Objective To investigate the efficacy of continuous fascia iliaca compartment block withdifferent concentrations of ropivacaine for postoperative analgesia in patients undergoing total hip arthroplasty.Methods One hundred and sixty ASA physical status Ⅰ or Ⅲ patients,aged 52-84 yr,body mass index 18-26 kg/m2,scheduled for total hip arthroplasty,were randomly divided into 4 groups (n =40 each) using a random number table:0.20％ ropivacaine group (group A),0.25％ ropivacaine group (group B),0.30％ ropivacaine group (group C) and 0.35％ ropivacaine group (group D).A catheter was inserted into the fascia iliaca compartment on the affected side within 30 min after operation.The corresponding concentrations of ropivacaine 20 ml were given in each group.The catheter was then connected to a patient-controlled analgesia pump programmed to deliver 10 ml with a lockout interval of 60 rin for postoperative analgesia (72 h).When VAS score at rest≥4,parecoxib sodium 40 mg was injected intravenously.At 12,24,48 and 72 h of blockade,the passive and active exercise VAS scores were recorded.The consumption of ropivacaine within 72 h after the end of blockade,and requirement for parecoxib sodium and development of adverse reactions during blockade were recorded.Results Compared with group A,the passive and active exercise VAS scores were significantly decreased in C and D groups (P ＜ 0.05),and no significant change was found in group B (P ＞ 0.05),and the consumption of ropivacaine within 72 h after the end of blockade was significantly decreased in B,C and D groups (P ＜ 0.05).There was no significant difference in the passive and active exercise VAS scores between group C and group D (P ＞ 0.05).There was no significant difference in consumption of ropivacaine within 72 h after the end of blockade between B,C and D groups (P ＞ 0.05).There were no significant differences in the requirement for parecoxib sodium and incidence of vomiting among the four groups (P ＞ 0.05).Conclusion The optimum concentration of ropivacaine is 0.30％ when used for continuous fascia iliaca compartment block in patients undergoing total hip arthroplasty.

Objective To investigate the efficacy of ultrasound-guided fascia iliaca compartment block (FICB) on postoperative analgesia in patients undergoing total hip arthroplasty.Methods Thirty-six ASA Ⅰ-Ⅲ patients aged 54-82 yr weighing 48-72 kg undergoing total hip arthroplasty were randomly divided into 2 groups (n =18 each): normal saline group(group NS)and ropivacaine group (group R).Ultrasound-guided FICB was performed within 30 min after operation.Group R received 0.25 ％ ropivacaine 30 ml,while the equal volume of normal saline was used instead of ropivacaine in group NS.All patients received PCIA with 0.01 mg/ml fentanyl after FICB.PCIA included a bolus dose of 2 ml with a 15 min lockout interval and no background infusion.Pain at rest was evaluated using VAS (RVAS) score before FICB (T0 ）and at 3 h(T1 ),6 h(T2 ),8 h(T3 ),12 h(T4 ),24 h(T5 ),48 h(T6 )and 72 h(T7 )after FICB.The passive exercise VAS (PVAS) score at T4-6,T7 and active exercise VAS (AVAS) score at T5-7 were recorded.The consumption of fentanyl at 0-12 h,12-24 h、24-48 h and 48-72 h after FICB and the adverse effects were also recorded.Results Compared with group NS,RVAS score,PVAS score,AVAS score and the consumption of fentanyl were significantly decreased in group R.There was no significant difference in the adverse effects between the two groups.Conclusion Ultrasound-guided FICB can provide better postoperative analgesia with little adverse effects in patients undergoing total hip arthroplasty.

OBJECTIVE： To study therapeutic effects of Spider toxin oral ulcer powder on recurrent aphthous ulcer （RAU） model rats and its mechanism. METHODS： In vitro antimicrobial activity of the powder was determined by disk diffusion method. 50 healthy SD rats were randomly divided into normal group， model group， positive group （Guilin watermelon frost， 100 mg/kg） and oral ulcer powder high-dose and low-dose groups （70， 35 mg/kg）， with 10 rats in each group. Except for normal group， RAU model was established in the right oral submucosa of rats in other groups by acetic acid method. After modeling， administration groups were smeared with corresponding drugs on ulcers for 3 days. Normal group and model group were not treated. The ulcer surface of rats was observed and the ulcer area was measured on the 1st and 3rd days after administration. The morphological changes of ulcer tissues were observed. The serum levels of SOD， MDA， GSH， TNF-α， IL-1， IL-6 and IFN-γ were detected. The protein expressions of MMP-9， NF-κB， Caspase-3 and PARP in ulcer tissues of rats were detected by immunohistochemistry. RESULTS： The oral ulcer powder showed obvious in vitro bacteriostasis effect. Compared with blank group， oral ulcer and histopathological changes were obvious in model group； serum levels of TNF-α， IL-1， IL-6 and MDA were increased significantly， while the levels of IFN-γ， SOD and GSH were decreased significantly （P＜0.01）； the expression of MMP-9， NF-κB， Caspase-3 and PARP in ulcer tissue were increased significantly （P＜0.05 or P＜0.01）. Compared with model group， the ulcer area of rats in each dosage group was significantly reduced （P＜0.05 or P＜0.01） or nearly healed， the pathological changes of  tissue were significantly alleviated； serum levels of MDA， TNF-α， IL-1 and IL-6 were decreased significantly， while the levels of SOD， GSH and IFN-γ were increased significantly （P＜0.05 or P＜0.01）； the expression of MMP-9， NF-κB， Caspase-3 and PARP in ulcer tissue were decreased significantly （P＜0.01）. CONCLUSIONS： Spider toxin oral ulcer powder shows strong bacteriostasis， detumescence and repair effects， and has obvious therapeutic effect on RAU model rats. Its mechanism may be related to reducing the level of inflammatory factors， mediating the expression of apoptotic factors and regulating immune imbalance.