Objective To investigate the analgesic efficacy and safety of continuous epidural infusion of 0.2% levobupivacaine in patients after lower abdominal surgery.Methods Sixty ASA Ⅰ - Ⅱ patients undergoing lower abdominal gynecologic operation under epidural anesthesia were randomly divided into two groups : group L levobupivacaine (n = 30) and group R ropivacaine ( n = 30) . An epidural catheter was placed at L2-3 . After operation the catheter was connected through a 3-way Stopcock to a Graseby 9 500 infusion pump for continuous infusion of 0.2% levobupivacaine or 0.2% ropivacaine at a rate of 4 ml?h-1 and a Graseby 3300 infusion pump for PCEA with 0.01% morphine (bolus dose = 2ml, lockout interval = 10 min, total dose limit = 16 ml?4 h-1) (1) VAS score (0 = no pain, 100 = severe pain). (2) the ratio of the number of attempts calculated (D1) to the number of successfully delivered doses (D2) (D1/D2), (3) modified Bromage Motor scale score, (4) Bruggmann comfort scale (BCS), (5) Ramsay sedation score and (6) the severity of side effects were recorded 0, 2,4, 8, 12, 20 and 24h after operation.Results The demographic data (age, body weight, height) and duration of operation were comparable between the two groups. The analgesia was satisfactory in both groups. VAS scores were significantly lower in levobupivacaine group than that in ropivacaine group at 8 and 24 h after operation ( P

Ca2+ leak via ryanodine receptor type 2 (RyR2) can cause potentially fatal arrhythmias, and RyR2 mutations have been shown in the aetiology of catecholaminergic polymorphic ventricular tachycardia. We report the case of a patient with catecholaminergic polymorphic ventricular tachycardia resulting from a RYR2 mutation who had not only typical electroencephalogram changes, but also epileptiform discharges in electroencephalogram. We believe the changes were closely related to the RYR2 mutation.

In this paper, Liuwei Dihuang pill was used to study the identification of Chinese patent medicine by fluorescence sequencing typing technology. The DNA of Paeonia suffruticosa was used as template to amplify by five pair of FAM fluorescence labeling primers. Then, the amplified products were sequenced. The sequencing results were analyzed by GeneMarker V1.80 to screen the best fluorescence labeling primers. As a result, psbA-trnH fluorescence labeling primer was used to identify the raw materials of Liuwei Dihuang pill. The results showed that three kinds of raw plant medicinal materials in Liuwei Dihuang pill were able to be correctly identified by psbA-trnH fluorescence labeling primer. The fluorescence sequencing typing technology can stably and accurately distinguish raw medicinal materials in Chinese patent medicine.
DNA Primers ; chemistry ; genetics ; DNA, Plant ; chemistry ; genetics ; Drugs, Chinese Herbal ; chemistry ; standards ; Fluorescent Dyes ; chemistry ; Plants, Medicinal ; chemistry ; genetics ; Polymerase Chain Reaction ; instrumentation ; methods ; Quality Control ; Staining and Labeling

Objective To evaluate factors influencing long-term survival of biliary atresia patients receiving Kasai procedure and the prevention and treatment of surgical complications.Methods Among 97 biliary atresia patients undergoing Kasai or Suruga operation from Mar 1989 to Mar 1999, 35 cases have survived over five years.These 35 cases were classified intraoperatively into type Ⅱ (4 cases) and type Ⅲ (31 cases).Procedures included hepaticojejunostomy (12 cases), Suruga operation (hepaticojejunostomy with a jejunal fistula in 21 cases), hepaticocystomy (2 cases).Six patients underwent second hepaticojejunostomy because of porta hepatis obstruction.Results (1) Eighteen patients suffered from early cholangiolitis, and four cases developed late cholangiolitis, 5-8 years after closing the ascending stoma.(2) Five cases presented upper digestive tract hemorrhage caused by portal hypertension.(3) All patients were followed up from 5 to 15 years with 2 deaths.Conclusion Conventional surgical procedures still take important part in treating biliary atresia before liver transplantation is popularized.Factors influencing long term survival of patients receiving Kasai′s operation include age at operation, pathological classification of extrahepatic bile duct, with or without cholangitis after operation, and portal hypertension.

Objective To explore the relationship between muscle fatigue and pain in lumbar muscle fatigue induced test. Methods From July to October, 21 healthy female volunteers were subjected to the fatigue induced test. Their root mean square (RMS) and median frequency (MF) of the surface electromyography were collected, their fatigue were assessed with Borg Fatigue Scale and Visual Analogue Scale (VAS), and their maximal voluntary contraction (MVC) and pressure pain threshold (PPT) were measured, before, during and after ex-periment. They were divided into pain or no-pain groups according to the symptom, and the differences before and after test were compared. Results There was significant difference in the scores of Borg Fatigue Scale and VAS, MVC, RMS, and MF after test (Z>6.064, P<0.001). There was significant difference between two groups in all the data before test, and there was significant difference between two groups in the difference before and after test of the VAS score (t=-4.112, P=0.001) and RMS (t>2.385, P<0.05) in some points. Receiver operating characteristic curve analysis showed that the optimal cut-off point of VAS score difference was 3.45 in predicting the pain onset, with sensi-tivity of 100％and specificity of 81.8％. Conclusion For the fatigue induced test, the fatigue VAS score difference may predict the induced pain, and RMS difference associate with the occurrence of pain. No significant is observed of the Borg Fatigue Scale and PPT.

Objective To understand the current status of malaria prevalence,its impacts and malaria transmission trends in Jiangsu Province.MethodsThe malaria incidence,and its symptoms,mosquito preventive measures,Anopheles density,mosquito biting rates and related factors were investigated in malaria epidemic villages as surveillance sites such as Guanshan Town of Suining County,Tangzhang Town of Tongshan County,Tianganghu town of Sihong County,Qiuji Town of Xuyi County and Zhangzhu Twon of Yixing City.ResultsIn 2006,the bednet coverage was 20.29% and bednet-using rate was 34.32% in 27903 residents of 7921 households of 15 administrative villages.In 2005,750 Anopheles sinensi were captured from 50 bednets in the early morning,the human biting ratio was 0.17/person per night,and in 2006,1927 Anopheles sinensi were captured from 50 bednets in the early morning,human biting ratio was 0.38/person per night.The average blood smear checking rate was 2.72%(6089 people)and the average positive rate was 0.48%(29 plasmodium positive individuals).ConclusionThe lower blood smear microscopy testing,few positive rates of febrile patients and increased Anopheles sinensis density were the main factors of malaria relapses in the area of the North Huaihe River in Jiangsu Province.

Cholecystolithiasis with choledocholithiasis (CCL) is a common disease.The removal of common bile stone is a challenge for the surgery.This paper discussed the clinical application of three stone removal techniques including direct stone removal,irrigation and stone extraction by basket under cholangioscopy in order to take the stones effectively and safely,shorten the procedure time,avoid the injuries of common bile duct wall caused by the repetition of a single method such as biliary endoscopic stone extraction,reduce the difficulty of taking stone and enhance recovery of patients.

Objective:To investigate the expression of CD56 antigen in leukemia cells of the patients with acute myeloid leukemia (AML)and its relationship with the prognosis of AML, and to clarify the role of CD5 6 antigen expression in predicting the prognosis of the AML patients.Methods:171 AML (non-M3)patients aged from 14 to 60 years old,who received a IA Regimen as the first time inducing chemotherapy were chosen.Flow cytometric analysis was used to evaluate the CD56 expression in leukemia cells.COX proportional regression analysis was used to select the prognostic factors,and bivariable analysis was used to study the relationship between the positive rate of CD56 and overall survival (OS).The CD56+ group (n=52),including CD56≥50% expression group (n=39) and CD56<50% expression group (n=13),and CD56- group (n=119)were identified by the expression of CD56 antigen.The complete remission rate (CRR), the relapse rate, the median OS, the median disease-free survival (DFS)and the survival rate of patients were compared.Results:The medium OS of the patients in CD56+ group (14.2 months)was shorter than that in CD56- group (39.4 months)(P<0.05).Moreover,the medium OS in CD56≥50% group was shorter than that in CD56<50% group (11.7 months vs 20.3 months,P<0.05).The 1-year and 2-year survival rates of the patients in CD56+ group (61.5%,46.2%)were lower than those in CD56-group (75.6%,63.9%)(P<0.05).The 1-year survival rate had no significant difference between CD56≥50%group and CD56<50% group (53.8%vs 84.6%,P>0.05),while the 2-year survival rate in CD56≥50% group was lower than that in CD56<50% group (41.0%vs 61.5%,P<0.05).There were no significant differences of the CRR between CD56+ group (76.9%)and CD56- group (68.9%)as well as CD56≥50% group (58.9%)and CD56<50% group (63.5%)(P>0.05).The relapse rate and first year relapse rate of patients in CD56+ group (64.3% and 37.5%)were significantly higher than those in CD56- group (34.3% and 17.9% )(P<0.05). However,there were no significant differences of the relapse rate and first year relapse rate between CD56≥50%group (75.0% and 42.9%)and CD56<50% group (37.5% and 16.7%)(P>0.05).The DFS in CD56+ group was shorter than that in CD56- group (P<0.05).The same DFS result was also found between CD56≥50%group and CD56<50% group (P<0.05).Conclusion:The expression of CD56 antigen in leukemia cells predicts a bad prognosis in the AML patients,and the higher expression of CD56 indicates the worse prognosis.

Objective To assess the clinical significance of endoscopic ultrasonography (EUS) in the diagnosis and preoperative staging of gastric cancer. Methods EUS was carried out in 22 patients inclu-ding 17 gastric cancer patients and 5 patients in suspicion. Helical CT scanning was performed in all of the patients and fine needle aspiration biopsies ( FNAB) were administrated to 5 suspicious patients. Compared the results of operation and pathology with those of tumor staging by estimating the depth of tumor invasion ( T) , local lymph node metastasis ( N) and metastasis to neighboring or remote organs ( M) in order to esti-mate the accuracy of diagnosis and TNM staging. The sensitivity and specificity of tumor-node-metastasis staging of gastric cancer by EUS were compared with those of the spiral CT according to the final histopatho-logical results. Results In 5 suspicious patients specimens were successfully obtained by FNAB under the guide of EUS with the pathological diagnosis of adenocarcinoma in 4 cases and signet ring cell carcinoma, 1 case. All patients underwent radical gastrectomy except one in T1N0M0, staging was treated by endoscopic mucosal resection (EMR). The sensitivity and specificity of EUS in T, N, and M stage were 84.9% and 74. 2% , 92. 1% and 77. 1% , 63. 4% and 87. 5% respectively; whereas those of CT in T, N, and M stage were 27. 3% and 75% , 31.5% and 100% , 50% and 100% respectively. The sensitivity of EUS in T and N staging were higher than those of CT with significant statistical difference (P

OBJECTIVETo study the chemical constituents contained in Acorus calamus.

METHODThe chemical constituents were separated and purified by various chromatographic methods including silica gel, ODS, HPLC and Sephadex LH-20, and their structures were identified on the basis of analysis on spectroscopic data.

RESULTTen compounds were separated from A. calamus and identified as 1beta, 4beta, 7alpha-trihydroxyeudesmane (1), bullatantriol (2), teuclatriol (3), threo-1', 2'-dihydroxyasarone (4), erythro-1', 2'-dihydroxyasarone (5), (+)-de-4'-O-methyleudesmin (6), (+)-de-4'-0-methylmagnolin (7), (+)-eudesmin (8), (+)-magnolin (9) and beta-sitosterol (10), respectively.

CONCLUSIONCompounds 1-2,4-9 were separated from this plant for the first time. Specifically, compounds 1-2,6-9 were obtained from Acorus genus for the first time.

Acorus ; chemistry ; Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Magnetic Resonance Spectroscopy ; Molecular Structure ; Plant Roots ; chemistry ; Spectrometry, Mass, Electrospray Ionization