Objective:To provide an effective treatment for the Osteoarthritis of the hip by observing the effect of local blocking of HongHua injection on relieving hip pain.Methods:Methods from June 2015 to May 2017,60 patients...Objective:To provide an effective treatment for the Osteoarthritis of the hip by observing the effect of local blocking of HongHua injection on relieving hip pain.Methods:Methods from June 2015 to May 2017,60 patients with Osteoarthritis of the hip in Wangjing Hospital of Chinese Academy of Sciences were randomly divided into treatment group and control group,30 cases in each group.The treatment group was given local blockingof HongHua injection treatment,control group using Compound Betamethasone Injection local closed treatment.Visual analogue scale(VAS)score,pericoxal local tenderness and hip mobility were used to evaluate the therapeutic effect.The therapeutic indicators at six different time points after 1 days,3 days,7 days,2 weeks and 1 months after treatment were compared.Results:All the 60 cases completed treatment and follow-up,and there were no cases of abscission.There was no significant difference in gender,age,etiology,classification and Harris score before treatment between the two groups(P>0.05),which was comparable.VAS score:There was no significant difference between the two groups on the 1st,3rd,7th and 2nd week after treatment(P>0.05),but the treatment group was lower than the control group on the 1st month after treatment(P<0.01).Hip joint activity:There was no significant difference in hip joint activity between the two groups 1 day,3 days,7 days,2 weeks and 1 month after treatment(P>0.05).Local tenderness around hip:The efficacy of the midpoint inguinal tenderness score was similar between the two groups at 1 day,7 days,2 weeks and 1 month after treatment(P>0.05);the treatment group was lower than the control group at 3 days after treatment(P<0.01);the adductor starting tenderness score had no significant difference at 1 day,3 days,7 days,2 weeks and 1 month after treatment(P>0.05).Conclusion:Local blockingof HongHua injection is effective and effective in treating hip pain in Osteoarthritis of the hip.The HongHua injection has many advantages,such as good safety and wide indications.It is worthy of further clinical application.展开更多
Aim: To study the features of local anesthetic solution spreading during sciatic nerve block in dependence on the anesthetic solution volume. Material and Methods: One hundred and sixty nine cases of sciatic nerve blo...Aim: To study the features of local anesthetic solution spreading during sciatic nerve block in dependence on the anesthetic solution volume. Material and Methods: One hundred and sixty nine cases of sciatic nerve blocks done under ultrasonic visualization control were analyzed. Sciatic nerve blocks were performed by lidocaine in volumes 30;25;20;15;12.5;10;7.5;6.5;5;4.5 ml. The cross-section area, equal to local anesthetic spreading, was determined;the extension of the anesthetic solution spreading along sciatic nerve was calculated. Results: The anesthetic agent solution spreads along sciatic nerve in proximal and distal direction, forming a kind of cylinder. The minimum volume of the local anesthetic, which covers sciatic nerve in the whole, is 5 ml. A rare (1.77%) variation of sciatic nerve structure was described, in which tibial and common peroneal nerves develop directly from the branches of sacral plexus. Conclusion: The decrease of the local anesthetic volume leads to reduction of its spreading distance and cross-section area. Ultrasonic visualization can provide for sciatic nerve anatomical peculiarities, which can have an effect on the block quality.展开更多
The identification of cancer tissues in Gastroenterology imaging poses novel challenges to the computer vision community in designing generic decision support systems.This generic nature demands the image descriptors ...The identification of cancer tissues in Gastroenterology imaging poses novel challenges to the computer vision community in designing generic decision support systems.This generic nature demands the image descriptors to be invariant to illumination gradients,scaling,homogeneous illumination,and rotation.In this article,we devise a novel feature extraction methodology,which explores the effectiveness of Gabor filters coupled with Block Local Binary Patterns in designing such descriptors.We effectively exploit the illumination invariance properties of Block Local Binary Patterns and the inherent capability of convolutional neural networks to construct novel rotation,scale and illumination invariant features.The invariance characteristics of the proposed Gabor Block Local Binary Patterns(GBLBP)are demonstrated using a publicly available texture dataset.We use the proposed feature extraction methodology to extract texture features from Chromoendoscopy(CH)images for the classification of cancer lesions.The proposed feature set is later used in conjuncture with convolutional neural networks to classify the CH images.The proposed convolutional neural network is a shallow network comprising of fewer parameters in contrast to other state-of-the-art networks exhibiting millions of parameters required for effective training.The obtained results reveal that the proposed GBLBP performs favorably to several other state-of-the-art methods including both hand crafted and convolutional neural networks-based features.展开更多
Background: Procedures that require anesthesia of entire length of the arm should have combined Interscalene block (ISB) and Supraclavicular block (SCB) to ensure adequate block. However, dual block requires high dose...Background: Procedures that require anesthesia of entire length of the arm should have combined Interscalene block (ISB) and Supraclavicular block (SCB) to ensure adequate block. However, dual block requires high dose of local anesthetic (LA). We examined if Ultrasound (U/S) guided block helps to decrease the required volume of LA by visualizing trunks, so we only need injection of LA toward cervical nerve roots C5 and C6 aiming to block branches escaped from supraclavicular block. Patients and methods: Ninety-three patients were randomly allocated into one of three equal groups, each included 31 patients. All patients received SCB 20 ml (10 ml Bupivacaine 0.5% plus 10 ml lidocaine 2%) and ISB with different volumes of LA according to the group as follow: group A: 20 ml, group B: 15 ml, and group C: 10 ml. Result: No significant difference in onset of block (sensory and motor) and duration of block (motor only) between the three groups (P value > 0.05). The duration of sensory block was significantly longer in group A (760.65 ± 30.87 minutes) than in either group B (740.48 ± 21.15 minutes, P value P value P value P value P value P value < 0.001). Conclusion: A reduced volume of LA can be used in ultra sound guided ISB in combined with SCB to give satisfactory level of anesthesia to entire length of the arm, but the sensory block duration and duration of post-operative analgesia will be decreased significantly with decreasing the volume.展开更多
In order to examine whether repeated sciatic nerve blocks showed tachyphylaxis and continuity of sciatic nerve with spinal cord affected development of tachyphylaxis when assayed in vivo by duration of depression comp...In order to examine whether repeated sciatic nerve blocks showed tachyphylaxis and continuity of sciatic nerve with spinal cord affected development of tachyphylaxis when assayed in vivo by duration of depression compound action potentials (CAP), rats were anesthetized with halothane, ventilated, monitored and supported with stable hemodynamics and temperature. Posterior tibial nerve distally and sciatic nerve in thigh were exposed, placed on bipolar silver electrodes for stimulation and recording respectively. Three sequential sciatic nerve blocks were performed between these electrodes using 0.15 ml of 3 % chloroprocaine. Nine rats were chosen to observe the effects of repeated sciatic nerve blocks on CAP. In another 18 rats, a second investigator exposed the sciatic nerve near its origin at spinal cord and randomly performed nerve cut and sham (n=9), and closed the incision blinding the electrophysiologic investigator. The results showed that electrical stimulated tibial nerve induced sciatic nerve Aα/β, Aδ, C fiber mediated CAP waves. CAP amplitudes were remained stable during whole experimental procedure. CAP amplitudes were decreased completely with 3% chloroprocaine blocked sciatic nerve and recovered fully. The duration of CAP depression were reduced with repeated blocks. There were no selective blocked effects on Aα/β, Aδ, C fiber mediated CAP. With sciatic nerve cut proximally, there was no statistical significant tachyphylaxis with 3 % chloroprocaine repeated blocked sciatic nerve, and the duration of first and third blocked Aδ fiber mediated CAP was 108±20 and 92±14 min respectively (P>0.05). In normal rats the duration of first and third blocked Aδ fiber mediated CAP was 110±20 and 75±16 min respectively (P<0.05). It was suggested that tachyphylaxis to local anesthetics can occur in rats repeated blocked sciatic nerve when assayed in vivo by duration of depression CAP. The continuity of sciatic nerve with spinal cord is one of the important factors affecting the development of tachyphylaxis.展开更多
Background and aims: we aimed to detect the outcome values of adding fentanyl, dexamethasone and sodium bicarbonate to mixture of local anesthetic in peribulbar block for vitreoretinal surgery. Methods: 120 adult ASA ...Background and aims: we aimed to detect the outcome values of adding fentanyl, dexamethasone and sodium bicarbonate to mixture of local anesthetic in peribulbar block for vitreoretinal surgery. Methods: 120 adult ASA I & II patients, admitted for vitreoretinal surgery under peribulbar block were included in this comparative study. This study included 4 groups: Group I: (30) patients using a mixture of 1 ml normal saline, 4 ml lidocaine 2% plus 4 ml from bupivacaine 0.5% 20 ml vial containing hyaluronidase 1500 IU. Group II: (30) patients using a mixture of 1 ml of sodium bicarbonate (from 1 ml sodium bicarbonate 8.4% diluted in 10 ml normal saline), 4 ml lidocaine 2% plus 4 ml from bupivacaine 0.5% 20 ml vial containing hyaluronidase 1500 IU. Group III: (30) patients using a mixture of 1 ml fentanyl 20 μg (from a mixture of fentanyl 100 μg diluted in 5 ml normal saline), 4 ml lidocaine 2% plus 4 ml from bupivacaine 0.5% 20 ml vial containing hyaluronidase 1500 IU. Group IV: (30) patients using a mixture of 1 ml of 4 mg dexamethasone (1 ampoule = 8 mg/2 ml), 4 ml lidocaine 2% plus 4 ml from bupivacaine 0.5% 20 ml vial containing hyaluronidase 1500 IU. We measured the onset and duration of anesthesia, IOP, eyelid and global akinesia, postoperative pain by numerical pain rating scale, first analgesic requirement and postoperative side effects. Results: No significant differences were detected among the four groups as respect to age, sex and the intraocular pressure (IOP) before the anesthesia block. While the intraocular pressure (IOP) after the anesthesia block there was a significant difference, as IOP was markedly decreased postoperatively in group II compared with other groups. As regard to the onset & duration of anesthesia there was significant difference among all groups, there was rapid onset and prolonged duration of anesthesia in group III compared with other groups (1.77 ± 0.63 & 5.03 ± 0.89) respectively. As regard the onset of lid akinesia there was significant difference among the four groups with better outcome in group III, as in group III represented the most rapid onset of lid akinesia. As respecting to the onset of global akinesia there was significant difference among the four groups. There was better outcome in group III as it represented more rapid onset of global akinesia compared with other groups. There were significant differences among the four groups as regard postoperative pain all over 6 hours, better results were in group III (0.27 ± 0.69) compared with group I (2.23 ± 1.17), group II (2.00 ± 1.70), group IV (0.67 ± 0.71). As regarding to the first time for analgesic requirement there were significant differences among groups, there was no request for analgesia with better outcome in group III with increasing need to the analgesic medication in group I compared to group II and group IV. As regard side effects postoperatively there were few side effects in all groups with few numbers of cases in groups III only one patient. Although these differences in number of patients are not significant among the four groups. Conclusion: Addition of sodium bicarbonate to local anesthetic mixture was the best way in lowering the IOP other than other groups and addition of fentanyl to local anesthesia provided more rapid onset and duration of anesthesia, more rapid onset and duration for lid and global akinesia, less pain, less analgesic requirement and minimal side effects than the other groups.展开更多
目的探讨局部浸润麻醉联合右美托咪定(dexmedetomidine)持续输注与收肌管神经阻滞两种镇痛方式对日间膝关节镜手术患者术后早期生活质量的影响。方法40例择期行日间膝关节镜手术患者随机分为局部浸润联合右美托咪定持续输注组(D组)和收...目的探讨局部浸润麻醉联合右美托咪定(dexmedetomidine)持续输注与收肌管神经阻滞两种镇痛方式对日间膝关节镜手术患者术后早期生活质量的影响。方法40例择期行日间膝关节镜手术患者随机分为局部浸润联合右美托咪定持续输注组(D组)和收肌管神经阻滞组(N组)。D组:术毕0.25%罗哌卡因10 mL关节腔内局部浸润后予右美托咪定0.04μg/(kg·h)持续输注至患者出院;N组:术毕在超声引导下给予0.25%罗哌卡因10 mL行收肌管神经阻滞后予同等剂量的生理盐水持续输注。主要观察结局为术后24 h EQ-5D-5L评分。次要结局包括阿森斯失眠量表(AIS)评分、视觉模拟评分(VAS),术后24 h内下肢酸胀麻木发生率和恶心呕吐发生率等。结果两组术后24 h EQ-5D-5L及各维度评分比较差异无统计学意义(P>0.05)。D组术后第1、2、3天的AIS评分均明显低于N组(P<0.05)。D组术后0.5、2、6、12、24 h下肢酸胀麻木发生率均明显低于N组(P<0.05)。两组患者术后VAS及恶心呕吐发生率比较差异无统计学意义(P>0.05)。结论局部浸润联合右美托咪定持续输注在术后24 h早期生活质量方面不劣于收肌管神经阻滞组,同时可改善患者睡眠质量并降低术后肢体酸胀麻木发生率。展开更多
基金Major new drug development project of Ministry of science and technology(NO.2019ZX09731-002)。
文摘Objective:To provide an effective treatment for the Osteoarthritis of the hip by observing the effect of local blocking of HongHua injection on relieving hip pain.Methods:Methods from June 2015 to May 2017,60 patients with Osteoarthritis of the hip in Wangjing Hospital of Chinese Academy of Sciences were randomly divided into treatment group and control group,30 cases in each group.The treatment group was given local blockingof HongHua injection treatment,control group using Compound Betamethasone Injection local closed treatment.Visual analogue scale(VAS)score,pericoxal local tenderness and hip mobility were used to evaluate the therapeutic effect.The therapeutic indicators at six different time points after 1 days,3 days,7 days,2 weeks and 1 months after treatment were compared.Results:All the 60 cases completed treatment and follow-up,and there were no cases of abscission.There was no significant difference in gender,age,etiology,classification and Harris score before treatment between the two groups(P>0.05),which was comparable.VAS score:There was no significant difference between the two groups on the 1st,3rd,7th and 2nd week after treatment(P>0.05),but the treatment group was lower than the control group on the 1st month after treatment(P<0.01).Hip joint activity:There was no significant difference in hip joint activity between the two groups 1 day,3 days,7 days,2 weeks and 1 month after treatment(P>0.05).Local tenderness around hip:The efficacy of the midpoint inguinal tenderness score was similar between the two groups at 1 day,7 days,2 weeks and 1 month after treatment(P>0.05);the treatment group was lower than the control group at 3 days after treatment(P<0.01);the adductor starting tenderness score had no significant difference at 1 day,3 days,7 days,2 weeks and 1 month after treatment(P>0.05).Conclusion:Local blockingof HongHua injection is effective and effective in treating hip pain in Osteoarthritis of the hip.The HongHua injection has many advantages,such as good safety and wide indications.It is worthy of further clinical application.
文摘Aim: To study the features of local anesthetic solution spreading during sciatic nerve block in dependence on the anesthetic solution volume. Material and Methods: One hundred and sixty nine cases of sciatic nerve blocks done under ultrasonic visualization control were analyzed. Sciatic nerve blocks were performed by lidocaine in volumes 30;25;20;15;12.5;10;7.5;6.5;5;4.5 ml. The cross-section area, equal to local anesthetic spreading, was determined;the extension of the anesthetic solution spreading along sciatic nerve was calculated. Results: The anesthetic agent solution spreads along sciatic nerve in proximal and distal direction, forming a kind of cylinder. The minimum volume of the local anesthetic, which covers sciatic nerve in the whole, is 5 ml. A rare (1.77%) variation of sciatic nerve structure was described, in which tibial and common peroneal nerves develop directly from the branches of sacral plexus. Conclusion: The decrease of the local anesthetic volume leads to reduction of its spreading distance and cross-section area. Ultrasonic visualization can provide for sciatic nerve anatomical peculiarities, which can have an effect on the block quality.
基金The authors extend their appreciation to the Deputyship for Research&Innovation,Ministry of Education in Saudi Arabia for funding this research work through the project number 7906。
文摘The identification of cancer tissues in Gastroenterology imaging poses novel challenges to the computer vision community in designing generic decision support systems.This generic nature demands the image descriptors to be invariant to illumination gradients,scaling,homogeneous illumination,and rotation.In this article,we devise a novel feature extraction methodology,which explores the effectiveness of Gabor filters coupled with Block Local Binary Patterns in designing such descriptors.We effectively exploit the illumination invariance properties of Block Local Binary Patterns and the inherent capability of convolutional neural networks to construct novel rotation,scale and illumination invariant features.The invariance characteristics of the proposed Gabor Block Local Binary Patterns(GBLBP)are demonstrated using a publicly available texture dataset.We use the proposed feature extraction methodology to extract texture features from Chromoendoscopy(CH)images for the classification of cancer lesions.The proposed feature set is later used in conjuncture with convolutional neural networks to classify the CH images.The proposed convolutional neural network is a shallow network comprising of fewer parameters in contrast to other state-of-the-art networks exhibiting millions of parameters required for effective training.The obtained results reveal that the proposed GBLBP performs favorably to several other state-of-the-art methods including both hand crafted and convolutional neural networks-based features.
文摘Background: Procedures that require anesthesia of entire length of the arm should have combined Interscalene block (ISB) and Supraclavicular block (SCB) to ensure adequate block. However, dual block requires high dose of local anesthetic (LA). We examined if Ultrasound (U/S) guided block helps to decrease the required volume of LA by visualizing trunks, so we only need injection of LA toward cervical nerve roots C5 and C6 aiming to block branches escaped from supraclavicular block. Patients and methods: Ninety-three patients were randomly allocated into one of three equal groups, each included 31 patients. All patients received SCB 20 ml (10 ml Bupivacaine 0.5% plus 10 ml lidocaine 2%) and ISB with different volumes of LA according to the group as follow: group A: 20 ml, group B: 15 ml, and group C: 10 ml. Result: No significant difference in onset of block (sensory and motor) and duration of block (motor only) between the three groups (P value > 0.05). The duration of sensory block was significantly longer in group A (760.65 ± 30.87 minutes) than in either group B (740.48 ± 21.15 minutes, P value P value P value P value P value P value < 0.001). Conclusion: A reduced volume of LA can be used in ultra sound guided ISB in combined with SCB to give satisfactory level of anesthesia to entire length of the arm, but the sensory block duration and duration of post-operative analgesia will be decreased significantly with decreasing the volume.
文摘In order to examine whether repeated sciatic nerve blocks showed tachyphylaxis and continuity of sciatic nerve with spinal cord affected development of tachyphylaxis when assayed in vivo by duration of depression compound action potentials (CAP), rats were anesthetized with halothane, ventilated, monitored and supported with stable hemodynamics and temperature. Posterior tibial nerve distally and sciatic nerve in thigh were exposed, placed on bipolar silver electrodes for stimulation and recording respectively. Three sequential sciatic nerve blocks were performed between these electrodes using 0.15 ml of 3 % chloroprocaine. Nine rats were chosen to observe the effects of repeated sciatic nerve blocks on CAP. In another 18 rats, a second investigator exposed the sciatic nerve near its origin at spinal cord and randomly performed nerve cut and sham (n=9), and closed the incision blinding the electrophysiologic investigator. The results showed that electrical stimulated tibial nerve induced sciatic nerve Aα/β, Aδ, C fiber mediated CAP waves. CAP amplitudes were remained stable during whole experimental procedure. CAP amplitudes were decreased completely with 3% chloroprocaine blocked sciatic nerve and recovered fully. The duration of CAP depression were reduced with repeated blocks. There were no selective blocked effects on Aα/β, Aδ, C fiber mediated CAP. With sciatic nerve cut proximally, there was no statistical significant tachyphylaxis with 3 % chloroprocaine repeated blocked sciatic nerve, and the duration of first and third blocked Aδ fiber mediated CAP was 108±20 and 92±14 min respectively (P>0.05). In normal rats the duration of first and third blocked Aδ fiber mediated CAP was 110±20 and 75±16 min respectively (P<0.05). It was suggested that tachyphylaxis to local anesthetics can occur in rats repeated blocked sciatic nerve when assayed in vivo by duration of depression CAP. The continuity of sciatic nerve with spinal cord is one of the important factors affecting the development of tachyphylaxis.
文摘Background and aims: we aimed to detect the outcome values of adding fentanyl, dexamethasone and sodium bicarbonate to mixture of local anesthetic in peribulbar block for vitreoretinal surgery. Methods: 120 adult ASA I & II patients, admitted for vitreoretinal surgery under peribulbar block were included in this comparative study. This study included 4 groups: Group I: (30) patients using a mixture of 1 ml normal saline, 4 ml lidocaine 2% plus 4 ml from bupivacaine 0.5% 20 ml vial containing hyaluronidase 1500 IU. Group II: (30) patients using a mixture of 1 ml of sodium bicarbonate (from 1 ml sodium bicarbonate 8.4% diluted in 10 ml normal saline), 4 ml lidocaine 2% plus 4 ml from bupivacaine 0.5% 20 ml vial containing hyaluronidase 1500 IU. Group III: (30) patients using a mixture of 1 ml fentanyl 20 μg (from a mixture of fentanyl 100 μg diluted in 5 ml normal saline), 4 ml lidocaine 2% plus 4 ml from bupivacaine 0.5% 20 ml vial containing hyaluronidase 1500 IU. Group IV: (30) patients using a mixture of 1 ml of 4 mg dexamethasone (1 ampoule = 8 mg/2 ml), 4 ml lidocaine 2% plus 4 ml from bupivacaine 0.5% 20 ml vial containing hyaluronidase 1500 IU. We measured the onset and duration of anesthesia, IOP, eyelid and global akinesia, postoperative pain by numerical pain rating scale, first analgesic requirement and postoperative side effects. Results: No significant differences were detected among the four groups as respect to age, sex and the intraocular pressure (IOP) before the anesthesia block. While the intraocular pressure (IOP) after the anesthesia block there was a significant difference, as IOP was markedly decreased postoperatively in group II compared with other groups. As regard to the onset & duration of anesthesia there was significant difference among all groups, there was rapid onset and prolonged duration of anesthesia in group III compared with other groups (1.77 ± 0.63 & 5.03 ± 0.89) respectively. As regard the onset of lid akinesia there was significant difference among the four groups with better outcome in group III, as in group III represented the most rapid onset of lid akinesia. As respecting to the onset of global akinesia there was significant difference among the four groups. There was better outcome in group III as it represented more rapid onset of global akinesia compared with other groups. There were significant differences among the four groups as regard postoperative pain all over 6 hours, better results were in group III (0.27 ± 0.69) compared with group I (2.23 ± 1.17), group II (2.00 ± 1.70), group IV (0.67 ± 0.71). As regarding to the first time for analgesic requirement there were significant differences among groups, there was no request for analgesia with better outcome in group III with increasing need to the analgesic medication in group I compared to group II and group IV. As regard side effects postoperatively there were few side effects in all groups with few numbers of cases in groups III only one patient. Although these differences in number of patients are not significant among the four groups. Conclusion: Addition of sodium bicarbonate to local anesthetic mixture was the best way in lowering the IOP other than other groups and addition of fentanyl to local anesthesia provided more rapid onset and duration of anesthesia, more rapid onset and duration for lid and global akinesia, less pain, less analgesic requirement and minimal side effects than the other groups.
文摘目的探讨局部浸润麻醉联合右美托咪定(dexmedetomidine)持续输注与收肌管神经阻滞两种镇痛方式对日间膝关节镜手术患者术后早期生活质量的影响。方法40例择期行日间膝关节镜手术患者随机分为局部浸润联合右美托咪定持续输注组(D组)和收肌管神经阻滞组(N组)。D组:术毕0.25%罗哌卡因10 mL关节腔内局部浸润后予右美托咪定0.04μg/(kg·h)持续输注至患者出院;N组:术毕在超声引导下给予0.25%罗哌卡因10 mL行收肌管神经阻滞后予同等剂量的生理盐水持续输注。主要观察结局为术后24 h EQ-5D-5L评分。次要结局包括阿森斯失眠量表(AIS)评分、视觉模拟评分(VAS),术后24 h内下肢酸胀麻木发生率和恶心呕吐发生率等。结果两组术后24 h EQ-5D-5L及各维度评分比较差异无统计学意义(P>0.05)。D组术后第1、2、3天的AIS评分均明显低于N组(P<0.05)。D组术后0.5、2、6、12、24 h下肢酸胀麻木发生率均明显低于N组(P<0.05)。两组患者术后VAS及恶心呕吐发生率比较差异无统计学意义(P>0.05)。结论局部浸润联合右美托咪定持续输注在术后24 h早期生活质量方面不劣于收肌管神经阻滞组,同时可改善患者睡眠质量并降低术后肢体酸胀麻木发生率。
