Objective To assess the efficacy and safety of multimodal analgesia with different doses of nalbuphine combined with flurbiprofen on patients who received intravenous patient -controlled analgesia(PCIA) after thoracotomy.Methods Sixty patients underwent thoracotomy,ASA Ⅰ -Ⅱ,18 -65 years old,who underwent postoperative PCIA,were randomly divideded into three groups according to the digital table,nalbuphine 60 mg group (N60 group),nalbuphine 80 mg group(N80 group)and nalbuphine 100 mg group (N100 group),20 cases in each group.All patients were given 150mg flurbiprofen,a total of 100mL.PCIA solution:the background dose was 2mL/h, PCIA dose of 0.5mL,locking time of 15min.10min before surgery,each patient was intravenously given flurbiprofen 50mg,given a loading dose of 0.1mL/kg when closed chest.All patients were followed up for 48h.The incidence of adverse reactions such as vital signs,number of times,visual analog scale(VAS)score,sedation score,nausea and vomiting were recorded.Results There were no significant differences in the age,gender,body mass index and surgery duration among the three groups(all P >0.05).The vital signs were stable within 48h after operation.The VAS scores of N60 group were higher than the other two groups(N80 group:t =7.94,6.35,6.49,5.21,5.63,all P =0.00;N100 group:t =8.41,9.10,5.80,8.07,8.18,all P =0.00)at 4,6,8,24 and 48h after operation(all P <0.05).The VAS score of N80 group 48 h after operation was lower than that of N100 group(t =2.30,P =0.03),and the difference was not statistically significant in remaining(all P >0.05).The effective /actual compression ratio of PCIA of N80 group and N100 group were significantly higher than that of N60 group (t =7.30,8.35,all P <0.05). There were no differences in the incidence of adverse reaction among the three groups(group N80:χ2 =0.17,0.23, 1.03,all P >0.05;group N100:χ2 =3.14,0.23,1.03,all P >0.05).Conclusion Postoperative PCIA with nalbu-phine (80 mg)combined with flurbiprofen(150 mg)has significant analgesic effect and lower costs.

Humans ; Ischemic Postconditioning ; Myocardial Reperfusion Injury

Objective To determine a possible role for Clara cell secretary protein(CCSP)during acute RSV infection.Method CCSP-deficient [CCSP (-/-)]and wild-type (WT) mice were intratracheally infected with RSV and the lung inflammatory response to RSV infection were assessed.Results RSV-F gene expression increased in the lungs of CCSP (-/-) mice compared to WT mice following RSV infection, consistent with increased viral persistence. Lung inflammation was significantly worsened in CCSP (-/-) mice compared to WT mice after RSV infection. Th2 cytokines and neutrophil chemokines increased in the lungs of CCSP (-/-) mice following RSV infection.Conclusion These findings suggest that lack of CCSP may promote the inflammatory and Th2 immune response to RSV infection.

Objective To observe the short-term curative effect and safety of recombinant human erythropoietin(rHu-EPO)on patients with primary brain stem injury. Methods Sixty patients with primary brain stem injury were recruited at Liaocheng People' Hospital from July 2010 to July 2013. All cases were randomly divided into EPO group and control group. The patients in EPO group were injected subcutaneous with rHu-EPO five times at dose of 6 000 U,while patients in the control group were treated with placebo in 2 weeks. All other conventional treatments were the same. NIHSS score and GOS score were evaluated in two weeks and three months respectively. Moreover,blood pressure and hemoglobin were also measured. Results NIHSS score in EPO group was 11. 37 ± 7. 78,significant higher than that of control group after two weeks(19. 41 ± 8. 26,P = 0. 019). GOS score in EPO group was also significant differences in two groups after three months (Z = - 2. 367,P = 0. 009 ). However,no significant difference was observed in the followed-up blood tests. Conclusion Recombinant human erythropoietin could be the exact nerve protective effect,and might be an effective therapy for patients with primary brain stem injury.

Objective To provide a framework for understanding the need for a structured assessment of altered mental status (AMS) to better understand underlying causes of the mental status changes in adults and therefore potentially improve diagnostic skills and eventually management.Methods This is a prospective cohort observational study.We recruited consecutive adult patients with undifferentiated AMS at a single center tertiary care academic emergency department over 24 months.Demographical,clinical presentations,assessment approaches,cause factors,emergency treatments and outcomes were collected prospectively.Results One thousand nine hundred and thirty-four patients with AMS were recruited,this number of patients represented 5％ of the total ED census.Out of 1934 patients,1026 (53.1％) were male,908 (46.9％) were female.Mean age was (51.95 ± 15.71) years.Etiologic factors included neurological (n =641,35.0％),pharmacologic & toxicologic (n =421,23.0％),systemic and organic (n =266,14.5％),infectious (n =167; 9.1％),endocrine/metabolic (n =145,7.9％),psychiatric (n =71,3.9％),traumatic (n =38,2.1％),gynecologic and obstetric (n =35,1.9％).Total mortality rate was 8.1％ (n =156).The death rate was higher in elderly patients (≥ 60) than that in younger patients (10.8％ vs.6.9％,P =0.003).Conclusions The patient with AMS poses a challenge to physicians in ED.The most frequently encountered diagnostic category causing AMS were primary CNS disorders,intoxication,organ system dysfunction and endocrine/metabolic diseases.Fatality rate is very high.Prompt evaluation and treatment are essential to decrease the morbidity and mortality associated with this condition.

OBJECTIVETo investigate the effect of Shenqi Fuzheng Injection (SFI) for hemopoietic and immune function reconstruction in patients with hematologic malignancies (HM) after chemotherapy.

METHODSEighty HM patients at remission inducing stage of initial treatment were randomly assigned to two groups, the treatment group treated with SFI (250 mL daily) plus chemotherapy and the control group only treated with chemotherapy for 14 days, with same supportive treatments administered to both. Levels of blood routine test, T lymphocyte subsets (CD3+, CD4+, CD4+ /CD8+) and B lymphocyte subsets CD3- CD19+ were determined before and after treatment, and the remission rate was assessed after treatment.

RESULTSThe remission rates in the two groups showed no significant difference [90% (36/40) vs 82.5% (33/40), P > 0.05] statistically. Levels of peripheral leucocyte count and hemoglobin as well as levels of CD3+, CD4+, CD4+ /CD8+; were significantly higher in the treatment group than in the control group (P < 0.05), but no significant difference was shown between groups in CD3- CD19+ level.

CONCLUSIONSFI can lighten the inhibition of chemotherapy on hemopoietic function of bone marrow, and promote its recovery, enhance the immune function, and improve the quality of life in patients with HM undergoing chemotherapy.

Adolescent ; Adult ; Aged ; Antineoplastic Agents ; therapeutic use ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Hematologic Neoplasms ; drug therapy ; immunology ; Hemoglobins ; analysis ; Humans ; Injections ; Leukocyte Count ; Male ; Middle Aged ; Phytotherapy ; Remission Induction ; T-Lymphocyte Subsets ; immunology ; Treatment Outcome ; Young Adult

Objective To investigate the safety of rituximab combination chemotherapy in the treatment of B-cell non-Hodgkin' s lymphoma (B-NHL) complicated with hepatitis B virus (HBV) infection,and assess the incidence of HBV reactivation reduced by prophylactic lamivudine.Methods A retrospective study of HBV-related markers,HBV-DNA and liver function was performed before and after rituximabcontaining treatment in B-NHL patients.Thirty nine B-NHL patients with HBcAb(+)/HBsAb(-) were divided into prophylactic group (14 cases) and control group (25 cases).The incidences of HBV reactivation,functional damage of liver were measured.Results Among the 108 B-NHL patients who received rituximab combinatio nchemotherapy,15 (13.89 ％) were HBsAg (+) and 39 (36.11％) HBsAg (-) / HBcAb (+).Of the 15 HBsAg (+)patients,2 (13.3 ％) experienced reactivation of HBV.The prevalence of HBV reactivation was 7.7 ％(1/13) in patients who received prophylactic antiviral treatment and 50 ％ (1/2) in those who did not receivelamivudine.Among the 39 HBsAg (-) / HBcAb (+) patients,3 cases (7.7 ％) experienced reactivation of HBV.The prevalence of HBV reactivation was 0 in patients who receivcd prophylactic lamivudine treatment and 12 ％ (3/25) in those who did not receive this antiviral drug.Conclusion Prophylactic lamivudine before rituximab combination chemotherapy can reduce HBV reactivation obviously.

Objective To understand the information of food hypersensitivity of children with Henoch-Schonlein purpura (HSP) by food intolerance test.Methods Seventy-four children (40 boys and 34 girls;aged from 3 to 14) with HSP who were hospitalized in our hospital from Dec.2006 to May 2007 were chosen.Two mils venous blood was collected from each object,separated serum.Enzymelinked immunosorbent assay method was applied to detect the serum concentration of 14 kinds food allergen IgG in 74 children with HSP.The concentration of food allergen IgG was divided into 4 levels: 0(IgG0.20 U/L,servious allergy).Results The positive rate was 77.0% in 74 cases with HSP.One type of food allergen specific IgG increased in 24 cases(42.1%),2 types of antibodies increased in 16 cases(28.1%),3 types of antibodies increased in 12 cases(21.1%).Four or more types of antibodies increased in 5 cases(8.7%).The positive rates of 14 food allergen IgG were as follow:egg 93.0%,milk 26.3%,soybean 15.8%,tomato 14.0%,wheat 12.3%,ling 12.3%,shrimp 8.8%,crab 8.8%,beef 3.5%,corn 1.8%,rice 1.8%.Conclusion Food intolerance test is a useful method for children with HSP to find food allergen and guideline for diet of these children.

To evaluate the automated segmentation algorithm for detection of intra - retinal layers to process images obtained from ultra- high resolution optical coherence tomography ( OCT ) . Graph theory and the shortest path search based on dynamic programming were applied to automatically segment the 8 intra - retinal layers. We experimentally verified the accuracy and reliability of the algorithm. The results showed that the intra-retinal layer boundaries between automated and manual segmentations matched well. The algorithm successfully segmented the intra- retinal layers in glaucoma, high myopia, and retinitis pigmentosa patients. The proposed automatic segmentation for intra-retinal layers provides a promising tool for quantitative analysis in clinical diagnosis and treatment.

AlM:To investigate the prevalence of pterygium of the household population aged 40 and above in Hengli Town of Dongguan.
METHODS: Using the method of cluster random sampling, select 3 628 people aged 40 and above in four villages and one community for visual examination, intraocular pressure check, slit lamp examination and questionnaire.
RESULTS: The actual number of subjects was 3 393 people, and examination rate was 93. 52%. We detected 843 patients with pterygium. The prevalence of pterygium was 24. 85%.
CONCLUSlON:There is high prevalence of pterygium in Dongguan area. The prevalence of pterygium is related with age and working environment, but has no relation with gender.