Objective To investigate the efficacy of preemptive analgesia with parecoxib, a novel intravenous cyclooxygenase type-2 inhibitor, far acute postoperative pain management after intracranial tumor resection.Methods Sixty ASA I or II patients of both sexes aged 18-60 yr with body mass index < 30 kg/m~2 were randomized into 2 groups ( n = 30 each) : control group (group C) and parecoxib group (group P) . In group P, parecoxib 40 mg in 2 ml of normal saline ( NS) was injected iv over 2 min before induction of anesthesia. In group C NS 2 ml was injected instead of parecoxib. Patient controlled intravenous analgesia (PCIA) with fentanyl (bolus dose 0.05 μg/kg, lockout interval 15 min, background infusion 0.2μg·kg~ (-1)·h~(-1), 24 h maximum dose 9.6μg /kg) was used after operation. The number of successfully delivered doses and the number of attempt were calculated. If PCIA did not provide satisfactory analgesia (VAS < 3) , iv bolus of fentanyl 1μg /kg or tramadol 12 mg/kg was given as rescue medication. VAS (0 = no pain, 10 = worst pain) was used to measure pain intensity and recorded at 2, 6, 12 and 24 h after operation. Patient's satisfaction, nausea and vomiting were recorded, and activated coagulation time (ACT), coagulation rate (CR) and platelet function (PF) were measured before and 2 h after parecoxib administration. Results The consumption of fentanyl, the number of successfully delivered doses and the number of attempt, the number of rescue medication administration and degree of nausea and vomiting were significantly lower while the level of patient's satisfaction was higher in group P than in group C. There was no difference in ACT, CR and PF between the two groups. Conclusion Parecoxib given before induction of anesthesia can improve the efficacy of PCIA with fentnayl and decrease side effects.

OBJECTIVETo explore a more effective therapy for acute gouty arthritis.

METHODSSixty cases were randomly divided into an observation group and a control group, 30 cases in eachgroup. On the basis of diet intervention, the observation group was treated with electroacupuncture at local points combined with blood-letting puncture and cupping, and the control group with oral administration of Probenecid. Their therapeutic effects were ob served.

RESULTSThe effective rate was 96.7% in the observation group which was better than 86.7% in the control group (P < 0.01). After treatment, blood uric acid decreased significantly in the two groups (both P < 0.01), the observed group being lower than the control group (P < 0.01).

CONCLUSIONOn the basis of diet intervention, electroacupuncture plus blood-letting puncture and cupping is a better therapy for acute gouty arthritis.

Adult ; Aged ; Arthritis, Gouty ; diet therapy ; drug therapy ; therapy ; Bloodletting ; Combined Modality Therapy ; Electroacupuncture ; Humans ; Male ; Middle Aged ; Probenecid ; therapeutic use ; Uricosuric Agents ; therapeutic use

Objective: To analyze the urinary iodine status of urban and rural residents in some areas of Gansu Province and its related influencing factors, and to provide certain references for scientific iodine intake of urban and rural residents in Gansu Province. Methods: Subjects in Gansu Province with normal thyroid function were recruited in the investigation of thyroid diseases and iodine nutritional status, conducted a questionnaire survey and measured height, weight, waist circumference, collected 1 urine sample, and tested their urinary iodine levels. The urinary iodine levels of different groups were compared based on different gender, region, age, body weight, the waist, and salt intaking. The affecting factors of urinary iodine levels were analyzed by multiple linear regression models. Results: Totally 1 964 subjects were recruited, including 1 099 males, and 865 females. The age was (41.23 ± 14.75) years old. The median urinary iodine of the selected group was 225.60 (158.80, 311.58) μg/L. The urinary iodine level of rural residents was significantly higher than that of urban residents [μg/L: 249.80 (180.58, 336.88) vs 206.25 (148.03, 280.33), Z=-8.015, P < 0.05], and there was no significant difference between the urinary iodine levels of male and female [μg/L: 222.40 (161.60, 298.90) vs 230.60 (158.00, 326.40), P > 0.05]. The composition ratio of < 100 μg/L group in rural areas was lower than that in urban areas (5.14% vs 8.27%, χ²= 7.45, P < 0.05), and the composition ratio of ≥300 μg/L group was higher than that in urban areas (34.93% vs 21.51%, χ²= 43.87, P < 0.05). The composition ratio of ≥300 μg/L group in male was lower than that in female (24.57% vs 31.21%, χ²= 10.73, P < 0.05). The multiple linear regression analysis showed that lived in rural areas, age, moderate and severe salt intaking, student, and weight were independently correlated with urinary iodine levels (β= 0.074, -0.001, 0.059, 0.034, 0.096, -0.003, P < 0.05). And the urinary iodine levels were decreased with age and weight increased (P < 0.05). Conclusions At present, the iodine nutrition level of urban and rural residents in some areas of Gansu Province is generally over the adequate level. The urinary iodine level of rural residents is higher than that of urban residents. In the future, we should pay attention to the impact of different living areas, salt intaking and body weight on urinary iodine levels to prevent thyroid diseases.