±4.64% vs. 64.08%±3.07%, P=0.016; 67.25%±4.34% vs. 64.20%±3.37%, P=0.040). In addition, the awakening time of patients in the epinephrine group was shorter than that of the saline group (P=0.004), and the awakening time was associated with the duration of low-dose rScO2 (r=0.374). Conclusion Continuous infusion of 0.01 μg/(kg·min) could improve the rScO2 during OLV and shorten awakening time in thoracic surgery.
Objective To investigate the effectiveness of double-plane high tibial osteotomy in treatment of medial compartment osteoarthritis. Methods The clinical data of 65 patients with medial compartment osteoarthritis who were treated with double-plane high tibial osteotomy between January 2014 and January 2017 was retrospectively analyzed. There were 28 males and 37 females. The age ranged from 46 to 75 years with an average of 53.2 years. There were 30 cases in the left knee and 35 cases in the right knee. The disease duration was 3-7 years (mean, 4.0 years). The patients had different degrees of pain in the knee joint and difficulty walking. The knee joint compression test was positive. The knee joint function was evaluated by Hospital for Special Surgery (HSS) score and knee society score (KSS) clinical and functional scores. The visual analogue scale (VAS) score was adopted to pain measurement. The healing of osteotomy was observed by X-ray films during follow-up; the femur tibia angle (FTA), posterior tibial slope (PTS), medial proximal tibial angle (MPTA), and knee varus angle (KVA) were also calculated. Results All the incisions healed by first intention after operation. Only 1 case had numbness of the toe, and the symptoms disappeared after symptomatic treatment. All patients were followed up 13-18 months with an average of 15.4 months. X-ray examination showed that all patients had bone healing at 12 weeks after operation. There were significant differences in MPTA, FTA, PTS, and KVA between pre- and post-operation (P<0.05). There was no significant difference in above parameters among 1 week, 6 months, and 12 months after operation (P>0.05). There was no loosening and rupture of the fixator during the follow-up. The HSS score and KSS clinical and functional scores at 12 months after operation were significantly higher than those before operation (P<0.05). The VAS scores at 1 week, 6 months, and 12 months after operation were significantly lower than that before operation (P<0.05). Conclusion Double-plane high tibial osteotomy for medial compartment osteoarthritis can effectively relieve pain symptoms and improve joint function.
Surgical operation is the first choice for most patients who suffer from early non-small cell lung cancer. The risk of ordinary thoracic surgery is between intermediate and high risk. Due to the high incidence of postoperative pulmonary complications after thoracic surgery, preoperative cardiopulmonary reserve assessment is extremely necessary and important. In recent years, lots of assessment tools are clinically used, including pulmonary function tests, arterial blood gas analysis, breath-holding test and 6-minute walk test. In addition, cardiopulmonary exercise test is used extensively. This article reviews the current status of preoperative cardiopulmonary reserve assessment in thoracic surgery to guide clinical decisions, reduce postoperative complications and improve outcomes.
In recent years, the potential benefits of acetazolamide in managing fluid overload in acute decompensated heart failure (ADHF) have attracted the attention of researchers. This article reviews the pharmacological mechanism of acetazolamide, how it improves patient symptoms and clinical prognosis in the treatment of heart failure, and the research progress in clinical application. The aim is to provide theoretical and research basis for clinicians to adjust and choose the comprehensive application plan of diuretics for ADHF, and to provide new ideas and directions for further research and development of new drugs targeting diuretic resistance in ADHF patients.
Atherosclerotic cardiovascular disease (ASCVD) is a disease caused by the accumulation of atherosclerotic plaques that leads to arterial hardening and impairment of contractility. Proprotein convertase subtilisin/kexin type 9 (PCSK9) can increase low-density lipoprotein cholesterol levels in plasma, which accelerates the development and progression of ASCVD. This article intends to review the biological characteristics and functional mechanisms of PCSK9, elucidate its impact on the development and progression of ASCVD, provide research literature support for the diagnosis and treatment of such diseases and improving the prognosis of patients.
Objective To systematically evaluate the correlation between coffee and risk of endometrial cancer. Methods Such databases as CBM, CNKI, WanFang data, PubMed, EMbase and The Cochrane Library (Issue 5, 2012) were searched to collect the prospective cohort studies about correlation between coffee and endometrial cancer. The retrieval time was by the end of May 2012, and the references of the included literature were also retrieved. Two evaluators independently screened the literature according to the inclusion and exclusion criteria, extracted the data, and assessed the quality, and then the statistical analysis was conducted by using Stata 12.0 software. Results A total of 10 cohort studies involving 4 484 patients with endometrial cancer were included. The results of meta-analysis showed that, compared with the women who didn’t drink coffee or drank in the lowest dose, the women who drank coffee in the highest dose had a decreased risk of endometrial cancer (RR=0.69, 95%CI 0.62 to 0.78), same as the women who drank coffee frequently (RR=0.83, 95%CI 0.77 to 0.89). The results of dose-response analysis revealed that, when there was an increase of 2 more cups of coffee per day, there was the risk of endometrial cancer decreased by 12%. Conclusion Drinking coffee frequently (more than 2 cups per day) can decrease the risk of endometrial cancer which can be significantly decreased when drinking in a big dose (more than 5 cups per day).
ObjectiveTo evaluate the ultrasonic pre locating internal jugular venous cannulation in infants, comparison with the external landmark technique.MethodsSixty two infants scheduled for cardiac surgery were randomized prospectively into two groups. In the anatomic landmarks group( n =30), the patient’s internal jugular vein(IJV) were cannulated by using the traditional method of palpation of carotid pulsation and identification of other anatomic landmarks. In the ultrasonic pre locating group ( n =32), an two dimensional ultrasound scanner image made for locating the puncture site of vessels was used with an operative probe of HP SONOS 4500 system. The number of attempts, success rate, and incidence of complications were compared for two groups.ResultsThe success rate was 100% vs 80% in the ultrasonic pre locating group vs anatomic landmarks group, with a 3.1% vs 26 7% incidence of carotid artery punctures and the number of attempts 1.57±1.04 vs 2.55±1.76. All differences were statistically significant ( P lt;0.05,0.05,0.01). Conclusion Ultrasonographic pre-localization of the IJV is superior to the anatomic landmarks technique in terms of overall success , and decreases incidence of carotid artery puncture.