The analgesic effect and duration of a transversus abdominis plane (TAP) block remain controversial. Transversus abdominis plane blocks are effective for somatic/incisional pain but do not provide analgesia for visceral pain from intra-abdominal procedures. The purpose of this study was to assess the area and extent of cutaneous sensory blockade and the regression of dermatomal anesthesia after bilateral oblique subcostal TAP block.
Methods
This observational, prospective clinical study consisted of 12 healthy volunteers. All volunteers received a bilateral oblique subcostal TAP block under real-time ultrasound guidance with 20 mL of 0.375% ropivacaine. The anterior abdominal cutaneous area was divided into 3 parts (midabdomen, left-lateral abdomen, right-lateral abdomen) using 2 lines drawn in a parasagittal fashion 5 cm lateral to the midline. The area of cutaneous sensory blockade involving the anterior abdomen was assessed 30 minutes after institution of the block using a cold stimulus. This was followed by repeated measurements using a cold stimulus applied along parasagittal lines drawn 3 cm lateral to the midline at 0.5, 6, 10, 14, 18, 22, and 26 hours after blockade.
Results
The area of cutaneous sensory blockade of the abdomen was 332 (SD, 73) cm2; that of the midabdomen was 253 (SD, 29) cm2, which represented an average of 90% of the area of the midabdomen; and that of the lateral abdominal wall (combination of left-lateral abdomen and right-lateral abdomen) was 79 (SD, 62) cm2, which represented an average of 26% of total lateral abdominal area. Dermatomes T7–T12 of the midabdomen were successfully blocked in all volunteers after using the bilateral oblique subcostal technique. However, T6 and L1 were only variably blocked. The area of cutaneous sensory block of the anterior abdomen regressed over the ensuing 22 hours in the following manner: 90%, 87%, 73%, 50%, 22%, 3%, and 0% at 0.5, 6, 10, 14, 18, 22, and 26 hours, respectively.
Conclusions
Bilateral oblique subcostal TAP block produces a widespread cutaneous sensory blockade with a consistent dermatomal distribution in the midabdomen for a considerable effective duration.
Theranostics in nuclear medicine is the combination of radionuclide imaging and internal radiotherapy, so as to realize the visual diagnosis and Precision treatment of diseases. At present, theranostics of nuclear medicine has played an important role in differentiated thyroid cancer, pheochromocytoma, bone metastases, neuroendocrine tumors and prostate cancer. China's medical radionuclides and radionuclides are in short supply, and those are heavily dependent on imports, so there is a bottleneck problem. It is necessary to strengthen the independent production, innovation and research of medical radionuclides and radiopharmaceutics of theranostics, so as to promote theranostics of nuclear medicine to better serve China's clinical practice.
Abstract Purpose To observe the clinical application value of 68 Ga-FAPI-04 PET/CT in the preoperative detection of lymph node metastasis and staging of esophageal cancer. Methods A prospective analysis of 29 surgical patients was performed. 68 Ga-FAPI-04 PET/CT was performed within 1 week before the operation. All patients received enhanced CT during the same period. None of these patients had received preoperative treatment before the operation. The value of 68 Ga-FAPI-04 PET/CT and enhanced CT in the diagnosis of lymph node metastasis and preoperative staging of esophageal cancer was compared according to postoperative pathology. Results Both 68 Ga-FAPI-04 PET/CT and CT detected the primary tumor (29/29 cases). 637 lymph nodes were surgically removed, of which 37 lymph nodes were metastasized. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of PET/CT for lymph node metastasis detection were 71.1%, 99.4%, 97.8%, 90.0%, and 98.2%; The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of CT for lymph node metastasis detection were 36.8%, 98.9%, 95.3%, 70.0%, and 96.1%, respectively. Conclusion 68 Ga-FAPI-04 PET/CT is better than enhanced CT in diagnosing lymph node metastasis and determining lymph node staging in esophageal cancer.
Abstract PurposeRenal fibrosis is a pathological state in the progression of chronic kidney disease. Early detection and treatment are vital to prolong the survival of patients. Renal puncture examination represents the gold standard examination method for renal fibrosis, but it has several limitations. This study aims to evaluate the diagnostic performance of a novel PET radiotracer, [ 68 Ga]Ga-fibroblast activation protein inhibitor (FAPI)-04, which specifically images fibroblast activation protein (FAP) expression for renal fibrosis.MethodsAll patients underwent renal puncture before receiving [ 68 Ga]Ga-FAPI-04 PET/CT imaging. They then underwent [ 68 Ga]Ga-FAPI-04 PET/CT and immunochemistry examinations, and the data obtained were analyzed.ResultsThe [ 68 Ga]Ga-FAPI-04 PET/CT examination results showed that almost all patients (12/13) exhibited increased radiotracer uptake. The maximum standardized uptake value (SUVmax) in patients with mild, moderate, and severe fibrosis was 3.92±1.50, 5.98±1.6, and 7.67±2.23, respectively.ConclusionCompared with renal puncture examination, non-invasive imaging of FAP expression through [ 68 Ga]Ga-FAPI-04 PET/CT can quickly show the patient’s bilateral kidney condition with high sensitivity. This can facilitate the evaluation of the patient’s disease progression, diagnosis, and the development of a treatment plan.
This paper presents a signal processing method for the electrophysiology simultaneously recorded during deep brain stimulation (DBS) as a research tool. Regarding the local field potential (LFP) signals recorded during stimulation, a novel method was proposed for removal of stimulation artifacts caused by the much stronger stimulating pulse compared to typical LFP. This artifact suppression method was tested and evaluated in an in vitro situation. The results indicate that the stimulation artifacts are well suppressed by this method. Secondly, this method was tested in vivo in Parkinson's disease (PD) patients. It was used to process the LFP signals recorded intraoperatively from PD patients to preliminarily explore the quantitative dependencies of beta band synchronization variations in the subthalamic nucleus (STNs) on the applied DBS parameters, including stimulation voltage, frequency and pulse width. The results confirm that DBS therapy can suppress excessive beta frequency activity and that the degree of attenuation increases with increasing DBS voltage within a range of 1-3 V and increasing DBS frequency within a range of 60-120 Hz. The proposed artifact suppression method provides technical support for exploring the direct effect of electrical stimulation on the brain activities.
Functional characterization of the lysine acetylation pathway requires quantitative measurement of the modification abundance at the stoichiometry level. Here, we developed a systematic workflow for global untargeted identification of site-specific Lys acetylation stoichiometries in mammalian cells. Our strategy includes an optimized protocol for in vitro chemical labeling of unmodified lysine with stable isotope-encoded acetyl-NHS ester, deep proteomic profiling with a high resolution mass spectrometer, and a new software tool for quantitative analysis and stoichiometry determination. The workflow was validated using in vitro chemically labeled BSA and synthetic peptides with multiple Lys acetylations at various positions. In the proof-of-concept study, we applied the strategy to analyze the proteome of HeLa cells and determined the stoichiometries of over 600 acetylation sites with good reproducibility. Sodium butyrate treatment induced a significant increase of acetylation stoichiometries in HeLa cells. Analysis of site-specific stoichiometry dynamics revealed the coregulation of closely positioned acetylation sites on histones H3 and H4 upon treatment.
To explore the neurofunctional change in spinocerebellar ataxia type 3 patients, regional homogeneity values were analyzed from this resting-state functional magnetic imaging study. The altered brain regional homogeneity mainly appeared in the left cerebellum and right cerebrum. And positive correlations were shown between regional homogeneity values for the right cerebrum and the clinical ataxia scores.
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