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简介：AIMTo评估关于光质量的培植根据包括的decentering.METHODSThis的不同的度估计了的V4c可植入的collamer透镜(洞ICL)的临床的结果收到了常规ICL的49只眼睛和收到了洞ICL的94只眼睛。收到了洞ICL的眼睛根据decentering的度被划分成三个组：组织1，在从学生中心的1条洞直径(HD)以内的中央洞；组织2，在到2HD的1HD以内的中央洞；并且组织3，在到3HD的2HD以内的中央洞。视觉尖酸(VA)，intraocular压力(IOP)，和球形的等价物(SE)价值在1wk被估计，1并且在外科以后的3mo。在surgery.RESULTSThere不是在VA，IOP，和SE的重要差别在之中以后，眼睛的调整转移功能，Strehl比率，客观散布索引，和更高的顺序错误(HOA)在3mo为4公里学生被测量常规并且洞ICL组。关于HOA，为昏迷和球形的错误的价值没显示出差别。全部的HOA和翘摇价值在比在组1的组2是显著地更高的(P=0.02，0.03，分别地)。在surgery.CONCLUSIONOur结果建议洞ICL培植提供等价于由常规ICL提供了那的令人满意的视觉质量以后，在关于在3mo的另外的光优秀参数的组之中没有重要差别，不管decentering的中央洞和度的存在。

简介：BackgroundAnomalousoriginoftheleftcoronaryarteryfromthepulmonaryartery(ALCAPA)isararecongenitalanomaly.Itdemonstratedthecombinedeffectsoftheabsenceofanormalcoronaryflowwithacoronarystealandtheprofoundischemiathatcanproduceleftventriculardysfunctionandmitralregurgitation.Wehereintroducethepostoperativemanagementofpatientswithrepairofanomalousoriginoftheleftcoronaryarteryfromthepulmonaryartery,withanemphasisonitsoutcome.MethodsRecordsof31patientswithanomalousoriginoftheleftcoronaryarteryfromthepulmonaryarteryreceivingsurgeryfrom1998to2010werereviewedretrospectively,10ofwhichweretreatedwiththemitralvalvesurgicallyatthesametime.Theageofpatientswas4monthsto16years(median,1year)andweightofthosewas5to53kilograms(median,7.8kilograms),allofwhichwerediagnosedofanomalousoriginoftheleftcoronaryarteryfromthepulmonarybyechocardiographyandcardiaccatheterization.Aftersurgery,electrocardiogram,echocardiography,arterialbloodpressure,transcutaneousoxygensaturationandcentralvenouspressureweremonitored.Commonpostoperativecomplicationsinourgroupwereanalysed.Andpreoperativeandpostoperativedataincludingareaofmitralregurgitation,leftventricularsystolicdiameterandleftventriculardistolicdiameterwereobtained.Cardiopulmonarybypasstimeandmechanicalventilationtimeofpostoperativepatientswithnopneumoniawerecomparedwiththosewithpneumonia.Binarylogisticregressionwasappliedfortheanalysisoftheriskfactorsofpostoperativepneumonia.ResultsOf31patients,30survivedaftersurgerywithearlymortalityof3.23%.Onepatientdiedofseverelowcardiacoutputsyndrome.Mechanicalventilationtimewas4hoursto168hourshours(mean,39.68±50.52hours;median,18hours).ICUstaywas16hoursto425hours(mean,111.65±127.03hours;median,44hours).Inourgroup,commonpostoperativecomplicationsweremyocardialischemia(n=12,36.4%),infection(n=

简介：Objective:Toexploretheeffectofearlyenteralnutrition(EN)onpostoperativenutritionalstatus,intestinalpermeability,andimmunefunctioninelderlypatientswithesophagealcancerorcardiaccancer.Methods:Atotalof96patientswithesophagealcancerorcardiaccancerwhounderwentsurgicaltreatmentinourhospitalfromJune2007toDecember2010wereenrolledinthisstudy.TheyweredividedintoENgroup(n=50)andparenteralnutrition(PN)group(n=46)basedonthenutritionsupportmodes.Thebodyweight,timetofirstflatus/defecation,averagehospitalstay,complicationsandmortalityafterthesurgeryaswellastheliverfunctionindicatorswererecordedandanalyzed.Peripheralbloodsampleswerecollectedonthedays1,4and7aftersurgery.Theplasmadiamineoxidase(DAO)activityandD-lactatelevelweredeterminedtoassesstheintestinalpermeability.TheplasmaendotoxinlevelsweredeterminedusingdynamicturbidimetricassaytoassesstheprotectiveeffectofENonintestinalmucosalbarrier.Thepostoperativebloodlevelsofinflammatorycytokinesandimmunoglobulinsweredeterminedusingenzyme-linkedimmunosorbentassay(ELISA).Results:Afterthesurgery,thetimetofirstflatus/defecation,averagehospitalstay,andcomplicationsweresignificantlylessintheENgroupthanthoseinthePNgroup(P<0.05),whereastheENgrouphadsignificantlyhigheralbuminlevelsthanthePNgroup(P<0.05).Onthe7thpostoperativeday,theDAOactivity,D-lactatelevelandendotoxincontentsweresignificantlylowerintheENgroupthanthoseinthePNgroup(allP<0.05).Inaddition,theENgrouphadsignificantlyhigherIgA,IgG,IgM,andCD4levelsthanthePNgroup(P<0.05)butsignificantlylowerIL-2,IL-6,andTNF-αlevels(P<0.05).Conclusions:Inelderlypatientswithesophagealcancerorcardiaccancer,earlyENaftersurgerycaneffectivelyimprovethenutritionalstatus,protectintestinalmucosalbarrier(byreducingplasmaendoxins),andenhancetheimmunefunction

简介：AbstractObjectives:Timing of drain removal and its effects on complications after major pancreatectomy remain controversial. We designed this study to assess whether early drain removal after major pancreatectomy influences the incidence of complications in the patients with low risk of postoperative pancreatic fistula (POPF).Methods:This is a single-center randomized controlled trial (RCT). A total of 144 patients undergoing pancreaticoduodenectomy (PD) and distal pancreatectomy (DP) who met the criteria, including drain amylase on postoperative day (POD) 1 and 3 less than 5000 U/L and drain output within POD 3 less than 300 mL/d, were randomly assigned to early drain removal (POD 3) or standard drain removal (≥POD 5). The primary outcome was major complications (Clavien-Dindo grades 2-4), and the secondary outcome was POPF, reintervention treatment, readmission, and total medical expense within 3 months after surgery.Results:A total of 5 patients in early drain removal group had at least 1 major complications (grades 2-4), compared to 15 patients in standard drain removal group (P=.028). The incidence of grade B/C pancreatic fistula was not significantly different (2.8% vs 0%). Multivariate analysis demonstrated that early drain removal was an independent factor associated with a reduced risk of major complications (P=.039, odds ratio=0.314). Majority of major complications occurred in PD patients, and only very few cases occurred in DP patients. Stratified analysis showed that early drain removal significantly reduced the major complications only in the patients undergoing PD.Conclusion:This single-center RCT shows early drain removal on POD 3 is safe for both DP and PD patients, under our criteria. Early drain removal could reduce the incidence of major complications in patients undergoing PD.

简介：BackgroundTherewerefewstudiestoexploretherelationshipbetweenpostoperativemeansystolicbloodpressure(PMSBP)within6haftercardiaccatheterizationandcontrast-inducednephropathy(CIN).MethodsFromJune2010toFebruary2013,299consecutivepatientsundergoingcardiaccatheterizationwererecruited.PatientswereclassifiedintoquartilesbasedonPMSBP(<112,112-120,121-131,and>132mmHg).Baselinedata,CINincidenceandin-hospitaloutcomeswerecomparedbetweenthegroups.LogisticregressionwasusedtoassesstherelationshipbetweenPMSBPandCIN.ResultsCINoccurredin26(8.7%)patients.TheincidenceofCINinPMSBPquartileswere15.3%(11/72),15.1%(11/73),2.4%(2/82)and2.8%(2/72)(P=0.001)respectively.Therewerenosignificantdifferenceinin-hospitaldeath,renalreplacementtherapyandintra-aorticballoonpump(IABP)supportbetweenthegroups(P>0.05).UnivariatelogisticregressionanalysisshowedthatPMSBPwassignificantlyassociatedwithCIN(OR=0.956,95%CI:0.928-0.986,P=0.004).Multivariatelogisticregressionanalysisfoundthatafteradjustingbaselineestimateglomerularfiltrationrate,age>75yearsandacutemyocardialinfarction,PMSBP<120mmHgwasstillanindependentriskfactorforCIN(OR=5.049,95%CI:1.820-14.009,P=0.002).ConclusionsLowerPMSBPwassignificantlyassociatedwithanincreasedriskofCIN.PMSBP<120mmHgwasanindependentriskfactorforCIN.Intensiveblood-pressurecontrolaftercardiaccatheterizationmightincreasetheriskofCIN.

简介：跟腱的客观外科的修理(在)破裂应该被活跃的腱动员立即跟随。动员什么时候应该开始的最佳的时间还是重要的争论。早kinesitherapy导致减少的康复时期。然而，进这个过程的详细机制的卓见没被获得。Proteomic技术能被用来由与不同蛋白质的函数有关的微分表达式侧面分开并且净化蛋白质，但是在proteomic分析的区域研究在3点，在修理以后的天到目前为止没被学习。47只新西兰白兔子被使随机化进3个组的方法。组A(固定组，n=16)收到的手术后的演员组固定；组B(早运动组，n=16)立即跟随修理的收到的早活跃的运动处理在从腱切断术另外一个的破裂，15只兔子担任了控制组(组C)。AT样品被准备3天列在后面microsurgery。蛋白质被分开采用二维的polyacrylamide胶化电气泳动(2D页)。PDQuest软件版本8.0被用来鉴别差别表示了蛋白质，由肽团指纹(PMF)和双人脚踏车团光谱分析列在后面，用生物工学信息(NCBI)蛋白质数据库检索然后为生物信息学分析的国家中心。446.33，436.33和462.67蛋白质吝啬的结果A在组在组A，在组B的14只兔子和13只兔子在13只兔子的跟腱样品上看到C成功地被检测在2D页。分别地在组A，B和C有40，36和79唯一的蛋白质。一些差别表示了蛋白质是有胶化的酶，帮助矩阵的laser-desorption/ionizationtime-of-flight团spectrometry(MALDI-TOFMS)。我们成功地在组A和B识别了9和11不同蛋白质，例如GAPDH，phosphoglyceratekinase1，pro-alpha-1类型1骨胶原，peroxiredoxin1，alpha-1-antiproteinaseEa-1和MAD2L1绑定蛋白质，等等。并且有分子的女伴的一些，氧化应力，精力新陈代谢，信号transduction，结合了腱房间表达式和蛋白质合成，增殖，区分并且仔细与AT有关正在愈合。GAPDH蛋白质进一步通过西方的弄污被验证。一

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简介：AbstractBackground:Managing acute postoperative pain is challenging for anesthesiologists, surgeons, and patients, leading to adverse events despite making significant progress. Patient-controlled intravenous analgesia (PCIA) is a recommended solution, where oxycodone has depicted unique advantages in recent years. However, controversy still exists in clinical practice and this study aimed to compare two drugs in PCIA.Methods:We performed a literature search in PubMed, Embase, the Cochrane Central Register of Controlled Trials, Web of Science, Chinese National Knowledge Infrastructure, Wanfang, and VIP databases up to December 2020 to select specific randomized controlled trials (RCTs) comparing the efficacy of oxycodone with sufentanil in PCIA. The analgesic effect was the primary outcome and the secondary outcome included PCIA consumption, the Ramsay sedation scale, patients’ satisfaction and side effects.Results:Fifteen RCTs were included in the meta-analysis. Compared with sufentanil, oxycodone showed lower Numerical Rating Scale scores (mean difference [MD] = -0.71, 95% confidence interval [CI]: -1.01 to -0.41; P < 0.001; I2 = 93%), demonstrated better relief from visceral pain (MD = -1.22, 95% CI: -1.58 to -0.85; P < 0.001; I2 = 90%), promoted a deeper sedative level as confirmed by the Ramsay Score (MD = 0.77, 95% CI: 0.35-1.19; P < 0.001; I2 = 97%), and resulted in fewer side effects (odds ratio [OR] = 0.46, 95% CI: 0.35-0.60; P < 0.001; I2= 11%). There was no statistical difference in the degree of patients' satisfaction (OR = 1.13, 95% CI: 0.88-1.44; P = 0.33; I2 = 72%) and drug consumption (MD = -5.55, 95% CI: -14.18 to 3.08; P= 0.21; I2= 93%).Conclusion:Oxycodone improves postoperative analgesia and causes fewer adverse effects, and could be recommended for PCIA, especially after abdominal surgeries.Registration:PROSPERO; https://www.crd.york.ac.uk/PROSPERO/; CRD42021229973.

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简介：AbstractBackground:Surgery is a conventional mature treatment for moyamoya disease (MMD). However, whether surgery is also an effective therapy for epileptic type MMD has seldom been investigated systematically. The study aims to summarize the pooled postoperative incidence of seizure and cerebral infarction in pediatric patients with epileptic type moyamoya disease.Method:The study was a systematic review and critical appraisal with a meta-analysis of cohort studies, both prospective and retrospective. Studies were identified by a computerized search of PubMed, Embase, Web of Science, Wanfang, and CNKI databases. In a literature search, a total of 7 cohort studies were identified. The I2statistic was used to quantify heterogeneity. A fixed-effect model was used to synthesize the results. The linear regression test of funnel plot asymmetry was used to estimate the potential publication bias.Results:The pooled estimated postoperative incidence of seizure in pediatric patients with epileptic type moyamoya disease was 23.44%. The pooled estimated postoperative incidence of cerebral infarction in pediatric patients with epileptic type moyamoya disease was 9.12%. Low substantial heterogeneity and potential publication bias were present.Conclusions:Evidence from this study suggests that the postoperative incidence of seizure and cerebral infarction is relatively low. Surgery is an effective and secure therapy for pediatric patients with epileptic type moyamoya disease.

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简介：From1990to2001,theauthortreated31casesofurinaryretentionofposthemorrhoidectomyorcesareansectionwithacupunctureofHegu(LI4)(reinforcingmethod)andSanyinjiao(SP6)(reducingmethod).Thetherapeuticeffectofthetreatmentwassatisfactory,thetotaleffectiveratewas96.7%.Followingisthereportofthetreatment.

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