Objective To discuss postoperative analgesia effect of patient automatic controlled epidural analgesia (PCEA) and cocktail therapy (CT) after total hip replacement. Methods Eighty-eighty patients of selective total hip replacement were selected, and the patients were divided into PCEA group and CT group by random digits table method with 44 cases each. The postoperative resting state and active state visual analogue score (VAS), dosage of opioid, discharge time, postoperative complications, postoperative sleep quality score and hip joint mobility were compared between 2 groups. Results The resting state and active state VAS in PCEA group 12, 24 and 48 h after operation were significantly lower than those in CT group, resting state: (3.68 ± 1.45) scores vs. (4.23 ± 1.14) scores, (2.61 ± 1.04) scores vs. (3.92 ± 1.23) scores and (2.31 ± 0.97) scores vs. (3.56 ± 1.21) scores, active state:(4.54 ± 1.63) scores vs. (5.87 ± 2.11) scores, (3.51 ± 0.94) scores vs. (4.34 ± 1.07) scores and (3.01 ± 0.95) scores vs. (4.05 ± 1.17) scores, and there were statistical differences (P<0.05). But there were no statistical differences in VAS 72 h after operation and at discharge between 2 groups (P>0.05). The dosage of opioid in PCEA group was significantly lower than that in CT group:(9.58 ± 5.35) mg vs. (11.27 ± 4.48) mg, and there was statistical difference (P<0.05). The incidences of nausea vomiting and headache dizziness in CT group were significantly lower than those in PCEA group: 20.45% (9/44) vs. 45.45% (20/44) and 4.55% (2/44) vs. 13.64% (6/44), and there were statistical differences (P<0.05). There were no statistical differences in length of hospital stay, postoperative sleep quality score and postoperative hip joint mobility between 2 groups (P>0.05). Conclusions Choice of analgesic regimen of choice should not be made only according to the length of hospital stay. Individualized treatment is recommended. According to specific circumstances and needs of patients, patients with less anesthetics and a tendency to nausea should use PCEA, and for chronic pain patients CT may be more effective.

OBJECTIVE: To evaluate short term quality of life of patients with chronic rhinosinusitis by using Chinese version of the sinonasal outcome test-22 (SNOT-22) and to formulate an ideal therapy system for patients with chronic rhinosinusitis. METHOD: Using prospective randomized controlled design,we chose the SNOT-22 to evaluate and compare 78 CRS patients' quality of life (QOL) before surgery, at 1-month,3-month, 6-month and 9-month after functional endoscopic sinus surgery(FESS). At the same time, we randomly chose 100 healthy controls to compare their QOL with those of CRS patients after FESS. RESULT: We found that except for 5 items (cough, ear expanding, otalgia, facail pain and weary ), the grade of 17 other items of CRS patients were significantly higher than those of the healthy controls (P<0. 05). There was no significant difference in 7 items (olfactory sensation, hypogeusis, backflow of nasal discharge, difficult to fall asleep, bad sleep, bad work efficiency, depression, embarrassment ) at 3 months after FESS between chronic rhinosinusitis patients and healthy controls (P>0. 05). There was no significant difference in 9 items (blow noses, sneeze, rhinorrhea, nasal discharge thickness, dizziness, night wake, tired of wake, attention deficit, sense of loss) at 6 months after FESS between chronic rhinosinusitis patients and healthy controls (P>0. 05). There was no significant difference in nasal obstruction at 6 months after FESS between chronic rhinosinusitis patients and healthy controls (P>0.05), at this time the totle grade was normal (P>0. 05). The recovery period of QOL in patients was about 9 months (P>0. 05). The 5 great items were nasal obstruction, olfactory sensation, hypogeusis, nasal discharge, nasal discharge thickness and blow noses. There was no difference in items except for bad sleep replacing nasal discharge thickness between 1-month and 9-month after surgery. CONCLUSION The Chinese vesion of SNOT-22 could evaluate QOL of CRS patients in this area. The recovery of QOL of CRS patients needs about 6 months after FESS, but problems of olfactory sensation, hypogeusis, nasal discharge and difficult to sleeep still needs to be resolved.
Asian Continental Ancestry Group ; Chronic Disease ; Humans ; Nasal Obstruction ; Prospective Studies ; Quality of Life ; Rhinitis ; complications ; surgery ; Sinusitis ; complications ; surgery ; Smell ; Treatment Outcome

Objective:This study aims to analyze the differences in the alternative splicing pattern of ADAR2 among glioma cell lines U87, U251, A172, and normal human astrocyte HA1800. Methods:A-to-I editing level at the Q/R-Site of GluR-2 was analyzed by RT-PCR and sequencing. Real-time PCR was performed to detect the expression level of each alternatively splicing variant using a specific primer that was confirmed to amplify only the targeted template and not other alternatively spliced variant fragments. Results:We verified that the Q/R-Site of GluR-2 is under-edited in glioma cell lines. Real-time PCR revealed that the ADAR2 pre-mRNA splic-ing pattern has no significant difference at exons 1a and 2 between glioma cell lines and normal human astrocyte. We also detected that the amount of alternative splicing variants, including exon 5a, was higher than that of alternative splicing variants not including exon 5a in human glioma cell lines. However, the expression of alternative splicing variants, including exon 5a, was lower than that of alterna-tive splicing variants not including exon 5a in human astrocyte. Conclusion:Evident differences in splicing were observed at the site of exon 5a between glioma cell lines and normal human astrocytes. The difference in the alternatively splicing pattern at exon 5a may be attributed to the decreased activity of ADAR2.

Heterotopic ossification is a common complication after acetabular fractures and fractures of the elbow.Heterotopic ossification often leads to severe joint movement disorder,which brings great pain to the patient.This paper reviewed the clinical research,including pathogenesis,clinical diagnosis,prevention,treatment and future directions of heterotopic ossification to investigate the effective method in prevention and treatment of heterotopic ossification.

Objective To investigate the changes and roles of Fc gamma receptors (FcγR) expressed on monocytes in the immune pathogenesis of Henoch-Schonlein purpura(HSP).Methods Thirty children of HSP and 15 health controls were enrolled in this study.The expressions of FcγR Ⅰ and FcγRⅢ on monocytes were determined by flow cytometry,and real-time PCR was performed to detect the transcription levels of FcγR Ⅱ a,FcγR Ⅱ b,cytokines(IL-1 β,IL-6,TNF-α,IFN-α),chemokine(IP-10,RANTES,iNOS),and BLyS/April in monocytes isolated by microbeads.The plasma concentrations of IL-4,IL-10 and TNF-α were analyzed by enzyme-linked immunosorbent assay (ELISA).Results (1) The expressions of FcγR Ⅰ and FcγR Ⅲ on monocytes in patients with HSP were significantly up-regulated compared with healthy controls.Transcription level of FcγR Ⅱ a on monocytes in patients with acute HSP was found to be higher than that in healthy controls while the inhibitory FcγR Ⅱ] b mRNA was significant down-regulated(P＜0.05),which resulted in a higher ratio of FcR Ⅱ a/Ⅱ b in patients with acute HSP.(2) The expressions of cytokine/chemokines factor such as IL-1 β,IL-6,TNF-α,IP-10,RANTES,and iNOS in patients with HSP was detected to be higher than those in healthy controls(P＜0.05).In addition,expression levels of BLyS/April were up-regulated during acute HSP(P＜0.05),the positive correlations were observed between the FcγR Ⅱ a/FcγR Ⅱ b and the cytokine/chemokines factor in monocytes(P＜0.05).(3) Plasma concentrations of IL-4,IL-10 and TNF-α were significantly elevated during acute HSP(P＜0.05),and a negative correlation was observed between concentrations of TNF-α and the mRNA level of FcγR Ⅱb in monocytes.Conclusion The abnormal expression of the cytokines and the imbalance of stimulatory and inhibitory FcγR of monocyte in acute HSP.

Objective To investigate the effects of the intravenous immunoglobulin (IVIG) on the expression of FcγR Ⅱ b and Toll-like receptor 4 (TLR4) in children with Kawasaki disease (KD).Methods 25 children with KD and 15 healthy controls were enrolled in this study.The levels of TLR4 expression on monocytes were assessed by flow cytometry.Real-time PCR was performed to detect the transcription levels of FcγR Ⅱ b,TLR4 signaling molecules(MyD88,TRAF-6,TAK1) and cytokines(IL-1β,IL-6,TNF-α) in monocytes.The concentrations of TNF-α in plasma was determined by enzyme-linked immunosorbent assay (ELISA).Results (1) Compared with healthy controls,the expression of TLR4 and the signaling molecules in the patients were significantly up-regulated but decreased after treatment with IVIG (P＜0.05).(2)The levels of FcγR Ⅱb expression from the patients were higher than those from healthy controls,and decreased after treatment with IVIG(P＜0.05).(3) The levels of cytokine factor expression such as IL-1β,IL-6 and TNF-α in the patients were found to be higher than those in healthy controls (P＜0.05) ; plasma concentrations of TNF-α were significantly elevated during acute KD (P＜0.05).(4)There were significantly correlations to follow between FcγR Ⅱb and the levels of cytokine,TLR4 expression in monocytes (P ＜0.05).Conclusion IVIG can up regulate FcγR Ⅱb expression and down regulate TLR4 expression which might inhibit the inflammatory response.

Objective To study the function of cyclooxygenase 2(COX 2) and its specific inhibitor NS 398 on the cell growth and invasion ability of urothelial carcinoma cell line EJ. Methods The cox 2 cDNA was transfected into the urothelial carcinoma cell line EJ and a cell line EJ COX 2 which highly expressed cox 2 gene permanently was gained. The cell growth rate before and after transfection was observed. Then at various concentrations of NS 398, the invasion ability was detected by Boyden Chamber and expression levels of uPA by RT PCR and Western blot. Results The EJ COX 2 cell line grew more rapidly and had a stronger invasion ability than EJ and its uPA expression increased significantly. NS 398 could dose dependently inhibit the expressions of COX 2 and uPA and the invasiveness of EJ COX 2 cell. Conclusion COX 2 can stimulate the growth of urothelial cell line EJ and promote its invasion ability by stimulating the expression of uPA.

Aged ; Aged, 80 and over ; Complement C3 ; metabolism ; Humans ; Immunoglobulin A ; blood ; Male ; Silicosis ; blood ; Tumor Necrosis Factor-alpha ; blood

Objective To discuss the feasibility of laparoscopic renal surgery following kidney rupture.Methods Two patients with left kidney rupture were treated laparoscopiclly at our institution in the last 4 years. 1 operated 7 days after hemorrhage and another operated immediately. Both of them performed retroperitoneal laparoscopic nephrectomy. Results The operations succeeded, the operating time being 100～120 min, the blood loss 200～300 mL. There were no postoperative complications in all cases. Conclusion Laparuscopic exploration and extirpation offer a viable measure to treat kidney rupture.

Objective To investigate the inhibitory mechanism of rabeprazole on acid secretion of parietal cells in rats. Methods Seventy two Spraque-Dawley rats were divided into control group(normal saline), low dose of rabeprazole group (rabeprazole 10 mg/kg) and high dose of rabeprazole group (rabeprazole 20 mg/kg) with 24 each. Four rats in each group were treated at 1 h, 2 h, 4 h, 6 h, 12 h and 24 h, respectively, pH value and activity of H+-K+-ATPase were tested by NaOH titrimetric method and chromatometry, respectively. The changes of ultrastructure of parietal cells were observed by electron microscope. Results Compared with control group(1.97±0.30), pH value in low (3.37± 0.97)and high (5.96±0.26)dose groups were significantly increased(P<0.01), and the activity of H+-K+-ATPase was inhibited obviously at 1 h after administration(3.28±0. 41 vs 1.47±0.27 and 0.92±0.07, P<0.05). Those differences could be found even at 12 h(P<0.01). The ultrastructural changes of parietal cells were consistent with the increase of pH value and decreased activity of H+-K+-ATPase. The significant difference was found in acid depression and excellent time between low and high dose of rabeprazole groups. Conclnsions The uhrastructural changes of parietal cells and the activity of H+-K+-ATPase can accurately reflect the acid secretion in rats. Rabeprazole has powerful and rapid effects in inhibiting acid secretion which correlates with the dosage.