Objective To compare the analgesic effects of flurbiprofen axetil combined with sufentil and sufentil alone used through intravenous postoperatively.Methods 40 cases under general anesthesia were randomly divided into the group A and group B with 20 cases in each group.The analgesia methods were flurbiprofen axetil 100 mg plus sufentanil 100 μg(diluted to 100 ml with normal saline) in the group A,and sufentanil 200 μg(diluted to 100 ml with normal saline) in the group B.The scores of Visual Analogue Scale(VAS) for pain and the incidence of side effects within postoperative 48 hours were recorded.Results The VAS scores of two groups were not significantly different(P>0.05).The incidence of side effects of the group A was significantly lower than that of the group B(P<0.05).Conclusion Flurbiprofen axetil combined with sufentanil has a good analgesic effect used through intravenous postoperatively,and can clearly reduce the dose of sufentanil and the incidence of side effects.

Objective To identify the factors enhancing the contusive brain hemorrhage following unilateral decompression craniectomy in patients with severe traumatic brain injury (TBI),and to explore the relationship between the initial Rotterdam CT score and clinical outcomes.Methods A prospective study of 291 consecutive patients with TBI admitted from Jan 2008 through Dec 2012 was carried out.Patients treated with unilateral decompression craniectomy were enrolled for study.Patients without preoperative or postoperative cranial CT imaging were excluded.Of them,235 patients were followed up.Gender,age,the causes of injury,preoperative general condition including Glasgow Coma Scale (GCS) score,pupillary response,laboratory data and the initial CT scans before operation,contusion hematoma size in CT scans following operation and Glasgow Outcome Scale (GOS) score were recorded.With t test,x2 test and nonparametric rank sum test,differences in the above listed variables were compared between patients with enlarged hematoma size group and those without change in hematoma size.A Classification And Regression Tree (CART) was used to predict the size of hematoma.Correlation analysis was used to find the relationship between the Rotterdam CT scores and GOS scores.Results The differences in age (t =2.034,P =0.043),first Rotterdam CT score (Z =4.838,P ＜ 0.01),GCS score (Z =4.440,P ＜ 0.01),pupillary response (Z =3.235,P =0.001),the length of time elapsed between the trauma occurred and the decompressive craniectomy (Z =3.874,P ＜ 0.01),glucose level (Z =3.880,P ＜ 0.01) and cerebrum hernia magnitude (Z =2.529,P =0.012) were significant between the patients with hematoma expanded (n =120) and those without change in hematoma size (n =115).The results of the CART indicated that Rotterdam score got from the initial head CT,glucose level and the length of time elapsed between trauma occurred and decompressive craniectomy were strong predictors of the risk for expanded hemorrhagic contusions following decompressive craniectomy.Both age and size of the removed bone-flap also could predict the risk of postoperative expansion of hemorrhagic contusions.The overall predictive accuracy of the CART model was 83.3％.Correlation analysis results indicated that Rotterdam CT score was negatively correlated with GOS (r =-0.333,P ＜ 0.01).Conclusions Initial Rotterdam CT scores,glucose level and the length of time between trauma and decompressive craniectomy may predict the risk of contusions expansion following decompressive craniectomy.Rotterdam CT score was negatively correlated with GOS.

Objective To observe the effect of ropivacaine in infiltration anesthesia before the end of surgical procedures for postoperative analgesia on patients with spinal cord injury. Methods 60 patients with spinal cord injury undergoing internal fixation of spine fractures under combined general anesthesia were assigned in 3 groups, who received 0.25% ropivacaine in infiltration anesthesia (group RL, n=20),0.5% ropivacaine in infiltration anesthesia (group RM, n=20), or no infiltration anesthesia (group C, n=20) before the end of surgical procedures.The time for post-anesthesia recovery (PART), agitation score (AS), and Visual Analogue Score (VAS) for pain 2 h, 6 h, 24 h, and 48 h post operation were recorded, and related side effects were observed. Results AS within 6 h postoperation was significantly less in group RL and RM than in group C (P<0.05), as well as VAS, PART, mean of arterial pressure and heart rate 2 h, 6 h, and 24 h post operative (P<0.05).There was no significant difference in side effects including postoperative nausea and vomiting, and pruritus among these groups (P>0.05). Conclusion Ropivacaine in infiltration anesthesia would provide better postoperative analgesia, decrease the incidence of postoperative agitation, and increase the safety of patients with spinal cord injury in the postoperative period.

ObjectiveTo compare the effect of rehabilitation training after surgical intervention of knee stiffness (SIKS) between femoral nerve block (FNB) and epidural nerve block (ENB).Methods60 patients undergoing SIKS at one knee joint were randomly assigned to two groups: 40 patients accepting a catheter for FNB in group A and 20 patients accepting a catheter for ENB in group B. All patients participated in passive rehabilitation therapy (PRT) and active rehabilitation therapy (ART) at 12 hours, 24 hours, 36 hours, and 48 hours after operation. 10 ml of lidocaine were applied via these catheters before rehabilitation therapy. The visual analogue score (VAS) for pain in PRT, the time needed from the end of PRT to the start of ART, and the incidence of side effects such as hypotension or nausea were recorded.ResultsThere was no significant difference in VAS between groups A and B. The time needed from the end of PRT to the start of ART in group A was significantly less than that of group B. The incidence of hypotension or nausea in group A was significantly less than those of group B.ConclusionFNB provides the same analgesic effect as ENB, has less time needed from the end of PRT to the start of ART, and lowers incidence of hypotension or nausea.

Objective To investigate the states of psychological condition and the quality of life in patients with functional constipation (FC) by comparing with those of healthy controls.Methods Symptom Checklist-90(SCL-90)and Patient Assessment Constipation-Quality of Life(PAC-QOL)were tested by self-report questionnaire in sixty patients with FC and thirty healthy controls with corresponding age and gender.Results (1)There was no difierence in age,body mass index and sex ratio between the FC patients and healthy controls,but the scores of stool form and frequency of defecation were significantly different between the two groups.(2)The following items of SCL-90 i.e.total scores,total symptomatic index.the number of positive items and positive symptom distress level were obviously higher in the FC patients than in controls (P＜0.05).The scores of the nine factors of SCL-90 except terror were also higher in the FC patients than in controls.(3)The average total score and scores of four sections (physical discomfort,psychological discomfort,anxiety,satisfaction) of PAC-QOL in FC patients were higher than those in basal level.(4)The average score of PAC-QOL was significantly correlated with the scores of SCL-90,especially in anxiety and depression.(5)The severity of symptoms in the FC patients was significantly correlated with the average score of PAC-QOL and the total score of SCL-90.Conclusioils FC patients have obviously psychological abnormality,which affects the quality of life significantly.The scores of quality of life is a better parameter to reflect the healthy status of the FC patients than the laboratory tests and the clinical symptoms.

Objective To explore the application of Airtraq(R) optical laryngoscope combined with bronchofibroscope for endotracheal in-tubation (EI) in patients with cervical spine injury (CSI). Methods 50 patients with CSI undergoing spine surgery under combined general anesthesia were randomly assigned to two groups, group A (n=25) received EI by using Airtraq(R) optical laryngoscope and group AF (n=25) received EI by using Airtraq(R) optical laryngoscope combined with bronchofibroscope. The intubation time (IT), success rate of single intuba-tion (SRSI), hemodynamic changes in endotracheal intubation, and complications related to EI were observed. Results IT was significantly longer in group A than in group AF (P<0.001), and SRSI was significantly lower than in group A in group AF (P<0.05). There was no signif-icant difference in hemodynamic changes in EI and complications related to EI between two groups (P>0.05). Conclusion Airtraq(R) optical laryngoscope combined with bronchofibroscope would be safely and effectively used for EI in patients with CSI.

Objective To systemically evaluate the effect of intravesical Botulinum toxin on pain of patientspain syndrom. Methods The following databases as Cochrane Library, PubMed, Web of Science, Embase, Springer, Wiley, Science Direct, OVID were searched to col-lect the randomized controlled trials (RCTs) with the treatment of intravesical Botulinum toxin vs. 0.9%sodium chloride for patients with bladder pain syndrome. Two reviewers screened the trials according to the inclusion and exclusion criterias, extracted the data, assessed the quality, and the changes of Visual Analogue Scales (VAS) before and after treatment were used to conduct Meta analysis with RevMan5.2 software. Results Five studies were included with a total of 218 patients, there were 127 cases in intravesical Botulinum toxin group and 91 cases in 0.9%sodium chloride group. Meta analysis showed that the pain relief effect of intravesical Botulinum toxin was better than that of 0.9%sodium chloride. Conclusion Intravesical Botulinum toxin can relieve the pain of patients with bladder pain syndrome.

Objective To investigate the efficacy and safety of sirolimus 0.1% ointment in the treatment of facial angiofibromas in children with tuberous sclerosis complex. Methods Sirolimus 0.1% ointment was prepared. Twenty children with tuberous sclerosis complex who had facial angiofibromas were enrolled in this study. Facial angiofibromas were topically treated with the self?prepared sirolimus 0.1% ointment twice a day for 12 weeks. The facial angiofibroma severity index(FASI)was calculated, the degree of satisfaction with the treatment was evaluated, and adverse reactions were analyzed at weeks 4 and 12. Plasma sirolimus concentrations as well as blood biochemical and immunological parameters were measured, blood coagulation activity was evaluated, and routine blood tests as well as urine tests were performed at baseline and week 12. Results The FASI of patients significantly decreased at weeks 4(4.400 ± 1.284)and 12(2.975 ± 1.543)compared with that at baseline(5.750 ± 1.175, both P<0.000 1), and was significantly lower at week 12 than at week 4(P < 0.000 1). The efficacy index was 49.87% ± 22.08% at week 12, significantly higher than that at week 4(24.43%± 10.18%, t=7.338, P<0.01). The color, size and number of lesions significantly decreased in all the patients, and facial angiofibromas completely disappeared in 2 patients at week 12. At week 4, 10 parents were satisfied with the improvement of erythema, 3 parents with that of lesion volume, and 3 parents with that of lesion area. The degree of parent satisfaction increased at week 12 in all the cases. The blood concentration of sirolimus was lower than 1.0μg/L both before and after the treatment. No severe systemic or local adverse reactions were noted in these patients. Conclusion Sirolimus 0.1%ointment is markedly effective and safe for the treatment of facial angiofibromas in patients with tuberous sclerosis complex.

AIM: To study the protective effect of mese nt eric lymph duct ligation on the functions of liver, kidney and heart, and morpho logy in multiple organ dysfunction syndrome (MODS) rats subjected to two-hit. METHODS: Male Wistar rats were divided into three groups: the me senteric lymph duct ligation group, the non-ligation group and sham group. The M ODS model of two-hit was established by bleeding and LPS administration in both ligation group and non-ligation group. After 24 h, all rats were cannulated to f acilitate blood withdrawal for serum sample, then all rats were killed and organ s including kidney, liver, lung and heart were collected for making microscopic sectio ns. The biochemical indexes of hepatic and renal functions and myocardial enzyme in s erum were determined before and after experiment. RESULTS: After two-hit, the serum contents of AST, ALT, TBA, BUN , Cr and LDH-1 in both non-ligation group and ligation group, and UA content in non-ligation group were obviously increased than those in pre-experiment and sh am group (P

BACKGROUND:Deluxe-PS knee prosthesis is designed based on the anatomical characteristics of the Chinese peoples’ knee joint, especial y the morphological features of femoral condyle. The distance between median and lateral knee prosthesis femoral condyle is less than that of the imported prosthesis for 3.5 mm.
OBJECTIVE:To explore the short-term efficacy of Deluxe-ps knee prosthesis in simultaneous bilateral total knee arthroplasty.
METHODS:Fifteen knee osteoarthritis patients (30 knees) were included as the experimental group, and treated with simultaneous bilateral knee arthroplasty by Deluxe-ps knee prosthesis. Twenty patients (40 knees) in the control group were treated with simultaneous bilateral knee arthroplasty by PFCSigma knee prosthesis. The knee society score, hospital for special surgery knee score and knee joint range of motion were compared between two groups;the operation time and the intraoperative blood loss were compared between two groups.
RESULTS AND CONCLUSION:The patients in both groups were fol owed-up for 12 to 24 months, with an average of 16 months. Postoperative knee pain was relieved, and the joint function was recovered satisfactorily. The knee society score, hospital for special surgery knee score and knee joint range of motion in two groups were improved significantly after treatment (P<0.05). There were no significant differences in postoperative knee society score, hospital for special surgery knee score and knee joint range of motion between two groups (P>0.05), and there was no significant difference in intraoperative blood loss between two groups (P>0.05), while there was significant difference in operation time between two groups (P<0.05). The results showed that the short-term effect of Deluxe-ps knee prosthesis in simultaneous bilateral total knee arthroplasty was satisfied.