Objective To assess the effectivity and safety of oxycodone plus acetaminophen for postoperative acute pain re‐lief .Methods Randomized controlled trials (RCT ) on combination of oxycodone plus acetaminophen treating postoperative pain re‐lief were searched from the following data‐bases as PubMed ,EMbase ,MEDLINE(Ovid) ,the Cochrane Library ,CNKI and WAN‐FANG from the date of their establishment to September 2014 .The data of RCT meeting the inclusive criteria were extracted ac‐cording to Cochrane methods by two reviewers independently ,and after the quality was evaluated and cross checked ,meta analyses were conducted using RevMan 5 .2 sotware .Results A total of 18 studies involving 2 213 patients were included .The results of Meta‐analyses showed that compared with placebo group or the equal dosage oxycodone alone group ,the combinations of oxycodone plus acetaminophen were more effective in postoperative pain relief (P<0 .01) .However ,there are no significant difference in the effective between the combinations of oxycodone plus acetaminophen and the higher dosage oxycodone alone group or the acetamin‐ophen alone group for postoperative pain relief (P>0 .05) .Adverse events occurred more frequently with combination therapy than placebo or acetaminophen alone group ,but were generally described as mild to moderate in severity and rarely led to withdrawal . There are no significant difference in the adverse events between the combination of oxycodone plus acetaminophen and the oxyc‐odone alone group .Conclusion The present study showed that combination of oxycodone plus acetaminophen is effective and high safe in postoperative acute pain relief .

Objective To assess the efficacy and safety of different dosages of oxycodone plus acetaminophen for treating acute pain after oral surgery,in order to provide a reasonable dosage of combination in clinic. Methods Randomized controlled trials ( RCTs ) on effect of combination of oxycodone plus acetaminophen on pain relief after oral operation were searched from the following data-bases:PubMed,EMbase,MEDLINE ( Ovid) ,the Cochrane Library,CNKI,and WANFANG from the date of their establishment to January 2015. The data of RCTs meeting the inclusive criteria were extracted according to Cochrane methods by two reviewers independently,and after the quality was evaluated and cross-checked,meta-analyses were conducted using RevMan 5.2 software. Results A total of 11 studies in 10 literatures involving 1 028 patients were included and were designated to 3 different dosage groups (5 mg/325 mg,10 mg/650 mg,10 mg/1 000 mg,respectively). The results of Meta-analyses showed that pain remission rate was significantly higher in the 3 different dosages of oxycodone plus acetaminophen groups than in the placebo group (RR5 mg/325 mg=3.35,95%CI [1.74,6.45],I2=38%,P=0.000 3;RR10 mg/650 mg=6.88,95%CI [4.00,11.83],I2=0%,P<0.000 01;RR10 mg/1 000 mg=4.94,95%CI [3.23,7.56],I2=81%,P=0.005). In additional,the RR of oxycodone 10 mg/acetaminophen 650 mg and placebo groups for pain remission rate was higher than that of the other 2 dosages groups,moreover,more studies were enrolled and its low heterogeneity led to high reliability. Usage rate of remedial painkillers was significally lower in oxycodone plus acetaminophen groups than in the placebo group (RR5mg/325mg=0.71,95%CI [0.60, 0.85],P<0.000 01;RR10mg/650mg=0.50,95%CI [0.41,0.61],P<0.000 01;RR10mg/1000mg=0.77,95%CI [0.66,0.90],P=0.001) ,In addition, the RRs of usage rate in oxycodone 10 mg/acetaminophen 650 mg and placebo groups were significantly lower than the other 2 dosages groups. Incidence rates of adverse effects were similar in the 3 different dosages groups and higher than that of the placebo group. However,the adverse events were generally described as mild to moderate in severity and rarely led to drug withdrawal according to all reports in the studies ( only one event ) . Conclusion The present study showed that combination of oxycodone plus acetaminophen can provide better analgesia in acute pain after oral surgery with high safety. In addition,combination of oxycodone 10 mg plus paracetamol 650 mg may be better for acute pain relief after oral surgery.

Objective To establish a modified dynamic 99Tcm-pertechnetate salivary gland scintigraphy(SGS) method,and to evaluate the value in the diagnosis of Sj(o)gren's syndrome(SS) by comparing SGS with labial gland biopsy (LGB).Methods A total of 204 patients (21 males,183 females,age range 20-85 years) with suspected SS who underwent the modified dynamic SGS and LGB were enrolled in this prospective study.Uptake ratio (UR) and excretion fraction (EF) of the left parotid gland (LPG),the right parotid gland (RPG),the left submandibular gland (LSG) and the right submandibular gland (RSG)were calculated.Two-sample t test was used for data analysis.The sensitivity,specificity,accuracy of the modified dynamic SGS and LGB were calculated,and x2 test was used for data analysis.Results SS was confirmed in 113 patients,including 79 patients with primary SS and 34 patients with secondary SS.SS was excluded in 88 patients.The UR and EF of the SS group (LPG:1.95±1.04 and (52.2±19.5)％,RPG:1.96±1.06 and (55.0±21.1)％,LSG:2.65±1.12 and (25.9±14.1)％,RSG:2.72±1.30 and (29.7± 14.7) ％) were significantly lower than those of the non-SS group (LPG:3.08± 1.10 and (65.9± 12.7) ％,RPG:3.26±1.16 and (66.4±12.6)％,LSG:3.71±1.31 and (43.2±12.3)％,RSG:3.74±1.39 and (46.6± 11.5) ％;t=4.40-9.00,all P＜0.05).The sensitivity,specificity,accuracy of the modified dynamic SGS were 99.1％ (112/113),72.7％ (64/88),87.6％ (176/201),respectively,while those of LGB were 83.2％ (94/113),96.6％ (85/88),89.1％ (179/201),respectively.The sensitivity and specificity of SGS method were significantly different from those of LGB (x2 =15.9,17.5,both P＜0.05).Conclusions The modified dynamic SGS can reduce the acquisition time and has a high sensitivity for SS.When combined with LGB,it will improve the diagnostic accuracy for SS.

Objective To analyze the emergercy epidemiological characteristics of coeualties with head in-jury in Shanghai. Method By a prospective study,the data of 18 076 casualties with head injury during the whole year 2004 collected from 12 joint hospitals in Shanghai were documented well in the unified survey tables with wide-range items failed in by the attending physician, who got the firsthand information from patients and witness.The data were analyzed by using SPPS version 11.5 software. Results Of 18 076 casualties with head injury,the ratio of male to female was 2.11: 1.The mean age of female was older than that of male (t=10.575, P<0.01).The highest incidence of casualties occurred in people of twenties (24.7 % ). The local residents of Shanghai ac-counted for 34.2% of casualties. More casualties often occurred in December,January,Mareh and August than in he rest. Of 5.1% casualties with head injury were assochted with labour work.The leading cause of injury was dif-ferent in patient cohorts of different ages. Fall was the most main cause of trauma in children cohort (aged<14)and the senile patients cohort (aged > 60). The violert assault and traffic accident caused the most head injuries in the adolescent people cohort ( aged 15～34 years old) and the young people cohort ( aged 35～59 year old). The majority of casualties (85.5%) received CT scan.The scalp laceration (40.2% of patients) was seen more often than other types of injury . The mortality of easualties with traumatic brain injury was 0. 5 % . Conclusions The kmowledge of epidemiologieal aend of emergency deparhnent visitors with head injury is amportant guidance to physicians arranging emergency medical resources rationally and formulating a comprehesive prevention stategy of castahies with head injury.

Objective To research the Annexin V-nanoscale ultrasound contrast agents'preparation, ultrasound imaging and the ability to binding apoptosis cells of tumor in vitro.Methods The nanoscale bubble (Nanobubbles,NBs ) packaged the octaflouropropane (C3 F8 ) gas was prepared by thin film hydration.The Annexin V-Nanobubbles (AVNBs ) solutions was acquired through conjugating the biotinylated-Annexin V to the surface of the NBs by biotin-streptavidin bridging chemistry.The size and zeta potential of AVNBs were measured by NanoPlus-3 zeta/nano particle analyzer.The shift in size distribution of AVNBs bubbles was analyzed for the stability,after it was stored at 4 ℃ for different time. AVNB's shape were measured by scanning electron microscopy.The AVNBs bubble was measured using an ultrasound system for echogenicity in vitro,and SonoVue was for control.Finally,the ability of AVNBs binding with apoptosis cells of tumor in vitro was determine via the fluorescence microscope.Results AVNBs has a size distribution of (640.2±32.1 )nm,and a mean zeta potential of (-23.30 ±5.71 )mV.Its size remained relatively constant and appeared to show less size variation within the 24 h analysis period. AVNBs solutions were visible milky white and slightly suspension liquid with the naked eye.Under scanning electron microscopy,AVNBs were uniform hollow sperical cavitation bubble with small size and larger dispersibility in solution.The AVNBs and SonoVue solution had the same higher grayscale signal intensity by ultrasonic imaging.The AVNBs binded well with apoptosis cells of tumor in vitro,and the rate of binding was (97.55 ± 1 .30 )%.Conclusions The AVNBs particles prepared by method of thin film hydration have a nanoscale size,good stability and echogenicity.It can be targeted binding with the apoptosis cells of tumor in vitro.

Objective To investigate podocyte number,the expression of nephrin and transforming growth factor-?1(TGF-?1) in adriamycin-induced-nephropathy rat model and its significance.Methods The rat adriamycin nephrosis model was constructed to detect blood and urine biochemical indicators and observe the pathological changes of renal tissues by light microscope and electron microscope.The expression levels of nephrin and TGF-?1 as well as the podocyte number were examined at different time points by immunohistochemistry.Results The pathological changes of the renal tissues were obvious.Nephrin presented a weak signal at the end of the first week(P

Objective To investigate podocyte number, the expression of nephrin and transforming growth factor-β1(TGF-β1) in adriamycin-induced-nephropathy rat model and its significance. Methods The rat adriamycin nephrosis model was constructed to detect blood and urine biochemical indicators and observe the pathological changes of renal tissues by light microscope and electron microscope. The expression levels of nephrin and TGF-β1 as well as the podocyte number were examined at different time points by immunohistochemistry. Results The pathological changes of the renal tissues were obvious. Nephrin presented a weak signal at the end of the first week (P<0.05). TGF-β1 started to increase (P<0.05) while the podocyte number started to decrease at the end of the eighth week (P<0.05). Expression of nephrin was negatively correlated with the P<0.05) and serum creatinine (r=-0.71, P<0.05). Expression of TGF-β1 was blood urea nitrogen (r=0.62, P<0.05) and serum creatinine (r=0.59, urinary protein (r=-0.63, P<0.05), blood urea nitrogen (r=-0.72, P<0.05) and serum creatinine (r=-0.76, P<0.05); it was positively correlated with nephrin (r=0.78, P<0.01) but negatively correlated with TGF-β1 (r=-0.64, P<0.05). Conclusion The acute and chronic adriamycin nephrosis models were twice every two weeks. The genesis and development of proteinuria are closely related to the abnormal expression of nephrin. Focal segmental glomerulosclerosis occurs when the podocyte number decreases and TGF-β1 accelerates it.

OBJECTIVETo study the correlation between brainstem auditory evoked potential (BAEP) and serum neuron-specific enolase (NSE) in neonates with asphyxia and explore the role of NSE in the evaluation of hearing impairment following asphyxia.

METHODSFifty-two term neonates with asphyxia, including 38 cases of simple asphyxia (mild: 23 cases; severe: 15 cases) and 14 cases of asphyxia complicated by hypoxic-ischemic encephalopathy (HIE), were enrolled. In the double-blind trial, BAEP and NSE were simultaneously detected 7 days after birth. The patients who did not pass BAEP test received another BAEP and NSE examinations 3 months after birth. Thirty healthy term neonates served as normal control group.

RESULTSOf the 52 neonates with asphyxia, 50.0% and 21.2% of patients failed the initial and the second BAEP tests, respectively. The detection rates of BAEP anomalies in the simple severe asphyxia group in the initial and the second tests (63.3% and 26.3%, respectively) were significantly higher than those in the simple mild asphyxia group (36.9% and 5.9%, respectively)(P<0.05). The neonates with asphyxia complicated by HIE showed a higher detection rate of BAEP anomalies in the second test compared with the asphyxiated neonates without HIE (31.3% vs 16.7%; P<0.05). Mean serum NSE levels in asphyxiated neonates were significantly higher than those in normal controls (<0.01). There were significant differences in serum NSE levels between the neonates with mild and severe asphyxia (26.70+/-2.34 microg/L vs 17.18+/-3.16 microg/L; P<0.01). The asphyxiated neonates with HIE had serum NSE levels similar to the simple severely asphyxiated neonates. Serum NSE levels in patients who failed the initial BAEP test were significantly higher than those who passed the test (25.69+/-4.12 microg/L vs 17.15+/-3.09 microg/L; <0.01). Serum NSE levels had a positive correlation with wave V reaction threshold detected in the BAFP test (<0.05).

CONCLUSIONSThe serum level of NSE is closely correlated with BAEP, and it may be useful to the evaluation of the hearing impairment and the outcome in neonates with asphyxia.

Asphyxia Neonatorum ; blood ; complications ; physiopathology ; Double-Blind Method ; Evoked Potentials, Auditory, Brain Stem ; Hearing Disorders ; etiology ; Humans ; Hypoxia-Ischemia, Brain ; etiology ; Infant ; Infant, Newborn ; Phosphopyruvate Hydratase ; blood

Drug Resistance, Bacterial ; Gram-Positive Bacteria ; isolation & purification ; Humans ; Infant, Newborn ; Microbial Sensitivity Tests ; Sepsis ; diagnosis ; drug therapy ; microbiology

OBJECTIVEVentilator-associated pneumonia (VAP) is a common nosocomial infection and is responsible for a very high mortality in neonatal intensive care unit (NICU) patients. This study was designed to investigate the etiology and high risk factors of neonatal VAP.

METHODSThe clinical data of 106 critical neonates who were treated with mechanical ventilator between 2003 and 2005 were studied retrospectively.

RESULTSOf the 106 neonates, 84 received mechanical ventilation for > or = 48 hrs. Thirty-five (41.7%) out of the 84 patients developed VAP. Univariate analysis showed that gestational age, duration of mechanical ventilation, reintubation, birth weights, primary lung disease and gamma globulin administration were associated with the development of VAP (P < 0.05). Multivariate stepwise logistic regression analysis showed that primary lung disease (OR=3.671, 95% CI=1.0-13.45, P < 0.05), duration of mechanical ventilation (OR=4.945, CI=1.51-16.21, P < 0.01), reintubation (OR=7.721, 95% CI=2.31-25.85, P < 0.01) and high-dose gamma globulin administration (OR=5.520, 95%CI=2.08-16.26, P < 0.01) were predicted factors for the development of VAP. The detection rate of gram negative bacilli (76.9%) was the highest, followed by gram positive coccus (17.9%) in VAP patients.

CONCLUSIONSOpportunistic drug-resistant bacteria are common pathogens for neonatal VAP. The risk of VAP is multifactorial, including external medical environments and patients' internal agents.

Anti-Bacterial Agents ; therapeutic use ; Female ; Humans ; Infant, Newborn ; Logistic Models ; Male ; Microbial Sensitivity Tests ; Pneumonia, Ventilator-Associated ; drug therapy ; etiology ; Retrospective Studies ; Risk Factors