OBJECTIVE:To evaluate the analgesic effects and ADR of fentanyl transdermal patches in different therapies. METHODS:189 patients with cancer pain were randomized into three groups:routine dose fentanyl transdermal patches group(group A) ;routine dose fentanyl transdermal patches +12 h controlled-release morphines(Ms) group(group B) ;twice routine dose fentanyl transdermal patches+12 h controlled-release Ms group(group C) . The curative effects of treatment for 6 days in3 groups were compared by VAS method. RESULTS:In group A,B and C,significant differences were noted in curative efficacy(P0.05) . CONCLUSION:The therapy of group C shows better analgesic effect,safety and clinical value than the other two groups.

OBJECTIVE: To compare the economic effects of MS Contin and oxycontin in treatment of cancer pain. METHODS: 120 patients with cancer pain were divided into GroupA1(30 cases),GroupA2 (30 cases),GroupB1 (30 cases) and GroupB2(30 cases). GroupA1 and GroupA2 were received MS Contin via p.o. for 15 days while GroupB1 and GroupB2 oxycontin via p.o. for 15 days. Pharmacoeconomics was applied in costeffectiveness analysis. RESULTS: Effective rates of GroupA1,GroupA2,GroupB1 and GroupB2 were 70.00%,83.33%,96.67% and 90.00%. The costeffectiveness ratios were 385.71,324.01, 284.58 and 305.67,respectively.The incremental costeffectiveness ratios of GroupB1 and GroupB2 were 19.12 and 25.50,respectively as comparing with GroupA1. CONCLUSION: Therapy of GroupB1 is optimal among 4 schemes based on the curative effect or costeffectiveness analysis.

Objective To observe and investigate the effects of the case-based learning assisted with WeChat software in the teaching of nursing constitution regulating theory. Method The two classes of nursing undergraduate Grade 2013 were randomized into the case-based learning (CBL) group and the traditional teaching group (LBL). WeChat group combined with CBL group made preparation before class, including teachers writing the cases and thinking questions, WeChat sending teaching information, students discussing problems in group and collecting information. In class, students gave presentation and made speech, and the teachers made comments, did summary and gave scores to students' performance. In LBL group teacher prepared a lesson, and taught lessens assisted by multimedia PPT. After class, we used the test of nursing constitution regulating and teaching effect questionnaire to compare the differences between the two groups, using SPSS 21.0 for data statistics, and t test for measurement data. Results The single choice score, multiple choice score and the total score of the test of nursing constitution regulating in the CBL group were (52.46±4.35), (33.42±3.11), and (85.88±5.72), higher than the LBL group which were (47.63±5.84), (29.88±4.55), and (77.50±7.88). The difference was statistically significant. Scores of self-study ability, interest in learning, literature retrieval ability, communication and cooperation ability, TCM differentiation and the examination scores in CBL group were significantly higher than that in LBL group. Conclusion The case-based learning assisted with WeChat software can inspire the interest of learning, cultivate the self-study ability and practice the ability of TCM differentiation. It is worthy of being generalized.

Objective To investigate effectiveness of treatment of Upper urinary tract calculus by MPCNL application.Methods From May 2000 to May 2007,causing artificial kidney hydronephrosis for the affected kidney,established renal percutaneous channels(F16～18),which established the single channels of 202 cases,dual-channel of 14 cases,by Ureteroscopic Lithotripsy and holmium laser lithotripsy.Results 183 cases of 216 patients were One-time stone;33 cases were second stone.The average clearance rate is 90.32%,the average operation time is 79min,average valume of about bleeding is 80ml,the average hospitalization days are 8 days,kidney ostomy average stay 7.5 days.Of the operation,9 cases of obviously bleeding(4%)before and after operation,1 case uncontrollable bleeding after interventional treatment failure with Nephrectomy,others to stop beeding by symptomatic treatment,2 cases find urinary extravasation postoperative and cured by adjusting location of renal ostomy.Conclusion Minimally invasive percutaneous nephrolithotomy for the treatment of Upper urinary tract calculus is safe and effective for patients with less trauma,quicker recovery and high learance rate,the efficacy is satifactory.

Objective To evaluate the method and result of thyroid artery embolization as a new therapy for hyperthyroidism. Methods Twenty two patients with hyperthyroidism underwent selective thyroid artery embolization. Totally 52 thyroid arteries were embolized with microspheres. The indications to this therapy were following: hyperthyroid patients having indications to surgical and 131 I therapy, clinically being difficult to complete the preparation for subtotal thyroidectomy and having high risk for surgical process because of their huge thyroid gland. Results Serum level of thyroid hormones dropped significantly [median T3 from 8 8 nmol/L(4 3～ 43 0 nmol/L) to 4 0 nmol/L(1 1～9 2 nmol/L), median T4 from 206 4 nmol/L(77 4～748 2 nmol/L) to 144 5 nmol/L(25 8～279 9 nmol/L), P

Rhetsinine has been isolated from the fruits of Evodia rutaecarpa ( Juss. ) Benth. ~1H NMR and ~(13)C NMR assignments reported previously for rhetsinine were revised on the basis of UV, IR, ESI-MS,~1H NMR, ~(13)C NMR and X-ray crystallographic analysis.

Objective To study the relationship between tacrolimus blood level/dose and the genotype of CYP3A5 at 6th month after lung transplantation.Method Forty-six cases of lung transplant recipients who received the surgery between January 1st,2011 and January 1st,2013 served as the research subjects,and the genotypes of these patients were measured.These patients were divided into 3 groups (CYP 3A5 * 1 * 1,CYP 3A5 * 1 * 3,CYP 3A5 * 3 * 3) according to their different genotypes.The dose of tacrolimus and daily intake were detected at 6th month after surgery in each group,then the level/dose of tacrolimus was calculated.Result In all 46 recipients,5 of them were CYP 3A5 * 1 * 1 homozygous genotype,20 CYP 3A5 * 1 * 3 heterozygous genotype and 21 CYP 3A5 * 3 * 3 homozygous genotype.Under the condition of holding tacrolimus blood level between therapeutic range,there was significant difference in the dose of tacrolimus between the CYP3A5 * 1/ * 1 and * 1/* 3 versus * 3/* 3 genotypes (P＜0.01),but there was no significant difference between CYP3A5 * 1/* 1 genotype and * 1/* 3 genotype.Conclusion Tacrolimus dosing in lung transplant patients is associated with CYP 3A5 gene polymorphisms.

Objective To investigate the diagnostic value of DSA for micro hepatocelluar carcinoma(MHCC)in patients with hepatic cirrhosis. Methods Three hundred and fourty cases of hepatic cirrhosis who were going to receive bone marrow stem cells transplantation via hepatic artery underwent hepatic arterial DSA. No definite evidence of hepatoma had been found during the former CT scan and ultrasound test in these patients. Multi-angle projection DSA was performed to display the characteristics of MHCC and super-selective TACE treatment was given in cases of the diagnosed MHCC. Results MHCC were found by DSA in 20 cases who were all of post-hepatitis B cirrhosis and with single-lesion of sized 0.4 - 1.0 cm. DSA showed the characteristics of nodular stains in early or middle arterial phase in angiography. 18 lesions were in the right lobe and 2 in the left lobe. AFP were negative in 16 cases and positive in 4 cases. Super-selective segmental TACE were performed with micro catheter system for the treatment. Conclusions DSA is more sensitive to detect MHCC in the patients with hepatic cirrhosis, comparing with regular contrasted CT scan or ultrasound.

Objective To evaluate interventional techniques for the treatment of visceral aneurysms. Methods A total of 11 aneurysms were found in 9 patients with visceral aneurysms who received interventional treatment. Of the 9 patients, single aneurysm at both superior mesenteric artery (SMA) and right colonic artery was seen in one, 2 aneurysms at same splenic artery in one, one aneurysm at splenic artery in 5, aneurysm at right gastric artery in one and pseudoaneurysm at hepatic artery in one. In 9 patients the transcatheter endovascular coil embolization was successfully carried out for 10 aneurysms, including splenic (n = 7), right colonic artery (n = 1), right gastric artery (n = 1) and hepatic pseudoaneurysm (n = 1). One stent-graft was used for the SMA aneurysm. Results Technical success was achieved in all cases without any serious complications. Conclusion Interventional embolization with coils can successfully occlude most visceral aneurysms, while stent-graft should be used when the aneurysm is difficult to be occluded with coil.

Objective To explore the feasibility and proper technique of subintimal racanalization in treating chronic aorto-iliac artery occlusion. Methods Subintimal racanalization via right brachial artery access was performed in a 57-years-old man with chronic total occlusion of aorto-iliac artery. Subintimal pathways were created with two hydrophilic guidwires (Teromo), which were inserted into the subintimal space from the occluded end of the abdominal aorta and got into the right and left external iliac arteries separately. Subintimal arterial flossing with antegrade-retrograde intervention was employed in left side to overcome the difficulty in reentering the true lumen. The exchange guidwires were conducted out of the femoral artery puncture sites on both sides in sequence, in this way the bilateral femoral pathways were established. Aorto-iliac artery balloon angioplasty and retrograde stent implantation, including one aortal and 5 iliac stents, were carried out by kissing technique from the femoral site. Results The aorto-iliac artery lumen was successfully reopened after the procedure. The internal lumen shape of the stents was satisfactory and the blood flow was unobstructed. The ischemic symptoms of the lower extremities disappeared completely. The ankle brachial index (ABI) rose from 0.32 to 0.96, and the condition remained stable in a follow-up period of 10 months. Conclusion Subintimal racanalization therapy is practical and safe for treating total aorto-iliac artery occlusion, especially for the patients with chronic arterial sclerosis.