Objective To analyse the pain analgesic efficacy and safety evaluation of diclofenac sodium and lidocaine hydrochloride combined with anisodamine in patients with bone fractures.Methods 54 patients who were diagnosed with acute fracture in the hospital were collected and randomly divided into experimental group and control group, 27 cases in each group, control group was treated with diclofenac sodium and lidocaine hydrochloride, and experimental group was treated with anisodamine on the basis of control group.Before 30 min and 2 h after treatment, the effect of 5-hydroxytryptamine ( 5-HT ), prostaglandin E2 ( PGE2 ), analgesic effect, tolerability and adverse reactions were detected in all patients. ResuIts Compared with control group post treatment, the plasma 5-HT content was significantly lower in experimental group ( P<0.05 ); the plasma PGE2 content in experimental group was significantly lower (P<0.05); the pain rating index (PRI) total score,PRI feel score, PRI emotion score, present pain intensity (PPI) and visual analogue scale (VAS) in experimental group was significantly lower (P<0.05).The tolerance of experimental group was 92.59%, which was significantly higher than 66.67% of control group (χ2 =5.59,P<0.05).ConcIusion Diclofenac sodium and lidocaine hydrochloride combined with anisodamine could significantly decrease 5-HT and PGE2 in patients with fracture pain, enhance the analgesic effect, reduce the incidence of adverse reactions, with a good tolerance, which have the guiding significance on clinical therapy.

Aphasia is a common clinical manifestation after ischemic stroke.The therapeutic effect of low-frequency repetitive transcranial magnetic stimulation and mechanisms at different times after stroke are not exactly the same.This article reviews the advances in low-frequency repetitive transcranial magnetic stimulation for the treatment of aphasia after ischemic stroke.

Objective To observe effects of acupuncture on different traditional Chinese medicine(TCM) syndrome types in patients with apoplectic hemiplegia.Methods 57 cases of apoplectic hemiplegia were divided into the Qi deficiency with blood stagnation group(35 cases) and blockage of the meridians and collaterals by phlegm and blood group(22 cases).All patients were treated by scalp acupuncture combined with body acupuncture.The clinical therapeutic effect was evaluated according to the scores of manner,speech,motor function of limbs,and so on.Results In the Qi deficiency and blood stagnation group,2 cases were basically cured,17 were remarkably effective,12 were effective,with a total effective rate of 88.6%;while,in the blockage of the meridians and collaterals by phlegm and blood group,3 cases were basically cured,14 were remarkably effective,3 were effective,with a total effective rate of 90.9%.There was a significant difference between the two groups in clinical remarkably effective rate(P<0.01),but no difference in total effective rate( P>0.05).Conclusion Acupuncture can obviously improve the consciousness,language and limb function of patients with apoplectic hemiplegia.The effective rate of type of blockage of the meridians and collaterals by phlegm and blood is superior to type of Qi deficiency with blood stagnation.

Objective To explore the safety and feasibility of operation procedure improvement and process optimization for pancreatoduodenectomy.Methods The effect of the duation time of opertion and postoperative complications of operation procedure improvement and process optimization for pancreatoduodenectomy in 98 patients in the Tumour Hospital Affiliated to Zhengzhou University from August 2008 to May 2015 were retrospective analyzed.Results The duation time of opertion was 145-205 min,average time was 175 min.There were 5 cases (5.1％) of bile leakage,6 case (6.12％) of pancreatic fistula and 4 cases (4.08％) of hemorrhage,and laparotomy revealed that one of them with pancreas-intestinal anastomotic hemorrhage,the haemorrhage stop after sufficient drainage,but due to infection,organ failure,this case was dead half a year after the operation.The remaining patients recovered uneventfully through open drainage,partial flush,somatostatin application,and other conservative treatment.Conclusion The improved pancreatoduodenectomy can shorten operation time and reduce operation complication,is a safe and feasible method,and worthy of clinical popularization.

Objective To investigate the surgical management of huge pelvic tumor.Methods The clinical data of 56 patients with huge pelvic tumor who were admitted to the Cancer Hospital of Henan Province from February 2005 to January 2012 were retrospectively analyzed.Tumor resectability was assessed via enhanced computed tomography or three-dimensional reconstruction,and the tumors were freed and resected by combination of muliiple surgical approaches.All the patients were followed up via telephone or re-examination at the out-patient department to learn the recurrence and metastasis of tumor.The survival rate was calculated using the life table.Results Fifty patients received preoperative computed tomography examination,and the imaging data of 6 patients were three-dimensionally reconstructed.Preoperative evaluation showed that 49 patients needed combined multivisceral resection,5 needed tumor resection,and the tumors of 2 patients were unresectable.Fourteen patients were diagnosed preoperatively,and 8 patients were diagnosed by intraoperative rapid frozen section examination,and the rest 34 patients were diagnosed by postoperative pathological examination.The surgical approaches including anterior median sacral approach combined with transperineal coccyx anterior approach (21 patients),anterior median sacral approach (11 patients),obturator approach (8 patients),retropubic approach (8 patients) and obturator approach combined with transperineal approach of coccyx (8 patients).Tumor and rectum resection was carried out on 18 patients,tumor and partial bladder resection on 12 patients,tumor,uterus and ovariectomization on 12 patients,tumor,part of the small intestine and colorectal resection on 10 patients,tumor and total pelvic exenteration on 4 patients.In all the 56 patients,53 achieved R0 resection,2 cases reached naked eye clean,1 case had residual tumor.The mean operation time was 100 minutes.Fifty patients recovered uneventfully.Six patients had postoperative complications,including 3 patients with intestinal obstruction (2 patients were cured by conservative treatment,and 1 patient was cured by surgery),2 patients with pelvic infection and 1 patient with colostomy hernia,and they were cured by drainage and nutritional support.One patient died of postoperative myocardial infarction.The results of postoperative pathologic study showed that 25 patients were with adenocarcinoma,16 with sarcoma and 15 with gastrointestinal stromal tumor.Forty-seven patients were followup to December 2012,and the 5-year survival rate was 26.7％ for patients with adenocarcinoma,18.9％ for patients with sarcoma,and 52.6％ for patients with gastrointestinal stromal tumor.Conclusion Preoperative assessment of resectability of huge pelvic tumor can reduce unnecessary laparotomy and improve the safety of operation.

Objective:To determine the content of notoginsenoside R1 , ginsenoside Rg1 and Rb1 in Shuxuening capsules. Meth-ods:The three constituents were determined on a Hypersil ODS-2 C18 column (250 mm × 4. 6 mm, 5 μm) with gradient elution using acetonitrile (A) -aqueous solution (B) (0-8 min, 20%A→20%A, 8-40 min, 20%A→30%A, 40-60 min, 30%A→45%A) at the detection wavelength of 203 nm with a flow rate of 1. 0 ml·min-1 . The column temperature was 25℃ and the injection volume was 20μl. Results:The calibration curve showed good linearity within the concentration range of 0. 05-0. 50 mg·ml-1 for notogisenoside R1 , and 0.20-2.00 mg·ml-1 for ginsenoside Rg1 and Rb1(r =0.999 9). The average relative recovery was 98.79%, 98.42% and 98. 89% for each constituent(RSD=0. 85%, 0. 97% and 0. 74%, respectively, n=6). The intra-day RSD was 0. 49%, 0. 20% and 0. 39%, and the inter-day RSD was 0. 75%, 0. 56% and 0. 51%, respectively. The RSDs of stability test and repeatability test were less than 1%. Conclusion:The method is simple with good accuracy and repeatability, which can be used for the determination of no-toginsenoside R1 , ginsenoside Rg1 and Rb1 in Shuxuening capsules.

Objective To investigate the effect of electro-acupuncture on cartilage renovation of knee osteoarthritis.Methods 40 female SD rats were randomly divided into the normal group,model group,electro-acupuncture treatment group and control group.The left knees of the treatment group and right ones of the control group were treated by electro-acupuncture for two weeks from the fifth week since operation.Collected left knees' cartilage of all rats at the seventh week since the beginning of experiment.HE and immunohistochemical staining were used to observe the expression characteristic of transforming growth factor-β1(TGF-β1)in cartilage.Results The expression of TGF-β1 in the treatment group was very significantly stronger than all other groups(P<0.01).Conclusion Electro-acupuncture can obviously up-regulate the level of TGF-β1 in cartilage of experimental rats with knee osteoarthritis,and promote the repair of cartilage.

Objective To explore the effect and mechanism of electroacupuncture at Baihui(GV20) and Zusanli(ST36) of patients with depression.Methods90 patients were randomly divided into group A electroacupunctured at Baihui(GV20) and Zusanli(ST36), group B electroacupunctured at Taichong(LR3), Sanyinjiao(SP6), Neiguan(PC6), and Shenmen(H7) and group C treated with Fluoxetine (20 mg/d, 6 weeks). The therapeutic effect was assessed by the Hamilton Depression Rating Scale (HAMD) before and after treatment. Serum cytokine levels (IL-2, IL-4, and IFN-γ) were measured by ELISA assay at admission and after treatment (6 weeks).ResultsCompared to pre-treatment, the mean levels of HAMD ( P<0.01)and IL-4 (P <0.01) decreased significantly in all groups after treatment. Rank distribution of HAMD scores had obvious difference between all groups. The mean levels of IL-2 and IFN-γ had no significant difference in group C after treatment (P>0.05). And the mean levels of IL-2 and IFN-γ increased significantly in groups A and B after treatment(P<0.01, P<0.05).ConclusionElectroacupuncture takes effect earlier than fluoxetine for depression. Electroacupuncture at Baihui(GV20) and Zusanli(ST36) was more effective than the other two methods. The three types of treatments can restore three types of cytokines and improve depressive syndrome.

Objective To analyze the characteristics of dynamic contrast enhanced MR imaging (DCE-MRI)in prostate cancer (PCa)at 3.0T,and to evaluate the diagnostic value of DCE-MRI.Methods 85 patients with suepected PCa received conventional MRI and DCE-MRI.The signal intense-time (SI-T)curve was analyzed.Then the time to maximum (Tmax),the maximum degree of enhancement (STmax%),and the rate of enhancement (Rmax)were calculated.The differences of styles of SI-T curve and the parameters between the positive and negative group were compared respectively.Results 59 cases of PCa were proved by biopsy,and there was no evidence of tumor in 26 cases.507 zones had histopathological results with 250 zones in positive group and 257 zones in negative group .The most common style of SI-T curve in positive group was rapidly ascending followed with descending curve,the most common style of SI-T curve in negative group was persistent ascending curve and plateau curve.The mean values of Tmax,SImax%,Rmax were (69.49±22.53)s,1.74±0.43,7.83±3.80 in positive group respectively,while (175.61±52.64)s,1.05±0.35,1.86±1.10 in negative group respectively,there were statistically significant differences between the two groups(t =-24.24,1 6.34,1 7.75,P <0.01)respectively. The mean values of Tmax,SImax% ,Rmax were (8 9 .1 9 ± 3 1 .7 2 )s,1 .5 8 ± 0 .4 6 ,5 .2 1 ± 3 .3 4 in the low-risk group (Gleason score 2 - 6 )respectively,while (64.25±14.68)s,1.76±0.43,8.25±3.70 in the high-risk group (Gleason score 7-10)respectively, there were statistically significant differences between them(t = 7.09,-8.74,- 7.83,P <0.01).Conclusion 3.0T DCE-MRI has great value in the diagnosis of PCa.

Objective:To assess the value of spiral CT in diagnosis and treatment of chronic otitis media.Methods:The spiral CT findings of 74 cases including 93 ears proved by operation and pathology were studied.Results:The lesions such as the disruption of the ossicular chain showed in spiral CT or three-dimensional image were in accord with those seen in the operation,the accuracy was 95.7%,the disruption of the ossicular chain and bony erosion in the tympanic cavity and antrum were severe in the typeⅢ chronic otitis media.Conclusion:Spiral CT is helpful to diagnose and definite the chronic otitis media,three-dimensional image can provide valuable information for surgery.