BACKGROUND: Unilateral spinal epidural anesthesia with ropivacaine can reduce the perioperative pain in the elderly undergoing hip or knee arthroplasty, but choosing which concentration of small dose hypobaric ropivacaine is an issue of concern.OBJECTIVE: To explore the anesthetic and analgesic effects of unilateral spinal epidural anesthesia with different concentrations of low dose hypobaric ropivacaine in senile knee or hip replacement.METHODS: Ninety patients undergoing knee or hip replacement in the Henan Province Hospital of TCM from August 2014 to December 2015 were enrolled, and randomized into 0.15%, 0.5% and 0.25% ropivacaine groups (n=30 per group), followed by spinal epidural anesthesia at L3-4 or L2-3 lumbar interspace, respectively.RESULTS AND CONCLUSION: (1) The order of the flat subsided time and motor block recovery time was as follows:0.15% ropivacaine group < 0.25% ropivacaine group < 0.5% ropivacaine group; the onset time of motor block was longest in the 0.25% ropivacaine group, followed by 0.5% ropivacaine group, and shortest in the 0.15% ropivacaine group (all P < 0.05). (2) The order of the visual analogue scale scores at 1, 5, and 10 hours after anesthesia and 24 hours postoperatively was as follows: 0.5% ropivacaine group < 0.25% ropivacaine group < 0.15% ropivacaine group (P < 0.05). (3) The change levels of heart rate and blood pressure were highest in the 0.5% ropivacaine group, followed by 0.15% ropivacaine group, and lowest in the 0.25% ropivacaine group. (4) The incidence of adverse events was highest in the 0.5% ropivacaine group, followed by 0.15% ropivacaine group, and lowest in the 0.25% ropivacaine group (P < 0.05). (5) To conclude, 3 mL of 0.25% ropivacaine exhibits desired anesthetic effect.

ObjectiveTo explore the therapeutic effects and value of endoscopic variceal ligation and tissue glue injection therapy in esophageal and gastric fundal varices.Methods184 patients with severe esophageal varices underwent endoscopic variceal ligation treatment,and 32 cases of those accompanied with gastric fundal varices were treated with tissue glue injection therapy.All patients were followed-up for 6-months to observe the therapeutic effects and complication of endoscopic variceal ligation and tissue glue injection therapy.ResultsThe effective rate of endoscopic variceal ligation in severe esophageal varices was 71.74 ％ ( 132/184 ),the rate of acute hemostasis was 95.00％(57/60)and the rate of complication was 2.17 ％ (4/184).The effective rate of tissue glue injection in gastric fundal varices was 100％ (32/32) and the rate of complication was 21.88％ (7/32) (7 cases with refractory ulcers in injection site,2 of refractory ulcers cases with bleeding).There was no perforation and severe infection complications.ConclusionEndoscopic variceal ligation and tissue glue injection therapy have good therapeutic effects in esophageal and gastric fundal varices.

Objective To detect genetic mutation of apolipoprotein B-100(apoB-100)in patients with primary hypercholesterolemia.Methods One special segment of apoB-100 gene from nucleotide 10549 to 10895 was amplified by polymerase chain reaction(PCR).The PCR products were denatured and hybridized with specific aligonucleotide labeled with digoxigenin,and were analyzed by single strand conformation polymorphism(SSCP)to detect the apoB-100 gene mutation 3531CGC→CGT or other mutations.Results Overall 41 members of 11 primary hypercholesterolemia families were detected,but the above genetic mutation was not detected.Conclusion This genetic mutation is unlikely to exist or of significantly low incidence in Chinese population,and might not be the main cause of primary hypercholesterolemia in the 11 primary hypercholesterolemia families.

AIM:To establish the HPLC fingerprint of Compound Naomaitong effective parts,and to study the correlation analysis between fingerprint peaks and the effective fraction and its relevant herbs. METHODS:The chromatographic fingerprints of the effective fraction and the relevant fractions of its herbs were configured by HPLC/PDAD analysis. The relative deviation of retention time was utilized as indices to evaluate the correlation, the wavelength was set at 203 nm. RESULTS:The fingerprint of Compound Naomaitong effective parts was established and 36 copossessing fingerprint peaks were indicated. The assignment results of 14 peaks effective parts of fraction were indicated. CONCLUSION:The quality of Compound Naomaitong effective parts can be controlled by the HPLC fingerprint.

Objective:To evalte a novel laparoscopic splenic artery ligation plus devascularization (LSALD) vs. laparoscopic splenectomy and devascularization (LSD) for the treatment of portal hypertention. Methods:From Jan 2014 to Dec 2019, 50 patients undergoing LSALD and 30 patients receiving LSD . We compared the safety and feasibility between LSALD and LSD groups by analyzing the patients′ blood routine, liver function before and after operation, intraoperative condition, postoperative recovery and prognosis.Results:The operation time[(181±72)min vs.(284±72)min , t=-6.205, P<0.01], intraoperative blood loss[(100±50)ml vs.( 700±86 ml), t=-5.166, P<0.01]and blood transfusion rate (28% vs.67%, χ 2=11.471, P<0.01)in LSALD group were significantly more favorite than those in LSD group ( P<0.05). The postoperative exhaust in the LSALD group was earlier than that in the LSD group (2 d vs.3 d, Z=2.361, P<0.05) though the WBC and blood platelet count was higher in LSD group ( P<0.05). Portal vein thrombosis occurred in 10 cases in LSD group and 6 cases in LSALD group (χ 2=5.757, P<0.05). Conclusion:Compared with laparoscopic splenectomy combined with periesophagogastric devascularization, laparoscopic splenic artery ligation combined with periesophagogastric devascularization is less traumatic, helping quick recovery and lower rate of post-op portal vein thrombosis.

This article was aimed to study the molecular network and bio-function ofBu-Fei-Yi-Shen (BFYS) decoction for chronic obstructive pulmonary disease (COPD) by bioinformatics analysis, in order to provide new ideas for research on pharmacological mechanism of Chinese medicine compound prescription. Components of herbs in BFYS decoction were searched in the databases. Targeted proteins of each component were found from PubChem. Comparison analyses were performed on molecular network, bio-function and canonical pathways by Ingenuity Pathway Analysis (IPA). The results showed that there were 239 target proteins of BFYS decoction. There were 9 molecular networks of BFYS decoction. The top 3 networks' functions were Cellular Development, Energy Production, and Cancer. The top 3 bio-function of BFYS decoction were Cellular Growth and Proliferation, Cell Death and Survival, and Inflammatory Response. The top 3 canonical pathways of BFYS decoction were Cell Cycle:G1/S Checkpoint Regulation, Chronic Myeloid Leukemia Signaling, and Cyclins and Cell Cycle Regulation. It was concluded that the search of target proteins for herbal compounds and bioinformatics analysis by IPA can be used to reveal the molecular network and bio-function of BFYS decoction.

Objective To analyze the value of MRI combined with single photon emission computed tomography?CT (SPECT?CT) for the diagnosis of nasopharyngeal carcinoma with early skull base bone invasion and the effect on clinical decision. Methods This retrospective study included 195 pathologically proven nasopharyngeal carcinoma patients with complete clinical and follow?up data, which did not find the signs of skull base bone invasion by CT and be subsequently performed MRI and SPECT?CT. The MRI and SPECT?CT images were respectively analyzed and the positive or negative judgment was made on whether there was skull base bone invasion. Clinical doctors made the routine clinical decision according to MR results, and then made the combined clinical decision based on the results of MR combined with SPECT?CT. The changes between 2 clinical decisions were analyzed. To assess the value of MR, SPECT-CT and combined examination in the diagnosis of skull base bone invasion on the basis of comprehensive clinical results (including symptoms, imaging and follow up, etc) as qualitative criteria. The diagnostic power of MRI, SPECT?CT and combined examination was analyzed by ROC. Results Compared with the routine clinical decisions, combined clinical decisions (44.6%, 87/195) were changed in 87 cases, including 21 cases with new diagnosis of skull base bone invasion, 46 cases with skull base invasion range increased and 87 cases with treatment plan changes. In 195 cases, 114 cases were confirmed to have the skull base bone invasion by comprehensive clinical results. When MRI was positive and SPECT?CT positive, MRI negative and SPECT?CT negative, MRI positive and SPECT?CT negative, MRI negative and SPECT?CT positive, the presence of skull base bone invasion respectively were 100.0%(74/74), 0 (58/58), 66.7%(16/24), 61.5%(24/39). MRI and (or) SPECT?CT positive was regarded as positive, it was used as the criterion of combined examination. For skull base bone invasion, MRI, SPECT?CT and combined examination had the sensitivities of 78.95%(90/114), 85.96%(98/114), and 100.00%(114/114), the specificities of 90.12%(73/81), 81.48% (66/81), 71.60% (58/81) , the area under the ROC curve of 0.845, 0.837, 0.858; and the misdiagnosis rate of 16.41%, (32/195), 15.90% (31/195), 11.79% (23/195). Conclusion MRI combined with SPECT?CT can improve the accuracy of diagnosing skull base bone invasion and effectively affect the clinical decision of nasopharyngeal carcinoma.

Objective To explore the changes of nitric oxide (NO) and superoxide dismutase(SOD) in the serum and intestine mucosal and the treatment of ulcerative colitis(UC) with Tanshinone.Methods Seventy-nine patients with UC were randomly divided into the treatment group(group A,n=40) and the routine treatment group(group B,n=39).Patients in the group A were given Tanshionon and routine treatment.Patients in group B were given routine treatment.The levels of NO and SOD were measured in all patients before and after the treatment.The clinical symptom,enteroscopy,and hospital day were compared in the patients of the two groups.Twenty normal healthy controls(group C) were involved in the study.Results The NO level in the serum and intestine mucosal was significantly increased and the SOD level was significantly decreased in the patients with UC compared with those of the controls(all P

Objective To investigate the impacts of S-ademetionine (SAM) on cell cycles,apoptosis and invasive capacity of gastric cancer cell lines,and its effects on methylation and expressions of c-myc and uPA.Methods MKN-28,SGC-7901 and MKN-45 cells were treated with gradient concentrations of SAM(0,2 and 4 mmol/L) for 72 hours.The changes of cell cycles and apoptosis were detected by flow eytometry,and invasion was detected by transwell assay.The expressions and methylations of c-myc and uPA were examined by RT-PCR and MSP,respectively.Results The cell apoptosis significantly increased and cell invasive capacity was restrained in three cell lines with increase of SAM concentration (all P values<0.01).In SGC-7901,the cell percentage of G0/G1 phase significantly increased [(74.53±2.49)% vs.(56.67±1.18)%,P<0.053,whereas the cell proliferation index (PI) decreased [(25.50±2.46)% vs.(43.33±1.18)%,P<0.05] in comparison with controls.The expressions of c-myc and uPA mRNA in SGC-7901,uPA mRNA in MKN-45 and in 4 mmol/L SAM treated MKN-28 significantly decreased.The methylations of c-myc gene in SGC-7901 and uPA gene in three cell lines were reversed after treated with SAM.Conclusions SAM reduces expressions of c-myc and uPA by reversing the methylations of c-myc in SGC-7901 and uPA in all three cell lines.However SAM,as methyl donor,can restrain the development and progression of tumor when hypomethylation widely presents in cancer.

ObjectiveTo compare the clinical characteristics of ischemic colitis (IC) and ulcerative colitis (UC).MethodsThe data of 43 IC patients and 36 UC patients diagnosed from January 2008 to June 2011 were compared on the clinical and endoscopic characteristics.ResultsThere were statistical differences in terms of gender,age,course of disease and underlying diseases between the two groups( P ＜0.05 ).IC was more frequently seen in aged women with cardiovascular diseases,and with short course of disease (29/43,67.0％).IC group showed higher CRP and lower PLT level than did UC group (P ＜ 0.05 ).IC mostly involved sigmoid colon,with localized lesions of vertical or irregular ulcer which cured more quick and characterized with mucosal inflammation,while UC mainly originated from rectum and involved the whole intestinal wall,manifested with scattered spot ulcer,cryptitis and abscess.Conclusion Age,disease course,underlying diseases,serum CRP level,endoscopic and pathological characteristics are all factors to consider for differential diagnosis of IC and UC.