Objective The purpose of this study was to investigate the preventive effect of flurbiprofen axetil or small-dose ketamine for remifentanil-induced postoperative hyperalgesia. Methods 120 anesthetized patients with ASA ⅠorⅡwere randomly divided into three groups. Group A (40 cases) was given 0.5 mg/kg of ketamine by intravenous injection,and 5μg/(kg.min) vein to maintain,group B (40 cases) was given 100 mg of preoperative flurbiprofen axetil by intravenous injection and group C (40 cases) had no flurbiprofen axetil or ketamine which was served as controls. After the treatment, all groups were given continuous intravenous tramadol controlled analgesia (PCIA) . Results After 1 h, 2 h, 4 h and 8 h, the visual analog scale (VAS) of group C was significantly higher than that of group A and group B ( <0.05);after 24 h, there was no statistically significant difference among the three groups in VAS scores ( > 0.05) . The number of fentanyl analgesia were 25 cases and postoperative 24 h PCIA self-control were (8.6 ±4.2) times, which were more than 7 cases and (3.3 ±2.8) times of group A, and 6 cases and (3.2 ± 2.2) times of group B ( <0.05) . Conclusion The preoperative administration of flurbiprofen axetil or intraoperative continuously administered ketamine is able to prevent the occurrence of remifentanil-induced postoperative hyperalgesia, and it will not affect the patient regained consciousness. The method is safe and reliable,so it is worth promoting and popularizing.

To stury the pharmacokinetie of tramadol and aeetaminophen in healthy volunteers. Methods Totally 20 healthy adult male volunteers participated in the study were randomly assigned to 2 treatment groups and were given respectively the dose of one and two pills by oral administration. Serum was separated and the concentrations of tramadol and acetaminophen in human serum were determined by HPLC using fluorescence and UV detector. The values of concentration were directly detected, and AUC was calculated by linear trapezoid method. Results The main pharmacokinetie parameters of tramadol and acetaminophen of 2 dosages groups were as follow: Tramadol: AUC_(0-24h)(ng · h· mL~(-1)) were 2 724. 89 ± 1 016.54 and 1 361.61 + 441. 79; AUC_(0-∞)(ng·h·mL~(-1)) were3 065.49±1 190.66 and 1 555.04±582.51; t_(max)(h) were 1.8±0.75 and 1.9±0.57; t_(t/2)(h) were 7.34±1.39and7.63±2.02; Kel(h~(-1)) were 0. 098±0. 019 and 0. 097± 0.027; Cl_r(mL · min~(-1)) were 31.84±13.65 and 30.03 ± 9.20; MRT(h) were 7.62 ± 1.07 and 7.77 ± 0.75. Acetaminophen. AUC_(0-24h)(μg · h · mL~(-1)) were 40.28 ± 10.36 and 18.37 ± 3.84 ; AUC_(0-∞)(μg · h · mL~(-1)) were 41.63 ± 10. 96 and 18. 81 ± 4.06; t_(max)(h) were 0. 9 ± 0.46 and 0. 9 ± 0. 39; t_(t/2)(h) were5.39 ± 1. 16 and 4. 96 ± 1.03; Kel(h~(-1)) were 0. 13 ± 0. 03 and 0. 15 ± 0. 03; Clr (mL · min~(-1)) were 17.17 ± 4.57 and 18.42 ± 3.89; MRT(h) were 4.86 ± 0.48 and 4.50 ± 0.53. Conclusions No significant difference in pharmacokinetic parameters, such as t_(max), t_(t/2), Ke,Cl, MRT,AUC_(0-t)/dose, AUC_(0-∞)/dose and C_(max)/dose are shown between these two dose groups and a linear pharmacokinetic is featured.

Objective To compare the clinical curative effect of partial hepatectomy combined with biliary intestinal anastomosis and T tube drainage in the treatment of intrahepatic stones.Methods 72 patients with intrahe-patic stones were selected and randomly divided into observation group and control group.The observation group received lobectomy of liver +bile duct jejunum anastomosis,the control group received lobectomy of liver +T tube drainage treatment.The operation time,intraoperative blood loss,functional exercise time,length of hospital stay, recurrence rate,clinical efficacy and complications were observed.Results The patients were followed up for 6 -12months.The operative time,blood loss,ambulation exercise time,length of hospital stay in the observation group were (158.29 ±32.53)min,(161.42 ±11.75)mL,(3.61 ±0.28)d,(5.31 ±1.17)d,which were significantly more than those in the control group[(127.57 ±26.38)min,(78.29 ±8.36)mL,(2.25 ±0.56)d,(4.86 ± 2.39)d].The recurrence rate of stone of the observation group during the postoperative follow -up was 5.56%, which was significantly lower than 16.67% of the control group (t =4.328,7.196,2.174,2.259,1.862,all P <0.05).The excellent and good rate of the observation group was 94.44%,which was higher than 83.33% of the control group,the difference was statistically significant (χ2 =1.257,P <0.05).6 cases in the observation group had complications (16.67%),including 1 case of incision infection,subphrenic infection in 2 cases,bile leakage in 2 cases,1 case of pulmonary infection.15 cases in the control group had postoperative complications (41.67%), including 3 cases of wound infection,bile leakage in 4 cases,3 cases of biliary tract bleeding,abdominal bleeding in 1 case,2 cases of pulmonary infection,subphrenic infection in 1 case,pleural effusion in 1 case,the difference between the two groups was significant (χ2 =2.291,P <0.05).Conclusion Liver resection is an effective method for treatment of intrahepatic bile duct stones,on the basis of liver resection by intestinal anastomosis in the treatment of intrahepatic bile duct stone long -term effect is better,which can effectively prevent recurrence of the intrahepatic bile duct stone and bile duct cancer,widely used in patients with indications for clinical physicians.

OBJECTIVE: To develop a HPLC method for the determination of the concentration of caffeic acid, chlorogenic acid and 1, 3-dicaffeoylquinic acid in rat urine and to observe the excretion of three compounds in rats. METHODS: Rat urine samples, collected at different intervals after vein injection of Dengzhanxixin injection traditional Chinese medicines, added with protocatechuic aldehyde as internal standard, handled by ethyl acetate, then were measured by HPLC. RESULTS: The recoveries of caffeic acid, chlorogenic acid and 1, 3-dicaffeoylquinic acid were about 95%-98%, 90%-95%, 95%-97%, respectively. The cumulative excretions of caffeic acid, chlorogenic acid and 1, 3-dicaffeoylquinic acid in urine within 60 h were (70.97 ± 7.31)%, (87.62 ± 12.23)% and (9.87 ± 2.63)%. Relative standard deviation(RSD) of intra- and inter-day assay was less than 10%. CONCLUSION: The established method is simple, accurate and specific. It can be successfully used for the analysis of three compounds in rat urine.

Humans ; Labyrinth Diseases ; pathology ; therapy

Recent researches of the association between helicobacter pylori (Hp) and colorectal adenocarcinoma have found that Hp infection rate is higher in the patients with colorectal cancer and other related colorectal adenoma,which suggest that Hp probably influence on local and distant intestinal mucosa epithelial cells achieve carcinogenesis by its own virulence and the role of elevated serum gastrin levels.Hp infection may be a potential risk factor of colorectal cancer.

Objective:To evaluate the utilization of antifungal drugs in Nanjing area, and provide clinical reference for the rational use of antifungal drugs. Methods:According to the sales data of antifungal drugs in 34 hospitals in Nanjing area from 2013 to 2015, the utilization of antifungal drugs was analyzed in respects of consumption sum, DDDs and DDC. Results:The consumption sum and use of antifungal drugs increased year by year. The maximum amount of consumption sum growth rate was 41. 13%. Triazole drugs oc-cupied the top of consumption sum during the past three years, and the sales amount accounted for more than 60% of all. In term of consumption sum, voriconazole, fluconazole, itraconazole and caspofungin ranked top 4 of antifungal drugs. Clotrimazole topical prepa-rations and oral itraconazole ranked top 2 of DDDs, and caspofungin, micafungin and voriconazole ranked top 3 of DDC. Conclusion:The clinical application of antifungal drugs continues to increase during 2013 and 2015. Invasive fungal infection is a lethal factor at high risk. Choosing reasonable, effective, safe and economic of antifungal drugs is the first principle in clinical treatment.

Objective To calculate the mean absorbed doses at celluar and subcellular levels for uniformly and non-uniformly distributed Auger electron emitters. Methods The energy deposited in cell or nucleus by Auger electrons was analytically calculated using the polynomial representation of energy loss.S-values were subsequently computed for several target-source combinations.The absorbed dose and dose distribution were calculated for spherically symmetric radionuclide distributions depending linearly and exponentially on the radial position.The dose profile as a function of the source radial coordinate was also evaluated for typical cell sizes.The contributions of photon radiation to absorbed dose in cells were ignored. Results The mean absorbed dose and dose distribution depend largely on the size of target cells,the radiation spectrum and intracellular localization and distribution of radionuclides.The contribution of intranuclear radionuclides to mean absorbed dose was larger than that of extranuclear ones. Conclusion Auger electrons can produce high local energy deposition in cells because of their very low energies and extremely short ranges.Our dose calculation method is simple.The results are reliable and can be used in many fields.

[Objective]To observe expression of inducible nitric oxide synthase and peroxynitrite anion around the prostheses,and study the relationship between the osteolysis and inducible nitric oxide synthase peroxyni-trite.[Method]Interface tissues were obtained at three Delee-Charnley acetabular sections and seven Gruen femur sections in six revision total hip arthroplasty surgery. The tissues were prepared for immunohistochemical assays to determine the expression of iNOS and nit rotyrosine (NT)-a specific“footprint”of peroxynitrite. Pre-revision X-ray films were observed to determine the incidence of osteolysis regions and non-osteolysis regions. The correlation between the positive cells and the severity of osteolysis were analyzed and compared.[Result]Data showed that zone Ⅲ has much higher iNOS positive immunostaining than that of zone Ⅰ and Ⅱ at acetabulum, and the expression of zone 1、2、6、7 was significantly higher than the other zone at femur(P