Objective To study the effect of preemptive analgesina of morphine injected to subarachnoid space on postoperative epidural analgesia with morphine. Methods Sixty ASA Ⅰ-Ⅱ patients were randomly divided into two groups. All patinents received combination spinal-epidural anesthesia(CSEA). In experimenta group (n=30), 0 5% bupivacaine 2ml and morphine 0 5mg were injected into the subarachnoid space of the patients for CSEA, and morphine 2 8mg was used for postoperative epidural analgesia. In control group (n=30),0 5% bupivacaine 2ml was injected into the subarachnoid space of the patients for CSEA, and morphine 3 3mg was used for postoperative epidural analgesia. The numerical rating score (NRS) and Ramsay sedation scores were performed after operation. The postoperative analgesic duration and frequency of side effect were recorded. Rusult NRS was significantly less and postoperative analgesic duration was obviously longer in experimental group compared with control group. Ramsay sedation scores and the frequency of side effect significantly increased in the experimental group compared with the control group. But the shaking frequency in experimental group was significantly less than that in the control group. Conclusions Preemtive analgesia of morphine injected to subarachnoid space could improve postoperative epidural analgesia with morphine and increase analgesia time. But it had more side effects.

Objective To analyze the clinical therapeutic effect of lumbar fusion in the treatment of lumbar degenerative diseases in the spine pelvic sagittal balance. Methods From June 2009 to June 2012,the clinical data of 92 cases with lumbar degenerative diseases ac-cepted lumbar spinal fusion operation in our hospital was collected. The contrast lumbar lordosis ( LL) ,lumbar sagittal vertical axis ( SVA) , pelvic incidence angle ( PI) ,sacral inclination angle ( SS) ,pelvic tilt angle ( PT) and other numerical parameters,using the Oswestry disabil-ity index ( ODI) ,visual analogue scale ( VAS) and the Japan Society of Department of orthopedics ( JOA) score were followed up two years after operation,and the postoperative effect was evaluated. Results The spinal pelvic parameters SVA,LL,SS and PT after surgery were changed obviously,and the difference was statistically significant(P<0. 05). The postoperative follow-up of VAS,ODI and JOA score were better than that of preoperation,the difference was significant(P<0. 05). Conclusion Lumbar fusion operation can restore lumbar lordosis, to maintain the spine pelvic sagittal balance and improve the effect of operation,and have positive significance to improve the postoperative symptoms.

Objective:To determinate the substances with high molecular weight in porcine anterior pituitary and adrenal cortex extracts injection. Methods:The HPLC analysis was performed on a TSK-GEL G2000SWXL(7. 8 mm × 300 mm,5 μm) column with the mobile phase of trifluoroacetic acid-acetonitrile-water(0. 05:35:65). The flow rate was 0. 5 ml·min-1, and the detection wave-length was 214 nm. Results:The substances with high molecular weight in porcine anterior pituitary and adrenal cortex extracts injec-tion was below 1%. Conclusion:The method is simple and repeatable, which can be used for the control of the substances with high molecular weight in porcine anterior pituitary and adrenal cortex extracts injection.

Objective To investigate the protective effect of butylphthalide for focal cerebral ischemiareperfusion injury and its possible mechanism.Methods A total of 60 healthy and clean adult Sprague-Dawley rats were randomly divided into sham operation,saline control,low-dose butylphthalide and high-dose butylphthalide groups (n =15 in each group).A focal cerebral ischemia-reperfusion model was induced by the suture method.At the beginning of reperfusion,100 rng/kg and 400 mg/kg butylphthalide injection were injected intraperitoneally in the rats of the low-dose butylphthalide and high-dose butylphthalide groups; 0.5 ml/kg saline was injected intraperitoneally in rats of the sham operation and saline control groups.All the rats were sacrificed after 24 h of ischemia-reperfusion.Results The degree of neurological deficit in the low-dose butylphthalide (t =1.488,P =0.000) and high-dose butylphthalide (t =2.362,P =0.000) groups were significantly improved compared to the saline control group,in which the high-dose butylphthalide group was improved more significantly than the low-dose butylphthalide group (t =-0.873,P =0.000).The infarct volume in the low-dose butylphthalide (t =18.589,P =0.000) and high-dose butylphthalide (t =36.963,P =0.000) groups were reduced significantly compared to the saline control group,in which the infarct volume of the high-dose butylphthalide group was reduce more significantly than that of the low-dose butylphthalide group (t =-18.374,P =0.000).HE staining showed that neurons were sparse,there were a large number of degeneration and necrosis,cell space became larger,and the intercellular substances showed vacuolar changes.In the butylphthalide group,the neuronal degeneration and necrosis reduced significantly,the survival of nerve cells increased,and the improvement of the high-dose butylphthalide group was more remarkable.SOD activity of the low-dose and high-dose butylphthalide groups were increased significantly compared to the sham operation and saline control groups (all P ＜0.05),in which the SOD activity in the high-dose butylphthalide group was significantly higher than that in the low-mall dose butylphthalide group (t =80.199,P =0.000); The MDA levels in the low-dose and high-dose butylphthalide groups were decreased significantly compared to the sham operation and saline control groups (all P ＜ 0.05),in which the MDA level in the high-dose butylphthalide group was significantly lower than that in the low-dose butylphthalide group (t =-1.308,P=0.000).Conclusions The protective effect of butylphthalide on ischemia-reperfusion injury may be associated with the increased antioxidant activity.

Objective To explore and analyze the timing and postoperative effect of proximal femoral nail anti-rotation( PFNA) for the treatment of elderly femoral intertrochanteric fracture. Methods From September 2011 to March 2013, there were 36 elderly patients with femoral intertrochanteric fractures in our hospital, including 6 cases of type A1, 16 cases of type A2, and 14 cases of type A3. All the 36 pa-tients received PFNA and systematic rehabilitation exercise. Treat the underlying disease and strengthen the nursing to prevent thrombosis at the same time. Hip joint function was evaluated by the Harris score system. Results The average hospitalization of patients is 4 weeks. The wound healing was good in 30 cases and wound infection occured in 2 cases who recovered after subsequent treatment, and the other 4 pa-tients died due to complicated internal medicine diseases. 21 cases of patients were followed up,and their hip joint function recovered well according to the Harris score system, including 12 cases of excellent, 6 cases of good, and 3 cases of eligible, with an excellent and good rate of 85%. Conclusion The application of PFNA for the treatment of elderly femoral intertrochanteric fractures has the advantages of less damage to the local blood supply and better recovery of fracture healing and hip joint function, which is an ideal treatment for the elderly pa-tients with femoral intertrochanteric fractures.

Objective To evaluate the prevalence of macrosomia in Beijing in 2013 and identify its risk factors. Methods Retrospective six months analysis of 14 188 full-term singleton pregnant women from 15 hospitals with different levels in Beijing in 2013. Each participant′s demographic data and medical information were collected individually by questionnaires. Multiple logistic regression analysis was used to examine the associations between variables and the risk of macrosomia. Results (1)The total prevalence of macrosomia was 7.069%(1 003/14 188) in Beijing in 2013. (2)The prevalence varied between the 15 hospitals, the lowest was 5.36%(89/1 659), while the highest reached 8.80%(46/523). Furthermore, the incidence of macrosomia was 1.284 times (95%CI: 1.114-1.480, P=0.001) higher in the second graded hospitals than that in the tertiary hospitals. (3) Multiple logistic regression analyses showed that risk factors for macrosomia were maternal height≥160 cm (adjusted OR=1.875, 95%CI: 1.559-2.256), pre-pregnant body mass index (p-BMI) ≥24.0 kg/m2 (24.0-27.9 kg/m2:adjusted OR=1.696, 95%CI: 1.426-2.018; p-BMI≥28.0 kg/m2:adjusted OR=2.393, 95%CI: 1.831-3.127), gestational weight gain (GWG)≥15.9 kg (adjusted OR=2.462, 95%CI: 2.125-2.853), gravidity>1 (adjusted OR=1.408, 95%CI: 1.224-1.620), gestational weeks≥40 (adjusted OR=2.007, 95%CI:1.745-2.308) and gestational diabetes mellitus (adjusted OR=1.522, 95%CI:1.298-1.784). GWG≥15.9 kg, p-BMI≥28.0 kg/m2 and gestational weeks≥40 were three risk factors that had the strongest associations with macrosomia (all P<0.01). Conclusions The prevalence of macrosomia in hospitals with different levels is obvious different. Gestational weeks, p-BMI and GWG are three main controllable risk factors for macrosomia, thus should receive more attentions.

Objective To investigate the protective effects of edaravone combined with ulinastatin on the treatment of brain injury in rats with severe acute pancreatitis.Methods A total of 100 male Sprague-Dawley rats were randomly divided into 10 groups that consisted of a normal control 6 and 48 hour group,a SAP 6 and 48 hour group,an edaravone treated 6 and 48 hour group,a ulinastatin treated 6 and 48 hour group,and finally a combination of edaravone and ulinastatin treated 6 and 48 hour group.Each group included 10 rats.Neurobehavioral scores were observed and a series of blood,pancreatic tissue,and brain tissue samples were obtained at 6 and 48 hours after operation.Serum amylase,brain tissue Evans Blue content,brain tissue water content,and the histopathological change of the pancreas and brain tissues were observed.Serum TNF-α was detected by RIA.The TNF-α mRNA and nuclear factor kappa B(NF-κB) p65 activity in brain tissues were measured with RT-PCR and immunohistochemistry,respectively.Results In contrast to the 48 hour SAP,edaravone treated,and ulinastatin treated groups,the serum amylase,brain tissue Evans Blue content,brain tissue water content,histopathological score of the rat pancreas and brain tissue,serum TNF-a,TNF-a mRNA,and NF-κB p65 activity in brain tissues significantly decreased while neurobehavioral scores significantly increased in the 48 hour combined edaravone and ulinastatin treatment group (P＜0.01).Conclusion Edaravone combined with ulinastatin can play a protective role on brain injury in rats with severe acute pancreatitis.

Assessing dry weight accurately is crucial in providing effective and safe haemodialysis. Biases towards dry weight assessment may bring a series of dialysis complications. This study introduces an online detection technique of relative blood volume (RBV) based on ultrasound, which analyzes the correlation between changes in blood density and sound speed. By measuring the attenuation in sound velocity, this method was employed to calculate RBV, and then to evaluate the dry weight of patients on dialysis. TDC-GP2 time measurement chip and MSP430 Single-chip Microcontroller (SCM) were used in the system to measure the ultrasonic travel time. In the clinical trials, RBV values range between 71.3% and 108.1%, showing consistent result with Fresenius 4008S blood volume monitor (BVM). This detection method possesses several advantages, such as real time, convenient, reproducible, non-invasive, and etc.
Blood Volume ; Body Weight ; Humans ; Monitoring, Physiologic ; Renal Dialysis ; Ultrasonics

Objective To explore the correlation between anaplastic lymphoma kinase (ALK) fusion gene detected by immunohistochemistry (IHC) and reverse transcription-polymerase chain reaction (RT-PCR) in non-small cell lung cancer. Methods The ALK fusion protein/gene in 71 patients of NSCLC which was detected both by IHC (1A4/1H7) and RT-PCR were retrospective studies, and the 2 methods were compared. Results Among the 71 NSCLC patients, the ALK fusion protein positive was in 21 cases and negative was in 50 cases by IHC detected, while the ALK fusion gene positive was in 12 cases and negative was in 59 cases by RT-PCR. The ALK fusion genes detected by RT-PCR were all negative when IHC negative and IHC 1+. All patients with IHC 2+ and IHC 3+ were confirmed ALK fusion genes positive with RT-PCR. The positive rate of ALK fusion protein detected by IHC in large surgical specimens was 28.95%(11/38), and the positive rate of ALK fusion protein detected by IHC in small biopsy specimen was 30.30%(10/33). The positive rate of ALK fusion gene detected by RT-PCR in large surgical specimens was 18.42%(7/38), and the positive rate of ALK fusion gene detected by RT-PCR in small biopsy specimen was 15.15% (5/33). Conclusions Although the ALK fusion protein detected by IHC may have certain false positive, IHC is highly consistent with RT-PCR in IHC 2+and IHC 3+ cases. The combination of IHC and RT-PCR can be used to ALK fusion gene positive NSCLC screening and diagnosis. The small biopsy specimen is also good material for ALK detection, when the surgical specimen can not be got from patients.

AIM: To investigate Jianwei Yuyang Granule(Radix Bupleuri,Radix codonopsis,Radix paeoniae alba,Rhizoma corydalis,etc.) the effects of on curative effect and quality of life of Helicobacter pylori(Hp)-positive peptic ulcer(PU) patients. METHODS: 46 Hp-positive PU patients whose differentiation of symptoms and signs of the traditional Chinese medicine was the stagnation of liver-QI with deficiency of the spleen type were divided randomly into Jianwei Yuyang Granule group and western medicine control group(Metronidazole,amoxycillin and ondansetron).Eradicative rate of Hp、curative effect under gastroscope、clinical curative effect in Chinese medicine syndrome were observed and quality of life were evaluated by McMaster questionnaire. RESULTS: Compared with western medicine control group,Hp eradicative rates was lower(P0.05),Jianwei Yuyang Granule gained an advantage against western medicine with regard to effect on traditional Chinese medicine syndrome and quality of life(P