Objective To research the anesthetic effect of ropivacaine compounding with dezocine on brachial plexus block.Methods From January 2011 to September 2013,180 cases upper extremity surgery patients were selected and divided into group A,group B and group C in Nanyang Central Hospital.Patients in group A received 25 mL 0.4%ropivacaine injection for brachial plexus block;based on group A,group B was injected 10 mg dezocine to assist anesthesia;group C received a mixture of 25 mL 0.4% ropivacaine and 10mg dezocine injection.The anesthetic effect and adverse reactions of the patients in three groups were recorded and compared. Results The onset of anesthesia of group C was(17.43 ±1.53)min,which was the shortest of three groups,but there were no significant differences.The duration of sensory blockade and duration of analgesia was(8.22 ±1.63)h and (11.33 ±1.90)h,which were all longer than group A and group B,and there was significant differences(P<0.05);the visual analogue scale(VAS) scores of group C at each time before surgery was the shortest,but there were no significant differences.The VAS scores of group C at 1 h,6 h,12 h and 24 h after surgery were all lower than group A and B,and there were no significant differences.Conclusion Ropivacaine compounding with dezocine on brachial plexus block can improve the effect of anesthesia,extend the duration of analgesia.

0.05).Conclusions IL-11 unlikely to stimulate the growth of the CEM leukemia cell.And did not affect the antitumor effect of HD-MTX.It can be used as an assisting drug in program of acute lymphoblastic leukemia(ALL) therapy.

Objective To study clinical application and complication of heavy silicon oil (Densiron68) in the treatment of traumat- ic proliferative vitreoretinopathy.Design Non-comparatives,retrospective case series.Participants Twenty patients with proliferative vitreoretinopathy resulting from ocular trauma were recruited,whose retinal detachment arising from inferior or posterior retinal breaks. Methods Heavy silicon oil was applied to patients during vitrectomy.Silicone oil or gas was applied to patients with redetachment after heavy silicon oil was removed.Main Outcome Measures The rate of retinal attachment,vision,intraocular pressure,inflammatory re- action of anterior segment and silicone oil emulsification period.Results The rate of retinal attachment with one operation using heavy silicon oil was 50%(10/20 eyes)and 15%(3/20 eyes)with further surgery.The average follow-up time was 3.90?1.41 months.At the end of the follow-up,all tamponade agents were removed in 50% patients.Patients' logMAR vision after the surgery was 2.19?0.86,which was better than before the surgery (2.63?1.00) (P=0.037).There was little evidence of high intraocular pressure,excessive inflammatory reaction of anterior segment and cornea endothelial cell damage,but cataract became more serious without exception.Emulsification rate was 100% and the average emulsification period was 2.18?0.87 months.Conclusions Heavy silicon oil tamponade in vitreoretinal surgery for traumatic proliferative vitreoretinopathy has good efficacy and relatively few complications.However,its emulsification period is relatively short,which may constraint its application to a certain extent.

The aim of the study is to investigate the effect of salvianolic acid B (SalB) on blood-brain barrier (BBB) in rats after cerebral ischemia-reperfusion, and to illustrate its possible mechanisms. Cerebral ischemia-reperfusion was induced by middle cerebral artery occlusion in rats. The break-down of BBB was indicated by extravasations of immunoglobulin (IgG) monitored with immunohistochemistry. The expression of MMP-9 and NOS2 in the brain was determined by immunohistochemistry, and the expression of p-p38 and p-ERK1/2 was detected by Western blotting. It was shown that on day 2 after ischemia-reperfusion the IgG accumulated around the vascular boundary zone, suggesting the break-down of BBB, and the expression of MMP-9 and NOS2 up-regulated at the same time. The result of Western blotting suggested that the expression of p-p38 and p-ERK1/2 increased. On day 7 after ischemia-reperfusion the. expression of MMP-9 and NOS2 was about the same level as day 2, the expression of p-p38 was higher than that on day 2 and the expression of p-ERK1/2 was slightly lower than that on day 2. SalB (1 and 10 mg x kg(-1)) significantly alleviated the extravasations of immunoglobulin induced by cerebral ischemia-reperfusion (P < 0.05). On day 2 and day 7 SalB attenuated the expression of MMP-9 and NOS2 (P < 0.05). SalB (10 mg x kg(-1)) reduced the expression of p-p38 and p-ERK1/2 apparently on day 2 and 7 after ischemia-reperfusion (P < 0.05). SalB (1 mg x kg(-1)) inhibited the expression of p-p38 on day 7 after ischemia-reperfusion (P < 0.05). The results indicate that SalB protects blood-brain barrier in rats after cerebral ischemia-reperfusion by inhibiting the MAPK pathway.

In order to explore a dose distribution verification procedure of intensity modulated radiation therapy (IMRT) for nasopharyngeal carcinoma (NPC) and establish its evaluation criteria, we performed 35 two-dimensional (2D) patient-specific IMRT verifications over the year 2006. The percent of pixels passing gamma and the normalized agreement test (NAT) index were mainly used to represent the agreement between the measured and computed dose distributions with three criteria (2%/2 mm, 3%/3 mm and 5%/3 mm) as recommended in the literature. The results were that all cases passed through verifications with three criteria except that the NAT index of one case was beyond the limitation, and the three tolerance levels of 2%/2 mm, 3%/3 mm and 5%/3 mm produced similar clinical verification results but led to different percent of pixels passing gamma and NAT index. Our data showed that the percent of pixels passing gamma and the NAT index were complementary to evaluate future IMRT verifications as two significant metrics. Due to the influence of the noise and the trait of the software, we considered an IMRT plan as acceptable in case of the percent of pixels passing gamma >95% and the NAT index <5 with the 5%/3 mm criteria for IMRT patient-specific quality assurance (QA).

To study the cause and mechanism of vascular dementia.The author considers kidney deficiency and sputum stasis is the cause and mechanism of vascular dementia,so the treatment of notifying kidney to supplement marrow,activating blood circulation and removing sputum,accompanied by opening orifices medicines should be adopted.

Objective To explore the dose rate response characterization of four kinds of dosimeters for clinical application.Methods Within the range of 100-600 cGy/min,the dose rate responses of the PTW 0.6 cm3 ion chamber,0.015 cm3 ion chamber,Matrixx Evolution 2D diode array and MapCHECK 2D diode array under the same measuring conditions were measured.The dose rate response of the PTW 0.6 cm3 ion chamber under different energy and working voltage were analyzed.Results All ionization chambe.r types of measured equipment showed certain dose rate dependence for 6 MV X-rays.All the differences were below 1％.The dose rate dependence disappeared for 15 MV X-rays.The 2D diode array had strong dose rate dependence and the response difference was about 2％.Conclusions It is necessary to test and analyze the dose rate response of the measured equipment in treatment technology with dose rate varying,in order to ensure the precision of daily calibration and dose verification.

ObjectiveTo explore the effects of different flushing and scanning processing on optical density (A) responding and set up the clinic quality assurance protocol based on silver halide emulsions radiographic films.MethodsSetting different flushing temperature and choosing different batch's film and developer and fixer or fixer in the same batch with different analyzing dose were performed to analyze the effect on A value; The effect of light uniform,the stabilize work time and the noise of different scanning resolution were discussed.ResultsThe A value at the same dose level would enhance as the temperature increased;the responding curve of dose and A value with different batches of films varied a lot;the responding curve of dose and A value with different batches of films and developer and fixer solution had marked variations;the responding of dose and A with the same batches would show some low.The heterogeneity of the scanner would achieve 0.03 ; the A value of the same dose would gradually steady while the time ofscanning was more than 10 minutes:the affect of noise would increase as the dose and resolution ratio increased.ConclusionsThe best processing temperature is 29-31 ℃.Different batches of film couldn't be confounded.A new calibration must be obtained when the film dosimetry to evaluate dose distribution is used.A 5 - 10 min warm up for stabilize work and the best setting resolution/depth lever are 72 dpi/16 bit for scanning films are determined.

BACKGROUND: To determine the non-or collapsed osteonecrosis of the femoral head (ONFH) and degree of collapse, can help surgeons design reasonable treatment strategy for patients with ONFH. In China, articular cartilage collapse less than or greater than 2 mm, is a basis for choosing palliative surgery or hip replacement. However, the measurement of collapsed ONFH before replacement has not yet been confirmed. OBJECTIVE: To predict the collapse of femoral head before replacement by CT and X-ray examinations, and to compare with the intraoperative excised femoral head specimens.METHODS: This was a single-center, open-label and diagnostic trial, which was finished at the Third Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, China. Eighty-six patients with unilateral ONFH undergoing total hip replacement were recruited, and allocated into three groups, such as X-ray, CT and specimen groups. The X-ray group underwent X-ray examination at anteroposterior pelvic (bilateral hips) at 1 week before surgery, the CT group received CT scan at bilateral hips at 1 week before surgery, and the specimen group was subjected to the removal of affected femoral head, and then directly measured using ruler and vernier caliper. Primary outcome was the sensitivity of thesethree methods for measuring collapsed femoral head. Secondary outcomes were the specificity, positive predictive value,negative predictive value, positive likelihood ratio, and negative likelihood ratio of these three methods for the diagnosisof collapsed femoral head and the diagnostic accuracy; the diagnostic consistence of CT and X-ray examinations; the height of the lateral, middle and external femoral head measured by three methods. The study was approved by the Ethics Committee of the Third Hospital of Hebei Medical University, China, and will be performed in accordance with the guidelines of the Declaration of Helsinki, formulated by the World Medical Association. Written informed consent will be obtained from all participants prior to the trial. DISCUSSION: In this study, the height of femoral head was measured and analyzed in all-dimensional and multi-anglemanner based on intraoperative removed specimens, so as to make an accurate prediction for collapsed femoral head, thus providing imaging reference for surgeons prior to choosing an appropriate operative scheme

Background: Xiaochaihu Tang was a compound traditional Chinese herbal medicine recorded in ancient Chinese medical book Shanghanlun, and has been widely used for chronic liver diseases especially in Japan. Objective: To assess the beneficial effects and safety of Xiaochaihu Tang, for chronic hepatitis B (CHB). Search strategy: Electronic and manual searches were conducted and the search ended in November 2009. Inclusion criteria: We included randomized clinical trials testing Xiaochaihu Tang against placebo, non-specific treatment, antivirals, or combined with antivirals against antivirals alone. Data extraction and analysis: Selection of trials for inclusion, assessment of methodological quality by Jadad score, data extraction and data syntheses were conducted according to the Cochrane Hepato-Biliary Group methods. Results: Sixteen randomized trials (involving 1 601 CHB patients) with various methodological quality were included. One trial published in English had good quality, while other trials published in Chinese were of poor quality. The pooled results showed that Xiaochaihu Tang combined with antiviral drugs was more effective in serum loss of hepatitis B viral markers and in improving liver function compared with antiviral drugs alone. Xiaochaihu Tang was not different from placebo in terms of viral clearance or improving liver function. However, Xiaochaihu Tang was superior to non-specific treatment in liver function improvement. There were no adverse effects reported in the trials regarding Xiaochaihu Tang, but adverse effects were reported in patients treated by interferon, and severe adverse effects occurred in few cases. Conclusion: Xiaochaihu Tang in this review appears to be effective in improving liver function and clearance of serum hepatitis B viral markers in patients with chronic hepatitis B. However, due to poor methodological quality in the majority of included trials the potential benefits need to be confirmed in rigorous clinical trials following international standards.