Objective To observe the effect of combined continuous femoral nerve blockade (CFNB)with epidural morphine postoperative analgesia on total knee arthroplasty (TKA)in elderly patients.Methods Eighty elderly patients scheduled to undergo TKA were randomly divided into two groups:groups FN and FNM.Groups FNM and FN were received 0.1% morphine 2 ml and normal saline 2 ml through epidural space respectively at the end of surgery.After surgery,all patients were implanted catheter around femoral nerve guided by ultrasound,and were infused 0.2% ropivacaine 25 ml.Continuous infusion of 0.2% ropivacaine for femoral never block was administrated at a rate of 5 ml/h for 48 hours to all patients.VAS scores and bending degree during rest,active and passive exer-cise were recorded at time point of postoperative 24,48,72,96 h.Ambulation status on the fifth day after operation were observed.Satisfaction of hospitalization were graded before hospital discharge. Results Compared with group FN,VAS scores during rest,active and passive excercise were signifi-cantly decrease at 24 h in group FNM (P <0.05 or P <0.01).The bending degree of knee joints in group FNM were significantly greater compared with group FN at 24 h after surgery (P <0.01).Am-bulation status on the fifth day after surgery were significantly better in group FNM compared with group FN (P <0.05).The level of patient satisfaction was much higher in group FNM (P <0.05). Conclusion After TKA,CFNB combined with single epidural morphine injection can provide better analgesia and bending degree with a high level of satisfaction.

To observe the effects of Fuhuang Shengji Yuchuang (FHSJYC) Ointment, a compound traditional Chinese herbal medicine, on the expressions of types I and III collagens in granulation tissue of wound in rats with diabetes.

Objective To compare in-vitro percutaneous absorption and pharmacodynamic actions of anti-inflammation and inhibiting delayed-type hypersensitivity of Chinese herbal compound cremor for eczema (CHCCE) with different mass concentrations of synthetic borneol. Methods By adopting modified Franz diffusion device add with isolated BALB/cnude mice skin as a barrier, in vitro percutaneous absorption effectiveness of CHCCE with different mass concentrations of borneol was compared by in vitro percutaneous test after the content of matrine was determined with high performance liquid chromatography(HPLC). Meanwhile, the effects of CHCCE with different mass concentrations of synthetic borneol on reducing dimethylbenzene-induced auricular edema and suppressing delayed-type hypersensitivity induced by 2,4-dinitrochlorobenzene(DNCB) in mice were compared. Results Cumulative permeation amount of matrine in CHCCE with synthetic borneol was higher than that in CHCCE without synthetic borneol 2～ 48 h after administration (P < 0.05). There was no significant difference of cumulative permeation amount (P>0.05) among CHCCE groups with different mass concentrations of synthetic borneol after 48 h. In vitro percutaneous absorption behavior of matrine arrived to the steady state and the cumulative permeation amount of matrine presented a decreasing trend in all medication groups 12 h after administration. Within 12 h of the medication, the permeation rate of CHCCE with different mass concentrations of borneol was in the sequence of 3％ borneol > 1％ borneol > 2％ borneol > 0.5％ borneol > no borneol. The content of matrine was decreased with the increase of mass concentration of synthetic borneol after 12 h. The results of pharmacodynamic actions of CHCCE showed that compared with the blank control group, CHCCE with 1％, 3％ synthetic borneol could significantly suppress the acute inflammation induced by dimethylbenzene and inhibit contact dermatitis induced by dinitrochlorobenzene (DNCB) in mice(P < 0.05). Compared with Triamcinolone Acetonide Acetate and Miconazole Nitrate and Neomycin Sulfate Cream, CHCCE with 1％, 3％synthetic borneol could decrease the serum level of IL-4, but the difference was insignificant(P>0.05). Conclusion CHCCE with 1％ synthetic borneol has good effects on in vitro transdermal absorption, and can suppress inflammation and delayed-type hypersensitivity effectively.

Aim To study the effects of propofol on apoptosis of cortical astrocytes isolated from neonatal rats.Methods Pure astrocytes(AST)were obtained from the cultured cerebral cortical cells and identified by the GFAP stain technology in neonatal rats.AST cells were treated with different concentrations of propofol(0,10,30,90 μmol·L-1)for 8 hours.Cell viability was measured by MTT method,and the apoptosis was detected by Annexin V/PI double staining.Cytochrome C(cyt-C)leakage was detected by Western blot.Caspase-3 and caspase-9 activities were measured by spectrophotometry.Results AST cells were administered with different concentrations of propofol(0,10,30,90 μmol·L-1)for 8 hours.It decreased the survival rate in a concentration-dependent manner,induced the leakage of cyt-C in mitochondria,up-regulated the expression of pro-apoptotic protein caspase-3 and caspase-9,and induced AST apoptosis.Conclusion Propofol induces the apoptosis of astrocytes in neonatal rat cortex in vitro,which may be related to the activation of mitochondria apoptosis pathway induced by mitochondrial cyt-C release.

With the rise of microecology and medical model getting into the stage of the development of the ecological medicine, the intersection and consistency in the cognition traditional of Chinese and Western medical system are highlighted. Yin-yang theory is the core theory in TCM. In order to extend the guidance effects of theory of the balance of yin and yang in the clinic, and help TCM theory and curative effect be further recognized by the world, this article analyzed the consistency of different systems by comparing TCM balance theory and microecology, with a purpose to explore the closed link between TCM balance theory and microecology and microscopic nature of TCM balance theory.

ObjectiveTo determine the prevalence of nutritional risk and application of nutrition support in hospitalized patients in the department of general surgey,and to evaluate the relationship between nutrition support and clinical outcome as well as between nutritional risk and clinical outcome.MethodsHospitalized patients in the department of general surgery were enrolled from September 2009 to April 2010.The patients were screened using Nutritional Risk Screening 2002 ( NRS 2002) on admission.Data were collected on the application of nutrition support within 2 weeks,complication rate,length of stay,and hospital charges.ResultsAltogether 3000 patients were included in the present study.The overall prevalence of nutritional risk was 18.5％,in which gastric cancer patients showed the highest prevalence (48.3％ ).The proportion of patients receiving nutrition support was 44.1％ in those with nutritional risk and 14.3％ in those without nutritional risk.The ratio of parenteral nutrition to enteral nutrition was 1.2:1.The patients with nutritional risk had higher complication rate,longer length of stay,and higher hospital charge [24.1％ vs.14.2％,(11.1 ±4.8) daysvs.(9.6±3.7) days,(12891.5±4831.2) yuan vs.(9982.7 ±3996.4) yuan,all P=0.0000].Among the gastric cancer,colorectal cancer,and hepato-biliopancreatic cancer patients with nutritional risk,the complication rate,length of stay,and hospital charge were significantly lower in the patients receiving nutrition support than those in the patients receiving no nutrition support ( all P ＜ 0.05 ).ConclusionsA number of inpatients in general surgery department are at nutritional risk.The prevalence of nutritional risk is considerably high in gastric cancer patients.Nutritional risk is correlated with the clinical outcome of the patients.Nutrition support may improve the clinical outcome of gastric cancer,colorectal cancer,and hepato-bilio-pancreatic cancer patients.

p53, as a transcription factor, is an important tumor suppressor gene and plays the key role in the p53-dependent gene regulatory network. Therefore, it is important to understand its biological function at the level of the whole system. In this paper, based on KEGG database and related literatures in English and Chinese, the interaction mode and quantitative relationship of the related molecules involved in p53 signaling pathway were extracted. By using S-system equations and 'Simulink' toolbox of Matlab7.0, a dynamic model of p53 signaling pathway was developed, and the dynamic regulatory characteristics of p53 signaling pathway were analyzed on model simulation. The results were in accord with the literatures and could reflect quantitatively the complex regulatory relationship between the interacting molecules involved in p53 signaling pathway. In addition, model simulation helped us find and identify the key molecules in this signaling pathway. Thus, this model can be used as a basis for the follow-up study of the relationship by precise and quantitative assessment.
Algorithms ; Computer Simulation ; Gene Expression Regulation ; Humans ; Models, Biological ; Signal Transduction ; physiology ; Transcription Factors ; genetics ; metabolism ; Tumor Suppressor Protein p53 ; genetics ; physiology

OBJECTIVETo establish an effective laboratory examination system for carrier detection and prenatal diagnosis of haemophilia Alpha(HA) with a variety of molecular biological methods which are simple,rapid and easy to use.

METHODSDetection of inversion involving intron 22 in the FVIII gene was completed by long distance polymerase chain reaction (PCR) and linkage analysis was performed by using several genetic polymorphisms including an intragenic Bcl I RFLP, 2 STRs and an extragenic St14 VNTR.

RESULTSIntron 22 inversion was observed in 10 out of the 21 (47.6%) pedigrees examined. Prenatal diagnosis was completed in 3 pedigrees. A further combination of the four intragenic and extragenic polymorphic loci gave an informative rate of 94.7%.

CONCLUSIONSFemale relatives in HA families with inversion can be detected with direct diagnostic procedure. The application of long distance PCR makes the detection much more simple and rapid. For families without inversions,it is easier and more cost-effective to undertake linkage analysis of genetic polymorphism based on PCR.

Chromosome Inversion ; Female ; Genetic Carrier Screening ; Hemophilia A ; diagnosis ; genetics ; Humans ; Introns ; Minisatellite Repeats ; Polymorphism, Restriction Fragment Length ; Pregnancy ; Prenatal Diagnosis

Objective:To investigate the association between Onodera's prognostic nutritional index (OPNI) and postoperative adverse outcomes in elderly gastrointestinal surgery patients and assess the predictive value.Methods:A total of 230 elderly patients who received gastrointestinal surgery were prospectively enrolled. Clinical data, including age, sex, preoperative laboratory parameters, surgery process and clinical outcomes, were collected. The optimal cut-off value of OPNI was obtained using NRS 2002, a well-recognized nutritional risk screening tool, as the standard. The associations of OPNI, geriatric nutritional risk index (GNRI) and albumin with in-hospital mortality, complication incidence and duration of postoperative hospital stay were evaluated using Chi-square test or nonparametric test as appropriate. Confounders were identified through univariate analysis and logistic and linear regression models were developed to validate the correlation and assess the predictive value of OPNI for postoperative clinical outcomes.Results:The optimal cut-off value for the OPNI was 41.25, which yielded a sensitivity of 72.7% and a specificity of 59.9% with area under the curve (AUC) at 0.682. The incidence of OPNI-based malnutrition (defined as OPNI < 41.25) was 50% (115/230). Univariate analysis indicated that patients with OPNI < 41.25 had a significantly higher mortality (8.70% versus 2.61%, P = 0.046) and complication incidence (20.00% versus 9.57%, P = 0.026) and significantly longer postoperative hospital stay (11.17 d versus 8.49 d, P = 0.009) than patients with OPNI ≥ 41.25. Patients with GNRI < 98 had a longer postoperative hospital stay than those with GNRI ≥ 98 (10.71 d versus 7.55 d, P = 0.001) while there was no significant difference in mortality or complication incidence between the two groups ( P > 0.05). As for subgroups divided according to albumin levels (< 35 g/L or ≥35 g/L), no significant differences in mortality, postoperative complications incidence, or duration of postoperative hospital stay were observed ( P > 0.05). Multivariate analysis verified that OPNI < 41.25 was an independent risk factor for the development of postoperative complications ( OR: 2.660, 95% CI: 1.079-6.557, P = 0.034) and prolonged postoperative hospital stay ( R2 = 0.135, regression coefficient = 2.73, P = 0.047), where the AUC of the regression model for complications was 0.812 (95% CI: 0.741-0.882). GNRI < 98 was the independent risk factor for prolonged postoperative hospital stay ( R2 = 0.134, regression coefficient = 2.797, P = 0.049). Conclusion:OPNI is an independent risk factor for adverse clinical outcomes after gastrointestinal surgery in elderly patients and demonstrates good predictive value with the cut-off value of 41.25.

Objective To study the pharmacokinetics and metabolism of arsenic trioixide (As2O3) and its main side effects.Method As2O3 was administered intravenously at the dose of 10 mg per day for the treatment of 8 relapsed acute promyelocytic leukemia (APL) patients. The arsenic content was measured by Gas-phase chromotography. Results The plasma maximal concentration (Cpmax) was 0.94±0.37 mg/L (±s), time to peak concentration (Tp) was 4 hours, plasma distribution half-time (t1/2α) and elimination half-time (t1/2β) were 0.89±0.29 hours and 12.13±3.31 hours, respectively. Apparent distribution volume (Vc) was 3.83±0.45 L, system clearance (CLs) was 1.43±0.17 L/h, and area under curve (AUC) was 7.25±0.97 mg*h/L. The continuous administration of As2O3 did not alter its pharmacokinetic behaviors. During As2O3 treatment, 24-hour arsenic content in urine accounted for 1%-8% of the dialy dose (10 mg). When arsenic accumulation in hair and nail increased continuously, the peak concentration could be five to seven-fold higher than that of pre-treatment. Importantly, arsenic contents in both urine and hair or nail declined gradually after drug withdrawal. No bone marrow suppression or severe organ-impairment was found.Conclusion As2O3 is a relatively safe and effective remedy in the treatment of patients with relapsed APL, in spite of certain degree of arsenic accumulation in some tissues.