Objective To analyze analgesics administration from July 2005 to July 2006 in emergency rooms of the First, the Second and Fourth Affiliated Hospitals of China Medical University in order to provide a reference for clinically rational administration. Method The data of 2313 prescriptions with analgesics administered during one-year period were analyzed in many respects including the overview of the prescriptions, the frequency of anal-gesics administration, the system of defined daily doses (DDDs) and drug utilization index (DUI) of narcotic anal-gesics were analyzed, and a survey of 200 patients managed with some of those analgesics was done by using ques-tionaire as they were admitted to and discharged from the emergency room. The pain intensity was evaluated by a 10-point numerical rating scale (NRS). The respondents, excluding the mute or deaf, police custody, victims of domestic violence,mental disorder and age under 14,rated the levels of satisfaction with medication for pain relief. The data of frequency and percentage of the administration of analgeics were analyzed,and the scores of NRS were evaluated with the Paired-samples t -test. Results Most of analgesics were in the form of parenteral route usage, of which anisodamine and bucinnazine were employed in large proportion, and a small number of them was in the form of tablets. Trauma was the commonest cause of pain. Of the narcotic analgesics, meperidine was the most com-monly used analgesics, and its DDDs and DUI were much lower than that of WHO limits. Of the 200 patients, 71.5% patients rated a considerably high satisfaction with scores of (7.47 ±2.21) and (5.00 ± 3. 16) by NRS before and after medication,respectively ( ( -value 23.38,P < 0.01) .The patients presenting pain intensity with a scores of 4 or greater accounted for 57.5% . Conclusions The patients suffering from pain could lie rationally treated in the emergency rooms of those three hospitals. Narcotic analgesics should be cautiously employed, and there is room for improvement in pain management practice in emergency room.

OBJECTIVE:To evaluate therapeutic efficacy of strontium dichloride (89SrCl2 ) combined with local radiotherapy for pain caused by malignant tumor bone metastasis. METHODS:115 patients with malignant tumor complicated with bone metasta-sis were analyzed retrospectively,and they received therapy regimen of 89SrCl2 combined with local radiotherapy. The amount of 89SrCl2 was calculated according to body weight of patients,and given by intravenous injection manner at the beginning of treat-ment,and then radiotherapy target section was confirmed according to iconography for irradiation. Effect of bone pain control,side effects (myelosuppression) and the effect of treatment on quality of life were evaluated at the end of treatment. RESULTS:After one month of treatment,there were 32 cases of complete remission(CR)and 62 cases of partial remission(PR),and total effec-tive rate was 81.7%;after one month of treatment,6 cases(5.1%)suffered from Ⅲ-Ⅳ degree myelosuppression;but there was none of Ⅲ-Ⅳdegree myelosuppression case after 2 months of treatment. The improvement of overall quality of life was not signifi-cant after treatment. Pain symptoms,general situation and sleep quality all improved significantly. CONCLUSIONS:89SrCl2 com-bined with local radiotherapy can control pain caused by malignant tumor bone metastasis and induce side effect,and improve quali-ty of life to certain extent.

Objective To observe the therapeutic effect of abdominal acupuncture combined with Chinese medicine for the treatment of functional constipation. Methods Ninety-three qi-deficiency functional constipation patients were evenly randomized into western medicine group, Chinese medicine group and combination group. The western medicine group was given oral use of Dupbalac, Chinese medicine group was given modified Buzhong Yiqi decoction, and the combination group was given abdominal acupuncture and oral use of modified Buzhong Yiqi decoction. The treatment of the three groups covered 3 months. After treatment, the therapeutic effect was evaluated accord ing to the symptom scores and the examination results of gastrointestinal kinetics. Results ( 1) The total effective rate for relieving symptoms was 100.00% in combination group, 90.32% in Chinese medicine group, and 38.71% in western medicine group, and the effect was the best in the combination group ( P<0.05). ( 2) The combination group had stronger effect on relieving dyskinesis of anal sphincter, rectal sensibility, colonic transportation than Chinese medicine group and western medicine group (P<0.05). Conclusion Abdominal acupuncture combined with Chinese medicine shows certain therapeutic effect for the treatment of qi-deficiency functional constipation, and the effect is superior to that of Chinese medicine or Dupbalac.

Objective To determine the content of total flavonoids and luteolin from Pteris multifida Poir. Methods The content of total flavonoids was determined by gradient elution of macroporous resin D101 and ultraviolet spectrophotometry. The content of luteolin was determined by HPLC. The analysis was performed on a RP-C18 column(4.6 mm×250 mm, 5 μm) with aceconitrile-0.2% phosphoric acid (35:65) as the mobile phase at a flow rate of 1.0 ml/min, and 30 ℃ temperature. Results The detection of wave length was set at 349 nm. The content of luteolin was 0.015%, 0.019%, 0.016%, and the content of total flavonoids was 0.015%, 0.019%, 0.016%, respectively. Conclusions The method is suitable for the determination of flavonoids componets from Pteris multifida Poir.

Objective To observe the regulatory effect of acupotomy lysis on SP level in spinal cord and tissues above spinal cord of rats with knee osteoarthritis.Methods 60 healthy SD rats were randomly divided into normal control group,model group,electro-acupuncture(EA)group,and acupotomy lysis(AL)group.Mix 4%papain solution with 0.3 mol/L cysteine solution in the ratio of 1∶1.After pausing for 0.5h,inject the mixture,20 μl each time,into the left knee joint cavities of rats in model,AL,and EA groups on the day of 1,4,7.After 4 weeks AL group was treated with acupotomy lysis and EA group with electro-acupuncture.Three weeks after treatment,take samples of spinal cord,midbrain,pituitary gland,thalamus,and hypothalamus from the swellings of rats'waists.Measure the content of SP therein separately.Results Compared with normal control group,there was a significant rise in the content of SP in spinal cord and the tissues above spinal cord of model group rats (P＜0.05,P＜0.01),and there was a significant rise in spinal cord,pituitary gland,thalamus and hypothalamus of EA group rats (P＜0.05,P＜0.01);in AL group,there was a significant rise in spinal cord,pituitary gland,thalamus,and there was no statistically difference in hypothalamus and midbrain.Compared with normal control group,there was a significant rise in spinal cord (P＜0.05)and a significant decrease in the SP contents in hypothalamus(P＜0.05,P＜0.01)in EA group.There was no statistically difference between EA group and AL group except in hypothalamus(P＜0.05).Conclusion Acupotomy lysis has positive functions in regulating SP content in centrum of rats with knee osteoarthritis,which helps easing pain.

Objective To establish an HPLC method for simultaneous determination of Isoquercitrin and astragalin in Moringa oleifera leaves prescription. Methods By using HPLC method with Cosmosil-C18 column (4.6 mm × 250 mm, 5 μm) and the column temperature was 40 degrees Celsius, the mobile phase contains a 0.1％phosphoric acid in water(A) and acetonitrile(B), the detection wavelength was set at 350nm by UV detector and the flow rate was 1.3 ml/min. Results The Isoquercitrin and astragalin was better separated in 30 minutes, and Isoquercitrin had a good linear correlation at the range of 0.24-4.73 μg, while astragalin was 0.11-2.19 μg, the average spiked recoveries of isoquercetin and astragalin were 99.09％ (RSD=0.60％) and 99.08％ (RSD=1.37％), respectively. Conclusions The proposed method is simple,accurate,and repeatable and can be used for quality control as well as a powerful tool to evaluate the processing of Moringa oleifera leaves. It can provide the reference basis and data support for the determination of content of Moringa oleifera health products.

Objective To optimize the extraction technology of Compound purgative Moringa Oleifera by central composite design-response surface method. Methods The content of isoquercetin and astragalin, the yield of dry extract and overall desirability (OD) were used as the evaluation indexes; the factors such as water addition, extraction times and time for extraction were employed to optimize extraction technology of central composite design-response surface method. Results Optimal extraction technology was as follows: 3 times extracted with 10-fold the amount of water for 1 h each time. Conclusions Central composite design-response surface method was suitable for optimizing extraction technology of compound purgative Moringa Oleifera.

Objective To observe over-time changes in rat blood flow in the skins of related meridian points during physiological status, the pathological state of ischemic myocardial injury and low or high frequency electroacupuncture intervention and explore the post effect of different frequency electroacupuncture on related meridian points after treating ischemic myocardial injury. Method Fifty male Wister rats were randomized into five groups: blank control, sham operation, model, low frequency electroacupuncture (meridian point A) and high frequency electroacupuncture (meridian point B), 10 rats each. Blood flow in the skins of bilateral points Neiguan (PC6), Ximen (PC4) and Tianquan (PC2), and non-meridian and non-acupoint control points was measured by laser speckle contrast imaging in every group immediately and at 30 and 60 min after the end of three treatments. Statistical analysis was made. Result Blood flow in the skins of bilateral points Neiguan, Ximen and Tianquan was significantly lower in the blank control group than in the model group (P<0.01,P<0.05). Blood flow in the skin of every acupoint increased in varing degrees after low or high frequency electroacupuncture treatment. Blood flow in bilateral points Neiguan, Ximen and Tianquan regions in meridian point group A was closer to that in the blank control group immediately after treatment. Blood flow in three left-side and three right-side acupoint regions in meridian point group B was closer to that in the blank control group at 30 and 60 min, respectively, after treatment. Conclusion The immediate effect of low frequency electroacupuncture on blood flow in acupoint regions is better than high frequency electroacupuncture during intervention in ischemic myocardial injury. The post effect of high frequency electroacupuncture on blood flow in acupoint regions is better than low frequency electroacupuncture during intervention in ischemic myocardial injury.

Objective To observe the surface area temperature of dysmenorrhea rats with cold stagnation syndrome; To compare the different effects of Sanyinjiao (SP6) and Guanyuan (RN4).Methods Forty female SD rats were randomized into control group, model group, Sanyinjiao (SP6) group, and Guanyuan (RN4) group, 12 rats in each group. Whole body freezing method combined with estradiol benzoate injection was used to establish models. Sanyinjiao (SP6) group and Guanyuan (RN4) group received moxibustion at corresponding points for 3 times after modeling. Infrared thermal imaging was used to measure the skin temperature at the surface projection area of Sanyinjiao (SP6) and Xuehai (SP10) and Sanyinjiao-Xuehai lines before and after moxibustion.Results Compared with control group, the temperature gap between double sides of Sanyinjiao-Xuehai lines significantly increased in model group 5-30 min after moxibustion (P<0.05). 30 min after moxibustion, the temperature of right Sanyinjiao significantly decreased in other three groups (P<0.01). Compared with model group, the temperature gap between double sides of Sanyinjiao-Xuehai lines significantly decreased after 5-30 min in Sanyinjiao group (P<0.05), while Sanyinjiao-Xuehai lines significantly decreased after 10-30 min in Guanyuan group (P<0.05). Comparison between two moxibustion groups, the influence of Sanyinjiao group to temperature gap between double sides of Sanyinjiao-Xuehai lines was earlier than Guanyuan group (P<0.05).Conclusion Moxbustion can decrease the temperature gap between double sides of Sanyinjiao-Xuehai lines and ease the imbalance. And the influence of moxbustion SP6 to temperature gap between double sides of Sanyinjiao-Xuehai lines is earlier than moxibustion RN4.

Objective To investigate the clinical features, treatment, and outcome characteristics of patients with Merkel cell carcinoma. Methods The clinical manifestations, laboratory tests, diagnosis and treatment, and follow-up data of six patients with Merkel cell carcinoma were retrospectively analyzed. Results Among the six patients with Merkel cell carcinoma, four were males and two were females, with a median age of 66 years old (57-76 years old). All six patients presented with skin swelling, and the clinical stages were as follows: stageⅠ in three patients, stage Ⅲ in one patient, and stage IV in two patients. Two patients were treated with surgery alone, three patients with surgery combined with radiotherapy and/or chemotherapy, and one patient with immunotherapy combined with chemotherapy. Until the follow-up time, four patients had no disease progression, one patient died because of disease progression, and one patient remained under treatment. Conclusion Limited-stage Merkel cell carcinoma is primarily treated with surgery and radiotherapy, meanwhile, metastatic Merkel cell carcinoma needs systemic therapy, and first-line immune checkpoint inhibitors targeting PD-1/ PD-L1 pathway can achieve better therapeutic results.