BACKGROUND:Accumulating studies have confirmed the excellent effectiveness of local infiltration analgesia, but the literature analysis is mainly limited to within 1 day after total knee arthroplasty or shorter period.
OBJECTIVE:To study the effectiveness of local infiltration analgesia (LIA) at low concentration after total knee arthroplasty, and to observe the analgesic effect at rest and movement states.
METHODS:Thirty patients undergoing total knee arthroplasty were randomly al ocated to control group and LIA group, receiving oral non-steroidal anti nflammatory drug (celebrex) and low concentration of ropivacaine (0.1%) for epidural analgesia. Control group was injected with 0.9%saline 150 mL, while LIA group was injected with equal volume of solution include ropivacaine 300 mg, morphine 5 mg and epinephrine 10μg. The rest pain and motion pain of patients in two groups were evaluated at 6, 12, 24, 36, 48 hours after operation by using visual analogue scale. The incidence rate and degree of nausea, vomiting, numbness and muscle weakness of the legs were observed after operation. The incision healing was also recorded.
RESULTS AND CONCLUSION:Visual analogue scale pain scores in the LIA group were significantly lower than the control group at 6, 12, 24 and 36 hours at rest (P<0.05), at 6, 12, 24, 36, 48 hours on movement (P<0.05). At 6 and 12 hours, there was no difference in the rest and motion pains in the LIA groups (P>0.05). No patient appeared drowsiness, nausea, and vomiting in both groups. Two patients in each group complained of slight numbness in legs. No case influenced function exercise because of muscle weakness. Al the wounds healed and there were no incision infections in two groups. Combined with oral non-steroidal anti-inflammatory drug and low concentration of ropivacaine for epidural analgesia, the local infiltration analgesia technique in total knee arthroplasty is effective in early post-operative pain management, and produces no analgesia related adverse reactions.

Objective To explore the clinical the efficacy of large diameter esophagogastric internal fistula combined with fundoplication and modified Heller surgery for treatment of achalasia.Methods From June 2008 to March 2014,18 patients diagnosed as achalasia were se-lected into this suty,and they were divided into the observation group (8 cases)and the control group (10 cases).Patients of the observation group were received large diameter esophagogastric internal fistula combined with fundoplication while patients of the control group received modified Heller surgery.Compared the surgical curative effect and complications between the two groups.Results All the 18 patients suc-cessfully completed the arranged surgical treatment.The imaging examination 3 months after the operation showed that the contrast agent suc-cessfully passed through the esophagus,cardia and the anastomosis,and then went into the gastric lumen.The total effective rate was 100% in the observation group 12 months after operation,while it was 60% in the control group,and the difference between the two groups was statisti-cally significant (P =0.014).The incidence of complications in the observation group was lower than that of the control group,the difference was statistically significant (P =0.026).Conclusion Large diameter esophagogastric internal fistula combined with fundoplication for treat-ment of achalasia is safer,and there is a possibiltiy to cure the achalasia.

Aim To test the skin healing and repairing efficacy and the mechanism of Hibiscus rosa-sinensis L bud extract by using the animal models. Methods KM mice were randomly divided into three groups:the model group, the positive control group, and the n-bu-tyl alcohol extract ( HrBN) group. Using the boils and carbuncles model, the healing condition of all the animals were observed. KM mice were kept in the SPF condition room and divided into five groups: the model group, the positive control group, and the low, middle, high dose groups. Using the full-thickness loss model, the repairing results of all the mice were ob-served. Through the antimicrobial test, the results of MIC and inhibition zone were obtained. The carbon clearance test was used to collect the blood at the time 5min and 15min, and get the liver and spleen, and the results of K andαwere obtained. Results In vivo ex-periments showed there was significant difference be-tween groups;the HrBN extract had the outstanding ef-ficacy in healing and repairing skin boils and full-thickness loss models. It had higher recovery rate than other ethanol extract, such as ethyl acetate extract and chloroform extract. In vitro experiments showed that the HrBN extract, ethyl acetate extract ( HrBE) ,AB-8 macroporous resin 30% alcohol part and 60% alcohol part had obvious antimicrobial efficacy. The carbon clearance test showed HrBN had a good effect in im-proving immune function, and it can increase the K and α. Conclusion HrBN in animal models exerts good skin healing and repairing efficacy, which might be related to its antibacterial activity and immunologic enhancement function.

In order to provide a scientific basis for the establishment of a Daphnes Cortex medicinal material fungus library and the screening of endophytic fungi that promote the growth of Daphnes Cortex and increase the content of daphnetin, we used Illumina high-throughput testing technology to analyze 9 Daphnes Cortex samples from Gansu and Shanxi provinces. A total of 632 766 valid sequences were obtained, including 348 OTUs, 4 phyla, 20 classes, 48 orders, 108 families, 154 genera, and 208 species. The sum of the first 3 fungal genera account for more than 65% of the total abundance, with the highest reaching 98.4%. Alternaria and Phoma are the main genuses of Daphne giraldii Nitsche, and Altemaria is the dominant genus. The endophytic fungi community of Daphnes Cortex is rich in diversity, and the order of fungal diversity in different producing areas is: Gangu County > Wutai County > Tanchang County.

OBJECTIVE This study aimed to optimize polysaccharides extraction from Urena lobata L.and investigate its antioxidant activity.METHODS The mathematical model was established by re-sponse surface method (RSM) based on the results of single factor experiments, using polysaccha-rides extraction rate as response value,and using the ratio of water to material,cellulase concentra-tion,extraction temperature and time as experimental factors,which was used to screen optimum poly-saccharide extraction conditions from Urena lobata L.. Antioxidant activity of polysaccharides was stud-ied by DPPH and ·OH free radical elimination method. RESULTS The optimum conditions obtained by RSM were as follows:the cellulase level was 10.8 g·L-1,extraction time duration was 72 min,the ra-tio of water to feedstock was 7 mL·g-1,extraction temperature was 43℃,the pH value was 5.0.Under the optimal conditions, there was a difference of less than 5％ between predicted extraction rate 13.37％ and experimental extraction rate 13.32％. The polysaccharide yield was most significantly af-fected by cellulase concentration,followed by extraction time,water to material ratio and extraction tem-perature.IC50of DPPH and·OH were 1.082 g·L-1and 3.202 mg·L-1,respectively.Antioxidant activity of sample polysaccharides was weaker than those of vitamin C. CONCLUSION The polysaccharide extraction process from Urena lobata L. by cellulase enzymolysis approach was obtained, which was convenient and feasible,and extracted polysaccharides had good free radical scavenging activity.

OBJECTIVETo summarize characteristics and outcomes of critically ill children with 2009 influenza A (H1N1).

METHODA prospective observational study of 14 critically ill children with 2009 influenza A (H1N1) in pediatric intensive care unit (PICU) in Suzhou between Oct. 1(st) 2009 and Dec. 25(th) 2009. The primary outcome measures included frequency and duration of mechanical ventilation and duration of ICU stay.

RESULTCritical illness occurred in 14 patients with confirmed (n = 14), community-acquired 2009 influenza A virus (H1N1) infection. The mean (SD) age of the 14 patients with confirmed 2009 influenza A (H1N1) was (4.91 ± 4.14) years, 7 were female (50.0%). The median duration from symptom onset to hospital admission was (3.09 ± 1.30) days and from hospitalization to ICU admission was (0.95 ± 0.96) day. All the patients were severely hypoxemic [mean (SD) ratio of PaO2/FiO2 was (191.27 ± 80.58) mm Hg] at ICU admission. ARDS occurred in 11 cases (78.6%). Mechanical ventilation was applied for 10 patients (71.4%). The median duration of ventilation was (12.51 ± 10.03) days and ICU stay was (12.58 ± 10.65) days. The median length of time during which the real-time RT-PCR test results were positive was (17.27 ± 5.57) days; Comorbidities such as iron deficiency anemia, cerebral palsy and congenital heart disease were found in 8 cases (57.1%). The longer length of mechanical ventilation and ICU stay were found in cases with higher admission PRISM III Score and lower Pediatrics Critical Illness Score.

CONCLUSIONCritical illness due to 2009 influenza A (H1N1) in Suzhou occurred rapidly after hospital admission and was associated with severe hypoxemia, ARDS, a condition that required prolonged mechanical ventilation. There were myocardial damages in critically ill children with severe 2009 influenza A (H1N1).

Child ; Child, Preschool ; Critical Illness ; Female ; Humans ; Infant ; Influenza A Virus, H1N1 Subtype ; Influenza, Human ; diagnosis ; epidemiology ; virology ; Male ; Prognosis ; Risk Assessment

This study aims to clarify out the anti-inflammatory mechanism of Qingfei Xiaoyan Wan. Chemical constituents of Qingfei Xiaoyan Wan identified by UPLC Q-TOF, were submit to Molinspiration, PharmMapper and KEGG bioinformatics softwares for predicting their absorption parameters, target proteins and related pathways respectively; and the gene chip and real time-PCR were carried out to investigate the expression of inflammatory genes on lung tissue of guinea pigs or human bronchial epithelial cell lines. The predicted results showed that 19 of the 24 absorbable constituents affected at 9 inflammation-related pathways through 11 protein targets; Qingfei Xiaoyan Wan treatment can significantly reduce the infiltration of cytokines through ERK1 gene and 5 inflammatory pathways (Focal adhesion, Fc epsilon RI, Toll-like receptors, NK cell-mediated cytotoxic, and ERK/MAPK). The results of real time-PCR further confirmed that the anti-inflammatory effects of Qingfei Xiaoyan Wan were due to active ingredients such as arctigenin, cholic acid and sinapic acid intervened focal adhesion, Fc epsilon RI signaling and ERK/MAPK pathways. The novel approach of 'drug-target-pathway' will present an effective strategy for the study of traditional Chinese medicines.
Animals ; Anti-Inflammatory Agents ; pharmacology ; Asthma ; metabolism ; pathology ; Cell Line ; Cholic Acid ; pharmacology ; Coumaric Acids ; pharmacology ; Cytokines ; metabolism ; Drug Combinations ; Drugs, Chinese Herbal ; pharmacology ; Epithelial Cells ; drug effects ; Female ; Furans ; pharmacology ; Guinea Pigs ; Humans ; Inflammation ; metabolism ; Lignans ; pharmacology ; Lung ; pathology ; MAP Kinase Signaling System ; Male ; Random Allocation ; Receptors, IgE ; metabolism ; Toll-Like Receptors ; metabolism

OBJECTIVETo observe the dynamic expression of calcium-sensing receptor(CaSR) in myocardium of diabetic rats.

METHODSThirty male Wistar rats were randomly divided into 3 groups including control, diabetic-4 week and diabetic-8 week groups(n = 10). The type 2 diabetes mellitus models were established by intraperitoneal injection of streptozotocin (STZ, 30 mg/kg) after high-fat and high-sugar diet for one month. The cardiac morphology was observed by electron microscope. Western blot analyzed the expression of CaSR, phospholamban (PLN), a calcium handling regulator, and Ca+-ATPase(SERCA) in cardiac tissues.

RESULTSCompared with control group, the expressions of CaSR and SERCA were decreased, while the expression of PLN was significantly increased in a time-dependent manner in diabetic groups. Meanwhile diabetic rats displayed abnormal cardiac structure.

CONCLUSIONThese results indicate that the CaSR expression of myocardium is reduced in the progression of DCM, and its potential mechanism may be related to the imnaired intracellular calcium homeostasis.

Animals ; Calcium-Binding Proteins ; metabolism ; Diabetes Mellitus, Experimental ; complications ; Diabetes Mellitus, Type 2 ; Diabetic Cardiomyopathies ; metabolism ; physiopathology ; Disease Progression ; Heart ; physiopathology ; Male ; Myocardium ; metabolism ; pathology ; Rats ; Rats, Wistar ; Receptors, Calcium-Sensing ; metabolism ; Sarcoplasmic Reticulum Calcium-Transporting ATPases ; metabolism ; Streptozocin

OBJECTIVETo investigate the anti-inflammatory effect of Herba Siegesbeckiae extracts on mouse rheumatoid arthritis induced by arthrogen-CIA monoclonal antibody.

METHODSThe rheumatoid arthritis was induced by arthrogen-CIA arthritogenic monoclonal antibody in mice. The sandwich enzyme-linked immunosorbent assay was used to determine the concentration of IL-1βin mouse serum,and the content of IL-6,IL-17 and MMP-3 in supernatant of tissue homogenate of hind limb below the stifle of mice. One-way ANOVA was used for data analysis.

RESULTSThe toe swelling was attenuated in Siegesbeckiae group than that in model group [(0.218 ± 0.0307)cm(3) compared with (0.2545 ± 0.0179)cm(3), P<0.05]. The serum IL-1β level in Siegesbeckiae group was lower than that in model group [(63.74 ± 21.74)pg/ml compared with (104.96 ± 31.22)pg/ml, P<0.01]. The contents of IL-6, IL-17 and MMP-3 in tissue supernatants of Siegesbeckiae group were all lower than those of model group [(171.10 ± 48.35)pg/ml compared with (249.64 ± 75.08)pg/ml, P<0.05; (115.42 ± 56.52)pg/ml compared with (208.40 ± 88.54)pg/ml, P<0.05;(3660.31 ± 1680.99) pg/ml compared with (5420.79 ± 1201.43)pg/ml, P<0.05, respectively].

CONCLUSIONThe extract of Herba Siegesbeckiae has anti-inflammatory effect on mouse rheumatoid arthritis induced by mixed arthrogen monoclonal antibody.

Animals ; Anti-Inflammatory Agents ; therapeutic use ; Antibodies, Monoclonal ; Arthritis, Experimental ; drug therapy ; Arthritis, Rheumatoid ; chemically induced ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Enzyme-Linked Immunosorbent Assay ; Interleukin-17 ; metabolism ; Interleukin-1beta ; blood ; Interleukin-6 ; metabolism ; Matrix Metalloproteinase 3 ; metabolism ; Mice ; Mice, Inbred BALB C

OBJECTIVETo summarize early experience in combined thoraco-laparoscopic esophagectomy with two-field lymph node dissection for esophageal carcinoma.

METHODSA total of 150 patients with thoracic esophageal cancer who underwent combined thoracoscopic and laparoscopic esophagectomy in Union Hospital, Fujan Medical University, were enrolled in this study.

RESULTSLocations of the tumors included upper esophagus (n=14), middle esophagus (n=95), and lower esophagus (n=41). Pathological type showed squamous cell cancer (n=142) and other types of cancer (n=8). There was no intraoperative death. Conversion to open thoracotomy was required in 6 patients and conversion to open laparotomy in 2 patients. The average total operative time was( 258±45) min. The average operative thoracoscopic time was (140±33) min. The average time for gastric mobilization and neck esophagogastric anastomosis was (119±28) min. The average blood loss during the procedure was (207±130) ml. The average number of harvested lymph node with the specimen was 23.3±8.2. The tumor staging included stage I (n=39), II (n=58) and III (n=53). Postoperative complications occurred in 48(32%) patients including pneumonia (n=17), recurrent laryngeal injury (n=13), anastomotic leak (n=9), arrhythmias (n=9), chyle chest (n=5), delayed gastric emptying (n=5), ileus (n=2), volvulus (n=1), and thrombocytopenia (n=1). Two patients died postoperatively due to respiratory failure resulting from pneumonia.

CONCLUSIONThoraco-laparoscopic two-field lymph node dissection of esophageal cancer is a feasible minimally invasive approach.

Adult ; Aged ; Aged, 80 and over ; Esophageal Neoplasms ; surgery ; Esophagectomy ; methods ; Female ; Follow-Up Studies ; Humans ; Laparoscopy ; methods ; Lymph Node Excision ; methods ; Male ; Middle Aged ; Retrospective Studies ; Thoracoscopy ; methods