Objective To investigate the clinical effects of continuous 3-in-1 femoral nerve block with stimulating catheters for patient controlled regional anesthesia(PCRA) in elderly patients after unilateral total knee replacement (TKR)surgery.Methods Thirty ASA Ⅰ - Ⅱ elderly patients wererandomly divided into two groups: FB group and Ⅳ group.FB group received continuous 3-in-1 femoral nerve block for postoperative analgesia with 0.2% ropivacaine plus 0.1 μg/ml sufentanil continuous infusion at 5 ml/h plus PCA boluses (1.0 ml/15 min).Ⅳ group received continuous intravenous analgesia with 1 μg/ml sufentanil plus 0.04 mg/ml tropisetron hydrochloride at 2 ml/h plus PCA boluses (0.5 ml/15 min).All patients were maintained analgesia for 48 hours.Results In FB group, the visual analogue scale(VAS) scores were 1.3 ±1.1, 1.2 ± 1.0, 1.1±0.9, 1.1 ± 1.0,1.0±0.9 at 4, 8, 12, 24, 48 hours after surgery under rest status respectively and were 3.04±1.4,2.3±1.3 at 24, 48 hours after surgery in active function training.These parameters in Ⅳ group were 4.0±1.6, 3.5±1.6, 3.2±1.4, 3.0±1.3, 2.5±1.2, 4.7±1.5 and 3.3±1.5 respectively, which were significantly different compared with FB group (t=5.358, 4.707, 4.852, 3.784, 3.743, 3.254,1.932,all P<0.05 or P<0.01).The incidence of nausea was higher in IV group than in FB group(P = 0.0022).Postoperative satisfaction ratings was higher (χ2 =41.1 ,P<0.01) and the total morphine use for 48 hours after operation was less(uc=2.412, P<0.01) in FB group than in Ⅳ group.Conclusions After TKR surgery, the continuous 3-in-1 femoral nerve block with stimulating catheters is an effective method with better pain relief,fewer side effects and higher satisfaction ratings in the elderly.

Cytokines ; Hashimoto Disease ; diagnosis ; prevention & control ; Humans

The challenge of the emergence of drug-resistant influenza strains, which is caused by wide spread utilization of direct-acting antivirals (DAAs), accelerates the research and exploration towards host targeted agents. In contrast to DAAs targeting viral replication components, host targeted agents, which regulate host factors and pathways linked to viral replication, can interfere the replication of influenza. Additionally, the innate immune system is activated by influenza during the early stage of infection, so manipulating the innate immune response may prevent the viral infection. However, the excessive inflammatory response induced at the late phase of influenza infection would lead to severe tissue injures. Thus, it is very important to explore drugs with anti-inflammatory actions to suppress these immune imbalances and tissue injures. Here we overview the current progresses about host targets related to anti-influenza drugs.
Anti-Inflammatory Agents ; pharmacology ; Antiviral Agents ; pharmacology ; Humans ; Immunity, Innate ; Influenza, Human ; drug therapy ; Virus Replication

Objective:To optimize the alcohol precipitation technology of Qingmai granules. Methods:The relative density of liq-uor,the concentration and time of alcohol precipitation were chosen as the factors,the yield of dry extract and content of diosgenin as the indices,the alcohol precipitation technology was optimized by orthogonal test. Results:The optimal alcohol precipitation technology was as follows:the extraction liquid was concentrated till the relative density was 1. 13-1. 18 g·ml-1 ,ethanol was added until the concen-tration was up to 60% with the alcohol precipitation time of 24h. Conclusion:The optimized technology is stable,reasonable and feasi-ble,which can provide experimental basis for the clinical application of Qingmai granules.

Objective In order to measure the nursing unit workload scientifically,we used the Delphi method to investigate the influencing factors of nursing unit workload.Methods After consulting literature and discussing with experts,alternative indicators were designed,then two rounds of consultations were made with experts by using the Delphi method.Results The questionnaires revealed that the valid recovery rate,after two rounds of consultations,were 95％ and 100％ respectively,which reflected the positivity of the experts which participated in this study.The expert authority coefficient was 0.896,which indicated the high reliability of the consulting.The coordination indexes of expert opinions were 0.467 and 0.239 respectively,which showed the expert advices had good coordination and the results had high reliability.Conclusions The influencing factors of nursing unit workload determined by Delphi method have high reliability,which is significant for the scientific measuring of the nursing unit workload.

Objective To investigate the relationship of the expression of phosphatidylinositol-3-kinase(PI3K)subunits,P85 and P110 to the pathogenesis of psoriasis.Methods Immunohistochemical staining for P85 and P110 was performed in the tissue specimens from patients with psoriasis(n=30),chronic dermatitis(n=20),seborrheic keratosis(n=20),squamous cell carcinoma(n=20),basal cell carcinoma(n=30)and normal human controls(n=10).The absorbance of immunostained tissue was quantified with image analysis system (Q550CW,Leica,Manheim,Germany).Statistical analysis was carried out by ANOVA,Results Among these groups,a significant difference was observed in the expression level of P110 in the epidermis(F=35.64,P＜0.01),as well as in that of P85(F=59.98,P＜0.01)and P110(F=323.23,P＜0.01)in the lymphocytes infiltrating the lesion.Increased expression of P110 was found in the epidermis of psoriatic lesions compared with the lesions in the other disorders,whereas no significant difference was noticed among the other disorders.In the case of P85 and P110 expression in the lesion-infiltrating lymphocytes infiltrating the lesion,psoriasis and squamous cell carcinoma significantly differed from the other disorders,while no difference was observed between psoriasis and squamous cell carcinoma (P＞0.05).Conclusions The high expression of P110 might be closely correlated to the hyperproliferation of keratinocytes;but filrther study is needed to clarify the relationship of increased expression of P85 and P110 to the activation and proliferation of lymphocytes in psoriatic lesions.

Objective To evaluate the therapeutic responses to transsphenoidal surgery and medical therapy in terms of normalization of prolactin(PRL),mortality,morbidity and the cost-effectiveness of PRL normalization in order to establish an individualized therapeutic protocol for the patients with prolactinoma.Methods A retrospective study was undertaken of a consecutive series of patients with prolactinoma who were followed for at least 1 year after transsphenoidal surgery or medical treatment.The clinical characteristics and the long-term outcomes(normalization of PRL,morbidity or mortality)were assessed.Utilizing the principle of medical economics and data from the two types of treatment,we worked out a Markov chain and calculated the lowest cost of two kinds of therapeutic protocols.Results(1)The success rate of normalizing serum PRL through surgical treatment in microadenoma was 85%(22/26),and that of medical treatment was 95%(19/20).There was no statistical difference between the two therapies(P＞0.05).The success rate of normalizing serum PRL through surgical treatment in macroadenoma was45%(19/42),and that of medical treatment was 5/5.There was a statistical difierence between the two therapies(P＜0.05).(2)According to the Markov model,it would cost a microprolactinoma patient 25 129.25 yuan to normalize serum PRL by surgical treatment.This is comparable to the cost of medical treatment which would be 24 943.99 yuan.Whereas for a macroprolactinoma patient surgery would cost 35 208.20 yuan and medical treatment would cost 25 344.38 yuan.Conclusions Medical therapy is superior to surgical treatment in regard to complication rate and cost-effectiveness for macro-and extra big prolactinomas.Transsphenoidal surgery remains an option for patients with microadenomas.Markov model is an effective way to predict the treatment cost for patients with hyperprolactinoma at different ages and with different canses

Objective To study the changes of motor cortex in patients with amyotrophic lateral sclerosis(ALS)while executing sequential finger tapping movement by using blood oxygenation level dependent(BOLD)functional MRI.Methods Fifteen patients with definite or probable ALS and 15 age and gender matched normal controls were enrolled in the BOLD study,and all the subjects were right-handed with no other diseases or any recent medication history.A 3.0 T MR scanner was employed and gradient echo EPI(GRE-EPI)sequence was used to acquire the functional images.Subjects executed sequential finger tapping movement at a frequency of 1-2 Hz during a block design task.fMRI data were analyzed by using statistical parametric mapping(SPM)2.Volume of activated brain areas was compared with the use of a Student's t-test.Results Bilateral primary sensorimotor cortex(PSM),bilateral posterior aspect of premotor area(PA),bilateral supplementary motor area(SMA),contralateral inferior lateral premotor area (ILPA),bilateral parietal region(PAR),and ipsilateral cerebellum showed activation in both ALS patients and normal controls when executing the same motor task.The activation areas in bilateral PSM and bilateral posterior aspect of PA(right hand ipsilateral activation:ALS(924.5±141.1)mm3,control(829.9±98.4)mm3,P=0.05;right hand contralateral activation:ALS(9143.8±702.8)mm3,control(8638.8±506.4)mm3,P＜0.05;left hand ipsilateral activation:ALS(1162.5±357.4)mm3,control(902.5±184.2)mm3,P＜0.05;left hand contralateral activation:ALS(8255.2±870.2)mm3,control (5934.6±616.4)mm3,P＜0.05),bilateral SMA(right hand bilateral activation:ALS(6564.3±720.6)mm3,control(4710.7±416.3)mm3,P＜0.05;left hand bilateral activation:ALS(6970.5±961.8)mm3,control(3688.9±672.3)mm3,P＜0.05),and ipsilateral cerebellum(right hand ipsilateral activation:ALS(2720.0±1154.2)mm3,control(254.3±84.4)mm3,P＜0.05;left hand ipsilateral activation:ALS(4794.4±1237.0)mm3,control(1689.0±719.6)mm3,P＜0.05)were significantly larger in ALS patients than in normal controls.Extra activation areas including ipsilateral ILPA,contralateral cerebellum and bilateral posterior limb of internal capsule were only detected in ALS patients.Conclusions Similar activation areas were seen in both groups while executing the same motor task,but the activated areas were more prominent in ALS group.The increased activation areas in ALS patients may represent neural reorganization.while the extra activation areas in ALS patients may indicate functional compensation.

As an indispensable part of minority traditional medicine, mineral medicine has used with less dosage and reliable efficacy for the last thousand years. Based on the unearthed relics and medical literatures of past dynasties, the history of Han nationality ap- years, which had been recorded in main literature. But there is less comprehensive report of its usage in the other 55-minority nationality. This article was based on the analysis of ethnic minority literature of thousands of years, and conducted a comprehensive collation and analysis of mineral medicine. It was mostly determined that there was 20 minority groups using mineral medicine, with a total of 163 species (limited our references), and the most used is the Tibetan, accounting for 141. The most serious problems of mineral medicine are that species should be further investigated and researched, and then become the legal commercial medicine, and the classification principles of mineral medicine should be established. Through the traditional processing and experimental studies, the problems of attenuation and detoxification should be solved.
China ; ethnology ; History, Ancient ; History, Medieval ; Humans ; Medicine in Literature ; Medicine, Chinese Traditional ; history ; Minerals ; analysis ; pharmacology

The main objective of this research is to investigate the effects of astragaloside IV, calycosin separately glucoside, formononetin on oxidative stress in Chang Liver cells induced by H2O2. In the experiments, Chang Liver cells (a kind of normal human hepatocytes) were used as the research object, bifendate which has a clear hepatoprotective effect was used as the positive control drug, then the oxidative damage model of Chang Liver cells were established by H2O2. Cells were divided into six groups: blank control group, oxidative stress group, astragaloside IV group, calycosin separately glucoside group, formononetin group and positive control group. Then endogenous antioxidant system related indexes were detected by micro plate and colorimetric method; intracellular reactive oxygen species (ROS) were detected by DCFH-DA fluorescent probe; and the expressions of CYP2E1 were evaluated by liver microsomes, mRNA, and protein, respectively with spectrophotometry, Real-time PCR method, and Western blot technique. Results showed that H2O2 decreased antioxidant activity, and increased ROS level and expression of CYP2E1. The above oxidative stress status had been changed with protections of the three components of Astragalus membranaceus (compared with oxidative stress group, P < 0.05, P < 0.01), which taken as a whole had equivalent effects as the drug of positive control group( bifendate). Taken together, three Astragalus membranaceus ingredients all had significant or extremely significant inhibiting effects on oxidative damaged Chang Liver cells which were induced by H2O2, and the oxidative damage of Chang Liver cells had been relieved.
Astragalus membranaceus ; chemistry ; Cells, Cultured ; Cytochrome P-450 CYP2E1 ; metabolism ; Humans ; Isoflavones ; pharmacology ; Liver ; drug effects ; Oxidative Stress ; drug effects ; Reactive Oxygen Species ; metabolism ; Saponins ; pharmacology ; Triterpenes ; pharmacology