OBJECTIVES: To explore the efficacy of DSA-guided intrathecal drug delivery system combined with Zi Wu Liu Zhu Acupoint Therapy for management of cancer pain and provide reference for its standardized clinical application. Methods and. RESULTS: Recommendations were formulated based on literature review and expert group discussion, and consensus was reached following expert consultation. The consensus recommendations are comprehensive, covering the entire treatment procedures from preoperative assessment and preparation, surgical operation process, postoperative management and traditional Chinese medicine treatment to individualized treatment planning. The study results showed that the treatment plans combining traditional Chinese with Western medicine effectively alleviated cancer pain, reduced the use of opioid drugs, and significantly improved the quality of life and enhanced immune function of the patients. Postoperative follow-up suggested good treatment tolerance among the patients without serious complications. CONCLUSIONS The formulated consensus is comprehensive and can provide reference for clinicians to use DSA-guided intrathecal drug delivery system combined with Zi Wu Liu Zhu Acupoint Therapy. The combined treatment has a high clinical value with a good safety profile for management of cancer pain.
Humans ; Medicine, Chinese Traditional ; Cancer Pain/therapy* ; Drugs, Chinese Herbal/therapeutic use* ; Drug Delivery Systems ; Pain Management/methods* ; China

ObjectiveTo analyze the effect of different fixation methods on the chemical quality characteristics and antioxidant activity of Rehmannia glutinosa leaves， so as to lay a foundation for the selection of processing technology and quality evaluation of this medicinal materials. MethodR. glutinosa leaves was dried at 55 ℃ after treating by three fixation methods （55 ℃， boiling water， 105 ℃）， and then the fingerprints of R. glutinosa leaves were collected by high performance liquid chromatography （HPLC） and near infrared spectroscopy （NIRS）， and their antioxidant activities were analyzed by the 2，2-biphenyl-1-picrylhydrazyl （DPPH） method. Finally， similarity analysis， principal component analysis （PCA）， orthogonal partial least squares-discriminant analysis （OPLS-DA） and Pearson correlation analysis were used to comprehensively evaluate the quality of R. glutinosa leaves with different fixation methods. ResultThe results of HPLC and NIRS fingerprint analysis indicated that there were differences in the quality characteristics of R. glutinosa leaves by different fixation treatments. The comprehensive score of chemical quality of R. glutinosa leaves by fixation at 55 ℃ was the highest， its average comprehensive score was 2.096， followed by fixation at 105 ℃， and the lowest was fixation with boiling water. The antioxidant activity of sample with fixation at 55 ℃ was the highest， followed by fixation with boiling water. The results of OPLS-DA showed that verbascoside， isoacteoside and catalpol were the main components causing the difference in chemical quality of the leaves from the three treatments， and the three components were positively correlated with the antioxidant activity of R. glutinosa leaves. Among them， the correlation between verbascoside and antioxidant activity was extremely significant， and the isoacteoside was significant. ConclusionThe chemical quality and antioxidant activity of R. glutinosa leaves are affected by the method of fixation， and the fixation at low temperature is the best primary processing method of R. glutinosa leaves.

ObjectiveTo analyze the changes of volatile organic compounds （VOCs） and bacterial community characteristics in rhizosphere soil during the growth of Rehmanniae Radix， as well as the relationship between VOCs and bacterial community structure， so as to lay the foundation for the evaluation of the characteristics of continuous cropping soil and the regulation of continuous cropping soil microorganisms. MethodThe rhizosphere soil during the three main growth periods of Rehmanniae Radix in July， August and October was used as the research object. Gas chromatography-mass spectrometry （GC-MS） was used to determine the relative contents of VOCs in ethyl acetate and dichloromethane parts in rhizosphere soil. The characteristics of rhizosphere bacterial community structure was determined by high-throughput sequencing， SPSS 24， SIMCA 14.1 and other software were used to analyze the differences of VOCs and bacterial community structure in rhizosphere soil of the three periods， and the main VOCs and iconic bacteria that caused the differences were screened， and the correlation between VOCs and bacterial community structure was analyzed. ResultThere were differences in VOCs in different parts of rhizosphere soil during the three growth stages of Rehmanniae Radix. Among them， and the main VOCs that cause differences were dioctyl isophthalate， 2-octyl-1-dodecanol and 2-ethylhexyl p-toluic acid in the ethyl acetate part， and 1，3-benzenedicarboxylic acid， di （2-propylpentyl） phthalate and 2-ethylhexyl p-toluenecarboxylic acid in the dichloromethane part. From the seedling stage to the end of tuber enlargement of Rehmanniae Radix， the relative abundance of dominant bacteria such as Actinobacteria， Firmicutes and Chloroflexi in the rhizosphere soil was gradually decreased， and there were unique bacterial communities in rhizosphere soil of each growth stage. Correlation analysis showed that the VOCs in rhizosphere soil of Rehmanniae Radix had an impact on the rhizosphere bacterial community structure， especially the components of esters and alcohols. ConclusionDuring the growth of Rehmanniae Radix， the characteristics of rhizosphere soil are mainly manifested in the content changes of main VOCs such as esters and alcohols and the gradual decrease of the abundance of the main beneficial bacteria， and the VOCs in rhizosphere soil play a certain role in shaping the structure of bacterial community.

OBJECTIVE: To establish a method for simultaneous detection of 2-aminopyridine, 3-aminopyridine and 4-aminopyridine in workplace air by solvent eluting-gas chromatography. METHODS: 2-aminopyridine, 3-Aminopyridine and 4-aminopyridine in workplace air were collected by glass fiber filter paper dipped with sulfuric acid solution, and eluted using sodium hydroxide solution. After that, the eluent was separated by capillary column, and finally detected using the nitrogen and phosphorus detector. RESULTS: The quantitative determination ranges of 2-aminopyridine, 3-aminopyridine and 4-aminopyridine were 0.30-800.00, 0.80-800.00 and 2.00-800.00 mg/L respectively, with the correlative coefficients greater than 0.999 9. The minimum detectable concentrations were 4.67, 8.00 and 40.00 μg/m~3 respectively, and the minimum quantification concentrations were 14.00, 28.00 and 133.33 μg/m~3(45.00 L sample, 3.00 mL eluent) respectively. The average elution efficiencies were 79.63%-98.61%, 83.80%-101.42% and 81.60%-100.29% respectively. The within-run relative standard deviations(RSD) were 1.13%-3.65%, 1.47%-4.00% and 1.94%-5.15% respectively, and the between-run RSD were 1.77%-5.30%, 2.06%-4.65% and 2.59%-6.46% respectively. Samples were stable at room temperature for at least 14 days. CONCLUSION: This method is appropriate to be applied for simultaneous detection of 2-aminopyridine, 3-aminopyridine and 4-aminopyridine in workplace air.

Objective To investigate the mechanism of neural protection of mouse nerve growth factor combined with sub-hypothermia in the treatment of patients with severe traumatic brain injury. Methods 90 cases of severe traumatic brain injury were randomly divided into study group and control group with 45 cases of each group, the control group were given routine treatment; the study group were given on the basis of routine treatment of mouse nerve growth factor combined with sub-hypothermia treatment, with 2 weeks treatment, the clinical indicators and corresponding nerve injury, inflammation, oxidative stress indexes, clinical effect and complications were compared after 2 weeks treatment. Results Compared with before treatment or control group, scores of Glasgow coma scale (GCS) and Glasgow outcome scale (GOS) and montreal cognitive assessment (MoCA) in study group after the treatment increased, National Institute of Health stroke scale (NIHSS) score decreased(P<0.05), neuronspecific enolase (NSE), myelin basic protein (MBP) and S100 beta levels decreased(P<0.05), the serum tumor necrosis factor-α (TNF-α),interleukin-6 (IL-6), IL-10 levels decreased (P<0.05), the malondialdehyde (MDA) decreased, the glutathione peroxidase (GPx) and oxidation resistance (AOA) levels increased (P<0.05). The control group efficiency was 73.33%, the study group efficiency was 91.11%, there was significant difference (P<0.05). All patients were followed up, no case off, there was no significant difference in adverse drug reaction rate between two groups. Conclusion Mouse nerve growth factor and sub-hypothermia has the significant neural protection for patients with severe traumatic brain injury, and its mechanism may be related to reduce nerve injury indicators and improve inflammatory factor and oxidative stress response.

Objective To study the clinical characteristics,treatment and prognosis of neonatal intestinal muscle defect with perforation.Methods The clinical data of 8 cases of newborns who had intestinal muscle defect with perforation in Department of Surgical Intensive Care Unit,Nanjing Children's Hospital Affiliated to Nanjing Medical University,were analyzed retrospectively.Results These 8 cases included 1 premature infant,1 term low birth weight infant,6 cases of term infants with normal birth weight,and all had no history of perinatal asphyxia.The ages of onset of all cases were ＜ 7 d.Clinical manifestations were crying and sudden onset of obvious abdominal distention.Bile or fecal vomiting occurred in 5 cases.These patients included 5 cases with congenital anorectal malformations,of which 3 cases had low deformity,1 case with middle deformity and 1 case with high deformity,with no other complications of gastrointestinal malformation.Surgical treatment was used in 8 cases,in which 7 cases of rectal perforation and 1 case of ileal perforation were confirmed.All cases were isolated perforation with a diameter of about 0.8-2.0 cm.The perforated periphery of the intestine was membranous.Intestinal repair was performed after total removal of the diseased tissue,and the patients with rectal perforation were performed at the same time for the proximal colostomy.The histopathologic examinations showed that the periphery of perforation had intact mucosa,muscularis propria was absent,myenteric plexus was absent in the region of muscle loss.Two cases were discharged within 1 d after colostomy.Except for 1 case with high anorectal malformation in the control of poor defecation functions,there were no other postoperative gastrointestinal complications in these 6 cases.Conclusions Rectal perforation is the most common in neonatal intestinal muscle defects,and it is an isolated and large diameter perforation.Most cases are term infants with normal birth weight.These patients are often associated with congenital anorectal malformations.High,middle and low deformity can be accompanied by intestinal muscle defect.Surgical excision of diseased tissue should be complete,in principle,and intestinal stoma should be performed proximal to the perforation.In case of congenital anorectal malformations complicated with gastrointestinal perforation,the rectum should be explored as an important region.Neonatal intestinal muscle defect maybe a primary lesion according to clinical characteristics of early sudden onset after birth and pathological examinations.Except for complications caused by associated malformations,the prognosis is satisfactory.

Objective To explore the clinical value of total hemihepatic vascular exclusion (THHVE) in right hepatectomy for hepatocellular carcinoma (HCC). Methods One hundred and twenty-three consecutive patients who underwent right hepatectomy for HCC between February 2006 and December 2008 were studied retrospectively. THHVE was used in 58 patients (group A) and Pringle maneuver in 65 patients (group B). The patient's demographics,surgical procedure and outcome were collected and compared between the two groups.ResultsThe tumor size was significantly bigger in group A than group B (7.69±3.70 cm vs.6.08±4.07 cm,P＜0.05).The vascular occlusion time in group A was significantly longer than groupB (28.55±8.67 min vs.19.85±6.71 min,P＜0.05). However, intraoperative blood loss in group A was significantly less than group B (304.31±270.36 ml vs.542.62±876.84 ml,P＜0.05),and the elevation of serum alanine aminotransferase (ALT) on day- 1,-3 and- 7 after operation in group A were significantly lower than group B (P＜0.05).The postoperative complication rate in group A was lower than group B (18.97％ vs.38.46％,P＜0.05).ConclusionTHHVE was a safe and efficacious technique in right hepatectomy for HCC.It significantly decreased blood loss,alleviated liver injury and reduced postoperative morbidity and mortality.

Objective To evaluate embedding 5-FU microparticles during operation after hepatectomy for small hepatocellular carcinoma to prevent recurrence. Methods A retrospective analysis on 184 patients was done.All patients received liver resection for HCC from 2007 Mar.to 2008 Mar.In 90 cases,5-FU releasing microparticles were embeded on liver cutting surface after the tumor was resected (group A).94 cases in which no micropaticles were given served as controls (group B).All patients had a single tumor( ≤5 cm) without visible vessel invasion. Results The postoperative disease-free survival ( DFS),and median period of DFS of group A vs.group B was 43 months vs 35 months.Postoperative DFS rates of 1-,2-and 3-year were 86％,76％ ％ and 64％ respectively in A group,while they were 77％,61％and 49％ respectively in B group ( x2 =4.77,P ＜ 0.05 ).In two groups the liver and kidney main function index( TB,ALB,ALT,BUN,Scr)on day 7 and postoperative complications were not statistically different (P ＞ 0.05 ). Conclusions Embeding 5-FU microparticle after hepatectomy for HCC could increase the postoperative DFS rates,and patients do not suffer from significant liver and kidney malfunctions.