Objective To observe the analgesic effect of COX-2 inhibitors combined with PCA in treatment of the pain after total knee arthroplasty(TKA)and explore novai method for pain control after TKA. Methods This study was,a double blind,controlled,randomized,placebo-controlled,parallelgroup and single center study and obtained the consent of the Medical Ethics Committee of Chongqing Medical University.Inclusion criteria:the patients with severe trauma or degenerative knee,at age of 58-75 vears.ASA Ⅰ or Ⅱ, tolerance of the intravenous anesthesia.The same solvent formula of PCA was routinely prepared based on body weight after TKA.Intravenous injection of 40 mg Parecoxib plus 2 ml normal saline or injection of only 2 ml normal saline was done when closing the incision.which was recorded and prescribed by the researcher A.The same reagent waft,used continually every other 12 hours till48 hours.Celecoxib or placebo capsules was not usod orally at 72 hours until two weeks later.The knee ioint function was observed preoperatively and at days 3,7 and 15 after TKA. Results The study was completed in 60 patients including 30 patients in the group treated with Parecoxib and Celecoxib sequential therapy and 30 patients in placebo-control group.There was no statistical difference in aspects of general condition in both groups(P>0.05).There was no statistical difference in aspect of preoperative knee score between two groups(P>0.05).The analysis showed statistical difference in the knee function score at days 3.7 and 15 after operation(P<0.05 or0.01).Conclusions The COX2 inhibitors combined with PCA has definite analgesic effect on the pain after TKA,which positively correlates with early modified HSS evaluation of TKA.

BACKGROUND:Many domestic and foreign scholars and institutions are studying how to relieve radiation damage and to find the most suitable drug, while ginsenosides as the main pharmacological ingredient of ginseng show significant antioxidant effect. OBJECTIVE:To investigate the ease effect of ginsenosides on human hematopoietic stem cels under different intensities of ionizing radiations. METHODS: The CD34+ hematopoietic stem cels were isolated from the healthy cord blood. Then the cels were divided into normal group and ginsenoside-pretreated group, respectively, exposed under 1, 2, 5 Gy of X-ray irradiations for 24 hours. Cel viability was detected in irradiated hematopoietic stem cels by MTT assay. Apoptosis was estimated using the folowing assays: Annexin-V assay, caspase-3 mRNA and protein levels. The generation of reactive oxygen species was evaluated, in the presence or absence of ginsenoside in liquid cultures of CD34+ human hematopoietic stem cels irradiated with 1-, 2- and 5-Gy X-rays, using a flow cytometry assay. The Nrf-2 mRNA and protein levels were also studied by western blot analysis and RT-PCR, respectively. RESULTS AND CONCLUSION: Ionizing radiation at the therapeutic dose could decrease the viability of CD34+ cels and induce the cel apoptosis, and meanwhile, the activity of intracelular reactive oxygen species also showed a progressive increase that was correlated with the dose of ionizing radiation. However, ginsenoside pretreatment could relieve these above-mentioned effects. Ginsenoside inhibited the increase in caspase-3 activity induced by ionizing radiation, and additionaly, enhanced the mRNA and protein expressions of Nrf-2 in CD34+cels. In conclusion, ginsenoside protects CD34+ hematopoietic stem cels from radiation effects, which is probably correlated with anti-apoptosis and anti-oxidant roles of ginsenosides.

Composition of the polysaccharide from Bupleurum scorzonerifolium Willd. was studiedby high resolution capillary gas chromatography after hydrolysis and followed by acetylation and esterifica-tion of the hydrolysate. The results showed that it is composed of arabinose, ribose, D-xylose, D-man-nose, D-glucose and D-galactose, with a molar ratio of 0. 106 : 2. 652 : 4. 070: 0. 519 : 0. 930 : 2. 518.

Objective To investigate the role of hysteroscopy combined with laparoscopy in treatment of infertility.Methods 102 patients with infertility treated by hysteroscopy combined with laparoscopy were retrospectively analyzed.Results Of 102 cases of infertility,there were 57 cases with Pelvic adhesions and tubal obstruction,24 cases with endometriosis,12 cases with polycystic ovary syndrome,4 cases with endometrial polyp,3 cases with hysteromyoma and 2 cases with uterus septum.The first three cases were chronic pelvic inflammatory with salpingemphraxis ( 55.88% ), endometriosis Ⅰ -Ⅱ (23.53% ) and polycystic ovary syndrome (11.76% ).The postoperative pregnancy rate was 41.18%, 3 patients with ectopic pregnancy (7.14%) and 4 spontaneous abortion (9.52%).Conclusion Laparoscopy with hysteroscopy played an important role in treatment of infertility.It was an effective method and worthy to be widely used.

Objective To study the role of MDC/CCL22-CCR4 axis in milky spots in peritoneal carcinomatosis of gastric cancer.Methods We examined the expression of CCR4 in 5 gastric cancer cell lines by RT-PCR and Western-blot.Cell growth rate of BGC-823 cell lines before and after incubated with CCL22 was detemined by MTT assay.The effects of CCL22 on invasion of BGC-823 cells into Matrigel were measured using Transwell test.Immunohistochemistry was conducted to detect the expression of CCR4.Results CCR4 mRNA and protein expression were detected in all 5 human gastric cancer cell lines:CCL22had a direct promotive effect on BGC-823 cell prolifetation and invasion.There was CCR4 expression in Stomach neoplasms.The expression of CCR4 in primary tumor was correlated with tumor pathological differentiation(P<0.05),but not with age of patients,gender,location of tumor,tumor size,tumor stage,lymph node metastasis(P>0.05).Conclusions The MDC/CCL22-CCR4 axis may be one of the mechanism of peritoneal metastasis in milky spot in gastric cancer.

Objective To know the epidemiological characteristics of hand-foot-mouth disease in Yangpu District and provide evidence for specific strategies and measures of hand-foot-mouth disease activity prevention and control. Methods Descriptive analysis of the data from hand-foot-mouth disease epidemic situation in Yangpu District from 2005 to 2008 was made. Results 1 348 cases were reported in the whole Yangpu District from 2005 to 2008, and no severe cases, no death. The average morbidity in Yangpu District was 27.48/100 000. The male to female ratio was 1.46∶1. The infection occurred to infants aged from 1 year to 5 years (85.39%). The incidence of the native population children aged 2 to 3 exceeded 10/100 000. The season peak appeared from May to July (70.18%), and outbreaks used to occur at nurseries and kindergartens. The typical clinical presentations mainly included fever and rash. The rash mainly occurred to hands, feet, mouth, buttocks and so on. Conclusions Incidence varied significantly between different sexes, seasons and ages. It can cause large-scale epidemic in a short period of time, the epidemic was very difficult to control, but the leaders attach importance to take the early warning and monitoring, accuratey deal with emergencies, health education promotion and training of comprehensive measures, the epidemic can be effectively controlled.

Objective To investigate tbe pharmacodynamics of different local anesthetics administered intrathecally for caesarean section. Methods Ninety-six parturients with singleton term pregnancies undergoing caesarean section under combined spinal-epidural anesthesia were enrolled in this study. The patients were randomly divided into 3 groups ( n = 32 each ) and received intrathecal (IT) 0.5 % bupivacaine, 0.5 %levobupivacaine and 0.5% ropivacaine respectively. The initial doses was 9 mg in all 3 groups. The ratio of two successive doses was 0.9. If the upper sensory block reached T7 or above and there was no need for additional dose in the 45 min after the initial dose, the IT analgesia was considered to be effective. The median effective dose ( ED50 ), the 95 % effective dose( ED95) and 95 % confidence interval (95 % CI )were calculated by Dixon. Results The ED50 and ED95 and 95%CI of bupivacaine were 6.15 (95%CI 5.48-6.68) mg and 7.62 (95%CI 6.91-11.82) mg; of levobupivacaine were 8.06 (95%CI 7.46-8.62) mg and 9.59 (95%CI 8.86-13.42) mg;of ropivacaine were 10.55 (95%CI 9.73-11.49) mg and 12.80 (95%CI 11.66-21.42) mg. The relative potency potency ratio between bupivacaine, levobupivacaine and rupivacaine is 1.00:0.76:0.58.

Objective To study role of MDC/CCI22-CCR4 axis in mouse milky spots with peritoneal carcinomatosis of gastric cancer. Methods We examined the expression of CCR4 in 615 Mouse gastric cancer cell (MFC) lines by RT-PCR and Western-blot; Peritoneal metastasis model on the 615mouse was established by intraperitoneal injection of 0.2 ml MFC cells(1×104 cells). Dil fluorescence was used to observe the transfer process and section of MFC. Immunohistochemistry was conducted to detect the expression of CCR4 and CCL22 in omental milky spot; the structure of Milky spot was observed by scanning electron microscopy. Mice were randomly divided into 2 groups, namely, the saline control group (received saline) and MFC group. The concentration of CCL22 in ascitic fluid was measured in the 615 mice injected MFC after 6,8,10 days and in the saline group. Results MFC first metastasizes to the milky spot on the omentum, the expression of CCR4 and CCL22 were observered in the milky spot. The surface layer cells in milky spot consisted of discontinuous mesothelial cells and mainly macrophages and lymphocytes. The average value of CCL22 was 43 pg/ml and 364 pg/ml respectively in saline control group and MFC group.Conclusions MDC/CCL22-CCR4 axis plays an important role in the development of peritoneal carcinomatosis in mouse gastric cancer.

Child ; Humans ; Muscular Atrophy, Spinal ; blood ; diagnosis ; Polymerase Chain Reaction ; methods

Objective To compare the effect of low concentration versus ultra-low concentration of ropivacaine in combination with sufentanil delivered via programmed intermittent epidural bolus (PIEB) with patient-controlled epidural analgesia (PCEA) during labour on obstetric and anesthetic outcomes.Methods Seventy-six ASA Ⅰ or Ⅱ nulliparous parturients who were at full term with a singleton fetus in vertex presentation were randomized to receive 0.1 ％ ropivacaine with 0.5 μg/mL sufentanil (Group L,38 cases) or 0.06％ ropivacaine with 0.5 μg/mL sufentanil (Group UL,38 cases).Another matched 76 cases of primiparas without labor analgesia (Group C) served as controls.For primiparas received analgesia,an epidural catheter was inserted when the cervical dilatation was up to 2-3 cm.The analgesia level was controlled below T8,and VAS score was controlled below 4.Thirty minutes after analgesia started,Group L and UL received PIEB with PCEA regimen including basal infusion of 8 mL/h of ropivacaine with sufentanil,patient-controlled bolus 6 mL and lockout interval 10 minutes.The duration of labor,delivery mode,Apgar score,VAS score and anesthetic drug consumption of each group were recorded.Results The second stage of labor were not statistically different between Group UL and C.The second stage of Group L was longer than that of Group C (P＜0.05).Furthermore,with similar performance in pain score and satisfactory level at each time point,Group UL consumed much less ropivacaine than Group L (P＜0.05).The cesarean section rate,instrumental delivery rate and the Apgar score were not significantly different among the 3 groups.Conclusions While using PIEB with PCEA,0.06％ ropivacaine was capable of providing satisfactory analgesia effects for primipara and has less effects on the obstetric outcome.Therefore,it could be recommended for labour analgesia.