Orthopaedic postoperative pain not only brings a lot of side effects to patients, but also directly affects early rehabilitation after surgery. Effective preoperative pain management mainly includes three-stage individual pattern analgesia, which refers to preoperative, intraoperative and postoperative analgesia. The purpose is to reduce pain in multiple planes and three-dimension, strengthen the effect of analgesics and reduce dosage and side effect of single drug. This paper summaries new progress on individual-multiple-pattern analgesics, pain assessment method and various therapies.
Analgesia ; methods ; Humans ; Orthopedics ; methods ; Preoperative Period ; Treatment Outcome

Purpose:To study analgesia effect and adverse reaction of diclofenac sodium extended release capsule for cancer pain in senile patients. Methods:20 senile patients with light or moderate cancer pain were selected.The analgesia effect and adverse reaction were observed after diclofenac sodium extended release capsule 100 mg qn po.Results:The treatment of cancer pain with diclofenac sodium extended release capsule in senile patients had obvious analgesia effect without obvious adverse reaction. Conclusions:Diclofenac sodium extended release capsule 100 mg qn po is a safe,effective and simple way to relieve cancer pain in senile patients with light or moderate cancer pain.

Colitis, Ulcerative ; immunology ; therapy ; Drugs, Chinese Herbal ; Humans ; Immunity, Cellular ; Medicine, Chinese Traditional

Objective A high performance liquid chromatographic (HPLC) method was established for the simultaneous determination of xylitol and L-xylulose in fermentation broth.Methods The chromatographic conditions were as follows:C18 column (250 mm ×4.6 mm) with the temperature 35℃, acetonitrile-water (85∶15,v/v)as mobile phase with the flow rate of 0.8 mL/min.Xylitol was detected by refractive index (RI) detector at 33℃and L-xylulose was determined by ultraviolet ( UV) detector at 210 nm at room temperature.Results This method showed good linearity over the range from 0.50~30.00 g/L with a correlation coefficient of 0.9995 for xylitol and 0.30~30.00 g/L with a correlation coefficient of 0.9986 for L-xylulose. Moreover, the limit of quantification (LOQ) for xylitol and L-xylulose were 0.58 and 0.40,respectively.The limit of determination (LOD) for xylitol and L-xylulose were 0.18 and 0.15,respectively.The relative standard deviations (RSDs) of intraday and interday for xylitol were less than 0.64%and 0.80%,respectively.The intraday and interday RSDs for L-xylulose were less than 0.31%and 0.59%.The recoveries of xylitol and L-xylulose in fermentation broth were between 99.00%-101.00%.Conclusion There was no interference from other constitutes in the fermentation broth by this method.The methods were suitable for the simultaneous determination of the substrate xylitol and the product L-xylulose in fermentation process.

Objective To study the X-ray features and differential diagnosis of duodenal obstruction in neonates.Methods X-ray data of duodenal obstruction in 52 cases confirmed surgically were analyzed retrospectively.Erect abdominal plain films were done in each case;Upper gastric intestinal investigations(UGI) were performed in 28 cases,and barium or meglumine diatyizoate enemas were done in 36 cases.Results On the plain films,9 cases with single-bubble,29 with double-bubble,6 with tri-tubble,8 with multiple stepladder-like gas-fluid level in the bowel loops were noted.14 cases with completive obstruction and 13 cases with partial obstruction were found in UGI series.Malposition of the jejunum was seen in 8 cases among them.Abnormal location of cecum on barium enema was demonstrated in 30 cases,included 10 cases of microcolon.The etiology of duodenal obstruction included intestinal malrotation 34 cases,duodenal atresia 9 cases,duodenal stenosis 4 cases and anaular pancreas 5 cases.Conclusion Most cases of duodenal obstruction can be diagnosed with plain films combining with clinical materials.Differential diagnosis should be made by UGI series and barium enema.

Anatomic hepatic resection not only enables enough tumor-free resection margin,but also guarantee the maximal remnant of normal liver tissue.A 61-year-old male patient with hepatic cancer was admitted to the Affiliated Hospital of Hainan Medical College in February 2012.Multiple space-occupying lesions were found in segment Ⅵ,Ⅶ and Ⅷ by computed tomography (CT).The results of CT volumetry analysis showed that the left hemihepatic volume was lesser than the minimal limit of survival,so anatomic hepatic segmentectomy of Ⅵ,Ⅶ and Ⅷ with preservation of segment Ⅴ was designed to guarantee the maximal remaining of normal liver tissue.Glisson's pedicle transection was used twice to divide the right hemihepatic Glisson's pedicle,segment Ⅵ and Ⅶ Glisson's pedicle,respectivley,then the resection line was determined,and anatomical hepatic segmentectomy of Ⅵ,Ⅶ and Ⅷ was completed.With the procedures adopted,the hepatic ischemia reperfusion injury and hemodynamic instability were maximally reduced during operation.

Objective　To study the clinical manifestation of small bowel tumors and the prognostic factors. Methods　Retrospective analysis of the clinical data were made on 42 cases of primary small bowel tumors (except periampullary tumors) admitted to our hospital from 1974 to 1999. Results　In this series, there were 6 cases of benign small bowel tumors, 5 of them were leiomyoma and 1 adenoma. Of the 36 cases of malignant 　tumors, there were malignant lyphoma in 17 cases (47.2%), adenocarcinoma in 11 (30.6%),　 leiomyosarcoma in 6(16.7%), carcinoid tumor in 1 (2.8%) and neurofibrosarcoma in 1 (2.8%). There was no characteristic clinical sign in small bowel tumors; endoscopy and barium series were the main diagnostic methods. About 50 per cent of patients with malignancy had metastasis, and only 18 cases (50%) received radical resection. Follow-up were available on 36 cases. The overall 5-year survival rate in the patients with malignant small bowel tumors was 47.3%. Multivariate analysis showed that metastasis and diameter of tumors were the main prognostic factors of the 5-year survival. Conclusions　Early diagnosis and early treatment play the key roles in improving the prognosis of malignant small bowel tumors. Radical resection should be taken if no metastasis is found.

AIM To investigate whether pretreatment with prostaglandin E 1 (PGE 1) might protect myocardium against peroxidative injury in early phase and in delayed phase. METHODS Rats were pretreated with PGE 1 (25 or 150 mg?kg -1 ). Isoproterenol (ISOP)(80 mg?kg -1 ) were injected peritoneally (ip) to induce acute myocardial infarction 20 minutes (early phase) or 24 hours (delayed phase) after pretreatment. Hearts were removed punctually 24 hours after ip ISOP and were assayed for content of malonaldehyde (MDA), activity of glutathione peroxidase (GSH Px) and superoxide dismutase (SOD). RESULTS ISOP caused myocardial injury with increased MDA content and SOD activity, and decreased GSH Px activity. Pretreatment with PGE 1, at each dose and in both phase, decreased the MDA content ( P

AIM : To contrastively observe the effects of combinative usage of ipratropium bromide, anti cholinergic inhalant and the small dosage of controlled release theophylline tablets or salbutamol on the patients with COPD. Clinical observation of efficacy of combinative usage of ipratropium bromide and small dosage of theophylline on patients with COPD$$$$ WENG Hai xia, DAI Yuan rong, WU Cheng yun, LIN Jie Department of Respiratory, the Second Affiliated Hospital of Wenzhou Medical College, Wenzhou 325027, Zhejiang, China ABSTRACT AIM : To contrastively observe the effects of combinative usage of ipratropium bromide, anti cholinergic inhalant and the small dosage of controlled release theophylline tablets or salbutamol on the patients with COPD. [WTHZ METHODS : Forty patients with stable COPD were randomly divided into two groups ( n =20 in each): theophylline group or salbutamol group. In theophylline group, each case inhaled 2 puffs of ipratropium bromide ter in die, meanwhile take 0.1 g ophylline capsule orally every 12 hours, measured the maximum and minimum concentration of ophylline. In salbutamol group, each case inhaled 2 puffs of ipratropium bromide and salbutamol ter in die. During 8 weeks trial, the base FEV 1.0 before using medicine and the FEV 1.0 when all the drug were stopped at the end of 1st, 4th, and 8th week was measured, separately. The FEV 1.0 amelioration ratio (△′FEV 1.0 ) compared with base FEV 1.0 was obtained , and another FEV 1.0 amelioration ratio (△FEV 1.0 ) was also detected after bronchodilatation test by salbutamol. Furthermore, PEFR aberration rate was evaluated by measuring peak expiratory flow rate in morning and evening daily. The maximum concentration of ophylline is 8.7 ? 2.1 mg?L -1 , the minimum is 6.1 ? 2.3 mg?L -1 . RESULTS : △FEV 1.0 increased markedly at end of 8th week in theophylline group (P