Objective To evaluate the efficacy of ultrasound?guided transversus abdominis plane ( TAP) block with different concentrations of ropivacaine for analgesia after cesarean section. Methods A total of 120 parturients, aged 24-31 yr, of American Society of Anesthesiologists physical statusⅠ or Ⅱ, weighing 64-73 kg, at 35 to 41 week gestation, scheduled for elective cesarean section, were randomly di?vided into 3 groups ( n= 40 each) using a random number table: 0?25% ropivacaine group ( group Ⅰ) , 0?20% ropivacaine group ( groupⅡ) , and 0?15% ropivacaine group ( groupⅢ) . A patient?controlled an?algesia pump was connected at the end of surgery, and the corresponding concentration of ropivacaine 1?5 mg∕kg was injected into the bilateral TAP under the guidance of ultrasound in each group. Visual analogue scale score was maintained ≤3. The number of attempt and the number of patients requiring rescue analge?sic were recorded at 48 h after surgery. The occurrence of TAP block?related complications was observed and recorded. Results Compared with groupⅢ, the number of attempt and the number of patients requi?ring rescue analgesic were significantly decreased in Ⅰ and Ⅱ groups ( P<0?05 ) . Compared with groupⅡ, the number of attempt and the number of patients requiring rescue analgesic were significantly de?creased in group Ⅰ (P<0?05). No TAP block?related complications were detected in the three groups. Conclusion Ultrasound?guided TAP block with 0?25% ropivacaine is helpful in improving the analgesic efficacy after cesarean section without serious complications.

Objective To study the influence of different positions in the isokinetic muscle test of knees by CON-TREX Biomechanical Test and Training System, so as to select the suitable conditions for forensic identification of muscle strength test. Methods Fifty-two healthy volunteers joined the isokinetic muscle strength test in unfixed and fixed position, respectively and in two kinds of angular speed (60°/s and 30°/s). The differences of peak torque (PT) and peak torque angle (PTA) between bilateral knee flexor and extensor were statistically analyzed. Results In the unfixed position, under the two speed, there was statistically significant difference in PT between bilateral knee flexor and extensor (P<0.05);while in the fixed position, under the two speed, there was no statistically significant difference (P>0.05). In any kind of conditions, the PTA of bilateral knee flexor and extensor did not have statistically signifi-cant difference(P>0.05). Conclusion The position of the subject influences the results of PT. So the po-sition of subject in knees isokinetic muscle test should be regulated.

OBJECTIVE: To study the objectivity and reliability of needle electromyography and nerve conduction for detection of musculus extensor digitorum brevis strength, which may provide a basis for establishing a quantitative detection of muscle strength in forensic clinical study. METHODS: Forty-four healthy people were enrolled as the subjects, and during toe dorsiflexion, the following items including needle electromyography indexes, motor unit potential (MUP) amplitude, MUP count, recruitment reaction type, and nerve conduction detection indexes, compound muscle action potential (CMAP) amplitude, CMAP latent period and motor nerve conduction velocity (MNCV), were simultaneously detected under the cooperation and disguise condition. RESULTS: Under the cooperation condition, regardless of the same operator or different operators, there were good test-retest reliabilities in MUP amplitude, CMAP amplitude, CMAP latent period and MNCV, while there were normal test-retest reliabilities in MUP count and recruitment reaction type and the repeatability of the same operator was slightly better than the repeatability between different operators. Under the disguise condition, test-retest reliabilities of MUP amplitude, CMAP amplitude, CMAP latent period and MNCV were relatively high, while test-retest reliabilities of MUP count and recruitment reaction type were relatively low. CONCLUSION There are good test-retest reliabilities in MUP amplitude, CMAP amplitude, CMAP latent period and MNCV, which can be conducive to comparison between different operators and results at various times; MUP count and recruitment reaction type, which can be easily affected by subjectivity of operators and examinees, can be used to differentiate whether an examinee disguises or not. The indexes used to objectively judge muscle strength remain to be further investigated.
Electrodes, Implanted ; Electromyography ; Humans ; Muscle Strength/physiology* ; Muscle, Skeletal/innervation* ; Neural Conduction/physiology* ; Reproducibility of Results ; Toes

AIM To investigate the effect of fenofibrate and simvastatin on the serum free fatty acids of alcoholic fatty liver in rats. METHODS The rat model of alcoholic fatty liver was reproduced by chronic ethanol ingestion plus olive oil diet. The model rats were divided into three groups as follows: finofibrate treatment group(finofibrate 80 mg?kg -1 po, once a day),simvastatin treatment group (simvastatin 4 mg?kg -1 po, once a day)and control group without either above-mentioned treatment. Experimental rats were treated for four weeks and then sacrificed for blood sampling. Serum free fatty acids were analyzed by gas chromatography. RESULTS Fenofibrate significantly ameliorated the decrease in polyunsaturated fatty acids induced by ethanol [oleic acid:(38.212?7.788) ?g?L -1 vs (31.620?6.142) ?g?L -1,linoleic acid:(37.269?8.065) ?g?L -1 vs (30.254?9.063) ?g?L -1,arachidonic acid:(11.646?2.601) ?g?L -1 vs (9.012?1.236) ?g?L -1] accompanied by the improvement of the fat infiltration of the liver, but demonstrated no effect on the increase in serum saturated fatty acids by ethanol. In the contrast, simvastatin can aggravate the decrease in polyunsatrurated fatty acids and significantly increase the levels of satrurated fatty acids in serum induced by ethanol along with the pathological aggravation of alcoholic fatty liver. CONCLUSION The results of present study revealed that fenofibrate and simvastatin exerted different effect on the serum free fatty acids of alcoholic fatty liver. Polyunsatrurated fatty acids in the serum play an important role in the pathogenesis and treatment response of alcoholic fatty liver.

Objective To determine the diagnostic value of shoulder MR arthrography in revealing the injuries of anterior glenoid labrum,and to compare MR arthrography with arm in neutral position with MR arthrography with arm in abduction and external rotation(ABER)position.Methods MR arthrography of the shoulder,including additional oblique axial sequences with the patient in the ABER position,was performed in 44 patients.The injuries of anterior glenoid labrum of these patients were retrospectively evaluated.The result was compared with that of arthroscopy.Results For displaying the abnormalities of anterior glenoid labrum,the sensitivity,specificity,and accuracy of axial MR images with arm in neutral position were 79.3%(23/29),100%(15/15),and 86.4%(38/44),respectively.While the results of ABER position oblique axial images were 93.1%(27/29),100%(15/15),and 95.5%(42/44), respectively.The difference of sensitivity between axial and ABER-position scans was statistically significant (P

Calcinosis ; complications ; Decalcification Technique ; Humans ; Meningeal Neoplasms ; complications ; Meningioma ; complications ; Specimen Handling ; methods ; Ultrasonics

OBJECTIVETo investigate and clarify the key surgical techniques and evaluate clinical effectiveness of modular cementless femoral stems(LINK MP modular stem) in complex revision hip arthroplasty.

METHODSFrom January 2002 to December 2013, 470 patients in Chinese PLA General Hospital received revision hip arthroplasties using MP stems. Among them, 246 patients were followed for an average of 5.7 years (ranged, 0.5 to 11 years). There were 148 males and 98 females, with an average age of 62.5 years old (ranged from 26 to 83 years old). The most common reason for revision was aseptic loosening of femoral stems (107 cases, 43.5%), followed by prosthetic joint infection (104 cases, 42.3%). Other reasons included unexplained hip or thigh pain, periprosthetic femoral fracture, prosthesis wear and dislocation. According to Paprosky classification of femoral deficiency, there were 171 cases of type IIIA (69.5%), 14 cases of type I, 39 cases of type II, and 22 cases of type IIIB. The average preoperative Harris hip score (HHS) was 37.4 ± 7.5. In addition, radiographic presentation, degree of patients' subjective satisfaction, and clinical effectiveness were assessed as well.

RESULTSThe average Harris score was im- proved to 87.8 ± 4.2 after operation,with significant statistical difference when compared to preoperative score (t = 92.13,P = 0.00). Analysis of patients' subjective satisfaction for leg length discrepancy, stability and overall degree of satisfaction showed that the number of patients with great satisfaction were 27, 60, 61 respectively. The most common complication was the periprosthetic fracture (intraoperatively 21 cases and postoperatively 8 cases). Other complications included infection (7 cases), dislocation (5 cases), numbness possibly caused by incomplete sciatic nerve injury (6 cases) and thigh swelling (3 cases). The X-ray taken at the final follow-up revealed that prosthesis subsidence occurred in 4 cases, 2 of which needed a second revision.

CONCLUSIONThe application of modular cementless femoral stems (LINK MP modular stem) in complex revision hip arthroplasty (especially in cases with the serious defect of proximal femoral bone) shows good results at both the short-term and long-term follow-up, especially in the revision for prosthetic infection with the high success rate. In order to avoid complications and improve clinical outcomes,the surgeons should carefully select proper surgery candidates,perform the procedure with care, and master the key surgical techniques.

Adult ; Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Hip ; adverse effects ; methods ; Female ; Hip Prosthesis ; Humans ; Male ; Middle Aged ; Patient Satisfaction ; Postoperative Complications ; therapy

OBJECTIVE: To study the influence of different positions in the isokinetic muscle test of knees by CON-TREX Biomechanical Test and Training System, so as to select the suitable conditions for forensic identification of muscle strength test. METHODS: Fifty-two healthy volunteers joined the isokinetic muscle strength test in unfixed and fixed position, respectively and in two kinds of angular speed (60 degrees/s and 30 degrees/s). The differences of peak torque (PT) and peak torque angle (PTA) between bilateral knee flexor and extensor were statistically analyzed. RESULTS: In the unfixed position, under the two speed, there was statistically significant difference in PT between bilateral knee flexor and extensor (P < 0.05); while in the fixed position, under the two speed, there was no statistically significant difference (P > 0.05). In any kind of conditions, the PTA of bilateral knee flexor and extensor did not have statistically significant difference (P > 0.05). CONCLUSION The position of the subject influences the results of PT. So the position of subject in knees isokinetic muscle test should be regulated.
Humans ; Knee ; Knee Joint ; Muscle Strength ; Muscle, Skeletal/physiology* ; Muscles ; Posture ; Torque

Objective To assess the therapeutic effectiveness of monotherapy of adefovir dipivoxil (ADV) and lamivudine (LAM),or ADV administered in combination with LAM,in order to find the effective and secure therapy for decompensated cirrhosis patients following chronic hepatitis B. Methods Totally 64 decompensated cirrhosis patients following chronic hepatitis B were divided into 2 groups by using a prospective randomized grouping method. In group A,patients received the therapy of adefovir dipivoxil (10mg/d) combined with lamivudine (100mg/d); and in group B,a monotherapy of adefovir dipivoxil (10mg/d) was used. The period of treatment was 48 weeks. Levels of serum ALT,HBeAg and HBV-DNA were detected in week 12,24,36 and 48 respectively. The liver function was evaluated with Child scores on these time points. Data were analyzed by a blinded independent investigator. Results After 48 weeks treatment,HBV DNA negative conversion rate of the two groups were 87.1%and 78.8%.The virtual rate were 96.8% and 87.9%;HBeAg negative conversion rate were 83.9%,and 57.6%. HBeAg/anti-HBe seroconversion rates of the two groups were 41.9%and 24.2%. Normalization of serum ALT levels were observed in 96.8% patients of group A and 97.0% of group B. Conclusion The combination therapy of adefovir dipivoxil (ADV) and lamivudine (LAM) could reduce the occurrence of drug resistance,and increase the anti-viral effect. It is a secure management for chronic hepatitis B virus infection.

Objective To study the expression of KAI1 and CD40 in gastric cancer and their correlation with clinicopathologic features and prognosis.Methods The expression of KAI1 and CD40 of 64 gastric cancer tissues was examinated by S-P immunohistochemieal methods.Results The overall positive rate of KAI1 was 22% in gastric cancer.Expression of KAI1 was positively related to the degree of tumor differentiation,it was negatively related to invasion depth and lymph node metastasis and the tumor clinical stage.The 5-year survival rate of cases with positive expression of KAII was significantly higher than that of cases with negative expression(X~2=42.426,P=0.000).The expression rate of CD40 in gastric cancer tissue was 34%.The expression of CD40 was significantly correlated with metastasis and clinical stage of gastric cancer.The 5-year survival rate of cases with positive expression of CD40 was significantly lower than that of cases with negative expression(X~2=4.841,P=0.028).There is no relationship between KAI1 and CD40 expression in gastric cancer.Conclusion KAI1 is associated with gastric cancer differentiation,invasion and metastasis.CD40 status helps to evaluate metastasis,and predict prognosis of gastric cancer.