Object To establish a proper research evaluation system for level-two general hospital.Method By using Delphi method,experts were invited by letter to review research evaluation indices for three times.Result Totally 62 indices were weighted and evaluated,including two primary-degree indices,14 secondary-degree indices,and 46 third-degree indices. A research evaluation system was preliminarily established in a level-two general hospital.Conclusion The evaluation system is simple and practicable,and can reflect the main aspects of research in the leveltwo general hospitals.

Objective To evaluate the analgesic efficacy of thoracic paravertebral block (PVB) in patients after lobectomy performed via video-assisted thoracoscope (VAT) .Methods Fifty ASA Ⅰ or Ⅱ patients of both sexes aged 20-76 yr weighing 45-90 kg undergoing elective lobectomy via VAT were randomly divided into 2 groups (n = 25 each): patient-controlled intravenous analgesia (PCIA) group and thoracic PVB group. PVB was performed according to the method described by Jamieson et al and Richardson et al. Paravertebral catheter was placed at T7-8 after induction of anesthesia and tracheal intubation. A loading dose of 0.5% ropivacaine 20 ml was administered via PVB catheter at 30 min before the end of operation. PVB was then controlled by the patients with 0.2% ropivacaine (bolus dose 8.0 ml, lockout interval 30 min). In PCIA group a loading dose of sufentanil 0.1 μg/kg was given iv at 30 mln before the end of operation. Sufentanil 1.0 μg/ml was used. PCIA included a bolus of 2 ml with a 15 min lockout interval and background infusion 2 ml/h. Numeric rating scale (NRS) (0=no pain, 10 = most severe pain) was used to assess the intensity of pain. NRS score, MAP, HR and SpO2 were recorded before operation (T0 ,baseline), 30 min after withdrawal of chest tube (Ti) and at 24, 48 and 72 h after operation (T2, T3, T4). Forced vital capacity (FVC) and forced expiratory volume first second (FEV1.0) were measured and FVC/FEV1.0 ratio was calculated after chest tube was withdrawn. Blood cortisone and glucose concentrations were determined at To, T1 and T4. Requirement for rescue analgesics and side effects were recorded. Results There was no significant difference in MAP, HR, SpO2 and NRS at rest between the 2 groups.NRS at coughing and blood cortisone and glucose concentrations were significantly lower and the postoperative FEV1.0 was significantly higher in PVB group than in PCIA group. The requirement for rescue analgesics and side effects were comparable between the 2 groups. Conclusion Thoracic PVB can provide better postoperative analgesia with little side effects.

AIM:To investigate the safety and effect of femtosecond laser-assisted cataract surgery with Cionni modified capsular tension ring (MCTR) implantation in the management of traumatic lens subluxation.METHODS: Totally 11 patients (11 eyes) with traumatic lens subluxation were divided into three groups according to the severity of lens dislocation, ranging from 90° to 120° (4 eyes), 120° to 180° (5 eyes) and 180° to 270° (2 eyes).The contact LenSx femtosecond laser cataract surgery platform was applied to create the capsulotomy, prepare nuclear fragmentation and make corneal wound creation.Anterior vitrectomy was performed in some patients during the surgery.After capsular retractors insertion and phacoemulsification, the MCTR was inserted to the capsular bag and fixed to the sclera.Finally, the IOL was implanted into the capsular bag.Postoperative visual acuity, intra-and post-operative complications, anterior capsular opening, IOL and MCTR position and intraocular pressure (IOP) were assessed.RESULTS:The duration of follow-up was 2mo.All the operations were completed successfully.Five eyes underwent cataract surgery combined with anterior vitrectomy.Four eyes had been inserted with 2-eyelet MCTR and seven eyes with 1-eyelet MCTR.The best corrected visual acuity (BCVA) after operation was better than 0.5 in 4 eyes, between 0.3 and 0.5 in 3 eyes, between 0.1 and 0.3 in 3 eyes, and less than 0.1 in 1 eye.Compared with preoperative BCVA, the difference was statistically significant (P<0.05).All the IOLs were stably centered and the eyelet of MCTR was fixated steadily between the iris and the anterior capsule.The common intra-and post-operative complications were subconjunctival hemorrhage, incomplete capsulotomy, residual cortex, secondary glaucoma and posterior capsular opacification.CONCLUSION:Femtosecond laser-assisted cataract surgery can improve the success rate of capsulorhexis, and reduce the difficulty of nuclear fragmentation.Femtosecond laser-assisted cataract surgery combined with MCTR implantation is an ideal surgical method for traumatic lens subluxation.

Objective To investigate the apoptosis induction effect of Cantharidin on pancreatic cancer cell line PANC1 and CFPAC-1 and possible mechanism. Methods PANC1 and CFPAC-1 was treated with Cantharidin. Cell growth was determined by MTT. Apoptosis was measured by flow cytometry. Caspase activity was measured by using enzyme chemical method. Apoptosis-related gene expressions were determined by using RT-PCR and Western blotting. Results Cantharidin significantly inhibited the growth of pancreatic cancer cells PANC1, CFPAC-1 and induced apoptosis in a dose-dependent manner. Seventy-two hours after 10 μmol/L Cantharidin treatment, the inhibitory rates of PANC1, CFPAC-1 were (52.95 ± 6.34)％ and (71.21 ±6.30)％. Twenty-four hours after treatment, the early and later period apoptotic cell of PANC1 was increased from 7.35％ to 24.89％, from 6.36％ to 17.73％. The early and later period apoptotic cell of CFPAC was increased from 6.39％ to 24.70％, from 9.21％ to 12.58％ (P＜0.01). Activity of caspase 8 and caspase 9 in PANC1 cells was (155.8 + 11.5)％ and (194.6 ± 14.7)％ when compared with that of control group. Activity of caspase 8 and caspase 9 in CFPAC- 1 was ( 182.5 ± 24.3 ) ％ and ( 215.8 ± 12.2) ％when compared with that of control group ( P ＜ 0. 01 ). The expression of pro-apoptotic genes, TNF-α,TRAILR1, TRAILR2, Bad, Bak and Bid was elevated, the expression of anti-apoptotic Bcl-2 gene was decreased. Conclusions Cantharidin can induce apoptosis in pancreatic cancer cell lines by activating caspase,up-regulating the expression of pro-apoptotic genes and down-regulating the expression of anti-apoptotic genes.

Objeetive To evaluate the efficacy of loratadine combined with de-escalation therapy for infant wheeze.Methods One hundred out-patients from Dec.2011 to Apr.2012 were randomly divided into 2 groups:Loratadine combined with de-escalation therapy was adopted in Loratadine group,while no Loratadine was taken in control group.The dose of Loratadine was 0.3 mL/(kg · d),14 days ; oral Prednisone 0.5 mg/(kg · d),3 days; Azithromycin 10 mg/(kg · d),3 days; Tulobuterol patch 0.5 mg/d,7 days; Montelukast 4 mg/d,14 days.Control group abolished Loratadine,but the rest of drugs were same as Loratadine group.Results The respiratory symptoms (gasp,wheeze sound,phlegm removal difficulty) and the nasal symptoms (including nasal congestion,sneeze,runny nose)in the acute phase of infant wheeze all had therapeutic effect,and there were significant differences in scoring symptoms (all P ＜ 0.05).The Loratadine group had certain treatment effect on eczema.The cough symptoms in 3 days,7days,14 days of the treatment had statistically significant differences between the both groups (all P ＜ 0.05).And there were statistical differences in eczema symptom of the Loratadine group in 7 days and 14 days of treatment (all P ＜ 0.05).Control group still had no statistical differences (all P ＞ 0.05).Days of improvement in symptoms,wheeze recurrence rate and frequency of respiratory infections in I month between 2 groups had no significant differences.Conclusions Loratadine can obviously improve the patients' breathing cough symptoms,and play a certain role in the treatment combined with de-escalation therapy in infant wheezing,and has high safety and eczema therapy effect.Loratadine can be used in clinic personally according to the patient's condition.

The aim of the manuscript was to optimize formulations and preparation technologies of cataplasm of white mustard seed varnish, and to evaluate its anti-asthma effect on rats. The single factor experiments included spreading thickness, types of crosslinking agents, dihydroxyaluminum aminoacetate amount, sodium polyacrylate amount, types of adhesive agents with human sense as the evaluation index. Blank cataplasm matrix was optimized by the orthogonal experiment with the amount of glycerine, citric acid, and sodium carboxymethylcellulose as the major influential factors. Initial adhesive force, peeling strength and human sense were as the evaluation index. The optimized formulation of blank cataplasm were as followings: glycerine-water-ethanol-PEG400-dihydroxyaluminum aminoacetate-citric acid-sodium carboxymethylcellulose-sodium carboxymethylcellulose 2 : 8 : 0.8 : 0.4 : 0.07: 0.15 : 0.1 : 0.5. The active ingredients of white mustard seed, corydalis, and gansui root were extracted by alcohol extraction method. Asiasarum volatile oil was extracted by oil extractor. The optimized drug loading amount was 11% with initial adhesive force, peeling strength and human sense as the evaluation index. Asthma rats model were established by sensitized with ovalbumin and nose-scratching time as the evaluation index. High dose (17%) group of drug-loaded cataplasm had the obvious inhibition effect on nose-scratching time of rats (P = 0.037 < 0.05). In comparison, middle dose (11%), low dose (4%) and positive-control groups had no obvious inhibitive effect on rats. White mustard seed cataplasm supplied a novel choice for anti-asthma therapy. And the overall pharmacodynamics assessment will be carried out on molecular level in near future.
Animals ; Anti-Asthmatic Agents ; administration & dosage ; chemistry ; Asthma ; drug therapy ; Chemistry, Pharmaceutical ; Drugs, Chinese Herbal ; administration & dosage ; chemistry ; Female ; Humans ; Male ; Mustard Plant ; chemistry ; Rats ; Rats, Sprague-Dawley ; Seeds ; chemistry

OBJECTIVETo observe clinical effect of different treatments for tennis elbow with small needle-knife according to its classification.

METHODSFrom March 2011 to December 2012,100 patients with 123 tennis elbows were treated with small needle-knife, including 36 males and 64 females, ranging in age from 29 to 76 years old (averaged, 49 years old). The course of disease ranged from 3 months to 2 years (averaged, 7.2 months). According to the classification, 46 elbows were with extra-articular type, 34 elbows with intra-articular type, 20 elbows with mixed type. All the patients were treated with small needle-knife by using different methods according to its classification.

RESULTSAll patients were followed up for 6 to 12 months with an average of 8.2 months. After treatment, the symptoms and signs of the patients improved significantly (P < 0.01). According to the criteria of the Verhaar scoring system, 35 of 46 patients with extra-articular type got an excellent result, 9 good, 2 fair; 24 of 34 patients with intra-articular type got an excellent result, 9 good, 1 fair; 9 of 20 patients with mixed type got an excellent result, 8 good, 3 fair.

CONCLUSIONThe causes of tennis elbow can not be explained by single pathogenesy, the patients with tennis elbow should be treated with different methods according to its classification, and the therapeutic effects can be improved.

Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Needles ; Tennis Elbow ; classification ; surgery

OBJECTIVETo investigate the clinical treatment of pancreatic encephalopathy (PE) complicated in severe acute pancreatitis (SAP) patients.

METHODSClinical data of 22 PE cases in 326 SAP patients admitted from January 1987 to December 2006 were collected and analyzed retrospectively. The incidence, clinical manifestation and therapy methods of PE were discussed respectively.

RESULTSAll the cases were divided into 2 subgroups according to the changing of treatment strategy for SAP in the past 20 years. Thirteen cases of PE complicated in 114 SAP patients during the first decade (1987 - 1996) with the incidence of 11.4%, including eight early pancreatic encephalopathy (EPE) ones and five cases of delayed pancreatic encephalopathy (DPE). Only one patient survived and the mortality was 92.3%. During the second decade (1997 - 2006), nine cases of PE (all EPE) were observed in 212 SAP patients. The incidence was 4.2% and they all survived. Patients with PE usually presented with dysphoria, disturbance of orientation, lethargy, illusion and even coma. Physical examination of nerve system could find signs of meningeal irritation, increased intracranial pressure and elevated amylase in cerebrospinal fluid. Fungal infection and body fluid and metabolic disturbance frequently complicated in DPE patients. The total incidence was 6.6% (22/326) and mortality was 54.5% (12/22). Death mostly happened in the first ten years and all died with multiple organ failure.

CONCLUSIONSElimination of different causes would be effective to decrease the incidence and intensive cerebral resuscitation and nerve nutrition therapy in the early stage is very important to decrease the mortality.

Aged ; Brain Diseases ; etiology ; therapy ; Female ; Humans ; Male ; Middle Aged ; Pancreatitis, Acute Necrotizing ; complications ; therapy ; Retrospective Studies

Objective To investigate the value of ultrasound-guided diffuse optical tomography (US-guided DOT) to predict clinical efficacy of breast cancer neoadjuvant chemotherapy (NAC).Methods Eighty-eight breast cancer patients with 93 lesions were included.Pre-and post-last chemotherapy,the size,total hemoglobin concentration (THC) of each lesion were measured by ultrasonography (US) and US-guided DOT.Based on the guidelines to evaluate the response to treatment in solid tumors,the lesions of treated breast cancer patients were divided into 4 types of responses to NAC:complete response (CR),partial response (PR),stable disease (SD),and progressive disease (PD).Efficient groups include CR and PR groups.Results As expected,no significant difference was found in size and THC for untreated lesions (all P ＞0.05).However,for the treated lesions(P =0.001),THC,pre-vs post-treatment size changes (△Size％) (P =0.002) and THC changes (△THC％) (P ＜0.001) were significantly varied among CR,PR,SD,PD groups.When compared with pre-treated,tumor sizes after treatment were changed significantly in all CR(P ＜0.001),PR(P ＜0.001),SD (P =0.023) and PD (P =0.001),while significant change of THC was only found in CR(P ＜0.001),PR(P ＜0.001) and SD (P =0.002).When △THC％ =23.9％ as the threshold for prediction of NAC efficiency,the area under the curve of ROC was 0.75,and the sensitivity was 73.7％,specificity was 76.5 ％,positive predictive value was 93.3 ％,negative predictive value was 39.4％,accuracy was 74.2％.Conclusions △size％ changes in consistent with △THC％ among the intergroups,but their changes levels are different,the highest change percent appears in CR,gradually decreased in PR,SD groups.△THC％ will contribute to predict preoperative clinical NAC efficacy.