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Comparison of dorsal penile nerve block alone and in combination with lidocaine–prilocaine cream in neonates undergoing circumcision: a randomized controlled study

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World Journal of Pediatric surgery 2022年第4期5卷 217-222页

作者： Ibukunolu Olufemi Ogundele Chigbundu Collins Nwokoro Tewogbade Adeoye Adedeji Arua Obasi Igwe Collins Chijioke Adumah Ademola Olusegun Talabi Aderibigbe Modupe Shonubi Oludayo Adedapo Sowande department of surgery Olabisi Onabanjo University Teaching HospitalSagamuNigeria department of Chemical Pathology Obafemi Awolowo University Teaching Hospitals ComplexIle-IfeNigeria department of surgery Obafemi Awolowo University Teaching Hospitals ComplexIle-IfeNigeria

Background Suboptimal neonatal circumcision analgesia causes a significant stress *** is continued search for more effective analgesia for neonatal *** aimed to determine whether lidocaine–prilocaine cream(LPC)prior to dorsal penile nerve block(DPNB)offers better analgesia than DPNB *** A prospective randomized study of 72 neonates undergoing plastibell circumcision was randomized into two groups of 36 *** I received DPNB alone with 4 mg/kg plain *** II had 1 g LPC applied to the phallus 1 hour before *** cortisol levels were measured 30 min preoperatively and 30 min *** rate(HR)and peripheral arterial oxygen saturation(SpO2)were noted at 30 min preoperatively,after DPNB injection,after excising the prepuce,and at 30 min *** primary outcome measure was change in serum cortisol levels,while secondary outcomes were changes in HR and *** Both groups had increased mean serum cortisol levels,decreased mean SpO2 and increased mean HR from *** rise in mean serum cortisol level was significantly lower in group II(8.09±4.53µg/dL)than that in group I(11.42±7.83µg/dL)(p=0.034).Changes in SpO2 and HR were significantly less in group II than that in group I patients(pges at 30 min after excision of the prepuce(p=0.086).Conclusion These data suggest that neonates who received LPC prior to DPNB experienced significantly less pain from plastibell circumcision than those who had DPNB alone.

关键词： randomized alone nates

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Interest of Beta-2-Microglobilin Plasma Assay in Iterative Haemodialysis in the Nephrology and Haemodialysis department of University teaching hospital of point g, Bamako, Mali

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Open Journal of Nephrology 2020年第4期10卷 282-289页

作者： Saharé Fongoro Magara Samaké Seydou Sy Hamadoun Yattara Djénèba Diallo Jacques Coulibaly Moctar Coulibaly Aboubacar Sidiki Fofana Atabième Kodio Djénéba Maiga Aboudou M. Dolo Moustapha Tangara Nouhoum Coulibaly Brahima Dégoga Ibrahima Koné Nephrology and Haemodialysis department of the University teaching hospital of point-g Bamako Mali Faculty of Medicine of Bamako Bamako Mali Nephrology Unit of the Fousseyni DAOU hospital in Kayes Kayes Mali Nephrology Unit of Ségou hospital Ségou Mali Nephrology Unit of the Mali gAVARDO hospital of Sébénicoro Bamako Mali Nephrology Unit of Sikasso hospital Sikasso Mali Nephrology Unit of Somino DOLO hospital in Mopti Mopti Mali

Beta-2-microglobulin (B2M) is a low molecular weight polypeptide (11,800 Da) that exists in a free form and a form bound to cell membranes (light chains of HLA class I molecules). Their dosage is used in the exploration and monitoring of renal function in haemodialysis patients, hence the interest of this study, the objective of which is to study the different players involved in the increase of beta-2-microglobulin. g>Materials and Methods:g> This was a prospective and descriptive study from January 1st, 2017 to August 31, 2017 (08 months). All patients with chronic hemodialysis for 3 years or more were included. We analyzed sociodemographic, clinical and paraclinical data. g>Results:g> We collected 50 patients. The mean age was 50 ± 4.6 years with extremes of 30 and 82 years. The female sex predominated (52%). Chronic end-stage renal failure was hypertensive (86%), diabetic (4%). All patients benefited from intermittent hemodialysis for 8 hours per week using a low permeability membrane (cuprophane). The average duration of hemodialysis was 68 ± 6.4 months with extremes of 36 and 204 months. Twenty percent (20%) and four percent (4%) of chronic dialysis patients had joint pain and sensory deficit. Phalen’s sign was positive in 2% (1 case), Tinel’s sign in 2% (1 case) and carpal tunnel syndrome in 2% (1 case). The mean serum beta-2-microglobulin level was 58.34 ng/l with extremes of 16.99 and 112.24 ng/l. There was a correlation between hypertensive nephropathies and beta-2-microglobulin levels above 50 ng/l (P g>Conclusion:g> Our study has objectified factors such as inadequate dialysis (8 hours/week), use of low permeability membrane in the increase of beta-2-microglobulin. The increase in serum beta-2-microglobulin levels in our patients is evidence of poor purification of medium molecules. Its reduction can be established by improving the quality of dialysis, in particular by

关键词： Chronic Hemodialysis Beta-2-Microglobulin Carpal Tunnel Syndrome

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MAJOR HEPATIC RESECTION UNDER TOTAL VASCULAR EXCLUSION

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Chinese Journal of Cancer Research 2001年第2期13卷 136-139页

作者：季加孚顾晋苏向前焦春雨王怡欧阳晓辉董培德杨成旺 department of Surgical Oncology Beijing Cancer Hospital School of Oncology Peking University department of surgery First Teaching Hospital Inner Mongolia Medical University

Objective: To eveluate major liver resections with vascular exclusion (TVE) in patients with hepatocellular carcinoma (HCC). Methods: Sixteen consecutive, major liver resections performed with TVE in HCC patients were analyzed retrospectively. The patients’ mean ages were 54 years. Ten patients had cirrhosis and eleven patients had chronic hepatitis B. Results: There was no perioperative death and the mean hospital stay was 20 days and the average amount of intraoperative blood transfusion was 400 mL (range 0–2000 mL). Forty-four percent of the patients did not receive intraoperative blood transfusion. The mean total bilirubin(T-BIL) and aspartate aminotransferase (AST) were 24 μ mol/L (range 8–56 μ mol/L) and 56 IU/L (range 10–204 IU/L) measured prior to discharge. Conclusion: In our experience, total vascular exclusion is invaluable in major or difficult liver resections, especially when lesions adjacent to the hepatic veins and vena cava. It is associated with a low blood transfusion requirement and a low incidence of complications. It further obviates the need for dissection of the porta hepatis thus reduces the associated risks. Total vascular exclusion time of 30min appears to be well tolerated, even in patients with cirrhosis.

关键词： HCC hepatic resection vascular exclusion

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Total Thyroidectomy in Multinodular goiter: An African Experience

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Surgical Science 2015年第12期6卷 527-531页

作者： Moussa Abdoulaye Ouattara Seydou Togo Ibrahima Sankaré Kadiatou Singaré Sekou Koumaré Issa Maiga Allaye Ombotibé Jacques Saye Assa Traoré Nouhoum Diani Zimogo Ziè Sanogo Sadio Yena department of Thoracic surgery Hospital of Mali Bamako Mali department of Otorhinolaryngology Gabriel Touré Teaching Hospital Bamako Mali department of general surgery “A” Point G Teaching Hospital Bamako Mali department of Endocrinology Hospital of Mali Bamako Mali department of Anesthesia Hospital of Mali Bamako Mali

Introduction: Total thyroidectomy is an operation that involves the surgical removal of the whole thyroid gland, with the preservation of the parathyroid glands. The aim of the present study was to assess the complication rates of total thyroidectomy on benign indication and first-time thyroid surgery and investigate the early outcome after opotherapy. Materials and Methods: In this retrospective study, patients who underwent total thyroidectomy for benign multinodular goiter in the department of thoracic surgery in our hospital from January 2012 to December 2014 were included. In postoperative time, we evaluated surgical complication, histopathological examination and opotherapy. Results: A total 53 patients underwent total thyroidectomy for multmodular goiter;they were 49 (92.45%) bilateral and 4 (7.55%) unilateral (recurrence). The mean age was 47 years and mean diameter of goiter was 10.75 cm. Among the patients 88.68% were females and 11.32% were male. Preoperative hormonal statuses were (70%) in euthyroid and (30%) hyperthyroid following surgery complications like transient laryngeal nerve palsy (3.77%), transient hypocalcemia (7.55%), hematoma (1.9%) and wound infection (1.9%). On histopathological examination of the surgical specimen, 5.7% were reported to be malignant. Six month following surgery 92.45% of patients was a good hormonal balance. Conclusion: Total thyroidectomy for multinodular goiter has a low morbidity and mortality;this procedure olves both the problem of recurrence of disease and reintervention. The opotherapy is doable with a good hormonal balance.

关键词： Multi-Nodular goiter Total Thyroidectomy Complication

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Primary biliary cirrhosis-associated hepatocellular carcinoma in Chinese patients:Incidence and risk factors

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World Journal of gastroenterology 2015年第12期21卷 3554-3563页

作者： Xue-Xiu Zhang Li-Feng Wang Lei Jin Yuan-Yuan Li Shu-Li Hao Yan-Chao Shi Qing-Lei Zeng Zhi-Wei Li Zheng Zhang george KK Lau Fu-Sheng Wang The Institute of Translational Hepatology 302 Military Hospital of China-Peking University Teaching Hospital Research Center for Biological Therapy Beijing 302 Hospital Non-Infectious Liver Disease Diagnosis and Treatment Center 302 Military Hospital of China-Peking University Teaching Hospital Research Center for Liver Transplantation 302 Military Hospital of China-Peking University Teaching Hospital department for Hepatobiliary surgery Beijing 302 Hospital

AIM: To investigate the incidence, characteristics, and risk factors for hepatocellular carcinoma(HCC) in Chinese patients with primary biliary cirrhosis(PBC).METHODS: We reviewed the data of 52 PB Cassociated HCC patients treated at Beijing 302 hospital from January 2002 to December 2013 and analyzed its incidence and characteristics between the two genders. The risk factors for PBC-associated HCC were analyzed via a case-control study comprising 20 PBC patients with HCC and 77 matched controls without HCC. The matched factors included gender, age, follow-up period and Child-Pugh scores. Conditional logistic regression was used to evaluate the odds ratios of potential risk factors for HCC development. A P gnificant. RESULTS: The incidence of HCC in Chinese PBC patients was 4.13%(52/1255) and was significantly higher in the males(9.52%) than in the females(3.31%). Among the 52 PBC patients with HCC, 55.76%(29/52) were diagnosed with HCC and PBC simultaneously, and 5.76%(3/52) were diagnosed with HCC before PBC. The males with PBC-associated HCCwere more likely than the females to have undergone blood transfusion(18.75% vs 8.33%, P = 0.043), consumed alcohol(31.25% vs 8.33%, P = 0.010), smoked(31.25% vs 8.33%, P = 0.010), had a family history of malignancy(25% vs 5.56%, P = 0.012), and had serious liver inflammation, as indicated by the elevated levels of alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, and γ-glutamyl transpeptidase(P gistic regression analysis revealed that body mass index(BMI) ≥ 25 [adjusted odds ratio(AOR) = 1.116, 95%CI: 1.002-1.244, P = 0.045] and history of alcohol intake(AOR = 10.294, 95%CI: 1.108-95.680, P = 0.040) were significantly associated with increased odds of HCC development in PBC patients. CONCLUSION: HCC is not rare in Chinese PBC patients. Risk factors for PBC-associated HCC include BMI ≥ 25 and a history of alcohol intake. In addition to regul

关键词： Primary biliary cirrhosis Hepatocellular carcinoma

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THE　EXPRESSIONS　AND　CHANgES　OF　TgF－α，β　gENES　IN　HUMAN　COLORECTAL　CANCEROUS，PARACANCEROUS　AND　NORMAL　MUCOSAL　TISSUES

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Chinese Journal of Cancer Research 1995年第4期7卷 267-271页

作者：朱兆文李勇李通王永潮 The department of surgery The First Teaching Hospital Beijing Medical University Beijing The department of Biology Beijing Normal University Beijing China

Transforming growth factor α. β(TgF α,β) acted as positive and negative growth regulators respectively play an important role in the development and progression of colorectal carcinoma. In this study, the dot, Northern and Southern blot analysis were used to explore the expressions and changes of TgF-α,β genes of colorectal cancerous, Paracancerous and normal mucosal tissues in 12 cases. The order of the expressions of TgF-a mRNA from high to low is cancerous, paracancerous and normal tissues in turn. In one case, the expression of TgF-αmRNA was much higher in paracancerous tissues, even than that in the cancerous tissues. The order of expressions of TgF-β mRNA from high to low was contrary to that of the TgF-α mRNA. That is from normal, paracancerous and cancerous tissues in turn. In two cases of patients, the expression of TgF-βmRNA were higher in paracancerous tissues than that in normal tissues. We also found that the amplification of TgF-α gene may be lead to the high expression of TgF-βmRNA were not known. These results indicate that the higher expression of TgF-α and the lower expression of TgF-β in cancerous tissues and the higher expressions of TgF- α,β in Paracancerous tissues of some cases may be correlated with the development and progression of the colorectal carcinoma by autocrine or paracrine growth regulation.

关键词： Colorectal carcinoma Transforming growth factor-α Transforming growth factor-β

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Artificial intelligence in the management and treatment of burns: a systematic review

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Burns & Trauma 2021年第1期9卷 318-338页

作者： Francisco Serra E Moura Kavit Amin Chidi Ekwobi department of Plastic surgery Norfolk and Norwich University HospitalColney LaneNorwichNR47UYUK department of Plastic surgery Manchester University NHS Foundation TrustUK department of Plastic surgery Lancashire Teaching Hospitals NHS Foundation TrustRoyal Preston HospitalPrestonUK

Background:Artificial intelligence(AI)is an innovative field with potential for improving burn *** article provides an updated review on machine learning in burn care and discusses future challenges and the role of healthcare professionals in the successful implementation of AI ***:A systematic search was carried out on MEDLINE,Embase and PubMed databases for English-language articles studying machine learning in *** were reviewed quantitatively and qualitatively for clinical applications,key features,algorithms,outcomes and validation ***:A total of 46 observational studies were included for *** of burn depth(n=26),support vector machines(n=19)and 10-fold cross-validation(n=11)were the most common application,algorithm and validation tool used,***:AI should be incorporated into clinical practice as an adjunct to the experienced burns provider once direct comparative analysis to current gold standards outlining its benefits and risks have been *** considerations must include the development of a burn-specific common *** should use common validation tools to allow for effective *** Ⅰ/Ⅱ evidence is required to produce robust proof about clinical and economic impacts.

关键词： Artificial intelligence Machine learning Computer vision Burn Neural networks

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Neuropsychic Disorders Unmasking the Coexistence of Fahr Syndrome and Neuromeningeal Cryptococcosis

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Case Reports in Clinical Medicine 2020年第11期9卷 329-334页

作者： Mikaila Kaboré Issa Konaté Yacouba Cissoko Souleymane P. Coulibaly Jean-Paul Dembélé Assetou Fofana Mariam Soumaré Hermine Méli Dramane Sogoba Oumar Magassouba Adama Sissoko Mohamed Aly Cissé Abdoulaye Zaré Bintou Coulibaly Fodé Kouyaté Moïse Nguemeni Sounkalo Dao Infectious Diseases department Point “G” University Teaching Hospital Bamako Mali Faculty of Medicine and Odontostomatology University of Sciences Techniques and Technologies of Bamako (USTTB) Bamako Mali Psychiatry department Point “G” University Teaching Hospital Bamako Mali Neurology department Point “G” University Teaching Hospital Bamako Mali Serefo Program University of Sciences Techniques and Technologies of Bamako (USTTB) Bamako Mali

Background: Fahr syndrome associates a set of neuropsychiatric manifestations with bilateral calcifications in the basal ganglia and phosphocalcic disorders. Neuromeningeal cryptococcosis can be present in its manifes... 详细信息

g>Background: g>Fahr syndrome associates a set of neuropsychiatric manifestations with bilateral calcifications in the basal ganglia and phosphocalcic disorders. Neuromeningeal cryptococcosis can be present in its manifestations, neuropsychic disorders with or without meningeal signs. The objective was to describe a rare association between Fahr syndrome and neuromeningeal cryptococcosis which can be expressed by the same clinical symptomatology in the context of co-infection with the human immunodeficiency virus (HIV) and the hepatitis B virus (HBV). g>Presentation:g> A 37-year-old patient without pathological history, who presented behavioral disorders that led to a fight with those around her and a psychiatric consultation. Then, she was hospitalized in the infectious diseases department upon discovery of her HIV status and viral hepatitis B. She was logorrheic with behavioral disturbances and subsequently presented with tonic-clonic convulsions. Laboratory tests and imaging have concomitantly discovered Fahr syndrome due to pseudohypoparathyroidism and neuromeningeal cryptococcosis. The correct management of these two pathologies enabled stabilization of the patient’s clinical condition with regular monitoring for HIV-HBV coinfection. g>Conclusion: g>Farh syndrome and neuromeningeal cryptococcosis are two different entities but sometimes similar symptoms and risk factors. Treatment of metabolic disorders combined with anticryptococcal therapy improved the prognosis.

关键词： Neuropsychic Disorders Neuromeningeal Cryptococcosis Fahr Syndrome Pseudohypoparathyroidism HIV

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Surgical outcome of laparoscopic sleeve gastrectomy and Roux-en-Y gastric bypass for resolution of type 2 diabetes mellitus:A systematic review and meta-analysis

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World Journal of gastroenterology 2020年第8期26卷 865-876页

作者： Salman Yousuf guraya Tim Strate Clinical Sciences department College of MedicineUniversity of SharjahSharjah 27272United Arab Emirates department of surgery Reinbek HospitalAcademic Teaching Hospital of the University of HamburgReinbek D-21465Germany

BACKgROUND Bariatric procedures are considered superior to medical therapies in managing type 2 diabetes mellitus(T2DM).Laparoscopic Roux-en-Y gastric bypass(LRYgB)and laparoscopic sleeve gastrectomy(LSg)are the most commonly used procedures for weight loss and comorbidity resolution ***,it is not yet known whether the degree of T2DM is influenced by the choice of bariatric *** To quantitatively compare T2DM resolution over 1-5 years follow-up by LRYgB and LSg in morbidly obese *** We searched the selected databases for full-text English language clinical studies that compared the effectiveness of LRYgB and LSg for T2DM *** manager 5.3 was used for data analysis,and the overall effect summary was represented in a forest *** From 1,650 titles retrieved by an initial search,we selected nine studies for this *** found insignificant differences for T2DM resolution by LRYgB and LSg,with an odds ratio of 0.93(95%CI:0.64-1.35,Z statistics=0.38,P=0.71).Additionally,subset analyses for T2DM resolution showed insignificant differences after 24 mo(χ^2=1.24,df=4,P=0.87,overall Z effect=0.23),36 mo(χ^2=0.41,df=2,P=0.81,overall Z effect=0.51),and 60 mo(χ^2=4.75,df=3,P=0.19,overall Z effect=1.20)by LRYgB and *** study reports a T2DM remission rate of 82.3%by LRYgB and 80.7%by *** This study reports similar T2DM resolution rates by both LRYgB and LSg during 1-5 years of ***,long-term follow-up of 10 years is needed to further substantiate these findings.

关键词： Morbid obesity Type 2 diabetes mellitus Laparoscopic sleeve gastrectomy Laparoscopic Roux-en-Y gastric bypass

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Risk factors for fever and sepsis after percutaneous nephrolithotomy

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Asian Journal of Urology 2016年第2期3卷 82-87页

作者： Aso Omer Rashid Saman Salih Fakhulddin department of surgery School of MedicineUniversity of SulaimaniSulaimaniIraq department of Urology Sulaimani Teaching HospitalSulaimaniIraq

Objective:Percutaneous nephrolithotomy(PCNL)is commonly used in the management of large renal *** infections are one of the most common complications of this *** present study is to determine and assess the factors that may increase the risk to develop fever and urinary sepsis after ***:A total of 60 patients(38 males and 22 females)with a mean age of 40.25 years enrolled in this study in Sulaimania teaching *** had renal stone disease need operation with different socioeconomic status,body mass index and different type and size of stones were included in this *** with preoperative positive urine culture and sensitivity were *** investigations done for all *** Patients received prophylactic antibiotic gentamicin intravenously at the induction of *** pelvis urine sample were taken from all patients after puncturing the pelvicalyceal system and send for culture and *** were monitored closely in the postoperative period for the development of fever and ***:Mean duration of the operations was 77.08 min ranged 40e120 *** patients had postoperative nephrostomy ***(28.33%)patients developed post PCNL fever and the statistically significant factors for post PCNL fever were diabetes mellitus(DM)(p Z 0.001),stone burden(p Z 0.001),number of the stones(pgree of hydronephrosis(p Z 0.001),duration of the operation(pgnificant risk factors for post PCNL sepsis were duration of the operation(p Z 0.013)and intraoperative blood loss,postoperative drop in haemoglobin(HB)level(p Z 0.046).Conclusion:DM,staghorn stones,degree of hydronephrosis,duration of the operation and number of tracts are risk factors for post PCNL fever,while number of stones,intraoperative blood loss,duration of the operation

关键词： Renal stones Percutaneous nephrolithotomy Urinary tract infection Fever Sepsis

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