Orthopaedic postoperative pain not only brings a lot of side effects to patients, but also directly affects early rehabilitation after surgery. Effective preoperative pain management mainly includes three-stage individual pattern analgesia, which refers to preoperative, intraoperative and postoperative analgesia. The purpose is to reduce pain in multiple planes and three-dimension, strengthen the effect of analgesics and reduce dosage and side effect of single drug. This paper summaries new progress on individual-multiple-pattern analgesics, pain assessment method and various therapies.
Analgesia ; methods ; Humans ; Orthopedics ; methods ; Preoperative Period ; Treatment Outcome

Traditional treatments of gastrointestinal fistula include early drainage, maintaining nutrition and then resection of fistula at the proper time,which usually take three to four months or even longer. Rapid treatments of gastrointestinal fistula mean promoting rapid spontaneous closure of tract fistula and early primary resection of fistula within two weeks after fistula occurrence. Early diagnosis is the premise of early management, and fistulography and abdominal CT scan are important early diagnostic methods. Most of fistula could close spontaneously in the maintaining stage. To promote the rapid closure, however, special measures including sufficient drainage, somatostatin and total parenteral nutrition in the early stage should be implemented to avoid intra-abdominal collection of intestinal fluid and infection, control further leakage of intestinal fluid and improve nutritional status. In the late stage,when leakage of intestinal fluid could be controlled, recombine human growth hormone (rhGH) and enteral nutrition should be administered in place of somatostatin and total parenteral nutrition respectively. The fistula can reach rapid spontaneous closure in both stages. Fibrin glue and rhGH used at the same time can improve the curative rate and shorten the treatment time even more. In the 1960s and 1970s, early primary resection of the fistula and re-anastomosis often resulted in anastomosis failure. The reasons for this included poor nutritional status, uncontrolled secretion of intestinal fluid, severe intra-abdominal infection and multiorgan dysfunction syndrome. Such stage management policy has been proposed, developed and persisted since late 1960s. Nowadays, the advance of medical science provided the possibility to change or improve the current policy. Our research proved that early resection of the primary fistula and re-anastomosis of the small bowel could be performed successfully in some selected patients whose general conditions are good and intestinal adhesion were not severe within ten to fourteen days after fistula occurrence. More studies are still needed to define the indications and contradictions for early resection of the primary gastrointestinal fistula, and prove the feasibility and rationality of rapid treatments of gastrointestinal fistula.
Early Diagnosis ; Humans ; Intestinal Fistula ; diagnosis ; therapy ; Parenteral Nutrition, Total

Objective To investigate the unusual CT features of pulmonary sclerosing hemangioma (SH). Methods Clinical and CT features of 25 patients of pulmonary SH proved with pathology were reviewed, among which 15 patients underwent plain and enhanced CT scan, 10 underwent only plain CT scan. Results Solitary nodules (20/25, 80.00%) and solitary mass (5/25, 20.00%) were found with CT. CT features included slight lobulation (6/25, 24.00%), calcification (6/25, 24.00%), ground glass opacity (2/25, 8.00%), emphysema (1/25, 4.00%), endobrochial variant (1/25, 4.00%), short speculation (1/25, 4.00%) and vascular bundle (2/25, 8.00%). Slight or remarkable enhancement was noticed in all 15 patients underwent contrast enhanced CT. Conclusion CT can reveal features and unusual manifestations of pulmonary SH, and is helpful to the diagnosis of pulmonary SH.

Objective To study the qualitative analysis and quantitative analysis of flavonoids and other ingredients in leaves of Lonicera hypoglauca miq,and to optimize the reflux extraction condition for total flavonoids from leaves of lonicera hypoglauca miq. Methods Preliminary test was used for qualitative analysis. UV-spectrophotometry was used to determinate content of total flavonoids. By orthogonal design,the extraction rate of flavonoids was determined in different factors of ethanol reflux extracting. Results Leaves of lonicera hypoglauca miq contained alkaloids and flavonoids.The optimum conditions of ethanol reflux extracting total flavonoids are 12 times 50% ethanol,and refluence for 1.0h at water bath for two times.According to validate experiment,the average total flavonoids content was 16.6% in leaves of lonicera hypoglauca miq,with RSD=1.52%(n=3). Conclusion Flavonoids are in higher level in leaves of Lonicera hypoglauca miq. There are some chemical similarity in leaves of lonicera hypoglauca miq and leaves of flos lonicerae.

Objective: To study the antitussive, expectorant and antiasthetic effects of Fortunella hindsii leaves. Methods: The antitussive effects were observed by the method of ammonia-induced cough in mice, the expectorant effects were observed by the method of phenolsulfonphthalein excretion in mice, and the antiasthmatic effects were observed by the method of histamine phosphate spray in guinea pigs. Results:The leaves of Fortunella hindsii at low, medium and high doses could decrease the cough times and prolong the cough latent period (P<0. 05 or P<0. 01), high dose could promote the phenol red excretion (P<0. 05), and high and medium do-ses could prolong the incubation period of guinea pigs for asthma caused by histamine phosphate (P<0. 05 or P<0. 01). Conclu-sion:The leaves of Fortunella hindsii have promising antitussive, expectorant and antiasthmatic effects.

Objective To observe the clinical effect and safety of propranololand imiquimod therapy for infantile hemangiomas of proliferative phase.Methods A total of 53 infantile patients with hemangiomas of proliferative phase that were treated in our department were collected.According to patient's condition,the patients were classified into treatment group and observation group.The treatment group consisted of 34 patients received propranolol and imiquimod treatment,and 19 cases belonged to the observation group.The changes of tumor were compared between the treatment group and the observation group.Pre-therapeutic and post-therapeutic heart rate,blood pressure,blood glucose were monitored in the treatment group,so were in post-treatment.Results After 6 months,the effective rate was 97.1％ (33/34) in treatment group,and the effective rate was 57.9％ (11/19)in observation group.There was significant difference between treatment group and observation group in effective rate (P＜0.05),and so did blood pressure and heart rate after medication in the treatment group,but not in blood glucose,heart rate six hours after medication (P＞0.05).Conclusions Propranolol and imiquimod therapy has a certain inhibitory effect on infantile hemangiomas of proliferative phase.Propranolol and imiquimod are safe in patients with infantile hemangioma,and adverse reactions are mild.

Objective To detect the apoptosis and the intensity of proliferation in different types of renal pathology in children with lupus nephritis (LN), analyzed the relationship between apoptosis and proliferation in LN. Methods Twenty - seven children (aged 7-16 years old, 21 type IV and 6 type V ) with biopsy- proven LN and nine as controls were included in the study. Apoptosis was detected by in situ nick- end labeling techniques (TUNEL) in renal biopsy samples. Immunohistochemistry was employed to detect the proliferating cells identified by proliferating cell nuclear antigen (PCNA) and detect the expressions of proteins of apoptosis associated gene PDCD5 and Caspase - 3 in these patients. Results 1. Compared to type V LN, the patients with type IV LN had more apoptolic cells,more PCNA positive cells and higher ratios of PCNA/apoptosis (P/A) in glomeruli. 2. There were no difference in expression of PDCD5 in glomeruli in type IV LN compared with those in type V LN. Numbers of apoptotic cells were observed in glomeruli. The expression of Caspase- 3 in type IV LN increased in glomeruli compared with that in type V LN. Conclusions The up- regulation of mechanism of apoptosis in type IV LN was less than that of type V LN. Caspase- 3 participated in the apoptosis of glomeruli of LN, but PDCD5 did not play a role during apoptosis of glomeruli of LN or the effect of PDCD5 promoting apoptosis was depressed.

Objective To probe into the quantizing rule of the thoracic vertebra rotation.Methods6 healthy corpses specimen were fixed on a wooden apparatus and rotated from 0° to 90° for X-ray examination.A X-ray examination was taken at each 5° rotational point.The characteristic of the image at each examinational point was observed.ResultsThere was radiology characteristic at each rotational point.ConclusionThe thoracic vertebra rotational degree could be quantized by X-ray examinations.

ObjectiveTo investigate the effect of a cervical back muscle trainer. MethodsA cervical back muscle trainer designed by ourself was used in 128 patients with different kinds of cervical spondylosis. The situation of pain and activity of daily life of the patients before and 1 month after treatment were recorded and compared. ResultsThe neck pain of all of the patients nearly completely disappeared in a month and their activity of daily life improved significantly(P<0.01). ConclusionThe cervical back muscle trainer can improve the stability of cervical vertebrae through increasing the strength of the cervical back muscle, which can be used as an assistant rehabilitation approach of all kinds of cervical spondylosis.

Humans ; Infant ; Intracellular Signaling Peptides and Proteins ; genetics ; Membrane Proteins ; genetics ; Mutation ; Nephrotic Syndrome ; etiology ; genetics ; WT1 Proteins ; genetics