OBJECTIVE:To investigate the influence of dexmedetomidine combined with fentanyl on analgesic effects and hemodynamics of orthopedics patients after surgery.METHODS:A total of 80 patients undergoing orthopedics surgery were randomly divided into observation group (40 cases) and control group (40 cases).Observation group was given patient-controlled analgesia (PCA) of Dexmedetomidine hydrochloride injection+Fentanyl citrate injection,maintaining analgesia for 48 h.Control group was given PCA of Fentanyl citrate injection,maintaining analgesia for 48 h.The MAP,SpO2,HR,VAS and the occurrence of ADR were observed in 2 groups from the application of multi-function monitor to connecting to PCA (T0),12 h after connecting (T1) and 48 h after connecting (T2).RESULTS:At T0,there was no statistical significance in VAS score between 2 groups (P＞0.05).VAS scores of 2 groups at T1-2 were significantly higher than at T0.Those of 2 groups at T1 were significantly higher than at T2;but the observation group was significantly lower than the control group,with statistical significance (P＜0.05).There was no statistical significance in MAP,SpO2 or HR between 2 groups at different time points (P＞0.05).The incidence of respiratory depression,sharp pain,nausea and vomiting,hypotension in observation group were significantly lower than control group,with statistical significance (P＜0.05).CONCLUSIONS:Dexmedetomidine combined with fentanyl show significant analgesic effect after orthopedics surgery,and have no effect on hemodynamics with good safety.

Objective:To observe the effect of ischemic preconditioning(IP)on hepatocellular apoptosis caused by ischemia-reperfus ion(IR)injury and expression of apoptosis regulatory genes(Survivin,HIF-1?)protein,to explore the protective mechanisms of IP on IR injury in rat liver.Methods:Ninty SD rats were randomly divided into sham operation(SO)group,ischemia-reperfusion(IR)group,ischemic preconditioning(IP)group.In SO group,the hepatoduodenal ligament of rat was only pulled and separated,and then closed the abdomen;IR group subjected to 30 minutes of ischemia;IP group was achieved by ischemia for 5 minutes,followed by reperfusion for 5 minutes before continuous to ischemia for 30 minutes.Ten rats of each group were killed after reperfusion for 2,6,12,24 hours respectively,then liver tissues were taken out.The rats in SO group were killed after operation for 2 hours.To detect the Apotosis index(A)Iand Survivin,HIF-1? protein levels.Results:AI of hepotocytes significantly increased in IR group and IP group than that in SO group(P

Objective To observe the effect of neural stem cell (NSC)transplantation on the hindlimb motor function and caspase-3 expression of motor cortex (MC) in spinal cord transected (SCT) rats. Methods S prague-Dawley (SD) rats were randomly divided into sham operated group, operation group( T9 transection), and subacute NSC transplantation group. The MC of each group( n= 8 )was harvested 7 days post operation (dpo), then western blot was employed to detect the level of caspase-3( β-actin was used as control ). The left 5 animals of each group were subjected to BBB score evaluation at 16th week,then the animals were sacrificed and the MC was harvested and performed immunostain by using caspase-3 rabbit antibody. Results Following NSC transplanta tion, BBB scores( ( 7.58 ± 0. 99 ) ) increased significantly than seen in the SCT animals( ( 5.16 ± 1.19) ). The expressional level of caspase-3 at 7day post operation was( (0.89 + 0.12)) in MC of SCT rats,while it decreased significantly to( (0.76 + 0.11 ) ) in NSC transplantation rats(P＜0.05). The immunoreactive stain of caspase-3 was seen in the cytoplasm of pyramidal neuron in the cortex. Conclusion NSC engraft can downregulate the expression of caspase-3, corresponding to a significant improvement in hindlimb motor function. These findings indicate that NSC transplantation probably regulate the expression of apoptosis genes in MC to promote neurological function recovery in rats subjected SCT.

Objective To retrospectively compare the postoperative recovery and medical cost of pediatric patients underwent fast track cardiac anesthesia(FTCA,extubated in operating room)or regular anesthesia(extubated out of operating room).Methods From January 2005 to January 2006,108 children with congenital heart disease were operated under FTCA,108 patients who received regular anesthesia were set as a control group.The general characteristics,anesthetic method,postoperative treatments,recovery,and medical cost of the two groups were compared.Results The mean body weight of FTCA group was significantly higher than that in the control [(13.8?4.2)kg vs(10.9?3.8)kg,t=5.321,P=0.000].The patients received sevoflurane for anesthesia induction in the FTCA group were more than those in the control(58 vs 16,?2=36.260,P=0.000).The mean dosage of fentanyl used during operation in FTCA group was significantly lower than that in the control [(10.9?7.3)?g/kg vs(18.0?5.7)?g/kg,t=-7.697,P=0.000].In addition,fewer patients in FTCA group used more than one kind of sedative after the operation(7 vs 19,?2=6.296,P=0.012).95 patients in FTCA group returned to their ward without extubation-related complications.No significant difference in length of hospital stay was found between the two groups,however,the medical cost of FTCA group was significantly lower than that in the control(P

Sleep deprivation (SD) has been taken as an independent predictor for cardiovascular risks, which was closely related to the increased morbidity and mortality in coronary heart disease (CHD). In this article, after reviewing the impact of modern medical method sleep deprivation on CHD and studies on principle method recipe medicines for preventing and treating CHD, the authors observed the autonomic nerve dysfunction, hormonal metabolism dysfunction, endothelial dysfunction and inflammatory responses after sleep deprivation, which can cause or aggravate CHD. On the basis of the traditional Chinese medicine theories of "heart dominating the blood and vessels and the mind", the authors considered that traditional Chinese medicines can tonify heart and soothe the nerves, reducing all of the risk factors through multi-target and multi-pathway, and improve sleep and decrease the risk factors caused by sleep deprivation, which provides a new idea for the prevention and treatment of CHD.
Animals ; Coronary Disease ; drug therapy ; etiology ; prevention & control ; Drugs, Chinese Herbal ; administration & dosage ; Humans ; Sleep Deprivation ; complications

Objective To determine the effects of endogenous testosterone on early atherosclerosis of coronary artery in castrated rabbits fed with high fat diet.Methods 30 adult male New Zealand white rabbits were randomly allocated to three groups:castrated group,physiological level group [6mg/kg intramuscular injection of testosterone undecanoate(TU)after cas tration,once every two weeks] and sham operation group.All animals were fed with high fat diet,but only the animals in both castrated group and physiological level group were castrated(bilateral castration)reproduce models with different testosterone levels.Serum total testosterone and estradiol,serum lipids and lipoproteins were determined 12 weeks after model establishment.The intimal thickness of coronary and kidney artery were measured and analyzed.Results The average level of serum TC,TG,LDL-C,ApoB,LDL-C/HDL-C and ApoB/ApoA1 were higher in castrated group than in sham operation group and physiological level group(P0.05).Conclusion The decrease in endogenous testosterone provokes early atherosclerosis of coronary artery in male rabbits fed with high fat eiet.

Objective To explore the key points of the diagnosis and treatment of severe pneumonia following renal transplantation in the elderly. Methods The clinical data of 28 patients with severe pneumonia following renal transplantation were retrospectively analyzed, including 20 cases aged <60 years (<60 years old group) and 8 cases aged ≥60 years (≥60 years old group). Results In <60 years old group, the severe pneumonia occurred during 1-13 months after the renal transplantation. All the patients had fever. 10 cases coughed and 8 cases had expectoration. 6 cases had type I respiratory failure (RF) and 3 cases experienced type 11 RF. 6 cases had lobar pneumonia and 13 cases occurred interstitial pneumonia. One case experienced lung consolidation. The pathogens of 16 cases in <60 years old group were identified, including 4 cases with bacterial pneumonia, 4 cases with cytomegalovirus (CMV) pneumonia, 2 cases with pneumocystis carinii pneumonia, Ⅰ case with mycoplasma infection, Ⅰ case with tuberculosis infection, and 4 cases with mixed infection (2 cases infected by bacteria plus CMV, 1 case by bacteria plus fungi and 1 case by bacteria plus tuberculosis). Combined drugs (broad-spectrum antibiotic, antivirus and antifungal agent) were administered on the initial stage and sensitive drugs were used later according to the pathogens. Hormone or immunoglobulin was used when other drugs were useless. 17 cases were cured and 3 cases died. In ≥60 years old group, the severe pneumonia occurred during 1-9 months after renal transplantation. All 8 patients had fever, too. 5 cases coughed and 3 cases had expectoration. 3 cases experienced type ⅠRF and 1 case experienced type Ⅱ RF. 3 cases had lobar pneumonia and 5 casesoccurred interstitial pneumonia. The pathogens of 5 eases were identified. Among them, 2 cases were affected by bacterial pneumonia, 1 case by CMV pneumonia and 2 cases by mixed pneumonia (one by bacteria plus CMV, one by bacteria plus fungi). Similar modality was applied, and 5 cases were cured and 3 cases died. Conclusions Most of severe pneumonia occur during 1-9 months after renal transplantation in the elderly. The main pathogens are bacteria and CMV. Medications for all of the most common pathogens and assisted ventilation should be used early. Specific narrow-spectrum antibiotic or antiviral drugs could be used quickly after pathogens were identified, and hormone or immunoglobulin could be administered to patients when the infection is severe or the pathogens are uncertain.

Child, Preschool ; Diagnosis, Differential ; Humans ; Male ; Myositis Ossificans ; diagnosis ; diagnostic imaging ; pathology ; physiopathology ; Prognosis ; Tomography, X-Ray Computed

OBJECTIVE:To provide reference for rational use of polycystic ovary syndrome(PCOS)drugs. METHODS:The utilization of PCOS drugs in our hospital during Jan.-Dec. 2013 were analyzed in respects of consumption sum,DDDs,sorting and so on. The rationality of prescription was analyzed according to guidelines and drug package inserts and so on. RESULTS:There were 1 551 prescriptions,involving 76 kinds of drugs,and their total consumption sum was 181 072.90 yuan. Main types of drugs were hormone related drugs (accounting for 81.37% of prescription frequency,73.51% of consumption sum) and Chinese patent medicine (accounting for 15.41% of prescription frequency,19.43% of consumption sum). Top 5 hormone drugs in the list of DDDs were Ethinylestradiol and Cyproterone acetate tablets,Metformin hydrochloride enteric-coated tablets,Progesterone soft cap-sule,Dydrogesterone tablets and Progesterone soft capsules. Top 5 Chinese patent medicines in the list of DDDs were Kuntai cap-sule,Yougui capsule,Huanshao capsule,Jiawei xiaoyao capsule and Nvjin capsule. Single drug accounted for 72.08% in prescrip-tion. The proportion of irrational drug use was 1.69%. CONCLUSIONS:The application of drug in patients with PCOS is reason-able generally. Some prescriptions are unreasonable,mainly manifesting as incomplete clinical diagnosis,irrational usage and dos-age. Pharmacists should strengthen prescription verification and intervention.