Objective To compare the analgesic efficacy and side effects of patient-controlled intravenous analgesia (PCIA) with Lornoxicam and patient-controlled epidural analgesia(PCEA) with morphine in patients undergoing Orthopaedics surgery. Methods 100 ASA Ⅰ-Ⅱ Patients scheduled for Orthopaedic surgery were divided randomly into two groups: Lornoxicam PCIA group( n =50) , Lornoxicam 48mg was diluted to 100ml with normal saline (0.9%NS). Morphine PCEA group( n =50), Morphine 9mg + bupivacaine 150mg were diluted to 100ml with normal saline (0.9%NS) .In both groups the patients were received PCA at a rate of 2ml/h with the bolus dose of 0.5ml and lockout interval of 15min. The loading dose was Lornoxicam 8mg plus Ondansetron 4mg in group PCIA and morphine 1mg and Ondansetron 4mg diluted to 10ml with normal saline (0.9%NS) in group PCEA 30 minutes before the end of operation. BP, RR, ECG, SpO_2 were monitored continuously after operation. Efficacy of analgesia was assessed by VAS scores. Side effects such as drowsiness, sweat, nausea, vomiting and skin pruritus were also observed. Results There was no significant difference in the mean VAS score between group PCIA and group PCEA at 4h, 8h, 16h ,20h, 24h, 32h and 48h. after operation. There was no significant difference in side effects between the two groups except the occurrence of sweat, nausea, vomiting and skin pruritus which was lower in group PCIA than in group PCEA ( P

Objective To observe the effect of acupuncture plus early-stage rehabilitation training on the neurological function and levels of serum ischemia-modified albumin (IMA) and neuron-specific enolase (NSE) in patients with acute cerebral infarction.Method Sixty-eight patients with acute cerebral infarction were randomized into a treatment group and a control group, 34 cases each. The control group was intervened by conventional medications, while the treatment group was intervened by acupuncture plus early-stage rehabilitation training in addition to the medications given to the control group. The two groups were both treated once a day, 10 d as a treatment course. Three treatment courses later, the changes of serum IMA and NSE levels were observed; the Modified Edinburgh-Scandinavian Stroke Scale (MESSS), Barthel Index (BI) and Fugl-Meyer Assessment (FMA) scores were compared before and after the treatment.Result The MESSS, BI and FMA scores were significantly changed in both groups after the intervention (P<0.01). After the intervention, the MESSS, BI and FMA scores in the treatment group were significantly different from those in the control group (P<0.05). The serum IMA and NSE levels were significantly changed in both groups after the intervention (P<0.01). After the treatment, the serum IMA and NSE levels in the treatment group were markedly lower than those in the control group (P<0.01).Conclusion Acupuncture medication combined plus early-stage rehabilitation training can promote the recovery of neurological function of acute cerebral infarction patients, which is related to the down-regulation of serum NSE and IMA levels.

Objective To investigate the relation between polymorphism of NOS3 G894T and susceptibility of cancer .Methods Literatures under the inclusion and exclusion criteria about relation between polymorphism of NOS 3 G894T and susceptibility of cancer were collected by computer -based retrieval and manual retrieval .The pools ORs with 95% CI were calculated to assess the association strength between polymorphism of NOS 3 G894T and cancer risk by Meta methods .Sensitivity and publication bias were evaluated .Results 19 literatures with 7679 cases of cancer and 8180 cases as control group were included .The pooled result indica-ted that no significant association between its polymorphism and cancer (ORT versus G=1 .030 ,95% CI=0 .964 -1 .101 ;ORTT versus GG=1 .056 ,95% CI=0 .895-1 .245 ;ORTG versus GG=1 .045 ,95% CI=0 .977-1 .119 ;ORTT/TG versus GG=1 .047 , 95% CI=0 .981-1 .117 ;ORTT versus TG/GG=1 .005 ,95% CI=0 .900-1 .123) .No significant association was observed in sub-group analysis based on ethnicity ,cancer type ,and source of control group .Conclusion There was no relationship between NOS3 G894T polymorphism and cancer susceptibility .

Objective To evaluate the efficacy and safety of induction chemotherapy and three-dimensional conformal radiation (3D-CRT) combined with endostar in the treatment of locally advanced non-small cell lung cancer (NSCLC).Methods Thirty patients with locally advanced NSCLC were enrolled and divided into observation group (15 cases) and control group (15 cases).In the observation group,the patients received induction chemotherapy and 3D-CRT combined with endostar.Chemotherapy:Vinorelbine 25mg/m2 on day 1 and 8,DDP 30mg/m2 on day 2 to 4.Endostar 7.5mg/m2 on day 1 to 14,which was used again after 7 days for 2 to 4 cycles.In the control group,the patients received induction chemotherapy and 3D-CRT at the same dosage.All patients were treated with 3D-CRT and the prescription dose was 60 ～ 68Gy per fraction.The responses were evaluated according to WHO criteria.The shortterm efficacy between the 2 groups was compared.Results The overall effective rate of the two groups were 66.7％ and 60.0％,respectively (P ＞ 0.05).The median progression-free survival time was 12 months in the observation group and 10 months in the control group.The median survival time was 20 months in the observation group and 18 months in the control group.The 1 year overall survival rate was 80.0％ in the observation group and 73.3％ in the control group(P ＞ 0.05).The main toxicities in the two groups were marrow suppression,gastrointestinal symptoms,acute radiation pneumonitis and acute radiation esophagitis.There was no significant difference between the two groups (P ＞ 0.05).Conclusions The combination of endostar with induction chemotherapy and 3D-CRT can improve the short-term efficacy rate of locally advanced NSCLC,the adverse events of which are tolerable,but the improvement is not significant in both groups.The result pending further randomized multi-center phase Ⅲ clinical study.

Objective To evaluate the long-term efficacy and safety of donepezil in treating patients with Alzheimer's disease(AD).Methods Totally 86 patients with AD were randomly divided into control group(n =43)and treatment group(n =43).The control grou,p received conventional therapy with aniracetam,nimoldipine and ginkgo tablet,while the study group was administrated with donepezil(10 mg/d)on the basis of conventional therapy.The improvements of recognitive ability,mental state,activities of daily life were graded by mini-mental state examination (MMSE),Alzheimer's disease assessment scale-cog(ADAS-cog),activity of daily living(ADL)and global deterioration scale(GDS).The scores were compared between the groups before the treatment and 3,6,12,18,24,30,36,42,48,54,60,66 and 72 months after the treatment,respectively.Results The scores of MMSE,ADAS-cog and GDS after 3 months and ADL score after 6 months (t=2.361,-2.198,-1.790,-2.420,P＜0.05 or P＜0.01)were improved in treatment group than in control group with the best effects at 12 months(all P＜0.01)and the scores continued to decrease after 36 months.At 72 months,the score improvements in treatment group were 7.5 for MMSE,20.3 for ADAS-cog,19.5 for ADL,and 1.4 for GDS as compared with control group(all P ＜0.01).In contrast to pretreatment,there were statistically significant differences in the scores of MMSE,ADAS-cog and GDS at 3,6,12,18 and 24 months,and in the score of ADL at 6,12,18,24 and 30 months after treatment(P＜0.05 or P＜0.01).The differences in the scores of ADAS-cog and GDS after 24 months as well as MMSE and ADL after 30 months were not found(P＞0.05)between pre-treatment and post-treatment.Conclusions Donepezil might be long term effective and safe in slowing down the recognitive and overall function deterioration of AD.

The neurovascular unit (NVU) consists of neurons,gllal cells and microvessels,etc.There were complex interactions among the various cellular components,which form as a uniform entirety preferably.Anong the various cellular components of NVU,the signal transduction occurred disorders during cerebral ischemia,resulting in neuronal and extracellular ratrix destruction,and thus occurring cerebral infarction and hemorrhagic transformation.Therefore,the treatment of ischemic sttroke should be based on the protection of the overall function of NVU.This article describes the changes and protection of NVU after cerebral ischemia.

Objective To investigate the effects of remffentanil pretreatment on myocardial ischemiareperfusion (I/R) injury in rabbits. Methods Thirty healthy rabbits, aged 12-18 months, weighing 2.5-3.5 kg,were randomly divided into 3 groups (n = 10 each): I/R group, low-dose remifentanil pretreatment group (group R1 ) and high-dose remifentanil pretreatment group (group R2 ). Myocardial I/R was induced by ligation of anterior descending branch of left coronary artery for 30 min followed by 6 h of reperfusion in the 3 groups. Remifentanil was infused intavenously at 1.65 and 3.30 μg· kg - 1 · min- 1 for 30 min before ischemia in group R1 and R2 respectively, while equal volume of normal saline was infused instead in group I/R. Blood samples were taken for determination of serum cardiac troponin-Ⅰ (cTnI) and creatine kinase-MB isoenzyme (CK-MB) concentrations before administration (baseline), after administration, at 30 min of ischemia and at 6 h of reperfusion. The rabbits were then sacrificed and hearts removed. Myocardial tissues were obtained for microscopic examination. Results Serum cTnI and CK-MB concentrations were significantly lower in group R1 and R2 than in group I/R and serum cTnI concentration lower in group R2 than in group R1 ( P ＜ 0.01). Remifentanil infusion significantly attenuated the pathologic changes in a dose-dependent manner. Conclusion Remifentanil pretreatment provides protective effect against myocardial I/R injury in rabbits and it is related to the dose.

BACKGROUND:Hyperbaric oxygen(HBO)treatment promotes the proliferation and differentiation of endogenous neural stem cells in neonatal rats following hypoxic/ischemic brain damage(HIBD).The Wnt signaling pathway is associated with neurogenesis.However,there are few data recording the role of HBO in the differentiation of neural stem cells in vitro.OBJECTIVE:To observe the effect of HBO on differentiation and Wnt3 expression of bone marrow mesenchymal stem cells(BMSCs).METHODS:BMSCs were isoiated and cultured.The rat BMSCs of passages 3-5 were cultured in DMEM/F12(1:1)medium with basic fibroblast growth factor,epidermal growth factor and B27 for 24 hours.The induced BMSCs were randomly divided into two groups:control group(no treatment)and HBO group(HBO,0.10 MPa,60 minutes stabilizing pressure with at least 90% oxygen).The neuron specific encloase(NSE),glial fibrillary acidic protein(GFAP)and 04 marked oligodendrocyte immunocytochemistry were detected by immunofluorescent staining,and Wnt3 protein expression was detected by Western-blot.RESULTS AND CONCLUSION:BMSCs cultured in classic medium of neural stem cells could significantly induce the expression of nestin.The expression of NSE and 04 of HBO group was greater than control group(P＜0.01),but GFAP expression displayed no significant difference between the groups(P＞0.05).Western blot showed HBO could enhance the Writ3 expression (P＜0.05).Results show that HBO can induce BMSCs to differentiate into neural cells and oligodendrocyte,which is correlated with the activation of the Wnt3 protein.

Objective To study in targeted therapy of cancer drug endostar combined with radiotherapy and chemotherapy in the treatment of newly diagnosed patients with advanced non-small cell lung cancer, and find an effective combined treatment mode of advanced non-small cell lung cancer, so as to improve the survival rate and quality of life of patients with advanced lung cancer. Methods 18 patients with newly diagnosed advanced non- small cell lung cancer admitted to our hospital from July 2009 to February 2010 were randomly divided into 2 groups and treated with induction chemotherapy and 3D-CRT,9 cases in the experimental group (including Endostar), 9 cases in the control group, All of the patients'clinical symptoms, efficacy and toxicity in the two groups were observed. At the same time, nursing of radiotherapy, chemotherapy and targeted therapy was given to paients. Results The efficacy of the experimental group and the control group were 77.8% and 66.7%, the clinical remission rates of the experimental group and the control group showed no significant difference, both of the patients in the two groups had varying degrees of toxicity, but all of the them completed the treatment well under the holistic nursing and systematical health education by nurses. Conclusions Endostar combined with induction chemotherapy and three-dimensional conformal radiotherapy (3D-CRT) in the treatment of advanced non-small cell lung cancer can improve the efficacy and survival rate, and the quality of life, although there are some side effects, but can be alleviated by symptomatic treatment and care.

Objective To sum up the experience of position nursing of patients with ankylosing spondylitis and severe kyphosis. Methods Eleven patients with ankylosing spondylitis and severe kyphosis underwent surgery. The patients′spine and head were kept in a line during anesthesia to avoid spinal cord injury. The eye mask was used to make sure the eyelid close, so the bulbar conjunctiva and corneal did become dry. The angle of operation bed in time during operation was adjusted. The crushed area was observed and the position was changed to avoid pressure sores and edema. After surgery, they were keep inactive to make sure the spine stable and relieve the pressure. Results The 11 patients′surgery were successful. There were no pressure ulcer, fracture, spinal cord injury or eye injury occurs. The operation time was 9.3 ± 2.9 h. Conclusion Position nursing is very important to improve the success rate of surgery and reduce complications.