目的 探討急性心肌梗死冠狀動脈介入治療（PCI）術后患者梗死區心肌存活性對左室重構及功能的影響。 方法 2006年2月－2010年12月208例急性心肌梗死急診PCI術后的患者接受靜息狀態下18氟-脫氧葡萄正電子斷層顯像進行心肌代謝顯像檢查，根據基線梗死區心肌有無存活分為兩組，同時進行超聲心動圖檢查，評價左室壁運動、左室射血分數，左室舒張末內徑、左房內徑及舒張期二尖瓣血流速度峰值的比值。血運重建術后12個月隨訪超聲心動圖，觀察梗死區心肌存活狀態對于左室重構以及心功能的影響。 結果 PCI術后12個月，有存活心肌組左室射血分數（46.7 ± 6.98）%高于無存活心肌組（45.1 ± 7.12）%，兩組差異有統計學意義（P＜0.01），有存活心肌組左室舒張末期內徑（53.17 ± 3.89） mm小于無存活心肌組（55.46 ± 4.75） mm，兩組差異有統計學意義（P＜0.05）。左房內徑及舒張期二尖瓣血流速度峰值的比值兩組隨訪時均無明顯變化。 結論 急性心肌梗死行PCI治療后的患者，在有存活心肌的情況下，心功能改善明顯；而梗死區無心肌存活的患者，12個月后，心功能減低，左室重構更加明顯。
Objective To investigate the effect and clinical significance of 3 d and 1 d bowel preparation method for colorectal carcinoma surgery on preoperative gut mucosal barrier function. Methods Plasma levels of D-lactate (D-LAC), diamine oxidase (DAO) and endotoxin (ET) were measured at 2 h before operation in 3 d bowel preparation group (50 cases) and 1 d bowel preparation group (50 cases), 25 cases of inguinal hernia were included as control group. D-LAC, DAO and ET were detected by using enzymatic spectrophotometric assay, spectrophotometric assay and limulus lysate test with azo chromogenic substrate, respectively. Results Preoperative plasma levels of D-LAC, DAO and ET in 3 d bowel preparation group were (10.25±1.43) mg/L, (5.82±0.80) U/ml and (10.11±1.41) ng/L respectively. In 1 d bowel preparation group the corresponding values were (10.19±1.35) mg/L, (5.80±0.81) U/ml and (9.82±1.35) ng/L respectively. There were no significant differences between 3 d and 1 d bowel preparation group (Pgt;0.05), compared with hernia group, 1 d and 3 d bowel preparation group were also no statistically significant differences (Pgt;0.05). Conclusions There are no significant preoperative gut mucosal barrier function damages in patients with 1 d and 3 d bowel preparation for colorectal carcinoma surgery, 1 d bowel preparation for colorectal carcinoma surgery can be performed in colorectal carcinoma patients, and 3 d bowel preparation can be used for certain special colorectal carcinoma patients.
Objective To assess the anesthetic efficacy of articaine versus lidocaine for irreversible pulpitis. Methods We electronically searched PubMed, EMbase, Cochrane Library (Issue 4, 2009), CNKI, VIP and CBM. The search was updated to December 2009. Randomized controlled trials (RCTs) and quasi-RCTs were indentified about articaine and lidocaine for irreversible pulpitis. Study selection and meta-analysis were conducted according to the Cochrane Handbook for systematic reviews. And RevMan5.0 was applied for statistical analysis in success rate. Results Nine trials involving 985 pulpitis patients were included. Meta-analysis indicated that, both the anesthetic success rate (RR=1.33, 95%CI 1.23 to1.44) and maxillary anesthetic success rate (RR=1.65, 95%CI 1.38 to 1.98) of articaine were superior to that of lidocaine, but there was no statistical significance in mandibular anesthetic success rate between two groups (RR=1.28, 95%CI 0.97 to 1.69). Conclusion The current evidence shows that articaine is superior to lidocaine in anesthetic efficacy, and is good at maxillary anesthesia.