Objective To observe and compare the efficacy and safety of chloroprocaine and ropivacaine for epidural labor analgesia.Methods 86 cases of voluntary acceptance of maternal painless natural childbirth were selected in the study.43 cases were given chloroprocaine epidural analgesia (chloroprocaine group),and the other 43 cases were given ropivacaine epidural analgesia (ropivacaine group).The pain (VAS score),lower limb motor block degree(MBS score),fetal heart rate(FHR) and contractions duration of maternal prenatal and medication immediately after 10min,20min,40min,80min were compared between two groups.The first,second and third stage of labor and fetal output after 1 min,5min,10min Apgar score were compared.The incidence of adverse events were observed.Results In the chloroprocaine group,the 10min VAS score was (2.10 ± 1.02),which was significantly lower than (4.31 ± 1.13) in the ropivacaine group (t =4.565,P ＜ 0.05).In the chloroprocaine group,analgesia 20min MBS score was (0.24 ± 0.03),which was significantly higher than (0.11 ± 0.04) in the ropivacaine group (t =4.126,P ＜ 0.05).In the chloroprocaine group,4 cases occurred nerve injury,which was more than the ropivacaine group (1 case),the difference was statistically significant (x2 =4.263,P ＜ 0.05).Conclusion Chloroprocaine and ropivacaine for epidural labor analgesia have superior efficacy and the clinical efficacy is similar.Chloroprocaine has the advantage of quick results,but the medication about 20min time period that the drug might lead to a greater degree of lower limb motor block,and has the risk of nerve injury,pregnant women can choose according to their medication.

Objective To establish a method to determine the concentration of Danshensu in rats sera by HPLC after rats were fed with Kangxianerhao(KXEH) extract.Metheds Rats were given 0.45g or 0.55g KXEH extract 7 times in 4 days by gavage,and blood were collected from heart of rats at different time.Condition of HPLC: C18A column was used,the mobile phase was consist of a mixture of acetonitrile-H_3PO_4,the detection wavelength was 205nm.Result Concentration of KXEH reached the highest level one hour after administration of KXEH in different doses,which showed that high dose of drug got higher concentration of drug Danshensu in serum than the medium dose.Linear correlation was obtained over the concentration of 76～1520mg/L,r=0.9932.Average recoveries of samples were 98.3%,101.5%,99.3% respectively at different dose of 76mg/L、304mg/Land 1520mg/L,with RSD was 5.9%、2.5%、2.0% respectively.It was proved indirectly that the concentration of KXEH in rat serum after administraion of KXEH extract reached effective concentration in blood.Conclusion It shows that large dose KXEH get higher concentration of Danshensu in blood than the medium dose.The concentration of drug serum is quantitated by HPLC assay.

Objective To investigate the mechanism of nuclear factor-kappa B(NF-κB)in thioactamide(TAA)induced acute hepatic injury.Methods Seventy-eight Wistar rats were randomly divided into normal group(n=18),TAA model group(n=30)and pyrrolidine dithiocarbamate (PDTC)pretreated group(n=30).The rats in PDTC group were received 100 rag/kg of PDTC 1 h before induction of the model.Every 10 rats in TAA group and PDTC pretreated group and 6 rats in normal group were sacrificed at 6,24,48 hour after induction of the model tO mesure levels of endotoxin,tumor necrosis factor(TNF)-α and interleukin(IL)-6.The expression of the intercellular adhesion molecular(ICAM)-1 in hepatic tissue was tested using RT-PCR and the NF-κB activity was 48 hour were higher in TAA group[(87.11±8.23)%.(78.55±6.82)%and(74.27±6.26)%,respectively]than those in normal group[(4.64±1.82)%,(4.55±1.67)%and(4.91±2.12)%,all comparison with normal group(P＜0.01).The serum concentration of endotoxin and TNF-α in PDTC pretreated group were higher than those in normal group(P＜0.0 1).but lower than those in TAA with ticrmal group(P＜0.01).The serum concentration of IL-6 in PDTC pretreated group was higher at 24 and 48 hour than those in normal group(P＜0.01),but lower than thoes in TAA group(P＜group(P＜0.01).The expression of ICAM-1 in PDTC pretreated group was higher than that in immunohistochemical examination showed that liver necrosis was folund in TAA group and PDTC pretreated group.Conclusion The Nuclear factor-κB may aggravate the injury of liver by promoting expressions of TNF-α,IL-6 and ICAM-1.

Objective To explore the clinical and pathological characters of chronic hepatitis B (CHB) in combination with hepatic steatosis in the elderly.Methods Totally 223 elderly patients with CHB and hepatic steatosis diagnosed by liver biopsy were retrospectively analyzed and 220 nonelderly patients with CHB and hepatic steatosis were randomly selected as control group.Clinical and pathological features and change in liver histology were compared between the two groups.Results The incidences of hypertension,coronary heart disease,type 2 diabetes mellitus and metabolic syndrome were increased in elderly groups (all P＜0.01 or 0.05),while the proportion of patients with hyperlipemia and obesity were decreased as compared with non-elderly group (both P＜0.01).The levels of body mass index,serum triglyceride and HBV-DNA were lower in elderly group than in non-elderly group (all P＜0.01).The ratio of mild degree of CHB was elevated in elderly group as compared with non-elderly group (P＜0.05).Liver histopathological examination showed that the proportion of patients with the inflammation grade less than G2 and fibrotic stages exceeding S2 were increased,while the positive rate of HBcAg by immunohistochemistry was reduced in elderly group as compared with non-elderly group (both P＜0.05).Conclusions The degree of inflammatory liver injury and inflammation grade are slighter,but the fibrotic stage is more serious in elderly patient with CHB and hepatic steatosis,which indicating a slower progress of liver injury.It is still to be investigated whether metabolic syndrome,hypertension,coronary heart disease and type 2 diabetes mellitus are easily complicated in elderly patient with CHB and hepatic steatosis.The serum hepatitis B virus DNA replication may be negatively correlated with ageing.

Aim To explore the effects and mecha-nisms of choro-oxime derivatives on spatial learning and memory impairment in Kunming mice and SD rats induced by scopolamine and Aβ1-42 , respectively. Methods 40 Kunming mice were randomly divided into 5 groups: control group, model group, donepezil treatment group, arimoclomol treatment group and TCO-2 treatment group. There were 8 mice in each group. Mice of control group were established by intra-peritoneal injection of saline, and mice of other groups were injected with scopolamine and caused memory im-pairment. Both control group and model group were treated with solvent by intraperitoneal administration;donepezil treatment group received donepezil by intra-gastric administration; arimoclomol treatment group and TCO-2 treatment group were given the correspond-ing drugs by abdominal injection, respectively. The solvent and drugs were given at the same time every morning for 8 days. Spatial learning and memory abili-ty were tested by Morris water maze from the fifth day of the drugs administration. 40 SD rats were divided into 5 groups the same as the dementia model men-tioned above. Mice of control group were established by intracerebroventricular injection of saline, and mice of other groups were injected with insoluble Aβ1-42 to be induced of memory impairment. Solvent and drugs were also delivered as mentioned above. Morris water maze was carried out from the fifth day of the drug de-livery. After that, acetyl cholinesterase activity of hip-pocampus was tested with acetyl cholinesterase reagent kit; the content of Aβ1-42 in hippocampus was meas-ured by ELISA assay kit;the expression of phosphoryl-ated tau proteins was detected by Western Blot. Re-sults In both two dementia models, choro-oxime de-rivatives could improve the spatial learning and memory ability, shorten the escape latency and increase the times of crossing the former platform. Choro-oxime de-rivatives could also inhibit the acetyl cholinesterase ac-tivity in animal brain, decrease the concentration of Aβ1-42 and the expression of phosphorylated tau pro-teins in the dementia rats’ hippocampus. Conclusions Spatial learning and memory deficits induced by sco-polamine and Aβ1-42 could be reversed by choro-oxime derivatives. It may be concerned with enhancement of the cholinergic system functions and reduction of the levels of Aβ1-42 and phosphorylated tau proteins in the brain.

ObjectiveTo explore the association between hepatic steatosis and the liver tissue expression of HBsAg and HBcAg in chronic hepatitis B (CHB) patients.MethodsFrom January 2005 to June 2008,a total of 147 CHB patients with hepatic steatosis diagnosed by liver biopsy and other 149 CHB patients without hepatic steatosis but with similar HBV DNA titer were enrolled.The differences of HBsAg and HBcAg immunostaining and liver injury in these two groups were compared.The data were analysed using t test and chi square test.ResultsCompared with non-steatosis group,the average age and body weight index of hepatic steatosis group were higher (t values were -3.31and -6.57,both P＜0.01).The percentage of moderate to severe hepatic inflammation in liver,obvious hepatic fibrosis and the strong positive HBsAg staining was lower (30.6％ vs 15.4％ ； 26.5％vs 12.8％； 23.1 ％ vs 6.7 ％； x2=9.63,8.92,15.76； all P＜0.01),and the percentage of strong positive HBcAg staining was also in downtrend.Compared with degree F1 and F2 of liver steatosis,the percentage of HBsAg and HBcAg strong positive staining in liver tissues of degree F3 and F4 was in downtrend.ConclusionsHepatic steatosis affected the expression of HBsAg and HBcAg in liver tissue of CHB patients.As hepatic steatosis appeared and became more severe,both expression of HBsAg and HBcAg and the degree of liver injury were in downtrend.

OBJECTIVE To improve capability of nosocomial infection(NI) prevention and control in reusable textiles management.METHODS In an investigation to previous reused textiles handled procedure,care to keep from creation of potential infectious aerosols should not be taken in contaminated textiles collection,transportation of clean and soiled textile was done in undistinguished uncovered vehicles,sorting room shared a common space with dressing room and washing room,and personal protection was not performed in handling contaminated textiles.RESULTS A series of NI management as follows effectively were adopted in hospital laundry.Appropriate bags were adopted for collecting used textiles or fabrics at the point of generation and subsequently closed securely for transportation of them to the laundry.An independent sorting area with exclusive ventilation system was separated from other parts of the laundry.Hand hygiene facilities and products and appropriate personal protective equipments were available.Transportation and storage of clean from soiled textiles were separated.CONCLUSIONS Appropriate handling and processing textiles in infectious disease hospital plays key role in NI management.

The gentamicin sulfate carried calcium sulfate (GSCS) implants were fabricated by the coagulating method, and the release rate of the gentamicin tested by UV-spectrometer and the absorbing rate of the calcium sulfate carrier in vitro were studied. The release patterns of two types of GSCS were compared. The trend of daily weight loss of GSCS was found being similar to that of pure calcium sulfate, which suggested that the gentamicin part has little effect on the absorbing pattern of calcium sulfate. The release rate of gentamicin is controlled by the erosion rate of calcium sulfate, so GSCS with different amount of gentamicin has the same release patterns. The DRP value of ED is higher than that of CO during the early stage, while the DRP value of ED is lower than that of CO during the late stage. The GSCS samples were implanted into the defect mold on the radii of the rabbits to investigate the potential for the use of GSCS implants as bone fillers, and the results revealed that new bone had been induced in a great part of the defect at 14 weeks after operation.
Animals ; Anti-Bacterial Agents ; administration & dosage ; pharmacokinetics ; Bone Regeneration ; drug effects ; Calcium Sulfate ; administration & dosage ; Gentamicins ; administration & dosage ; pharmacokinetics ; Implants, Experimental ; Rabbits ; Radius Fractures ; therapy

OBJECTIVETo evaluate the controlled attenuation parameter (CAP) assessment of fatty liver and choose a cut-off value of hepatic steatosis more than 5%.

METHODSConsecutive patients, 18 years or older, who had undergone percutaneous liver biopsy and CAP measurement were recruited from five liver healthcare centers in China. All enrollees were categorized as hepatic steatosis grade S0 (<5%) or S1 (5%). An M-probe equipped FibroScan 502 was used to capture CAP values. Receiver operating characteristic (ROC) curves were plotted, and the areas under (AU) the curves were calculated to determine the diagnostic efficacy. The CAP cut-off values at the optimal thresholds were defined by maximum Youden indices; sensitivity and specificity were also calculated.

RESULTSA total of 332 patients were enrolled in the study, including 67 patients with non-alcoholic fatty liver disease (NAFLD) and 265 with chronic hepatitis B (CHB) viru: infection. The median age (inter quartile range, IQR) of the study cohort was 39.0 (32.0-50.5) years-old. There were 46 males (68.7%) in the NAFLD group, with a median age of 37.0 (28.0-45.0) years-old, and 182 males (68.7%) in the CHB group; the differences between the two groups in median age and male: female ratio did not reach statistical significance. Multivariate linear regression analysis identified steatosis grade and body mass index (BMI) as independently associated with CAP. The median (IQR) CAP values among patients with S0 and S1 grade steatosis were 215.0 (190.0-241.0) dB/m and 294.0 (255.0-325.5) dB/m (P<0.001), respectively. For all patients, when BMI was <25 kg/m2, the ability of the AUROC of the CAP to discriminate hepatic steatosis more than or equal to 5% was 0.853, and the optimal cut-off value was 244.5 dB/m; however, when BMI≥25 kg/m2, the AUROC was 0.835 and the optimal cut-off value 269.5 dB/m.

CONCLUSIONCAP can identify hepatic steatosis more than or equal to 5% and is applicable for the diagnosis of fatty liver if it is adjusted for BMI.

Adult ; Area Under Curve ; Bile ; Biopsy ; Body Mass Index ; China ; Fatty Liver ; Female ; Hepatitis B, Chronic ; Humans ; Linear Models ; Male ; Middle Aged ; Multivariate Analysis ; ROC Curve ; Tissue Extracts

Objective:To evaluate the safety and feasibility of neoadjuvant chemotherapy (NACT) combined with radical surgery for elderly patients with locally advanced gastric cancer (LAGC).Methods:One hundred and fourty eight patients with LAGC after NACT and gastrectomy between 2012 and 2020 were retrospectively reviewed. They were divided into two groups: (1) <65 years old (111 cases) and (2) ≥65 years old (37 cases) and their clinicopathological and prognostic data were compared.Results:There was no significant difference between the two groups in the incidence of hematological complications such as anemia ( χ2=0.235, P=0.628), leukopenia ( χ2=0.613, P=0.434), neutropenia ( χ2=0.011, P=0.918) and thrombocytopenia ( χ2=0.253, P=0.615) and non-hematological complications such as nausea ( χ2=0.092, P=0.762), vomiting ( χ2=0.166, P=0.683), diarrhea ( χ2=0.015, P=0.902) and mucositis ( χ2=0.199, P=0.766) due to NACT. There were no statistical differences between the older patients and the younger in operation duration ( t=0.270, P=0.604), intraoperative bleeding ( t=1.140, P=0.250) and R 0 resection rate ( χ2=0.105, P=0.750). The incidence of postoperative complications was 25.2% and 37.8% in the younger patients and the olders ( χ2=2.172, P=0.141). Pleural effusion ( χ2=7.007, P=0.008) and pulmonary infection ( χ2=10.204, P=0.001) was significantly higher in the older patients than in the youngers. The 3-year progression-free survival rate ( t=0.494, P=0.482) and 3-year overall survival rate ( t=0.013, P=0.908) were comparable between the two groups. Conclusions:NACT combined with radical surgery is safe and effective in elderly patients with LAGC, except for higher perioperative pulmonary-related complications.