0.05).However,there were significant differences between group C and A,group C and B,respectively(Pa

Objective To investigate the accuracy of analgesia/nociception index (ANI) in assessing the severity of postoperative pain in patients.Methods Eighty patients,aged 21-77 yr,of American Society of Anesthesiologists physical status Ⅰ-Ⅲ,scheduled for elective operation,were admitted to the postanesthesia care unit after the patients were extubated at the end of operation,and ANI was monitored.Immediately after admission to the postanesthesia care unit (T0),numerical rating scale (NRS) score was recorded.If NRS score was 0-3,the patients received no treatment,and NRS score was recorded again 10 min later (T1).If NRS score was 4-10,fentanyl 50 μg was injected intravenously,and NRS score was recorded again 5 min later (T2).ANI value was recorded at T0,T1 and T2.NRS score was considered as the criterion for assessment of the severity of pain.The receiver operating characteristic curve was used to analyze the sensitivity and specificity of ANI in determining NRS scores,the cut-off value was determined,and the area under the curve and 95％ confidence interval were calculated.Pearson correlation was used to analyze the correlation between ANI and NRS score.Results The area under the curve (95％ confidence interval) of ANI in determining NRS scores was 0.873 (0.816-0.929),and the cut-off value was 45 with a sensitivity of 74.8％ and a specificity of 87.5％.ANI was negatively correlated with NRS score,and the correlation coefficient was-0.705 (P＜0.05).Conclusion ANI provides high accuracy in assessing the severity of postoperative pain with a cut-off value of 45 in the patients.

Objective To assess the safety and effectiveness of nasegastric enteral nutrition (NGEN) in patients with severe acute pancreatitis (SAP).Methods A meta-analysis of all the relevant clinical trials was performed.Clinical trials were identified from the following electronic databases:Medline,EMBASE,the Cochrane Controlled Trials Register,and Chinese Bio-medicine Database.The search was undertaken in October 2008.The literature quality was evaluated with Cochrane Handbook 5.0.The statistical analysis was performed by RevMan 4.2 software.Results Four trials involving 157 patients were included.The combined results showed that no significant differences in the safety and tolerance between nasogastric and conventional routes in patients with SAP.Conclusions Currently available data show early NGEN appears to be effective,safe,and tolerable in patients with SAP.However,more large-scale high-quality trials are required to further elucidate this topic.

This article was aimed to explore the method of traditional Chinese medicine (TCM) health maintenance knowledge base building. TCM health maintenance knowledge classification method was studied under the guidance of TCM health maintenance classification system to construct a special literature database to store TCM health maintenance knowledge. Based on TCM literature resources, TCM health maintenance knowledge service platform was designed and developed for the static display and dynamic query support of TCM health maintenance knowledge. The content of knowledge base will be accessed to the whole society. The results showed that the construction method can be a system arrangement and modern interpretation of TCM health maintenance knowledge, in order to support TCM health maintenance knowledge base and its update and service system. It was concluded that under the guidance of TCM theories, the construction of TCM health maintenance knowledge base will realize the health maintenance knowledge-sharing and service requirement of TCM.

To study the changes of metabolites in rat urine after treatment of Aristolochia fangchi decoction by metabonomic method.

Objective To observe the reactivity of pupillary diameter variation responding to numerical rating scale on postoperative pain to explore the accuracy of pupillary diameter variation for pain assessment.Methods Eighty patients after selected surgery (male 43 cases,female 37 cases,aged 24-79 years,ASA gradeⅠorⅡ)were included for the trial.After endotracheal extubation and on arri-val in the post-anaesthesia care unit (PACU),the levels of pain on numerical rating scale (NRS)were rated and recorded subsequently.If NRS was within 0-3,no analgesic was administered and 50 μg fentanyl was administrated after 5 min if NRS rated in 4-10.The pupillary diameter (PD),systolic blood pressure (SBP)and heart rate (HR)were recorded every minute during 20 minute after first NRS evaluation,the corresponding maximum variation of above index were calculated simultaneously in 10 minutes with NRS 0-3,after 5 minutes with NRS 0-3 to 4-10,after 5 minutes with NRS 4-10 to 0-3,in 10 minutes with NRS 4-10 which were marked respectively with ΔPD,ΔSBP and ΔHR.With the variation of NRS as a criterion,the reactivity of ΔHR,ΔSBP and ΔPD responding to NRS varia-tion were assessed by analysing the receiver operating characteristic curve (ROC),the area under the receiver operating characteristic curve (AUC)was calculated.Results The patients' ROC value ofΔHR,ΔSBP and ΔPD responding to NRS variation were AUCΔPD 0.904 (95% CI 0.822-0.987 ), AUCΔSBP 0.65 1(95%CI 0.5 10-0.781)and AUCΔHR 0.588(95%CI 0.444-0.733)respectively.Value of AUCΔPD was larger than that of AUCΔSBP and AUCΔHR respectively (P < 0.05 ).Importantly, operating characteristic curve (ROC)analysis showed that the diagnostic cutoff value of ΔPD was 41.3% with a sensitivity of 80.0% and a specificity of 93.5% and the diagnostic cutoff value of ΔSBP was 10.3% with a sensitivity of 62.4% and a specificity of 71.5%.Conclusion This study demon-strated that the accuracy of ΔPD was higher than ΔSBP and ΔHR responding to pain/analgesia evalu-ation.ΔPD was a valuable index for assessment of postoperative pain.

Objective To establish the MCF-7 cell models of Beclin 1 over-and low-expressions,and to detect the autophagic and apoptotic changes after 4 Gy irradiation,and to explore their molecular regulation mechanisms. Methods MCF-7,MCF-7 + 4Gy,MCF-7-Beclin 1 + 4Gy and MCF-7-Belcin 1 RNAi+ 4Gy groups were set up. Molecular biology method was used to construct Beclin 1 over-expression vector pcDNA3.1-Beclin 1,and to estabilish the Beclin 1 over- and low-expression cell models.After the cells were irradiated with 4 Gy, the autopahgic cell percentages were measured by fluorescence microscope with MDC staining, the apoptotic cell percentages were measured by FCM with AnnexinⅤ-FITC and PI staining,and the expressions of Beclin1,P53, Bcl-2 and Bax proteins were measured by Western blotting method.Results Compared with MCF-7 group,the autophagic and apoptotic cell percentages in MCF-7+4 Gy,MCF-7 Beclin 1 +4 Gy and MCF-7-Beclin 1 RNAi+4 Gy groups were significantly increased (P <0.05 or P <0.001 ),especially in MCF-7 Beclin 1+4 Gy group which was significantly higher than those in MCF-7 + 4 Gy (P < 0.05);while there was significant difference in the necrotic cell percentages between various groups. After 4 Gy irradiation, compared with MCF-7 group, the expression levels of Beclin 1,P53 and Bax proteins in MCF-7 + 4 Gy and MCF-7-Beclin 1 + 4 Gy groups were increased,but the expression levels of Bcl-2 protein were decreased,especially in MCF-7-Beclin 1 + 4 Gy group. Conclusion The MCF-7 cell models of Beclin 1 over-and low-expressions are successfully established,and ionizing radiation could induce the autophagy and apoptosis of MCF-7 cells,which is more obvious in Beclin 1 over-expression MCF-7 cells.Beclin 1 can activate P53,inhibit Bcl-2 and activate Bax,which forms the regulation of autophagy and apoptosis by P53 .

Objective To introduce a new and practical method of treating blepharoptosis with direct suspension of the frontal muscle-fascia improvement. Methods 22 cases of blepharoptosis were corrected by direct suspension of the frontal muscle-fascia in which the dynamia still came from frontal muscle.Through double-fold eyelid incision, the frontal muscle-fascia was dissected from the subcutaneous tissue and a 1.5 cm length incision of the frontal muscle-fascia was cut under the supraorbital margin. And through the incision, the frontal muscle-fascia on the superficies of periosteum was dissected 1.5 cm to the upper margin of orbital, and then the frontal muscle-fascia was pulled down and fixed to the levator muscle aponeurosis directly by mattress sutures, with the tension being adjusted to a moderate degree. Results 22 cases of blepharoptosis were cured by primary healing with this method. The patients were followed up for 3 to 6 months with satisfactory results and no recurrence. Conclusion Compared with the traditional methods,this one may decrease the damage to the upper lid and frontalis area, leaving no risk of damaging the vessels or nerves. The technique is simple and the curative effect is affirmed. It can be used to treat any blepharoptosis patient with normal frontal muscle function.

Objective To reveal the relationship between a certain ratio of the length to width of a slender narrow pedicle and random flap in survival area with an experimental study. Methods 25 pigs were randomly divided into 5 groups. The ratio of length to width of slender narrow pedicle in 5 groups was different and every ratio's slender narrow pedicle was carrying 5 different sizes of random flaps. In each group, these 5 flaps were created randomly in each pigs' bilateral back. The flaps were evaluated with the general observation, fluorescence examination, blood flow ECT test, and computerized analysis of survival area. Results When the ratio of the length to width of the slender narrow pedicle was constant, along with the flap area increased, the flap survival area also increased, but when the flap reached a certain area, the distal flap would develop necrosis, the flap survival area would not reduce; when the flap size remained unchanged, along with the ratio of the length to width of the slender narrow pedicle increased, the flap survival area was not affected, but, when the ratio of the length to width of the slender narrow pedicle increased to a certain limit, distal flap would lead to necrosis, and the flap survival area would reduce. Conclusion The slender narrow pedicle flap is a new and practical random flap. The pedicle of random flap can be designed as slender shape, and the ratio of pedicle width to flap length is far less than traditional ratio. Increasing the flap size or ratio of the length to width of a slender narrow pedicle in a certain extent will not lead to flap necrosis.

Objective To investigate the prognostic impact of carcinoembryonic antigen-related cell adhesion molecule 1 (CEACAM1) and CD34 on invasion and metastasis of gastric cancer.Methods CEACAM1 and CD34 expressions were detected by immunhistochemistry in 90 cases of gastric cancer and 30 cases of normal gastric mucosa.Then the relationship among CEACAM1, MVD marked by CD34 antibody and gastric cancer patients` clinical pathological features and prognosis were analyzed.Results The positive rates of CEACAM1 and CD34 protein in gastric cancer were significantly higher than those in normal gastric mucosa (P<0.05).The positive rate of CEACAM1 was closely related to histological differentiation, tumor invasion, nodal metastasis and TNM stage.MVD marked by CD34 was related with tumor size, histological differentiation, tumor invasion, nodal metastasis and TNM stage(P<0.05).Conclusions In gastric cancer, CEACAM1 and CD34 promote its invasion and metastasis, and they are potential indicators of predicting development and prognosis.