Objectives: To compare the efficacy of patient-controlled epidural analgesia and patient-controlled intravenous analgesia in postoperative analgesia after spinal fusion. Methods: The CNKI, Wanfang, CBM, Pubmed, Embase, Ovid, Cochrane library databases were searched by computer. The randomized controlled trails with patient-controlled epidural analgesia or patient-controlled intravenous analgesia after spinal fusion published from May 1985 to July 2013 were selected. All of them were assessed by the standard of Cochrane systematic review. Data of postoperative VAS and the rate of side effects after using the analgesic drugs were extracted into an electrical sheet, which was synthesized by a Meta-analysis with RevMan 5.2 software. Re-sult: Eight randomized controlled trails involving 482 patients met the inclusion criteria. And the quality grade of 3 literatures was A, 5 literatures was B. The result of meta-analysis showed that: ①Visual analogue score(VAS). The postoperative first day′s VAS[WMD=-0.47, 95%CI(-0.74, -0.20)], second day′s VAS[WMD=-0.66, 95%CI(-1.14, -0.19)] showed that the patient-controlled epidural analgesia had a good analgesic effect compared with the patient-controlled intravenous analgesia, and both had statistic differences(P<0.05). No dif-ference in the postoperative third day′s VAS[WMD=-0.58, 95%CI(-1.38, 0.21)] was observed between the two methods, and no statistic difference(P>0.05); ②The side effects. The patient-controlled epidural analgesia had a higher incidence of skin itch[RR=1.53, 95%CI(1.08, 2.16)], paresthesia[RR=3.34, 95%CI(1.12, 9.98)] after surgery than the patient-controlled intravenous analgesia, and both had statistic differences(P<0.05). While two groups had no a significant deviation about nausea [RR=1.05, 95%CI (0.79, 1.40)], vomiting [RR=0.80, 95%CI (0.48, 1.31)], and no statistic difference(P>0.05). Conclusions: The patient-controlled epidural analgesia has better analgesic effects on the postoperative first and second day after spinal fusion, but obviously has a high-er incidence of skin itch and paresthesia than the patient-controlled intravenous analgesia.

Objective To study content of interleuin-2 receptor(SIL-2R) pathologic relation with inflammation and fibrosis degree in patient with hepatitis of chronic B type.Methods 250 cases in hepatitis of chronic B type and 40 cases in fat liver were alive examined,according to inflammation degree different divided in to the G_1 80 example,G_2 75 example,G_3 50 example,G_4 45 example;According to fibrosis degree different S_0 40 example,S_1 60 example,S_2 50 example,S_3 50 example with the S_4 50 example;40 example fat liver of control group;The comtents of sIL-2R,HA,Ⅳ?C,PLD,LN,PCⅢ had been detected by radioimmunoassy(RIA) and enzyme immunity.Results The contents of SIL-2R of S_1,S_2,S_3 were obviously higher than that S_0(P

Esophageal cancer is a cause of cancer mortality and accounts for the sixth most common cause of cancer-related death. The focus of recent study has shifted towards testing novel agents that target specific molecular abnormalities known to occur in esophageal squamous cell carcinoma (ESCC). The preclinical studies involving various cancer models, including ESCC, epidermal growth factor receptor (EGFR) over-expression, are linked to epithelial cell proliferation, differentiation and migration, and have an inverse relationship to tumor chemotherapy curability. Nimotuzumab is a humanized anti-EGFR monoclonal antibody that binds to the extracellular domain of the EGFR and inhibits EGF binding. In many phase Ⅱ trials, nimotuzumab showed marked antiproliferative, proapoptotic and antiangiogenic effects in tumors that overexpress EGFR. Some phaseⅢtrials are ongoing.

Objective To determine the anatomical and visual outcome of indocyanine-green (ICG)-assisted internal limiting membrane (ILM) peeling for idiopathic macular holes. Methods Thirty-one eyes of 31 patients with 3- (14 eyes, 45.2%) and 4-staged (17 eyes, 54.8%) primary idiopathic macular holes were analyzed. All the patients underwent the subtotal pars plana vitrectomy with removal of the posterior vitreous. ICG solution with the concentration of 1.25 mg/ml was injected into vitreous cavity. The ILM was stained and removed in a circular fashion of 2 to 3 disc-diameter from the edge of the hole. At the end of the surgery, 14% C 3F 8 mixed gas was used and the patients were required to maintain a prostrate posture for two weeks postoperatively. The mean follow-up duration was 9.1 months. Results The preoperative median visual acuity was 20/200. In the final follow-up, 28 eyes (90.3%) had anatomical restoration of the macular holes, 21 eyes had improvement of two lines or more of visual acuity. There was no direct complication or toxicity related to ICG-assisted ILM peeling except one patient with retinal detachment caused by peripheral retinal hole. Conclusion ICG-assisted retinal ILM removal appears beneficial and safe for primary idiopathic 3 and 4-staged macular holes.

Objective To observe the protective effects of mycelium of cultured Cordyceps sinensis on testis in diabetic Wistar rats. Methods 21 rats were divided into control group(C), diabetes group(D) and treatment group (T) at random. Diabetic model was reproduced by intraperitoneal injection of alloxan. After having been treated with Jinshuibao capsule for 8 weeks, serum levels of glucose, insulin, testosterone and levels of high energy phosphate compound, MDA, SOD, GSH-Px, and ATPases in the testis were determined respectively. Results Compared with control group, testicular mitochondria showed lipid peroxidase injury, with disturbed energy metabolism, and the activity of ATPases was lowered. All the changes in serum and testes were improved when Jinshuibao capsule was given. Conclusion Mycelium of cultured Cordyceps sinensis might have protective effects on the testis in diabetic Wistar rats.

ObjectiveTo evaluate the influence of chronic obstructive pulmonary disease on the risk of intrathoracic operation.Methods35 patients associated with chronic obstructive pulmonary disease undergoing intrathoracic operation were analyzed retrospectively.ResultsPostoperative acute and chronic respiratory failure occurred in 4 patients respectively, resulting in 6 deaths.ConclusionThe indication of patients associated with chronic obstructive pulmonary disease for intrathoracic operation should be critically scrutinized, which may include FVC>60% and MVV>40% or FEV1>40%.

Objective To explore the diagnostic value of full-field digital mammography (FFDM) combined with digital breast tomosynthesis (DBT) in breast diseases.Methods 506 patients receiving mammary gland molybdenum target inspection from January 1, 2014 to December 31, 2014 were selected.The images from FFDM and DBT were analyzed, respectively.The breast imaging reports and pathological results were compared to investigate the sensitivity, specificity and accuracy of FFDM, DBT alone and combined use of DBT and FFDM.Results The results of preoperative mammography in the 506 women (bilateral breast) were as follows: FFDM combined with DBT detected 202 benign cases (39.9%) and 304 malignant cases (60.1%);FFDM alone detected 194 benign cases (38.3%) and 312 malignant cases (61.7%);DBT alone detected 187 benign cases (37.0%) and 319 malignant cases (63.0%).Pathologically, 214 benign cases (42.3%) were detected and 292 malignant cases (57.7%).In terms of the sensitivity, specificity and accuracy, The combined use of DBT combined with FFDM was the best, followed by FFDM alone and DBT alone.Conclusion The sensitivity, specificity and accuracy of FFDM combined with DBT for diagnosis are better than those of FFDM alone or DBT alone.

Objective Scutellarin (SCU), a Chinese traditional medicine, has a protective effect against ischemia-reperfusion (IR) induced myocardial injury, but it is not yet clear whether SCU acts against vascular endothelial IR injury via extracellular signal-regulated kinase 1/2 (ERK1/2).The aim of this study was to explore the effect of SCU on hypoxia-reoxygenation (HR)-induced injury to human cardiac microvascular endothelial cells (HCMECs) and its influence on the ERK1/2 signaling pathway.Methods HCMECs were subjected to normal culture and divided into a normal control, a DMSO, an SCU 1 μmol/L, and an SCU 10 μmol/L group.The model of HR injury was established by exposing the HCMECs to 12-h hypoxia and 12-h reoxygenation after treated with DMSO or SCU at 1 and 10 μmol/L for 2 hours.Then, the survival rate of the HCMECs was detected by MTT and trypan blue staining, the concentration of malondialdehyde (MDA) in the cells measured, and the expressions of the p-ERK1/2, ERK2 and GAPDH proteins determined by Western blot.Results SCU at 1 and 10 μmol/L significantly increased the survival rate of the normally cultured HCMECs ([110.40±2.34] and [122.00±1.25] ％) as compared with that of the normal control (100％) (P<0.05), while HR injury markedly decreased the vitality of the HCMECs ([68.00±4.06] ％) in comparison with that of the blank control (100％) (P<0.05).The survival rate of the HCMECs was remarkably higher in the HR+SCU 1 μmol/L and HR+SCU 10 μmol/L groups than in the HR model group ([90.53±3.67] and [92.04±2.32] ％) (P<0.05), and so was their vitality in the SCU 10 μmol/L group than in the normal control ([96.78±2.01] vs [90.06±1.85] ％, P<0.01), while their survival rate was significantly lower in the HR model than in the blank control ([73.72±4.91] vs [91.83±2.34] ％, P<0.01) and remarkably higher in the SCU 10 μmol/L ([87.59±2.64] ％) than in the HR model group (P<0.05).The MDA concentration in the HCMECs was markedly increased in the HR model and HR+DMSO groups as compared with the blank control (P<0.01), but decreased in the HR+SCU 1 μmol/L and HR+SCU 10 μmol/L groups in comparison with the HR model group (P<0.05).The expression of the p-ERK1/2 protein was significantly down-regulated in the HR model group as compared with the blank control (P<0.01), but up-regulated in the HR+SCU 10 μmol/L group in comparison with the HR model (P<0.01).Conclusion HR injury reduces the vitality of HCMECs, increases the MDA concentration, and down-regulates the expression of the p-ERK1/2 protein in HCMECs, while SCU acts against ischemia-reperfusion injury to HCMECs by increasing ERK phosphorylation.

Objective To analyze the clinical features and diagnosis-treatment of pancreatic lymphoma presenting as acute pancreatitis.Methods The clinical records of 7 patients including laboratory findings were retrospectively reviewed.Some related medical literatures were reviewed.Results Seven patients presented acute abdominal pain.Laboratory findings revealed significant increase of serum amylase and lipase levels.CT scan of the abdomen or PET-CT showed a diffuse swelling of the pancreas or masses in the body or tail.Extrapancreatic spread such as bone,bone marrow,spleen infiltrate was found out in 5 patients.Of the 7 patients,6 were diagnosed as the diffuse large B-cell lymphoma,1 as the anaplastic large cell lymphoma.Six patients underwent systematic chemotherapy.Two died and the others received complete or part remission.Conclusion Pancreatic lymphoma is uncommon and represents a rare cause of acute pancreatitis.It needs to be confirmed by histopathologic examination.The standard treatment is not only for acute pancreatitis,but also for NHL including CHOP or CHOP-like chemotherapy.

BACKGROUND:Previous studies have demonstrated that amblyopic patients have a variety of dysopsia compared with normal people.Engineered visual system could find amblyopia through detection of human visual system.OBJECTIVE:To screen sensitive indexes for amblyopia through visual function examination to establish a intemet-based amblyopia screening method.DESIGN,TIME AND SETTING:Randomized,blinded,and controlled experiment.The study was performed at Department of Optometry,People's Hospital of Guangxi Zhuang Autonomous Region from September to November 2008.PARTICIPANTS:A total of 80 volunteers undergoing visual examination in Department of Optometry,People's Hospital of Guangxi Zhuang Autonomous Region were selected,aged 4-19 years.All people had no organic diseases of eyes.They were divided into normal group (n=40) and ambiyopic group (n=40) according to their corrected visual acuity (whether ＞ 4.9).METHODS:Using vision system,the various visual function indexes of each participant were examined.The data from single eye and both eyes were collected and analyzed using Fisher.The sensitive indexes were selected to establish identification function for amblyopia screening.MAIN OUTCOME MEASURES:Age,visual noise,orientation identification and contour integration of participants were examined.RESULTS:Results showed that age,visual noise,orientation identification and contour integration were clinically significant indexes,and cross validation suggested that the identification correct rate was 92.5%.The discriminant function of amblyopia was Y1=1.175X1+0.786X2+0.928X3+1.061X4-0.225X5+2.547X6+1.313X7-18.651;the discdminant function of normal vision was Y2=1.369X1+ 1.728X2+1.779X3+1.549X4-1.912X5+2.665X6+0.387X7 26.640.CONCLUSION:Visual noise,orientation identification and contour integration in vision detection system could be used to screen amblyopia in children,in particular with assistance of internat.