BACKGROUND:In the elderly patients with a variety of diseases, poor physical and compensatory ability results in a high demand for anesthesia during hip replacement and internal fixation. Lumbar epidural anesthesia with ropivacaine is the commonly used method of narcotic analgesics, but this method of anesthesia has been less studied in elderly hip replacement and internal fixation. OBJECTIVE: To investigate the effects of lumbar epidural anesthesia with ropivacaine in elderly hip replacement and internal fixation. METHODS: Data of fifty elderly patients with hip replacement implants and internal fixation, who were treated in the Department of Orthopedics, Affiliated Hospital of Xizang Minzu University from February 2014 to August 2015, were analyzed. 50 patients were randomly divided into continuous epidural anesthesia group and ropivacaine lumbar epidural anesthesia group, with 25 patients in each group. Anesthetic effect was compared. Self questionnaire on risk factors was used for non-conditional Logistic multivariate analysis between the two groups. RESULTS AND CONCLUSION: (1) Anesthetics onset time, the amount of local anesthesia, the use of trimetaphan camsilate agent number, complete block time, heart rate after anesthesia and complication rate were significantly less in the ropivacaine lumbar epidural anesthesia group than in the continuous epidural anesthesia group (P < 0.05). (2) The highest block level, Bromage score, mean arterial pressure after anesthesia and anesthesia satisfaction rate were significantly higher in the ropivacaine lumbar epidural anesthesia group than in the continuous epidural anesthesia group (P < 0.05). (3) Logistic multivariate analysis on postoperative cognitive dysfunction showed that postoperative cognitive dysfunction was strongly associated with age, education, complications, and hip arthroplasty (P < 0.05). (4) Results verified that lumbar epidural anesthesia with ropivacaine showed ideal effects in hip arthroplasty and internal fixation. Postoperative recovery was rapid, and it is safe and reliable.

To investigate the kinetics of activation of the activator protein-1(AP-1) and elucidate its role in TNF-? expression induced by lipopolysaccharide(LPS) in rat alveolar macrophages(AM), dynamic changes of the activity of AP-1 were detected with electrophoretic mobility shift assay(EMSA). The phosphorothioate oligodeoxynucleotide (S-ODN) decoy was transfected into AM prior to LPS stimulation. The level of TNF-? in culture supernatants was measured with an ELISA kit. The results showed that after LPS stimulation for 0.5 hour, remarkable activation of AP-1 could be detected and reached the highest level. The activation of AP-1 rapidly decreased at 1 hour, then increased at 3 hours again and reduced at 5 and 8 hours after LPS stimulation. The activation of AP-1 could persist at least 8 hours and showed a dose-dependent manner to LPS within 1000ng/ml. AP-1 S-ODN decoys could markedly inhibit the LPS-induced TNF-? production by rat AM, but it could not completely inhibit the production of TNF-? induced by LPS in rat AM. It is suggested that LPS could induce activation of AP-1 in rat AM; AP-1 played an important role in LPS-induced inflammatory response. It is also suggested that AP-1 involved in the regulation on LPS-induced TNF-? production by rat AM, however, entirely inhibition of the activity of AP-1 could not completely prevent TNF-? production by rat AM. It is also implied that other nuclear factors might also play an important role in the regulation on LPS-induced TNF-? expression by rat AM.

Objective To investigate the activation of nuclear factor ?B (NF-?B) induced by lipopolysaccharides (LPS) in rat alveolar macrophages (AM) and its regulative role in tumor necrosis factor (TNF-?) expression. Methods The dynamic activity changes of NF-?B DNA induced by LPS (E.coli 026:B6) were determined with electrophoretic mobility shift assay (EMSA). The phosphorothioate oligodeoxynucleotides (S-ODN) decoy was transfected into AM 12 hours prior to LPS stimulation. The effect of NF-?B S-ODN decoy on expression of TNF-? in AM stimulated by LPS were measured with enzyme-linked immunosorbent assay (ELISA) kit. Results NF-?B could be activated remarkably after 0.5 hour of LPS stimulation at concentration of 100 ng/ml, reached the highest level 1 hour after LPS stimulation and gradually decreased. But the activation of NF-?B could last at least 8 hours. The dose for LPS stimulation was related to activation of NF-?B in a dose-dependent fashion, ie, the activation of NF-?B gradually strengthened with dose increase of LPS. Supershift assays proved that p50 and p65 were involved in the activation of NF-?B. NF-?B S-ODN decoy could markedly (not completely) inhibit LPS-induced TNF-? production. Conclusions NF-?B plays an important role in LPS induced inflammatory response. However, entire inhibition of the activity of NF-?B can not completely prevent TNF-? expression induced by LPS in rat AM, which implies that other nuclear factors may participate in TNF-? expression.

Y0, then the diagnosis of hypertension with liver cirrhosis obtained. The positive rate of diagnosis is 95% and the specificity is 96% and 91% respectively, much better than those in type B ultrasonography or gastric endoscopy, 78% or 75% respectively (P

Objective: To investigate the diagnostic value and clinical significance of trans-splenic portal scintigraphy in cirrhotic portal hypertension and compensatory circulation. Methods: Transsplenic portal scintigraphy, ultrasound, and gastroscopy were performed on 50 patients with cirrhotic portal hypertension and on 10 controls. According to the Child-Pugh classification, 15 patients with cirrhosis were Child A, 19 cases were Child B, and 16 cases were Child C. Results: In the control group, the splenoportal vein was shaped like the letter S, and the portosystemic shunt index was 0.19?0.07. Portal hypertension portosystemic shunts were of 3 types: intrahepatic (13 patients; index, 0.52?0.19), compensatory(31 patients; index, 0.64?0.28)and completely extrahepatic (6 patients; index, 0.91?0.03). Collateral vessels were uphill, downhill, or complex. The portosystemic shunt index increased as cirrhosis and esophageal varices increased. There was statistical significance among groups(P

Ebola vims was extremely virulent and highly transmissible and caused outbreak of severe hemorrhagic fevers with high mortality in the Africa tropical regions. Currently. Ebola epidemic raging in West Africa, antiviral vaccines and drugs have also accelerated the development process. Basing on antigen delivery methods. EBOV vaccines can be divided into three categories of technology platform, including nonreplicative viral vector-based vaccines, replicative viral vector-based vaccines and viral protein antigen-based vaccines. ChAd3-ZEBOV and VSV-EBOV are the most promising vaccines against Ebola. With the basic molecular research of Ebola virus infection deepening, polynucleotides drugs and nucleoside analogue drugs against Ebola virus are hot research topics.

ObjectiveTo observe the effects of Huqi Zhengxiao Formula （槲芪癥消方） on the survival rate and quality of life of patients with stage Ⅲ hepatitis B-associated primary liver cancer （PLC） with syndrome of healthy qi deficiency and toxic stasis accumulation after transcatheter arterial chemoembolisation （TACE） treatment. MethodsOne hundred and twenty-six patients with stage Ⅲ hepatitis B-associated PLC who were identified as syndrome of healthy qi deficiency and toxic stasis accumulation after TACE treatment were selected， and were randomly assigned to 63 cases each of the treatment group and the control group in a ratio of 1∶1 by using the random number table method； the control group was given symptomatic supportive treatments with western internal medicine， and the treatment group was given the addition of Huqi Zhengxiao Formula on the basis of the control group. All patients were treated for a period of 48 weeks， and were followed up at weeks 4， 8， 12， 24， 36， and 48 of the treatment process. The primary effectiveness index was the 1-year survival rate， and the secondary effectiveness index was the Karnofsky score and the traditional Chinese medicine （TCM） syndrome score. Survival analysis was performed using the Kaplan-meier method， and Log-rank test was used to compare the differences between the survival curves of each group. ResultsSix withdrawals in the treatment group and seven withdrawals in the control group， and finally 57 patients in the test group and 56 patients in the control group were included in the statistical analysis. The 1-year survival rate of patients in the treatment group was 56.1% （32/57）， which was higher than that of 33.9% （19/56） in the control group （P = 0.033）. The mean survival time was （275.30±15.50） days in the treatment group， higher than （227.16±17.11） days in the control group （P = 0.039）. Thirty-two patients in the treatment group and 19 patients in the control group completed the Karnofsky score and TCM symptom score at each time point. At weeks 4， 8， 12 and 36， the difference in the Karnofsky score between the two groups was not statistically significant （P＞0.05）； at weeks 24 and 48， the Karnofsky score in the treatment group was higher than that in the control group at the same time point （P＜0.05）； analysis of variance of repeated measurements found that the downward trend of the Karnofsky score in the treatment group was slower than that in the control group （F = 4.47， P = 0.037）. The difference between the TCM symptom scores of the two groups at each follow-up observation point was not statistically significant （P＞0.05）； there was a tendency for the TCM symptom scores of the two groups to increase， but the ANOVA of repeated measurements found that the difference between the two groups was not statistically significant either （F = 0.31， P = 0.58）. Concusion The oral administration of Huqi Zhengxiao Formula can improve the survival rate， prolong the survival time， and improve the quality of life of patients with stage Ⅲ hepatitis B-associated PLC with syndrome of healthy qi deficiency and toxic stasis accumulations after TACE treatment.

Albumin is synthesized in the liver， and in case of severe liver injury， albumin synthesis is reduced with structural alterations （such as an increase in methylation and glycosylation）， leading to a significant reduction in effective albumin in circulation. Albumin not only maintains plasma oncotic pressure， but also has the functions of antioxidation， anti-inflammation， immunomodulation， and transport. Current guidelines recommend the short-term application of human serum albumin in the treatment of large-volume paracentesis， hepatorenal syndrome， and spontaneous bacterial peritonitis in patients with liver cirrhosis， as it is shown that human serum albumin can help to reduce mortality. In addition， human serum albumin may improve the prognosis of cirrhotic patients with hyponatremia， non-SBP infections， and hepatic encephalopathy. However， there are still controversies over the application of human serum albumin in liver cirrhosis and related complications in terms of optimal dose and long-term efficacy.

ObjectiveTo investigate the traditional Chinese herbs and core prescriptions commonly used by Professor Qian Ying in the syndrome differentiation-based treatment of primary liver cancer, and to guide clinical medication. MethodsA retrospective analysis was performed for the clinical data of the patients diagnosed and treated by Professor Qian Ying. A descriptive analysis was performed to analyze Professor Qian Ying′s clinical medication and prescriptions in the treatment of primary liver cancer, and the complex network and clustering with point mutual information were used to analyze the complex association between multiple traditional Chinese herbs. ResultsA total of 111 patients with primary liver cancer were enrolled. There were 287 visits, 287 prescriptions, and 132 traditional Chinese herbs in total. The core herbs used by Professor Qian Ying were Visci herba, raw Astragalus membranaceus, Salvia miltiorrhiza, Oldenlandia diffusa, and Polygoni Orientalis Fructus, and this result was consistent with the composition of Huqi powder developed by Professor Qian Ying. The prescriptions commonly used included Huqi powder, Shengmai decoction, and Xiaoyao powder. ConclusionSalvia miltiorrhiza is the special herb used by Professor Qian Ying in the treatment of primary liver cancer and Huqi powder developed by Professor Qian Ying is the commonly used prescription.

Esophagogastric variceal bleeding (EVB) is a common fatal complication secondary to cirrhotic portal hypertension. Terlipressin can shrink visceral blood vessels, reduce portal pressure, and increase renal perfusion and is mainly used in the treatment of EVB. This article summarizes the mechanism of action and clinical effect of terlipressin in the treatment of EVB in liver cirrhosis and points out that if conditions permit, terlipressin combined with endoscopic variceal ligation should be the preferred treatment method for EVB.