OBJECTIVETo study the effects of transcutaneous electrical nerve stimulation on multimodal analgesia after total knee arthroplasty.

METHODSSixty patients diagnosed as knee osteoarthritis and suffered unilateral total knee arthroplasty in the department of orthopedics, Zhejiang Traditional Chinese Medicine Hospital from March 2009 to May 2012 were randomly divided into control group and test group, 30 cases in each group. All the patients received celecoxib preoperatively, knee periarticular injection with the drug mixture intraoperatively, and celecoxib and morphine sulfate controlled-release tablets postoperatively. The patients in the test group were also treated with transcutaneous electrical nerve stimulation each day after operation. All the patients started doing functional exercises at 24 h after operation. Postoperative visual analogue scales(VAS), passive and active range of motion of knee joint,and complications were recorded.

RESULTSThe VAS scores of test group during postoperative 24 h to 1 week were 3.39 +/- 0.69, 2.79 +/- 0.51, 2.16 +/- 0.52, and 1.07 +/- 0.57 separately,which were lower than 3.80 +/- 0.86, 3.22 +/- 0.58, 2.53 +/- 0.54 and 1.38 +/- 0.52 in the control group. The passive and active range of knee joint motion in the test group during postoperative 24 h to 2 weeks were (30.67 +/- 3.65) degrees, (39.17 +/- 3.96) degrees, (47.83 +/- 4.86) degrees, (93.67 +/- 7.30) degrees, (107.67 +/- 7.51) degrees and (29.83 +/- 5.33) degrees, (78.33 +/- 8.24) degrees, (95.17 +/- 5.94) degrees respectively,which were higher than (28.67 +/- 3.92) degrees, (36.83 +/- 4.25) degrees, (45.17 +/- 5.17) degrees, (89.83 +/- 7.25) degrees, (103.17 +/- 7.37) degrees and (24.17 +/- 10.26) degrees, (73.83 +/- 9.07) degrees, (91.33 +/- 7.42) degrees in the control group. In the test group, 19 patients had ring-shaped haemostasis impression to some extent in the skin of knee joint to different degree, and 5 patients had blister formation.

CONCLUSIONIt is meaningful to apply transcutaneous electrical nerve stimulation for treating multimodal analgesia after total knee arthroplasty,which can not only relieve patients' postoperative pain, and also promote the rehabilitation of knee function as far as possible.

Aged ; Aged, 80 and over ; Analgesia ; Arthroplasty, Replacement, Knee ; adverse effects ; Female ; Humans ; Knee Joint ; surgery ; Male ; Middle Aged ; Pain, Postoperative ; etiology ; therapy ; Transcutaneous Electric Nerve Stimulation ; Treatment Outcome

AIM:To study and compare the outcomes of coaxial 2. 2 mm phacoemulsiflcation with conventional coaxial 3 mm small-incision cataract surgery.
METHODS: A randomized prospective study was conducted on 100 patients with age - related cataract:coaxial 2. 2 mm micro - incision cataract surgery was performed in 50 cases (50 eyes), and coaxial 3 mm small incision cataract surgery was performed in 50 cases ( 50 eyes) . Statistical analysis was takenwith the data of the two groups. Visual acuity, VF and QOL were compared at intervals of 1wk and 3mo after surgery. In addition, surgically induced astigmatism ( SIA ) was analyzed. Statistic analysis was taken by Student's t-test and Chi-square test.
RESULTS:There was no significant difference on BCVA (t=-1. 366, -1. 688; P=0. 148, 0. 107) between these two groups. One week and 3mo after the surgery, SIA was (0. 46±0.29)D, (0. 43±0. 26)D in the 2. 2 group; and (1. 55±0. 59) D, (0. 89±0. 28) D, in 3. 0 group. The differences between these two groups were statistically significant ( t=-7. 348, -3. 788; P = 0. 000, 0. 000 ) There were no statistically significant differences on VF scores between two group, while it's got a better score in 2. 2 groups on vision adaptation. (t=-3. 348, P<0. 05).
CONCLUSION:Coaxial 2. 2mm micro-incision cataract surgery could significantly reduce SIA and obtain morestable status of VF and QOL. This suggests that the coaxial 2. 2 phacoemulsification surgery implanted AkreosMI60 intraocular lens could get earliervisual rehabilitation postoperation.

Objective To study the chemical constituents from mycelium of marine fungus Aspergillus versicolor.Methods The compounds were separated by column chromatography and their structures were elucidated based on chemical and spectral analysis. Results Seven compounds have been isolated from the acetone and methanol extracts from the mycelia of Aspergillus versicolor. Their structures were determined as sterigmatocystin (I), 6-methoxysterigmatocystin (II), averufin (III), tyrosine (IV), 3-methyl-pyrrolopiperazine-2, 5-dione (V), 3-isopropyl-pyrrolopiperazine-2, 5-dione (VI), carbamide (VII). Conclusion Compounds IV,V and VI were isolated for the first time from this genus of marine fungi.

Object To study the chemical constituents from the roots of Stellera chamaejasme L. Methods Chemical constituents were isolated by chromatographic methods and identified by physiochemical and spectral analysis. Results One lignan and three biflavonoids were purified and determined as bursehernin (Ⅰ), chamaejasmenin B (Ⅱ), isoneochamaejasmin A (Ⅲ),and (+)-chamaejasmin (Ⅳ). Conclusion Compound Ⅲ and Ⅳ are determined as new optical compounds. Compound I is first isolated from Stellera L. species.

CD19-targeted chimeric antigen receptor T-cell (CAR-T) therapy is effective in refractory/relapsed (R/R) B-cell acute lymphoblastic leukemia (B-ALL).This review focuses on achievements,current obstacles,and future directions in CAR-T research.A high complete remission rate of 68 ％ to 93％ could be achieved after and-CD19 CAR-T treatment for B-ALL Cytokine release syndrome and CAR-T-related neurotoxicity could be managed.In view of difficulties collecting autologous lymphocytes,universal CAR-T is a direction to explore.Regarding the high relapse rate after anti-CD19 CAR-T therapy,the main solutions have been developing new targets including CD22 CAR-T,or CD19/CD22 dual CAR-T.Additionally,some studies showed that bridging into transplant postCAR-T could improve leukemia-free survival.Some patients who did not respond to CAR-T therapy were found to have an abnormal conformation of the CD 19 exon or trogocytosis.Anti-CD19 CAR-T therapy for R/R B-ALL is effective.From individual to universal CAR-T,from one target to multi-targets,CAR-T-cell has a chance to be off the shelf in the future.

Objective To explore the effect of protoporphyrin Ⅸ zinc(Znpp) on hyperoxic lung injury in preterm rats.Methods Three-day-old preterm SD rats were randomly assigned to room air control group(group Ⅰ)hyperoxia control group(oxygen≥900 mL/L)(group Ⅱ),room air plus Znpp group(group Ⅲ),hyperoxia plus Znpp group(group Ⅳ).Group Ⅲ and group Ⅳ were injected intraperitoneally with ZnPP 45 ?mol/kg each day.After the third day and the 7th day of exposure,the activity of heme oxygenase-1(HO-1) and the percent of carboxyhemoglobin(HbCO) in the lungs,the lung wet weight /dry weight ratio(W/D),tumor necrosis factor-?(TNF-?),total protein and malondialdehyde(MDA) in bronchoalveolar lavage fluid were determined and lung histophathological changes were examined in all groups.Results On the third day,compared with group Ⅰ the activity of HO-1 and the percent of HbCO in the lungs,W/D,TNF-?,total protein and MDA,all greatly rised in group Ⅱ(Pa

OBJECTIVETo observe the clinical efficacy of treating chronic persistent bronchial asthma (CPBA) children with abnormal myocardial enzyme spectrum (AMES) by Yupingfeng Powder (YP) combined routine therapy.

METHODSFrom January 2010 to December 2012, 156 CPBA children patients with AMES were randomly assigned to the treatment group (80 cases) and the control group (76 cases). All patients received routine treatment (inhaled corticosteroids and/or leukotriene regulator). Besides, those in the treatment group took YP. The treatment duration was 3 months. The scores of children asthma control test (C-ACT), pulmonary function (FEV,% and PEF%), myocardial enzyme spectrum were observed before and after treatment, and 3 months before and after treatment. The myocardial enzyme spectrum of 40 healthy children at the baby clinics during the same period were recruited as the control.

RESULTSCompared with the control group, creatine kinase isoenzyme (CK-MB), creatine kinase(CK), and lactate dehydrogenase (LDH) increased in the two treatment groups (P <0.01), but there was no statistical difference in AST (P >0.05). Compared with before treatment in the same group, CK-MB, CK, LDH, and AST decreased in the treatment group after treatment and 3 months after treatment (P <0.01). CK-MB, CK, LDH, and AST decreased in the control group 3 months after treatment (P <0.01, P <0.05).Compared with after treatment, CK decreased in the control group 3 months after treatment (P <0.01). C-ACT score, FEV(1),%, and PEF% all increased in the two groups after treatment and 3 months after treatment (P <0.01, P <0.05). Compared with after treatment in the same group, CK decreased in the control group 3 months after treatment (P <0. 01). Compared with the control group in the same period, post-treatment CK-MB and CK decreased (P <0. 01, P <0. 05), while post-treatment C-ACT score, FEV, %, and PEF% increased (P <0.05) in the treatment group (P <0.05).

CONCLUSIONYP could strengthen specific and non-specific immunity of the organism, and improve clinical symptoms and the level of myocardial enzyme spectrum.

Asthma ; therapy ; Child ; Chronic Disease ; therapy ; Creatine Kinase, MB Form ; metabolism ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; L-Lactate Dehydrogenase ; metabolism ; Myocardium ; enzymology

Objective To discuss the value of moving darkroom and accompanying X-rays protective shield in endemic fluorosis areas.Methods Using moving and fixed darkrooms,the X-rays photos of the forearms and shanks of the 320 persons were developed in the endemic fluorosis areas,while the time for development and installing-uninstalling films was documented.The films develpoed in the darkroom were evaluated for the quality.Results Among the 320 films develpoed in the moving darkroom,the 268 had fingerprints,47 had scratches,298 were in good quality(93.13%),while in the fixed darkroom,the figure was correspondingly 735,384,227(70.93%);The moving darkroom increased excellent film rate significantly than fixed darkroom(χ2=53.43,P＜0.01),The detectable rate of skelelal fluorosis and degree Ⅰ skelelal fluorosis were highter than that in the fixed darkroom did (χ2=10.34,χ2=9.56,P＜0.01).Conclusions The films developed in moving darkroom have superior quality and higher diagnostic value,so it is important to use moving X-rays photographing in ecdemic fluorosis areas.

Whole cell patch-clamp technique was used to record the changes of persistent sodium current (I(Na.P)) and the effect of administered agents in ventricular myocytes of guinea pig to investigate the essence of I(Na.P) and mechanism of increased I(Na.P) of ventricular myocytes during hypoxia. The results showed: (1) Pro-NO L-arginine(L-Arg) and donor sodium nitroprusside (SNP) increased I(Na.P) in a concentration-dependent manner in normoxia. (2) I(Na.P) increased gradually with the prolongation of hypoxia time. After 15 min of hypoxia, administration of N(G)-nitro-L-arginine methyl ester (L-NAME), a NO synthase inhibitor, could not significantly recover the increased I(Na.P) [(1.344+/-0.320) vs (1.301+/-0.317) pA/pF, P>0.05, n=5]; (3) During hypoxia the perfusion solution with L-NAME decreased the increased I(Na.P), and the difference was significant compared with pure hypoxia [(0.914+/-0.263), n=5 vs (1.344+/-0.320) pA/pF, P<0.05, n=6], whereas the amplitude of I(Na.P) was still larger than that in normoxia [(0.914+/-0.263) vs (0.497+/-0.149) pA/pF, P<0.05, n=5]; (4) Reducing agent dithiothreitiol (DTT) not only recovered the increased I(Na.P) by L-Arg and administered SNP after hypoxia [(1.449+/-0.522) vs (0.414+/-0.067) pA/pF, P<0.01, n=6, and (1.786+/-0.636) vs (0.436+/-0.141) pA/pF, P<0.01, n=5, respectively], but also decreased the I(Na.P) in normoxia [(0.442+/-0.056) vs (0.396+/-0.057) pA/pF, P<0.01, n=6]. Our results suggest that hypoxia increases I(Na.P) of ventricular myocytes, which is induced by raised NO oxidating sodium channel protein in myocardial membrane during hypoxia. The activity of I(Na.P) in normoxia is related to the oxidation state of the channel protein.
Animals ; Cell Hypoxia ; physiology ; Cell Separation ; Female ; Guinea Pigs ; Heart Ventricles ; Male ; Myocardium ; cytology ; Myocytes, Cardiac ; metabolism ; physiology ; Nitric Oxide ; pharmacology ; Nitroprusside ; pharmacology ; Patch-Clamp Techniques ; Sodium Channels ; physiology

AIMTo investigate the effect of hypoxia/early reoxygenation on persistent sodium current (I(Na.P)) in single ventricular myocytes of guinea pig and discuss its role and significance during this pathological condition.

METHODSThe whole cell patch clamp technology was used to record this current and study its change under the condition of hypoxia/reoxygenation model.

RESULTS(1) With 0.5 Hz, 1 Hz and 2 Hz pulse frequency, the current density gap between the first and the eighth pulse of I(Na.P) was (0.021 +/- 0.014) pA/ pF, (0.097 +/- 0.014) pA/pF and (0.133 +/- 0.024) pA/pF (P < 0.01) respectively. (2) Depolarization with membrane holding potential of -150 - -80 mV respectively, I(Na.P) density attenuated gradually. (3) The amplitude of I(Na.P) was increased consistently with the prolongation of hypoxia time during hypoxia. (4) I(Na.P) was (0.500 +/- 0.125) pA/pF, (1.294 +/- 0.321) pA/pF and (0.988 +/- 0.189) pA/pF (P < 0.01, vs normoxia, respectively) during normoxia, hypoxia after 15 min and reoxygenation after 5 min, respectively.

CONCLUSIONThese results indicate that I(Na.P) has great significance in arrhythmogenesis and calcium-overload, which causes the following postischemia and post hypoxia myocardial damage.

Animals ; Calcium ; metabolism ; Cell Hypoxia ; Guinea Pigs ; Heart Ventricles ; Membrane Potentials ; Myocytes, Cardiac ; metabolism ; physiology ; Oxygen ; metabolism ; Patch-Clamp Techniques ; Sodium ; metabolism ; Sodium Channels ; metabolism