Objective To compare analgesic efficacy of intravenous postoperative and preemptive analgesia with flurbiprofen axetil combined with small dose of morphine and with morphine alone. Methods One hundred and twenty patients were randomly divided into four groups: group A,morphine 30 mg +0.9% NaCl for postoperative analgesia,n=30;group B,morphine 20 mg +0.9% NaCl for postoperative analgesia,n=30;group C,flurbiprofen axetil 100 mg + morphine 20 mg +0.9% NaCl for postoperative analgesia,n=30;group D,flurbiprofen axetil 100 mg before operation + morphine 20 mg +0.9% NaCl for postoperative analgesia,n=30.The drugs in each group were diluted to 100 mL and infused by a pump at a rate of 2 mL/h with a patient-controlled analgesia(PCA)bolus of 2 mL after a loading dose of 5 mL.The visual analogue scale(VAS),demanding times for PCA and incidence of side effects were recorded during the period of postoperative 24 h. Results The VAS of group B at 3 h after operation was significantly higher than those of the other three groups(P

ObjectiveTo investigate the effect of defibrase on hemorheology on the patients with acute ischemic stroke. Methods40 patients with acute ischemic stroke were treated by defibrase and the change of hemorheology was recorded before and after the treatment respectively. ResultsThe whole blood viscosity, the blood plasma viscosity, RBC aggregate index and RBC hematocrit got reduced on different degrees.Conclusions Defibrase can reduce the blood viscosity,inhibit RBC aggregate,and improve the micro-circulation. It is helpful to recover the nerve function earlier.

Purpose To investigate the clinicopathological features, treatment and prognosis of perivascular epithelioid cell tumor ( PEComa) of the head and neck. Methods Two cases of PEComa were analyzed by studying clinical data, histopathologic and immu-nohistochemical ( EnVision) changes and the related literatures were reviewed. Results Case 1 was a 26-year-old woman with a re-current larynx tumor, and case 2 was diagnosed in a 56-year-old man with a left nasal cavity mass. Their tumors were well-demarcated, and ranged from 2. 5 to 3. 5 cm in diameter. Microscopically, the tumors were composed of epithelioid cells arranged in nets, organoid pattern. The tumor cells had abundant pale eosinophilic granular to clear cytoplasm, vesicular nuclei, and mild atypia. The stroma was rich in capillaries, sinusoidal vasculature. There was mitotic activity and focal necrosis. By immunohistochemistry, the tumor cells were diffusely or focally positive for vimentin (2/2), HMB-45(1/2), Melan-A(2/2), SMA(2/2), Calponin(2/2), desmin(1/2), and TFE3(1/2). They were negative for CK, CD10, S-100, CgA, Syn, and MyoD1. Conclusion PEComa of the head and neck is rare. Definite diagnosis depends upon the comprehensive analysis of histopathology and coexpression of melanocytic and myoid mark-ers. The differential diagnosis include paraganglioma, malignant melanoma and metastatic carcinoma. Few PEComas of the head and neck behaved in an aggressive fashion with distant or loco-regional metastases and died of disease-related causes, it should be regarded as tumors with a malignant potential.

Objective To evaluate the effect of nitrous oxide(N2O) on the cuff pressure of ProSeal laryngeal mask airway(PLMA) in pediatric anesthesia. Methods Thirty-two pediatic patients were enrolled and divided into two groups randomly.PLMA cuffs were inflated with air(Group A) or 50% N2O/oxyen(Group N) to 20 mmHg as initial pressure.The intracuff pressure was monitored during anesthesia with 50% N2O in oxygen. Results Intracuff pressure increased to(40.6?9.3) mmHg in Group A and slightly decreased in Group N.Deflation volume in Group A was much more than that in Group N[(4.4?2.3) mL vs(2.6?1.0) mL,P

Objective To identify the mechanisms of oral administered rapamycin on the prevention of restenosis after stent implantation with intravascular ultrasound (IVUS) and pathology.Methods Twenty-four New Zealand white rabbits underwent balloon-induced abdominal aortic wall injury and were given a diet of 1 ％ cholesterol for 8 weeks.Then,the rabbits were divided into three groups:the bare metal stent group(BMS group),the bare metal stent with oral rapamycin group(BMS + RAPA group) and the rapamycin eluting stent group(DES group).Rabbits in the RAPA and BMS + RAPA groups received a daily oral dose of rapamycin(0.5 mg/kg),whereas rabbits in the DES group received no drugs.All the rabbits were euthanized after the 4-week intervention.Serum lipids were measured.IVUS and pathologic studies were performed.The minimal luminal diameter (MLD),external elastic membrane (EEM) area,lumen area (LA),and plaque area(PA),plaque burden(PB) were measured.Mammalian target of rapamycin(mTOR) expression level was examined by immunohistochemistry.Results After the 4-week intervention,there was no significant difference of serum lipid levels among the three groups.IVUS showed that oral administration of rapamycin in the BMS + RAPA groups showed similar effects in reducing PA and PB as the DES group,which all were better than the BMS group.The BMS + RAPA and DES groups showed much more MLD and less lumen reduction,compared with the BMS group( P ＜0.05).Level of mTOR expression of the BMS + RAPA group and DES group was significantly lower than that of BMS group.Conclusions Oral administration of rapamycin demonstrates the same effect in the reduction of plaque burden and stent restenosis as the rapamycin eluting stent.Inhibition of mTOR by rapamycin involves in the stent restenosis.

Carcinoma in Situ ; pathology ; Carcinoma, Squamous Cell ; classification ; pathology ; Cervical Intraepithelial Neoplasia ; classification ; pathology ; Diagnosis, Differential ; Female ; Humans ; Precancerous Conditions ; classification ; pathology ; Uterine Cervical Neoplasms ; classification ; pathology

OBJECTIVE To enhance the rational usage of antibiotics by comprehensive interventional measures in clinics.METHODS Several interventional measures have been adopted in our hospital since January 2001: to(establish) expert team on antibiotics usage and administration consultation;constitute antibiotics use criteria(suitable) for each clinical specialty;train and examine the usage of antibiotics;censor the distribution of pathogen and drug-resistance variance.Then 10% of the discharged medical records in 2000,2002 and 2004 were drawn out respectively to analyze the usage of antibiotics and the isolation of pathogen from nosocomial infection cases.(RESULTS) The proportion of the patients with prophylactic and remedial indications was increased remarkably((P

Objective To discuss the value of echocardiography for the assessment of structure and function of right heart in normal Chinese adults Methods The structure and function of right heart was assessed by echocardiography according to 2010 guideline of American Society of Echocardiography (ASE). The echocardiographic data of right heart of 130 normal Chinese adults were analyzed to acquire the normal reference values of echocardiographic parameters and evaluate the differences of these results among different age groups. Results There were significant differences among different age groups for some of the parameters. Right atrium (RA) transverse diameter was greater in the middle-aged group than that in the young-aged group [(36.90±5.10) mm vs (33.90±5.20) mm, t=-2.79, P=0.006]. RA longitudinal diameter (RAL) and RA area (RAA) were smaller in the young-aged group than those in the middle-aged and old-aged groups [(40.10±5.10) mm vs (42.90±5.10) mm, (43.40±5.60) mm, t=-2.51 and-2.91, P=0.013 and 0.004;(11.90±3.20) mm2 vs (13.40±2.90) mm2, (13.90±3.60) mm2, t=-2.24 and-2.90, P=0.027 and 0.004]. Parasternal long-axis right ventricule outflow tract (PLAX RVOT), parasternal short-axis right ventricule outflow tract (PSAX RVOT) and pulmonary artery diameter (PAD) were smaller in the young-aged group than those in the middle-aged and old-aged groups [(24.20±3.00) mm vs (26.20±2.30) mm, (25.90±2.90) mm, t=-2.80 and-2.32, P=0.006 and 0.022;(24.70±3.00) mm vs (27.20±2.50) mm, (26.90±2.60) mm, t=-4.40 and -3.84, P=0.000 and 0.000; (20.60±2.00) mm vs (22.10±2.70) mm, (21.90±2.10) mm, t=-3.12 and-2.67, P=0.002 and 0.008]. RV lateral wall thickness was smaller in the young-aged group than that in the middle-aged and old-aged groups [(5.10±0.60) mm vs (5.60±0.60) mm, (5.40±0.70) mm, t=-3.12 and-2.22, P=0.02 and 0.028];DTI e wave was greater in the young-aged group than that in the middle-aged and old-aged groups [(14.90±3.70) cm/s vs (10.90±3.10) cm/s, (11.10±2.60) cm/s, t=5.82 and 5.49, P=0.000 and 0.000]. DTI a wave was smaller in the young-aged group than that in the middle-aged and old-aged groups [(12.50±3.90) cm/s vs (14.60±3.70) cm/s, (16.60±3.60) cm/s, t=-2.79 and -5.04, P=0.007 and 0.000] and DTI a wave was smaller in the middle-aged group than that in the old-aged group (t=-2.26, P=0.02). Tricuspid E wave was greater in the young-aged group than that in the middle-aged and old-aged groups [(0.61±0.11) m/s vs (0.51±0.11) m/s, (0.48±0.08) m/s, t=4.58 and 5.44, P=0.000 and 0.000]. E/A was greater in the young-aged group than that in the middle-aged and old-aged groups (1.45±0.30 vs 1.12±0.33, 1.10±0.27, t=4.58 and 5.44, P=0.000 and 0.000). No significant differences were found among different age groups in RV systolic function parameters, whereas a trend of decrease in RV diastolic function was detected. Conclusion Echocardiography can be useful in assessing the structure and function of right heart quantitatively.

ObjectiveTo elucidate the clinical application value of intravascular ultrasound(IVUS) in assessing intermediate lesions and the relationship between serum levels of fractalkine,CD36 and LP-PLA2and severity of coronary artery atherosclerosis.MethodsOne hundred and twenty patients with unstable angina underwent coronary angiography.Then the patients were divided into two groups:severe lesion group (lumen diameter stenosis greater than 70％,including 40 patients),and the intermediate lesion group lumen diameter stenosis(50％～70％,80 patients).IVUS were performed in all patients to analysis the coronary lesions.Concentrations of CD36,fractalkine and LP-PLA2 were measured by means of ELISA.Results IVUS found that 74％ intermediate lesion patients had soft lipid plaques,while 48％ severe lesion patients had lipid plaques ( P＜0.01 ).Patients with severe lesion had larger plaque burden and vascular remodeling index than those of patients with intermediate lesions(P＜0.05～0.01).There were 59 patients(74％) in the intermediate lesion group underwent PCI.IVUS also found the PCI patients had larger plaque burden and vascular remodeling index.Concentration of CD36 was significantly higher in severe lesion group than that of intermediate lesion group (P＜0.05).ConclusionsIVUS could further clarify the characteristics of the intermediate and severe lesions,and provide guidance for PCI treatment.Plasma CD36 level could be used to predict pathological severity of coronary atherosclerosis.

Objective To investigate the clinical features,diagnostic modalities and treatment of duodenal Brunner′gland adenoma(BGA).Methods Fifteen patients with duodenal BGA were evaluated base on clinical presentations,the results of serologic test,barium meal examination,gastroscopy and endoscopic ultrasonography(EUS)as well as treatment.The post-operative histological results were compared with pre-operation EUS findings.Results Eight out of 15 patients with duodenal BGA had presentations,including duodenal ulcer(4 patients),upper gastrointestinal hemorrhage (4 patients). The serologic tests of all patients were within the normal limits.Six patients underwent barium meal examination and 13 patients received gastroscopy.Seven patients underwent surgical treatment and 8 patients received endoscopic resection.The post-operative histological results were compatible with the pre-operative EUS findings.Conclusions Duodenal BGA is a benign tumor.EUS was helpful in making the diagnosis and determination of treatment methods(surgical operation or endoscopic resection).