Orthopaedic postoperative pain not only brings a lot of side effects to patients, but also directly affects early rehabilitation after surgery. Effective preoperative pain management mainly includes three-stage individual pattern analgesia, which refers to preoperative, intraoperative and postoperative analgesia. The purpose is to reduce pain in multiple planes and three-dimension, strengthen the effect of analgesics and reduce dosage and side effect of single drug. This paper summaries new progress on individual-multiple-pattern analgesics, pain assessment method and various therapies.
Analgesia ; methods ; Humans ; Orthopedics ; methods ; Preoperative Period ; Treatment Outcome

Objective: To observe the effects of 5-aza-2′-deoxycitydine (5-aza CdR) on the proliferation and transcription of tumor suppressor gene GSTP1 and RASSF1A in prostate cancer cell line PC3. Methods: The status of 5′CpG island methylation of RASSF1A and GSTP1 genes in PC3 was analyzed by methylation specific PCR (MSP) before treatment with 5-aza CdR. RASSF1A and GSTP1 mRNA were quantified by real time PCR during the demethylation process by 5-aza-CdR. MTT assay and flow cytometry were used to examine the proliferative activity of PC3 cells before and after 5-aza-CdR treatment. Results: The 5′ CpG island methylation of RASSF1A and GSTP1 genes were detected in human prostate cancer cell line PC3. Compared with control group, RASSF1A and GSTP1 mRNA expression had no significant change 24 h after culture with 5-aza-CdR; their expression was up-regulated 48 h after cultured with 5-aza-CdR, with significant difference found between 5 μmol/L and 10 μmol/L 5-aza-CdR groups. Compared with control group, the expression of RASSF1A and GSTP1 mRNA was significantly increased 72 h after cultured with all concentrations of 5-aza-CdR. MTT assay and cell cycle examination indicated that exposure to 5-aza-CdR for 24 h and 48 h resulted in no obvious growth inhibition and cell cycle change; exposure to 5-aza-CdR for 72 h induced significant growth inhibition (P<0.05) and cell cycle change (P<0.05); and cells were arrested at G0/ G1, phase. Conclusion: The 5′CpG island methylation of RASSF1A and GSTP1 genes is probably responsible for RASSF1A and GSTP1 silencing in PC3 cells. 5-aza-CdR can inhibit the proliferation of PC3 cells, disturb the cell cycle, and elevate transcription of GSTP1 and RASSF1A.

Guidelines as Topic ; Hepatitis B, Chronic ; drug therapy ; prevention & control ; Humans

Objective To determine the current prevalence and risk factors of metabolic syndrome (MS) among adult residents in Chinese developed areas.Methods The clinical data of 6614 adult residents,including 4051 women,from Guangdong and Jiangsu provinces from China Diabetes and Metabolic Disorders Study (2007-2008) were analyzed.Age and sex standardized prevalences of MS were calculated according to the criteria of Chinese Diabetes Society (CDS),US National Cholesterol Education Program Adult Treatment Panel Ⅲ (ATP Ⅲ),International Diabetes Federation (IDF) and Joint Interim Statement (JIS),respectively.Logistic regression analysis was performed to identify the risk factors of MS.Results Age and sex standardized prevalences of MS were 17.88％ (CDS),28.50％ (ATP Ⅲ),21.99％ (IDF) and 31.50％ (JIS),respectively.The prevalences of residents with at least one metabolic abnormality were 67.86％ (CDS) 79.56％ (ATP Ⅲ),79.62％ (IDF) and 80.74％ (JIS),respectively.MS was more common in female than in male by the ATPⅢ and IDF criterion (ATPⅢ:30.63％ vs 26.45％,P ＜0.01 ; IDF:26.04％ vs 17.91％,P ＜ 0.01),while the prevalence was higher in male by CDS criteria (15.94％ vs 19.87％,P ＜0.01).There was no significant difference in the MS prevalence between the rural and the urban residents.Kappa test showed ATP Ⅲ and JIS criteria were most homogenous (κ =0.95,P ＜ 0.01).The risk factors for MS by the logistic regression model were male,older age,lower degree of education,family history of hypertension and obesity,drinker as well as uncontrolled diet.Conclusion The prevalence of MS is high in the adult residents of Chinese developed areas (Guangdong and Jiangsu provinces),whatever diagnostic criterion was used.Effective measures should be taken to control the modifiable MS risk factors.

Aim This study was designed to investigate the inhibition of matrine on U251 glioma cell line and its mechanism. Methods MTT was used to measure the levels of the proliferation of U251 cultured with matrine in different concentrations.The effects of matrine on cell cycle of U251 were observed by FCM. The expression of proto oncogenes c myc was measured by RT PCR. Results The proliferation of U251 was obviously inhibited by matrine in a dose dependent manner. The inhibitory rate was (53 7?6 0)%,when cultured with matrine at 0 10 g?L -1 . The outcome of FCM showed that the proportion of G 0/G 1 phase cells were decreased. The proportion of S phase cells were reduced obviously,when cultured with matrine at 0 10 g?L -1 in 3 days.The outcome of RT PCR showed that the expression of proto onco gene C myc was notably decreased, when the dose of matrine was increased. Conclusion Matrine can inhibit the proliferation of U251 and inhibit the expression of proto onco gene C myc.

Objective To make a Meta-analysis of the effectiveness and safety of Shenling Baizhu Powder (SBP) for the treatment of ulcerative colitis(UC),thus to provide evidence for the clinical treatment of ulcerative colitis.Methods Randomized controlled trials (RCTs) of SBP combined with western medicine vs western medicine in treating ulcerative colitis were included.The quality of RCTs was assessed by the Cochrane scale.A Meta-analysis was performed for the clinical efficacy,improvement of disease activity index (DAI) levels of the included trials.Results A total of 19 RCTs were included,involving 1498 cases.The results of Metaanalysis showed that compared with the western medicine group,the combined risk ratio(RR) of clinical efficacy in the SBP combined group was 1.55,95％ confidence interval (CI) being (1.39,1.72).The subgroup analysis based on control medicine showed that the combined RR of combined use of sulfasalazine or mesalazine/Olsalazine was 1.46,1.59 [95％CI (1.19,1.77) vs 95％CI (1.40,1.80)].The subgroup analysis based on different treatment courses showed that the combined RR of 1-30 days,31-60 days,61-90 days was 1.42,1.69,1.47 [95％CI (1.18,1.70) vs 95％CI (1.44,1.97) vs 95％CI (1.15,1.88)] respectively.The differences were significant (P ＜ 0.05).(2) The differences of the two groups on the improvement of DAI and inflammatory factors levels of interlekin-17(IL-17),IL-23,tumor necrosis factor alpha(TNF-α),C-reactive protein(CRP) were statistically significant(P ＜ 0.05).(3)The sensitivity analysis of the primary outcomes showed a higher homogeneity in the literatures and the funnel plot analysis showed no evidence of publication bias.Conclusion Compared with western medicine,SBP combined with western medicine has better clinical efficacy for the treatment of UC,and the combined use of mesalazine/Olsalazine medicated for 30-60 days is more effective on improving DAI and inflammatory factors levels.However,for the low quality of the included literatures and insufficient experimental design,the conclusion needs more evidence from large sample-size randomized double-blind controlled trials.

Objective To assess the predictive value of serum uric acid levels to the incident nonalcoholic fatty liver disease(NAFLD)in a cohort of healthy population. Methods A prospective cohort study of NAFLD incidence was conducted in Xinjiang province, from 2012 to 2014. A cohort study was performed on 2 207 subjects with no evidence of fatty liver disease by liver ultrasound and with no major risk factors for liver disease at baseline. All participants were interviewed to carry out the epidemiological questionnaire survey, physical examination, abdominal ultrasonography, as well as blood biochemistry measurements. The hazard ratios of NAFLD were compared among groups with different uric acid levels. All subjects were classified according to serum uric acid (within normal range grouped by quartile: Q1-Q4 group; above the normal range: Q5 group). Results NAFLD was newly diagnosed in 13.72% subjects within the 3-year period. The incidence of NAFLD was increased with elevated serum uric acid quartiles(P<0.01). In multivariate logistic regression, after adjustment for gender, age, race, metabolic syndrome and its components, OR for incident fatty liver in Q2 to Q5 of serum uric acid concentration as compared to Q1 were 2.509, 3.172, 3.392, and 4.041 respectively. Conclusion Elevated serum uric acid concentrations may predict NAFLD in the subjects for a regular health checkup.

Objective The study aimed to analyze the clinical data of patients with pulmonary embolism and summarize the clinical characteristics of pulmonary embolism,in order to improve the correct diagnostic rate and the prognosis. Methods Data of 178 patients who were cured in our hospital from January 2011 to December 2014 were analyzed retrospectively,including relative risk factors,clinical behaviors,examination data,misdiagnosis and prognosis. Results Patients with pulmonary embolism had related basic diseases and risk factors. Their clinical symptoms,signs and ordinary detection methods indicated pneumatorexis and cardiovascular injury,but lacked of specificity. The misdiagnosis rate of the first diagnosis was 48.88%,including 22 cases of the misdiagnosis to COPD, 18 cases to pneumonia and 16 cases to coronary heart disease. The misdiagnosis rate of elderly patients was 56.36%, while that of the young and middle-aged patients was 36.80%,the difference was statistically significant,P < 0.05. Computed tomography pulmonary angiography(CTPA)could accurately observe the pathological changes of pulmonary embolism,and all the patients were diagnosed by CTPA in the research. 11 cases(10%)of elderly patients died,while 2 cases(2.9%)happened in young and middle-aged patients. There was no statistical significant difference(P > 0.05). Conclusion Although the related risk factors of pulmonary embolism in patients existed,the misdiagnosed rate of the disease was high and prognosis was poor due to many confusing basic diseases. And the symptoms,signs and ordinary inspection of the patients lacked specificity. CTPA,being utilized to diagnose pulmonary embolism reliably,should be promoted.

Actins ; metabolism ; Female ; Heart Atria ; pathology ; Heart Neoplasms ; secondary ; surgery ; Humans ; Iliac Vein ; pathology ; surgery ; Leiomyomatosis ; metabolism ; pathology ; surgery ; Middle Aged ; Uterine Neoplasms ; metabolism ; pathology ; surgery ; Vascular Neoplasms ; metabolism ; pathology ; surgery ; Veins ; pathology ; surgery ; Vena Cava, Inferior ; pathology

Objective To improve the sensitivity of PCR for studying the rifampin resistant gene (rpoB) of M.Leprae from clinical samples.Method After comparing the results of PCR with Q-Solution (PCR Enhancer) and without Q-solution,Nested-PCR was then applied for the detection of rpoB gene.Results Although PCR Enhancer improves the amplification of rpoB gene, the sensitivity of routine PCR is only 45. 2%.The sensitivity of Nested-PCR for detecting mutants in rpoB gene can further increase to 90.5% after selection of optimum parameters.Conclusion The combinaion of PCR Enhancer and Nested-PCR improves the sensitivity and specificity of PCR for detection of rifampin resistant gene of M. Leprae.