Objective To compare the preemptive analgesia effect of flurbiprofen axetil with tramadol in patients undergoing laparoscopic hysterectomy. Methods Ninety patients undergoing laparoscopic hysterectomy were divided randomly into group A (n=30), group B (n=30) and group C (n=30). The patients in group A were administrated 1mg/kg flurbiprofen axetil intravenously before tracheal intubation, and in group B 2mg/kg tramadol intravenously before tracheal intubation, while in group C 1mg/kg flurbiprofen axetil were administrated intravenously at the end of operation. The postoperative analgesic effects (1, 2, 4, 8, 12, 24 hours) were evaluated by VAS score and BCS score, while the times of pain-killer boosting and the side effects were recorded. Results VAS scores of group C were significantly higher than those of group A and B at all time points (P<0.05), except for 12 hours and 24 hours after the surgery, while BCS scores of group C Were lower than those of group A and B at the same time points (P<0.05).The side effects of group A and group C were significantly lower than those of group B (P<0.05). Conclusion Preemptive analgesia with flurbiprofen axetil and tramadol in patients undergoing laparoscopic hysterectomy is effective and convenient, while flurbiprofen axetil has less side effects.

ObjectiveTo investigate the TCM pathogenesis of male infertility through analyzing the characteristics of the pulse of oligoathenoteratospermia patients.MethodsRetrospect analysis was performed to get the pulse characteristics of oligoathenoteratospermia patients.The relation between the regularity of pulse and oligoathenoteratospermia was studied.ResultsThe pulse of oligoathenoteratospermia patients mainly presented at the both guan pulses and the both chi pulses,especially at the left guan pulse and the right chi pulse with thready pulse,wiry pulse,slippery pulse,uneven pulse,and moderate pulse,besides there were some differences of pulse between oligospermia and asthenozoospermia.ConclusionThe liver and kidney were the main location of oligoathenoteratospermia,and the main pathogenesis was asthenia of kidney,blood stasis,and dampness-heat.

Objective:To construct a esophageal cancer module with Chinese characteristics based on MD Anderson Symptom Inventory (MDASI) public scale, develop the Perioperative Esophageal Cancer Symptoms Assessment Scale combining above two parts.Methods:The original item pool was formulated through literature review, clinical interviews, and reference of existing symptoms assessment tools. After two rounds of expert evaluation and pilot survey, the preliminary Perioperative Esophageal Cancer Symptoms Assessmment Scale was developed combining Chinese MDASI (MDASI-C). A total of 150 perioperative esophageal cancer patients was assessed using the new scale, the included items were analyzed one by one, the reliability, validity and sensitivity of scale were checked.Results:Feasibility: the scale recovery was 100%, the completion rate of scale was 93.75%, the average completion time was 10 min. Reliability: the value of Cronbach α of the esophageal cancer module, MDASI-C, the combined scale were 0.747, 0.894, 0.883, respectively. Validity: the range of content validity index of items was 0.83-1.00, the scale-level content validity index average value was 0.93. Two common factors, which explained for 67.994% of variance, were extracted by exploratory factor analysis, the validity of criterion had statistical significance ( P<0.05). Sensitivity: the scores of the esophageal cancer module were significantly different among perioperative esophageal cancer patients with different Eastern Cooperative Oncology Group performance status ( H value was 9.264, P<0.05). Conclusions:The Perioperative Esophageal Cancer Symptoms Assessment Scale has good feasibility, reliability, validity and sensitivity, it is suitable for symptoms assessment of Chinese perioperative esophageal cancer patients.

Objective To investigate the current status and influencing factors of stethoscope cleaning and disinfection of medical staff in a tertiary hospital.Methods With simple random sampling,168 medical staff of a tertiary hospital were recruited and surveyed using a self-designed questionnaire.Results 4.88％ of the respondents never cleaned or disinfected stethoscopes,73.17％ of them used alcohol cotton to wipe stethoscopes.After cleaning or disinfecting stethoscopes,83.54％ used natural drying method.Only 33.53％ respondents stored stethoscopes in clean bags or containers while not using them.The mean of respondents' scores of stethoscope cleaning and disinfection was (20.42±3.07)points.There were significant differences in scores of stethoscope cleaning and disinfection between different occupations.However,there were no significant differences among different age groups or different departments.Conclusions The current status of stethoscope cleaning and disinfection of medical staff is not satisfactory.It is imperative for medical staff to improve the drying and storage method and promote their compliance with stethoscope cleaning and disinfection.Appropriate interventions should be taken aiming at the influencing factors of stethoscope cleaning and disinfection.

OBJECTlVE To develop an LC-MS/MS method for simultaneous determination of pro-damine ( PDM) and its metabolite 2,4-dinitro-N3-propyl-6-trifluoromethyl-1,3-benzenediamine ( DTB) in rat plasma in order to study toxicokinetics of PDM in rats. METHODS SD male rats were administered a single dose of PDM ( ig: 100 and 1000 mg·kg-1; iv: 100 mg·kg-1 ) . LC-MS/MS method was used to determine PDM and DTB in rat plasma. Toxicokinetic parameters were fitted using DAS Ver2. 1. 1. RESULTS After ig administration of PDM 100 mg·kg-1 , the parameters of PDM and DTB were as fol-lows:AUC(0-t) was 2715±102 and (6845±316)μg·h·L-1, t1/2z was 9.0±1.4 and (7.1±1.3)h, Tmax was 7.0± 1.6 and (7.0±0.0)h, cmax was 146±51 and (473±103)μg·L-1. After ig administration of PDM 1000 mg·kg-1, the parameters of PDM and DTB were as follows:AUC(0-t) was 3401±242 and (10364± 573)μg·h·L-1, t1/2z was 8.8±2.1 and (6.0±1.8)h, Tmax was (7.0±1.6)h, cmax was 175±56 and (586± 152)μg·L-1 . The absolute bioavailability of PDM was 44.9%( 100 mg·kg-1 ) and 17.1%( 1000 mg·kg-1 ) . CONCLUSlON This method is suitable for the analysis of PDM and DTB in rat plasma. There is evidence that PDM and DTB display nonlinear toxicokinetic characteristics in the studied dose range.

This article was aimed to study constructive standards for the database of traditional Chinese medicine (TCM) documentation. Refer to relevant national standards, specifications and other fields of universal standards such as metadata specification of health information dataset, medical science data sharing, metadata standard, data of pop-ulation health sciences shared metadata standard, basic scientific data sharing network project standard, Chinese A-cademy of Sciences data application environment construction and service standards, combined with the specification for TCM literature resources, Chinese medicine literature database was constructed. The results showed that 6 major categories and 17 specifications were established to standardize the construction of TCM literature database. It was concluded that the standardization of TCM literature database was able to realize TCM literature database construc-tion standard and process, and to facilitate the sharing of TCM data resources.

Objective To retrospectively study the efficacy and side-effect of 125I seed implantation combined with endocrinal therapy in stage T3N0M0 prostate cancer.Methods The study included 22 patients with clinical stage T3 N0 M0 prostate cancer who were treated with transperineal 125I seed implantation guided by transrectal ultrasound,real time TPS and endocrinal therapy.The minimum peripheral doses (MPD) were 140-160 Gy.The median number of seeds was 74(26-90).The activity of each seed was 1.55 × 107 (1.30 × 107-1.85 × 107) Bq.11 patients were treated with orchidectomy,and 11 patients were treated with androgen deprivation therapy.Results All 22 patients completed the seed implantation successfully.The 5-year biochemical progression-free survival was 70.6％,and 5-year overall survival was 81.8％.2 patients were found biochemical failure in 12 months after seed implantation,and another 1 patient failed in 90 months.Endocrinal therapy was followed thereafter.After the seed implantation,the urinary complications of grade 1 and 2 were 54.5％ and 9.1％ respectively,and the rectum side-effect of grade 1 and 2 were 22.7％ and 9.1％.1 patient suffered rectal complication of grade 4.Conclusions Good effect and tolerance are observed in prostate cancer patients of stage T3N0M0 receiving 125I seed implantation plus endocrinal therapy.The treatment can be considered for those who refuse to receive external beam radiotherapy.

OBJECTIVETo compare the clinical efficacy difference in dysantonomia between transcutaneous electrical stimulation at Renying(ST 9) combined with stellate ganglion block(SGB) and simple SGB.

METHODSSixty patients in accord with the diagnostic criteria of dysantonomia were randomly divided into two groups,30 cases in each group. In the observation group,transcutaneous electrical stimulation at Renying(ST 9) combined with SGB were adopted; in the control group,simple SGB was applied. In the two groups, treatment was used three times a week,and nine treatments were considered as one course. There was an interval of one week between courses,and two courses were treated. Total seven weeks were required. Scores were evaluated according to subjective symptoms before treatment,one month and three months after treatment in the two groups.

RESULTSThe scores of subjective symptoms were not statistically different before treatment in the two groups(P>0. 05). The scores of subjective symptoms one month and three months after treatment were all lower than those before treatment(all P< 0. 01), and subjective symptoms scores in the observation group were lower than those in the control group(both P<0. 01).

CONCLUSIONTranscutaneous electrical stimulation at Renying(ST 9) combined with SGB could obviously enhance the clinical effects for dysantonomia, and the control and improvement for clinical symptoms are apparently superior to simple SGB.

Acupuncture Points ; Adult ; Anesthetics ; administration & dosage ; Autonomic Nerve Block ; Autonomic Nervous System Diseases ; drug therapy ; therapy ; Combined Modality Therapy ; Female ; Humans ; Male ; Middle Aged ; Stellate Ganglion ; drug effects ; physiopathology ; Transcutaneous Electric Nerve Stimulation ; Young Adult

Objective:To investigate the levels of periphreal blood free carnitine and amino acids in healthy pregnant women in the third trimester and their association with maternal, fetal, and neonatal cardiac function and structure.Methods:This prospective descriptive study included healthy singleton pregnancies who underwent routine obstetric examination and delivered in two district maternal and child health hospitals (one in the urban and one in the suburb an area) in Beijing from June 2017 to February 2018. All recruiters had serology Down's syndrome screening test at (18±1) gestational weeks. Besides measurement of amino acids and free carnitine levels in whole blood and urine samples by liquid chromatography-tandem mass spectrometry, all cases underwent maternal and fetal echocardiography at (35±1) weeks of gestation. And neonatal echocardiography was performed after delivery to assess the heart function and structure. Antenatal factors were also collected, including maternal education background, age at first marriage and conception, gravidity, and folic acid supplement in early pregnancy. Statistical analysis was performed using t-test, ANOVA, Chi-square test, Pearson correlation coefficient, and Kappa test. Results:A total of 493 mother-neonate dyads were enrolled in this study. Blood free carnitine levels in the healthy pregnant women in the third trimester ranged from 5.09 to 59.17 μmol/L (reference value: 10.00-50.00 μmol/L) with an average value of (13.03±3.87) μmol/L. None was found with structural abnormalities by cardiac ultrasound, showing an average left ventricular end diastolic diameter (LVEDD) and end systolic diameter (LVESD) of (45.70±3.08) mm and (29.17±3.12) mm, respectively, and left ventricular ejection fraction (LVEF) of all cases were over 55%. No cardiac malformation was detected by the third-trimester fetal echocardiography. The average birth weight of the 493 newborns was (3 340±313) g. Those whose birth weight <2 500 g and >4 000 g were accounted for 1.0% (5 cases) and 3.0% (15 cases) with the average maternal blood free carnitine level of (13.25±2.17) μmol/L (10.46-19.21 μmol/L) and (12.64±2.50) μmol/L (8.78-17.73 μmol/L) ( t=0.42, P>0.05). The average LVEDD and LVESD of the 493 newborns were (17.21±1.27) mm and (11.03±1.30) mm, respectively. For the 64 newborns (13.0%) whose LVEF<60%, the maternal blood free carnitine level was (12.93±2.78) μmol/L (7.34-22.13 μmol/L), showing no statistical difference ( t=-0.29, P>0.05) with those 59 neonates (12.0%) whose LVEF over 75% and maternal carnitine level of (13.09±3.24) μmol/L (8.66-27.49 μmol/L). All cases were divided into four groups based on the quartiles of maternal blood free carnitine level and no significant difference in maternal or neonatal LVEDD or LVEF was observed among these groups (all P>0.05). Conclusions:Blood free carnitine concentration in healthy pregnant women in the third trimester is at the lower limit of normal range, and no significant effect on maternal cardiac function and fetal cardiac structure is seen. However, the effect of low maternal carnitine level in the third trimester on children's myocardial function and whether carnitine should be supplemented in the third trimester are worthy of further investigation with larger sample size.

Objective To evaluate the setup errors of image guided radiation therapy (IGRT) for head-and-neck cancer using kilovoltage cone beam CT( kV CBCT).Methods 256 patients with head-and-neck cancer were treated with intensity modulated radiation therapy (IMRT) from March 2009 to October 2011.All patients were immobilized with head-and-neck mask and localized with final isocenter marking method using the Philips PQS CT or Philips Brilliance CT Big Bore scanners,which were equipped with LAP movable laser systems.The CT images were transferred to a Varian Eclipse V8.6 workstation for contouring and planning.A kV cone-beam CT scans was acquired,and registered before the treatment for every patient on a Varian iX linear accelerator via OBI system.The setup errors in the right-left ( RL),superior-inferior (SI),and anterior-posterior (AP) directions were recorded.Results The setup errors for the 473 datasets followed a Gaussian distribution.The systematic errors ± random errors in the RL,SI and AP were(-0.6 ± 1.3 ),(0.5 ± 1.6) and (0.9 ± 1.7 ) mm,respectively.The planning target volume (PTV) margins were calculated respectively as 2.4,2.4 and 3.4 mm according to the formula of M =2.5∑ +0.7δ The margins of 288 sets of data using the Big Bore CT scanner were calculated as 2.0,2.1 and 1.7 mm,respectively.Conclusions The setup errors using final isocenter marking method are smaller than those using reference point marking method.The result derived from this retrospective study could be used to set the margin between CTV and PTV.