Objective To investigate the effects of a variety of different methods of analgesia on postoperative pain and cognitive function in elderly esophageal cancer patients.Methods Sixty elderly pa-tients scheduled for the left into the thoracic esophageal cancer surgery were randomly divided into two groups (n =30).Group A:Before the closure of thoracic cavity to block intercostal nerve with 0.375% rop-ivacaine,followed by intravenous pumps for analgesia,formulation of sufentanil 3 μg/kg+flurbiprofen 100 mg,pump speed 2 ml/h,self-controlled analgesia 0.5 ml/pressing,locking time 15 min.Group B:Before the closure of thoracic cavity given sufentanil 10 μg+flurbiprofen 50 mg as loading dose followed by epidural analgesia pump,recipe with group A.Two groups were observed mini mental state examination (MMSE) score 1 d before surgery and 3,5,7 d after surgery,each time point visual analogue pain score (resting and exercise VAS)score postoperative within 48 h,BCS comfort score and effective pressing times of postopera-tive analgesia pump.Results Compared with group B,the rest and exercise VAS scores of group A at post-operative recovery,4,8,12,24,48 h were significantly lower (P <0.05);the BCS scores of group A at postoperative 4,8,12,24,48 h were significantly higher (P <0.05);the pressing times of group A at postoperative 4,8,12,24,48 h were significantly reduced (P <0.05);the MMSE scores of group A at postoperative 3,5,7 d were significantly higher (P <0.05);the incidence of POCD of group A on postop-erative 3,5,7 d were significantly lower.Conclusion Thoracic surgery perioperative multimodal analgesia (intercostal nerve block and intravenous analgesia)can relieve postoperative pain,reduce the incidence of POCD,improve the postoperative patient comfort and help postoperative patients with rapid recovery.

Hoxa3-Pax1/Pax9-Eya1-Six1/4 regulatory pathway seems to be operating during forming the bilateral parathyroid/thymus common primordial in early embryonic development.The specification of the parathyroid domain in the parathyroid/thymus primordial is regulated through a Shh-Tbx1-Gcm2 pathway.Gcm2 also may play roles in later steps of parathyroid development,including CaSR and PTH gene expression.MafB and Gcm2 interact with each other and synergistically activate PTH transcription.Genetic basis and the etiology of some hypoparathyroid disorders in man are involved defects in transcription factors that include GCMB,GATA3,Tbxl,SOX3 and GNA11.This marker expression in thymus and parathyroid primordium includes HoxA3,Pax1,Eya1,and Six1;and expression of parathyroid cell-like cells includes Gcm2,CaSR,and PTH.These expressions may serve as markers of stem cell differentiation into parathyroid cell-like cells.

To investigate the morphogenetic process of human adenovirus type 41 (HAdV-41), 293TE cells were infected with purified wild-type HAdV-41, and ultrathin sections of infected cells were prepared and observed under a transmission electron microscope. Results showed that HAdV-41 entered host cells mainly through three ways: non-clathrin-coated pit, clathrin-coated pit, and direct penetration of plasma membrane. In addition, cell microvilli might help HAdV-41 enter cells. After entering into cells, HAdV-41 virus particles could be found in vacuoles or lysosomes or be in a free state in cytoplasm. Only free virus particles could be found near nuclear pores (NP), suggesting that the virus needed to escape from lysosomes for effective infection and viral nucleoprotein entered the nucleus through NP. Progeny viruses were as-sembled in the nucleus. Three types of inclusion bodies, which were termed as fibrillous inclusion body, condense inclusion body, and stripped condense inclusion body, were involved in HAdV-41 morphogenesis. In the late phase of viral replication, the membrane integrity of the infected cells was lost and viral particles were released extracellularly. This study reveals the partial process of HAdV-41 morphogenesis and provides more biological information on HAdV-41.
Adenovirus Infections, Human ; virology ; Adenoviruses, Human ; genetics ; growth & development ; physiology ; ultrastructure ; Cell Membrane ; virology ; Cell Nucleus ; virology ; Humans ; Virus Release ; Virus Replication

To study the chemical constituents of Nervilia fordii (Hance) Schltr., various chromatographic methods were used, including D101 macroporous resin, silica gel, ODS and preparative HPLC chromatographic techniques. A new labdane diterpenoid glycoside named as nervilifordoside A was isolated from 60% EtOH extract of Nerviliafordii. The structure of compound 1 was elucidated as 12, 17-epoxy-3-hydroxy-17-methoxy-labdan-13-en-16, 15-olide 3-O-alpha-rhamnopyranosyl-(1 --> 2)-O-beta-glucopyranoside on the basis of HR-MS, 1D and 2D NMR spectroscopic data as well as chemical methods.
Chromatography, High Pressure Liquid ; Molecular Structure ; Orchidaceae ; chemistry ; Plants, Medicinal ; chemistry

Adult ; Diabetes Mellitus, Type 2 ; diagnosis ; Diagnosis, Differential ; Female ; Humans ; Insulin Resistance ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Yang Deficiency ; diagnosis ; Yin Deficiency ; diagnosis

Objective To evaluate the effect of transitional care intervention on quality of life for patients with chronic obstructive pulmonary disease (COPD). Methods The Cochrane library, PubMed, Embase, Chinese biomedical literature database(CBM), Chinese scientific journals full-text database, Wanfang data were searched up to June 2015 to identify randomized controlled trials(RCTs) comparing continuity of patient care with conventional treatment.The data were analyzed using Revman 5.2 software. Results 26 RCTs involving 2 443 participants were included.The results of Meta-analysis showed continuity of care couldreduce the scores of The COPD Assessment Test [ SMD=-2.24, 95%CI=(-3.52--0.96), P<0.01],and St George′s Respiratory Questionnaire [SMD=-0.26, 95%CI(-0.50--0.02), P≤0.05], and could improve the scores of Chronic Respiratory Disease Questionnaires [SMD=0.46, 95%CI(0.08-0.84), P≤0.05]. Conclusions Transitional care can improve the quality of life of patients with COPD.

The effects of Cinnamon granules on pharmacokinetics of berberine in Rhizoma Coptidis granules in healthy male volunteers, and the compatibility mechanism of Jiao-Tai-Wan (JTW) composed of Rhizoma Coptidis granules and Cinnamon granules were investigated. The concentration of berberine in plasma of healthy male volunteers was determined directly by high performance liquid chromatography (HPLC) after an oral administration of Rhizoma Coptidis granules alone or combined with Cinnamon granules (JTW). The plasma concentration-time curves of berberine were plotted. The data were analyzed with Drug and Statistics (DAS) 2.0 pharmacokinetic program (Chinese Pharmacology Society) to obtain the main pharmacokinetic parameters. The results showed that the plasma concentration-time curve of berberine was described by a two-compartment model. The C(max), T(max), t(1/2) and CLz/F of berberine in Rhizoma Coptidis granules were 360.883 μg/L, 2.0 h, 3.882 h, 119.320 L·h(-1)·kg(-1) respectively, and those of berberine in JTW were 396.124 μg/L, 1.5 h, 4.727 h, 57.709 L·h(-1)·kg(-1) respectively. It was suggested that Rhizoma Coptidis granules combined with Cinnamon granules could increase the plasma concentration of berberine, promote berberine absorption and lengthen the detention time of berberine in healthy male volunteers.

One hundred and thirty patients with esophageal carcinoma were randomly asigned into two groups:62 cases received thoracoscopic esophagectomy (TE group) and 68 cases received open thoracic esophagectomy group (OE group).All patients underwent lymph nodes dissection along bilateral recurrent laryngeal nerve.Compared with OE group,TE group had a less blood loss during the lymph nodes dissection (P ＜ 0.05) and a lower incidence of pulmonary infection (P ＜ 0.05).There were no significant differences in the number of dissected lymph nodes,dissection time,incidence of temporary hoarseness,permanent hoarseness and mechanical ventilation for respiratory failure between two groups (P ＞ 0.05).The study suggests that lymph nodes dissection along bilateral recurrent laryngeal nerve can be succesfully completed by thoracoscopic esophagestomy,and it has the advantage of less intraoperative blood loss and lower incidence of pulmonary infection,compared to open thoracic surgery.

Objective To analyze the changes of the intima-media thickness(IMT)of carotid and femoral arteries, serum advanced glycosylation end-products(AGEs),and AGEs soluble receptor(sRAGE)after intensively controlling blood glucose, blood pressure, and lipid. Methods One hundred and thirty-two type 2 diabetic patients were divided into 3 groups and followed for 5 years: 20 patients were treated with intensive control of blood glucose and blood pressure, 80 patients with intensive control of blood glucose, blood pressure, and lipid; and 32 patients with conventional therapy. AGEs, sRAGE, and IMT of carotid and femoral arteries were measured and compared among different groups. Results The IMT of carotid and femoral arteries and serum level of AGEs were significantly decreased after intensive treatment. The ratio of sRAGE and HbA1C(sRAGE/HbA1C)were negatively correlated with the mean of HbA1Cin the past five years(r=-0.417, P＜0.001)and the fluctuation of HbA1C(r=-0.309,P＜0.001). Multinomial regression analysis showed that AGEs were the important risk factors of IMT of femoral artery(β=0.152,P=0.068). Conclusion Intensive treatment is significant in controlling the growing IMT of carotid and femoral arteries, while decreasing serum level of AGEs.