OBJECTIVE: To compare the economic effects of MS Contin and oxycontin in treatment of cancer pain. METHODS: 120 patients with cancer pain were divided into GroupA1(30 cases),GroupA2 (30 cases),GroupB1 (30 cases) and GroupB2(30 cases). GroupA1 and GroupA2 were received MS Contin via p.o. for 15 days while GroupB1 and GroupB2 oxycontin via p.o. for 15 days. Pharmacoeconomics was applied in costeffectiveness analysis. RESULTS: Effective rates of GroupA1,GroupA2,GroupB1 and GroupB2 were 70.00%,83.33%,96.67% and 90.00%. The costeffectiveness ratios were 385.71,324.01, 284.58 and 305.67,respectively.The incremental costeffectiveness ratios of GroupB1 and GroupB2 were 19.12 and 25.50,respectively as comparing with GroupA1. CONCLUSION: Therapy of GroupB1 is optimal among 4 schemes based on the curative effect or costeffectiveness analysis.

Objective To observe and investigate the effects of the case-based learning assisted with WeChat software in the teaching of nursing constitution regulating theory. Method The two classes of nursing undergraduate Grade 2013 were randomized into the case-based learning (CBL) group and the traditional teaching group (LBL). WeChat group combined with CBL group made preparation before class, including teachers writing the cases and thinking questions, WeChat sending teaching information, students discussing problems in group and collecting information. In class, students gave presentation and made speech, and the teachers made comments, did summary and gave scores to students' performance. In LBL group teacher prepared a lesson, and taught lessens assisted by multimedia PPT. After class, we used the test of nursing constitution regulating and teaching effect questionnaire to compare the differences between the two groups, using SPSS 21.0 for data statistics, and t test for measurement data. Results The single choice score, multiple choice score and the total score of the test of nursing constitution regulating in the CBL group were (52.46±4.35), (33.42±3.11), and (85.88±5.72), higher than the LBL group which were (47.63±5.84), (29.88±4.55), and (77.50±7.88). The difference was statistically significant. Scores of self-study ability, interest in learning, literature retrieval ability, communication and cooperation ability, TCM differentiation and the examination scores in CBL group were significantly higher than that in LBL group. Conclusion The case-based learning assisted with WeChat software can inspire the interest of learning, cultivate the self-study ability and practice the ability of TCM differentiation. It is worthy of being generalized.

OBJECTIVE:To evaluate the analgesic effects and ADR of fentanyl transdermal patches in different therapies. METHODS:189 patients with cancer pain were randomized into three groups:routine dose fentanyl transdermal patches group(group A) ;routine dose fentanyl transdermal patches +12 h controlled-release morphines(Ms) group(group B) ;twice routine dose fentanyl transdermal patches+12 h controlled-release Ms group(group C) . The curative effects of treatment for 6 days in3 groups were compared by VAS method. RESULTS:In group A,B and C,significant differences were noted in curative efficacy(P0.05) . CONCLUSION:The therapy of group C shows better analgesic effect,safety and clinical value than the other two groups.

Rhetsinine has been isolated from the fruits of Evodia rutaecarpa ( Juss. ) Benth. ~1H NMR and ~(13)C NMR assignments reported previously for rhetsinine were revised on the basis of UV, IR, ESI-MS,~1H NMR, ~(13)C NMR and X-ray crystallographic analysis.

Objective To study the relationship between tacrolimus blood level/dose and the genotype of CYP3A5 at 6th month after lung transplantation.Method Forty-six cases of lung transplant recipients who received the surgery between January 1st,2011 and January 1st,2013 served as the research subjects,and the genotypes of these patients were measured.These patients were divided into 3 groups (CYP 3A5 * 1 * 1,CYP 3A5 * 1 * 3,CYP 3A5 * 3 * 3) according to their different genotypes.The dose of tacrolimus and daily intake were detected at 6th month after surgery in each group,then the level/dose of tacrolimus was calculated.Result In all 46 recipients,5 of them were CYP 3A5 * 1 * 1 homozygous genotype,20 CYP 3A5 * 1 * 3 heterozygous genotype and 21 CYP 3A5 * 3 * 3 homozygous genotype.Under the condition of holding tacrolimus blood level between therapeutic range,there was significant difference in the dose of tacrolimus between the CYP3A5 * 1/ * 1 and * 1/* 3 versus * 3/* 3 genotypes (P＜0.01),but there was no significant difference between CYP3A5 * 1/* 1 genotype and * 1/* 3 genotype.Conclusion Tacrolimus dosing in lung transplant patients is associated with CYP 3A5 gene polymorphisms.

Objective To investigate effectiveness of treatment of Upper urinary tract calculus by MPCNL application.Methods From May 2000 to May 2007,causing artificial kidney hydronephrosis for the affected kidney,established renal percutaneous channels(F16～18),which established the single channels of 202 cases,dual-channel of 14 cases,by Ureteroscopic Lithotripsy and holmium laser lithotripsy.Results 183 cases of 216 patients were One-time stone;33 cases were second stone.The average clearance rate is 90.32%,the average operation time is 79min,average valume of about bleeding is 80ml,the average hospitalization days are 8 days,kidney ostomy average stay 7.5 days.Of the operation,9 cases of obviously bleeding(4%)before and after operation,1 case uncontrollable bleeding after interventional treatment failure with Nephrectomy,others to stop beeding by symptomatic treatment,2 cases find urinary extravasation postoperative and cured by adjusting location of renal ostomy.Conclusion Minimally invasive percutaneous nephrolithotomy for the treatment of Upper urinary tract calculus is safe and effective for patients with less trauma,quicker recovery and high learance rate,the efficacy is satifactory.

Objective To evaluate the method and result of thyroid artery embolization as a new therapy for hyperthyroidism. Methods Twenty two patients with hyperthyroidism underwent selective thyroid artery embolization. Totally 52 thyroid arteries were embolized with microspheres. The indications to this therapy were following: hyperthyroid patients having indications to surgical and 131 I therapy, clinically being difficult to complete the preparation for subtotal thyroidectomy and having high risk for surgical process because of their huge thyroid gland. Results Serum level of thyroid hormones dropped significantly [median T3 from 8 8 nmol/L(4 3～ 43 0 nmol/L) to 4 0 nmol/L(1 1～9 2 nmol/L), median T4 from 206 4 nmol/L(77 4～748 2 nmol/L) to 144 5 nmol/L(25 8～279 9 nmol/L), P

Objective To study the effect of dexmedetomidine complex with remifentanil in elderly patients with laparoscopic colon cancer resection.Methods 80 cases of elderly patients with laparoscopic colon cancer resec-tion were selected and divided into the study group and the control group with 40 patients in each group according to the random number table method.Two groups were induced conventionally,and intraoperative anesthesia maintained by remifentanil and sevoflurane.The study group were pumped dexmedetomidine 0.8μg/kg 10min before induction, then the doses reduced to 0.2 μg·kg -1 ·h -1 for continuous pumping until to the end of surgery,while the control group was pumped the same dose 0.9% sodium chloride injection,then the heart rate(HR)and mean arterial pres-sure(MAP)of the two groups were compared when entered into surgery room(T0 ),administered 5min(T1 ),after intubation(T2 ),surgical incision(T3 )and after extubation(T4 ),and the compose score,recovery time,and agitation score of two groups were compared.Results HR and MAP of the study group at T1 ,T2 ,T3 and T4 were (62.2 ± 1.1)times/min,(67.3 ±3.2)times/min,(69.2 ±2.3)times/min,(70.2 ±2.5)beats/min and(68.3 ±0.5)mmHg,(70.1 ±0.9)mmHg,(71.5 ±0.9)mmHg,(68.2 ±1.9)mmHg significantly lower than which of the control group (t =9.289,10.293,8.928,9.039,9.278,10.789,9.322,8.399,all P <0.05),and HR and MAP of the control group at T1 ,T2 ,T3 and T4 were significantly higher than T0,the differences were statistically significant(t =8.928, 9.892,8.387,8.927,9,783,9,073,9.039,7.938,all P <0.05);Compose score(4.2 ±1.3)points of the study group was significantly higher than (1.2 ±0.2)points of the control group,but the agitation score of the study group was(1.2 ±0.7)points,which was significantly lower than (2.9 ±1.5)points of the control group,the differences were statistically significant(t =9.38,8.379,all P <0.05).Conclusion Dexmedetomidine complex with remifen-tanil has a anesthetic good effect in elderly patients with laparoscopic colon cancer resection,and which can maintain the more stable hemodynamics.

Objective To explore effect of propofol or sevoflurane combined with dexmedetomidine on postoperative cognitive function , erythrocyte sedimentation rate and oxidative stress in patients with bone tumour .Methods 52 cases with bone tumor and requiring a surgery were selected and divided into sevoflurane group and propofol group randomly.The sevoflurane group were anesthetized with sevoflurane and dexmedetomidine.Propofol group were anesthetized with propofol and dexmedetomidine.The cognitive function score, recovery time, sedimentation value and oxidative stress level were compared after operation.ResuIts Compared with propofol group at the same time, the cognitive function score of patients in sevoflurane group at postoperative 6, 12, 24 h were higher (P<0.05) and restored to preoperative levels at postoperative 24 h (P<0.05) .The recovery time of spontaneous breathing, eyes open, remove endotracheal intubation and directional force in sevoflurane group were shorter than that in propofol group (P<0.05).Compared with propofol group at the same time, the erythrocyte sedimentation rate in sevoflurane group at postoperative 5, 10d were lower (P<0.05) and restored to preoperative levels at postoperative 10 d (P<0.05).Compared with propofol group postoperation, the superoxide dismutase (SOD) and methane dicarboxylic aldehyde (MDA) levels in sevoflurane group were lower, total antioxidant capacity (T-AOC) level was higher (P<0.05).ConcIusion Sevoflurane has a smaller effect on postoperative cognitive function than propofol in patients with bone tumor, combined with dexmedetomidine, which has an important significance to clinical surgery.

BACKGROUND:Insulin-like growth factor-1 (IGF-1) is an important mitogen and an indispensable regulator during normal hair cell development. Extracellular signal regulated kinase 1/2 (ERK1/2) is also expressed in mammalian vestibular organs.OBJECTIVE: To investigate the changes of the expression and the distribution of IGF-1, IGF-1 receptor (IGF-1R) and ERK1/2 in guinea pig's vestibular epithelium following gentamycin injury.DESIGN: A randomly controlled study.SETTING: Department of Otorhinolaryngology, General Hospital of Chengdu Military Area Command of Chinese PLA.MATERIALS: Twenty healthy and adult guinea pigs, weighing 300 to 350 g, provided by the Experimental Animal Center,Fourth Military Medical University of Chinese PLA, were randomly divided into four experimental groups and a control group with 4 in each group.METHODS: The experiment was performed at Department of Otorhinolaryngology Research Laboratory of Xijing Hospital,Fourth Military Medical University of Chinese PLA from January 2002 to May 2002. In the experimental groups,gentamycin was intraperitoneally administered daily (80 mg/kg) for 10 consecutive days. For the control group, 1 mL of 0.9% sterile saline was administered in the same way. The guinea pigs, in which unsteady gait or nystagmus appeared,could be involved in the further experiments. Before being sacrificed, the animals' gait, nystagmus and the amount of food-intake were observed every day. The animals were anesthetized deeply with 50 mg/kg pentobarbital 1, 7, 14 or 21days after the last gentamycin administration and then decapitated. Bilateral otic vesicles were harvested and immersed in 4% paraformaldehyde. Then the specimens were decalcified in 10% ethylenediamine tetraacetic acid (EDTA),thereafter embedded in OCT gel and serially sectioned at a thickness of 10 μm in the cryostat. The behavioral changes of guinea pigs were observed. The morphological changes of vestibular epithelium were examined by hematoxylin and eosin (HE) staining. The expression and distribution changes of IGF-1/1R and ERK1/2 were investigated immunohistochemically. MAIN OUTCOME MEASURES: The behavioral, morphological, expression and distribution changes of IGF-1/1R and ERK1/2 of guinea pigs in each group.RESULTS: Twenty involved guinea pigs entered the stage of final analysis. ① All the guinea pigs' vestibular functions were impaired after gentamycin treatment, then partially restored without any pharmaceutical treatment. ②Morphological injury was obvious after gentamycin treatment, and improved 1 week later. ③The expression of IGF-1/1R was low in the control group, and in the 1-day group it increased significantly to its maximum. After that, its expression decreased gradually, but was still higher in the 21-day group than that in the control group. There were significant differences in the expression of IGF-1/1R among different groups (F =51.8,45.7,P ＜ 0.05). The expression changes of IGF-1 and its receptor were similar. ④The expression of ERK1/2 was low in the control group, and increased gradually after gentamycin toxicity. In the 7-day group, the immunoreactivity reached its maximum. Then the levels of ERK1/2 decreased gradually, but were still higher in the 21-day group than that in the control group. There were significant differences in the expression of ERK1/2 among different groups (F =103.7,106.4, P ＜ 0.01), but no significant differences existed in the expression between ERK1 and ERK2 among different groups (P ＞ 0.05).CONCLUSION: The expression of IGF-1/1R and ERK1/2 in vestibular epithelium increased after gentamycin treatment,and IGF-1 may play an important role as an endogenous mitogen through a paracrine or autocrine manner in the early stage of hair cell self-repair of guinea pigs. ERK1/2 may play an important role in signal transduction during vestibular hair cell self-repair after gentamycin toxicity in guinea pigs.