OBJECTIVE: To evaluate the preemptive analgesia effects of both the parecoxib sodium and the pentazocine in patients undergoing nasal endoscopic surgery. METHOD: In the randomized, double blind, controlled study, 120 patients undergoing septoplasty were divided into 3 groups (n = 40): group A received parecoxib 40 mg by muscle injection 30 min before the operation; group B received pentazocine 30 mg; group C received an equal volume of saline. The preemptive analgesia effect was evaluated with VAS scores which recorded at different time points. The proportion of participants using rescue analgesia after the operation were recorded as additional measures of preemptive analgesia. RESULT: Intra-operative as well as the postoperative pain scores were less in the group A and group B than in the control group. Fewer participants required rescue medication after operation with parecoxib as well as pentazocine than placebo. However there were no difference in the preemptive effects between the group A and group B. CONCLUSION Administration of both the parecoxib and pentazocine before the nasal endoscopic surgery can provide preemptive analgesia without serious adverse side effects that deserves popularization in the clinic.
Analgesia ; methods ; Analgesics ; therapeutic use ; Double-Blind Method ; Endoscopy ; adverse effects ; Humans ; Isoxazoles ; therapeutic use ; Nasal Surgical Procedures ; adverse effects ; Nose ; Pain ; prevention & control ; Pain, Postoperative ; prevention & control ; Pentazocine ; therapeutic use

OBJECTIVE: To observe the clinical effect of mini-plate fixation on the treatment of children unstable fractures of the distal ulna and radius. METHODS: A total of 18 children with unstable fracture of the distal ulna and radius (15 boys and 3 girls, aging 4.1-13.3 years, with the mean age of 9.8 years) were selected from Department of Orthopaedics, Wuhan Children and Women's Hospital, Tongji Medical College, Huazhong University of Science and Technology from August 2006 to September 2009. The fracture occurred on right side (n=9) and left side (n=9). All children were treated with mini-plate fixation which was instead of the traditional pinning fixation. Before operation, stainless steel or titanium plates of adult digital bone, metacarpal bone, and metatarsal bone were chosen according to fracture types and sites. The distance from fracture line to epiphyseal plate was measured to get ready the T-, L-, clover or straight plates. Joint function, degree of forearm rotation loss, bone healing, and complications were monitored postoperatively and within following up. RESULTS: All cases were followed up in out-patient for an average 26.4 months. An average 10°limitation was measured on forearm pronation function of all children, but the function was recovered by doing exercises which did not influence daily activities. Supination, flexion and extension of wrist joint were generally normal, and the fracture was generally healed. Complications including re-displacement, refracture, malunion, delayed union, bone bridge formation, vascular and nerve injury were not found. CONCLUSION: Patients who were not satisfied with the reduction, re-displacement, or old distal radius fracture needed an open reduction. Micro-plate was fixed to avoid epiphyseal injury of distal forearm and reduce postoperative complications. An ideal mini-plate may replace the traditional pinning fixation.

OBJECTIVE: To evaluate the perioperative analgesic effects of parecoxib sodium in patients undergoing nasal endoscopic surgery. METHOD: In the randomized, double blind, controlled study, 120 patients undergoing septoplasty were divided into 3 groups (n = 40): A group received parecoxib at a dose of 40 mg by muscle injection 30 min before the operation followed by saline at the same volume every 24 h for 48 h; B group received parecoxib at a dose of 40 mg by muscle injection 30 min before the operation followed by 40 mg every 24 h for 48 h; C group received an equal volume of 0.9% saline at the same time points. Patients were assessed with respect to pain score (VAS), rescue analgesia requirement and the side effects during the operation as well as at 3, 24, 48 h after the surgery. RESULT: Intra-operative as well as the postoperative pain scores were less in the A group and B group than in the.control group. Compared with group A, group B had significantly lower VAS score at 24 h after the operation, however there were no significant difference on other time points. Fewer participants of both the A and B groups required rescue medication after operation. CONCLUSION Administration of parecoxib can provide ideal analgesic effects without serious adverse side effects at the perioperative period for patients who received nasal endoscopic operation. Intramuscular parecoxib (40 mg 30 min before the operation followed 40 mg qd for 48 h) designed as preoperative analgesia mode resulted in sufficient perioperative analgesia that deserves popularization in the clinical works.
Analgesia ; methods ; Double-Blind Method ; Endoscopy ; Humans ; Isoxazoles ; administration & dosage ; therapeutic use ; Nasal Surgical Procedures ; methods ; Pain, Postoperative

Objective To evaluate the efffects of leukocyte-depleted blood transfusion the protection of cardio pulmonary tissue and the reduction of postoperative bacterial infection.Methods Three hundred and forty-four pediatric patients were allocated to one of 3 groups based on transfusing different components of blood during open heart surgery:control group(n=109),routing blood transfusion group(RBT,n=113),leukocyte depleted blood transfusion group (LDBT,n=122). Blood samples were taken before operation,at 6h,and 24h after operation fir determination of creatininee kinase MB( CK MB),aspartate transaminase(AST),lactate dehydrogenase(LDH)and MDA. At the same time,we monitored changes of TPR and RI,and recorded changes of body temperature and days of utilizing antibiotics after operation.Results After operation serum concentrations of CK MB,AST, LDH and MDA significantly increased in all groups as compared to the values before operation,but the values of those in group LDBT were significantly loert than those in group RBT(P0.05).Conclusions Leukocyte depleted blood transfusion can effectively prevent the patients from cardion pulmonary ischemia-reperfusion injury and reduce postoperative bacterial infection in pediatric open heart surgery.

Objective To explore the role of intercellular adhesion molecule-1(ICAM-1) in the metastasis of lung cancer.Methods The expression of ICAM-1 in the tissue and the serum ICAM-1(sICAM-1) level in the 52 cases of primary lung cancer were detected with immunohistochemical staining method(SP) and enzyme linked immunosorbent assay(ELISA),with 20 cases of adjacent non-cancerous tissue as the control.Results The positive rate of ICAM-1 expression in lung cancer was significantly higher than that of adjacent non-cancerous tissue.The expression of ICAM-1 in the cases with lymph node metastasis was higher than that of no lymph node metastasis.The expression of ICAM-1 in stage III+IV was higher than that of stage I+II,and that in adenocarcinoma was higher than that of squamous cell carcinoma.The level of sICAM-1 in patients with lymph node metastasis was higher than that without lymph node metastasis.The sICAM-1 level in patients of adenocarcinoma was higher than that of squamous cell carcinoma,and that in patients with positive expression of ICAM-1 in tissue was higher than that of negative expression of ICAM-1.Conclusion The expression of ICAM-1 may be associated with the metastasis in lung cancer.The sICAM-1 level reflects the expression of ICAM-1 in tissue and may be used as a tumor marker of metastasis and prognosis in lung cancer.

Objective To investigate the influences of sodium salicylate on the auditory brainstem response (ABR)and expression of EphA4mRNA in rat inferior colliculus and its effects on salicylate ototoxicity.Methods A total of 30 healthy SPF rats were randomly divided into five groups:the control group (without any treatment),S7 (i.m.injection of sodium salicylate,175mg/kg,twice daily for 7 days),S14(the same method as S7,twice daily for 14 days),S14+R14(the same method as S14,twice daily for 14 days and recovered for 14 days),and S14+R28(the same method as S14,twice daily for 14 days and recovered for 28 days).After the ABR assessment,rats were sacri-ficed after deep anesthesia and the inferior colliculus tissues were dissected.Real-time PCR was used to detect the expression of EphA4mRNA.Results Compared with the control group,ABR thresholds in the S7 group and S14 group were increased significantly (P<0.05),while there was no significant difference between the control group and the S14+R28 group (P>0.05).The inferior colliculus EphA4mRNA expression level of S7 group was signifi-cantly decreased than the control group (P<0.05).The EphA4mRNA expression level of S7 group was significant-ly decreased than the control group (P<0.05),while there was no significantly difference between the control group and the S14+R28 group (P>0.05).Conclusion Long term injection of sodium salicylate can cause changes in the inferior colliculus of EphA4mRNA which are related closely with synaptic plasticity.It may lead the alteration of the inferior colliculus synaptic plasticity,which is associated with the changes of the hearing failure and the tinni-tus behavior.This indicates that EphA4 which is considered as a related protein in the inferior colliculus may play an important role in the pathology of tinnitus.

Seen from the development of the treatment for hepatocellular carcinoma (HCC),although great progress has been made on the optimization of the treatment,the patients' overall survival (OS) has not been greatly improved compared with other tumors of digestive system such as colorectal cancer.That is mainly because of the early microvascular invasion (MIV) and portal vein tumor thrombus (PVTT) which are among the most important reasons for poor prognosis in HCC.Thus we overviewed the recent research findings on the treatment of HCC with PVTT,which might help the clinicians select the optimal therapeutic strategy.

Objective To investigate the morphological responses of enteric nervous system (ENS) neurons of submucosal plexus (SMP) in distal colon of rat models with irritable bowel syndrome with diarrhea (IBS-D). Methods Rat models with IBS-D were established with chronic unpredictable mild stress and acute wrap restrain stress (CAS). Double staining with immunohistofluorescence for colonic whole mount preparations was used to evaluate the distribution and proportion of SMP neurons expressing specific neurochemical markers [choline acetyltransferase (CHAT), vasoactive intestinal polypeptide (VIP), and nitric oxide synthase (NOS)] and their colocalization with anti-Hu antibody, which is the hallmark for whole enteric neurons. Results There was no obvious difference in the total numbers of anti-Hu positive neurons and ganglia between IBS-D and control group. The proportions of both VIP-immunoreactive (VIP-IR) and NOS-IR neurons in colonic SMP were higher in IBS-D rats compared with controls (62.2%±6.2% vs 55.4% ±5.4%;15.0%±4.0%vs 10.5%±2.9%, P<0.05). There was no difference in the proportion of ChAT-IR neurons between two groups. Conclusions VIP is the most specific neurotransmitter for excitatory secretomotor neurons in rat SMP, the increase of VIP-IR neurons can promote intestinal mucosal secretion, which might play an important role in the pathophysiological mechanisms of IBS with diarrhea.

Objective To study the correlations of anxiety and depression at different phases with curative outcomes in female patients at IVF-ET cycle.Methods One hundred and seventeen patients were involved the study using the Self-Rating Anxiety Scale (SAS), Self-Rating Depression(SDS)questionnaires when registered for IVF-ET cycle(T1), one day prior to oocyte retrieval(T2), and 5 to 7 days after embryo transfer(T3).SDS scores and SAS scores were compared between different phases.Logistic regression was used to analyze the correlation of SAS scores with outcome.Results SDS scores of T1, T2 and T3 phases showed no significant differences(all P<0.05).The SAS scores at T2 and T3 were higher than that at T1(all P<0.05), the SAS scores at T2 were higher than that at T3(P<0.05).The SAS scores at T2 in patients achieved clinical pregnancy were significantly lower than that in patients achieved no clinical pregnancy.Logistic regression model showed that lower SAS scores were associated with higher pregnancy rates (P<0.05).Conclusions Anxiety level is the most remarkable one in the phase prior to oocyte retrieval.Low anxiety level prior to oocyte retrieval predicts higher a pregnancy rate.

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