A single drug or a method may not achieve the best result for the management post-operative pain, so multimodal analgesia is proposed as a new analgesic concept in recent years. This article describes the mechanism of postoperative pain, some of the factors affecting postoperative pain and the importance of the treatment of postoperative pain after surgery. It also introduces a variety of analgesic drugs and methods commonly used as multimodal analgesia in postoperative pain treatment in orthopaedic. Foreground of the research is prospected as well.

Fasting plasma gastrin levels were found to be elevated in 35 cases of hyperthyroidism (265.17?143.17 pg / ml) as-compared with the normal controls (68.30?28.00 pg / ml). The elevated gastrin levels were obviously lowered after the thyroid function was normalized by treatment (115.54?45.86 pg / ml, P

Objective To investigate the clinicopathological characteristics,diagnosis and therapy,as well as the prognosis of accessory breast cancer. Methods Twenty-two cases were diagnosed as accessory breast cancer from Jan 1,1984 to Dec 31,2008, their clinicopatholgical data were analyzed retrospectively.Results Up to Mar. 1, 2010,2 cases had local recurrence;7 cases had long-distance metastasis;6 cases died. In the current study,the 5-year survival rate of accessory breast cancer was 43. 7%. Conclusions Accessory breast cancer is aggressive. The diagnosis was mainly based on clinical characteristics and postoperative pathology. The combined therapies may improve the survival rate.

Objective To determine the diagnostic value of fractional exhaled nitric (FeNO) measurement in diagnosis of bronchial asthma. Methods The patients with unkown-cause respiratory symptoms including wheezing, cough, and breathlessness were enrolled from August to September in 2008. FeNO was measured by nitric oxide analyzer (NIOX; Aerocrine AB; Solna, Sweden). Bronchial challenge test (BCT) or bronchodilator test was defined as golden standard for asthma diagnosis. The value of FeNO was assessed and the optimal operating point of FeNO testing was determined by the means of the receiver operating characteristic (ROC) curves. Results A total of 101 patients were enrolled, in which 48 cases were diagnosed as asthma by positive yield in BCT (in 38 cases) or bronchodilator test (in 10 cases). The severity of airway hyperresponsiveness (AHR) judged by BCT was mild in 15 cases, moderate in 15 cases and severe in 8 cases. The levels of FeNO of asthma group were higher than those of non-asthma group [(68.19±43.00) pph vs (19.52±10.60) ppb, P < 0.05]. A linear correlation of FeNO with lnPD20 FEV1 was revealed in the cases with AHR. Area under ROC curve was 0.9. The optimal diagnostic cutoff point was 36.5 ppb which was capable of differentiating asthma and non-asthma with sensitivity of 92.7%, specificity of 83.3%, positive predictive value of 79.17% , negative predictive value of 94.34% and accuracy of 87.13%. Conclusion FeNO test may be helpful in the diagnosis of asthma with high sensitivity and specificity.

Objective To observe the effect of topical application with warm and wet carthamus tinctorius alcohol and anisodaminum on phlebitis caused by mannitol injection. Methods 100 patients with fractured bones suffered from phlebitis caused by mannitol injection were randomized into the observation group and the control group with 50 cases in each group. The observation group adopted topical application with warm and wet carthamus tinctorius alcohol and anisodaminum while the control received external application of 50% magnesium sulfate. The dosage was 3 hours per time,2 times a day, one time in the morning and afternoon respectively. The treatment continued till the phlebitis disappeared and the effect at the 24th,48th and 72th post treatment was compared between the two groups. Results The effect at the above mentioned time points in the obsevation group was superior to that of the control group(P＜0.05).Conclusion Topical application with warm and wet carthamus tinctorius alcohol and anisodaminum on phlebitis caused by mannitol injection proved to be safe and had no adverse effect.

Object A systematic study on the chemical constituents of Citrus changshan huyou Y B Chang was carried out in order to reveal the active components for their further development Methods By repeated silica gel chromatographic separation and spectral analysis the structures were determined Results Six compounds of the flavonoids were obtained and identified They were hesperidin (hysperetin 7 O rutonoside) (Ⅰ); naringenin (Ⅱ); nobiletin (3′, 4′, 5, 6, 7, 8 hexamethoxyflavone) (Ⅲ); tangertin (4′, 5, 6, 7, 8 pentamethoxyflavone) (Ⅳ); 5 hydroxy 3′, 4′, 6, 7, 8 pentamethoxyflavone (Ⅴ); 5 hydroxy 3′, 4′, 6, 7, 8 haxamethoxyflavone (Ⅵ) Conclusion The above six compounds were obtained from this plant for the first time

OBJECTIVE:To establish the quality standard of Flemingia philippinensis. METHODS:The properties and micro-scopic characteristics were observed;TLC was adopted for qualitative identification of genistin and genistein;the moisture,total ash and extract were detected;HPLC was adopted for contents determination of genistin and genistein:the column was Thermo BE-TASIL C18 with mobile phase of Acetonitrile-0.5% glacial acetic acid(gradient elution)at a flow rate of 1.0 ml/min,the detection wavelength was 261 nm,column temperature was 25℃,and the injection volume was 10μl. RESULTS:The properties and micro-scopic characteristics of F. philippinensis and F. macrophylla showed strong specificity. TLC spots of genistin and genistein we- re clear and well separated,with no interference in negative control. The moisture was 3.69%-8.37%,total ash was 1.72%-6.74%,and extract was 5.89%-19.65%. The linear range was 0.012 9-2.588 μg for genistin(r=0.999 9)and 0.004 6-0.923 2 μg for genistein (r=0.999 9);RSDs of precision,stability and reproducibility tests were lower than 3.0%;recoveries were 99.63%-101.87%(RSD=0.82%,n=6)and 97.19%-100.34%(RSD=1.23%,n=6). CONCLUSIONS:The method is simple,accurate and specif-ic,and can be used for the quality control of F. philippinensis.

Objective To explore the changing rule of schistosomiasis endemic situation in Gaoyou City,so as to provide the evidences for schistosomiasis control in lake and marshland regions. Methods The endemic data of schistosomiasis of Gaoy?ou City from 1970 to 2009 were collected to analyze the endemic patterns of schistosomiasis in different control stages compre?hensively. Results In the first years of infection control stage(1970-1975),transmission control stage(1976-1994)and transmission interruption stage(1995-2009),the prevalence rates of schistosomiasis were 4.20%,0.80%and 0 in human and 3.00%,0.51%and 0 in cattle respectively. In 1984,the positive rate of crowd stool tests fell to 0.04%,which was reduced by 99.05%compared with that in 1970. From 1970 to 1980,the positive rates of stool tests of people and livestock were positively correlated significantly(r=0.67,P<0.05). After 1985,no local infection patients or cattle were found. No schistosome infect?ed Oncomelania hupensis snails were found from 1970 to 2009. Conclusion The comprehensive control measures have been insisted in Gaoyou City in different prevention and control stages. Although the snail situation is undulate,the prevalence of schistosomiasis steadily declines and the interruption of transmission has achieved.

OBJECTIVE To survey the therapeutic effect of lamivudine alone or in combination with bicyclol on chronical viral hepatitis B.METHODS Ninety patients with chronic viral hepatitis B were divided into 3 groups: A,B and C.Patients of group A(n=30) were given each 100mg lamivudine po qd,and 25 mg(bicyclol) po,tid,and the course of treatment lasted 72 weeks.Patients of group B(n=30) were subjected to(lamivudine) treatment alone at the same dosage as that of patients in group A.Patients of group C(n=30) were treated with(conventional) hepatinica and symptomatic therapeutic measures,serving as controls.Changes in serum HBV DNA and liver functions and YMDD mutant were dynamically monitored.RESULTS At the end of the 24,48 and 72 weeks of treatment,the rates of sera to turn negative for HBV DNA were 90.0%,(86.7%,) and(83.3%),(respectively),in patients of group A,and 86.7%,83.3%,and 76.7%,respectively,in patients of group B.The rates of sera to turn negative for HBV DNA,in patients of groups A and B were significantly higher than those in patients of group C(P0.05);at the end of 72 weeks,the rates of YMDD mutant were 16.7% in group A and 36.7% in group B,the rates in group A were significantly higher than in group B((P