OBJECTIVETo systematically evaluate the efficacy and safety of preoperative administration of cyclooxygenase-2 (COX-2) inhibitor on pain occurring with total knee arthroplasty (TKA).

METHODSWe electronically searched PubMed, Cochrane Library, EMBASE, CNKI, CBM, Wanfang data from inception to March 15, 2014 and manual searched journal of library collection to identify randomized controlled trials (RCTs) about preoperative administration of COX-2 inhibitor on pain occurring with TKA. The methodological quality of the included RCTs was assessed and the data were extracted according to the Cochrane Handbook 5.1.0. Meta-analysis was performed by using RevMan 5.2 software.

RESULTSA total of 6 RCTs involving 228 patients were included. The results of meta-analyses showed that: (1) Efficacy: The visual analog scale (VAS) of post-operation at 12-hour (WMD = -0.60, 95% CI -0.83 to -0.37, P < 0.000 01) and 24-hour (WMD = -0.74, 95% CI -1.29 to - 0.19, P = 0.008) was decreased when COX-2 inhibitor was used before operation. And compared with control group, experimental group decreased the modified numerical pain rating scale (MNPRS) at 24-hour (WMD = -0.50, 95% CI -0.70 to -0.30, P < 0.000 01), 48-hour (WMD = -0.55,95% CI -0.65 to -0.45,P < 0.000 01) under quiescent conditions, and the same result at 24-hour (WMD = -0.82, 95% CI -1.26 to -0.38, P <0.000 01), 48-hour (WMD = -0.71, 95% CI -0.82 to -0.60, P < 0.000 01) under active conditions. The morphine consumption postoperatively were fewer in experimental group at the first day (WMD = - 1.35, 95% CI -1.92 to -0.79, P < 0.000 01) and the second day (WMD = -1.60, 95% CI -2.68 to -0.52, P = 0.004). (2) Safety: COX-2 inhibitor could lessen the incidence of postoperative pruritus (RR = 0.35, 95% CI 0.15 to 0.84, P = 0.02), but not statistically decrease of nausea and vomiting (RR = 0.83, 95% CI 0.54 to 1.28, P = 0.40) and exhaustion (RR = 0.63, 95% CI 0.05 to 7.67, P = 0.72).

CONCLUSIONThe current evidence indicated that preoperative administration of COX-2inhibitor can effectively improve the effect of postoperative analgesia, reduce the consumption of morphine and lessen the incidence of pruritus. Due to the limited quantity of the included studies and the evidence with limited strength,further high-quality RCTs are needed to verify the aforementioned conclusion.

Arthroplasty, Replacement, Knee ; Cyclooxygenase 2 Inhibitors ; therapeutic use ; Humans ; Pain, Postoperative ; drug therapy ; Postoperative Complications ; prevention & control ; Pruritus ; prevention & control

Objective To investigate the typical value of gamma-radiation dose rate and its confidence interval in tank-transported copper ore by using bootstrap resampling techniques. Methods Bootstrap resampling method, coupled with kernel density estimation, introduced to acquire the typical value of gamma-radiation dose rate in copper ore. Results The typical value of gamma-radiation dose rate in copper ore was expressed as the central tendency of the means of resampling, and two kinds of confidence interval, empirical percentile and bias-corrected accelerated confidence interval, were provided as standard error. Conclusion It is clearly demonstrated that this method has an advantage to give a robust description in explanation of central tendency and variation range of gamma-radiation dose rate data profiles.

Aim To establish a model of the vascular endothelial cell (VEC) injury in SDrats.Methods SD rats were randomly divided into the control and the modelgroups. The model rats were injected with adrenaline diluted to 2. 5 times 0. 05 mg?100 g-1 (tid) for 5 d continously. From the 4th d, they were irritated for 5 min in the0℃ cold-water in the middle between adrenaline injections.The control rats weregiven 0. 9% NS as above. At 6th d, blood samples were taken from carotid arteries ofthe rats and the CEC counts, t - PA、PAI activities, 6-keto-PGF1? concentrations andthe platelet aggregation rate(max) were detected respectively. Results In the modelgroup, as compared with those in the control group, t - PA activity and 6-keto-PGF1?concentration decreased significantly(P

OBJECTIVETo assess the efficacy and safety of Tangzu Yuyang Ointment (TYO) for treatment of chronic diabetic foot ulcers.

METHODSFifty-seven patients with chronic diabetic foot ulcers of Wagner's ulcer grade 1 to 3 were randomly assigned to the control group (29 cases) and the treatment group (28 cases). Patients in the control group received the standard wound therapy (SWT), while those in the treatment group received SWT plus TYO. The ulcer healing rate, the ulcer improvement rate and the incidence of adverse events were compared between the two groups. Totally 48 patients finished the final follow-ups and entered the data analysis.

RESULTSThe ulcer improvement rate was 79.2% in the TYO group and 41.7% in the SWT group (P=0.017) at the 12th week, and 91.7% vs. 62.5% (P=0.036) at the 24th week. There was no statistical difference in the ulcer healing rate and the incidence of adverse events between the two groups at week 4, 12, and 24, respectively. The ulcer healing time was 96 +/- 56 days in the TYO group and 75 +/- 53 days in the SWT group, showing insignificant difference (P=0.271).

CONCLUSIONTYO plus SWT was more safe and effective than SWT alone in the treatment of chronic diabetic foot ulcers.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Diabetic Foot ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Ointments ; Phytotherapy ; Treatment Outcome ; Wound Healing ; Young Adult

Objective To assess the value of detecting sympathetic skin response (SSR) in the diagnosis of autonomic dysfunction in patients with Parkinson disease (PD). Methods SSR measurement was performed in 47 PD patients and 20 healthy control subjects and the results were compared. The SSR was also comparatively analyzed between patients with and those without autonomic dysfimction. Results Compared with the healthy controls, the PD patients showed significantly lowered mean amplitude (2.56±1.47 vs 1.87±0.26, P<0.05) and prolonged latency (1.42±0.29 vs 1.55± 0.18, P<0.05) of the SSR in the upper limbs, with also lowered mean amplitude (0.76±0.39 vs 0.49±0.21, P<0.05) and prolonged latency (2.04±0.27 vs 2.13±0.16, P<0.05) in the lower limbs. Compared with the PD patients without autonomic dysfunction, those having autonomic dysfunction showed significantly lowered mean amplitude (1.89±0.33 vs 1.75±0.21, P<0.05) and prolonged latency (1.53±0.15 vs 1.56±0.17, P<0.05) of SSR in the upper limbs and lowered mean amplitude (0.51±0.17 vs 0.46±0.20,P<0.05) and prolonged latency (2.08±0.24 vs 2.17±0.18, P<0.05) in the lower limbs. Conclusion The results of SSR measurements are consistent with the clinical manifestations of the PD patients. SSR can be of value in the diagnosis of autonomic nerve dysfunction in PD.

Objective To explore the effects of PPARγ agonist rosiglitazone and inhibitor T0070907 on apoptosis and anti-tumor in renal carcinoma A498 cells.Methods A498 cells were divided into three groups and PBS, rosiglitazone (50 μmol/L) and T0070907 50 (μmol/L) were added respectively of 24 h incubation completely. each group of cell proliferation was determined by MTT method and Western Blot analysis and RT-qPCR were applied to detect the expression level of BAX, Caspase 3, Cyt C and Bcl-2. A498 cell morphological changes were observed under light microscope and fluorescence microscope. Results MTT experiment results showed that rosiglitazone and T0070907 could significantly inhibit A498 cell proliferation rate (P＜0.05), increased the protein and mRNA expression levels of Caspase 3, Cyt C and Bax in A498 cell, and decreased the protein and mRNA expression levels of Bcl-2 (P＜0.05); Microscopic observation and Hochest staining also found that rosiglitazone and T0070907 could promote apoptosis of A498 cells. Conclusion Rosiglitazone and T0070907 can inhibit the proliferation of renal cell carcinoma A498 cells and induce apoptosis. The anti-tumor mechanism may be related to PPARγ mediation.

OBJECTIVETo study the clinical and pathological features of drug-induced liver injury (DILI).

METHODSLiver specimens were obtained through needle biopsies from 100 patients with DILI. The histological preparations of the specimens were stained with haematoxylin eosin, several histochemistry methods, and immunohistochemistry stains. The pathological changes of the livers were analyzed together with the patients's clinical data. The patients were divided into two groups, an acute DILI group (n=39) and a chronic DILI group (n=61), based on their clinical courses and histological changes in their livers. In the chronic DILI group, the clinical courses were longer than 6 months and/or fibrosis or cirrhosis occurred in their liver tissues.

RESULTSAmong our cases the leading cause of DILI was Chinese herb medicine, accounting for 21% of the 100 cases; steroids induced cases were 11% of the total. 78% of the patients presented elevated serum transaminases and/or jaundice. The degree of transaminases elevation and the frequency of jaundice happening in the acute group were significantly higher than those in the chronic group (P less than 0.05). The histopathological liver changes in these DILI cases included: (1) necrosis commonly occurred in acinar zone 3, (2) abundant neutrophil and/or eosinophil infiltrations, (3) hepatocytic and/or canalicular cholestasis with little or no inflammation, (4) microvesicular steatosis mixed with macrovesicular steatosis, and (5) presentation of epitheloid cell granuloma. There were no significant differences in liver histopathology between the acute and the chronic DILI groups, except that the fibrosis and the ductular proliferation were different.

CONCLUSIONDILI has become a notable liver disease in mainland China, and the use of Chinese herbal medicine must be improved, standardized and regulated more closely.

Adolescent ; Adult ; Aged ; Chemical and Drug Induced Liver Injury ; pathology ; Child ; Child, Preschool ; Female ; Humans ; Liver ; pathology ; Male ; Middle Aged ; Young Adult

Objective To evaluate the clinical effect of embolization of cerebral dural atreriovenous fistulas (cDAVF) of the eavemous sinus through the superior ophthalmic vein approach. Methods Twnety-seven patients with eDAVF of the cavernous sinus were embolized through the superior ophthalmic vein approach. Cerebral angiography and follow-up examination of the patients were performed to evaluate the effect ofernbolization. Results The fistulae showed complete angiographic disappearance in 15 patients, and 12 patients had blood velocity flow reduction at the fistula orifice. Ocular proptosis and chemosis deteriorated transiently in 11 patients after the procedure. The patients were followed-op for 3 to 48 months, and clinical cure was achieved in 17 patients, and 10 showed significant symptom relief. Conclusion cDAVF of the cavernous sinus can be effectively embolized through the superior ophthalmic vein approach.

Adult ; Antigens, Neoplasm ; genetics ; Carcinoma, Hepatocellular ; genetics ; pathology ; Female ; Humans ; Liver ; pathology ; Liver Neoplasms ; genetics ; pathology ; Male ; Middle Aged ; RNA, Messenger ; genetics

OBJECTIVETo investigate the polymorphisms of HLA-DPA1 and HLA-DPB1 loci of Han population in Zhejiang province of China.

METHODSThe alleles of HLA-DPA1 and HLA-DPB1 loci in 100 unrelated healthy individuals were analyzed using polymerase chain reaction-sequence based typing.

RESULTSEight HLA-DPA1 alleles and 19 HLA-DPB1 alleles were found in the population. The HLA-DPA1 alleles with higher frequencies were DPA1*020202 (47.0%), DPA1*010301 (38.5%) and DPA1*020101(10.5%). The HLA-DPB1 alleles with higher frequencies were DPB1*0501, DPB1*020102 and DPB1*040101. The frequencies were 39.5%, 13.5% and 13.0%, respectively. A total of 44 estimated DPA1-DPB1 haplotypes were detected. The HLA-DPA1*020202-DPB1*0501(29.5%) was the most frequent haplotype.

CONCLUSIONThe polymorphism data of the HLA-DPA1 and -DPB1 were obtained in Han population in Zhejiang province of China. There was linkage disequilibrium between the two loci.

Asian Continental Ancestry Group ; ethnology ; genetics ; China ; ethnology ; Databases, Genetic ; Ethnic Groups ; genetics ; Female ; Gene Frequency ; Genetic Loci ; genetics ; HLA-DP Antigens ; genetics ; HLA-DP alpha-Chains ; HLA-DP beta-Chains ; Haplotypes ; Humans ; Linkage Disequilibrium ; Male ; Polymerase Chain Reaction ; Polymorphism, Genetic