Objective To investigate the clinical effects of continuous 3-in-1 femoral nerve block with stimulating catheters for patient controlled regional anesthesia(PCRA) in elderly patients after unilateral total knee replacement (TKR)surgery.Methods Thirty ASA Ⅰ - Ⅱ elderly patients wererandomly divided into two groups: FB group and Ⅳ group.FB group received continuous 3-in-1 femoral nerve block for postoperative analgesia with 0.2% ropivacaine plus 0.1 μg/ml sufentanil continuous infusion at 5 ml/h plus PCA boluses (1.0 ml/15 min).Ⅳ group received continuous intravenous analgesia with 1 μg/ml sufentanil plus 0.04 mg/ml tropisetron hydrochloride at 2 ml/h plus PCA boluses (0.5 ml/15 min).All patients were maintained analgesia for 48 hours.Results In FB group, the visual analogue scale(VAS) scores were 1.3 ±1.1, 1.2 ± 1.0, 1.1±0.9, 1.1 ± 1.0,1.0±0.9 at 4, 8, 12, 24, 48 hours after surgery under rest status respectively and were 3.04±1.4,2.3±1.3 at 24, 48 hours after surgery in active function training.These parameters in Ⅳ group were 4.0±1.6, 3.5±1.6, 3.2±1.4, 3.0±1.3, 2.5±1.2, 4.7±1.5 and 3.3±1.5 respectively, which were significantly different compared with FB group (t=5.358, 4.707, 4.852, 3.784, 3.743, 3.254,1.932,all P<0.05 or P<0.01).The incidence of nausea was higher in IV group than in FB group(P = 0.0022).Postoperative satisfaction ratings was higher (χ2 =41.1 ,P<0.01) and the total morphine use for 48 hours after operation was less(uc=2.412, P<0.01) in FB group than in Ⅳ group.Conclusions After TKR surgery, the continuous 3-in-1 femoral nerve block with stimulating catheters is an effective method with better pain relief,fewer side effects and higher satisfaction ratings in the elderly.

Objective To analyse the kidney damage situation of the elderly health examination people,and identify its characteristic.Methods A cross-sectional study was held which enrolled 1088 elderly health examination people.Urine routine,random urine albumin/creatinine ratio (ACR),serum creatinine,urea nitrogen were detected by biochemical analyzer,and estimated glomerular filtration rate (GFR) with CKD-EPI formula.Kidney structure change was examined by Color doppler ultrasound detector.Results The prevalence of hypertension,hyperlipemia,diabetes mellitus was 61.5％,62.1％,11.6％,respectively.The abnormal detection rate of urine routine was 19.0％,including 2.6％ proteinuria,14.1％ hematuresis and 5.4％ leucocyturia.The abnormal detection rate in the people with was higher than those without (P＜0.01).However,the albuminuria detection rate with random urine ACR was 25.1％,obviously higher than that of urine routine (P＜0.01).The ultrasound results showed that 6.8％ of the total were examined with elderly characteristic kidney change,the proportion of renal cyst was the highest,accounted for 21.8％.70.7％ of all people were in the level of eGFR more than 60 ml· min-1 · 1.73 m-2.The level of eGFR＜60 ml· min-1 · 1.73m-2 in the people with was higher than those without (P＜0.01).eGFR was declined with age.When age increased every 10 years,eGFR was decreased 7 ml · min-1 · 1.73 m-2.Conclusions No matter in structure or function,the elderly people's kidney damage has its characteristic.We should make it clear to correctly diagnose and cure elderly kidney disease.

Objective To study the effect of small diameter graft (0.8 cm) splenocaval or mesocaval shunts combined with pericardial devascularization in the treatment of portal hypertensive variceal bleeding. Methods Splenocaval shunts were performed in 14 patients and mesocaval shunts were done in 24 patients, in combination with pericardial devascularization. Results The average decrease of free portal pressure was 6.6±1.2 cm. There was no significant changes in liver function postoperatively (P>0.05). Platelet counts and leukocyte counts were back to normal in splenocaval shunt patients postoperatively (P< 0.05). Operative mortality was 3%. Pyrexia developed in 4 patients, intractable ascites in 1 patient, chylons ascites in 1 patient, hepatic encephalopathy in 1 patient, intraabdominal infection in 1 patient and stress ulceration in 1 patient. All patients recovered after expectant treatment except one who died from severe intraabdominal infection. 35 patients received follow-up between 6 months and 3 years, total effective rate was 89%, 2 patients died from recurrent variceal bleeding, the shunt potency rate was 80% in 1 year and 75% in 3 years. Esophagogastric varices disappeared or alleviated as shown by endoscopy in 25 patients on 6 months postoperatively. Conclusions Small diameter portosystemic graft shunts combined with poricardial devascularization is an effective therapy for bleeding esophagogastric varices with a low rate of hepatic encephalopathy. Splenocaval shunt alleviates hypersplenism concurrently.

Objective To investigate the effect of stage 1 acute kidney injury (AKI) on the prognosis of patients underwent cardiopulmonary bypass (CPB) cardiac operation. Methods A retrospective analysis was conducted. All patients aged ≥ 18 years who underwent cardiac operation with CPB admitted to Beijing Anzhen Hospital from July 1st, 2013 to December 31st, 2015 were enrolled. According to the standard of serum creatinice (SCr) of Kidney Disease Improving Global Outcomes (KDIGO) criteria, the AKI patients with stage 1 and non-AKI patients were served as the research objects. Perioperative clinical data of two groups were collected, and the prognosis was recorded during follow up to draw the Kaplan-Meier survival curve. Cox regression model was used to analyze the risk factors of prognosis in patients with stage 1 AKI experienced CPB during cardiac operation. Results A total of 5 823 patients were enrolled, of which 1 285 patients with AKI, and those in stage 1 was 998, accounting for 77.67% of total AKI patients; and 4 538 in non-AKI group. The mean follow-up period among survivors was (23.13±12.28) months. Compared with non-AKI patients, 30-day mortality of patients with stage 1 AKI was significantly increased [4.00% (40/998) vs. 0.40% (18/4 538), P < 0.01]. It was showed by Kaplan-Meier survival analysis that the cumulative survival rate of patients with stage 1 AKI was significantly lower than that of non-AKI patients (log-rank = 51.989, P < 0.001). It was showed by further subgroup analysis that the cumulative survival rate of patients with stage 1 AKI without serum creatinine (SCr) recovery was significantly lower than that of patients with SCr recovery from stage 1 AKI (log-rank = 43.580, P = 0.000). It was showed by Cox multivariate analysis that stage 1 AKI [hazard ratio (HR) = 2.725, 95% confidence interval (95%CI) = 1.810-4.230, P = 0.000] and prolonged CPB in patients undergoing cardiac operation (HR = 1.013, 95%CI = 1.001-1.017, P = 0.000), combined with coronary heart disease (HR = 1.046, 95%CI = 1.010-1.063, P = 0.005) and diabetes mellitus (HR = 1.060, 95%CI = 1.010-1.090, P = 0.002) were independent risk factors of death in patients undergoing CPB during cardiac operation. Conclusion Stage 1 AKI is the main stage of AKI and it is independently related to all-cause mortality in patients underwent cardiovascular operation using CPB.

Traditional Chinese medicine is a treasure of Chinese culture, absorbing the wisdom of the Chinese people. Continuous application of new technologies makes traditional Chinese medicine research advance with the times. After several years of development, high-throughput transcriptome study has become a mature research tool in biology. This paper reviewed the advances in medicine transcriptome study, and compared two sequencing platforms, Roche's GS FLX platform and Illumina's HiSeq 2000 platform. Moreover, this paper introduced medicine transcriptome analysis process, with Panax quinquefolius and Lonicera japonica for examples, showing the characteristics of traditional Chinese medicine transcriptome studies. High-throughput transcriptome studies facilitate traditional Chinese medicine research with overall understand of functional genes, give clear elucidation of metabolic pathways, lay molecular foundation for the traditional Chinese medicine research and offer modern interpretation for traditional Chinese medicine theory. However, the current study faces several difficulties, including weak molecular basis, high sequencing cost and staff shortages in data anaysis. In the future, with the development in sequencing technology, the combination of transcriptome and other genomics, such as proteome and metabolome, will lay a solid foundation for the new high-throughput screening and developing model for the traditional Chinese medicine industry.
Biomedical Research ; methods ; trends ; Forecasting ; Gene Expression Profiling ; methods ; Gene Expression Regulation, Plant ; Humans ; Lonicera ; genetics ; Medicine, Chinese Traditional ; methods ; trends ; Panax ; genetics ; Phytotherapy ; methods ; trends ; Transcriptome ; genetics

BACKGROUND:Lumbar spine MRI and electrophysiological test are reliable methods for evaluating nerve root injury caused by lumbar disc herniation.
OBJECTIVE:To analyze the correlation between the MRI-based grading system and the latency and frequency of F wave as wel as latency and amplitude of H-reflex in patients with lumbar disc herniation.
METHODS:MRI imaging of the lumbar spine was performed with a 3.0-T imager and a dedicated TCL coil to classify lumbar disc herniation and nerve root compression. F wave and H reflex were detected on the patient bilateral tibial nerves using Oxford myoelectricity evoked potential instrument.
RESULTS AND CONCLUSION:Spearman correlation analysis showed that the MRI-based grading of patients with lumbar disc herniation had a negative correlation with F wave frequency (r=-0.594 0, P<0.000 1), and a positive correlation with F wave latency (r=0.825 6, P<0.000 1) and H-reflex latency (r=0.875 0, P<0.000 1), but no correlation with H-reflex amplitude (R=0.117 4, P=0.257 3). With MRI grading increased, F wave frequency was decreased, and F wave and H-reflex latency were prolonged gradual y, indicating aggravating nerve root compression.

The medical records of patients underwent thoracic surgery with cardiopulmonary bypass (CPB) from July 1,2013 to May 30,2014 were collected and reviewed,the patients who developed postsurgical acute kidney injury (increase in postsurgical serum creatinine＞26.6 μmol/L) during hospital stay were excluded,and a total of 1 509 cases were enrolled in the study.Age,gender,body weight,presurgical complications,presurgical ejection fraction,serum concentration of creatinine on presurgical day 1,CPB duration during surgery,aortic clamping time,volume of blood transfused,duration of intensive care unit stay,mechanical ventilation time,length of hospital stay,and the highest serum concentration of creatinine were collected.The patients were divided into 2 groups according to the increase in postsurgical serum creatinine concentrations (the difference between the highest serum concentration of creatinine during hospital stay and the serum concentration of creatinine on presurgical day 1):no increase in creatinine group (n =508) and minimal increase in creatinine group (increase in postsurgical serum creatinine concentrations≤26.6 μmol/L,n=1 001).All the patients were followed up by telephone,and the fatality was recorded.Kaplan-Meier and log-rank analyses were used to analyze the survival condition,and the risk factors for fatality were identified by using multivariate Cox regression analysis.Compared with no increase in creatinine group,age was significantly increased,the constituent ratios of coronary heart disease,hypertension,diabetes mellitus,and pulmonary hypertension were significantly increased,CPB duration and length of hospital stay were significantly prolonged (P＜0.05),and no significant change was found in the fatality rate on postsurgical day 30 in minimal increase in creatinine group (P＞0.05).The patients were followed up for (298±104) days,and Kaplan-Meier analysis showed that the long-term fatality rate was significantly higher in minimal increase in creatinine group than in no increase in creatinine group (P＜0.05).Multivariate Cox regression analysis showed that age,presurgical coronary heart disease,CPB duration and minimal increase in postsurgical creatinine were the risk factors for fatality,and among these factors,minimal increase in postsurgical creatinine resulted in a 9％ increase in the fatality rate.In conclusion,minimal increase in postsurgical creatinine can not only prolong the length of hospital stay,but also increase the long-term fatality rate in the patients undergoing cardiac surgery with CPB.

Objective To investigate and evaluate the changes of T lymphocytes and red cell immunity of peripheral blood in patients with primary hepatocyte carcinoma (PHCC) after radiofrequency ablation(RFA) treatment. Methods The pre- and post- RFA(3d,7d,14d) peripheral blood T lymphocyte subsets(T3,T4,T8,T4/T8) and red cell immunity (RBC C3 receptor flower and RBC-immuocomplex formation rate) were investigated in 120 patients with PHCC treated by RFA. Results On 7d, 14d after RFA, T3, T4 lymphocytes and T4/T8 were higher than those on preoperative day significantly(P

Objective To establish binomial equation Cole-Cole mathematical modeling methods and the parameters in rat erythrocyte impedance spectra,as well as to discuss the sources of the ? and the ? dispersion.Methods The impedance of erythrocyte suspension was measured with Agilent 4294A impedance analyzer within the frequency range of 0.01~100 MHz.The residual error of the fitting curve was determined with non-linear numerical calculation of Cole-Cole equation.Then the Cole-Cole mathematical model parameters of rat erythrocyte were established with the Bode and the Nyquist plots.Results The Cole-Cole mathematical model parameters of rat erythrocyte impedance spectrum: the high-frequency limit of impedance R∞=63/?cm,the 1st relaxation impedance increment ?R1=59/?cm,the 1st characteristic frequency fC1 =2.4 MHz,the 1st relaxation dispersion angle ?1=0.07,the 2nd relaxation impedance increment ?R2=48/?cm,the 2nd characteristic frequency fC2 =370 MHz,the 2nd relaxation dispersion angle ?2=0.22.Conclusion The ? and ? relaxation behavior of rat erythrocyte impedance spectrum can be expressed with the two-type Cole-Cole mathematical model.The ? dispersion is formed from the capacitive response of cell membrane and the ? dispersion from frequency response of intracellular hemoglobin.

OBJECTIVETo compare the effect and impact of holmium laser enucleation of the prostate (HoLEP) and 120-W thulium: YAG vapoenucleation of the prostate (ThuVEP) on erectile function in the treatment of benign prostatic hyperplasia (BPH).

METHODSWe retrospectively analyzed 93 cases of symptomatic BPH treated by HoLEP or 120 W ThuVEP. We made comparisons between the two groups of patients in the baseline and postoperative clinical and surgical indexes as well as their IPSS, quality of life (QOL), maximum flow rate (Qmax), postvoid residual urine volume (PVR), and IIEF-EF scores before surgery and during the 12-month follow-up.

RESULTSThuVEP, in comparison with HoLEP, achieved a significantly shorter operation time ([57.6 +/- 12. 8] vs. [70.4 +/- 21.8] min, P = 0.001) and a higher laser efficiency ([0.71 +/- 0.18] vs. [0.62 +/- 0.19] g/min, P = 0. 021). At 1, 6, or 12 months of follow-up, no significant differences were observed in IPSS, OOL, Omax, and PVR between the two groups (P > 0.05). Both the HoLEP and ThuVEP groups showed low incidences of complications and remarkably improved IIEF-EF scores at 12 months postoperatively, but with no significant differences (both P > 0.05). However, in those with relatively normal erectile functions before operation, the mean IIEF-EF score was reduced from 22.8 +/- 2.2 preoperatively to 21.0 +/- 2.7 after HoLEP, (P = 0.036).

CONCLUSIONBoth HoLEP and 120W ThuVEP are effective and safe in the treatment of BPH. Compared with HoLEP, 120 W ThuVEP has even a higher laser efficiency. However, neither can significantly improve erectile function, and HoLEP may have a short-term negative impact on the relatively normal erectile function of the patient.

Aged ; Holmium ; Humans ; Laser Therapy ; adverse effects ; methods ; Lasers, Solid-State ; therapeutic use ; Male ; Middle Aged ; Penile Erection ; Prostatectomy ; adverse effects ; methods ; Prostatic Hyperplasia ; surgery ; Quality of Life ; Retrospective Studies ; Thulium ; Transurethral Resection of Prostate ; Treatment Outcome ; Urine