Objective To study the role of recombinant human epidermal growth factor (rhEGF) in the prognosis of multiple organ dysfunction syndrome (MODS) in mice. Methods One hundred and twenty clean male Kunming mice were randomly ( random number) divided into normal saline control group (n =15),MODS model control group (n =15) and MODS + rhEGF treatment group (n =90).The MODS models were made by using Caballero ME method with thioacetamide (TAA) 2000 mg/kg injected intraperitoneally to establish monophasic rapid onset pattern of MODS model in mice.MODS + rhEGF treatment group was further randomly divided into two subgroups,namely intraperitoneal injection group (n =45 ) and subcutaneous injection group (n =45 ).Each subgroup was divided again into three small subgroups (n =15) as per different doses of rhEGF used,namely 10 μg/kg,30 μg/kg and 50 μg/kg.Within 24 hours after modeling,the respiration,body weight,food eaten and general physical changes were observed.Mortality was calculated 24 hours after modeling.After the animals sacrificed,the tissues of viscus including liver,kidney,heart,brain,lung,spleen,pancreas,intestine and stomach were collected immediately.The histological changes of visceral tissues were studied by using hematoxylin -eosin staining under the light microscope.All the experimental data were presented in,and body weight changes were compared using t-test,and after different routes of administration with different doses of rhEGF used in MODS,the mice body weight changes were analysed by using the Dunnett method,and the mortalities of mice were compared by using Fisher exact test,and P ＜ 0.05 was considered statistically significant difference. Results There was no significant difference in mortality betweeu mice in rhEGF subcutaneous administration group and MODS model control group (P ＞ 0.05 ),but the total mortality of hrEGF MODS intraperitoneal administration group (6.7％ in dose of 50 μg/kg and 20％ in dose of 30 μg/kg) was significantly lower than that of MODS model control group (73.3％) ( P ＜ 0.05 ) and the mortality of mice treated with intraperitoneal 50μg/kg rhEGF (6.7％ ) was lower than that treated with 10μg/kg rhEGF (P=0.014).The mortality of mice in rhEGF MODS (50 μg/kg ) intraperitoneal administration group was significantly lower than that in subcutaneous administration group (40％) (P =0.031 ), The histopathological changes in rhEGF MODS treatment group were not as remarkable as seen in mice of control group.The histopathological changes were dose - dependent.The higher doses of rhEGF,the lesser hepatic congestion,liver cell apoptosis,hepatic cell cloudy swelling and cell vacuolization.Similarly,as RhEGF dosage increased,pulmonary interstitial congestion,inflammatory cells and apoptotic bodies reduced,and bronchial ciliated columnar epithelium less shed.Conclusions RhEGF plays a positive role in repairement of tissue damage in TAA - induced MODS murine model.The rhEGF given by intraperitoneal route of administration is more effective to reduce the 24 h mortality of MODS mice than that by subcutaneous route.

Objective To compare the efficacy of flurbiprofen axetil combined with fentanyl administered using different modes for postoperative analgesia.Methods This was a prospective,multicenter,randomized,double-blind,control,parallel-group study.ASA Ⅰ or Ⅱ patients,aged 14-91 yr,weighing 35-95 kg,scheduled for orthopedic,thoracic or hepatobiliary surgery under general anesthesia from January 2010 to October 2010,were randomly divided into A,B and C groups.The three groups received patient-controlled intravenous analgesia (PCIA) after surgery.In group A,flurbiprofen axetil 100 mg was injected immediately after the end of surgery and then PCIA was performed with fentanyl 1.0 mg in 100 ml of normal saline.In group B,PCIA was performed with flurbiprofen axetil 200 mg and fentanyl 0.6 mg in 100 ml of normal saline.In group C,flurbiprofen axetil 100 mg was injected immediately after the end of surgery and then PCIA was performed with flurbiprofen axetil 200 mg and fentanyl 0.6 mg in 100 ml of normal saline.The PCA pump was set up with a 2 ml bolus dose,a 10 min lockout interval and background infusion at a rate of 2 ml/h.VAS scores at rest and during activity and sedation score were recorded at the end of surgery and 4,8 and 24 h after surgery.The effective analgesia,excessive sedation,nausea and vomiting,dizziness,somnolence and respiratory depression were recorded within 24 h after surgery.Samples from the PCIA bump were taken to do microbe culture experiment at 24 and 48 h after surgery.Results Two thousand five hundred and ninety-six cases completed this trial (875 cases in group A,946 cases in group B and 775 cases in group C).Compared with group A,VAS scores at rest and during activity at the end of surgery and 4,8 and 24 h after surgery and sedation score were significantly decreased in group B,VAS scores at rest and during activity were significantly decreased at the end of surgery and 4 and 8 h after surgery and sedation scores were significantly increased at 4 and 8 h after surgery in group C,the rate of effective analgesia was increased in groups B and C,the incidence of excessive sedation was decreased in group B,while increased in group C,the incidence of postoperative nausea and vomiting was significantly decreased in groups B and C,and the incidence of postoperative dizziness was significantly decreased in group C (P ＜ 0.05).Compared with group B,no significant change was found in the VAS scores at rest and during activity,rate of effective analgesia,and incidences of nausea and vomiting,and somnolence (P ＞ 0.05),sedation scores were significantly increased at the end of operation and 4 and 8 h after surgery,the incidence of excessive sedation was increased,and the incidence of postoperative dizziness was decreased in group C (P ＜ 0.05).Neither bacterium nor fungus was found in the PCIA pump samples.Conclusion PCIA with flurbiprofen axetil 200 mg and fentanyl 0.6 mg (background infusion at a rate of 2 ml/h,2 ml bolus dose,10 min lockout interval) provides better efficacy and the occurrence of sides effects is low for the patients undergoing moderate or major operations.

Objective To analyze the effect of evidence based practice on feeding after spinal operation. Methods To formulate an answerable question, find the best available evidence, appraise the evidence and formulate the recommendations by using the method of evidence-based medicine. A total of 60 postoperative patients who received spinal operation were divided into observation group and control group (30 cases in each group). Those patients in control group received the routine diet guidance and the guidelines for the standardization of intake and consumption after spinal cord surgery were used for patients in observation group. The outcomes were evaluated by postoperative recovery and complications of patients after spinal operation. Results There were no significant difference in the incidence of nausea, vomiting , bloating and celialgia in the 5 hours after surgery and 2 hours after feeding between the two groups (P>0.05). The incidence of thirst and hunger in the 5 hours after surgery in observation group were 3.33％(1/30) and 13.33％(4/30).The incidence of thirst and hunger in the 5 hours after surgery in control group were 80.00％(24/30) and 83.33％(25/30). There were statistically significant in the incidence of thirst and hunger in the 5 hours after surgery between the two groups (χ2=36.27, 24.09, P<0.05). There were not statistically significant in the time of anal exsufflation and first defecation time between the two groups(P>0.05). Conclusions Evidence-based practice in the use of guidelines for the standardization of intake and consumption after spinal cord surgery can guide clinical practice.