Objective To survey the current clinical practice of chronic non-cancer pain (CNCP)management including opioid use in Chinese subgroup report of Current Practices of Cancer and Chronic Non-Cancer Pain Management:A Pan-Asian Study (ACHEON).Methods This questionnaire-based survey included 100 pain physicians and 250 patients experiencing CNCP in the period of September to December in 2013.Results CNCP management training was believed by 40％ of physicians,while 30％ reported adequate pain-relief training on opioid use.Opioids were not considered as the best choice for CNCP management by 65％ of physicians.The majority of location of pain with CNCP was legs/feet (59.2％) and neck (39.2％),arthritis (37.22％),overuse (26.91％),and poor posture (35.56％) were reported as the primary causes of pain.A portion (81.6％) of patients was under treatment,while 66.67％ of patients claimed to be satisfied with their current pain treatment.74.51％ of patients reported that CNCP management was effective pain-relief.Conclusions The Chinese physicians were insufficient cognition of CNCP management on opioid use.The CNCP education and cognition strengthening,CNCP management practice and patient's satisfaction are still necessary for Chinese physicians and patients.

Objective To study the effect of nasal decontamination on clinical index of elderly patients with long -term indwelling nasogastric tube.Methods 89 elderly patients with long -term indwelling nasogastric tube were randomly divided into nasal decontamination group and routine treatment group.The sputum culture positive rate of bacterial and the incidence of pulmonary complications,pharyngitis,sinusitis of the two groups were observed. Results Sputum Staphylococcus aureus positive rates in the nasal decontamination group and conventional group were 13.043% (6 cases)and 39.535% (17 cases)respectively,the difference was significant(χ2 =8.139,P =0.004).The incidence rates of pulmonary infection in the nasal decontamination group and conventional group were 4.348% (2 cases)and 18.605% (8 cases)respectively,the difference was significant(χ2 =4.529,P =0.033). The incidence rates of pharyngitis in the nasal decontamination group and conventional group were 10.870%(5 cases)and 37.209% (16 cases) respectively,the difference was significant (χ2 =8.553,P =0.003 ). Conclusion Nasal decontamination can decrease the positive rate of sputum bacterial culture,the incidence of pulmonary infection and pharyngitis in elderly patients with long -term indwelling nasogastric tube.For its efficacy and safety,it deserves clinical application.

Objective Coronary heart disease (CHD) is a multifactorial disease. This meta-analysis was performed to evaluate the relationship between angiotensinogen gene polymorphisms and CHD in the Chinese population. Methods We searched literature in pubmed (1990-2010.8) and CNKI (1990-2010.8) for all the relevant studies on 2 angiotensinogen polymorphisms (M235T and T174M) and risk of CHD. The meta-analysis software Stata 10.0 was used for ascertaining heterogeneity among individual studies and for combining all the studies. Furthermore,Egger's test and sensitivity analysis were performed to insure authenticity of the outcome.Results Ten associations studies on 2 angiotensinogen polymorphisms (M235T and T174M) were included in this meta-analysis. In a combined analysis, the summary per-allele odds ratio for CHD of the M235T polymorphism was 1.374 (95% confidence interval, 1.019 to 1.852) and T174M polymorphism was 4.089 (95% confidence interval, 1.697 to 9.851). Conclusions The M235T polymorphism had weak but statistically significant association with CHD while the T174M polymorphism was more strongly associated with a CHD risk in Chinese population, but further confirmation studies are needed.

Objective To study the clinical value of procalcitonon (PCT) for predicting development of acute kidney injury and outcomes in patients with acute pancreatitis (AP). Methods 205 inpatients with acute pancreatitis in our hospital were enrolled in our study during January 2012 to March 2013. According to acute kidney injury (AKI) occurred in three consecutive days or not, the patients were divided into AKI group (n = 32) and control group (n=173). Crea, Urea, CysC and PCT, serum amyloid A (SAA), interleukin-6 (IL-6) and C reactive protein (CRP) were analyzed. The predictive validity of these indicators was constructed by receiver operating characteristics (ROC) curve. Results PCT, IL-6, and CRP level of AKI group showed significant higher in AKI group than control group (P<0.05). However, there were no statistically significant difference of the level of Urea, Crea, Cys C and SAA between the two groups (P>0.05). The AUC value of PCT showed significant higher than the AUC value of CRP, IL-6 and SAA(P<0.05). Conclusion PCT is a early, sensitive, specific biomarker for predicting AKI of patients with AP.

Objective To understand the gray-scale, color and pulsed Doppler sonographic feature of the corpus luteum during the early trimester of pregnancy. Methods The ovaries of 174 patients with intrauterine gestations between 5 to 9 weeks' menstrual age were examined with transvaginal sonography. Size, sonographic appearance, color Doppler feature, resistance index, peak systolic velocity of the corpus letuem were recorded. Results The corpus luteum was identified in 169 of 174 patients(97.1%) . The mean diameter was ( 1.7 ? 0.8 ) cm. The gray-scale appearances were classified into four types:a thin wall cyst(47 patients, 27.8 %), a thick wall simple cyst(45 patients, 26.6 %), a round hypoechoic structure(43 patients, 25.4 %), a thin-walled cyst containing internal debris (34 patients, 20.1 %). Color blood flow was visualized with color Doppler imaging in 92.3 %(156/169). Color Doppler imaging typically revealed a circumferential rim surrounding part or all of the corpus luteum. Low-resistance blood flow was seen with pulsed Doppler, with a mean resistance index of 0.41?0.10 . Conclusions The corpus lutuem in early pregnancy is identified with transvaginal sonography and has different sonographic appearances. It is important to recognize the various appearances of the corpus lutuem to avoidits confusion with true ovarian abnormalities and ectopic pregnancy.

Objective:To study the feasibility of extraction of impacted mandibular wisdom teeth using turbine drill.Methods:Fifty-one patients with impacted mandibular wisdom teeth on both sides were included.In each patient the two wisdom teeth were randomly divided into test and control groups,the tooth on one side was extracted by means of turbine drill and that on another side by dental chisel method.The operation time,postoperative swell and pain were recorded to assess the effects of the methods.Results:In the extraction of deeply impacted teeth the operation time by turbine drill was shorter(P

AIM:To determine the effect of reactive oxygen species on the baroreflex and to investigate the intracellular mechanism responsible for baroreflex dysfunction in the heart failure state.METHODS:In the rat model of cardiomyocytes infarct induced heart failure,baroreflex function was evaluated by measuring the relationship between renal sympathetic nerve activity(RSNA)responses and change of blood pressure by intravenous injection of nitroglycerin and phenylephrine.Alteration in baroreflex function was measured under the different reactive oxygen species(ROS)level induced by intracerebroventricular administration of several chemicals.RESULTS:(1)The range of RSNA response,average slope and maximum gain of baroreflex function curve were(92.2?9.9) mmHg,(0.07%?0.01%)/mmHg and(1.20%?0.10%)/mmHg,respectively,in CHF rats,which were significantly lower than those in sham rats(65.6?7.4) mmHg,(0.13%?0.02%)/mmHg and(3.00%? 0.20%)/mmHg(P

Objective To Compare the postoperative recovery of continence after 3D and 2D laparoscopic radical prostatectomy.Methods A retrospective analysis of 72 patients underwent radical prostatectomy in our department from January 2013 to December 2015,including 38 cases underwent 3D laparoscopic radical prostatectomy,3D group's mean age was (64.2 ± 6.0)years,mean of preoperative PSA was (14.5±7.6)ng/ml,Gleason score (13 cases≤6,17 cases =7,8 cases ≥8),the mean prostate volume (41.4 ±9.1) ml,the classification of clinical stage in 3D group included 2 cases in cT1,26 cases in cT2,9 cases in cT3a,1 cases in cT3b,mean body mass index was (22.8 ± 2.2) kg/m2,mean of MUL (membranous urethral length) was (15.6 ±2.6) mm;34 cases in the 2D group,3D group's mean age was (61.9 ±6.6)years,mean of preoperative PSA was (16.7 ±6.8) ng/ml,Gleason score (10 cases≤6,18 cases =7,6 cases ≥8),the mean prostate volume (42.1 ± 10.6) ml,the classification of clinical stage in 3D group included 1 cases in cT1,28 cases in cT2,5 cases in cT3a,mean body mass index was (21.7 ± 1.9) kg/m2,mean of MUL(membranous urethral length) was (15.5 ± 2.5) mm.All patients got a good function of micturition and urinary continence before the surgery.We compared surgical time,bladder neckurethral anastomosis time and blood loss in two groups.Membranous urethral length(MUL) were measured on preoperative and postoperative magnetic resonance imaging (MRI).Postoperative continence rate was analyzed at 2 weeks,4 weeks,8 weeks,12 weeks,24 weeks and 36 weeks after the remove of the catheter.Results All the operations were completed successfully by the same surgeon and none was transferred to open surgery.The age,PSA value,Gleason score,prostate volume,TNM stage,BMI (body mass index)and other relevant aspects of the clinical data showed no significant difference (P ＞ 0.05).The time of bladder neck-urethral anastomosis is less than the 2D group [(12.9 ± 1.7) min and (15.7 ±2.6) min,P =0.021],MUL loss in the 3D laparoscopic surgery group is less than that of 2D laparoscopic [(0.5 ±0.1) ml vs.(0.6±0.2) ml,P =0.044],the two groups in operative time [(162.7 ± 17.1) min vs.(175.7 ± 15.7) min,P =0.802],intraoperative blood loss[(191.1 ± 31.6) ml vs.(211.8 ±43.2) ml,P =0.021],intraoperative blood transfusion rate [5.2％ (2/38) vs.8.8％ (3/34),P =0.662],postoperative incidence of urine leakage [7.9％ (3/38) vs.14.7％ (5/34),P =0.463],postoperative the MUL [(15.1 ± 2.6) mm vs.(15.0 ± 2.6) mm,P =0.767),there was no statistically significant differen.All patients were followed up for urinary function at least 36 months.The continence rate between two groups at 8 weeks (60.5％ vs.35.3％),12 weeks (73.7％ vs.47.1％) got significantly difference.Conclusions Compared with 2D laparoscopic,3D laparoscopic may help early postoperative recovery of urinary continence after laparoscopic radical prostatectomy.

Building civilized environment is not only the inevitable hequirement of obeying the law of natrue and society and stick to scientific development orientation, but also the inevitable choice to give a impetus to the career of public health and national health care and finally realize the goal of a harmonious society.

Leptomeningeal metastasis (LM),with a high omission rate in diagnosis in approximately 5 ％～8 ％ of all patients, is increasingly recognized as a lethality complication. The diagnosis of LM remains challenges,but commonly can be established by CSF cytology or by definitive neuroimaging. Although a combination of focal radiotherapy,intrathecal chemotherapy,and systemic chemotherapy may be necessary to achieve optimal treatment of patients, but prognosis is unacceptable and therapy remains palliative in most patients.