BACKGROUND:Psychological factors could influence the degree of pain after total knee arthroplasty. However, the effects of perioperative psychological intervention on postoperative pain and joint function are rarely reported. OBJECTIVE:To study the efficacy and safety of alprazolam for patients with anxiety and depression before total knee arthroplasty. METHODS:Sixty-one patients with anxiety and depression before unilateral total knee arthroplasty were recruited. The patients were given the treatment of alprazolam (experimental group) or placebo (control group) at 2 weeks preoperatively. Baseline data were collected, preoperative anxiety and depression were assessed with Hamilton Anxiety Scale and Beck Depression Inventory, perioperative pain at rest and in activity at each time point was evaluated, postoperative NSAIDs drugs and intravenous self-control analgesia pump usage were recorded, the peripheral neurotransmitters were detected by ELISA, short-and mediate-term joint fuction was evaluated through Western Ontario and McMaster Universities Osteoarthritis Index and Knee Society Score after joint replacement, patient satisfaction and in-hospital relevant indexes and adverse reactions were detected. RESULTS AND CONCLUSION:(1) After the application of alprazolam, anxiety and depression were improved notablely, and the levels of 5-hydroxytryptamine andγ-aminobutyric acid in peripheral blood were increased at 2 weeks. (2) The visual analogue scale scores at rest in the experiemntal group were significnatly lower than those in the control group at 12 hours, 1, 2, 3, 5 and 7 days postoperatively (P<0.05);the visual analogue scale scores in activity in the experiemntal group were significnatly lower than those in the control group at 12 hours, 1, 2, 3, and 5 days postoperatively (P<0.05). (3) Analgesia pump and analgesic drug usage in the experiemntal group were significantly less than those in the control group, and the analgesic drug dosage and preoperative anxiety depression were correlated. (4) There were no significant differences in the Western Ontario and McMaster Universities Osteoarthritis Index and Knee Society Score between two groups. (5) The patient satisfaction, sleep index and hospitation time in the experimental group were superior to those in the control group. No obvious adverse reactions occurred during medication. (6) Our results suggest that for patients diagnosised with anxiety and depression before total knee replacement, the preoperative application of alprazolam can alleviate anxiety and depression, improve perioperative pain at rest and in activity, reduce postoperative analgesia drug useage, and increase patient satisfaction.

Objective To investigate the status of the rehabilitation service and rehabilitation medical professionals in Tianjin. Methods130 hospitals and Disabled Persons' Federations in Tianjin selected by stratified random cluster sampling were surveyed by questionnaires.Results About 49.2% institutions had carried out the rehabilitation services; there were 842 rehabilitation medical professionals in total, including237 rehabilitation physicians and 3 prosthetic orthopaedic technicians, with a gap of nearly 3000 people; most of them were in loweducation. Conclusion The rehabilitation service should be developed; the quantities and quality of the rehabilitation medical professionalsshould be improved, the classified structure and the service objects are unbalanced.

Aged ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Cyclophosphamide ; therapeutic use ; Doxorubicin ; therapeutic use ; Epstein-Barr Virus Infections ; Female ; Herpesvirus 4, Human ; Humans ; Lymphoma, Large B-Cell, Diffuse ; drug therapy ; pathology ; virology ; Lymphoma, T-Cell, Peripheral ; drug therapy ; pathology ; Neoplasms, Second Primary ; drug therapy ; pathology ; Prednisone ; therapeutic use ; Vincristine ; therapeutic use

OBJECTIVETo observe the effect of purgation and detoxification therapy on gastrointestinal dysfunction of critically ill patients undergoing abdominal surgery.

METHODSTotally 56 inpatients with severe gastrointestinal dysfunction after abdominal surgery at ICU of Guangdong Provincial Hospital of Traditional Chinese Medicine were assigned to the treatment group and the control group, 28 in each group. All patients received routine Western medical treatment. Patients in the treatment group additionally took Modified Huanglian Jiedu Decoction (MHJD) and received electroacupuncture (EA) for 7 days. The first exhaust time, defecation time, scores for gastrointestinal dysfunction, mechanical ventilation time, ICU hospitalization time, and 28-day fatality rate were observed. Furthermore, serum levels of diamine oxidase (DAO) and D-lactic acid were detected at day 1, 3, and 7 after treatment.

RESULTSThe first exhaust time and the first defecation time in the treatment group were ahead of schedule, when compared with those of the control group (P <0. 05). Scores for gastrointestinal dysfunction, mechanical ventilation time, serum levels of DAO obviously decreased in the treatment group (P <0. 05). There was no statistical difference in serum levels of D-lactic acid, ICU stay time, the incidence of pulmonary infection, and 28-day mortality between the two groups (P >0. 05). Results of Logistic analysis showed that scores for gastrointestinal dysfunction were related with the incidence of pulmonary infection (P <0. 05).

CONCLUSIONMHJD combined EA could promote the recovery of gastrointestinal function in critically ill patients after abdominal surgery via improving intestinal barrier function, which was benefit for shortening mechanical ventilation time.

Critical Illness ; Defecation ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Electroacupuncture ; Gastrointestinal Diseases ; drug therapy ; Humans ; Lactic Acid ; Medicine, Chinese Traditional

Adult ; Antigens, CD20 ; metabolism ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; CD79 Antigens ; metabolism ; Humans ; Lymphoma, Large B-Cell, Diffuse ; drug therapy ; metabolism ; pathology ; Male ; PAX5 Transcription Factor ; metabolism ; Young Adult

OBJECTIVEXinmailong, a compound extracted from Periplaneta americana, is used for the treatment of cardiovascular diseases. This study investigated the effects of Xinmailong on myocardial hypoxia-inducible factor-1alpha (HIF-1alpha) and plasma endothelin-1(ET-1) levels in neonatal rats with asphyxia and explored the protection mechanism of Xinmailong in hypoxia-ischemic myocardial injury.

METHODSSeven-day-old Sprague-Dawley rats were randomly divided into three groups (n=30 each): sham-operated, asphyxia, Xinmailong-treated asphyxia. Each group was randomly subdivided into three groups according to the observed time points: 6 hrs, 24 hrs and 72 hrs. Xinmailong (5 mg/kg) was intraperitoneally injected to the rats in the Xinmailong-treated group five minutes before asphyxia. Myocardial HIF-1alpha expression, and plasma ET-1 and creatine kinase (CK) levels were measured. The histopathologic changes of the myocardium were observed by hematoxylin-eosin staining.

RESULTSFour rats died in the asphyxia group while only one died in the Xinmailong-treated group during the experiment. The plasma ET-1 and CK levels as well as myocardial HIF-1alpha expression increased at 6 hrs, reached a peak at 24 hrs, and declined at 72 hrs after asphyxia in the asphyxia group, being higher than that in the sham-operated group (P<0.01). Myocardial ischemia was observed in the three time points, and cell necrosis occurred at 24 hrs after asphyxia in the asphyxia group. Myocardial HIF-1alpha expression was positively correlated with plasma ET-1 levels (r=0.876, P<0.01). In the Xinmailong-treated group, plasma levels of CK and ET-1 as well as myocardial HIF-1alpha expression were significantly lower than those in the asphyxia group (P<0.01). Myocardial ischemia was alleviated and no cell necrosis was found in the Xinmailong-treated group.

CONCLUSIONSAsphyxia leads to increase in myocardial HIF-1alpha expression and plasma levels of ET-1 and CK. Xinmailong can reduce the myocardial expression of HIF-1alpha and decrease plasma ET-1 levels, thus alleviating hypoxia-ischemic myocardial injury.

Animals ; Animals, Newborn ; Asphyxia ; metabolism ; Creatine Kinase ; blood ; Endothelin-1 ; blood ; Female ; Hypoxia-Inducible Factor 1, alpha Subunit ; analysis ; Immunohistochemistry ; Male ; Myocardial Ischemia ; drug therapy ; Myocardium ; pathology ; Periplaneta ; chemistry ; Rats ; Rats, Sprague-Dawley

Objective The aim of this study was to investigate how different concentrations of dextran sulfate sodi-um ( DSS) influence the establishment of mouse model of inflammatory bowel disease ( IBD) and the effect of DSS on the expression of colitis-associated immune factors.Methods The DSS solution in different concentrations (3%, 5%, 7%) were given to male C57BL/6J mice to generate mouse inflammatory bowel disease model.The IBD mice were observed by defecation characteristics, body weight, and survival time.The animals were sacrificed at 6 days after the start of DSS drinking.The general appearance of colons was observed and scored.Moreover, the pathological changes of the colon were examined and analyzed by routine histology.The expression of immune factors in the spleen was detected by real-time PCR.Results The mice in the 3%, 5%, 7% DSS groups developed murine colitis.In addition, the incidence of IBD and mouse mortality rate was directly proportional to the increase of DSS concentration.Furthermore, the higher concentra-tion of DSS induced the expression of proinflammatory factors including TNF-α, IFN-γand IL-17A, but cause a decrease of anti-inflammatory factors such as IL-4, IL-10 and Treg-related transcription factor Foxp3.Conclusions Our data suggest that giving 5%DSS solution to C57BL/6J mouse is appropriate to efficiently establish a murine IBD model.This laid an important foundation for further studies of the pathogenesis of IBD, biological characteristics, and intervention factors.

Objective To explore the parental personality traits and affective expression in abuse children.Methods The investigation was carried out in 3 villages in Xinxiang,Henan province,with a total of 1 310 households,of which there were altogether 370 households that had children at 10-15 years old.From them,200 households were randomly selected to screen the children for child abuse,and the Eysenck Personality Questionnaire (EPQ) and Toronto Alexithymia Scale(TAS) assessment were made among the parents who were primary caregi-vers.Independent samples t-test and Chi-square test were conducted to the 196 valid questionnaires.Results The average educated years of parents in abuse group and non-abuse group were (7.75?5.437)years old and (7.28? 2.532) years old,there was no significant diffe-rence (P=0.413).The average age of fathers in abuse group and non-abuse group were (36.16?8.96)years and (39.06?7.99)years repectively,there was no significant difference(P=0.170),and those of mothers in both groups were (36.06?5.15)years and (37.62?5.70) years respectively,there was no significant difference(P=0.121).There were 31 fathers and 49 mothers who were guardian in abuse group,while there were 35 fathers and 81 mothers in non-abuse group (?2=1.56 P=0.212).No significant differences were found in parental psychoticism [t(father)=1.221 P= 0.227;t (mother)=-0.471 P=0.639],neuroticism[t (father)=-0.524 P=0.602;t(mother)=-0.556 P=0.579],extraversion/ introversion[t(father)=-0.449 P=0.655;t(mother)=-0.859 P=0.392] and lie [t(father)=-1.263 P= 0.211;t(mother)=0.733 P= 0.465],the ability to identify and describe feelings[t(father)=0.946 P=0.348;t(mother)=0.815 P=0.417],to distinguish between bodily sensations[t(father)=0.215 P=0.831;t(mother)=2.107 P=0.037],to daydream [t(father)=-0.088 P=0.930;t(mother)=-0.971 P=0.333]and to focus on externally oriented thinking[t(father)=-0.648 P= 0.519;t(mother)=-0.164 P= 0.870] in TAS.Conclusions In a general way parents who abuse their children do not necessarily have problems with their personalities or affective expression.Not only abnormal parents are likely to assault their children,but also normal parents may do it as well.

Objective To study the effect of administration of transient receptor potential vanilloid 1 (TRPV1) antagonist capsazepine (CPZ) into the nucleus accumbens (NAc) on the regulation of body weight and fat accumulation in rats, and evaluate the therapeutic effect of CPZ on neuropathic obesity. Methods Forty rats were randomly divided into 5 groups (n=8), namely, control group (without giving any treatment),group A (performed intra-NAc injection of 1 nmol/mL CPZ),group B (performed intra-NAc injection of 10 nmol/mL CPZ),group C (performed injection of 10 nmol/mL CPZ via the areas adjacent to NAc) and group D (performed injection of 10 nmol/mL CPZ via the dorsal striatum); rats of the later 4 groups were given 1 μL CPZ daily for a consecutive 3 d.The body weight of rats from different treatment groups 1 and 3 weeks after the injection was measured and compared them to that of the control group.Then,the animals were sacrificed,the body fat content of each group was evaluated. Results The body weight in rats of group A 1 week after the injection increased (126.31± 10.25)％ as compared with their original weight, and that in rats of control group increased (148.78±6.98)％ as compared with their original weight, which showed significant difference between the 2 increment (P＜0.05); the body weight in rats of group B 1 week after the injection increased (115.87± 13.90)％ as compared with their original weight, which showed significant decrease as compared with that in the control group (P＜0.05); The body weight in rats of group B 3 week after the injection increased (132.82±15.8)％ as compared with their original weight, and that in rats of control group increased (164.86±6.34)％ as compared with their original weight,which showed significant difference between the 2 increment (P＜0.05).Furthermore,the body fat content in group B was significantly lower than that of other groups (P＜0.05). Conclusion Blockade of NAc TRPV1 receptor by CPZ has significant inhibitory central adjusting effect on body weight and fat content in rats; and TRPV1 antagonist may potentially serve as a specific drug for neuropathic obesity.

OBJECTIVETo investigate the correlation between left atrial size and left ventricular filling pressure (LVFP) and the value of left atrial size assessment on detecting diastolic dysfunction in hypertensive patients with preserved LVEF by echocardiography.

METHODSEchocardiography was performed in 346 hypertensive patients with preserved LVEF(≥ 50%), left atrial size including left atrial diameter (LAD) and left atrial area (LAA) was measured and indexed to body surface area (LADI, LAAI). The ratio of early diastolic transmitral velocity to early diastolic mitral annular velocity (E/Em) was determined and LVFP was calculated with the formula: LVFP = 1.24×E/Em + 1.9. Patients were divided into diastolic dysfunction group [DD group, LVFP > 15 mm Hg (1 mm Hg = 0.133 kPa), n = 81] and normal diastolic function group (NDF group, LVFP ≤ 15 mm Hg, n = 265).

RESULTSAs compared to patients in NDF group, the patients in DD group had larger LA [LADI: (21.4 ± 2.6) mm/m(2) vs. (19.6 ± 2.4) mm/m(2); LAAI: (12.1 ± 2.6) cm(2)/m(2) vs. (10.4 ± 1.7)cm(2)/m(2); all P < 0.01]. LA size parameters were positively correlated with LVFP (r = 0.211-0.450, all P < 0.01), LAAI was best correlated with LVFP (r = 0.450, P < 0.01). ROC analysis showed that LAAI ≥ 11.4 cm(2)/m(2) diagnosed DD with a sensitivity of 63%, specificity of 74% and accuracy of 72%.

CONCLUSIONLeft atrium dilation correlates positively with LVFP in hypertensive patients with preserved LVEF. The LAAI is a more accurate parameter for identifying patients with diastolic dysfunction in this cohort.

Adult ; Aged ; Aged, 80 and over ; Female ; Heart Atria ; diagnostic imaging ; physiopathology ; Humans ; Male ; Middle Aged ; Ultrasonography ; Ventricular Dysfunction, Left ; diagnostic imaging ; physiopathology ; Ventricular Function, Left