Objective To explore the pain education program on the pain intensity and beliefs of patients with cancer pain.Methods 119 patients with cancer pain were divided into the control group (61 cases) and the experimental group (58 cases) according to the patients’ room number.The control group was given general health education by the ward nurses,while the experimental group was given pain education program by research nurses.The pain intensity and beliefs of two groups were compared.Results After the implementation of pain education program,pain scores were significantly reduced in both groups,and the pain beliefs scores were significantly promoted compared with the control group.Conclusions Pain education program for cancer pain patients can improve effect of cancer pain management.

Objective To assess the safety and effect of intraoperative cell salvage (ICS) during cesarean section.Methods This was a case-control study in which 60 gravidas who received ICS (ICS group) and 60 gravidas who received allogenic transfusion (control group) during caesarean section in Obstetrics and Gynecology Hospital of Fudan University during January 2014 to December 2016 were enrolled.Subjects in the two groups were matched in age,gestational age,gestational complications (placenta increta,placenta previa,scarred uterine,leiomyomas and anemia) and hemorrhagic volume during cesarean section.Several indicators including complications of transfusion,postoperative recovery,expense of transfusion,as well as the complete blood count and body temperature before and after operation were compared between the two groups.T,rank-sum or Chi-square test was used for statistical analysis.Results (1) No significant difference in age,gestational age,twin gestation,complications,preoperative body temperature,or the volume of hemorrhage or transfusion was observed between the two groups (all P＞0.05).(2) The autotransfusion volume was 385 (161-583) ml in the ICS group.Fifteen cases (20.0％) in the ICS group also received additional transfusions of leukocyte-reduced red blood cell (RBC) suspension,fresh frozen plasma and cryoprecipitate and two cases (3.3％) received additional transfusions of leukocyte reduced RBC suspension and fresh frozen plasma.The two groups showed no significant difference in the cost of transfusion or per-capita transfusion volume of fresh frozen plasma or cryoprecipitate.However,the transfusion volume of leukocyte-reduced RBC suspension was lower in the ICS group as compared with that in the control group [M(P25-P75),1.9 (1.5-4.5) vs 4.1 (2.8-6.2) U,Z=-2.800,P=0.005].(3) There was no significant difference in complete blood count or coagulation function between the two groups before the operation.White blood cell (WBC) counts in the two groups were elevated following operation.Postoperative WBC count in the control group was higher than that in the ICS group,while the levels of RBC and hemoglobin were lower than those in the ICS group following operation (all P＜0.05).(4) No amniotic fluid embolism was reported in the two groups.Only one case of rash was reported in the ICS group,which was fewer than the transfusion reactions occurred in the control group [1.7％ (1/60) vs 13.3％ (8/60),x2=5.886,P=0.016].(5) The two groups showed no significant difference in preoperative temperature,the highest temperature within three days after operation or incision healing.Compared with the patients in the control group,those in the ICS group had shorter hospital stay [(4.7± 1.1) vs (6.3 ±1.8) d,t=3.341,P＜0.05].Conclusion ICS is a safe and effective measure for gravidas at higher risk of hemorrhage during cesarean section.

Objective To evaluate the effects of fraction of inspired oxygen (FiO2) and positive end-expiratory pressure (PEEP) on the gradient between arterial and end-tidal carbon dioxide (D(a-ET)CO2).Methods Sixty ASA Ⅰ or Ⅱ patients (body mass index ＜ 30 kg/m2),aged 25-50 yr,weighing 45-75 kg,scheduled for elective gynecological laparoscopic surgery,were randomized into A,B and C groups (n =20 each).The patients were mechanically ventilated with pure oxygen in group A,and with air and O2 (FiO2 =50％) in groups B (PEEP =0) and C (PEEP =5 cm H2O).PETCO2 was monitored during mechanically ventilation.Blood samples were obtained from the radial artery immediately after tracheal intubation (T1) and at 1 h of pneumoperitoneum (T2) for blood gas analysis.D(a-ET) CO2 and Qs/Qt were calculated.Results D(a-ET) CO2 and Qs/Qt were significantly lower at T2 in groups B and C than in group A (P ＜ 0.05).Compared with group B,D(a-ET)CO2 was significantly decreased at T2 (P ＜ 0.05),and no significant change was found in Qs/Qt in group C (P ＞ 0.05).Conclusion Decreased FiO2 and PEEP of 5 cm H2O can decrease D(a-ET)CO2 and increase the accuracy of PErCO2 for reflection of PaCO2,which is due to reduced intrapulmonary shunt.

ObjectiveTo investigate the effect of ropivacaine administered intrathecally on the pulmonary function after caesarean section.MethodsThirty-six ASA Ⅰ or Ⅱ parturients,aged 22-34 yr,with body mass index ≤35 kg/m2,undergoing elective cesarean section,were randomly divided into 2 groups (n=18 each):bupivacaine group (group B) and ropivacaine group (group R).Spinal anesthesia was performed at L3,4 interspace and 0.5％ bupivacaine 1.8 ml (in cerebrospinal fluid 3 ml) and 1.0％ ropivacaine 1.4 ml (in cerebrospinal fluid 3 ml) were injected into the subarachnoid space over 10 s in groups B and R respectively.Forced vital capacity (FVC),forced expiratory volume first second (FEV1) and peak expiratory flow (PEF) were measured by spirometry before surgery (T0),and at 1,1.5 and 2 h after intrathecal injection (T1-3).The motor block score was recorded at T1-3.It is regarded as the criteria for respiratory dysfunction that the measured values of FVC and FEV1 are lower than their 80 ％ and 70 ％ predicted levels respectively.ResultsFVC and FEV1 were significantly decreased at T1 compared with the baseline value at T0 in both groups (P＜0.05).Compared with that at T1,PEF was significantly increased at T2,3 in group R (P ＜0.05).Compared with group B,PEF at T1 and motor block score atT3 were significantly decreased in group R (P＜0.05).The respiratory dysfunction was not found in both groups.ConclusionSpinal anesthesia with ropivacaine and bupivacaine can inhibit the parameter level of carly pulmonary function afrer caesarean section in parturient without respiratory complications,but the pulmonary function still remains normal.

Objective To investigate the accuracy of predicting acute postoperative pain by assessment of intravenous propofol injection-induced pain.Methods Seventy-one ASA I or Ⅱ patients aged 20-40 yr scheduled for induced abortion operation were enrolled in this study. The patients were unpremedicated. ECG, HR, BP and SpO_2 were continuously monitored before and during anesthesia. Anesthesia was induced with 2 mg/kg propofol. A third of the induction dose was injected via a dorsal hand vein. Pain induced by iv propofol injection was assessed with verbal rating scale (VRS) (0 = no pain, 3 = severe pain) . Postoperative abdominal pain was assessed with visual analog scale (VAS) (0 = no pain, 100 = most severe pain) at 20 min after operation. Results The propofol injection pain occurred in 66% of patients. Postoperative VAS scores at rest and during activity and intravenous propofol injection-induced pain were significantly correlated (r = 0.561, P<0.01; r = 0.608, P<0.01). The sensitivity and specificity of iv propofol injection-induced pain (VRS > 1) in predicting clinically significant acute postoperative pain (VAS > 30) were 96% and 52% respectively. Conclusion Preoperative iv propofol injection induced pain is a reliable factor in predicting acute postoperative pain and is useful in identifying those women who will experience greater pain after operation.

Objective To investigate the expression levels of phospholipase C(PLC)-γ1 and PLC-γ2 in the peripheral blood mononuclear cells (PBMCs) of patients with systemic lupus erythematosus (SLE),and explore the relations between these genes expression levels and disease activity of SLE.Methods Reverse transcription polymerase chain reaction (RT-PCR) method was used to detect the expression levels of PLC-γ1 and PLC-γ2 in 30 patients with SLE and 25 controls.The associations between the expression levels of PLC- γ1 and PLC-γ2,complement C3,C4,antidouble stranded DNA antibody and SLEDAI scores in patients with SLE were analyzed by Pearson correlation analysis.Results ①The expression levels of PLC-γ1 and PLC-γ2 in the SLE patients were significantly higher than those of the normal controls (P＜0.01).) The expression levels of PLC-γ1 and PLC-γ2 showed positive correlations with each other (r=0.726,P＜0.01 ).③ The expression levels of PLC-γ2 were negatively correlated with serum complement C3,C4 (P＜0.05),but positively correlated with anti-double stranded DNA antibody,at the same time,they were not correlated with SLEDAI scores (P＞0.05).There was no correlation between complement C3,C4,anti-double stranded DNA antibody and the expression levels of PLC-γ1 (r=0.220,0.256,0.116,P＞0.05),but the expression levels of PLC-γ1 were positively correlated with SLEDAI scores.Conclusion We have shown that the expression levels of PLC-γ1 and PLC-γ2 is positively correlated and the PLC-γ1 and PLC-γ2 in patients with SLE are significantly higher than those of the normal controls.PLC-γ2 is negatively associated with complement C3,C4,PLC-γ1 is positively correlated with SLEDAI scores.Both PLC-γ1 and PLC-γ2 are be helpful in evaluating SLE disease activity and severity.

Objective: To explore the clinical value of plasma copeptin level on major adverse cardiovascular event (MACE) occurrence in patients with acute ST-segment elevation myocardial infarction (STEMI) during hospitalization.
Methods: Our research included 2 groups:STEMI group, n=80 and Control group, n=80 patients with stable coronary artery disease (CAD). All patients were treated in our hospital from 2012-06 to 2014-06. Plasma level of copeptin was detected by ELISA, other relevant examinations were conducted to study the MACE occurrence in STEMI patients.
Results: Plasma copeptin level in STEMI group (523.26 ± 142.69) pg/ml was higher than that in Control group (345.25 ± 89.36) pg/ml, P<0.05. In STEMI group, there were 28/80 (35%) patients suffered from MACE, compared with non-MACE patients, they had increased plasma copeptin, cardiac muscle protein I (cTnI), kinase isoenzyme (CK-MB) and left ventricular ejection fraction (LVEF), P<0.05. Multivariate regression analysis indicated that plasma copeptin, cTnI and LVEF were the independent risk factors for MACE occurrence. According to occurred area under the curve, compared with cTnI and CK-MB, plasma copeptin level had the higher predictive value to judge the ROC, positive/negative possibility, sensitivity and speciifcity for MACE occurrence in STEAMI patients, P<0.05.
Conclusion: Plasma copeptin level could effectively predict MACE occurrence in patients with acute STEMI during
hospitalization, it may predict their prognosis at certain point.

Objective To evaluate the efficacy of different doses of dexmedetomidine for prevention of shivering after combined spinal-epidural anesthesia in the patients undergoing caesarean section.Methods A total of 120 patients,of ASA physical status Ⅱ or Ⅱ,aged 20-40 yr,with body mass index≤ 35 kg/m2,scheduled for elective caesarean section under combined spinal-epidural anesthesia,were randomly divided into 4 groups (n =30 each) using a random number table:control group (group C) and dexmedetomidine 0.1,0.3 and 0.5 μg/kg groups (D1,D2 and D3 groups).Combined spinal-epidural anesthesia was performed at L3,4 interspace with isobaric 0.5％ bupivacaine 2 ml.In D1,D2 and D3 groups,dexmedetomidine 0.1,0.3 and 0.5 μg/kg (in 50 ml of normal saline) were infused intravenously,respectively.In group C,normal saline 50 ml was infused at a rate of 5 ml/min.The development of shivering,bradycardia,hypotension,nausea and vomiting was recorded during the period from the end of dexmedetomidine infusion to PACU discharge time.Results Compared with group C,the incidence and degree of shivering and incidence of nausea and vomiting were significantly decreased in D2 and D3 groups,and no significant change was found in the parameters mentioned above in group D1.Compared with group D2,the incidence and degree of shivering and incidence of nausea and vomiting were significantly decreased in D3 group.Conclusion Dexmedetomidine 0.3 and 0.5 μg/kg can prevent shivering after combined spinal-epidural anesthesia in the patients undergoing caesarean section,and 0.5 μg/kg provides better efficacy.

Objective To evaluate the endoscopic and pathologic characteristics and etiological ex-amination of viral esophagitis. Methods The data of 16 patients with viral esophagitis, including endoscop-ic, pathological and immunohistochemical findings were retrospectively studied. Results Endoscopic find-ings of viral esophagitis were characterized by single or multiple round and oval ulcers, located at the upper and middle esophagus. The surface of the ulcer was clean, and the boundary was distinct. Pathologic findings included degeneration and necrosis in squamons epithelium, accompanied by ulcer, infiltration of neutrophils and lymphocytes, hyperplasia of capillaries and basal cells and formation of granulation tissues, Immunocyto-chemical examination showed HSV-1 was positive in biopses, while CMV, EBV, HHV8 were negetive. Con-dusion Viral esophagtitis exhibited distinctive endosoopic and pathological features, and etiology can be confirmed by immunohistochemical examinations.

OBJECTIVE To investigate the characteristics of hypopharyngeal carcinoma detected by narrow band imaging(NBI)endoscopy and evaluate the value of NBI in the early diagnosis of hypopharyngeal carcinoma. METHODS Between December 2008 and July 2009,a total of 46 consecutive patients with hypopharyngeal squamous cell carcinoma were enrolled in this study. High performance endoscopic system equipped with the white light mode and NBI mode was introduced in the examination of pharynx and larynx. The quality of visualization of morphologies of epithelial capillary and demarcation line of each lesion under NBI view was evaluated in comparison with conventional white light endoscopy. RESULTS Among the 46 patients,a total of 86 lesions were detected. The notable characteristic of hypopharyngeal squamous cell carcinoma is the well demarcated brownish area and scattered brown dots. The NBI laryngoscope could provide better visualization of morphologies of epithelial capillary and demarcation line in superficial carcinoma of hypopharynx than the white light mode(P