OBJECTIVE:To observe the effects of parecoxib preemptive analgesia combined with postoperative epidural analgesia on hip replacement and immune function. METHODS:Totally 86 patients undergoing unilateral hip replacement selected from Xining Third People's Hospital during Jan. 2014-Jun. 2016 were divided into observation group and control group according to random num-ber table,with 43 cases in each group. Two groups underwent unilateral hip replacement under spinal epidural anesthesia. Observation group was given Parecoxib sodium for injection 40 mg intravenously 30 min before the end of surgery. Control group was given con-stant volume of normal saline intravenously. Both groups were given epidural analgesia pump(Ropivacaine hydrochloride injection 150 mg+Ondansetron hydrochloride injection 16 mg+Dezocine injection 10 mg,added into normal saline to 100 mL)after surgery with dripping speed of 2 mL/h and patient-controlled time of 15 min. The hemodynamic indexes,analgesic effect,T lymphocyte subsets and NK cells levels were compared between 2 groups at different time points as well as the occurrence of ADR after surgery. RE-SULTS:Two patients of observation group and one patient of control group withdrew from the study. Before surgery,there was no sta-tistical significance in MAP and HR between 2 groups(P>0.05);12,24 h after surgery,MAP and HR of control group were signifi-cantly increased and higher than observation group,with statistical significance(P<0.05). There was no statistical significance in MAP and HR of observation group at different time points compared to before treatment;there was no statistical significance in MAP and HR between 2 groups immediately after surgery,48 h after surgery(P>0.05). There was no statistical significance in VAS score between 2 groups immediately after surgery(P>0.05);6,12,24,48 h after surgery,VAS scores of observation group were signifi-cantly lower than those of control group,with statistical significance(P<0.05). There was no statistical significance in CD3+,CD4+, CD4+/CD8+and NK cells levels between 2 groups before surgery(P>0.05). CD3+,CD4+and NK cells levels of 2 groups immediately after surgery,CD3+,CD4+,CD4+/CD8+ and NK cells levels of 2 groups at 12,24 h after surgery,CD3+and CD4+of control group at 48 h after surgery all changed significantly;CD3+,CD4+,CD4+/CD8+and NK cells levels of observation group at 12,24 h after sur-gery were significantly higher than those of control group,with statistical significantly(P<0.05). There was no statistical significance in the incidence of ADR between 2 groups(P>0.05). CONCLUSIONS:The parecoxib preemptive analgesia combined with postopera-tive epidural analgesia shows good analgesic effect for hip replacement patients,keeps their hemodynamics stable and protects immune function to certain extent with good safety.

Objective To detect the expression of humar telomerase reverse transcriptase (hTERT) and telomerase activity in HeLa,MCF-7,SMMC7721 PC-3m and U2OS cell lines. Methods The techniques of immunochemistry and TRAP-ELISA were employed to detect the expression of hTERT and telomerase activity in different tumor cell lines.Results The positive rate of hTERT in HeLa cells(93.75%?3.10%)was significantly higher than that in U2OS cells(2.75%?0.96%),besides the other three cell lines showed an positive rates of hTERT in MCF-7(92.50%?2.65%),SMMC7721 (53.75%?2.22%)and PC-3m(23.50%?2.89%); Meanwhile,the telomerase activity of HeLa cells (94.58%?3.49%) was also much higher than that of U2OS(3.02%?0.43%),likewise the telomerase activities of the other three cell lines (MCF-7,SMMC7721,PC-3m) were 73.90%?4.50%,66.67%?3.35% and 50.62%?1.96%, respectively. Conclusion The expression of hTERT and telomerase activity show obvious differences among five tumor cell lines,suggesting that telomerase inhibitors cannot effect on all the tumor cell lines.

Objective:To study the changes of upper airway dimension and morphology in Class Ⅱ mandibular retrusion children af-ter functional treatment by Twin-block appliance.Methods:The Cone-Beam CT(CBCT)data of upper airway of the subjects were measured with Dolphin 11.5 software before and after fuctional treatment by Twin-block appliance.The comparison of upper airway di-mension and morphology between pre-treatment and post-treatment was performed by paired t-text.Results:After functional treatment the volume of total upper airway,velopharyngeal airway,glossopharyngeal airway,laryngopharyngeal airway,oropharyngeal airway,the sectional area of the inferior of the soft palate(SP),tip of the epiglotti(TE),the sagittal diameter of SP,the lateral diameter of SP and TE increased(P <0.05)in the children;the airway's shape of SP was attended to be rounder and TE to be more flat.Conclusion:Functional treatment is effective in the treatment of skeletal Class Ⅱ mandibular retrusion of children by increase of the upper airway and improvement of respiration.

Child, Preschool ; Female ; Humans ; Male ; Shock, Septic ; etiology ; microbiology ; Streptococcal Infections ; complications ; pathology

ObjectiveTo observe the effect of community-based rehabilitation (CBR) on older stroke patients in ability of activities of daily living (ADL).Methods50 older stroke patients were randomly divided into the rehabilitation group and control group. The rehabilitation group was treated with motor function exercise and ADL training, while the control group only took medicine. Two groups were evaluated with Barthel index before and after treatment. ResultsScores of Barthel index on the rehabilitation group were higher than that on the control group after treatment, and there was a significantly difference between two groups (P<0.01). Conclusions CBR has the significant effect on improving ADL in older stroke patients.

Objective To study the effect of Shenqi Fuzheng injection (SQFZI,参芪扶正注射液) on renal function in patients after cardiac surgery and cardiopulmonary bypass (CPB).Methods Forty patients ready for receiving CPB and cardiac surgery were randomly assigned to two groups,20 being in each group. Patients in the SQFZI group were administered of 250 ml SQFZI intravenously before anesthesia,125 ml SQFZI before CPB in CPB mechanical equipment,and 250 ml SQFZI once a day after operation for 3 days. Equal volume balanced solution was received in control group.Creatinine (Cr) in blood and Cr,microalbumin (m-Alb),?_2-microglobulin (?_2-MG) and N-acetylglucosaminidase (NAG) in urine were measured and endogeneous creatinine clearance (CCr) was calculated in 40 patients at the time points of before anesthesia, at the end of operation,and 1,3 and 5 days after operation.Results Urinary levels of m-Alb,?_2-MG and NAG were increased significantly after CPB in both groups at different time points at the end of and after the operation (all P0.05).Conclusion CPB has a deteriorating effect on renal function,and the application of SQFZI in peri-operational period has a protective effect on renal function in patients who undergo CPB.

Objective To evaluate the feasibility and efficacy of twin grasper combined with endoloops on closing acute stomach perforation.Methods Two experimental porcines of stomach perforation underwent endoscopic closure by twin grasper combined with endoloops.Survival conditions and closure of perforating were observed.Results Mild infection and abdominal adhesions were observed in one week after operation.The nylon rope fell off and an ulcer-like lesion was presented in the closed position.The methylene blue leak test was negative.Histologic examination revealed chronic inflammatory cells infiltration,granulation,fibroplasias,and regenerative mucous membrane crawling toward the center of perforation.Conclusion The technique of twin grasper combined with nylon ropes in closing the acute stomach perforation is feasible and effective.

This study examined the dynamic characteristics of upper airway collapse at soft palate level in patients with obstructive sleep apnea/hypopnea syndrome (OSAHS) by using dynamic 3-Dimensional (3-D) CT imaging. A total of 41 male patients who presented with 2 of the following symptoms, i.e., daytime sleepiness and fatigue, frequent snoring, and apnea with witness, were diagnosed as having OSAHS. They underwent full-night polysomnography and then dynamic 3-D CT imaging of the upper airway during quiet breathing and in Muller's maneuver. The soft palate length (SPL), the minimal cross-sectional area of the retropalatal region (mXSA-RP), and the vertical distance from the hard palate to the upper posterior part of the hyoid (hhL) were compared between the two breathing states. These parameters, together with hard palate length (HPL), were also compared between mild/moderate and severe OSAHS groups. Association of these parameters with the severity of OSAHS [as reflected by apnea hypopnea index (AHI) and the lowest saturation of blood oxygen (LSaO(2))] was examined. The results showed that 31 patients had severe OSAHS, and 10 mild/moderate OSAHS. All the patients had airway obstruction at soft palate level. mXSA-RP was significantly decreased and SPL remarkably increased during Muller's maneuver as compared with the quiet breathing state. There were no significant differences in these airway parameters (except the position of the hyoid bone) between severe and mild/moderate OSAHS groups. And no significant correlation between these airway parameters and the severity of OSAHS was found. The position of hyoid was lower in the severe OSAHS group than in the mild/moderate OSAHS group. The patients in group with body mass index (BMI)≥26 had higher collapse ratio of mXSA-RP, greater neck circumference and smaller mXSA-RP in the Muller's maneuver than those in group with BMI<26 (P<0.05 for all). It was concluded that dynamic 3-D CT imaging could dynamically show the upper airway changes at soft palate level in OSAHS patients. All the OSAHS patients had airway obstruction of various degrees at soft palate level. But no correlation was observed between the airway change at soft palate level and the severity of OSAHS. The patients in group with BMI≥26 were more likely to develop airway obstruction at soft palate level than those with BMI<26.

Objective To establish HPLC determination method and impurity profile of the related substances in metronidazole.Methods A Welch Ultimate(R)XB-C1s (4.6 mm× 250 mm,5 μm)was used with a mobile phase consisting of methanol-1.36 g· L-1 solution of potassium dihydrogen phosphate (20∶ 80).The detection wavelength was 315 nm and the flow rate was 1 mL· min-1.Its related substances were determined by principal component self-contrast method.Results Good separation of metronidazole and the impurities could be achieved.Twenty batches of samples in the past six years were determined which meet quality standards.The study of impurity profiles could effectively monitor the synthetic process and the change of impurities in metronidazole.Conclusion The method is simple,quick and sensitive,which can be used to control the related substances in metronidazole.Meanwhile,the impurity profiles ensure the quality stability of metronidazole.

OBJECTIVE To explore the treatment measure of pulmonary infection after liver transplantation.METHODS The clinical data of 78 cases of pulmonary infection after liver transplantation in our hospital were analyzed retrospectively.RESULTS The incidence of pulmonary infection in this group of patients was 48.8%.The mean onset time of the first pulmonary infection after operation was(9.56?5.53)days after surgery.Forty four patients were diagnosed as right pneumonia,14 as left pneumonia,and 20 bilateral pneumonia.Long operation time,mechanical ventilatory time,abdominal bleeding,intraoperative total fluid perfusion and renal dysfunction after liver transplantation were risk factors of pulmonary infection.87.2% Of these patients improved,and 12.8% died.CONCLUSIONS The mortality of pulmonary infection after liver transplantation is high.Bacteria and fungi are the major pathogens.The key of prevention and cure of pulmonary infection after liver transplantation wis included of cutting down operation time,lessening abdominal bleeding,controlling intraoperative fluid perfusion,extubating as soon as possible,protecting renal dysfunction and raising pathogeny to check.