Objective To examine the distribution of flurbiprofen axetil in cerebral-spinal fluid (CSF) by determining the CSF concentration of flurbiprofen after iv administration. Methods Seventy-two ASA Ⅰ or Ⅱ patients of both sexes aged 18-75 yr weighing 54-82 kg undergoing spinal or combined spinal-epidural anesthesia for lower extremity or lower abdominal surgery were studied. Flurbiprofen axetil 1 mg/kg was injected intravenously.CSF 2 ml and venous blood 3 ml were obtained simultaneously every 5 min after iv injection for 45 min (T1-9 ) for determination of flurbiprofen concentration using high performance liquid chromatography, and the CSF/blood flurbiprofen concentration ratio was caculated. Results Flurbiprofen was not detected in CSF at T1,2 after iv injection in 3 and 4 patients. The CSF flurbiprofen concentration was significantly higher at T4-9, and CSF/blood flubiprofen concentration ratio higher at T5-9 than at T3 ( P ＜ 0.05). There was no significant difference in CSF flurbiprofen concentrations among T4-9 ( P ＞ 0.05 ) Conclusion Flurbiprofen is detected in CSF after iv injection, the CSF flurbiprofen concentration peaks at 20 min after iv injection and it lasts until 45 min after iv injection.

Administration, Topical ; Ear, Inner ; pathology ; Humans ; Meniere Disease ; therapy

Female ; Humans ; Infant ; Mutation ; Pain Insensitivity, Congenital ; complications ; genetics ; pathology ; Receptor, trkA ; genetics

OBJECTIVETo systematically assess the efficacy and safety of Rhodiola in treating chronic stable angina pectoris.

METHODSOur group searched the Cochrane library, PubMed, Embase, Chinese biomedical literature database (CBM), VIP database (VIP), Chinese Journal Full-text Database (CNKI) for the literature published in English and Chinese till April 2013. Randomized controlled trials (RCTs) were included on the therapeutic effect of Rhodiola or Rhodiola plus conventional Western medicine in comparison with the conventional Western medicine treatment on stable angina. Data were extracted according the data extraction form. The literature methodological quality was assessed by using the Cochrane handbook, and data analyzed by Rev-Man 5.2 Software for Meta-analysis. The effect indicators of outcomes was expressed by odds ratio (OR) and 95% CI.

RESULTSA total of 7 randomized controlled trials, 662 cases of stable angina pectoris patients met the inclusion criteria and all published in Chinese, without one scientific design and high quality literature. Compared with the conventional Western medicine treatment, combined with oral administration of Rhodiola could improve the efficiency of anti-angina (OR = 2.49, 95% CI: 1.02 - 6.09). Combined with intravenous infusion of Rhodiola could also improve the efficacy of angina pectoris (OR = 4.86, 95% CI: 2.4 - 9.82). Oral administration of Rhodiola couldn't improve ECG efficacy (OR = 1.25, 95% CI: 0.67 - 2.34). Intravenous infusion of Rhodiola could improve the clinical efficacy (OR = 2.94, 95% CI: 1.61 - 5.35). Combined with the conventional treatment, intravenous infusion of Rhodiola could improve the whole blood viscosity (low and high shear rates) and inverse variance (IV) (-1.36 and -0.99, 95% CI: -1.65 - 1.07 and -1.26 - 0.71), but could not reduce serum fibrinogen and D-dimer level. The incidence rate of adverse reactions was higher than that of the conventional treatment combined with Rhodiola (OR = 0.1, 95% CI: 0.02 - 0.51).

CONCLUSIONSOn the basis of routine treatment, Rhodiola could further improve patients' symptoms. Combined with intravenous medication, Rhodiola could increase the ECG improvement rate, and reduce adverse reactions. But the methodological quality of included studies was poor, the number of samples was small, and influence factors such as the intervention period was short. This conclusion needs scientific and rational design in a larger sample, multicenter clinical trial to verify.

Objective To compare the effect of intra-articular injection of recombinant human tumor necrosis factor-Fc (rhTNFR:Fc) in the treatment of knee arthritis in spondyloarthritis (SPA) with that in rheumatoid arthritis (RA).Methods The subjects included in this study were SpA and RA patients with knee arthritis without deformity,moderate or severe bone erosion and obvious joint space narrowing in radiography,who had taken at least 6-week therapy with routine dosage of disease modifying anti-rheumatic drugs (DMARDs) before the study.All subjects received one dose of 25 mg rhTNFR:Fc injected to the target knee joints after synovial fluid being drawn away before injection.They were followed up for four weeks after injection.The primary end-point was the 4-week change in the moditied hospital for special surgery (HSS) knee score for the target knee.The secondary end-point were the 4-week change in patients assessment of the knee,and investigators assessment of knee,pain VAS of the knee joint when walking or standing,the range of knee inflexion,circumference of the knee cross section,synovium thickness detected by ultrasound in the part of the thickest synovium in the suprapatellar bursa.Paired t test,independed t test and Wilcoxon test were used for statistical analysis.Results Twenty-seven SpA patients and fifteen RA patients were included in the trial.The modified HSS knee score for the SpA group was 66±14 at baseline,86±11 (P＜0.05) at follow-up,and for the RA group,the score was 64±13 at baseline,80±9 (P＜0.05) at follow-up.24.2％ (16.5％-41.9％) improve-ment on the modified HSS knee score was achieved in the SpA group,while 22.2％ (15.3％-37.7％) improvement on the modified HSS knee score was achieved in the RA group (P＞0.05).31.8％ (9.3％-57.3％) improvement on the synovium thickness was achieved in the SpA group,while 1.5％ (-19.3％-25.5％) improvement on the synovium thickness was achieved in the RA group (P＜0.05).Adverse events were observed in six patients in SpA group and two patients in RA group.No serious adverse events had been observed.Conclusion Single intra-articular rhTNFR:Fc injection is an effective and safe therapeutic option for knee arthritis in both SpA and RA patients.This treatment may relieve knee synovitis in SpA patients more effectively than in RA patients.

Objective To construct and identify the siRNA eukaryotic expression vector targeting gene CXC chemo-kine receptor-4 and explore its role in invasion process of breast cancer cells in vitro. Methods Two siRNAs were designed and synthesized according to the coding sequence of CXCR4 gene and cloned into eukaryotic expression plasmid pGE-1-U6/kna. The constructed CXCR4-siRNA expression vector was transfected into MDA-MB-231 cells by liposome. Western blot was used to evaluate the suppression of CXCR4 expression in different groups. The inva-sion and migration of MDA-MB-231 cells were evaluated by cell invasion assay in vitro. Results Enzyme digestion and DNA sequencing confirmed that the CXCR4-siRNA expression vector was successfully constructed. After trans-fection,the CXCR4-siRNA obviously suppressed the expression of CXCR4 compared with control groups and the ability of cell migration was decreased markedly. Conclusion CXCR4-siRNA expression vector can effectively sup-press CXCR4 expression in the breast cancer cells and decrease potential of cell invasion, which may provide a no-vel strategy for gene therapy of breast cancer metastasis.

Objective To observe the characteristic features of musculoskeletal ultrasound (MSUS) in gouty arthritis (GA) and to assess its value in GA diagnosis.Methods Patients with GA and non-GA who underwent MSUS examination in Chinese PLA General Hospital were enrolled in this study. The synovitis,tenosynovitis,soft tissue swelling,bone erosion,bursitis and ossification were measured by greyscale ultrasound,and the synovial vascularity was measured by power Doppler ultrasound to evaluate the degree of inflammation.Results The ultrasound images of GA were intended to have specific features like tophus,hyperechoic deposition on the surface of the articular hyaline cartilage ( double contour sign ),hyperechoic deposition in the synovium appearing as bright stippled foci,and bright strap in tendons with a significant difference when compared with non-GA group (P ＜ 0.05).The percentage of tenosynovitis and bone erosion in non-GA group was higher than that in the GA group with a significant difference (P ＜0.05 ). Tophus,double contour sign,bright stippled foci or bright stippled foci in tendons together suggested gout with a specificity of 92.4％ and a sensitivity of 60.3％,the AUC of ROC was 0.764 ( P ＜0.05).Conclusion Tophus,double contour sign,bright foci and bright strap detected by MSUS are of diagnostic value on GA and MSUS may be a promising tool in diagnosing GA.

Adolescent ; Ethmoid Sinus ; Humans ; Male ; Osteoma ; complications ; Skull Neoplasms ; complications ; Vision, Low ; etiology

Adult ; Angiolymphoid Hyperplasia with Eosinophilia ; Female ; Humans ; Male ; Middle Aged

Consensus Development Conferences as Topic ; Endoscopy ; Europe ; Humans ; Nose Neoplasms ; diagnosis ; surgery ; Skull Base Neoplasms ; diagnosis ; surgery