Exp Ther Med
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This study compared the effects of sevoflurane and propofol on the inflammatory response and pulmonary function of patients with lung cancer during the perioperative period. Forty patients who underwent a selective resection of the inferior lobe of the left lung were randomly divided into two groups, with one group anesthetized with sevoflurane and the other with propofol (groups S and P, respectively). Radial arterial and mixed venous blood were extracted for blood gas analysis, in order to calculate the alveolar-arterial oxygen partial pressure difference (PA-aDO2), respiratory index (RI) and pulmonary shunt ratio (Qs/Qt) prior to the induction of anesthesia (T0), prior to one-lung ventilation (OLV) (T1), 1 h subsequent to the commencement of OLV (T2), 1 h following restoration of two-lung ventilation (T3), 2 h following restoration of two-lung ventilation (T4) and 24 h post-surgery (T5). ⋯ Qs/Qt increased at T2 in the S group. The results of the present study demonstrated that, in comparison with propofol, sevoflurane exhibited an enhanced capacity to aggravate injury to pulmonary function during the perioperative stages. This occurred via the release of inflammatory factors, the aggravation of lung edema and the inhibition of hypoxic pulmonary vasoconstriction.
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The aim of this study was to evaluate the clinical value of multislice 3-dimensional computed tomographic angiography (3D-CTA) in the preoperative assessment of meningiomas. A total of 331 cases with meningiomas confirmed by CT and MRI were examined using 3D-CTA. The locations of the tumors were observed to be as follows: parasagittal and falcine in 125 cases, sphenoidal in 39 cases, in the olfactory groove in 19 cases, tentorial in 21 cases, parasellar in 33 cases, petroclival in 29 cases, intraventricular in 7 cases and on the convexity of the brain in 58 cases. ⋯ Surgery was performed according to the information provided in the 3D-CTA images. 3D-CTA provided clear 3D images of the meningioma and the relationship with the adjacent vessels and the skull base, and demonstrated the optimal surgical approach for removing the neoplasm. The results of 3D-CTA corresponded extremely well with the surgical observations. 3D-CTA is able to provide 3D images of the meningioma, adjacent vessels and the bones in the skull base. Furthermore, 3D-CTA supplies information vital in the selection of the optimal surgical approach and information that aids the management of the sinus during the surgery. 3D-CTA is of great value in the preoperative evaluation of meningiomas.
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This meta-analysis was performed to evaluate the efficacy and safety of parecoxib sodium for acute postoperative pain. PubMed, Cochrane Central Register of Controlled Trials, EBSCO, Springer, Ovid and Chinese National Knowledge Infrastructure (CNKI) databases were searched from January 1999 to January 2013 to comprehensively collect randomized controlled trials (RCTs) of parecoxib sodium for acute postoperative pain. The methodological quality of the included RCTs were assessed and the data were extracted by two reviewers independently according to the Cochrane Handbook. ⋯ The rate of 'ineffective' treatment in the PCA combined with parecoxib sodium group was lower compared with that of the control group [RR=0.43, 95% CI (0.26-0.72); RR= 0.44, 95% CI (0.34-0.57); and RR= 0.33, 95% CI (0.23-0.48), respectively]. Combination of PCA with parecoxib sodium reduced the incidence of postoperative fever [RR=0.34, 95% CI (0.22-0.53)], as well as nausea and vomiting [RR=0.69, 95% CI (0.57-0.83)]; however, it did not significantly reduce respiratory depression [RR= 0.84, 95% CI (0.38-1.83)], pruritus [RR= 0.91, 95% CI (0.54-1.52)] or headache [RR=0.77, 95% CI (0.47-1.28)]. The combination of PCA with parecoxib sodium successively injected for <3 days significantly increases the scores of PGESM and reduces the incidence of adverse effects and postoperative complications.
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Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a complex condition for which the etiological determinants are still poorly defined. To better characterize the diagnostic and therapeutic profile of patients, an algorithm known as UPOINT was created, addressing six major phenotypic domains of CP/CPPS, specifically the urinary (U), psycho-social (P), organ-specific (O), infection (I), neurological/systemic (N) and muscular tenderness (T) domains. An additional sexual dysfunction domain may be included in the UPOINT(S) system. ⋯ This modified cluster showed symptom scores significantly less severe than the original cluster, and the CPSI values became comparable to the scores of the five other clusters, which were virtually devoid of patients with evidence of infection. These results suggest that the presence of pathogens in the prostate gland may significantly affect the clinical presentation of patients affected by CP/CPPS, and that the infection domain may be a determinant of the severity of CP/CPPS symptoms in clusters of patients phenotyped with the UPOINTS system. This evidence may convey considerable therapeutic implications.
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The aim of this study was to observe the impact of dexmedetomidine on postoperative myocardial injury in patients undergoing off-pump coronary artery bypass (OPCAB) grafting. One hundred and sixty-two patients who were undergoing OPCAB surgery were randomly divided into control and dexmedetomidine groups (groups C and Dex, respectively). Following the first vascular anastomosis grafting, the patients in group Dex received a continuous intravenous infusion of 0.2-0.5 μg/kg/h dexmedetomidine, until they were transferred to the Cardiac Surgery intensive care unit (ICU) for 12 h. ⋯ The blood pressure, heart rate, levels of cTnI, CK-MB, norepinephrine and cortisol, and postoperative arrhythmic events in the patients in group Dex all decreased compared with those in group C. The duration of mechanical ventilation and ICU residence time were also shorter than those in the control group (P<0.05). Dexmedetomidine reduced post-surgical myocardial injury in patients who had undergone OPCAB surgery.