BACKGROUND:In recent years, continuous femoral nerve block has been extensively used in total knee replacement, but there has a great dispute on the effect of analgesic mode in the clinic. OBJECTIVE:To compare the analgesic effects of continuous femoral nerve block and conventional intravenous patient-control ed analgesia in total knee arthroplasty. METHODS:A total of 50 cases treated with unilateral total knee arthroplasty in the Department of Orthopedics, Huaian First Hospital Affiliated to Nanjing Medical University from January 2014 to January 2015 were enrol ed in this study. Primary disease was osteoarthritis of the knee. They were randomly divided into two groups. Patients in the control group received intravenous patient-control ed analgesia, and those in the test group received continuous femoral nerve block analgesia. Postoperative pain Visual Analog Scale scores, adverse reactions and analgesic satisfaction score were compared between the two groups. RESULTS AND CONCLUSION:The Visual Analog Scale scores were significantly lower in the test group than in the control group at 4, 12, 24, 48 and 72 hours after surgery (P<0.05). The application rate of analgesic adjuvant drugs within 48-72 hours after surgery was significantly lower in the test group (4%) than in the control group (24%) (P<0.05). The incidence of complications was significantly lower in the test group (12%) than in the control group (48%) (P<0.05). The postoperative analgesic satisfaction rate was significantly higher in the test group (88%) than in the control group (60%) (P<0.05). Range of motion of the affected knee was significantly bigger in the test group than in the control group at 2, 3 and 4 days after replacement (P<0.05). Length of stay was significantly shorter in the test group than in the control group after surgery (P<0.05). These results suggest that multimodal continuous femoral nerve block analgesia has an ideal analgesic effect in total knee replacement. The incidence of adverse reactions is low. The analgesic satisfaction rate is high. Thus, it is an ideal analgesic method after total knee replacement.

Objective To investigate the efficacy of the clinical pathway introduced in children with Mycoplasma pneu-moniae pneumonia (MMP). Methods Based on a retrospective study, the length of hospital stay, hospital expenses and curative rate were compared between 145 MMP patients managed according to clinical pathway and other 45 MMP patients. The causes of variation were analyzed in the clinical pathway group as well. Results The length of hospital stay in clinical pathway group [9 (6~10) days] was significantly shorter than that in the control group [10 (7-12.5) days] (P=0.003). The curative rate (93.8%) was significantly higher than that in the control group (84.4%) (P=0.043). The hospital expenses [4 696.5 (3 608.3-5 677.6) CNY] was significantly higher than that in the control group [3175.3 (2490.8-4585.0) CNY] (P<0.001). The variation rate of clinical pathway was 48.3%(70/145 cases) in clinical pathway group. Conclusions The curative rate is improved and the length of hospital stay is shortened after the clinical pathway is introduced in MMP children. However, there is a high variation rate in the clinical pathway. It is necessary to optimize the clinical pathway before it is adapted in clinic.

AIM: To explore the cytokines level and the discrepancy of reaction to dexamethasone (Dex) in ALI rats induced by hydrochloric acid (HCl) and lipopolysaccharide (LPS). METHODS: Ninety-six SD rats were divided into six groups at random (n=16 in each group): NS group, HCl group, LPS group, NS+Dex group, HCl+Dex group and LPS+Dex group. Every group was divided into two subgroups: the bronchoalveolar lavage (BAL) subgroup and no bronchoalveolar lavage (NBAL) subgroup. The total leukocytes, PMN%, macrophage%, lymphocyte%, total protein in BALF and the wet/dry of the lung weight were measured. The concentrations of TNF-?, IL-1?, IL-4 and IL-10 in serum and BALF in every group were compared. RESULTS: (1) In the groups of LPS and HCl, the total leukocytes, PMN numbers, the protein concentration in the BALF and W/D were higher than those in control group (P

OBJECTIVE:To clarify the bio-transformation form of apigenin in rats,and to speculate its possible metabolic path-way. METHODS:Rats were divided into blank group and medication group(apigenin 200 mg/kg,i.g.)with 6 rats in each group. Urine and feces samples were collected from 2 groups within 24 h after medication. After corresponding treatment,urine and feces samples were analyzed and detected by HPLC-IT-TOF-MSn under cation mode and anion mode. RESULTS:9 metabolites were iden-tified in urine sample of rats from medication group,i.e. 2,3-double bond reduction of apigenin (U1,U7,U8,U9),bonded to glucuronic acid(U2,U3,U4),bonded to sulphate(U5,U6,U7,U8,U9)and bonded to glucose(U2). 4 metabolites were iden-tified in feces sample of rats from medication group,i.e. 2,3-double bond reduction of apigenin(F3),bonded to glucuronic acid (F2)and bonded to glucose(F1). CONCLUSIONS:Apigenin mainly exists in form of prototype drug in rats. The reduction hap-pens on 2,3-double bond by the intestinal bacteria,and the product of apigenin boned to glucuronic acid or glucose can be formed when excreting in intestinal tract and rats in vivo,while the product of apigenin boned to sulphate can be formed only when excret-ing in rats in vivo.

This experimental study sought to find out the inhibitory effects of Ad-GFP-nm23-H1 on proliferation and metastasis of human colorectal carcinoma cell line Lovo, and, further, to gain an insight into some theoretical and methodical basis for instituting nm23-H1 gene therapy of cancers. MTT assay and Transwell chamber were used to detect the rates of proliferation and invasion as well as the adhesion of Lovo cells in vitro. The results demonstrated that the proliferation inhibition rates of Lovo cells treated with Ad-GFP-nm23-H1 of 10(10) PFU/ml, 10(9) PFU/ml and 10(8) PFU/ml were 84.9% +/- 1.51%, 48.5% +/- 7.23% and 22.5% +/- 5.47%, that the adherence inhibition rates of Lovo cells treated with Ad-GFP-nm23-H1 of 10(10) PFU/ml, 10(9) PFU/ml and 10(8) PFU/ml were 70.3% +/- 2.40%, 60.1% +/- 5.68% and 18.5% +/- 3.61%, and that the invasiveness inhibition rates of Lovo cells treated with Ad-GFP-nm23-H1 of 10(10) PFU/ml, 10(9) PFU/ml and 10(8) PFU/ml were 83.2% +/- 5.71%, 52.2% +/- 6.94% and 28.1% +/- 8.21%. These data suggested that Ad-GFP-nm23-H1 exerted significant inhibitory effects on the proliferation and metastasis of human colorectal carcinoma cell line Lovo in a dose-dependent way.
Adenoviridae ; genetics ; metabolism ; Cell Line, Tumor ; Cell Proliferation ; Colorectal Neoplasms ; genetics ; pathology ; Gene Expression Regulation, Neoplastic ; Genetic Therapy ; Green Fluorescent Proteins ; genetics ; metabolism ; Humans ; NM23 Nucleoside Diphosphate Kinases ; genetics ; metabolism

Objective To summarize the perioperative nursing of huge malignant lobulated breast tumor, so as to promote the recovery of patients. Methods A total of 11 patients with huge malignant lobulated breast tumor patients were selected, assessed the preoperative status,finished breast tumor site nursing, strengthen psychological nutritional assessment, the adjustment of the respiratory system for the operation, prevent falls. In addition to do a good job in general nursing and postoperative pain management, but should also focus on the observation of the chest wall flap, drainage tube care, to prevent bleeding and infection, etc. Results By implementing the nursing plan, 1 case of breathing difficulties preoperative patients with respiratory function improved, 1 case of refuse treatment of patients accepted surgical treatment after psychological intervention, 2 cases of postoperative patients with skin flap necrosis, local treatment, after compression bandage, 1 case of good recovery, 1 case of poor treatment effect for the wound recovered well after back surgery graft;1 case of patients with subcutaneous effusion, to adjust the drainage tube, suction fluid, after compression bandage, partial treatment, recovering well. Patients were good recovery, discharged smoothly. Conclusions By constantly sum up experience, through positive assessment of patients after preoperative mental and physical health and attaches importance to patients' skin flap, bleeding, pain, completes the drainage tube nursing and prevention of infection, can effectively promote the recovery of patients.

Objective To explore the correlation and role of E2F3 gene,miR-17-5p and miR-20a in the cell lines of transitional cell carcinoma of bladder. Methods The plasmids of pcDNA3.1-HA-E2F3 and pAAV-siRNA-E2F3 were used to overexpress and knockdown E2F3.The mimics of miR-17-5p,miR-20a and their anti-miRNA oligonucleotides were used to overexpress and screen miR-17-5p and miR-20a.The expression levels of E2F3 gene,miR-17-5p and miR-20a were detected by quantitative real-time PCR,and E2F3 protein were detected by Western blot. Results When E2F3 was overexpressed,the 2- △△Ct of miR-17-5p and miR-20a were 2.26 ± 0.30 and 4.04 ± 0.51,it was statistically significant to compared with control (P ＜ 0.05) ; when E2F3 was knockdown,the 2 △△Ct of miR-17-5p and miR-20a were 0.49 ± 0.02and 0.65 ± 0.04 (P ＜ 0.05) ; when miR-17-5p and miR-20a were overexpressed simultaneously,the level of E2F3 mRNA was significantly decreased,the average E2F3 protein gray scale was 55.31 ± 7.89,the control was 103.67 ± 13.61 (P ＜ 0.05 ) ; when miR-17-5p and miR-20a were knockdown simultaneously,the E2F3 mRNA was significantly increased,the E2F3 protein gray scale was 295.68 ± 19.25,the control was 103.67 ± 13.61 ( P ＜ 0.05 ). Conclusions miR-17-5p and miR-20a could be up-regulated by E2F3 gene,and the E2F3 gene could be down-regulated by miR-17-5p and miR-20a.The regulatory feedback loop of E2F3 gene,miR-17-5p and miR-20a exists in transitional cell carcinoma of bladder. The loop maybe plays a key role in the development of bladder cancer.

Objective:To investigate the neural mechanism of long-term exposure to high altitudes environment on the processing stage of perceptual closure.Methods:A cross-sectional study was conducted. Thirty college students who first entered the plateau area (at an altitude of 3 658 m) and had lived in high-altitude areas for two years were selected as high altitude group (HA group), and 29 college students matched in age, gender and education level who had never been to the plateau area were selected as sea level group (SL group). The differences of basic physiological parameters were compared between the two groups.The face pairwise comparison paradigm was applied in the subjects of the two groups and the differences between the two groups were compared by event-related potentials (ERPs) technology. SPSS 22.0 software was used for statistical analysis, and the mean ± standard deviation was used for statistical description. Independent sample t test was used for comparison of physiological data between the two groups, and repeated measurement variance analysis was used for ERP data. Results:The physiological results revealed that the HA group had a higher pulse rate((86.71±10.82)/min, (75.97±11.28)/min ; t=-3.19, P=0.002) and diastolic blood pressure than the SL group ((75.93±9.19)mmHg, ( 68.59±11.42) mmHg ; t=-3.20, P=0.002). The oxygen saturation level was significantly lower than that of SL group ((90.77±2.25)%, (98.31±1.56) %) ; t=14.00, P<0.001). In the face pairwise comparison paradigm test, the main effect of P1 latency of ERP was significant.Compared with SL group, HA group showed significantly shortened latency of P1 ((105.10±15.59) ms, (128.35±14.40)ms, P<0.001). The main effect of group of N170 amplitude was significant, HA group was larger than that of SL group((-7.57±3.83) μV, ( -5.11±3.26) μV, P=0.005). The interaction effect between group and hemisphere of NCL amplitude was significant ( F(1, 57)=9.72, P=0.003). Simple effect test showed that the amplitude on the right hemisphere of SL group was significantly larger than that on the left hemisphere((0.46±1.31) μV), (1.16±1.33) μV ). The latency of P1 was significantly correlated with heart rate( r=-0.46, P<0.01), oxygen saturation level( r=0.64, P<0.01) and diastolic blood pressure( r=-0.26, P=0.049). Conclusion:After long-term exposure to high altitude, the neural response related to early visual perception is faster. More psychological resources are recruited during the face structural encoding stage. Contra-lateral compensating effect appeares in the stage of perceptual closure.

With the development of cancer precision medicine, it is very important to study the detection of tumor driving genes. Because of the difficulty to get tissue biopsy, liquid biopsy especially like circulating tumor DNA (ctDNA) has received extensive attention in recent years. However, many issues have not been completely described. What kinds of approaches have been used for ctDNA detection? How about their sensitivity and specificity are? What their advantages and disadvantages are? What are the clinical applications of ctDNA?This article will summarize these questions.

Objective To evaluate the method of vulvar reconstruction after extended vulvectomy. Methods Retrospectively, fourteen cases of vulva carcinoma were treated by radical wide local excision, and the defects were repaired with anterolateral thigh flap and inferior pedicle rectus abdominal myocutaneous flap. After the flap was harvested, it was put on the defect through the tunnel between the donor and the recipient site and the vulvae was reconstructed. Results All the flaps were survived except 1 anterolateral thigh flap with partial necrosis. One patient was infected at the groin incision but the flap and the grafted skin were survived. The patients were treated with change of the dressing and recovered after skin grafting. All other incisions were healed with first intention. The partial necrosis area was about 4 cm?6 cm, it healed at 36 postoperative days after free skin grafting. The reconstructed vulvae were plump and elastic. It appeared like the normal vulvae and there was no contraction of the vagina. Conclusions Vulvar reconstruction with the anterolateral thigh flap and rectus abdominal flaps after the radical vulvectomy could make the patients recover easily. It produces almost normal appearance and function of the vulvae, reduces the time of would healing. The patient could have the next therapy more quickly and the quality of life improves. It has wide application value in clinics.