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

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

Objective Based on animal model of left ventricular pressure overload induced cardiac fibrosis,to investigate the specific role and molecular mechanism of KLF15 gene in this process.Methods To establish rat animal model of pressure overload induced cardiac hypertrophy by aortic coarctation under non artificial ventilation conditions,and then release the constriction,to observe the rat heart color Doppler images,myocardial interstitial fibrosis features and protein expression level changes of KLF15、Transforming growth factor-β (TGF-β) 、Connective tissue growth factor (CTGF)、Myocardin-related transcription factor A(MRTF-A) in overload-unload corresponding time points.Results We successfully completed aortic banding and debanding operations by use of SD rats without artificial ventilation.Through color Doppler echocardiography detection,from images to know:the effect of constriction and loosening is definite.The expression of collagen type Ⅰ,collagen type Ⅲ,TGF-β,CTGF,MRTF-A were significantly higher and myocardial hypertrophy was aggravated but the KLF15 protein expression level was significantly lower in pressure overloaded rats than in Sham rats(all P ＜ 0.05).All values were in an increasing tendency with the constrictive time prolonged (P ＜ 0.05).The response to unloading was opposite,the sooner to loose the better to the recovery to normal.The differences of indicators are very notable (P ＜ 0.05).Conclusion By feedback regulation TGF-β,KLF15 inhibited the effect of CTGF and MRTF-A,reducing myocardial interstitial fibrosis.

Objective To investigate the effects of antisense Smad2 oligodeoxynudeotides(ODN) on fibronetin(FN) and collagen Ⅳ(ColⅣ) secretion of rat mesangial cells cultured with high glucose, explore the action of Smad2 in the glomerulosclerosis and to find a new method to retard the progress of glomerular fibrosis. Methods 20-mer antisense, sense and random ODNs were designed and synthesized that were phosphorothioate modified to increase stability. The antisense ODN encompassed the ATG of the rat Smad2 gene. ODN was tranferred transiently into rat mesangial cells through liposome. Rat cells were treated with high glucose. mRNA and protein of Smad2 were detected by RT-PCR and cytochemistry. FN and ColⅣ were examined by ELISA. Results Antisense ODN significantly decreased mRNA and protein expression of Smad2 in rat mesangial cells treated with high glucose(P

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.