Objective To investigate the effects of different analgesia protocols on immune function in patients undergoing surgery for ovarian neoplasms after neoadjuvant chemotherapy.Methods Forty ovarian neoplasms patients ageing from 31 to 62 years undergoing neoadjuvant chemotherapy were randomly divided into 2groups:epidural analgesia group (group E,n =20) and intravenous analgesia group (group Ⅰ,n =20).All patients underwent surgery under total intravenous general anesthesia.Patients in group E were given 2 mg morphine in epidural space at half an hour before abdomen was closed,then epidural analgesia pump was installed,with ropivacaine composite morphine in the pump.Analgesia time was 48 h.Patients in group Ⅰ were given sufentanil 0.1 μg/kg intravenously at half an hour before abdomen was closed,then analgesia pump was installed,with sufentanil compound flurbiprofen ester in the pump.Analgesia time was 48 h.The cervical venous blood samples were obtained from the patients at 30 min before surgery(T0),immediately(T1),12 h(T2),24 h(T3) and 48 h (T4) after the end of operation for determination of the expression of CD3 +,CD4 +,CD8 + on T cells and natural killer cell.Visual analogue scales (VAS)and adverse reaction at T2-4 were recorded.Results No statistical difference was found between group E and group Ⅰ in VAS and adverse reaction.Compared with T0,CD3 +,CD4 + T-lymphocytes,CD4 +/CD8 +,and NK cell decreased.Compared with group E,CD8 + increased at T1-2in both groups and at T3-4 in group Ⅰ.CD3 +,CD4+ T-lymphocytes,CD4+/CD8 + and NK cell decreased while CD8 + increased at T2-4 in group Ⅰ.Conclusion Epidural analgesia may be better to promote the immunologic function of ovarian neoplasms patients undergoing surgery after neoadjuvant chemotherapy.

Adult ; Amides ; adverse effects ; Benzene ; adverse effects ; Burns, Chemical ; pathology ; therapy ; Female ; Humans ; Male ; Middle Aged ; Nitro Compounds ; adverse effects ; Young Adult

Based on the structure and function of acupoint and in association of the definition and principle of sensor, the acupoint is the sensitive element, being sensitive to the physical stimulation with acupuncture and moxibustion and sensitively responded to the disorders; the acupoint is the sensing element, transforming the changes of the acupoint information via the complicated internet conduction, integration and regulation, so as to generate the effects on organic body; the acupoint is the conversion element, transforming every irritation into the bioelectric signal or optical signal so that the organic body could recognize it. Therefore, the acupoint is regarded as the sensor of information in the organic body.
Acupuncture Points ; Electrophysiological Phenomena ; Humans ; Meridians

With low molecular weight chitosan and poloxamer 188 as the joint carriers, ginsenoside Rg3 solid dispersions were prepared by using the solvent evaporation method for an in vitro dissolution test. Subsequently, differential scanning calorimetry (DSC), scanning electron microscopy (SEM) and X-ray diffraction (X-RD) were adopted for a phase analysis. The results showed that the 60 min in vitro cumulative dissolution rate of ginsenoside Rg3 solid dispersions prepared with low molecular weight chitosan and poloxamer 188 at the ratio of 2:1 exceeded 90%, and the drug was dispersed in carriers in an amorphous state. Therefore, ginsenoside Rg3 solid dispersions prepared with low molecular weight chitosan and poloxamer 188 could help significantly improve the drug dissolution, with a practical application value.
Chitosan ; chemistry ; Drug Compounding ; methods ; Ginsenosides ; chemistry ; Molecular Weight ; Poloxamer ; chemistry ; Solvents ; chemistry

To prepare ginseng saponin Compound K with ultrasound-assisted total zymolytic ginseng saponins. The conversion rate was taken as the index to detect the pre-treatment factors such as ultrasonic power and ultrasonic time, as well as the impact of enzymatic factors, such as pH value, temperature, concentration of substrate, dosage of enzyme and reaction time, on the conversion rate. The response surface method was used to optimize the preparation conditions. The enzymolytic products were identified with MS, 1H-NMR and 13C-NMR. The results showed that the optimum conditions of the ultrasound-assisted enzymolysis were 250 W for ultrasonic power, 15 min for ultrasonic time, 5.5 for enzymolytic pH, 50 degrees C for enzymolytic temperature, 36 h for enzymolytic time, 4:5 for enzymolytic dosage: substrate and 1.0 g x L(-1) for concentration of substrate. The relative molecular mass of reaction products was 622.4. Therefore, the nuclear magnetic map verified that the reaction product was rare ginseng saponin Compound K. Under the above conditions, based on the total zymolytic ginseng saponins, the conversion rate of rare ginseng saponin Compound K was 6.91% in proportion to the total of ginsenosides. The process features gentle reaction conditions, high conversion rate and simple and reliable process, which is suitable for industrial production.
Chemistry, Pharmaceutical ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Enzymes ; chemistry ; Panax ; chemistry ; Plant Roots ; chemistry ; Saponins ; chemistry ; isolation & purification ; Ultrasonics ; methods

A novel drug delivery system combining oral fast dissolving film with sodium deoxycholate/phospholipid mixed micelles was prepared to increase the absorption of cucurbitacin B that is a poor aqueous solubility substance. Encapsulation efficiency, particle size, zeta potential, polydispersity coefficient, investigated the morphology, disintegration time of oral fast dissolving film and the pharmacodynamic properties of cucurbitacin B sodium deoxycholate/phospholipid-mixed micelles before and after solidified in mice were evaluated and compared. The oral fast dissolving film prepared in this study showed a homogeneous pale yellow and could completely disintegrated in the 30 s. It could meet the requirements of rapidly disintegrating fully. The encapsulation efficiency, particle size, zeta potential, polydispersity coefficient of cucurbitacin B sodium deoxycholate/phospholipid-mixed micelles loaded in oral fast dissolving film were (43.36 +/- 2.12)%, (108.82 +/- 5.2) nm, (-34.18 +/- 1.07) mV, 0.088 +/- 0.012, respectively. The encapsulation efficiency, particle size, zeta potential, polydispersity coefficient of cucurbitacin B sodium deoxycholate/phospholipid-mixed micelles in solution were (41.26 +/- 2.22)%, (181.82 +/- 4.48) nm, (-30.67 +/- 0.81) mV, 0.092 +/- 0.012, respectively. The difference of pharmacodynamics among film of cucurbitacin B-loaded micelles, cucurbitacin B-loaded micelles and free cucurbitacin B in vivo was compared. Solubility of cucurbitacin B loaded in sodium deoxycholate/phospholipid-mixed micelles has also been greatly improved. The tumor inhibition rate of cucurbitacin B loaded in sodium deoxycholate/phospholipid-mixed micelles was significantly improved and did not change significantly before and after solidified. These showed that the sodium deoxycholate/phospholipid-mixed micelles could enhance the antitumor activities of cucurbitacin B and the stability of cucurbitacin B sodium deoxycholate/phospholipid-mixed micelles was improved significantly after solidified by oral fast dissolving film technology without pharmacodynamic properties changed significantly.
Animals ; Antineoplastic Agents ; administration & dosage ; chemistry ; Cell Line, Tumor ; Deoxycholic Acid ; chemistry ; Drug Carriers ; chemistry ; Humans ; Male ; Mice ; Neoplasms ; drug therapy ; Phospholipids ; chemistry ; Solubility ; Triterpenes ; administration & dosage ; chemistry

OBJECTIVETo explore the methods and therapeutic effects of trans-fibular anterior-lateral approach combined with external fixation in the treatment of Gustilo III distal tibiofibula fractures.

METHODSFrom 2007 to 2010,9 patients including 7 males and 2 females with the mean age of 40 years(ranging from 29 to 51 years). All patients received internal fixation of fibula after debridement on the first phase, external fixator were used to fix tibia across ankle joint, and removed after successful skin graft; The second phase tibia was used to fix through the lateral incision used in phase I. Early functional exercise was encouraged ,the union condition and functional results of the ankle joint was evealuated. The criteria of the AOFAS Foot and Ankle Surgery was used to evaluate the effects.

RESULTSAll patients were followed up,and the duration ranged for 8 to 37 months(averaged 21 months). Nine patients were achieved bony union, the average healing time was 24 weeks. No plate rupture or screw loosening was found. According to the AOFAS Foot and Ankle Surgery evaluation system, 3 cases got excellent results, 4 good cases and 2 fair.

CONCLUSIONTrans-fibular anterior-lateral approach combined with external fixation for Gustilo III distal tibiofibula fractures can receive satisfactory reset, debond ankle joint eralier and imporove the clinical effects.

Adult ; Female ; Fibula ; Fracture Fixation ; methods ; Fractures, Bone ; diagnostic imaging ; surgery ; Humans ; Male ; Middle Aged ; Radiography ; Tibia ; Treatment Outcome

Objective To evaluate the diagnostic value of CT and PET-CT characteristics in predicting the presence of epidermal growth factor receptor(EGFR) gene mutations in lung adenocarcinomas. Methods One hundred and sixty-eight lung adenocarcinomas cases confirmed by pathology were enrolled in our study. They were divided into EGFR gene mutations group (89 cases) and wild types group (79cases) according to whether EGFR gene mutation occurred. All patients underwent CT examination. Seventy-five patients underwent PET-CT examination, including 37 gene mutationsand 38 wild types.The demographic (the patients' age, the gender and smoking history), CT characteristics(lobulation, cavitation, spiculation, pleural-indentation, air-bronchogram, ground glass opacity/tumor ratio(G/T) and the maximum diameter of tumor(Dmax)) and PET-CT characteristics(the maximum standardized uptake value, (SUVmax))between these two groups were retrospectively compared. The independent sample t test was used to analyze the
difference between these two groups regarding the patients' age,Dmax,SUVmax. The χ2 test was used to demonstrate the difference between these two groups regarding the gender, smoking history and CT features including lobulation, cavitation, spiculation, pleural-indentation, air-bronchogram and G/T.The trend analysis between SUVmax and EGFR gene mutations was performed by usingχ2 test for trend.Results No significant difference was found regarding partial CT characteristics of lesions including lobulation, cavitation, spiculation, pleural-indentation, air-bronchogram (P>0.05),however, the Dmax of EGFR gene mutations group and wild types group were(2.53±1.39),(3.00±1.77)cm, respectively. The amount of G/T>50%in EGFR gene mutations group and wild types group was 21 and 5, respectively. Significant differences were found regarding the G/T and Dmax(χ2=9.538, P<0.05;t=1.974,P<0.05). The SUVmax in EGFR gene mutations group (37 cases) and wild types group (38 cases) were 5.13 ± 4.35 and 9.64 ± 5.12, respectively. Significant difference was found regarding SUVmax(t=4.104, P<0.05). The sensitivity and specificity in predicting EGFR gene mutations were 24%and 93%, respectively, using G/T>50%as diagnostic criterion. Receiver operating characteristic (ROC) results indicated Dmax=1.85 cm was the optimal value in predicting EGFR gene mutations, with the sensitivity and specificity of 76% and 42%, respectively. Meanwhile, SUVmax=6.85 was the optimal value, with the sensitivity and specificity of 71% and 73%, respectively. Moreover,χ2 test for trend showed that an obvious trend was found to associate SUVmax with the incidence of EGFR gene mutations (χ2=15.755, P<0.05). Conclusion SUVmax may be helpful in predicting EGFR gene mutations in lung adenocarcinomas with relatively high diagnostic value.

·AIM:To present a case of late onset bilateral keratectasis after laser in situ keratomileusis (LASIK) for myopia with rigid gas-permeable contact lenses with a brief review of literature on this subject.·METHODS:A 27-year-old woman underwent bilateral uneventful LASIK for moderate myopia. Preoperative cycloplegic refractions were -5.50/-0.50×50° right eye (OD) and - 4.50/-1.00×15° left eye (OS).Corneal pachymetry was 526μm OD and 541μm OS, Preoperative corneal topography was normal and did not reveal any keratoconus or forme fruste keratoconus.Following the creation of flaps with 160μm plates,ablations of 102μm OD and 86μm OS were performed,estimated to leave residual stromal beds of 264μm OD and 295μm OS.·RESULTS:Twenty-nine months postoperatively,the patient developed bilateral inferior keratectasia of -12.50/-4.00×160° OD and -6.00/- 4.25×125° OS.Visual acuity was reduced in both eyes;the central cornea had steepened; and pachymetry showed central corneal thinning.Keratectasia was diagnosed,and rigid contact lenses were fitted.Three years later,the patient achieved satisfactory visual acuity and all-day lens wear with minimal complications.·CONCLUSION:Late keratectasia may follow LASIK for low to moderate myopia despite a thorough preoperative work-up.Rigid contact lenses can offer a safe,reversible option for improving visual acuity in such patients by delaying or avoiding the need for intracorneal ring segments implanting or penetrating keratoplasty.

Objective:To explore clinical and histopathological characteristics of primary biliary cirrho-sis-autoimmune hepatitis overlap syndrome.Methods:Clinical data and pathological findings of 10 pa-tients were reviewed.Results:Serum glutamine transpeptidase,alkaline phosphatase levels,alaninetransaminase,aspartate transaminase,serum IgG and IgM were elevated in all the patients.They were allpositive for anti-mitochondrial antibody and AMA-M2.Nine patients were positive for anti-nuclear anti-body and one patient was positive for anti liver-kidney microsome antibody.Liver biopsies in these pa-tients revealed:ten patients had bile duct lesion,hepatitis activities ranged from moderate to severe,andfibrosis ranged from S1 to S3.Conclusion:PBC-AIH overlap syndrome is mostly found in middle-agedwomen.It has the clinical and histopathological characteristics of both PBC and AIH.Accurate andprompt diagnosis of overlap syndrome patients should be based on the clinical presentation,biochemicaland immune indexes,and hepalic pathological changes.