BACKGROUND:Traditional analgesia method can relieve the pain after total knee arthroplasty, but the prognosis is poor and drug dependence is strong. Therefore, it is of great significance to study the analgesic drugs in perioperative period of total knee arthroplasty. OBJECTIVE:To explore the analgesic effect of gabapentin combined with continuous femoral nerve block on total knee arthroplasty. METHODS: A total of 48 patients with knee osteoarthritis receiving total knee arthroplasty in the Department of Orthopedics, Affiliated Hospital of Inner Mongolia Medical University from October 2013 to October 2014 were enroled in this study. Using general anesthesia, femoral nerve block was conducted before anesthesia. Analgesia pump was connected after arthroplasty. Patients were randomized to two groups. The control group received multimodal analgesia, and the experimental group received gabapentin combined with continuous femoral nerve block analgesia. Patient’s pain was scored by using resting, activity visual analog scale. Postoperative quality of life, range of motion of knee joint and complications were observed. RESULTS AND CONCLUSION:No significant difference in preoperative resting pain and activity pain was detected between the two groups (P > 0.05). Visual analog scale scores were decreased with time prolonged after arthroplasty in both groups. Visual analog scale scores of resting pain and activity pain were significantly lower in the experimental group than in the control group at 1, 3 and 7 days and 1 month (P < 0.05). Range of motion was significantly larger in the experimental group than in the control group at 3-7 days after arthroplasty (P< 0.05). Activity of daily living score, physical function score, mental function score and social function score were significantly higher in the experimental group than in the control group (P < 0.05). The complication rate was significantly lower in the experimental group than in the control group (17%, 46%,P < 0.05). These data indicate that during perioperative period of total knee arthroplasty, analgesic effect of gabapentin combined with continuous femoral nerve block is ideal. In particular, in patients with acute pain within 48 hours, their combination can promote early rehabilitation of the patient’s knee, and few side effects are found.

Objective To investigate influence of lafutidine combined with omeprazole in serum pepsinogen subgroup levels of patients with chronic atrophic gastritis. Methods One hundred and thirty-eight patients with chronic atrophic gastritis were selected in the First Affiliated Hospital of Changchun Traditional Chinese Medicine University from Dec. 2010 to Dec. 2013,who were randomly divided into two groups. Sixty-nine patients treated omeprazole( oral 1 pill/times,1 times/d)as control group,and another 69 patients were treated lafutidine( oral 2 pills/times,2 times/d ) combined with omeprazole as observation group. Both Course of treatment was 8 weeks. Changes of serum pepsinogen subgroups,improvement of clinical symptoms,treatment effect and adverse reactions were compared between two groups. Results After treatment,the levels of pepsinogen I,pepsinogen I/pepsinogen II increased significantly while pepsinogen II decreased significantly in two groups. Pepsinogen I,pepsinogen I/pepsinogen II in observation group were(89. 46 ± 13. 25)μg/L,10. 21 ± 1. 27,significantly higher than control group(( 62. 34 ± 11. 90 )μg/L,6. 45 ± 0. 93;t =7. 358,9. 125;P=0. 017,0. 004). Pepsinogen II in observation group was(8. 76 ± 3. 24)μg/L,significantly lower than control group((9. 68 ± 4. 76 )μg/L,t =4. 035,P =0. 049 ). Stomachache disappearance rate,abdominal distention disappearance rate,loss of appetite disappearance rate,total efficiency in observation group were 89. 9%, 85. 5%,84. 1% and 98. 6% respectively,significantly higher than control group( 73. 9%,65. 2%,60. 9% and 82. 6%),and the differences were statistically significant( P ﹤ 0. 05 ). Incidence of adverse reaction in observation group was 5. 8%,higher than control group( 2. 9%),but the difference was not statistically significant(χ2 =0. 697,P﹥0. 05). Conclusion Lafutidine combined with omeprazole can significantly improve clinical symptoms of patients with chronic atrophic gastritis,which can also significantly improve serum pepsinogen subgroup levels. Lafutidine combined with omeprazole have significant clinical effect and high safety, which is worthy of clinical application.

Objective To investigate the effect of different loading doses of atorvastatin in patients with stable plaques.Methods Consecutive 174 patients with stable plaque who underwent coronary arteriongraphy (CAG) and intravascular unltrasound(IVUS) were randomly assigned to receive 10 mg atorvastatin treatment (group 10 mg,n =47),20 mg atorvastatin treatment(group 20 mag,n =45),40 mg atorvastatin treatment (group 40 mg,n =43) and 80 mg atorvastatin treatment (group 80 mg,n =39).The endpoints including low density lipoprotein-cholesterol(LDL-C),high density lipoprotein-cholesterol (HDL-C),high-sensitivity C-reactive protein (hs-CRP) levels,necrotic and plaque volumes,were assessed after 3-6 months' follow-up.Results Mean LDL-C,HDL-C,hs-CRP,the percentage of necrotic,plaques volumes were similar at baseline (P ＞ 0.05).During 3-6 months of follow up:(1)LDL-C levels in group 10 mg,20 mg,40 mg,80 mg were lower than at baseline (t =3.12,4.23,3.26 and 5.21 respectively,P ＜ 0.01).There was significant difference between the 20 mg group and the 40 mg group(P ＜ 0.05) ; (2) There was no significant difference of HDL-C levels in 10 mg,20 mg and 40 mg groups after atorvastatin treatment.However,its level was significantly higher in the 80 mg group after atorvastatin treatment than other dose groups(P ＜ 0.05) and were higher than at baseline(t =2.35,P ＜ 0.01) ;(3)the 80 mg group's hs-CRP levels decreased significantly after treatment than at baseline((3.59 + 1.07)mg/L vs (6.10 + 2.12) mg/L,t =2.37,P ＜ 0.01);(4)According to the VH of IVUS,the percentage of necrotic in 10 mg group became higher than at baseline ((16.54 + 1.76) ％ vs.(7.83 + 1.03) ％,t =2.38,P ＜0.01) and conformed to unstable plaques diagnostic criteria(＞ 10％).There was no significant difference in group 20 mg,40 mg and 80 mg with at baseline (t =1.24,0.21,0.69 respectively,P =0.069,0.846,0.643respectively) ; (5)Plaques volumes in group 10 mg,20 mg were not larger than at baseline.However,in group 40mg and 80 mg.Plaques volumes were smaller than at baseline ((30.69 ± 8.12) mm3 vs (37.09 + 12.01)mm3,t=l.29,P=0.019;(24.99±l.01) mm3 vs (36.47+14.68) mm3,t =2.62,P＜0.01).Conclusion The effects of atorvastatin on stable plaques vary with doses.(1) For LDL-C,the use of atorvastation 20 mg/d can make LDL-C reaching standard,and atorvastation 40 mg/d was superior to 20 mg/d and similar to 80 mg/d.(2)For HDL-C,atorvastation 80 mg/d can make it higher.(3)Atorvastation 80 mg/d can make hs-CRP lower.(4)Atorvastation≥20 mg/d can make plaques stable and atorvastation 80 mg/d was superior to 20 mg/d and 40mg/d.Atorvastation 40-80 mg/d can make plaques dwindled.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Chronic Disease ; therapy ; Defecation ; Diarrhea ; physiopathology ; therapy ; Humans ; Male

Hyperhomocysteinemia is one of the independent risk factors of cerebrovascular diseases. Methylenetetrahydrofolate reductase (MTHFR) C677T gene mutation often results in the increase of plasma homocysteine levels, but the relationship between the genetic polymorphism of MTHFR and cerebrovascular diseases is not significant.

Objective To investigate the expression of integrin ?_(1) in human osteosarcoma_()and its relationship to prognosis.Methods The expression of integrin ?_(1)was measured by immunohistochemistry and its relationship to prognosis was analyzed statistically.Results Twenty-five of 34 osteosarcoma specimens were found positive staining of integrin ?_(1)(73.5%).The expression levels of integrin ?_(1)was not related to Dahlin classification of osteosarcoma,age and sex,but significantly increased in the osteoblast type and was related to poor survival.Conclusion Integrin ?_(1) can serve as a new biological indicator for the prognosis in osteosarcoma.

To evaluate the clinical effects of rotary nickel-titanium instruments Mtwo in root canal therapy in the aged patients. Using step-back technique,80 teeth with pulpal and periapical involvement were instrumented by Mtwo in the M group, and by K file in the K group. Mtwo could keep the original curvature and flow of the root canals. No transportation, apical blockage, ledge or perforation was found in the M group. There was more complications in the K group than in the M group.The operative time was shorter and posttreatment pain seldom occurred in the M group. With rotary NiTi instruments Mtwo for seniles' root canals treatment, root canals can be prepared effectively and quickly,and is worth of clinical application.

Objective The PRESENT ( Physicians' Routine Evaluation of Safety and Efficacy of NovoMix 30 Therapy) study is a multinational clinical experience program to report the efficacy, safety and acceptability of NovoMix 30 (BlAsp 30) in patients with type 2 diabetes mellitus inadequately controlled with oral antidiabetic drugs (OADs). Methods A total of 4 754 type 2 diabetes patients inadequately controlled with oral antidiabetic drugs were enrolled in the study. All patients were prescribed BIAsp 30 in accordance with the approved labeling. Data were collected at baseline and at the end of 3 months treatment. Results The mean HbA1c, body mass index (BMI), age, and duration were (9.09±1.70)%, (24.30±2.68)kg/m2, (54.63±10.94)years, and (5.46 ±4.17) years separately. The mean daily dose was (0.43±0.14) U/kg at treatment initiation and (0.48±0.15) U/kg after 3 months treatment. After 3 months, the mean HbA1c, fasting plasma glucose (FPG) and postprandial plasma glucose (PPG) were significantly reduced from baseline levels. The mean HbA1c decreased by (2.04± 1.57)%, FPG by a (3.51±2.55)retool/L, and PPG by a (6.51±4.02) mmol/L (all P<0.01). A significant proportion (49.4%) of the patients achieved target HbA1c of ≤7%. The overall rate of hypoglycaemic episodes (events/patient-yr) decreased from 10. 098 at baseline to 3. 810 at study end. The rate of major hypoglycaemia decreased from 0. 787 to 0.126, and the rate of nocturnal hypoglycaemia decreased from 2.356 to 0.547. Compared with previous treatment, more than 99% of the patients and physicians were "satisfied" or "very satisfied" with BIAsp 30 treatment. Conclusions BIAsp 30 was found to be safe and effective to improve the glycaemia control of type 2 diabetes inadequately controlled with OADs in routine clinical practice.

Objective To investigate the clinical features,pathology and prognostic factors of young patients with cervical cancer less than 35 years old.Methods One hundred and twenty cases cervical cancer less than 35 years old were selected as study group,while 120 cases of cervical cancer over 35 years old as control group in the same period.The clinical features and pathology were compared between two groups and risk factors were analyzed.Results The proportion of contact vaginal bleeding,menstrual disorders,mild cervical erosion,HPV infection,and the number of pregnancy preserving ovarian surgery in study group were significantly higher than that in control group(60.8％(73/120)vs.47.5％(57/120),30.0％(36/120)vs.11.7％(14/120),57.5％(69/120)vs.23.3％(28/120),81.7％(98/120)vs.60.0％(72/120),52.5％(63/120)vs.25.8％(31/120)),the differences were statistically significant(x2=4.30,12.23,29.90,13.63,17.91;P＜0.05).The incidence of irregular vaginal bleeding in study group was significantly lower than that in control group(6.7％(8/120)vs.15.8％(19/120)),the differences was statistically significant(x2=5.05,P＜0.05).The main pathological types of two groups were squamous cell carcinoma,non squamous cell carcinoma rate in study group was significantly higher than that in control group(27.5％(33/120)vs.15.0％(18/120)),the differences was statistically significant(x2=5.60,P＜0.05).Pelvic lymph node metastasis rate in study group was 68.3％(82/120),significantly higher than that in control group(55.0％(66/120),x2=4.49,P＜0.05).Multivariate analysis of prognostic factors in young patients with cervical cancer showed that clinical stage,pathological type,depth of cervical invasion and pelvic lymph node metastasis were independent risk factors for the prognosis of young patients with cervical cancer(Wald x2=4.02,6.93,8.92,10.87;OR=3.22,5.57,6.84,5.48;95％CI=1.13-8.62,1.24-11.75,2.82-17.35,1.88-12.35,P＜0.05).Conclusion There are some differences in the clinical features and pathological characteristics of young patients with cervical cancer and middle-aged and elderly patients with cervical cancer.More attention should be paid on the high clinical staging,non squamous cell carcinoma,deep cervical infiltration positive pelvic lymph node metastasis patients,focus on the investigation and prevention,improve the individual treatment and prevention and control system.

Objective To study the time relationships between apoptosis of neurons and endotheliocytes with the expression of Bcl 2 and Bax after reperfusion of focal cerebral ischemia in rats. Methods Coronal sections of brain were analyzed using an in situ terminal deoxynucleotidyl transferase mediated biotinylated deoxyuridine triphosphate nick end labeling(TUNEL)and immunohistochemical staining methods to observe apoptosis of neurons and endotheliocytes,and expression of Bcl 2 and Bax after reperfusion(2,6,12,24hours and 2,3,7,14,21 days)of focal cerebral ischemia. Results 1.In the ischemic penumbra,apoptotic cells were increased at 2h after reperfusion,peaked at 12 24?h,then decreased successfully for 7 14?days.The time of apoptotic endothelial cells was 12?h later than that of apoptotic neurons.2.The expression of Bcl 2 protein began at 2?h after reperfusion,peaked at 12 24?h,and decreased for 7 14?days.3.Bax protein expressed from 6?h after reperfusion;peaked at 24 48?h,and lasted for 14days.4.The time phase of Bcl 2 expression was similar to the Bax is but later than it. Conclusion\ Apoptosis was a pattern of cell death after cerebral ischemia/reperfusion.The time of apoptotic endothelial cells was later than that of apoptotic neurons.Bcl 2 and Bax play a regulatory role in the apoptotic process.\;[