Objective To explore the effect of preoperative local blocking with compound lidocaine hydrochloride (CLH) on postoperative pain of patients undergoing craniotomy.Methods40 patients suffered from superatentorial occupying lesion and scheduled for craniotomy were randomly divided into the CLH group and control group with 20 cases in each group. In the CLH group, local blocking with CLH was performed just before craniotomy, while in control group local blocking with 0.5% procaine was performed preoperatively and all patients of two groups used patient-controlled intravenous analgesia (PCIA) with fentanyl postoperatively. Postoperative pain was assessed for 48 hours according to visual analogue scale (VAS), and the comparison of analgesia-related postoperative complications of the two groups was demonstrated.ResultsThere was no significant difference in VAS postoperatively and incidence rate of complications between two groups ( P>0.05).ConclusionCompound lidocaine hydrochloride local infiltration may provide a safe and effective analgesia for postoperative pain in patients after craniotomy.

OBJECTIVE:To systematically review the efficacy and safety of Xiaoke pill versus glibenclamide in the treatment of type 2 diabetes mellitus,and provide evidence-based reference for clinical treatment. METHODS:Retrieved from Medline, PubMed,EMBase,Cochrane Library,CBM,CJFD,Wanfang Database and VIP Database,randomized controlled trials (RCT) about the Xiaoke pill(test group)versus glibenclamide(control group)in the treatment of type 2 diabetes mellitus were enrolled. Meta-analysis was performed by using Rev Man 5.2 software after document selection,data extract and quality assessment by Co-chrane systematical evaluation. RESULTS:A total of 15 RCT were included,involving 3 319 patients. Results of Meta-analysis showed the hemoglobin A1c (HbA1c) level [MD=-0.39,95%CI(-0.75,-0.02),P=0.04],fasting plasma glucose (FPG) level [MD=-0.70,95%CI(-1.27,-0.12),P=0.02],2 h PG[MD=-0.87,95%CI(-1.55,-0.20),P=0.01],incidence of thirst with desire for drinks [RR=3.35,95%CI(1.92,5.85),P<0.001],incidence of tiredness and debilitation[RR=5.74,95%CI(3.52, 9.36),P<0.001] and incidence of hypoglycemia [RR=0.67,95%CI(0.49,0.91),P=0.01] in test group were significantly lower than control group,the differences were statistically significant. CONCLUSIONS:Xiaoke pill has better efficacy and safety than glibenclamide in the treatment of type 2 diabetes mellitus,can obviously improve the HbA1c,FPG,2 h PG tevel and TCM symp-toms.

OBJECTIVE: To observe the effect of ginseng fruit saponins (GFS) on insulin sensitivity index in high fat-fed rats. METHODS: An animal model of insulin resistance was established by injecting low dose of streptozotocin (STZ) in high fat-fed rats. Effect of GFS on insulin sensitivity was detected with glucose infusion rate (GIR) by euglycemic hyperinsulinemic clamp technique. RESULTS: The level of fasting blood glucose and insulin in untreated group increased more significantly than that in normal control group (P<0.05, P<0.01), while the index of GIR decreased significantly (P<0.01). As compared with the untreated groupìthe parameters of GFS-treated groups were improved significantly in a dosage-dependent manner (P<0.05, P<0.01). CONCLUSION: GFS can improve experimental insulin resistance in rats.

Objective The rapid multiplex PCR (MPCR) system for detection of genes encoding aminoglycoside resistance in Staphylococcus aureus was developed. The distribution of antibiotic resistant genes acc(6')-Ie+aph(2″), aph(3')-Ⅲa and ant(4')-Ia in Guangzhou was analyzed using the established system.Methods S. aureus strains were identified and susceptibility tests were performed using VITEK-60 or PHOENIX-100 system as recommended by the manufacturer. Aminoglycoside resistance was determined by disk diffusion method. MPCR system for detection of antibiotic resistance genes was optimized.Results The MPCR assay was established successfully. The prevalence of acc(6')-Ie+aph(2″), aph(3')-Ⅲa and ant(4')-Ia in the 124 clinical S. aureus isolates was 62.1%, 32.3% and 1.6%, respectively as analyzed by MPCR. Good correlation between antibiotic resistance phenotypes and genotypes was observed. One or more of the genes encoding aminoglycoside modifying enzymes could be detected in all gentamicin- or netilmicin- or amikacin-resistant isolates. The acc(6')-Ie+aph(2″) gene was identified in 72 of 74 mecA-positive isolates.Conclusions This MPCR system could be used for rapid and reliable analysis of the antibiotic-resistant genotypes of clinical S. aureus isolates. The gene acc(6')-Ie+aph(2″) may be the predominant determinant of aminoglycoside resistance, followed by gene aph(3')-Ⅲa. The prevalence of ant(4')-Ia gene is relatively low.

Objective To observe the regulation of Toll-like receptor 4 (TLR4) signal and the release of inflammation factors after angiotensin Ⅱ (Ang Ⅱ) stimulation in rat mesangial cells under high glucose condition,revealing the innate immune-related mechanism of injury by Ang Ⅱ on mesangial cells under high glucose.Methods After synchronization,cells incubated with Ang Ⅱ (10-7 mmo/L) and/or high glucose (25 mmol/L) were used as the stimulation group,cells without stimulation were as normal control (5.6 mmol/L glucose).To determine the role of TLR4 and the adaptor myeloid differentiation factor 88 (MyD88),equal number of HBZY-1 cells were added with 10-5 mmol/L irbesartan and/or TLR4 blocker (10 mg/L) for 1 h and then incubated with Ang Ⅱ (10-7 mmo/L) and/or high glucose (25 mmol/L) for 12 h or 24 h respectively.Real-time PCR was used to analyze TLR4 mRNA and MyD88 mRNA expression after 12 h.Immunofluorescence was used to observe TLR4 protein expression after 24 h; Western blotting was used to observe TLR4,MyD88 and nuclear factor κB (NF-κB) protein; ELISA was used to detect the concentration of MCP-1,IL-6 in cell supernatant respectively.Results Compared with normal control group,TLR4 mRNA and MyD88 mRNA were highly expressed in high glucose or Ang Ⅱ-induced HBZY-1 cells (P ＜ 0.01),TLR4,MyD88 and NF-κB protein as well as MCP-1,IL-6 were also up-regulated significantly (P ＜ 0.01).Compared with high glucose or Ang Ⅱ group,MyD88 and NF-κB protein as well as MCP-1,IL-6 were further up-regulated markedly in Ang Ⅱ and high glucose costimulated group (P ＜ 0.01).In HBZY-1 cells that were preincubated with irbesartan and/or TLR4 blocker,TLR4 and MyD88 protein expression were obviously inhibited,IL-6 and MCP-1 production were also decreased remarkably compared with high glucose and/or Ang Ⅱ group (P ＜ 0.01).Conclusions High glucose and Ang Ⅱ stimulate the release of proinflammatory factors in rat glomerular mesangial cells via TLR4-MyD88 pathway.This process is inhibited by irbesartan or TLR4 blocker via modulation of the signal.Ang Ⅱ has the positive-regulation potential on the release of inflammation factors via TLR4 signal in rat mesangial cells under high glucose condition.

Objective To observe the clinical effects of hyaluronidase iontophoresis in the treatment of in- fants with congenital muscular torticollis(CMT).Methods Fifty infants with congenital muscular torticollis were divided randomly into a treatment group and a control group.Manual stretching was performed with both groups,while hyaluronidase iontophoresis was also administered to those in the treatment group.The range of side-flexion and rota- tion of the neck was examined at the beginning of and after 1 and 2 months of treatment.At the end of the treatment, the overall outcome was assessed according to a scoring system.Results There was no significant difference be- tween the two groups at admission.Compared with the control group,the range of side-flexion and rotation of the neck,and the overall treatment outcome were all significantly better in the treatment group after treatment.Conclu- sion Hyaluronidase iontophoresis can effectively improve function in infants with CMT and alleviate their symptoms.

Objective To evaluate the value of interventional embolism therapy for metastatic carcinoma of adrenal gland.Methods Fifty four patients with metastatic carcinoma of adrenal gland were treated with interventional catheterization perfusion and embolism therapy.Results Except one case with failure of finding the feeding artery, totally 76 sessions of interventional therapy were performed on 53 patients. Technical successful rate was 98.1% with 100% of complete release of clinical sign in 14 patients. Good deposition of iodized oil in tumor area reached 75.4% in three months after the procedure. Severe complication rate ocurred in 1.88%. Conclusion Interventional therapy seemed to be safe and effective for patients with metastatic carcinoma of adrenal gland.

Objective To investigate the role of outer membrane protein in clinical isolated car-bapenem resistance Acinetobacter baumannii. Methods Carbapenem resistance and sensitive strains were collected from the same patient. After MIST and REP-PCR analysis, carbapenemases were detected by isoe-lectric focusing. Different expressed membrane proteins were identified by two-dimension electrophoresis and mass spectrometry analysis. We also used efflux pump inhibitor PAβN(Phe-Arg-β-naphthylamide) to con-firm the phenotype. Results Carbapenem resistance and sensitive strains were attributed to the same pat-tern. At positions of P17.6 and P19.0, two β-lactamases were expressed in two investigated strains, no cabapenemases were detected. Six differential expressed membrane proteins were identified, a 34 × 10~3 membrane protein that was confirmed by efflux pump inhibitor PAβN experiment (imiponem MIC decreased from far above 32 μg/ml to 8μ/ml) and OprD and CarO. Conclusion Up-regulation of exported protein accompanied with down-regulation of OprD and CarO other than carbaponemases are responsible for carbap-enem resistance in A. baumannii.

Objective To study the clinical effects of addition treatment of liver-kidney yin deficiency and postmenopausal osteoporosis with Liuwei Dihuang pill.Methods 120 patients suffering from postmenopausal osteopo-rosis who were determined to be subject to liver -kidney Yin deficiency by doctors of traditional Chinese medicine when they received treatment at the outpatient clinic of traditional Chinese medicine department of our hospital in the period from February 2010 to june 2013 were divided into three groups:group A,B and C,with the random number table.For group A:provided the honeyed pills made up by supplemented six -ingredient rehmannia pill,and taken two pills per day continuously for six months;For group B:provided 5mg of zoledronic acid injection for intravenous drip infusion;For group C:provided traditional Chinese medicine honeyed pills and zoledronic acid for treatment at the same time;all of the three groups take Calcium carbonate D3 at the same time;The three groups of cases until the 12th month were observed and followed -up.The clinical efficacy of three groups were compared.Results A,C group 3 months after treatment with estradiol levels compared with before treatment,the difference was statistically significant (t =2.54,P =0.05,t =2.07,P =0.06).A group 3 months after treatment,the VAS scores at 6 months respectively (3.75 ±1.32),(2.06 ±1.53)points before treatment,and the differences were statistically significant(t =10.18, P =0.00,t =9.26,P =0.00).A group 3 months after treatment,the SF -36 scores at 6 months were (90.82 ± 12.38),(105.82 ±9.06)% respectively,compared with that before treatment,the differences were statistically significant(t =8.40,P =0.00,t =5.21,P =0.00).A group 6 months after treatment of lumbar 1 -4 bone density-were (0.85 ±0.07)g/m2 ,and before treatment[(0.76 ±0.07)g/m2 ]comparison,the difference was statistically significant(t =7.56,P =0.00);A group 6 months after treatment of Wards bone density compared with before treatment,the difference was statistically significant(t =8.07,P =0.00).C group 6 months after treatment of lumbar 1 -4 bone density(0.91 ±0.07)g/m2 ,and B Group[(0.88 ±0.05)g/m2 ]comparison,the difference was statistical-ly significant(t =27.19,P =0.00);C group after treatment,the bone mineral density of Wards area for 6 months were (0.62 ±0.04)g/m2 .The difference was statistically significant (t =26.22,P =0.00),compared with the B group. The TCMsyndromes of TCMin the 6 months after treatment in A group were (5.42 ±2.13),and the difference was statistically significant (t =13.29,P =0.00),compared with the B Group (10.75 ±4.08).(t =13.29,P =0.00). Compared with B group,the difference was statistically significant(t =26.22,P =0.00).A group after the treatment of TCMsyndrome score was 6 months(5.42 ±2.13),and B Group[(10.75 ±4.08)],the difference was statistically significant(t =13.29,P =0.00).Conclusion The addition of Liuwei Dihuang pill can improve BMD,alleviate the ostealgia and improve life quality of patients suffering from postmenopausal osteoporosis,and has no obvious adverse effects.It can enhance curative effects through using with diphosphonate.

Objective:To research the effect of lumbar spinal nerve block combined with ultrashort wave on the pain and biomechanics of lumbar back muscle of patients biomechanics with lumbar disc.Methods:98 patients with lumbar disc herniation in our hospital from February 2014 to August 2016,according to the lottery method divided into control group and research group.The control group was treated with Lumbar spinal nerve block.The research group was based on the control group treated with ultrashort wave,clinical curative effect,changes of the visual analogue scale (VAS),60 ° /s angular velocity,120° /s average apical power (AP),peak torque (PT),lumbar dorsiflexion / dorsal flexion (F/E),serum levels of substance P (SP),β-endorphin (β-EP),interleukin-6 (IL-6),tumor necrosis factor-α (TNF-α) before and after treatment,and adverse reactions were compared between two groups.Results:The total effective rate of research group was95.91％,which was significant higher than that of the control group,the difference was statistically significant (P＜0.05).After treatment,The VAS,F/E,serum levels of SP,IL-6 and TNF-α of two groups were significantly lower than those before treatment,the above indicators of research group were significantly lower than those of the control group.The AP,PT and serum levels of β-EP between two groups were significantly higher than those before treatment,the above indicators of research group were significantly higher than those of the control group (P＜0.05).No statistical difference was found in the incidence of adverse effects between the two groups (P＞0.05).Conclusion:Umbar spinal nerve block combined with ultrashort wave was more effective than lumbar paravertebral nerve block treatment alone in the treatment of lumbar disc herniation,it could effectively relieve the pain and improve the low back muscle biological mechanics performance and reduce the inflammatory response.