Objective To investigate the analgesic effect and safety of intravenous flurbiprofen axetil combind with fentanyl and propofol on coloscopy.Methods Ninety patients undergone coloscopy were randomly assigned into three groups according to different analgesics received(30 in each,groupⅠ: fentanyl 1?g/kg;groupⅡ flurbiprofen axetil combined with fentany 0.5?g/kg;group Ⅲ: fentany 0.5?g/kg).Patients in group Ⅱ received intravenous flurbiprofen axetil 1mg/kg 10min before examination.All patients were given intravenous midazolam 0.02mg/kg 2mins before examination,however patients in group Ⅰ received intravenous fentanyl 1?g/kg followed by intravenous propofol 0.5-1mg/kg,whereas patients in group Ⅱ and Ⅲ received intravenous fentanyl 0.5?g/kg followed by equal dosage of propofol.Propofol was administrated according to patients' reaction during examination.After the examination all patients were transferred to recovery room.BP,HR and SpO2 were measured before and after drug administration,when the coloscope reached the splenic flexure of the colon and after the examination.Dosage of propofol and fentanyl,duration of coloscopy,side effects and patients' memory of pain during examination were recorded.Results Propofol dosages of the three groups were 82.0?23.8mg,73.0?25.0mg and 108.2?36.5mg,respectively.Propofol dosage of group Ⅲ was much larger than that of groups Ⅰand Ⅱ(P0.05).Dizziness and nausea occurred in 17 patients in group Ⅰ when they left the recovery room,whereas the same side effects only appeared in one patient in group Ⅱ and 3 patients in group Ⅲ,respectively.It was shown by follow-up that all patients of the three groups had no memory of pain.Conclusion Intravenous flurbiprofen axetil may strengthen intraoperative analgesia during coloscopy,reduce the dosage of fentanyl and propofol,and decrease the side effects of anesthesia.

Objective To study the effects of total intravenous anesthesia and combined inhalation and intravenous anesthesia on arousing time and recovery quality in rectifying surgery of scoliosis. Methods Forty patients (ASAⅠ-Ⅱ) were divided randomly into total-intravenous anesthesia group and combined inhalation and intravenous anesthesia group (n=20 each). Target controlled infusion (TCI) with propofol (2-4?g/ml) was used for maintenance in total intravenous anesthesia group, while isoflurane (0.8%-1.5%) and nitrous oxide (50%) were used in combined inhalation and intravenous anesthesia group. TCI remifentanyl (2-6ng/ml) was used for maintenance in both groups. Results Arousing time were 19.7?5.1min in total intravenous anesthesia group, but 11.9?3.3 min in combined inhalation and intravenous anesthesia group (P

Objective To compare the influences of sulfentanyl or fentanyl combined with midazolam on respiratory function in slow induction of anesthesia.Methods Forty ASA Ⅰ-Ⅱ patients were divided into two groups.Anesthesia was induced with midazolam 0.03mg/kg in both groups,and fentanyl 2?g/kg(i.v.)was given in fentanyl group or sulfentanyl 0.2?g/kg(i.v.)in sulfentanyl group.Five minutes later,2ml of 1% decicaine was administered by cricothyroid membrane puncture to facilitate the intubation.Respiratory indexes(respiratory frequency,VT,MVV,PETCO2,SPO2),circulatory indexes(MAP,HR)and sedation level were measured before and 1,2,3,4,5 minute(s)after injection of drugs,at cricothyroid membrane puncture,and pre-and post-intubation.Results Patients showed respiratory depression(respiratory frequency was reduced)in both groups 2 minutes after injection of drugs.However,respiratory frequency was decreased more markedly in fentanyl group than that in sulfentanyl group.Ten out of 20 patients were obliged to receive breathing intervention in fentanyl group,but two in sulfentanyl group.Conclusion In combination with midazolam,sedative effect of sulfentanyl is stronger than that of fentanyl in equivalent analgesic dose,but with less respiratory depression.Sulfentanyl may be more suitable for slow induction of anesthesia.

Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) comprise an effective therapy for advanced non-small cell lung cancer patients with EGFR-activating mutations. Unfortunately, most patients eventually develop resistance to EG-FR-TKIs, probably due to a secondary point mutation of EGFR T790M. Thus, a sensitive method for accurate detection of T790M mu-tation is essential. Peripheral blood detection has gained our attention because it is convenient, making dynamic noninvasive quantita-tive detection of T790M mutation an optimal means of monitoring the efficacy of EGFR-TKIs. To date, the clinical significance of T790M mutation and EGFR-TKI resistance remains controversial. Several EGFR-TKIs targeting EGFR mutation, which have been in-troduced in recent years, showed better response in patients with T790M mutation, indicating that T790M may be a biomarker for con-quering resistance. This review introduces the methodology of T790M detection and its role in clinical practice.

Objective To evaluate the effects of different concentrations and different duration of sevoflurane anesthesia on cognitive function in mice.Methods Fifty adult male C57BL/6 mice,weighing 20-24 g,aged 10 weeks,were randomly divided into 5 groups (n =10 each) using a random number table:control group (group C),1.3％ sevoflurane inhaled for0.5 h group (group S1),1.3％ sevoflurane inhaled for 2.0 h group (group S2),2.5％ sevoflurane inhaled for 2.0 h group (group S3),and 2.5％ sevoflurane inhaled for 4.0 h group (group S4).At 2 weeks after anesthesia,Morris water maze test was performed,and the escape latency and frequency of crossing the original platform were recorded.After the end of the test,the mice were sacrificed,and brains were removed to detect the expression of 2B subunit-containing N-methyl-D-aspartate receptors (NR2B) and activated caspase-3 in the hippocampus.Results Compared with group C,the escape latency was significantly shortened,and the frequency of crossing the original platform was increased in S1-3 groups,and the escape latency was prolonged,and no significant change was found in the frequency of crossing the original platform in group S4.Compared with group C,the expression of NR2B in hippocampal tissues was up-regulated in S1-4 groups,and the expression of activated caspase-3 in hippocampal tissues was up-regulated in S3 and S4 groups.Conclusion The reason for different effects of sevoflurane anesthesia on cognitive function is related to the concentration and duration in mice.

BACKGROUND: Donor complications have been detected following autologous tendon transplantation for posterior cruciate ligament reconstruction. Although artificial tendon development and tissue-engineered tendon have achieved great progresses, there are some issues in clinical application. Since 1980's, allogenic tendon transplantation has aroused increasing attention. OBJECTIVE: To explore the selection of allogenic tendon materials and the effect of their application on reconstructing posterior cruciate ligament. METHODS: A total of 17 patients with posterior cruciate ligament injury of knee joint were treated with cryopreserved allogenic tendon by Tibial-inlay technique. During the operation, two tracts of tendons soaked in gentamicin saline for 15 minutes were conduplicated, and one end of the tendon was cancellous bone screw and fixed to the tibia attachment point of posterior cruciate ligament, and the other end was introduced into the joint through retention suture. The posterior joint capsule was repaired. The patient was placed at supine position, and the knee was flexed for 90°. The other end of the graft was introduced to femoral tunnel, and anterior drawer was tensed, and fixed by screw. RESULTS AND CONCLUSlN: The preoperative posterior drawer test of patients was >2+, including 7 cases of 3+ and 6 of 4+. The postoperative posterior drawer test was 0 in 4 cases, 1+ in 8 cases, 2+ in 4 cases and 3+ in 1 case, suggesting the posterior movement of the knee joint was significantly improved. Lysholm scores of patients were (48.5±4.3) points before operation and (88.3±5.4) points after operation. Results show that cryopreserved allogenic tendon by Tibial-inlay technique could restored function of posterior cruciate ligament with a favorable effect.

The paper presented the competence theory,and its application in the current hospital recruitment in China.Based on existing studies,the authors proposed a competence-based hospital recruitment indicator system and measurement approach,consisting of 15 level-1 indicators and 16 level-2 indicators.They also named the merits of such a system compared to conventional ones as evidenced in practice.On such basis the paper proposed to further improve such a system and mechanism,as well as the quantitative research and empirical study of the competence indicator system.

BACKGROUND:Recent report addressing new vertebral fracture after vertebroplasty or bal oon kyphoplasty has increased gradual y. It remains controversial whether new vertebral fracture is induced by bone cement augmentation or osteoporosis.
OBJECTIVE:To observe new vertebral fracture after conservative treatment and bone cement augmentation for osteoporotic vertebral compression fractures, analyze the relationship between new vertebral fracture and spinal sagittal parameters, and explore the risk factors for new vertebral fracture.
METHODS:From June 2011 to December 2014, 160 patients with osteoporotic vertebral compression fractures in thoracic and lumbar vertebrae were selected from the Department of Spine Surgery, the Affiliated Hospital of Chengde Medical Col ege. According to therapeutic regimen, the patients were divided into two groups. The observation group (n=80) received vertebroplasty or kyphoplasty. The control group (n=80) underwent conservative treatment. At 1 day after surgery in the observation group and after walking in the control group, patients were subjected to anteroposterior and lateral X-ray in the entire length of the spine. Bone mineral density, number and location of new vertebral fractures and sagittal parameters during fol ow-up were recorded and compared between groups. After final fol ow-up, according to the appearance of new vertebral fracture, patients in both groups were assigned to two subgroups. The difference in above indicators was compared between the two subgroups. The relationship between new vertebral fracture and spinal sagittal parameters was analyzed.
RESULTS AND CONCLUSION:(1) There were no statistical y significant differences in gender, age, body mass index, bone mineral density, pelvic index, sacral slope, pelvic tilt, thoracic kyphotic angle, lumbar lordotic angle, C7/sacro-femoral distance ratio and occurrence rate of new fractures between the two treated groups (P>0.05). (2) There were no statistical y significant differences in gender, age, body mass index, pelvic index, and lumbar lordotic angle between new vertebral fracture group and non-fracture group. There were statistical y significant differences in bone mineral density, sacral slope, pelvic tilt, thoracic kyphotic angle and the C7/sacro-femoral distance between the new vertebral fracture group and the control group (P<0.05). (3) Results confirmed that new vertebral compression fractures after vertebroplasty, Kyphoplasty or conservative treatment for osteoporotic vertebral compression fractures were definitely associated with osteoporosis and spinal sagittal imbalance.

Objective To assess the correlation of newly fracture and spinal sagittal parameters.Methods From March 2011 to December 2014,80 patients of osteoporosis vertebral compression fracture treated by PVP as observation group were studied.The whole-spine anteroposterior view and lateral view XRay Photographes of the patients were taken,the sagittal parameters such as Pelvic index (PI),sacral slope (SS),pelvic tilt (PT),thoracic kyphotic angle(TK),lumbar lordotic angle(LL),the C7/SFD ratio were recorded.The whole cases were divided into two groups according to the presence of new fracture or not after the last followup of one year,the index of two groups were compared,and the risk factors of newly vertebral compression fractures were analysed.Results There were no statistically significant difference in gender,age,body mass index,BMD,PI,TK,LL between the two trea ted groups (P＞0.05);there were statistically significant difference in SS,PT and the C7/SFD between the new vertebral fracture group and the control group (P＜0.05).The analytic results of Logistic regression model showed that the smaller SS,larger TK and C7/SFD were risk factors of newly vertebral compression fractures.Conclusion The newly occurred vertebral compression fractures,after the primary treatment of PVP,are associated with changed spinal sagittal parameters.