Objective To compare the analgesia effect and the safety of Flurbiprofen Axetil (FA) and Parecoxib Sodium (PS) after posterior lumbar fusion surgery. Methods 90 patients undergoing internal fixation of lumbar spine randomly assigned to 3 groups:those in Group A(n = 30) received 100 mg of FA; those in Group B (n=30) received 40 mg of PS and those in Group C received saline.The VAS scores of 2, 6, 12, 24, 48, 72 h after operation and the dose of tramadol hydrochloride (TH) used and the side effect was recorded respectively. Results Group A and B had significantly better analgesic effect than Group C(P<0.05). Group A and B had lower average dose of TH than Group C (P<0.05). The VAS scores in Group A was lower than that in Group B in 2 h after the surgery. The VAS scores after the surgery showed no significant difference between Group A and B in 6 , 12, 24 h after the surgery. The VAS scores in Group A was higer than that in Group B in 48,72 h after the surgery. Conclusion Both PS and FA can alleviate postoperative pain and have fewer adverse reactions.

Objective To investigate the influencing factors of satisfaction with surgical treatment decision-making in gynecologic cancer patients. Methods One hundred and eighty gynecologic oncology patients in the First People's Hospital of Yulin, Guangxi were selected as the study group. The questionnaire of CPE was used to investigate the decision-making participation expectation scale. Results Toally 95 patients (52.78%) were satisfied with the operation decision-making. Logistic regression analysis showed that the satisfaction degree was correlated with information of the treatment plan, full communication between the doctors and patients and worry about the operation failure (P<0.05). Conclusions The patient's satisfaction with operation decision-making among gynecologic tumor patients is at a lower level. The communication between patients and relatives, doctors and patients should both be improved to eliminate patients' concerns about the surgical failure and thus improve their satisfaction with the operation decision-making.

Objective To observe and analyze the effect of HbA1c level on macular microcirculation in patients with type 2 diabetes mellitus (T2DM).Methods A cross-sectional study.One hundred and twenty-four T2DM patients (124 eyes) without diabetic retinopathy who diagnosed by the examination of fundus color photography in Lixiang Eye Hospital Of Soochow University during September to December 2017 were enrolled in this study.There were 59 males (59 eyes) and 65 females (65 eyes),with the mean age of 65.06±7.99 years old.All patients underwent BCVA,fundus color photography,and OCT angiography (OCTA).The history of diabetes,hypertension and dyslipidemia were recorded in detail.According to the HbA 1 c level,patients were divided into three groups,HbA1c ideal control group (group A,HbA1c ＜7％,67 eyes),HbA1c control group (group B,7％≤HbA1c≤9％,44 eyes),and HbA1c poor control group (group C,HbA1c＞9％,13 eyes),respectively.The 3 mm × 3 mm range of the macular area was scanned by OCTA instrument.The vascular density (VD) and skeleton density (SD) of nonsegmented retinal layer (NRL),superficial retinal layer (SRL) and deep retinal layer (DRL) in the macular area and foveal avascular zone (FAZ) area,non-circularity index,axial rate (AR) of SRL were measured.The correlation between HbA1c,BCVA and VD,SD ofNRL,SRL,DRL was analyzed statistically with Spearman correlation test.The correlation between systemic factors and the above indicators was analyzed statistically with linear regression analysis.Results The results of linear regression analysis showed that HbA1 c was significantly correlated with VD (t=-3.237,-3.156,-2.050) and SD (t=-0.3.45,-3.034,-2.248) of NRL,SRL and DRL (P＜0.05);but no correlation with FAZ,non-circularity index and AR (t=1.739,0.429,1.155;P＞0.05).The differences of VD (F=6.349,5.981,3.709),SD (F=7.275,6.085,1.904) and AR (F=0.027) of NRL,SRL and DRL in group A,B and C were statistically significant (P＜0.05);but the differences of FAZ (F=1.904),non-circularity index (F=0.280) was not statistically significant (P＞0.05).Significant differences (P＜0.05) of VD and SD of NRL were found between group A and B (t=1.987,2.201),group A and C (t=3.365,3.572),group B and C (t=2.010,2.076).Significant differences (P＜0.05) of VD and SD of SRL were found between group A and B (t=2.087,2.168),group A and C (t=3.197,3.194).There were significant differences (P＜ 0.05) in SD of DRL between group A and B (t=2.239),group A and C (t=-2.519).There was significant difference in VD of DRL between group A and C (t=2.363).The results of Spearman correlation analysis showed that HbA1c was negatively correlated with VD (r=-0.273,-0.255,-0.222;P=0.002,0.004,0.013) and SD (r=-0.275,-0.236,-0.254;P＜0.05) ofNRL,SRL,DRL;positively correlated with FAZ and BCVA (r=0.221,0.183;P＜0.05).BCVA was negatively correlated with VD (r=-0.210,-0.190,-0.245) and SD (r=-0.239,-0.207,-0.296) of NRL,SRL,and DRL (P＜0.05),but not correlated with FAZ (r=0.099,P＞0.05).Conclusion The decrease of macular perfusion and the morphological change of FAZ accompanied by HbA1c increased.

BACKGROUND:Previous studies have found that neohesperidin can delay bone loss in ovariectomized mice and has the potential to treat osteoporosis,but its specific mechanism of action remains to be explored. OBJECTIVE:To explore the key targets and possible mechanisms of neohesperidin in the treatment of osteoporosis based on bioinformatics and cell experiments in vitro. METHODS:The gene expression dataset related to osteoporosis was obtained from GEO database,and the differentially expressed genes were screened and analyzed in R language.The osteoporosis-related targets were screened from GeneCards and DisGeNET databases,and the neohesperidin-related targets were screened from ChEMBL and PubChem databases,and the common targets were obtained by intersection of the three.The String database was used to construct the PPI network of intersection genes,and the key targets were screened.The DAVID database was used for GO and KEGG enrichment analysis.The AutoDock software was used to verify the molecular docking between the neohesperidin and the target protein.The effect of neohesperidin on osteogenic differentiation of C57 mouse bone marrow mesenchymal stem cells was detected.Complete medium was used as blank control group;osteogenic induction medium was used as the control group;and osteogenic induction medium containing different concentrations of neohesperidin(25,50 μmol/L)was used as experimental group.The expression of alkaline phosphatase,the degree of mineralization,the expression of osteogenic-related genes and target genes during osteogenic differentiation of cells were measured at corresponding time points. RESULTS AND CONCLUSION:(1)9 253 differentially expressed genes,2 161 osteoporosis-related targets,and 326 neohesperidin-related targets were screened.There were 53 common targets among the three.All 53 genes were up-regulated in osteoporosis samples.The PPI network screened the target gene PRKACA of research significance.GO function and KEGG pathway enrichment analysis showed that neohesperidin's treatment of osteoporosis through PRKACA target mainly depended on biological processes such as protein phosphorylation and protein autophosphorylation,acting on endocrine resistance,proteoglycan in cancer,and estrogen signaling pathway to play a therapeutic role.Molecular docking results showed that neohesperidin had a certain binding ability to the protein corresponding to the target PRKACA.(2)The results of alkaline phosphatase staining showed that neohesperidin could promote the expression of alkaline phosphatase in the early stage of osteogenic differentiation of mesenchymal stem cells.Alizarin red staining showed that neohesperidin could promote the mineralization of osteogenic differentiation of mesenchymal stem cells.RT-qPCR results showed that neohesperidin could increase the mRNA expression of alkaline phosphatase,PRKACA,and osteocalcin.(3)These results indicate that neohesperidin may promote osteogenic differentiation through PRKACA target on the estrogen signaling pathway to prevent and treat osteoporosis.