OBJECTIVE:To observe the short-term efficacy and safety of nimesulide combined with ibuprofen in the treatment of pain. METHODS:84 patients with pain were randomly divided into observation group and control group. Control group was oral-ly given 0.3 g Ibuprofen sustained-release capsule,twice a day. Observation group was additionally given 100 mg Nimesulide cap-sule,twice a day. The treatment course for both groups was 7 d. Clinical efficacy,visual analogue (VAS) score,quality of life (QOL) score,coagulation indexes (prothrombin time,thrombin time,fibrinogen,activated partial thromboplastin time) before and after treatment,and incidence of adverse reactions in 2 groups were observed. RESULTS:The total effective rate in observa-tion group was significantly higher than control group,the differences were statistically significant(P<0.05). Before treatment, there were no significant differences in the VAS score and QOL score between 2 groups(P>0.05). After treatment,VAS scores in 2 groups were significantly lower than before,and observation group was lower than control group,QOL scores were significantly higher than before,and observation group was higher than control group,the differences were statistically significant(P<0.05). And there were no significant differences in the coagulation indexes and incidence of adverse reactions between 2 groups(P>0.05). CONCLUSIONS:The short-term efficacy of ibuprofen combined with nimesulide is superior to ibuprofen alone in the treatment of pain,with similar short-term safety.

AIM: To observe the curative effect of titanium wiring in treatment of the fractures of Neer Ⅱ type distal clavicle and dislocation of Tossy Ⅲ type acromioclavicular joint. METHODS: From March 2004 to December 2006, 37 cases with Neer Ⅱ type distal clavicle fractures or Tossy Ⅲ type acromioclavicular joint dislocation were treated with titanium wiring in Changzheng Hospital, Second Military Medical University of Chinese PLA. Titanium wiring (produced by Sofamor-Danek Company in USA) had good histocompatibility, intensity of tension and flexibility. The broken coracoclavicular ligament was repaired directly by titanium wiring in all cases. The outcomes were evaluated according to Herscovici's criteria. RESULTS: All the cases were followed up for 6 to 24 months. All the dislocated acromioclavicular joints returned to normal 2 weeks after operation. Excellent and good rate of shoulder function was 100% according to Herscovici standard. X-ray imaging showed all clavicle fractures united, acromioclavicular joint had no redislocation or titanium wiring breaking. The incisions of all cases had no obvious swelling and exudation. CONCLUSION: When Neer Ⅱ type distal clavicular fracture and Tossy Ⅲ type acromioclavicular joint dislocation are treated with titanium wiring, the acromioclavicular joint can exercise earlier and recover quickly.

Objective To investigate the effect of pronuciferine on apoptosis of cultured human umbilical vein endothelium cells(HUVECs) induced by angiotensin Ⅱ(AngⅡ).Methods HUVECs cell line ECV304 was cultured in vitro,pretreated with Captopril(10 ?mol/L) or pronuciferine 10,1,0.1,0.01 ?mol/L for 30 min,respectively,then treated with AngⅡ(1 ?mol/L).Cell-morphosis was observed by light microscope.Cells viability was assessed by MTT assay.Production of nitric oxide(NO),activities of total nitric oxide synthase(tNOS),and inducible nitric oxide synthase(iNOS) were measured by colorimetry.Apoptosis rate was measured by Flow Cytometer(FCM).Results AngⅡ induced typical endothelial cell apoptosis and the apoptosis rates were significantly higher than those of the control group((P

Objective To investigate the clinical curative effects and side effects of concurrent radiotherapy combined with interventional artery infusion chemotherapy in advanced cervical carcinoma.Methods 48 patients with advanced cervical carcinoma were randomly divided into two groups including concurrent radiotherapy combied with interventional artery.infusion ehemotherapy group (25 patients) and radiotherapy group (23 patients).Each patient in the concurrent radiotherapy combined with interventional artery infusion chemotherapy group was given THP,DDP and 5-Fu,repeatedly every 28 days,total 3-4 cycles.Radiotherapy was given at the same time.Results The effective rates of the concurrent radiotherapy combined with interventional artery infusion chemotherapy group and radiotherapy group were 92.0 ％ (23/25)and 69.6 ％ (16/23),respectively.The overall 3 year survival rates for the patients in concurrent radiotherapy eombined with interventional artery infusion chemotherapy group and radiotherapy group were 80.0 ％ (20/25)and 52.2 ％ (12/23),respectively,and there was statistically significant between the 2 groups (all P ＜ 0.05).No more side effects were found in the concurrent radiotherapy combined interventional artery infusion chemotherapy group (P ＞ 0.05).Conclusion Concurrent radiotherapy combined with interventional artery infusion chemotherapy in advanced cervical carcinoma can increase short term therapeutic effect and improve the survival rate of the patients without more side effects.

Objective:To assess the effect of isokinetic muscle strength training on cognitive function and motor function of patients with Alzheimer's disease (AD).Methods:Forty patients with AD were randomly assigned to trial group and control group.All patients in both groups received conventional treatment,while the patients in the trial group received isokinetic muscle strength training at the same time.After two months,the cognitive function and motor function were assessed.Results:After two months,the trial group showed improvement in cognition CAMCOG whereas the control group declined.Compared to the control group,the trial group presented significant improvement on the functional capacity such as Berg balance,timed-up and go,as well as Functional reach.Conclusion:Isokinetic muscle strength training may be recommended as an augmentation treatment for patients with AD.

ObjectiveTo explore the relationship between plasma A-FABP and obesity type and degree,glucose and lipid metabolism parameters and insulin sensitivity.MethodsPlasma adipocyte fatty acid binding protein (A-FABP) was detected by double antibody sandwich ELISA in fasting status in subjects with normal glucose regulation and normal weight (NW-NGR,n =44),overweight or obese subjects with normal glucose regulation (OB-NGR,n =36),newly-diagnosed type 2 diabetes mellitus (T2DM) and its subgroups of T2DM with normal weight ( NW-T2DM,n =89 ) and T2D)M with overweight or obesity (OB-T2DM,n =44).And glucose,lipids,insulin levels as well as anthropometrical parameters such as body mass index ( BMI ),fat content ( Fat％ ),waist circumference (WC) and waist hip ratio (WHR) were measured.Meanwhile insulin sensitivity was assessed by HOMA-IR.ResultsAfter age and sex adjustment,plasma A-FABP levels in OB-NGR,NW-T2DM,and OB-T2DM were significantly higher than that of NW-NGR [11.32(6.54 - 15.43)μg/L,14.60(10.35 -20.10) μg/L,18.25(12.85 -26.65) μg/L vs 9.32(3.72 - 14.00) μg/L,all P ＜0.05].There was no difference in plasma A-FABP levels between OB-NGR and NW-T2DM [ 11.32 (6.54 - 15.43 ) vs 14.60 ( 10.35 -20.10) μg/L,P ＞ 0.05 ],but the plasma A-FABP levels in OB-NGR and NW-T2DM were significantly lower than that of OB-T2DM [ 11.32(6.54 - 15.43) μg/L,14.60( 10.35 -20.10) μg/L vs 18.25( 12.85 -26.65 ) μg/L,P ＜0.01 ].In a multiple stepwise regression analysis,HOMA-IR,sex,WC and age were the most significant independent determinants for plasma A-FABP concentration (all P ＜ 0.05 ).Conclusions Plasma A-FABP is strongly associated with the abdominal obesity and insulin resistance,measurement of plasma A-FABP concentrations might be useful for diagnosis of abdominal obesity and type 2 diabetics.

OBJECTIVE: To investigate the effect of pre-amputation pain block on the N-methyl-D-aspartate receptor activation in the central nervous system of amputated rats, and the association between pre-amputation pain block and chronic amputation-related pain. METHODS: Thirty-six adult male SD rats were randomly assigned to an NA group (n=12), a PA group (n=12) and a PAB group (n=12). Group NA was intraplantarly injected saline l00 μL while group PA and group PAB were intraplantarly injected complete Freund adjuvant (CFA) 100 μL. The sciatic nerve of group NA and group PA were freed from surrounding tissue, and that of group PAB was blocked by bupivacaine under pentobarbital sodium anesthesia 5 days after the injection. Thermal withdrawal latency (TWL) was measured before and after the injection. All rats were amputated at the scheduled survival time. The expression of N-methyl-D-aspartate receptor (NR2B) was measured by immunohistochemistry in L4-6 of the spinal cord and the anterior cingulated cortex 7 days after the amputation procedure. RESULTS: The TWL after intraplantar administration of CFA in group PA and group PAB decreased significantly compared with the baseline value (P<0.05), while the saline treated control group remained unchanged. Besides the basic value, the TWL of group PA was shorter than that of group NA at the above-mentioned time-points (P<0.05). Compared with the basic value and group NA, the TWL of group PAB after the block increased significantly (P<0.05). Compared with group NA and group PAB, group PA had a remarkably high expression of NR2B (P<0.05), while there was no difference between group PA and group PAB. CONCLUSION Pre-amputation pain may activate N-methyl-D-aspartate receptor of the central nervous system, which may lead acute postoperative pain to chronic pain. It is necessary to treat pre-amputation pain.
Amputation ; Animals ; Bupivacaine ; administration & dosage ; Freund's Adjuvant ; administration & dosage ; Gyrus Cinguli ; metabolism ; Male ; Nerve Block ; Pain Measurement ; Pain, Postoperative ; prevention & control ; Rats ; Rats, Sprague-Dawley ; Receptors, N-Methyl-D-Aspartate ; metabolism ; Sciatic Nerve ; Spinal Cord ; metabolism

OBJECTIVE: To determine the short and mid-term effect of paravertebral adriamycin injection under CT guidance on intractable postherpetic neuralgia (PHN). METHODS: From January 2010 to May 2012, 68 patients with intractable PHN receiving paravertebral adriamycin injection under CT guidance were enrolled. The outcome included the Quality of Life Score (QLS), Visual Analogue Score (VAS) (average, the worst and the least VAS), pain relief rate at the time before and after the injection, and 1 year after discharge. RESULTS: Lower VAS was observed after the injection than that before the injection [(3.5 ± 1.5) vs (7.9 ± 1.3) on average; (2.1 ± 0.9) vs (6.5 ± 1.7) at least and (4.5 ± 1.4) vs (9.2 ± 1.1) at worst, P<0.05]. Lower VAS at 1 year after discharge was found than that before the injection [(2.2 ± 1.8) vs (7.9 ± 1.3) on average; (1.5 ± 0.8) vs (6.5 ± 1.7) at least; (3.2 ± 1.6) vs (9.2 ± 1.1) at worst ] and that after the injection [(3.5 ± 1.5) vs (2.2 ± 1.8) on average; (1.5 ± 0.8) vs (2.1 ± 0.9) at least and (3.2 ± 1.6) vs (4.5 ± 1.4) at worst, P<0.05]. The pain relief rate after the injection was (68 ± 23)%. The pain relief rate at 1 year after discharge (81 ± 22)% was higher than that at discharge (68 ± 23)% (P<0.05). The quality of life evaluation index scale after the injection (daily life, diet, general activities, sleep, work and social activities) was significantly improved than that before the injection [(10.1 ± 2.2) vs (14.2 ± 1.9), P<0.05]. The quality of life evaluation index scale at 1 year after discharge was significantly improved than that before the injection [(7.0 ± 2.1) vs (14.2 ± 1.9)] and that after the injection [(7.0 ± 2.1) vs (10.1 ± 2.2), P<0.05]. No complication was observed when the patients were discharged and 1 year after discharge. CONCLUSION Paravertebral adriamycin injection under CT guidance for intractable PHN can effectively relieve the patient's pain, improve the quality of sleep and life without obvious complications. It is safe and effective for intractable PHN.
Doxorubicin ; administration & dosage ; therapeutic use ; Humans ; Neuralgia, Postherpetic ; drug therapy ; Pain Measurement ; Quality of Life

ObjectiveTo analyze the risk factors for false negative diagnosis of obscure gastrointestinal bleeding (OGIB) by capsule endoscopy.MethodsA total of 133 OGIB inpatients,104 in true positive group and 29 in false negativc group,were reviewed.The features of demography,diseases and capsule endoscopy were collected and then analyzed,which included 10 variables like age,sex,time of bleeding,diseases accompanied,type and location of the disease,hemoglobin concentration,transit time of CE,quality of CE pictures and type of purgative agents.All data were analyzed with t test,and all the enumeration data were analyzed with chi square test.Logistic regression was used to analyze the correlation between the factors and results of diagnosis.ResultsAge ( t =2.095,P =0.038 ),concentration of hemoglobin ( t =2.143,P=0.034),type (X2 =20.222,P ＜0.001) and location (X2 =33.732,P ＜0.001) of the diseases,image quality of the CE (X2 =9.219,P =0.002 ) and the type of purgative agents (X2 =6.999,P =0.024) were found to have statistical differences between the two groups.Chi-square and partition Chi-square test revealed the occurrence of civerticulosis and lesion location,i.e.lower ileum and ileumcecum,were of statistical difference between the two groups (X2 =22.233,P ＜ 0.001 and x2 =24.412,P ＜ 0.001 ).Univariate logistic regression showed diverticulosis ( OR =0.102,P ＜0.001 ),lower bowel diseases ( OR =0.110,P ＜0.001 ),poor quality of CE pictures ( OR =0.258,P =0.004 ) and the use of sodium phosphate agent ( OR =0.367,P =0.027) were risk factors for false negative diagnosis,while older age facilitated diagnosis ( OR =1.024,P =0.041 ).However,multivariate logistic regression showed no statistic significance in type of purgative agent ( P =0.05 ) or the concentration of hemoglobin ( P =0.394).Furthermore,elder age facilitated positive diagnosis ( OR =1.031,P =0.032),while diverticulosis ( OR =0.118,P =0.001 ),lower bowel diseases ( OR =0.145,P =0.001 ) and poor quality of CE pictures ( OR =0.245,P =0.016) were correlated with higher probability of false negative diagnosis.ConclusionAge,disease type,disease location and image quality exert great influence on CE diagnosis.Diverticulosis,lower location of the diseases and poor CE image quality are risk factors for false negative diagnosis.

Psychological research results confirmed that the negative impact of shame on self often causes psychological diseases, and shame does not always related to ethical value. People with serious sense of shame will lead to negative evaluation and overall negation to themselves, and the sense of shame accompanied by great pain will cause great harm to individuals. To realize the sublimation of shame, the ethical orientation of its self cognitive schema and evaluation method must be changed, from the orientation of "transforming self and reaching perfection" to the position of "caring for self and accepting imperfect self" . To tap the positive value of shame, individuals must avoid hurting themselves and then care for themselves. "The principle of not harming life" and "do not denying people’s ethical subject status" are the bottom line of the ethical value of shame.