Objective To investigate the effects of preemptive analgesia with nalbuphine on inflammatory factors in elderly patients undergoing thoracotomy. Methods Eighty elderly patients with ASA I or Ⅱ undergoing thoracotomy were randomly allocated into control group (group C:n=40) and Nalbuphine group (group N:n=40). Each patient received 20 mg of Nalbuphine intravenously before induction of anesthesia in group N and same volume of normal saline in group C. Plasma levels of IL-10, TNF-α and IL-6 were measured at different time points. The VAS was recorded and the MAP, HR, SpO2 and PaCO2 were monitored. Results Compared with group C, the levels of TNF-α and IL-6 were lower, while IL-10 was higher at T2, T3, T4 in group N(P < 0.05). The VAS, MAP, HR and PaCO2 in group N were lower than those in group C at T2, T3 and T4 (P < 0.05). Conclusion Preemptive analgesia with Nalbuphine can improve the efficacy of postoperative analgesia and effectively reduce inflammatory reaction in the old patients undergoing thoracotomy.

OBJECTIVE:To provide reference for developing the ideas of Hui medicine research. METHODS:By retrieving relevant literatures about Hui medicine and ethnic medicine,combing with modernization needs,idea for systematic research of Hui medicine was sorted out. RESULTS & CONCLUSIONS:Hui medicine should be studied by theoretical research,herbal textu-al research,establishment of quality standards,formula and folk unilateral,prescription finishing,establishment of herbaria and da-tabase,new drug R&D,etc.

Objective: To observe the conditions of the eighth costal cartilage in ear reconstructed patients, and accomplish individualized aesthetic helix fabrication according to the texture and features of the cartilage. Methods: From May 2013 to May 2016, the conditions of the eighth costal cartilages in 415 patients who received ear reconstruction with autogenous costal cartilage in our hospital were analyzed, during which, the length, width, flexibility, and plasticity that were closely related with the reconstruction of the helix attracted predominant attentions. During the surgery, based on the features of the above-mentioned aspects, 4 different methods were used to achieve reasonable length and strength of the helix as well as natural jointing between the helix and ear lobe. Results: Four possible methods of using the eighth costal cartilage to reconstruct the helix were summarized and an autogenous costal cartilage framework that was individualized and with natural appearance was obtained. Conclutions According to the conditions of the eighth costal cartilage, a more satisfactory appearance of the reconstructed ear than ever before is obtained by choosing relevant helix fabrication programs.

BACKGROUND: Dual regimen dolutegravir (DTG) plus lamivudine (3TC) has demonstrated non-inferior efficacy compared to DTG-based three-drug regimens (3DRs), yet directly comparative data regarding the efficacy and safety of DTG + 3TC and bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) for therapy-naïve people with human immunodeficiency virus (HIV)-1 (PWH) are still limited. We aimed to assess the antiviral potency and safety profiles of DTG + 3TC vs. B/F/TAF based on antiretroviral therapy (ART)-naïve PWH in China. METHODS: This retrospective multicenter study enrolled PWH initiating ART with DTG + 3TC or B/F/TAF from 2020 to 2022 in Guangdong and Guangxi. We analyzed response rates based on target not detected (TND) status using intention-to-treat (ITT) analysis. Subgroups were formed based on baseline viral load (VL) (<100,000 vs . ≥100,000 copies/mL) and CD4 + cell count (<200 vs . ≥200 cell/µL). Median time to TND VL was assessed by Kaplan-Meier method. We also measured changes from baseline in CD4 + cell counts, CD4/CD8 ratio, lipid parameters, weight, creatinine (Cr), estimated glomerular filtration rate (eGFR), and drug-related adverse effects (DRAEs). RESULTS: We enrolled 280 participants, including 137 (48.9%) on DTG + 3TC and 143 (51.1%) on B/F/TAF. At week 48, 96.4% (132/137) on DTG+3TC and 100% (143/143) on B/F/TAF achieved TND ( P = 0.064). At week 12, TND responses were higher with B/F/TAF (78.3% [112/143]) than DTG+3TC (30.7% [42/137]) ( P <0.001). This trend held across subgroups. B/F/TAF achieved TND faster (12 weeks) than DTG+3TC (24 weeks) ( P <0.001). No differences were seen in CD4 + cell count and CD4/CD8 ratio, except in the high-VL subgroup, where B/F/TAF showed better recovery. DRAEs were significantly lower with B/F/TAF (4.9% [7/143]) than with DTG + 3TC (13.1% [18/137]) ( P = 0.016). Lipid parameters, body weight, and Cr increased in both groups over 48 weeks, with DTG+3TC showing a more favorable effect on triglycerides, high-density lipoprotein (HDL) cholesterol, and weight gain. CONCLUSIONS In this real-life study, B/F/TAF led to a faster viral decline and fewer DRAEs compared to DTG+3TC. No significant difference was observed in the TND rate at week 48, regardless of baseline VL and CD4 + cell count. CD4 + recovery was superior for B/F/TAF in participants with high VL. The DTG + 3TC regimen had less impact on metabolic changes than B/F/TAF.
Adult ; Humans ; Anti-HIV Agents/therapeutic use* ; China ; Emtricitabine/pharmacology* ; HIV Infections/drug therapy* ; HIV-1 ; Lamivudine/pharmacology* ; Lipids ; Retrospective Studies