International journal of clinical and experimental medicine
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Mechanical ventilation using lower tidal volume ventilation with associated hypercapnia is supported to avoid ventilator-induced lung injury, but the underlying mechanism is not clear. This study was intended to explore whether low tidal volume ventilation with associated hypercapnia would ameliorate pneumoperitoneum-induced lung injury and whether this protection strategy might work through mediating inflammation and oxidative stress via TLR 4 signaling pathway. ⋯ Low tidal volume ventilation with associated hypercapnia ameliorated pneumoperitoneum-induced lung injury by reducing TLR 4-mediated inflammation and oxidative stress.
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Several observational studies have shown that metformin therapy may modify the risk of prostate cancer. We carried out a meta-analysis of relevant studies evaluating the effect of metformin therapy on prostate cancer risk. ⋯ Our findings indicate that metformin therapy is not significantly associated with lower prostate cancer risk.
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This study aims to explore the analgesic effects of melatonin on post-herpetic neuralgia and its possible mechanism. ⋯ MT had significant analgesic effects in the treatment of PHN, and its mechanism was closely related with δopioid receptor, NO and MT2 receptor.
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The aim of this study was to identify predictive factors for higher conversion ratio in opioid switching from oral oxycodone to transdermal fentanyl (TDF) in patients with cancer pain. The participants of this study were 156 hospitalized cancer patients who underwent opioid switching from oral oxycodone to TDF at the Affiliated Hospital of Binzhou Medical University between January 1st, 2010 and March 31st, 2014. Patient characteristics, modified Glasgow Prognostic Score (mGPS), daily oxycodone dose, and reasons for opioid switching were retrospectively collected. ⋯ The results showed that the mGPS (odds ratio [OR], 2.358; 95% CI 1.379-4.031; P = 0.002), the reason for opioid switching (OR, 0.497; 95% CI, 0.298-0.828; P = 0.007) and equivalent oral morphine dose (OR, 1.700; 95% CI, 1.008-2.867; P = 0.046) were found to be significant predictors requiring higher conversion ratio in opioid switching. This study indicates that higher mGPS, poor pain control before switching and higher equivalent oral morphine dose are significant predictors of a need for higher conversion ratio in opioid switching from oral oxycodone to TDF. These results could contribute to the establishment of evidence-based medicine in cancer pain relief.
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Vertebral artery injury (VAI) is a rare but serious complication of cervical spine surgery. Instrumented posterior surgery of the upper cervical spine places the vertebral artery at the highest risk of injury. However, VAI during removal of cervical internal fixation is really rare and unexpected. ⋯ An interventional vertebral artery embolism was performed and the patient suffered a sudden cerebral infarction one day after interventional vertebral artery embolism. From this case, removal of upper cervical pedicle screws of malposition is not recommended if it is not really necessary for some other reasons. Interventional vertebral artery embolism is an effective and less invasive procedure than open ligation surgery in the treatment of haemorrhage resulted from VAI but potential risk of cerebral infarction should not be ignored.