Orthopaedic postoperative pain not only brings a lot of side effects to patients, but also directly affects early rehabilitation after surgery. Effective preoperative pain management mainly includes three-stage individual pattern analgesia, which refers to preoperative, intraoperative and postoperative analgesia. The purpose is to reduce pain in multiple planes and three-dimension, strengthen the effect of analgesics and reduce dosage and side effect of single drug. This paper summaries new progress on individual-multiple-pattern analgesics, pain assessment method and various therapies.
Analgesia ; methods ; Humans ; Orthopedics ; methods ; Preoperative Period ; Treatment Outcome

Objective: To observe the effects of 5-aza-2′-deoxycitydine (5-aza CdR) on the proliferation and transcription of tumor suppressor gene GSTP1 and RASSF1A in prostate cancer cell line PC3. Methods: The status of 5′CpG island methylation of RASSF1A and GSTP1 genes in PC3 was analyzed by methylation specific PCR (MSP) before treatment with 5-aza CdR. RASSF1A and GSTP1 mRNA were quantified by real time PCR during the demethylation process by 5-aza-CdR. MTT assay and flow cytometry were used to examine the proliferative activity of PC3 cells before and after 5-aza-CdR treatment. Results: The 5′ CpG island methylation of RASSF1A and GSTP1 genes were detected in human prostate cancer cell line PC3. Compared with control group, RASSF1A and GSTP1 mRNA expression had no significant change 24 h after culture with 5-aza-CdR; their expression was up-regulated 48 h after cultured with 5-aza-CdR, with significant difference found between 5 μmol/L and 10 μmol/L 5-aza-CdR groups. Compared with control group, the expression of RASSF1A and GSTP1 mRNA was significantly increased 72 h after cultured with all concentrations of 5-aza-CdR. MTT assay and cell cycle examination indicated that exposure to 5-aza-CdR for 24 h and 48 h resulted in no obvious growth inhibition and cell cycle change; exposure to 5-aza-CdR for 72 h induced significant growth inhibition (P<0.05) and cell cycle change (P<0.05); and cells were arrested at G0/ G1, phase. Conclusion: The 5′CpG island methylation of RASSF1A and GSTP1 genes is probably responsible for RASSF1A and GSTP1 silencing in PC3 cells. 5-aza-CdR can inhibit the proliferation of PC3 cells, disturb the cell cycle, and elevate transcription of GSTP1 and RASSF1A.

Guidelines as Topic ; Hepatitis B, Chronic ; drug therapy ; prevention & control ; Humans

Objective To improve the sensitivity of PCR for studying the rifampin resistant gene (rpoB) of M.Leprae from clinical samples.Method After comparing the results of PCR with Q-Solution (PCR Enhancer) and without Q-solution,Nested-PCR was then applied for the detection of rpoB gene.Results Although PCR Enhancer improves the amplification of rpoB gene, the sensitivity of routine PCR is only 45. 2%.The sensitivity of Nested-PCR for detecting mutants in rpoB gene can further increase to 90.5% after selection of optimum parameters.Conclusion The combinaion of PCR Enhancer and Nested-PCR improves the sensitivity and specificity of PCR for detection of rifampin resistant gene of M. Leprae.

tralateral parietal lobe. Conclusions CIMT can improve the patients' upper-limb function effectively. The constraint-induced movement of the affected arm during CIMT appears to induce cortical reorganization and compensation as measured by fMRL

To compare the effect and advantage of performing rhegmatogenous retina detachment surgery under operation microscope with under direct ophthalmoscopes .METHODS: Ninety - three patients ( 93 eyes ) were randomized to two groups, Group A ( under operation microscope during rhegmatogenous retina detachment surgery, 47 cases ) , Group B ( under direct ophthalmoscopes during rhegmatogenous retina detachment surgery, 46 cases ) . All patients were followed up for 2wk to observe success rate and visual improving rate.RESULTS: Total percentage of success was 95. 74% in group A and 80. 43% in group B. The visual improving rate of group A was 82. 98% and it was 67. 39% in group B. Operative time in group A was significantly shorter than that in group B (P<0. 05). CONCLUSlON: Performing rhegmatogenous retina detachment surgery under operation microscope is ascertaining and it is more effective and handy than performing that surgery under direct ophthalmoscopes.

Actins ; metabolism ; Female ; Heart Atria ; pathology ; Heart Neoplasms ; secondary ; surgery ; Humans ; Iliac Vein ; pathology ; surgery ; Leiomyomatosis ; metabolism ; pathology ; surgery ; Middle Aged ; Uterine Neoplasms ; metabolism ; pathology ; surgery ; Vascular Neoplasms ; metabolism ; pathology ; surgery ; Veins ; pathology ; surgery ; Vena Cava, Inferior ; pathology

Objective To determine the current prevalence and risk factors of metabolic syndrome (MS) among adult residents in Chinese developed areas.Methods The clinical data of 6614 adult residents,including 4051 women,from Guangdong and Jiangsu provinces from China Diabetes and Metabolic Disorders Study (2007-2008) were analyzed.Age and sex standardized prevalences of MS were calculated according to the criteria of Chinese Diabetes Society (CDS),US National Cholesterol Education Program Adult Treatment Panel Ⅲ (ATP Ⅲ),International Diabetes Federation (IDF) and Joint Interim Statement (JIS),respectively.Logistic regression analysis was performed to identify the risk factors of MS.Results Age and sex standardized prevalences of MS were 17.88％ (CDS),28.50％ (ATP Ⅲ),21.99％ (IDF) and 31.50％ (JIS),respectively.The prevalences of residents with at least one metabolic abnormality were 67.86％ (CDS) 79.56％ (ATP Ⅲ),79.62％ (IDF) and 80.74％ (JIS),respectively.MS was more common in female than in male by the ATPⅢ and IDF criterion (ATPⅢ:30.63％ vs 26.45％,P ＜0.01 ; IDF:26.04％ vs 17.91％,P ＜ 0.01),while the prevalence was higher in male by CDS criteria (15.94％ vs 19.87％,P ＜0.01).There was no significant difference in the MS prevalence between the rural and the urban residents.Kappa test showed ATP Ⅲ and JIS criteria were most homogenous (κ =0.95,P ＜ 0.01).The risk factors for MS by the logistic regression model were male,older age,lower degree of education,family history of hypertension and obesity,drinker as well as uncontrolled diet.Conclusion The prevalence of MS is high in the adult residents of Chinese developed areas (Guangdong and Jiangsu provinces),whatever diagnostic criterion was used.Effective measures should be taken to control the modifiable MS risk factors.

Objective The study aimed to analyze the clinical data of patients with pulmonary embolism and summarize the clinical characteristics of pulmonary embolism,in order to improve the correct diagnostic rate and the prognosis. Methods Data of 178 patients who were cured in our hospital from January 2011 to December 2014 were analyzed retrospectively,including relative risk factors,clinical behaviors,examination data,misdiagnosis and prognosis. Results Patients with pulmonary embolism had related basic diseases and risk factors. Their clinical symptoms,signs and ordinary detection methods indicated pneumatorexis and cardiovascular injury,but lacked of specificity. The misdiagnosis rate of the first diagnosis was 48.88%,including 22 cases of the misdiagnosis to COPD, 18 cases to pneumonia and 16 cases to coronary heart disease. The misdiagnosis rate of elderly patients was 56.36%, while that of the young and middle-aged patients was 36.80%,the difference was statistically significant,P < 0.05. Computed tomography pulmonary angiography(CTPA)could accurately observe the pathological changes of pulmonary embolism,and all the patients were diagnosed by CTPA in the research. 11 cases(10%)of elderly patients died,while 2 cases(2.9%)happened in young and middle-aged patients. There was no statistical significant difference(P > 0.05). Conclusion Although the related risk factors of pulmonary embolism in patients existed,the misdiagnosed rate of the disease was high and prognosis was poor due to many confusing basic diseases. And the symptoms,signs and ordinary inspection of the patients lacked specificity. CTPA,being utilized to diagnose pulmonary embolism reliably,should be promoted.

Objective To assess the predictive value of serum uric acid levels to the incident nonalcoholic fatty liver disease(NAFLD)in a cohort of healthy population. Methods A prospective cohort study of NAFLD incidence was conducted in Xinjiang province, from 2012 to 2014. A cohort study was performed on 2 207 subjects with no evidence of fatty liver disease by liver ultrasound and with no major risk factors for liver disease at baseline. All participants were interviewed to carry out the epidemiological questionnaire survey, physical examination, abdominal ultrasonography, as well as blood biochemistry measurements. The hazard ratios of NAFLD were compared among groups with different uric acid levels. All subjects were classified according to serum uric acid (within normal range grouped by quartile: Q1-Q4 group; above the normal range: Q5 group). Results NAFLD was newly diagnosed in 13.72% subjects within the 3-year period. The incidence of NAFLD was increased with elevated serum uric acid quartiles(P<0.01). In multivariate logistic regression, after adjustment for gender, age, race, metabolic syndrome and its components, OR for incident fatty liver in Q2 to Q5 of serum uric acid concentration as compared to Q1 were 2.509, 3.172, 3.392, and 4.041 respectively. Conclusion Elevated serum uric acid concentrations may predict NAFLD in the subjects for a regular health checkup.