Objective To observe the efficacy of oxycodone or fentanyl combined with flurbi-profen esters (FA)for postoperative analgesic after thoracic surgery.Methods Eighty patients,53 males and 24 females,aged 40-65 years,ASA physical status Ⅰ-Ⅲ,undergoing elective thoracotomy surgery,randomly divided into two groups (n =40 each).Oxycodone 0.1 mg/kg (group O)or fenta-nyl 1 μg/kg (group F)were intravenously injected 1 5 minutes before the end of surgery.Each patient was given PCIA,with solution including oxycodone 0.8 mg/kg plus FA 4 mg/kg plus ondansetron 8 mg plus 0.9% NaCl (1 50 ml)in group O and fentanyl 8 μg/kg plus FA 4 mg/kg plus ondansetron 8 mg plus 0.9% NaCl (1 50 ml)in group F.The coughing and resting visual analogue scale (VAS), Ramsay score at 2,6,12,24,36 and 48 hours after operation,complications,the times of patient controlled pressing and requirement for rescue analgesic were evaluated.Results Compared with group F, the resting and coughing VAS at 2, 6, 12, 24, 36 and 48 hours after operation, requirement for rescue analgesic,the incidence of nausea and vomiting and the times of patient con-trolled pressing were significantly lower in group O (P <0.05).There was no significantly difference in the Ramsay score.Conclusion It is effective that the patients undergoing thoracic surgery used the PCIA of oxycodone combined FA to control the postoperative pain, and analgesic effect more excellent than fentanyl combined FA,and with fewer side effects.

OBJECTIVETo study the long-term curative effects of suture plus proximal gastric vagotomy (PGV) and suture plus triad-therapy (omeprazole, amoxycillin and flagyl taken orally) for the treatment of duodenal ulcer with acute perforation.

METHODSThree hundred and twenty-nine patients with duodenal ulcer and acute perforation were treated with 2 different methods, respectively. Method A was suture plus PGV (group A, 153 cases), and method B was suture plus triad-therapy (group B, 176 cases). Follow-up was made by means of correspondence, outpatient reexamination and cooperation with local hospitals in 5 to 8 years after operation. The contents of follow-up included symptom acquisition (such as upper abdominal pain or distention, pyrosis, belch, acid regurgitation, vomiting, diarrhea and conditions of living or working), gastroscopy and Helicobacter pylori (HP) detection. The curative effects were evaluated by the Visick scale.

RESULTSThree hundred and one patients were followed up (group A 142 and group B 159). According to the Visick scale, 97 (68.3%), 19 (13.4%), 13 (9.15%) and 13 (9.15%) patients in group A, and 31 (19.5%), 28 (17.6%), 24 (15.1%) and 76 (47.8%) in group B were classified as Visick I, II, III and IV respectively (Z = -9.818, P < 0.01). As for HP detection, there were 130 (91.5%) patients in group A and 94 (59.1%) in group B (chi(2) = 41.438, P < 0.01).

CONCLUSIONSThe long-term curative effects of suture plus PGV were superior to those of suture plus triad-therapy for duodenal ulcer with acute perforation although HP positive rate was higher in group A than in group B. HP infection is one of the etiological factors of duodenal ulcer. The increased excitability of the vagus nerve remains to play an important role in duodenal ulcer.

Acute Disease ; Adolescent ; Adult ; Aged ; Amoxicillin ; administration & dosage ; Drug Therapy, Combination ; Duodenal Ulcer ; drug therapy ; etiology ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Metronidazole ; administration & dosage ; Middle Aged ; Omeprazole ; administration & dosage ; Peptic Ulcer Perforation ; drug therapy ; surgery ; Suture Techniques ; Vagotomy, Proximal Gastric ; methods

Objective:To study the pharmacodynamics of Shaoteng Decoction obtained by three different extraction methods; To explore the immunosuppressive effect of Shaoteng Decoction; To optimize the extraction process.Methods:The extract of Shaoteng Decoction was prepared by water extraction, 70% ethanol extraction and water extraction and alcohol precipitation respectively. Totally 30 NOD mice were randomly divided into Shaoteng Decoction water extraction group (processⅠ), Shaoteng Decoction 70% ethanol extraction group (processⅡ), Shaoteng Decoction water extraction and alcohol precipitation group (processⅢ), model group and hydroxychloroquine group according to their body weight, with 6 mice in each group. Another 6 Balb/C mice were set as normal control group. In the processⅠ, process Ⅱ, and process Ⅲ groups, 16 g/kg of Shaoteng Decoction extract was given by gavage, while in the hydroxychloroquine group, 60 mg/kg of hydroxychloroquine sulfate was given by gavage. The normal control group and the model group were given the same volume of deionized water once a day for 4 weeks. After the last administration, the spleen index and submandibular gland index were calculated, the pathological morphology of submandibular gland was observed by HE staining, and the serum levels of IL-1β, IL-6, TNF-α, dehydroepiandrosterone (DHEA), estradiol (E 2) and immunoglobulin G (IgG) were determined by ELISA. Results:Compared with the model group, the spleen index of each drug group decreased ( P<0.01 or P<0.05), and the submandibular gland index of the process Ⅲ group and hydroxychloroquine group increased ( P < 0.01). The pathological score of submandibular gland in each administration group decreased ( P<0.01 or P<0.05), the serum levels of IL-1β, IL-6, TNF-α and IgG decreased ( P<0.01 or P<0.05), and the DHEA level increased ( P<0.01 or P < 0.05). The level of serum E 2 in process group Ⅰ, process group Ⅲ and hydroxychloroquine group increased ( P<0.01 or P<0.05). Conclusion:Shaoteng Decoction can effectively reduce inflammation and inhibit immunity of NOD mice. In addition, the extract under the process of water extraction and alcohol precipitation has better efficacy, which is the optimal technology.

Objective:To screen the active components, target genes and signaling pathways of Shaoteng Decoction in the treatment of Sjogren's syndrome by network pharmacology; To conduct relevant experimental verification to explore the mechanism of action of Shaoteng Decoction in the treatment of Sjogren's syndrome.Methods:The active components and targets of Shaoteng Decoction were collected by retrieving TCMSP. The target genes of Sjogren's syndrome were collected through the GeneCards database. The intersection targets of drugs and diseases were obtained by using Venn. The intersection targets were imported into the STRING database to obtain PPI networks, and the "drug-active component -therapeutic target-disease" network was constructed by Cytospace 3.7.2 software. The DAVID database was used for GO function enrichment analysis and KEGG pathway analysis. The 18 NOD mice were divided into model group, TCM group, hydroxychloroquine group, with 6 mice in each group, and 6 Balb/C mice were set as normal control group. TCM group was gavaged with 2.3 g/kg of Shaoteng Decoction, hydroxychloroquine group was gavaged with 60 mg/kg of hydroxychloroquine, and model group and normal control group were gavaged with equal volume of deionized water once a day for 4 consecutive weeks. The daily water intake of mice during the administration period was recorded, the pathological changes of submandibular gland tissue were observed by HE staining, and the levels of serum inflammatory factors IL-17 and TNF-α were determined by ELISA method.Results:39 main active components of Shaoteng Decoction, 1 062 targets of Sjogren's syndrome, and 64 targets of drug and disease intersection were obtained, including TNF, IL6, NCOA1, AKT1, TP53, etc. The treatment targets of Sjogren's syndrome mainly affected biological processes such as response to bacterium and cellular response to lipid, and regulated TNF-α pathway and IL-17 signaling pathway. The experimental results showed that the levels of TNF-α and IL-17 in the TCM group were lower than those in the model group ( P<0.05). Conclusion:Shaoteng Decoction can regulate IL-17 and TNF-α signaling pathways, inhibit inflammation, delay submandibular gland disruption, and alleviate the symptoms of Sjogren's syndrome.

Objective To evaluate the clinical effect of iliac artery interventional chemotherapy combination with bladder perfusion for high level of bladder urothelial carcinoma after transurethral bladder tumor electricity cut operation for those who intend to retain the bladder.Methods From February 2010 to December 2016,a total of 74 cases high-grade urothelial carcinoma of the bladder,giving chemotherapy and suitted support were retrospectively analyzed.The patients were divided into two groups according to different chemotherapy methods.Artery perfusion chemotherapy group:43 cases treated by transurethral bladder tumor cutting + bilateral iliac artery interventional perfusion chemotherapy + bladder perfusion in combination therapy;Intravenous chemotherapy group:31 cases underwent transurethral bladder tumor cut method + cisplatin,vein gemcitabine + bladder perfusion chemotherapy combined therapy.According to the ((x) ± s) between the groups.The method of count data is represented by chi-square test.Kaplan-meier method was used to describe the survival time of two groups of patients after operation.Results Two groups of patients with postoperative there was no statistically significant difference in disease-free survival time.In the bone marrow suppression (x2 =4.956,P =0.029);gastrointestinal tract reaction (x2 =5.912,P =0.012);dermatitis,mucositis (x2 =4.276,P =0.013),etc.,has the advantages in the iliac artery interventional perfusion chemotherapy (P ＜ 0.05).Conclusion Via efficient iliac arterial infusion chemotherapy in patients with venous chemotherapy patients,to the retention of the bladder has a certain value,and the incidence of adverse reactions after surgery is low,have certain advantages.

OBJECTIVE: To explore the influencing factors of the occurrence of propagated sensation effects at Zusanli (ST 36) based on artificial intelligence technology. METHODS: A total of 272 undergraduates and postgraduates of Guangzhou University of TCM were recruited. The basic information, including TCM constitution, body weight index (BMI), pulse, tongue and coating, face complexion, as well as the occurrence of propagated sensation effects at Zusanli (ST 36) with different acupuncture needles and techniques, were recorded. The repeated incremental pruning to produce error reduction (RIPPER) algorithm was applied to predict the results and summarize the rules of relevant factors. RESULTS: ① The propagated sensation effects were often observed in the subject with -deficiency constitution (55 cases in total, of them 1 case was misclassified). ② The propagated sensation effects were observed in the subject with balanced - constitution (39 cases in total, of them 0 case was misclassified). ③ The propagated sensation effects were observed in the subject with phlegm-damp constitution combined with thin tongue and white coating (31 cases in total, of them 8 cases were misclassified). ④ The propagated sensation effects were observed in the subject with phlegm-damp constitution combined with light tongue coating (7 cases in total, of them 2 cases were misclassified). ⑤ The propagated sensation effects were observed in all the subject with special constitution (6 cases in total, of them 0 cases were misclassified). ⑥ The propagated sensation effects were not observed in the subject with other constitution or the combination of constitution and symptoms (134 cases in total, of them 4 cases were misclassified). The accuracy rate of classification was 94.49%. The difference of acupuncture needles and techniques was not significant in propagated sensation effects (>0.05). CONCLUSION The TCM constitution may be the most essential factor in the occurrence of propagated sensation effects.
Artificial Intelligence ; Humans ; Medicine, Chinese Traditional ; Mucus ; Sensation ; Yin Deficiency ; Yin-Yang

Objective:To evaluate the effect of gender on neuromuscular blockade of rocuronium in epileptics.Methods:Forty American Society of Anesthesiologists physical status Ⅱ or Ⅲ patients, aged 18-59 yr, with body mass index of 18.5-24.0 kg/m 2, scheduled for elective surgery for treatment of epilepsy under general anesthesia, were divided into 2 groups ( n=20 each) according to gender: male group (group M) and female group (group F). Neuromuscular conduction function was monitored with a muscle relaxation monitor.Ulnar nerve was stimulated in TOF mode (frequency 2 Hz, wave width 0.2 ms, stimulation current 70 mA and interval 12 s). Rocuronium 0.8 mg/kg was injected intravenously during anesthesia induction, and endotracheal intubation was performed when T l reached maximum inhibition.The conditions of endotracheal intubation were evaluated by the modified method.When T 1 recovered to 25% during operation, rocuronium 0.15 mg/kg was intravenously injected.Sugammadex sodium 2 mg/kg was injected intravenously when T 1 recovered to 50% after surgery.The onset time (T onset), peak time (T peak), 10% recovery time (T 10%), 10%-25% recovery time (T 10%-25%), 25%-50% recovery time (T 25%-50%), 50%-75% recovery time (T 50%-75%) and 75%-90% recovery time (T 75%-90%) of rocuronium were recorded.Peripheral venous blood samples (3 ml) were collected when T 1 recovered to 25% and 75%, and the concentration of rocuronium was detected by liquid chromatography-tandem mass spectrum.The consumption of rocuronium per unit of weight per minute was calculated. Results:There was no significant difference between the two groups in terms of T onset, T peak, T 10%, T 10%-25%, T 25%-50%, T 50%-75%, T 75%-90%, endotracheal intubation conditions, blood concentration of rocuronium at varied time points, or consumption of rocuronium per unit of weight per minute ( P>0.05). Conclusion:Gender exerts no effect on the neuromuscular blockade of rocuronium in epileptics.