ObjectiveTo systematically evaluate the efficacy and safety of local anesthesia for venipuncture in children, and to provide evidence for related nursing practice.MethodsWeb of Science, PubMed, Cochrane Library, Embase, China National Knowledge Infrastructure, Wanfang Data, Chinese Biomedical Database and VIP databases were searched for randomized controlled trials (RCTs) about the application of local anesthesia in venipuncture in children till June 25th, 2021. Two reviewers independently reviewed the literature, extracted data, and assessed the risk of bias of included RCTs. RevMan 5.3 software was used for meta-analysis.ResultsA total of 19 RCTs were included, comprising 2 566 patients. All of them were high-quality English articles included in SCI or Medline. The results of meta-analysis showed that: the painless rate [odds ratio (OR)=3.80, 95% confidence interval (CI) (1.88, 7.66), P=0.000 2] and satisfaction rate of venipuncture [OR=2.12, 95%CI (1.27, 3.54), P=0.004] in the local anesthesia group were higher than those in the non-anesthesia group, and the pain score [mean difference=?0.62, 95%CI (?0.77, ?0.48), P<0.000 01] in the local anesthesia group was lower than that in the non-anesthesia group. There was no statistically significant difference between the two groups in the success rate of the first puncture [OR=1.14, 95%CI (0.77, 1.68), P=0.52], the incidence of transient skin reactions [OR=1.15, 95%CI (0.67, 1.95), P=0.62], the incidence of paleness [OR=1.11, 95%CI (0.57, 2.15), P=0.76], or the incidence of edema at the puncture site [OR=0.64, 95%CI (0.21, 1.96), P=0.44].ConclusionsLocal anesthesia can effectively reduce pain and improve the satisfaction of children with venipuncture, and has good clinical safety. It can be used by nursing staff in clinical practice.
Objective To examine the expression of proliferating cell nuclear antigen (PCNA) of retinal pigment epithelial (RPE) cells, thus assessing the role of mechanism of contact inhibition playing in the process of experimental retinal detachment and reattachemnt.Methods Retinal detachment was produced in 72 cats by subretinal injection of 0.25% solution of healon through a micropipette three weeks after extracapsular lens extraction and vitrectomy. Some of the detached retinae were reattached 24 hours later. At different time, the cats were killed and eye globes were fixed and embeded in paraffin. Histologic sections were processed for immunohistochemistry examination using an antibody to detect PCNA protein. Labeled RPE cells were identified, and the proliferation was quantified in detached and un-detached retinae of detachment group, and also in reattached retinae of reattachment group. The comparsion of PCNA-labeled RPE cells in different groups were analyzed by ANOVA. Results In detached regions of detachment group, PCNA-expression of RPE cells occured within 24 hours, and reached a maximum after 5-6 days, then gradually declined to barely detectable levels after 20 days. Similar tendency was found in reattached retinae, but the number of PCNA-labeled RPE cells was obviously small. Fewer PCNA-labeled RPE cells were found in regions of un-detached retinae in detachment group. The difference of these three groups was significant.Conclusion Proliferation of RPE cells is induced when they lose contact with neural retina, but inhibited after neural retina reattached to RPE cells. It suggests that the mechanism of contact inhibition plays a role in the proliferative process after retinal detachment and reattachment. (Chin J Ocul Fundus Dis，2003，19：20-23)
Six patients with moderate to advanced primary carcinoma of the liver were treated in this hospital with perfusion chemotherapy and embolization through the regional portal vein under the guidance of B-ultrasongraph rather than (with) operatie catheteization of the portal vein. The results show that all the tumor masses were reduced in size after the treatment (1.2-3.2cm, average value 1.9cm). It might be a new way for treating the primary carcinom of liver. The detailed procedure is descibed and the effects are also discussed in this article.
ObjectiveTo evaluate the diagnostic value of BRAFV600E mutation test in high-risk thyroid nodules with easily underdiagnosed fine-needle aspiration biopsy (FNAB) results.MethodsRetrospectively collected 122 cases of thyroid nodule who treated in the Hebei Petrochina Central Hospital between January 2017 and December 2018, all the cases admitted preoperative ultrasound and FNAB detection. All of the patients had the non-positive cytological results of FNAB and the high-risk features of ultrasound. Contrasted the postoperative pathological coincidence rate of combination of FNAB and BRAFV600E test with FNAB alone.ResultsThe BRAFV600E mutation rate was 27.0% (33/122). The positive rate of BRAFV600E mutation increased with the increase of ultrasound thyroid imaging reporting and data system(TI-RADS) grade (P<0.05), which was independent of patients’ age, gender, number of nodules, diameter of nodules, and FNAB results (P>0.05). The coincidence rate of FNAB combined with BRAFV600E mutation detection was higher than that of FNAB alone ［86.9% (106/122) vs. 69.7% (85/122), P<0.05).ConclusionsThe BRAFV600E mutation test can detect papillary thyroid carcinoma that might be missed by FNAB. We recommend that FNAB should be routinely accompanied by the BRAFV600E mutation test in the high-risk thyroid nodules.
ObjectiveTo evaluate the effectiveness of Curved Diffusion Needle in unilateral percutaneous vertebroplasty (PVP) by compared with bilateral PVP. MethodsA clinical data of 93 patients with osteoporotic vertebral compression fracture (OVCF) treated with PVP between January 2020 and January 2021 was retrospectively analyzed, including 47 patients underwent unilateral PVP assisted with Curved Diffusion Needle (unilateral group) and 46 patients underwent bilateral PVP (bilateral group). There was no significant difference in gender, age, cause of injury, time from injury to operation, T value of bone mineral density, AO classification, distribution of injured vertebrae, and preoperative visual analogue scale (VAS) score, Oswestry disability index (ODI), relative height of injured vertebrae, and Cobb angle between the two groups (P>0.05). The operation time, the amount of bone cement injection, the incidence of bone cement leakage, the bone cement diffusion distribution, VAS score, ODI, the relative height of injured vertebrae, and Cobb angle were recorded and compared between the two groups. Results All operations successfully completed. The operation time was significantly shorter in unilateral group than in bilateral group (t=?13.936, P=0.000), and the amount of bone cement injection was significantly less in unilateral group than in bilateral group (t=?13.237, P=0.000). The incidence of bone cement leakage in unilateral group was 19.14%, which was significantly lower than that in bilateral group (39.13%) (χ2=4.505, P=0.034). The score of bone cement distribution in unilateral group was 7.0±1.3, of which 41 cases were excellent and 6 cases were well. The score of bilateral group was 7.4±0.8, of which 43 cases were excellent and 3 cases were well. There was no significant difference in score and grading of bone cement distribution between the two groups (t=?1.630, P=0.107; Z=?1.013, P=0.311). All patients were followed up and the follow-up time was 3-10 months (mean, 6.5 months) in unilateral group and 3-10 months (mean, 6.1 months) in bilateral group. The VAS score, ODI, the relative height of injured vertebrae, and Cobb angle at 24 hours after operation and last follow-up were significantly better than those before operation in the two groups (P<0.05). There were significant differences in all indicators between 24 hours after operation and last follow-up (P<0.05). There was no significant difference in all indexes between the two groups (P>0.05) at the same time point after operation. During follow-up, there was no complication such as contralateral vertebral collapse, refracture, adjacent vertebral fracture, or local kyphosis in the two groups. ConclusionUnilateral PVP assisted with Curved Diffusion Needle for OVCF is beneficial to the distribution of bone cement, which can not only achieve similar effectiveness to bilateral PVP, but also achieve shorter operation time, less bone cement injection, and lower risk of bone cement leakage.
