Objective To evaluate the efficacy and safety of continuous infiltration of Lidocaine in joint replacement surgery.Methods From May 2013 to October 2013,patients scheduled to undergo total hip or total knee arthroplasty were randomized into two groups:the local infiltration analgesia group received continuous infiltration of Lidocaine while the other group received PCIA filled with fentanyl after surgery.The equipments were removed 48 hours after the surgery.The visual analogue scale score at five points (immediate postoperative,24 hours after the surgery while resting,24 hours after the surgery while exercising,48 hours after the surgery while resting,48 hours after the surgery while exercising) were recorded and if the score was higher than 4,analgesics wound be given to the patients.The vital sign,blood test,ECG,the circumference of lower limbs,the range of motion of the joint,the rehabilitation and complications were also recorded.Results 42 patients were included,11 male and 31 female.There were 25 patients and 36 total knee arthroplasties.17 patients underwent a total of 19 hip arthroplasties.The demographic data,the diagnosis and the surgery type were comparable between two groups.The VAS scores at immediate postoperative,24 hours and 48 hours after the surgery while resting,the average dose of analgesics and the complication rate were statistically different be tween two groups.However,the VAS scores at 24 hours after the surgery and 48 hours after the surgery while exercising,the change of the circumferences of the lower limb,the range of motion of the joint,the rehabilitation satisfactory rate and length of stay were comparable between two groups,while no significant difference was observed.One patient in the PCIA group suffered from incision fat liquefaction and healed after three weeks.There were no infection and subcutaneous hydrocele in both groups.Conclusion Continuous infiltration of Lidocaine is more effective than the PCIA while resting after joint replacement surgery and no inferior to it while exercising.It can decrease the amount of Opioid.

Objective To investigate the effect of fire needling on tumor marker CA-125 levels and endometrial antibody (EMAb) in endometriosis patients.Methods Eighty endometriosis patients were randomly allocated to a treatment group of 43 cases and a control group of 37 cases. The treatment group received fire needling and the control group took gestrinone capsules. CA-125 levels and EMAb were measured in the two groups before and after treatment.Results CA-125 levels and EMAb positive rate decreased significantly in the two groups after treatment compared with before (P<0.05) but there were no statistically significant post-treatment differences between the two groups (P>0.05).Conclusion Fire needling has a good interference effect on CA-125 levels and EMAb in endometriosis patients.

Objective To ob serve the clinical effect of blood-activating and stasis-dissolving drugs combined with western medicine ( WM) for the treatment of recurrent spontaneous abortion ( RSA) induced by prethrombotic state ( PTS). Methods A total of 120 patients with RSA at PTS were randomly assigned to treatment group (68 cases) and control group (52 cases). Patients in both groups were treated with aspirin and low molecular weight heparin, while those in the treatment group additionally received Chinese medicine for activating blood and dissolving stasis. Before and after treatment, indexes of coagulation-fibrinolysis and the development of embryos were compared between the two groups. Results The therapeutic effective rate was 88.24% in the treatment group, higher than that of the control group ( 69.23%, P<0.05). The levels of plasma thrombin time ( TT) , D-dimer, fibrinogen and antithrombin Ⅲ ( AT-Ⅲ) were all improved ( P<0.05) in the two groups after treatment. Besides, the treatment group had better effect on improving levels of plasma D-dimer, fibrinogen and AT-Ⅲ ( P<0.05). During the treatment, no drug-induced adverse reaction was found. Neither neonatal deformity nor maldevelopment occurred. Ninety-seven cases achieved successful pregnancy, and 45 cases had given term girth ( 29 cases from the treatment group and 16 from the control group). Fifty-two cases were in stable middle- and late-stage of pregnancy. Conclusion Therapy of activating blood and dissolving stasis is an effective method for RSA at PTS. It has obvious effects on improving high coagulation state during pregnancy. Chinese medicine combined with WM shows better therapeutic efficacy than WM alone.

Objective To compare the clinical efficacy of postoperative analgesia between intercostal nerve freezing and con‐trolled intravenous analgesia in patients of thoracic surgery .Methods 80 patients of thoracic surgery from January 2012 to June 2013 were randomly divided into two groups :Intercostal nerve cryotherapy group (frozen group n=40) and intravenous analgesia group(control group n=40) .Frozen group :the intercostal incision and down each one intercostal and chest tube placement of inter‐costal nerve roots were frozen before sternal closure ;control group :intravenous analgesia pump were used postoperative .According to VAS method to evaluate pain level and observe adverse reactions ,complications and analgesic drug usage of postoperative pa‐tients .Results The analgesic effect of frozen group was better than that of control group within five days after thoracotomy .Com‐pared with the control group ,the incidence of adverse reactions ,postoperative complications ,and analgesic drug usage was signifi‐cantly reduced in frozen group ,there was a significant difference between the two groups (P<0 .05) .Postoperative follow‐up dis‐play :intercostal nerve area in some patients may appear numbness ,dysesthesia ,etc .,but the above situation can return to normal gradually .Conclusion The analgesic effect of intercostal nerve cryotherapy for thoracotomy patients is excellent ,and with few side effects and good safety ,and it is worthy of promotion .

Objective To evaluate the long-term efficacy and the influencing factors of biofeedback (BF) treatment in functional constipation (FC).Methods Totally 120 BF treated FC patients were retrospectively followed up.The clinical symptom score,the use of laxatives,the result of colonic transit test and anorectal manometry were compared before BF treatment and during follow-up.The long-term efficacy of biofeedback treatment was evaluated.Thirty-two possible influencing factors of long-term efficacy were selected and univariate and multivariate analysis were conducted.The groups were compared with t test,rank-sum test and x2 test.The influencing factors of long-term efficacy were analyzed with a stepwise multiple regression analysis.Results The median score of clinical symptoms in follow-up period (3) was significantly lower than that before BF treatment (10,Z=-7.900,P＜0.01).The total long-term efficacy rate was 70.6％ (77/109).During follow-up,the rate of laxatives use [39.4 ％ (43/109)] was lower than that before BF treatment [83.5％ (91/109),x2 =44.623,P＜0.01].During follow-up,the 48 hour median colonic emptying rate (30.0％)was higher than that before BF treatment (0,Z=-2.298,P=0.022).During follow-up,the proportion of patients with uncoordinated defecation (51.4％) was lower than that before BF treatment (77.1％,x2 =5.040,P=0.025).The results of univariate and multivariate analysis showed that the long-term efficacy of BF treatment was positively correlated with the compliance for home training and utilization of social support,negatively correlated with the course of disease.Conclusions BF therapy can improve clinical symptoms of FC patients,correct physiological dysfunction and have a satisfactory lon~term efficacy.Compliance for home training,utilization of social support and the course of disease were independent influencing factors.

Objective To compare the sedative and analgesic effects of remifentanil combined with propofol administered by target-controlled infusion(TCI)and intravenous infusion during local anesthesia.Methods Sixty ASA Ⅰ or Ⅱ patients,aged 18-55 yr,with body mass index ＜ 30 kg/m2,scheduled for plastic surgery under local anesthesia,were equally and randomly divided into TCI group(group T)and intravenous infusion group (group V).Remifentanil(the initial target plasma concentration 1.0 ng/ml)and propofol(the initial target plasma concentration 1.0 ng/ml)were given by TCI before local anesthesia in group T.Remifentanil was infused at a rate of 0.05 μg·kg-1 ·min-1 after a loading dose of 0.25 μg/kg and propofol was infused at a rate of 3 mg·kg-1 ·h-1 after a loading dose of 0.5 mg/kg in group V.The target plasma concentration or infusion rate was adjusted to maintain the modified OAA/S score of 2 or 3.Hypoxemia,bradypnea and/or apnea were recorded during operation.The total amount of remifentanil and propofol consumed was calculated.Results Compared with group V,the incidence of hypoxemia,bradypnea and/or apnea were significantly decreased during operation,and the total amount of remifentanil and propofol consumed was significantly reduced in group T(P ＜ 0.05).Conclusion The sedative and analgesic effects of remifentanil combined with propofol given by TCI are superior to those given by intravenous infusion during local anesthesia,with better safety.

Objective To investigate the significance of CD44v6 expression in acute leukemia( AL) and it's relation with the prognosis of AL. Methods Sixty AL patients were treated by enzyme linked immunosorbent assay( ELISA)as initial treatment group. Fourty-seven cases were remission as remission group, and 20 cases with no-remission group. Meanwhile,45 healthy people were served as the control group. The level of CD44v6 was measured by ELISA. Results The serum CD44v6 in initial treatment patients,remission group, no-remission group and control group were( 179. 34 ± 39. 41 )μg/L,( 190. 61 ± 28. 05 )μg/L,( 106. 72 ± 26. 38)μg/L and(98. 31 ± 21. 78)μg/L respectively,and the difference was significant( F =56. 303,P﹤0. 01),and the CD44v6 of initial treatment group and remission group were higher than that of no-remission group and control group(P﹤0. 05). The leukocyte levels was positive related to CD44v6 levels in 60 patients(r=0. 826,P﹤0. 01),and it was also related to disease stage,extramedullary infiltration(( r=0. 485,0. 512;P﹤0. 01). Conclusion The level of CD44v6 is closely related with the occurrence and development of acute leukemia. The assay of CD44v6 in serum of AL patients is helpful in diagnosing and predicting the risk of metastasis and prognosis in AL.

Objective To investigate the clinical efficacy of fire needling in treating endometriosis.Method Fifty-eight endometriosis patients were randomly allocated to treatment and control groups. The treatment group received fire needling at specific points. The treatment was given at one week before menstruation until the end of it, twice a week, three months as a course. The control group took gestrinone 2.5 mg from the first day of menstruation, twice a week, for three consecutive months. The therapeutic effects were evaluated in both groups at three months after the end of treatment.Result The cure rate and the efficacy rate were significantly higher in the treatment group than in the control group (P＜0.05). The pregnancy rate was also higher in the treatment group than in the control group (P＜0.05).Conclusion Fire needling treatment for endometriosis has the advantages of good therapeutic effect, high cure rate and no influence on pregnancy.

Objective To compare remifentanil?propofol target?controlled infusion ( TCI ) with sufentanil?propofol TCI for sedation and analgesia in the patients undergoing local anesthesia. Methods Sixty patients, aged 17?54 yr, with body mass index <30 kg∕m2, scheduled for elective plastic surgery underlocal anesthesia, were equally and randomly divided into remifentanil group (group R) and sufentanil group(group S) by using a random number table. Remifentanil (the initial target plasma concentration 1?? 0ng∕ml) and propofol (the initial target plasma concentration 1?? 0 μg∕ml) were given by TCI in group R.Sufentanil (the initial target plasma concentration 0?? 10 ng∕ml) and propofol (the initial target plasma con?centration 1?? 0 μg∕ml) were given by TCI in group S. The target plasma concentration was adjusted to main?tain the modified Observer′s Assessment of Alertness∕Sedation Scale score of 2 or 3. The occurrence of painresponses, hypoxemia, bradypnea and∕or apnea was recorded during operation. The total amount of propofolconsumed was calculated. Results There was no significant difference in the incidence of pain response,hypoxemia, bradypnea and∕or apnea, and total amount of propofol consumed between the two groups (P >0?? 05). Conclusion Remifentanil?propofol TCI provides similar sedative and analgesic efficacy to that a?chieved by sufentanil?propofol TCI in the patients undergoing local anesthesia.

Objective The purpose of the study was to investigate clinical manifestation and the characters of diagnosis and treatment among children with primary angiitis of the central nervous system (cPACNS) in order to improve awareness of the disease.Methods Clinical data of 5 children with cPACNS in the First People's Hospital of Yunnan Province from January 2009 to December 2013 were collected,and the clinical manifestations and laboratory test results were analyzed and summarized.Results Five cases of children with cPACNS were misdiagnosed at the first clinic visit,and were confirmed a clear diagnosis on the average of (4±6) months; clinical manifestations of five cases of varying degrees of headache,one case with severe headache,2 patients with decreased visual acuity,a cases with hearing were loss,two cases with secondarily generalized seizures; five cases with mild abnormal cerebrospinal fluid examination; 1 case with elevated ESR and CRP level,1 case with elevated immunoglobulin IgG level; 5 cases with abnomal MRI examinations,which showed multiple bilateral lesions,diffuse,lesions,involving the cortex and deep white matter; 4 cases had vascular abnormalities on MRA,treated with corticosteroids alone or in combination with cyclophosphamide and achieved good results.Conclusion Children of primary central nervous system vasculitis is ar are autoimmmune disease primarily involving the central nervous system.It is difficult for the clinical diagnosis.Children need to be wary of the major manifestation of headache associated with vision loss,hearing loss,seizures and other focal neurological system damage.