Objective To study effect of general anesthesia combined with epidural anesthesia on analgesia and microcirculation in patients undergoing total hysterectomy. Methods 92 patients of total hysterectomy who received therapy were selected, according to random number table,those patients were divided into the observation group (n=42) and the control group (n=48),the observation group received general anesthesia combined with epidural anesthesia, the control group were only given general anesthesia.The operation condition, hemodynamics and stress response before anesthesia(T0), at tracheal intubation(T1), after pneumoperitoneum 10min(T2), after surgery(T3), at extubation(T4) were compared,and postoperative pain (VAS) score was compared. Results There was no significant difference in operation time and fluid volume between the two groups. In the control group,the levels of mean arterial pressure (MAP), heart rate (HR) at the time of T1, T2, T3 were significantly increased(P<0.05), the levels of MAP and HR at the time of T1,T2,T3 in the observation group were lower than the control group(P<0.05). The cortisol (Cor), epinephrine (E), norepinephrine (NE) at the time of T1,T2,T3,T4 in the observation group were lower than the control group(P<0.05). Two groups of patients in the postoperative 12h, 6h, the VAS scores in the resting state and cough state were higher than the postoperative 1h(P<0.05),but the scores in the observation group were lower than the control group(P<0.05). Conclusion General anesthesia combined with epidural anesthesia is well for total hysterectomy,which can maintain hemodynamic stability during surgery, relieve stress reaction, alleviate postoperative pain, it is worthy of application and promotion.

Objective To study the effects of propofol on the expressions of tumor necrosis factor(TNF)-α, interleukin-10 (IL-10) and nuclear factor-κB(NF-κB) in rat cerebrum undergoing ischemia and reperfusion. Methods Thirty rats were randomly divided into five groups with 6 rats each. The rats in group S accepted sharm operation as the controls, in group IR focal cerebral ischemia Concentrations of TNF-α and IL-10 in the cerebrum were measured by enzyme-linked immunosorbance assay(ELISA). An isotope([32P]-ATP) technique was applied for detecting nuclear factor-κB(NF-κB) in rat cerebral cortex. Electrophoretic mobility shift assay (EMSA) was performed in nuclear extracts from cerebral tissues. Results Compared with group S,TNF-α of group IR increased [(2.57±0.19) pg/g vs. (1.60±0.15) pg/g](P<0.05),so did the IL-10 [(11.59±1.32) pg/g vs. (7.97±1.96) pg/g](P<0.05). Compaered with group IR,TNF-α of group PP decreased [(1.88±0.26) pg/g vs. (2. 57±0. 9) pg/g](P<0.05) ,so did the IL-10 [(8.35±1.00) pg/g vs. (11.59±1.32) pg/g](P< 0.05),with decreased activity of NF-κB. There was no significant difference in the levels of TNF-α, IL-10 and NF-κB between group IR and group PA. The changes of IL-10 and NF-κB activity were parallel to that of TNF-α. Conclusion Pre-treatment with propofol can prevent the elevation of inflammatory factors in the cerebrum undergoing ischemia and reperfusion, which was not when used after cerebral ischemia. The effect of propofol on reduction of TNF-α production in ischemic cerebrum may be through inhibiting transduction pathway of NF-κB.

Objective To investigate the expression and distribution of COX-2 in benign and malignant breast disease,and the relationship among COX-2 expression and the clinicopathologic factors,hormone receptors.Methods Immunohistochemistry Was used to investigate the expression and distribution of COX-2 in 8 accessory.breasts,31 BPBDs(15 in adnosis,16 in fibroadnoma),70 IDCs(35 of them accompany with DCIS);The relationships between the expression of COX-2 and hormone receptor(ER and PR),C-erbB-2.and the clinicopathologic factors were studied respectively.Results①The expression of COX-2 in various kinds mammary diseases:8 accessory breasts were all negative;the positive rate of COX-2 in BPBD was 96.5%(30/31),among these,the positive rate of COX-2 in adnosis was 93.3%(14/15),and in fibroadnonm was 100%(16/16).The positive rate of COX-2 in DCIS was 85.7%(30/35).The intensity of COX-2 expression in DCIS of periph-IDC was higher than that in corresponding carcinoma.The positive rate of COX-2 in IDC Was 84.3%(59/70),the expression of COX-2 Was different among non-cancer gland.②COX-2 expression in BPBD was obviously higher compared with COX-2 in IDC,the difference was significant in statistics(χ2=9.39,P＜0.025).③The expression of COX-2 in DCIS was correlative with low histological differentiation(χ2=10.98,P＜0.005),PR negative(P=0.019,Fisher exact probability),and C-erbB-2 positive(P=0.0008,Fisher exact probability).The expression of COX-2 in IDC was correlative with lymph node metastasis(χ2=4.09,P＜0.05),tissue poorly differentiated(P=0.004,Fisher exact probability),PR negative(χ2=6.91,P＜0.01)and C-erbB-2 positive(χ2=5.94,P＜0.025).Conclusion COX-2 does not express in normal mammary gland.It is high-expressed in BPBD,DCIS and IDC;These indicate the up-regulation of COX-2 expression not only participates in breast carcinogenesis,but also promotes its metastasis and progression,and suggests COX-2 may down-regulate reactivity of endocrine thempy by participating in therapy resistance of PR negative breast cancer.

Micro-syringe as a result of the high frequency of clinical use, direct contact with patients, the failure of its equipment will have a direct impact on the patient's disease status. Researchers in this paper, by simulating the test fluid, electrical safety testing and analysis of statistical methods such as maintenance records, consider six kinds of common injection pump, in terms of performance, safety and the failure rate of three performance. Compared the performance analysis, summarized the various types of injection pump characteristics, researchers make suggestions to clinical departments, equipment procurement and equipment management departments for usage and improvement.
Equipment Failure ; Equipment Safety ; Syringes

Objective To search for an effective acupuncture-moxibustion therapy for high fever in common cold. Methods According to the randomized and multi-central trial principle, 276 cases enrolled were randomly assigned to observation group of 138 cases and control group of 138 cases. The observation group were treated by electroacupuncture at Dazhui and the control group were treated by Antondinie injection coordinating pathogeny therapy to observe the prompt effects in 24 hours. Results After treatment, the temperature of every time point of the observation group was lower than that of the control group (P 0.05). Conclusion The method of electroacupuncturing at Dazhui has a definite therapeutic effect on high fever in common cold.

With the strengthening of nuclear weapon development and the expanding of neutron application in economic area,the injury accidents of neutron radiation are happening from time to time.Neutron exposure,with high linear energy transfer,has high casualty rate,severe symptom and poor prognosis.In comparison with low-LET radiation damage,neutron irradiation induced injuries are more difficult to rescue.This review focused on the recent research progresses of radiation effects,intrinsic mechanisms and clinical prevention measures of neutron radiation,and to provide a theoretical clue for establishing an effective prevention protocol of neutron radiation damage.

Objective To probe into the clinical effect of acupuncture combined with herbal medicine with the functions of detoxication and purging fu-organ on patients with constipation of phlegm-heat and bowel-repletion type in acute cerebral infarction.Methods The enrolled cases were randomly assigned to an observation group of 35 cases and a control grouD of 35 cases.Besides both groups were treated with routine neurological treatment and acupuncture with the flinchon of brain activating,the observation group was treated by acupuncture combined with herbal medicine with the functions of detoxication and purging fu-organ and the control group was treated with Dilute Glycerol.Such indexes of patients in both groups were observed 7 days and 21 days before and after the treatment as clinical effect of constipation,scores of related symptoms,and scores of traditional Chinese medical category and clinical effect.Results The effective rates of eonstipation 7 davs and 21 days after treatment were 93.7% and96.9% in the observation group,and 61.8% and79.4% in the control group,with significant differences between the two groups(P＜0.01).After the treatment for 7 days and 21 days,the symptoms of constipation.dark tongue,yellow and greasy fur were improved significantly in the observation group than those in the control group(P＜0.05);The observation group also showed a definite therapeutic effect than the control group on treating the svmptoms of upset minded,constipation,red or dark tongue,yellow and greasy fur(P＜0.01).The scores of traditional Chinese medical category of the observation group were lower than that of the control group(P＜0.01)after treatment for21 days.The total improvement rate was 97.0% in the observation group comparing 55.8%in the control group,showing significant difference(P＜0.01).Conclusion The method of acupuncture combined with herbal medicine with the functions of detoxication and purging fu-organ has a definite therapeutic effect on treating constipation of phlegm-heat and bowel-repletion in acute cerebral infarction.It can also improve clinical effects of these patients,which is worth generalizing in the clinical practice.

The anti-endotoxic effect of syringic acid (SA) isolated from Radix Isatidis (Banlangen, BLG) was studied. SA was extracted and isolated from BLG and diluted into 1% solution. The content of SA-pretreated endotoxin (ET) was quantitatively determined using Limulus test. The ability of fever induction of ET pretreated with SA was measured using endotoxin-induced fever test in rabbits. The LPS-induced death in mice pretreated with and without SA was compared. Results showed that after pretreatment with SA, 83.16% of ET was destroyed, the ET-induced fever in rabbits relieved markedly and the LPS-induced death rate in mice dropped from 68% to 20%. It was concluded that SA isolated from BLG had anti-endotoxic effects.
Drugs, Chinese Herbal/*pharmacology ; Endotoxemia/blood ; Endotoxins/*antagonists & inhibitors ; Escherichia coli ; Gallic Acid/*analogs & derivatives ; Gallic Acid/*pharmacology ; Isatis/*chemistry ; Limulus Test ; Plant Roots/chemistry

Objective To compare the clinical effect of proximal femoral nail anti-rotation(PFNA) and dynamic hip screw(DHS) internal fixation in the treatment of femoral intertrochanteric fracture.Methods 80 patients with femoral intertrochanteric fracture were selected as research subjects.They were divided into PFNA group and DHS group by random number table,40 cases in each group.The operation time,intraoperative blood loss,postoperative wound drainage,postoperative weight-bearing time,healing time,complication rate,Harris hip function score between two groups were compared.Results The operation time of the PFNA group was lower than that of DHS group(t=22.66,P＜0.05),the amount of bleeding in operation was less than that in the DHS group(t=54.85,P＜0.05),the postoperative wound drainage volume was less than that of the DHS group(t=16.85,P＜0.05),the weight-bearing time after operation was shorter than that in the DHS group(t=20.18,P＜0.05),and the healing time was shorter than that in the DHS group(t=22.00,P＜0.05).The excellence rate of Harris hip function score in the PFNA group was 95.00％,which was significantly higher than 80.00％ in the DHS group,the difference was statistically significant(χ2=4.11,P＜0.05).The incidence rate of complication of the PFNA group was 7.50％,which was significantly lower than 25.00％ of the DHS group(χ2=4.50,P＜0.05).Conclusion Compared with DHS,PFNA internal fixation has the advantages of less operation time,less intraoperative blood loss,shorter healing time and low complication rate in the treatment of femoral intertrochanteric fracture.It is worthy to be promoted clinically.

Human immunodeficiency virus (HIV) is the infectious agent causing acquired immunodeficiency syndrome (AIDS), a deadliest scourge of human society. Hepatitis C virus (HCV) is a major causative agent of chronic liver disease and infects an estimated 170 million people worldwide,resulting in a serious public health burden. Due to shared routes of transmission, co-infection with HIV and HCV has become common among individuals who had high risks of blood exposures. Among hemophiliacs the co-infection rate accounts for 85%; while among injection drug users (IDU) the rate can be as high as 90%. HIV can accelerate the progression of HCV-related liver disease, particularly when immunodeficiency has developed. Although the effect of HCV on HIV infection is controversial,most studies showed an increase in mortality due to liver disease. HCV may act as a direct cofactor to fasten the progression of AIDS and decrease the tolerance of highly active antiretroviral therapy(HARRT). Conversely, HAART-related hepatotoxicity may enhance the progression of liver fibrosis.Due to above complications, co-infection with HCV and HIV-1 has imposed a critical challenge in the management of these patients. In this review, we focus on the epidemiology and transmission of HIV and HCV, the impact of the two viruses on each other, and their treatment.