Objective To discuss postoperative analgesia effect of patient automatic controlled epidural analgesia (PCEA) and cocktail therapy (CT) after total hip replacement. Methods Eighty-eighty patients of selective total hip replacement were selected, and the patients were divided into PCEA group and CT group by random digits table method with 44 cases each. The postoperative resting state and active state visual analogue score (VAS), dosage of opioid, discharge time, postoperative complications, postoperative sleep quality score and hip joint mobility were compared between 2 groups. Results The resting state and active state VAS in PCEA group 12, 24 and 48 h after operation were significantly lower than those in CT group, resting state: (3.68 ± 1.45) scores vs. (4.23 ± 1.14) scores, (2.61 ± 1.04) scores vs. (3.92 ± 1.23) scores and (2.31 ± 0.97) scores vs. (3.56 ± 1.21) scores, active state:(4.54 ± 1.63) scores vs. (5.87 ± 2.11) scores, (3.51 ± 0.94) scores vs. (4.34 ± 1.07) scores and (3.01 ± 0.95) scores vs. (4.05 ± 1.17) scores, and there were statistical differences (P<0.05). But there were no statistical differences in VAS 72 h after operation and at discharge between 2 groups (P>0.05). The dosage of opioid in PCEA group was significantly lower than that in CT group:(9.58 ± 5.35) mg vs. (11.27 ± 4.48) mg, and there was statistical difference (P<0.05). The incidences of nausea vomiting and headache dizziness in CT group were significantly lower than those in PCEA group: 20.45% (9/44) vs. 45.45% (20/44) and 4.55% (2/44) vs. 13.64% (6/44), and there were statistical differences (P<0.05). There were no statistical differences in length of hospital stay, postoperative sleep quality score and postoperative hip joint mobility between 2 groups (P>0.05). Conclusions Choice of analgesic regimen of choice should not be made only according to the length of hospital stay. Individualized treatment is recommended. According to specific circumstances and needs of patients, patients with less anesthetics and a tendency to nausea should use PCEA, and for chronic pain patients CT may be more effective.

OBJECTIVE: To evaluate short term quality of life of patients with chronic rhinosinusitis by using Chinese version of the sinonasal outcome test-22 (SNOT-22) and to formulate an ideal therapy system for patients with chronic rhinosinusitis. METHOD: Using prospective randomized controlled design,we chose the SNOT-22 to evaluate and compare 78 CRS patients' quality of life (QOL) before surgery, at 1-month,3-month, 6-month and 9-month after functional endoscopic sinus surgery(FESS). At the same time, we randomly chose 100 healthy controls to compare their QOL with those of CRS patients after FESS. RESULT: We found that except for 5 items (cough, ear expanding, otalgia, facail pain and weary ), the grade of 17 other items of CRS patients were significantly higher than those of the healthy controls (P<0. 05). There was no significant difference in 7 items (olfactory sensation, hypogeusis, backflow of nasal discharge, difficult to fall asleep, bad sleep, bad work efficiency, depression, embarrassment ) at 3 months after FESS between chronic rhinosinusitis patients and healthy controls (P>0. 05). There was no significant difference in 9 items (blow noses, sneeze, rhinorrhea, nasal discharge thickness, dizziness, night wake, tired of wake, attention deficit, sense of loss) at 6 months after FESS between chronic rhinosinusitis patients and healthy controls (P>0. 05). There was no significant difference in nasal obstruction at 6 months after FESS between chronic rhinosinusitis patients and healthy controls (P>0.05), at this time the totle grade was normal (P>0. 05). The recovery period of QOL in patients was about 9 months (P>0. 05). The 5 great items were nasal obstruction, olfactory sensation, hypogeusis, nasal discharge, nasal discharge thickness and blow noses. There was no difference in items except for bad sleep replacing nasal discharge thickness between 1-month and 9-month after surgery. CONCLUSION The Chinese vesion of SNOT-22 could evaluate QOL of CRS patients in this area. The recovery of QOL of CRS patients needs about 6 months after FESS, but problems of olfactory sensation, hypogeusis, nasal discharge and difficult to sleeep still needs to be resolved.
Asian Continental Ancestry Group ; Chronic Disease ; Humans ; Nasal Obstruction ; Prospective Studies ; Quality of Life ; Rhinitis ; complications ; surgery ; Sinusitis ; complications ; surgery ; Smell ; Treatment Outcome

Objective:This study aims to analyze the differences in the alternative splicing pattern of ADAR2 among glioma cell lines U87, U251, A172, and normal human astrocyte HA1800. Methods:A-to-I editing level at the Q/R-Site of GluR-2 was analyzed by RT-PCR and sequencing. Real-time PCR was performed to detect the expression level of each alternatively splicing variant using a specific primer that was confirmed to amplify only the targeted template and not other alternatively spliced variant fragments. Results:We verified that the Q/R-Site of GluR-2 is under-edited in glioma cell lines. Real-time PCR revealed that the ADAR2 pre-mRNA splic-ing pattern has no significant difference at exons 1a and 2 between glioma cell lines and normal human astrocyte. We also detected that the amount of alternative splicing variants, including exon 5a, was higher than that of alternative splicing variants not including exon 5a in human glioma cell lines. However, the expression of alternative splicing variants, including exon 5a, was lower than that of alterna-tive splicing variants not including exon 5a in human astrocyte. Conclusion:Evident differences in splicing were observed at the site of exon 5a between glioma cell lines and normal human astrocytes. The difference in the alternatively splicing pattern at exon 5a may be attributed to the decreased activity of ADAR2.

Objective To investigate the effects of the intravenous immunoglobulin (IVIG) on the expression of FcγR Ⅱ b and Toll-like receptor 4 (TLR4) in children with Kawasaki disease (KD).Methods 25 children with KD and 15 healthy controls were enrolled in this study.The levels of TLR4 expression on monocytes were assessed by flow cytometry.Real-time PCR was performed to detect the transcription levels of FcγR Ⅱ b,TLR4 signaling molecules(MyD88,TRAF-6,TAK1) and cytokines(IL-1β,IL-6,TNF-α) in monocytes.The concentrations of TNF-α in plasma was determined by enzyme-linked immunosorbent assay (ELISA).Results (1) Compared with healthy controls,the expression of TLR4 and the signaling molecules in the patients were significantly up-regulated but decreased after treatment with IVIG (P＜0.05).(2)The levels of FcγR Ⅱb expression from the patients were higher than those from healthy controls,and decreased after treatment with IVIG(P＜0.05).(3) The levels of cytokine factor expression such as IL-1β,IL-6 and TNF-α in the patients were found to be higher than those in healthy controls (P＜0.05) ; plasma concentrations of TNF-α were significantly elevated during acute KD (P＜0.05).(4)There were significantly correlations to follow between FcγR Ⅱb and the levels of cytokine,TLR4 expression in monocytes (P ＜0.05).Conclusion IVIG can up regulate FcγR Ⅱb expression and down regulate TLR4 expression which might inhibit the inflammatory response.

Heterotopic ossification is a common complication after acetabular fractures and fractures of the elbow.Heterotopic ossification often leads to severe joint movement disorder,which brings great pain to the patient.This paper reviewed the clinical research,including pathogenesis,clinical diagnosis,prevention,treatment and future directions of heterotopic ossification to investigate the effective method in prevention and treatment of heterotopic ossification.

Objective To study the function of cyclooxygenase 2(COX 2) and its specific inhibitor NS 398 on the cell growth and invasion ability of urothelial carcinoma cell line EJ. Methods The cox 2 cDNA was transfected into the urothelial carcinoma cell line EJ and a cell line EJ COX 2 which highly expressed cox 2 gene permanently was gained. The cell growth rate before and after transfection was observed. Then at various concentrations of NS 398, the invasion ability was detected by Boyden Chamber and expression levels of uPA by RT PCR and Western blot. Results The EJ COX 2 cell line grew more rapidly and had a stronger invasion ability than EJ and its uPA expression increased significantly. NS 398 could dose dependently inhibit the expressions of COX 2 and uPA and the invasiveness of EJ COX 2 cell. Conclusion COX 2 can stimulate the growth of urothelial cell line EJ and promote its invasion ability by stimulating the expression of uPA.

Objective To investigate the changes and roles of Fc gamma receptors (FcγR) expressed on monocytes in the immune pathogenesis of Henoch-Schonlein purpura(HSP).Methods Thirty children of HSP and 15 health controls were enrolled in this study.The expressions of FcγR Ⅰ and FcγRⅢ on monocytes were determined by flow cytometry,and real-time PCR was performed to detect the transcription levels of FcγR Ⅱ a,FcγR Ⅱ b,cytokines(IL-1 β,IL-6,TNF-α,IFN-α),chemokine(IP-10,RANTES,iNOS),and BLyS/April in monocytes isolated by microbeads.The plasma concentrations of IL-4,IL-10 and TNF-α were analyzed by enzyme-linked immunosorbent assay (ELISA).Results (1) The expressions of FcγR Ⅰ and FcγR Ⅲ on monocytes in patients with HSP were significantly up-regulated compared with healthy controls.Transcription level of FcγR Ⅱ a on monocytes in patients with acute HSP was found to be higher than that in healthy controls while the inhibitory FcγR Ⅱ] b mRNA was significant down-regulated(P＜0.05),which resulted in a higher ratio of FcR Ⅱ a/Ⅱ b in patients with acute HSP.(2) The expressions of cytokine/chemokines factor such as IL-1 β,IL-6,TNF-α,IP-10,RANTES,and iNOS in patients with HSP was detected to be higher than those in healthy controls(P＜0.05).In addition,expression levels of BLyS/April were up-regulated during acute HSP(P＜0.05),the positive correlations were observed between the FcγR Ⅱ a/FcγR Ⅱ b and the cytokine/chemokines factor in monocytes(P＜0.05).(3) Plasma concentrations of IL-4,IL-10 and TNF-α were significantly elevated during acute HSP(P＜0.05),and a negative correlation was observed between concentrations of TNF-α and the mRNA level of FcγR Ⅱb in monocytes.Conclusion The abnormal expression of the cytokines and the imbalance of stimulatory and inhibitory FcγR of monocyte in acute HSP.

Objectiye To improve the diagnosis and treatment of chromophobe renal cell carcinoma(CRCC). Methods The clinical dota of 25 patients of CRCC were reviewed.Thirteen were xmales and 12 were females and thirteen on the left and twelve on the right.The mean age was 51 years.Sixteen(64%)patients were asymptomatic.Gross hematuria,low back pain and discomfort and fever occurred in the other 9 patients.Laboratory investigations showed 1 patient had raised alanine aminotransferase and 1 had high erythrocyte sedimentation rate. Results B-ultrasound was mainly characterized by low echo renal mass with intact capsule and low blood flow signals.CT and MR of CRCC were typically well circumscribed,homogeneous(unenhanced CT was 70%,MR was 73%)with no necrosis and hemorrhage,homogenous enhancement(CT was 65%,MR was 67%)and mild enhanced(CT was 65%,MR was 67 %)renal mass.Twenty-two patients with tumors＞4.0 cm had radical nephrectomy and three with tumors≤4.0 cm had partial nephrectomy.The average diameter of tumors was 7.6 cm.The cross-sections of the tumors were grossly homogeneous,pale or dark brown solid.Light microscopy showed that the tumors were composed of trabeculae or sheets with voluminous cells in pale or eosinophilic cytoplasm.Immunohistochemical assay was positive of CK8 and negative of Vimentin.The pathologic TNM stages were 8 with T1a,9 with T1b,6 with T2 and 2 with T3a.Twenty-three patients were followed up.After mean follow-up of 28 months,22 cases were tumor free.One patient had pulmonary metastasis 58 months after operation and had no reaction to interferon-α and chemotherapy and died. Conclusions The majority of CRCC patients are asymptomatic and usually with low-stages.There are some features in CT and MR appearance of CRCC such as well circumscribed and homogenous.Surgical treatment should follow the treatment principles of renal cell carcinoma and carries an excellent prognosis for most localized tumors but there has been no effective measures to treat metastasis disease.The interval between operation and metastasis is relatively long and the time of follow-up should be prolonged in CRCC.

Objective To construct the eukaryotic expression vector encoding IT15 gene and detect its expression in SH-SY5Y cells.Methods The exon1 of IT15 gene was amplified from genomic DNA isolated from a healthy adult and a Huntington disease patient lymphoblastoid cell lines by PCR.PCR products were subcloned into eukaryotic expression vector pEGFP-C1.The SH-SY5Y cells were transiently transfected with the recombinant plasmids and observed under fluorescence microscope.Western blot was used to detect the expression of the fusion protein.Results PCR products had approximately 170 and 310 bp specific segments.The recombinant eukaryotie expression plasmids were confirmed by restriction endonuclease analysis and sequencing.The N-terminal fragment of normal huntingtin primarily localized in the cytoplasim of SH-SY5Y cells,while the N-terminal fragment of mutant huntingtin aggregated both perinuclearly and intranuelearly.Conclusions The recombinant eukaryotic expression vectors encoding wild type and mutant IT15 gene fragments are useful for studying pathogenesis of Huntington disease.The Nterminal fragment of mutant huntingtin aggregats both perinuclearly and intranuclearly,which could be important for Huntington disease pathophysiology.

Objective To study the effect of low-level 84 disinfection solution on reproductive physiology of mice . Methods 72 KM mice were randomly divided into three groups :0.5%84 disinfection solution group ( group A) , 2.0%84 disinfection solution group (group B) and saline solution group (group C).12 males and 12 females in each group. Corresponding medicine was given once a day by intragastric gavage for 9 weeks.The estrous cycle of female mice was observed by exfoliative cytology of vagina .After 9 weeks, The sperm abnormality test was performed , Serum samples were taken for sex hormone test by ELISA, and the histological change of testis (or ovary), heart, liver, lung and kidney were observed.Results Compared with group C , No significant difference was observed in the weight variation and serum sex hormone level in group A and B (P >0.05).The difference of the estrous cycle of female mice was not significant (P >0.05).No histopathological abnormality was observed .Compared with group C, There was no significant difference in the rate of sperm abnormality in group A ( P >0.05 ) , but the rate in group B was significantly increased ( P <0.05 ) . Conclusion 0.5% 84 disinfection solution has no significant effect on reproductive physiology of mice , The concentration of disinfection solution must be strictly controlled when used .