OBJECTIVE To investigate the incidence of bacteria colonization on lumbar epidural catheter tips in postoperative analgesia patients. METHODS The catheter tips were cultured in 100 patients with ASA grade Ⅰ-Ⅱ undergoing lower extremity osteoarticular operation.Lumbar epidural catheters were placed in the operating room with aseptic technique.Diluted local anesthetic and fentanyl infusions were used for postoperative analgesia.The epidural catheter was removed with aseptic technique and the tips sent for microbiological culture after 3 days. RESULTS From 100 patients,bacteriological examination revealed bacteria colonization in 9(9.0%),mainly Staphylococcus epidermidis(6;66.7%),followed by Enterococcus(1;11.1%),Gram-negative bacilli(1;11.1%),and yeasts(1;11.1%).No patient developd infectious complications. CONCLUSIONS Our results show that the risk of bacteria colonization associated with lumber postoperative analgesia in three days is low.No patient develops local or central nervous infection.Epidural postoperative analgesia can be routinely used without worry of infection in epidural space.But we recommend prophylactic measures should be applied in the high-risk groups.

Objective:To research and compare the therapeutic effect of oxycodone hydrochloride controlled—release tablets and morphine sulfate controlled—release tablets on the visceral cancer pain.Methods:Total of 72 patients with visceral cancer pain were randomly assigned into two groups:OO group was treaded by oxycodone hydrochloride controlled—release tablets,MO Group was given morphine sulfate controlled—release tablets.According to the principle of NCCN(2008),the two groups were titrated by morphine,and then diverted to controlled-release agent.The visual analogue scale(VAS)was kept smaller than 4.The side effects of two groups'and the rescue analgesic doses were recorded after the application of the controlled-release agent for 15 days,and the cost-effectiveness was analysed.Results:The rescue analgesic doses of the OO group were smaller than that of the MO group (P0.05).Conclusion:The two drugs have notable analgesic effect in the visceral cancer pain.Considered gastrointestinal tract side effects and the rescue analgesic dose,Oxycodone hydrochloride controlled—release tablets surpass the Morphine sulfate controlled-release tablets.Oxycodone hydrochloride controlled-release tablets may be a potential regimen for visceral cancer pain.

Objective To investigate the changes and clinical significance of serum tumor markers in patients with non-small cell lung cancer before and after gefitinib targeted therapy.Methods 80 cases of non-small cell lung cancer patients in our hospital from June 2015 to May 2017 were divided into control group and observation group randomly,40 cases in each group.The control group were treated with docetaxel conventional chemotherapy,and the observation group were treated with gefitinib targeted therapy.The clinical treatment effect,changes of serum tumor markers cancer antigen125 (CA125),carcinoembryonic antigen (CEA),neuron specific enolase (NSE) and adverse reactions were observed and compared between the two groups before and after treatment.Results The effective rate and disease control rate of the observation group were higher than that in the control group,with statistically significant difference (P ＜ 0.05).The levels of serum tumor markers CA125,CEA and NSE in the control group and the observation group before treatment were not significantly different (P ＞ 0.05).After 1 months of treatment,the levels of serum tumor markers CA125,CEA and NSE in the two groups were all decreased,and the level of serum tumor markers,CA125,CEA and NSE in the observation group were lower than those in the control group,with statistically significant difference.The incidence of adverse reactions in the observation group was lower than that in the control group (P ＜ 0.05),with statistically significant difference.Conclusions Gefitinib is effective in the treatment of non-small cell lung cancer.It reduces the level of serum tumor markers CA125,CEA,NSE,and reduces postoperative adverse reactions.It is worthy of clinical application.

OBJECTIVETo compare the efficacy difference between acupotomy and acupuncture in the treatment of avascular necrosis of femoral head at the early and middle stages.

METHODSThe randomized controlled prospective study method was adopted. Sixty cases of avascular necrosis of femoral head at Ficat-ArletⅠto Ⅱ stages were randomized into an acupotomy group (32 cases) and an acupuncture group (28 cases) by the third part. In the acupotomy group, the acupotomy was adopted for the loose solution at the treatment sites of hip joint, once every two weeks, totally for 3 times. In the acupuncture group,points around the hip joint were selected and stimulated with warm acupuncture therapy, once every day, for 6 weeks. Harris hip score was observed before and after treatment. The efficacy was evaluated in the two groups.

RESULTSHarris hip score was improved significantly after treatment in the two groups (both<0.05). The result in acupotomy group was better than that in the acupuncture group (<0.05). The effective rate was 90.6% (29/32) in the acupotomy group, better than 75.0% (21/28) in the acupuncture group after treatment (<0.05).

CONCLUSIONSHarris hip score and the effective rate in the acupotomy group are better than those in the treatment with routine acupuncture for avascular necrosis of femoral head at the early and middle stages.