Objective To compare the effects of oxycodone hydrochloride injection versus sufentanil for postoperative analgesia in patients undergoing laparoscopic cholecystectomy (LC) operation. Methods Sixty patients of both sexes , aged 18-65 yr , weighing 46-85 kg , scheduled for LC operation , were randomly divided into 2 groups (n = 30). Patient-controlled intravenous analgesia (PCIA) pump (oxycodone hydrochloride injection 20 mg or sufentanil 100 μg with physiological saline to 100 ml ) was used for postoperative analgesia five minutes before the end of operation. The first dose and bolus dose were both 5 ml , background infusion was 2 ml/h,lockout interval was 5 minute. The NRS score of rest and during movement at 1 ,6 and 24 h after operation,total oxycodone or sufentanil consumption in 24 h, requirement for rescue analgesic, the level of patient′s satisfaction , the adverse events were recorded. Results There was no significant difference in the NRS scores at rest and during movement , total oxycodone or sufentanil consumption in 24 h and postoperative nausea and vomiting (PONV) between the two groups. The patient’s satisfaction were significantly higher (P < 0.05), and the incidence of dizziness were significantly lower (P = 0.026) in group Q than in group S. Both groups were no requirement for rescue analgesic , no sleepiness , no itch , no retention of urine and other adverse reaction. Conclusion PCIA with oxycodone hydrochloride injection is safe and effective in reducing pain after LC operation, however the incidence of dizziness is lower and the level of patient’s satisfaction is higher with oxycodone hydrochloride than with sufentanil.

BACKGROUND: Benign prostatic hyperplasia is a common disease of older males. Although the etiology remains unclear, the factors of life style and habits may have an effect on the disease.OBJECTIVE:To examine the association of cigarette smoking and body mass index with the risk of clinical benign prostatic hyperplasia.DESIGN: A hospital-based case-control study SETTINGS:Department of Epidemiology and Statistics, Public Health School,Tongji Medical College, Huazhong University of Science and Technology; Department of Preventive Medicine, Liaoning Medical College.PARTICIPANTS：Totally 343 males with benign prostatic hyperplasia of 50-82 years old (patient group),who were surgically treated between May 2004 and May 2006,were selected from the Department of Urinary Surgery of the First Affiliated Hospital and Third Affiliated Hospital of Liaoning Medical College (former Jinzhou Railway Central Hospital),Jinzhou Central Hospital and Jinzhou Second People's Hospital．Inclusive criteria：① males above 50 years old；intemational prostatic symptom score(IPSS)＞7；②Digital recta examination (DRE) after miction indicated prostate grade Ⅰ(transverse diameter＞3 cm); ③prostatic volume≥30 g;④maximum unnary flow rate＜15 mL／s；Meanwhile，361 inpatients with diseases irrelative to the risk factors of benign prostatic hyperplasia,prostatic cancer and prostatitis were selected trom the above hospitals as the control group,they were 50-82 years of age with an average of 65 years old．Informed contents were obtained from all the enrolled subjects．METHODS：All the patients and controls were interviewed using an anonymous questionnaire．All participants were asked to report whether they had smoked 20 packs of cigarettes or more in their lifetimes and,if yes,they were smokers,on the contrary they were non-smokers．Based on usual number of cigarettes reported in the questionnaire, men were categorized as 1-10，11-20，21-30 and ＞30 cigarettes per day．Based on duration of smoking,the participants were funher classified as never smoke，1-19,20-29 and ≥30 years．Body mass index(BMI)was assessed from measured body mass and body height，and che standards of BMI in adults in China was 18．5-23．9 for normal,24．0-27．9 for overweight and ≥28．0 for obesity)，then the participants were further classified as BMI＜18．4，18．5-23．9,24．0-27．9 and ≥28．0 subgroups respectively．Years of education(＜7,7-11,and≥12) and occupation(worker,peasant, Intellectual and others) were also investigated．The results of the investigation were input into computer to establish database，the odds ratios (OR) and the 95％ confidence interval(CI)in relation to the various measures were estimated using unconditional multiple logistic regression models, including number of cigarettes smoked per day，BMI,years smoked，years of education,occupation．MAIN OUTCOME MEASURES：Relationships of number of cigarettes smoked per day,years smoked．BMI,years of education and occupation with benign prostatic hyperplasia．RESULTS：Totally 343 cases in the patient group and 361 cases in the control group were involved in the analysis of results．①Patients smoked≥30 cigarettes per day had an elevated risk of benign prostatic hypertrophy as compared with the non-smokers(OR=1．32，95％ CI:0．92-2．58，P＜0．01)．②The risks of benign prostatic hypertrophy in overweight and obesity were significantly increased as compared with non-smokers(OR=1.68,95％ CI: 1．32-3．67；OR=2．35，95％CI:1．83-4．16)，③Manual worker (peasant) was negatively correlated with the risk of benign prostatic hyperplasia (χ2=6．62，P＜0．01)．CONCLUSION:Smoking 30 cigarettes per day was positively related to benign prostatic hyperplasia.For male who were both overweight(BMI 24.0-27.9)and obesity(BMI≥28.0)，smoking was significantly associated the increased risk of surgically treated benign prostatic hyperplasia.

Objectives To research clinical effects of severe brain injury patients treated by acupuncture and herb combine mild hypothermia,discuss the new approach of severe brain injury patients treatment combine Chinese traditional and Western medicine.Methods Investigated 68 severe traumatic brain injured patients,randomly divided into three groups,acupuncture and herb combine mild hypothermia group (n =22),mild hypothermia group (n =24) and normal temperature routine treatment group (n =22).Dynamic intracranial pressure,brain damage index (cytoskeletal protein),immunologic function (IL-6,β2 microglobulin),combine rate of complications (including irritable ulcer,lung infection,epilepsy,sugar metabolism disorder,and so on),and long-term GOS score were analyzed.SPSS12.0 software was used for statistical processing,and the standard deviation of the measurement data were expressed as the standard deviation.The counting data were expressed as apercentage,and the chi-square test was used for the comparison between group.Results There were significant differences between three groups of intracranial pressure,immunologic function,complication occurring rate (P ＜0.05),but there had no significant difference between acupuncture and herb combine mild hypothermia group and mild hypothermia group of brain damage index and GOS,and there have significant difference between these two groups and normal temperature routine treatment group.Conclusions Acupuncture and herb combined mild hypothermia might be better in reducing intracranial pressure,the incidence of complication,and improving immune function of severe brain injury,than mild hypothermia group and normal temperature routine treatment group.

Objective:To investigate the effect of cranioplasty with polyetheretherketone (PEEK) after craniectomy in patients with traumatic brain injury (TBI).Methods:A retrospective case series study was used to analyze the clinical data of 85 TBI patients undergone craniectomy admitted to Renji Hospital, Shanghai Jiaotong University School of Medicine from February 2017 to April 2021, including 57 males and 28 females, aged 7-70 years [(40.8±15.5)years]. Patients′ Glasgow Coma Scale (GCS) was 6-15 points [15 (13, 15)points]. All patients underwent PEEK cranioplasty as scheduled. The extended Glasgow Outcome Scale (GOSE) was used to evaluate the neurological function before, at 3 and 6 months after operation. After excluding 33 patients with preoperative GOSE score of 8 points, 52 patients with preoperative GOSE score less than 8 points were analyzed on the degree of GOSE improvement. Patients′ satisfaction with PEEK repair was evaluated through telephone interviews at 6 months postoperatively. The incidence of complications were observed during hospitalization and within 6 months postoperatively.Results:All patients were followed up for 6-7 months [6 (6, 7)months]. The GOSE was 6 (5, 8)points before operation, 6 (5, 8)points at 3 months after operation, and 7 (5, 8)points at 6 months after operation. There was no significant difference in GOSE at 3 months after operation and before operation ( P>0.05), but it was significantly increased at 6 months after operation when compared to the preoperative level ( P<0.05). With regards to GOSE, there were 10 patients with mild amelioration but 42 with no amelioration at 3 months after operation, while 4 patients with significant amelioration and 31 with no amelioration were observed at 6 months after operation ( P<0.05). For PEEK repair, Patients′ satisfaction was very high in 43 patients, high in 33, general in 7 and poor in 2. A total of 25 patients had postoperative complications during hospitalization and within 6 months postoperatively, with the incidence of complications of 29%. Specifically, there was 1 patient with wound infection, 1 new epilepsy, 8 epidural hemorrhage, 13 subcutaneous effusion, 1 subcutaneous effusion, severe infection and material exposure, and 1 severe infection, new-onset epilepsy and subcutaneous effusion. Repair materials were removed in 2 patients due to multiple complications; other patients obtained alleviation via treatment, without affect on their daily life. Conclusion:PEEK cranioplasty following craniectomy for TBI patients can improve prognosis, attain high satisfaction and has low incidences of postoperative infection and exposure of repair materials.

AIM:To study the expression of signal transduction molecules in the striatum G protein protein 4 (RGS4) and dopamine D2 receptor (D2) in conditioned place preference (CPP) rats treated with methamphetamine (meth).METHODS:METH dependence CPP model was established (1 week and 2 weeks of METH dependence groups),The protein expression of RGS4 and D2,inhibitory G protein alpha-subunit (Gαi),mitogenactivated protein kinase (MAPK) in striatum were determined by Western blotting (WB).The changes of cyclic adenosine monophosphate (cAMP) content in striatum of rats were determined by enzyme linked immunosorbent assay (ELISA).RESULTS:Compared with saline control group,the average time of rats in the methamphetamine-paired chamber for two groups was increased (P ＜ 0.05).Compared with saline control group,RGS4 protein expressions in the two METH dependent groups were reduced (P ＜0.01);compared with 1 week of METH dependence group,that of 2 weeks group was reduced significantly(P ＜ 0.05).D2,Gαi,MAPK protein and cAMP expressions in the two METH dependent groups were increased (P ＜ 0.01);compared with 1 week of METH dependence group,those of 2 weeks were increased significantly (P ＜ 0.05).CONCLUSION:RGS4 and D2 receptor signaling pathways in striatum have changed in METH dependent rats,RGS4 may be involved in the regulation of METH-dependent D2 receptor signaling pathway in METH dependent rats.

OBJECTIVE To prepare Leonurine hydrochloride tablets and evaluate the quality. METHODS The wet granulation technology was adopted ；leonurine hydrochloride was used as the crude drug ，and the types of fillers ，disintegrants，binders and lubricants were screened by single-factor experiments. Combined with orthogonal experiments ，using the cumulative dissolution rate within 15 minutes（using water as dissolution media ）as index ，the proportion of disintegrants ，the mass fraction of binder solution，and the proportion of lubricants were screened and verified. The in vitro dissolution behavior of the prepared Leonurine hydrochloride tablets （dissolution media were hydrochloric acid solution of pH 1.2，acetic acid-sodium acetate solution of pH 4.5， phosphate buffer solution of pH 6.8，water），tablet appearance ，hardness，friability and content uniformity were tested according to the general principles in 2020 edition of Chinese Pharmacopoeia （part Ⅳ）. RESULTS The optimal formulation of Leonurine hydrochloride tablets included leonurine hydrochloride crude drug of 500 mg，dextrin of 9 250 mg，crosslinking polyving y- pyrrolidone of 200 mg，magnesium stearate of 50 mg，1％ hydroxypropyl methyl cellulose solution of 4 mL. The average 15-minute cumulative dissolution rate of the three batches of tablets was 81.25％（RSD＝1.12％，n＝3）. In above 4 dissolution media，the dissolution equilibrium of prepared tablets could be reached within 30 minutes，and the cumulative dissolution rates exceeded 85％. The prepared tablets had uniform beige in color ，smooth surface ，complete edge ，no mottle ，spot，foreign matter ， etc.，hardness of 57.3 N（n＝6），weight loss rate of 0.15％. The content uniformity was in accordance with relevant provisions in 2020 edition of Chinese Pharmacopoeia （part Ⅳ）. CONCLUSIONS Leonurine hydrochloride tablets are successfully prepared ， and the quality comply with relevant regulations.

Traumatic cerebrospinal fluid leakage commonly presents in traumatic brain injury patients, and it may lead to complications such as meningitis, ventriculitis, brain abscess, subdural hematoma or tension pneumocephalus. When misdiagnosed or inappropriately treated, traumatic cerebrospinal fluid leakage may result in severe complications and may be life-threatening. Some traumatic cerebrospinal fluid leakage has concealed manifestations and is prone to misdiagnosis. Due to different sites and mechanisms of trauma and degree of cerebrospinal fluid leak, treatments for traumatic cerebrospinal fluid leakage varies greatly. Hence, the Craniocerebral Trauma Professional Group of Neurosurgery Branch of Chinese Medical Association and the Neurological Injury Professional Group of Trauma Branch of Chinese Medical Association organized relevant experts to formulate the " Chinese expert consensus on the diagnosis and treatment of traumatic cerebrospinal fluid leakage in adults ( version 2023)" based on existing clinical evidence and experience. The consensus consisted of 16 recommendations, covering the leakage diagnosis, localization, treatments, and intracranial infection prevention, so as to standardize the diagnosis and treatment of traumatic cerebrospinal fluid leakage and improve the overall prognosis of the patients.

Humans ; Melanoma ; Metaplasia ; Mucous Membrane ; Nasopharynx

The condition of patients with severe traumatic brain injury (sTBI) complicated by corona virus 2019 disease (COVID-19) is complex. sTBI can significantly increase the probability of COVID-19 developing into severe or critical stage, while COVID-19 can also increase the surgical risk of sTBI and the severity of postoperative lung lesions. There are many contradictions in the treatment process, which brings difficulties to the clinical treatment of such patients. Up to now, there are few clinical studies and therapeutic norms relevant to sTBI complicated by COVID-19. In order to standardize the clinical treatment of such patients, Critical Care Medicine Branch of China International Exchange and Promotive Association for Medical and Healthcare and Editorial Board of Chinese Journal of Trauma organized relevant experts to formulate the Chinese expert consensus on clinical treatment of adult patients with severe traumatic brain injury complicated by corona virus infection 2019 ( version 2023) based on the joint prevention and control mechanism scheme of the State Council and domestic and foreign literatures on sTBI and COVID-19 in the past 3 years of the international epidemic. Fifteen recommendations focused on emergency treatment, emergency surgery and comprehensive management were put forward to provide a guidance for the diagnosis and treatment of sTBI complicated by COVID-19.