Objective To observe the effect and adverse reaction of fentanyl ransdermal system on the cancer pain resulted from lung cancer metastasizing to bone.Methods Thirty -two patients with moderate to severe cancer pain of bone metastasis from lung cancer were treated with fentanyl transdermal system.Analgesic effect was observed.The quality of life and adverse reactions were evaluated.Results The PI evaluation were (7.62 ± 1.35)and (1.93 ±2.41)before /after treated with fentanyl ransdermal system.The differences of bone pain between before and after treated were significant(t =3.983,P <0.01).Among the thirty -two patients with moderate to severe cancer pain used by fentanyl transdermal system,complete relief was in 12 cases(37.5%),apparent relief was in 11 cases(34.3%),moderate relief was in 7 cases(21.8%),mild relief was in 2 cases(6.3%),the total relief rate was 93.7%.The adverse reactions included hypersomnia were in 13 cases,dizziness in 11 cases,nausea and vomiting in 6 cases,constipation in 5 cases,pruritus and erythra in 4 cases,dysuria in 2 cases.All above adverse reactions dis-appeared after stopping fentanyl ransdermal system and /or undergoing symptomatic treatment.Conclusion Fentanyl transdermal system is easy to use,the effect is significant,there is few adverse reactions,which can significantly improve quality of life of cancer patients.

BACKGROUND:N-methyl-D-aspartate receptor is an ionic glutamate receptor which is closely related with the neural synaptic plasticity, and also can regulate neural synaptic plasticity. OBJECTIVE:To explore the mechanism by which N-methyl-D-aspartate receptor subunits NR2A and NR2B regulate neural synaptic plasticity after cerebral ischemia. METHODS: 60 Wister rats were randomly and evenly divided into a sham-operated group and a cerebral ischemia group. Rat models of chronic cerebral ischemia were established using the modified bilateral common carotid artery occlusion method in the cerebral ischemia group, while rats in the sham-operated group did not undergo occlusion of the common carotid artery and vagus nerve. RESULTS AND CONCLUSION:At 0-12 hours after chronic cerebral ischemia, NR2A expression in the rat hippocampus was gradualy decreased, while the expression of NR2B reached its peak level at 4 hours after cerebral ischemia. Under the circumstance of cerebral ischemia, neither low frequency nor high frequency induced long-term potentiation. These findings suggest that NR2B exhibit inhibitory effect, while NR2A exhibit promoting effect on long-term potentiation induced by stimulation.

Objective To explore the teaching effects of Lecture Based Learning (LBL) incorporated with Case Based Learning (CBL) and Problem Based Learning (PBL) methods in the teach-ing of anatomy.Methods 740 students of Grades 2012 and 2013 from clinical medical major were chosen as the subjects,randomly divided into experimental and control groups.LBL was conducted in the control group of 644 students,while LBL+PBL+CBL method was applied in the experimental group of 96 students.After completion of the course,all students were surveyed with the questionnaire and tested with specimen and theoretical examinations.The data was collected and analyzed with SPSS 17.0 and two sample U tests.Results The students' time of learning anatomy in the control group outside classroom teaching was (105 ± 25) minutes per week,while the students' time of learning anatomy in the experimental group was (190 ± 25) minutes per week.The difference was statistically significant (t=31.08,P=0.000).The difference of after-class total learn-ing time was also statistically significant between two groups(t=27.42,P=0.000).Percentages of satisfaction with teaching methods for control group were 87.5％ and 87％,while for the experimental group 98％ and 100％.Kruskal-Wallis test showed there were significant differences in experimental groups of grades 2012(x2=31.19,P=0.000) and 2013 (x2=40.35,P=0.000) compared with control group.Comparison of both groups' results of the examinations was statistically significant concerning multiple choices,essays and case analysis questions (P＜0.05).Conclusion Teaching method of LBL incorporated with PBL and CBL was significantly effective than that of the sole traditional LBL method,which indicated its practice value.

Objective To evaluate the efficacy and safety of recombinant human brain natriuretic peptide (rh-BNP) combined with levosimendan on acute myocardial infarction complicated by heart failure.Methods Patients who suffered from anterior wall acute myocardial infarction (AMI) with heart failure (KillipⅡ ～ Ⅲ) within 12 to 24 hours after the onset of chest pain were randomized into two groups: the control group (n=30, receiving dobutamine and/or cedilanid) and the experimental group (n=30, receiving rh-BNP combined with levosimendan).The hemodynamics, parameters of laboratory tests and adverse events were observed before and after treatment.Results The experimental group showed that the respiratory rate (RR), heart rate (HR), systolic blood pressure (SBP), arterial blood gas oxygen saturation (SaO2), cardiac index (CI), extravascular lung water index (EVLWI) were significantly different between 2 h and sequential time points after treatment and pre-treatment (allP＜0.05).The control group showed that RR, HR, SaO2, CI, EVLWI were significantly different between 6 h and sequential time points after treatment and pre-treatment (P＜0.05 for all).There were significant differences in RR, HR, SBP, SaO2, CI, EVLWI at 2 h and 6 h after treatment between the two groups (P＜0.05 for all).Parameters of RR, HR, CI, EVLWI at 72 h after treatment had differences between the experimental group and controls.Patients in the experimental group presented larger urine volume, lower level of plasma NT-pro BNP, higher left ventricular ejection fraction (LVEF) and shorter length of stay in CCU as compared with patients in the control group (P＜0.05 for all).In adverse events monitoring in hepatic parameters, electrolyte level and coagulation function before and after treatment, there was no significant difference between the two groups.Conclusions Compared with the conventional treatment, the combination therapy with rh-BNP and levosimendon can improve the hemodynamics, increase the urine volume, decrease the level of plasma NT-proBNP and elevate LVEF significantly, so as to improve the clinical symptoms and shorten the hospital stay in patients with acute myocardial infarction complicated by heart failure.

OBJECTIVE: To study the influence caused by the different intervention opportunity and frequencies in treatment chronic sinusitis after endoscopic sinus surgery. METHOD: Eighty patients with chronic sinusitis and nasal polyps were divided into group A and group B randomly. First postoperative management of functional endoscopic sinus surgery was taken in one week after operation, a week one time at first and second month, two weeks one time at third and fourth month, one month one time after fifth month, in group A. First postoperative management of functional endoscopic sinus surgery was taken in two weeks after operation, two weeks one time at first and second month, one month one time from third month to fifth month, two month one time after sixth month, in group B. The nasal middle meatus mucociliary transport rate (MTR) was measured by saccharin method at third month, sixth month and twelfth month, the rate of epithelialization was measured at third months and the efficiency rate was measured at twelfth months after operation. RESULT: All results were no significant difference. CONCLUSION Appropriate extended postoperative management time and decrease intervention frequencies were not influence the therapeutic effect of endoscopic surgery for chronic sinusitis and/or nasal polyps.
Adolescent ; Adult ; Aged ; Chronic Disease ; Endoscopy ; methods ; Female ; Humans ; Male ; Middle Aged ; Nasal Polyps ; surgery ; Nitric Oxide Synthase Type II ; metabolism ; Otorhinolaryngologic Surgical Procedures ; Postoperative Period ; Sinusitis ; surgery ; Time Factors ; Young Adult