ObjectiveTo observe the clinical efficacy of duloxetine combined with psychological intervention in patients with somatoform disorder.Methods67 patients with somatoform disorder were randomly divided into two groups:study group (34 cases) treated with duloxetine and psychological intervention and control group (33 cases) treated with duloxetine only.And all the 67 patients in the study were assessed by symptom checklisth-90-R (SCL-90),hamilton anxiety scale(HAMA) and global assessment scale(GAS).ResultsAfter 8 weeks treatment,the results of SCL-90 showed that the scores of somatization,obsessive-compulsive,depression,anxiety and phobia factors in the study group ( 1.39 ± 0.45 ; 1.66 ± 0.52 ; 1.83 ± 0.69 ; 1.73 ± 0.66 ; 1.30 ± 0.48 )were notably lower than that in the control group ( 1.78 ± 0.61 ; 1.69 ± 0.47 ;2.39 ± 0.54 ; 2.1 1 ± 0.49 ; 1.49 ±0.78 ).And there were significant statistical differences (P＜ 0.01 ).At the end of the 2nd and 4th week the,scores of SCL-90 somatization,depression,anxiety and phobia factors were lower in the study group than the control group with statistical significance (P＜0.05).At the end of 8th week,the HAMA score in the study group( 10.20 ±3.70) was significantly decreased than the control group (13.07 ± 3.20 ),and with statistical significant (P ＜0.05 ).The response rate was 85.29％ in study group and 60.60％ in control group.And there was a statistically singnificant difference in complete remission ( χ2 =4.08,P ＜ 0.05 ) between the two groups.ConclusionThe study indicates that the combination of duloxetine and psychological intervention is more effective in treating somatoform disorder than using duloxetine only.So this combination treatment is worth generalizing and applying.

Objective To discuss the influence of μ-opioid receptor ( OPRM1) and CYP3A gene polymor-phism on analgesic effect of fentanyl for abdominal hysterectomy patients .Methods 198 cases of gynecologic anes-thesia patients who were treated by elective abdominal hysterectomy surgery ,were selected in the hospital .The rela-tionship between the fentanyl consumption of intravenous analgesia and OPRMI and CYP 3A gene polymorphisms was detected by using polymerase chain reaction-restriction fragment length polymorphism detection .Results In 198 pa-tients,OPRM1 genotyping was 186 cases,the other 10 patients failed to typing were excluded ,including 89 cases of type A/A,type A/G 76 cases,type G/G 21 cases,OPRM1 the frequency of A118G allele was 31.7%.No statistically significant differences were found in mean VAS score of CYP 3A4*1/*1,CYP3A4*1/*1G,CYP3A4*1G/*1G instantly after operation in the three groups and 24h postoperation.By using analysis of variance with body mass ,age and intraoperative volume as a covariate factors after first 24h fentanyl consumption ,the difference was statistically sig-nificant among the three groups (P<0.05),CYP3A4*1G/*1G group was significantly lower than that in CYP3A4*1/*1G group and CYP3A4*1/*1 group,there was no significant difference between CYP 3A4*1/*1G group and CYP3A4*1/*1 group (P>0.05).In addition,because the OPRM1 A118G interacts with CYP3A4*1G, reducedthe quantity of expression of opioid receptor carrying CYP 3A4*1 and OPRM1 A118G/G,and thus more fent-anyl was needed postoperation to achieve the same effect .Conclusion It provided a theoretical basis and reference for clinical application of personalized medicine by analyzing the gynecological patients μopioid receptor gene A118G and CYP3A4*1G polymorphism.

Objective To investigate whether oral propofol has any inhibitory effects and dose-response relationship on the pain inducing tissue injury in mice. Methods The effect of propofol on pain was observed in formalin test and acetic acid writhing test in mice. Formalin was injected subcutaneously into the plantar surface of one hind paw. Spontaneous nocuous responses were immediately scored by counting the number of flinches of the injected hindpaw at every 5-minute interval during a 60-minute period. The number of writhing caused by intraperitoneal injection of 0.6% acetic acid was also observed in mice. Results Oral propofol in a dose of 100mg/kg did not significantly inhibit nocuous stimulation. With higher doses, propofol inhibited both the phases 1 and 2 of persistent spontaneous pain induced by subcutaneous formalin injection. Orally taken propofol also inhibited the number of writhing after intraperitoneal acetic acid injection in a dose dependent manner. Conclusion Oral propofol is effective in inhibiting pain induced by formalin and acetic acid.

ObjectiveTo investigate the association of HLA-Cw alleles with inflammatory bowel disease(IBD), so as to identify IBD susceptibility gene.MethodsThe HLA-Cw genotype were analyzed in 100 patients with ulcerative colitis (UC), 73 patients with Crohn's disease (CD) and 106 randomly ethnically matched healthy controls by sequence specific primer polymerase chain (PCR-SSP).Results HLA-Cw * 07 gene phenotype frequencies increased in patients with UC (0.430) compared with that in healthy controls (0.226), P = 0.002; while HLA-Cw * 12 gene phenotype frequencies increased in patients with CD (0.356) compared with that in healthy controls (0.123), P = 0.000.ConclusionHLA-Cw * 07 allele and HLA-Cw * 12 allele may be strongly associated with the susceptibility of UC and CD, respectively.

Objective To study the effects of nutgrass galingale rhizome decotion on contractile activity of uterine smooth muscle strips of non-pregnant rats.Methods We selected 60 Wistar non-pregnant rats of weight 250-300 g to record the effects of nutgrass galingale rhizome decotion(1.0 g/L,2.0 g/L,4.0 g/L,8.0 g/L) on contractile activity of uterine smooth muscle strips of non-pregnant rats with Biolap 410 Biological System.Four antagonists,diphenhydramine(2?10-6mol/L),phentolamine(2?10-6mol/L), verapamil(2?10-7mol/L),and indomethacin(2?10-5mol/L) were used to study their mechanisms respectively.Results Water extract of nutgrass galingale rhizome(4?10-3kg/L) could significantly weaken uterine contractile activity of non-pregnant rats,lessen the frequencies,shorten the duration and lower the amplitude of contractile activity.Conclusion The effect of nutgrass galingale rhizome on contractile activity of uterine smooth muscle strips in rats may be mainly associated with prostaglandin synthese or release nothing with L-voltage-dependant calcium channels,H1 receptor or ? receptor.

OBJECTIVE: To provide reference for patients with type I incisions about rational use of antibiotics.METHODS: Between Oct.2007 and Mar.2008,a total of 1 024 medical records of patients with type I incisions from orthopaedics,common surgery,department of gynecology in 12 hospitals of Xining area were sampled for analysis of prophylactic use of antibiotics.RESULTS: 100.0% of the type I incision patients received prophylactic antibiotics;28.4% used antibiotics without indication;16.9% used antibiotics at 0.5～2 h before operation;33.4% used antibiotics at more than 2 h before operation;and 49.7% received antibiotics postoperatively rather than preoperatively.The irrational and nonstandard use of antibiotics manifested as improper in the choice of drug variety,nonstandard in drug combination,irrational in dosage and administration,prolonged use of antibiotics,lacking basis for the change of drug variety etc.CONCLUSION: The prophylactic use of antibiotics in patients with type I incisions from 12 hospitals of Xining area is far from perfect,therefore,it is urgent to strengthen the standard management on the use of antibiotics.

Objective To detect the differences of triggering receptor expressed on myeloid cells-1 (TREM-1) and cyclo-oxygenase-2 (COX-2) expressions in rectal cancer tissues and carcinoma adjacent tissues so as to explore the relationship between the two factors and clinical pathological characteristics and their effects on the patients` survival.Methods The expressions of TREM-1 and COX-2 were analyzed in 68 cases of rectal cancer tissues and 58 cases of carcinoma adjacent tissues with the method of immunohistochemical staining.We made a regular follow-up of the patients, analyzed the relationship between the two factors and prognosis of rectal cancer.Results The positive expression rates of TREM-1 and COX-2 in rectal cancer tissues were higher than those in carcinoma adjacent tissues (P<0.05).The expression of TREM-1 was related to lymph node metastasis, while COX-2 was related to pathological stage and lymph node metastasis (P<0.05).However, the two factors were not related to age, sex, histological differentiation or tumor size.The expressions of the two factors were positively correlated (r=0.550, P<0.001).The overall survival (OS) of TREM-1 and COX-2 positive expression groups was shorter than that of the negative groups (P<0.05).Cox multiple regression analysis showed that the expression of TREM-1, pathological stage, lymph node metastasis and tumor size affected the prognosis.Conclusion The expressions of COX-2 and TREM-1 in rectal cancer increase, suggesting that the two factors may promote the development and lymph node metastasis of rectal cancer, and the expressions of the two factors are related to the patients` poor prognosis.

We have developed an out-patient/emergency information system with the collaboration of Haitai Information Technology Co,Lth,and the out-patient medical workstaion have been put into full application.As our main experiences,we think that the on-line application of the workstation should be implemented step-by-step,in coordination with related departments,and with efficient safeguarding.

This paper briefly introduces the frame structure, design concept and main functional modules of outpatient emergency care information system developed by our hospital. This system can optimize the procedure when patients seek medical advice, create warm medical circumstances, increase work efficiency of medical care personnel, strengthen quality management of medical cases and promote hospital modern construction.

Objective To evaluate the video urodynamic abnormalities of women with lower urinary tract symptoms.Methods 38 females with lower urinary tract symptoms underwent video urodynamic test.Filling cystometry was done with 15% urographin saline fluid.A diagnosis was made in each case based on cystometrography finding,voiding pressure flow study,EMG and fluoroscopic appearance.Results Video urodynamic showed abnormalities in 23 cases(60.5%),including sensory urgency in 6,detrusor instability(DI) in 5,pseudodyssynergia(PDS) in 4,PDS+DI in 2,urethral orifice stricture in 2,DI+urgency incontinence in 1,impaired compliance in 1,bladder neck stricture in 1 and urethral diverticulum in 1.Conclusion Video urodynamic is useful not only for understanding the abnormalities of functions and morphology of women with lower urinary tract symptoms,but also for properly diagnosing and treating such cases.