Objective: To retrospectively analyze the efficacy and safety of three high-dose opioids in the treatment of cancer pain in our hospital.Methods: The medical records of 73 patients with severe cancer pain were collected, and according to the taken drugs, they were divided into group A (sustained-release morphine tablets, 25 ones), group B (sustained-release oxycodone tablets, 36 ones) and group C (transdermal fentanyl, 12 ones).Evaluation of patients with average of pain NRS,breakthough pain NRS,dosage of opioids,quality of life on admission and in 24h after the 4 weeks treatment;In addition,the other analgesic medications,auxiliary medicines,and adverse drug reations were recorded at the same time.Results: The NRS was significantly lowed in the three groups after the 4-week treatment (P＜0.01), and that in group B was lowest with notable difference when compared with that in group A (P＜0.05).The number of breakthrough pain also significantly decreased in the three groups after the treatment (P＜0.01), and there was no significant difference among them (P＞0.05).The doses of opioids analgesics after the 4-week treatment were significantly higher than those on admission (P＜0.01), and the doses in group B were slightly lower than those in the other two groups, while there was no significant difference among them (P＞0.05).The quality of life in the three groups was improved significantly after the treatment (P＜0.01), and no significant difference was shown among them (P＞0.05).The other pain medications and auxiliary medicines used in the three groups were similar (P＞0.05).The incidence of adverse reactions in the three groups had no significant difference (P＞0.05).Conclusion: The standardization of the three high-dose opioids analgesics can control pain effectively and improve the quality of life, which is worthy of clinical promotion.In addition, oxycodone shows the best analgesic effect, whiel fentanyl transdermal patches have the lowest incidence of adverse reactions.

Objective To investigate and analyze the application of three steps therapy analgesics in good pain management(GPM)-ward,in order to provide rational analgesics drug application in clinical practice.Methods Through the hospital HIS system,the application data of analgesics in GPM-ward from Jan.2014 to Dec.2015 were collected and analyzed.Results The sum and proportion of the strong opioid drug was lined first.The total DDDs of the three -stage analgesics ranked from high to low was celecoxib >tramadol >oxycontin >morphine >fentanyl trans-dermal.The celecoxib was usually assisted the other;in addition,tramadol's DDDs and expense amount decreased, which was in the line with NCCN guidelines.Moreover,oxycontin's DDDs and expense amount increased.As well as, anesthesia prescription qualified rate was 93.5%,medical record standard rate was 80.5% in 2014,prescription qual-ified rate was rose to 97.5%,medical record standard rate was rose to 91.5% in 2015.Conclusion The application of cancer pain drug was basically rational in GPM-ward,which is in line with the principles of cancer pain relief by the mouth,by the clock,by the ladder and for the individual.

Objective To investigate the clinical effects of the treatment of cancer pain control by the partic-ipation of pharmacist,and the effect on cancer patients and families mental state and quality of life.Methods Clini-cal pharmacists took participate in the standardized treatment of pain,before and after different intervention,NRS scale was used to assess the patients'pain,self -rating anxiety scale(SAS)and self -rating depression scale(SDS)were used to assess the patients and families'psychological mental status.SF -36 scale was used to assess the quality of life.Results Compared with pre -intervention,two weeks later,the overall situation of patients with pain was signifi-cantly improved[NRS score (4.72 ±1.13)points vs.(3.57 ±0.97)points,t =7.722,P <0.01].Patients and their families,anxiety and depression significantly alleviated [patients:SAS (32.56 ±4.66 )points vs.(60.31 ± 4.27)points,t =38.180,P <0.01,SDS (45.89 ±5.46)points vs.(68.34 ±6.23)points,t =28.250,P <0.01;families:SAS(33.76 ±4.82)points vs.(50.31 ±6.47)points,t =15.593,P <0.01,SDS (32.89 ±3.54)points vs. (52.34 ±6.23)points,t =15.593,P <0.01 ].At the same time,the patients and families'quality of life were improved.Conclusion Clinical pharmaceutical care can relieve the body pain,meanwhile,those could effectively relieve the anxiety,depression and other negative psychology of cancer patients and families,improve the whole quality of life.

Objective To observe the influence of whole nursing model on health-related knowledge awareness and satisfaction rate of patients with liver hydatidosis receiving pericystectomy.Methods 180 patients in hospital receiving resection of liver hepatic cyst were randomly divided into the observation group and the control group with 90 patients in each group.The control group was given usual care,while the observation group received whole treatment model.The patients' health-related knowledge awareness and satisfaction rate were compared between two groups.Results The rate of health-related knowledge awareness and satisfaction about nursing work in the observation group preceded the control group.Conclusions This whole treatment model can boost the awareness rate of health-related knowledge and nursing satisfaction,which not only provides the care with full,comfortable and efficient services,but also advances the self-care capacity and cognition of disease of patients.

Objective To measure the sternal angle corresponded to thoracic plane by three-dimensional reconstruction of spiral CT , and to explore the accurate positioning methods and the preoperative assessment of cervicothoracic junction lesions .Methods Selected 42 cases of normal bone mass , 48 cases with bone loss , and 60 cases of osteoporosis who were diagnosed by dual-energy X-ray absorptiometry , and measured the location of thoracic sternal angle corresponded to the thoracic spine and thoracic kyphosis angle through the volume recon -struction data of the 16-slice spiral CT chest examinations .Results The range of sternal angle corresponded to thoracic plane was measure-ment units ⅢtoⅥ.The measure unit Ⅳwas the most, accounting for about 55%.There was no statistical significance between the position of sternal angle corresponded to thoracic plane and the relationship of bone mass , which required further study .The position of sternal angle corresponded to thoracic plane was associated with the thoracic kyphosis angle .The larger the thoracic kyphosis angle , the lower the corre-sponding position was .Conclusion The thoracic segment corresponded to the sternal angle is not a constant or accurate plane , which is not properly concerned as an accurate positioning mark to the thoracic segment .The measurement of the thoracic sternal angle was corresponded to the thoracic spine location , and its co-relationship evaluation between the thoracic kyphosis angle was vital for the accurately positioning of cervico-thoracic junction area lesions , the pre-assessment methods of surgical treatment , approach selection , and different methods for ster-num and other such contents .This research was of important clinical significance .

Objective To study the protective effect of normothermic ex vivo perfusion to prevent donor-lung injury.Method After being flushed with perfadex solution through the pulmonary artery and vein,the donor lungs were divided to control group (preserved with 4℃ cold static preservation,n =8) and experimental group (preserved with ex vivo oxygenated blood continuous perfusion,n =8).Pulmonary function indexes,including pulmonary vascular resistance (PVR),lung ventilation resistance(LVR),the left inferior pulmonary vein(LIPV) blood PO2,and lung water content,were evaluated.Lung injury were studied by light microscopic observation and detecting the expression of proimflammatory factor IL-1β was detected.Result (1) Lung function evaluation:in both group,PVR,LVR and lung water content gradually increased,LIPV PO2 gradually declined;But in the same time point PVR and LVR in group were were significantly less than in control group (P＜0.05),LIPV PO2 in experimental group were were significantly more than in control group(P＜0.05).(2)Lung injury evaluation:Lung tissue edema classification in both group were significantly higher than in normal lung(P＜0.05),but classification in experimental group were significantly lower than in control group(P＜0.05).The expression of IL-1β in experimental group (0.422 ± 0.132) were significantly lower than in control group(0.578 ± 0.163,P＜0.05).Conclusion Ex vivo oxygenated blood continuous perfusion without ventilator is a feasible technique for lung preservation.It ameliorates hypothermic time-dependent ischemic injury.But further systems evaluation in complete physiologic condition is necessary.

Objective To investigate the feasibility and efficacy of treating atrial fibrillation(AF)in beating heart surgery using bipolar Radiofrequency Ablation(RFA)system. Methods Treating AF in beating heart under normal temperature CBP surgery with bipolar RFA following the circuit of maze operation,2 - 6 times each place,until sinus rhythm appeared,then perform AVR or MVR in the stopped beating heart. Results All 18 cases survived the surgery. Sinus rhythm appeared in all cases. The average treating time was 28 minutes. Conclusions Application of bipolar RFA in the treatment of AF in beating heart is a safe and efficacy method. It is recommended to be applied widely.

Objective To explore the influences of decorin ( DCN) gene down-regulating on biological behavior in human lung adenocarcinoma A 549 cell line.Methods Chemically synthesis in vitro targeting DCN -siRNA was transfected into human lung adenocarcinoma A 549 cells by LipofectamineTM 2000 .The gene expres-sion of DCN was detected using Real-Time PCR ;The protein expression of DCN was investigated using Western blot;Checkout DCN-siRNA effects on lung adenocarcinoma cancer cell proliferation was detected by CCK -8;The migration and invasion ability were determined by Transwell assay .Results DCN-siRNA was successfully transfected into human lung adenocarcinoma A 549 cells.Real-Time PCR results showed that DCN mRNA ex-pression level significantly decreased ,compared with untransfected group ,negative control group .Western blot re-sults showed that DCN-siRNA transfection inhibited DCN protein expression level;CCK-8 results showed that the proliferation was enhanced in the DCN -siRNA group as compared with untransfected group ,as well as the negative control group and empty vector group .Transwell assay results showed the invasion of A 549 cells in DCN-siRNA group was significantly enhanced as compared with untransfected group [(22.6 ±1.14) vs.(5.2 ± 0.84)].Wound-Healing assay results revealed that the cell repairing rate was markedly increased in DCN -siRNA group.A549 cells were close to complete repair after 48 hours.Apoptosis was not significant in DCN -siR-NA group as compared with untransfected group (P=0.214).Conclusion Down-regulation the expression of DCN gene by DCN-siRNA may enhance the ability of invasion ,migration and proliferation of A 549 cells without affecting apoptosis ,which provides a new evidence of function for advancing research of lung cancer .

Objective To study the expression of the extracellular fragment of P glycoprotein in the bacteria. Methods According to the P glycoprotein antigen analyses and mdr1 gene structure, a couple of primers were designed to amplify the extracellular DNA fragment of the protein with PCR. The product was inserted into pGEM T vector followed by sequencing. The sequencing verified vectors were cloned into pGEX 2T to get a highly expression recombinant vector pGEX Pgp. The recombinant was transferred into E. coli DH5?, and its expression, identification and purification were studied. Results The highest level of recombinant expression was achieved at 4 h after IPTG induction. SDS PAGE analysis indicated that the expressed protein was about 30?10 3. Conclusion The target gene fragment expression at high level is established for the preparation of its antibody and biospanning of its specific peptide by using random phage library, founding a basis for the targeting treatment of multidrug resistance.

AIM:To analyze the changes in the active components alignment of Puerariae Decoctions between its two different compatibility proportion. METHODS: Reversed phase high-performance liquid chromatography (RP-HPLC) was applied. RESULTS: When the compatibility ratio of Radix Puerariae Lobatea, Radix Scutellariae, Rhizoma Coptidis and Radix et Rhizoma Glycyrrhizae Praeparata cum melle was 5∶3∶3∶2, the contents of the eight drug active components alignment were 2.48% puerarin, 0.101% daidzin, 0.614% baicalin, 0.155% berberine, 0.048% palmatine, 0.094% jateorhizine, 0.154% glycyrrhizic acid, 0.283% liquiritin, and the proportional relationship of compatibility was 51.7∶2.1∶12.8∶3.2∶1∶2∶3.2∶5.9. When the compatibility ratio of Radix puerariae lobatae, Radix scutellariae, Radix Coptidis and Radix et Rhizoma Glycyrrhizae Praeparata cum melle was 8∶3∶3∶2, the proportion of contents of the eight active components alignment were 1.67%, 0.143%, 0.36%, 0.085%, 0.031%, 0.048%, 0.126%, 0.174%. And the proportional relationship of compatibility was 54.4∶4.7∶11.7∶2.6∶1∶1.5∶4.1∶5.7. CONCLUSION: When the compatibility percentage consists of 8∶3∶3∶2, only the puerarin content relatively increases. The active components alignment of the rest have no significant difference. This illustrates the contents of the active components alignment of puerariae decoction is related to the compatibility percentage and herb solubility.