OBJECTIVE To compare the efficacy and safety of parecoxib and ketorolac tromethamine for perioperative analgesia， and to provide evidence-based reference for clinical drug use. METHODS Retrieved from PubMed， Embase， the Cochrane Library， CNKI， VIP， Wanfang Data， Baidu and Google， randomized controlled trials （RCT） about parecoxib （trial group） versus ketorolac tromethamine （control group） for perioperative analgesia were collected from the inception to Jun. 17th， 2022. After screening the literature and extracting the data， the quality of the included literature was evaluated using the bias risk assessment tool recommended by Cochrane system evaluator manual 5.1.0. Meta-analysis， sensitivity analysis and publication bias analysis were performed with RevMan 5.4 software. RESULTS A total of 12 RCTs were included， with 1 118 patients. Meta- analysis results showed that at the time of administration before anesthesia induction， there was no statistically significant difference between the 2 groups in visual analogue scale （VAS） [MD＝－0.16， 95%CI （－0.41， 0.09）， P＝0.20]， numerical rating scale （NRS） [MD＝0.01， 95%CI （－0.36， 0.38）， P＝0.97]， postoperative bleeding [MD＝0.15， 95%CI （－0.63， 0.93）， P＝0.71]， and consumption of opioid analgesics [MD＝0.12， 95%CI （－0.77， 1.01）， P＝0.79]. At the time of postoperative administration， VAS and bleeding volume at 48 h after operation of trial group were significantly lower than control group （P＜0.05）. The results of subgroup analysis by different com assessment time points showed that the VAS of patients in trial group at 0 h after operation were significantly lower than control group at the time of administration before anesthesia induction； at the time of postoperative administration， VAS of patients in the trial group at 12 h and 48 h after operation were significantly lower than control group （P＜0.05）. There was no statistical significance in the incidence of ADR between 2 groups [RR＝0.93，95%CI （0.78，1.11），P＝0.43]. The results of subgroup analysis according to different types of adverse reactions showed that the incidence of nausea and vomiting of trial group was significantly lower than control group， and the incidence of other adverse reactions was significantly higher than control group （P＜0.05）. Results of sensitivity analysis showed that study results were stable and reliable. Results of publication bias analysis showed that there was great possibility of publication bias in this study. CONCLUSIONS The efficacy of parecoxib is equivalent to that of ketorolac tromethamine for perioperative analgesia before operation； at the time of administration after operation， parecoxib has better analgesic effect and less postoperative bleeding； the incidence of nausea and vomiting caused by parecoxib is lower at any time of administration.

Objective:To investigate the effect of multi line therapy for lung adenocarcinoma transformed into small cell lung cancer (SCLC), and review and discuss the related literature.Methods:Combined with the clinical examples of lung adenocarcinoma transformed SCLC after treatment with anti epidermal growth factor receptor tyrosine kinase inhibitors (EGFR TKIs), the diagnostic process and multi line treatment plan of transformed SCLC were analyzed, and the therapeutic effect was evaluated by imaging. At the same time, it was reviewed and discussed in combination with relevant literature.Results:Serological tumor markers were significant for the diagnosis of transformed SCLC after EGFR-TKI treatment of lung adenocarcinoma, and pathology was still the gold standard for its diagnosis. The multiline therapy of SCLC has certain effect on transformed small cell lung cancer.Conclusion:The overall prognosis of lung adenocarcinoma transformed into SCLC after EGFR TKIs treatment is poor, so it is necessary to diagnose and treat it as early as possible, evaluate the effect of imaging in time, and make treatment adjustment quickly.

Six new abietane diterpenoids (1-6) and five undescribed iridoids (7-11) have been isolated from the aerial parts of Caryopteris mongolica. The intricate structural characterization of these compounds was meticulously undertaken using an array of advanced spectroscopic techniques. This process was further enhanced by the application of DP4+ probability analyses and electronic circular dichroism (ECD) calculations. Following isolation and structural elucidation, the cytotoxicity of these compounds was evaluated. Among them, compound 3 stood out, displaying significant cytotoxic activity against HeLa cells with an IC₅₀ value of 7.83 ± 1.28 μmol·L^-1. Additionally, compounds 1, 2, 4, 9, and 10 manifested moderate cytotoxic effects on specific cell lines, with IC₅₀ values ranging from 11.7 to 20.9 μmol·L^-1.
Humans ; Abietanes/chemistry* ; HeLa Cells ; Lamiaceae/chemistry* ; Circular Dichroism ; Diterpenes/chemistry* ; Molecular Structure

Objective:To investigate the reasonable dosage of heparin anticoagulation scheme during plasma adsorption (PA) therapy for liver failure.Methods:Patients with liver failure treated with PA therapy were retrospectively collected and divided according to the anticoagulation scheme into the first-dose heparin anticoagulation group and the first-dose plus maintenance heparin anticoagulation group. Clinical data and laboratory test results were compared before and after treatment between the two groups. Paired t-tests were used for comparison within the normally distributed groups. An independent two-sample t-test was used for inter group comparison. Wilcoxon rank-sum test was used for measurement data that did not conform to a normal distribution. Fisher's exact test was used to compare the count data between groups. Results:There were 138 cases with liver failure treated with PA therapy from October 2017 to September 2020. Among them, 83 and 55 cases were in the first-dose heparin anticoagulation and first-dose plus maintenance heparin anticoagulation group, respectively. Age, gender, and laboratory data before treatment were comparable between the two groups. PA treatment was successfully completed in both groups of patient, and there was no statistically significant difference in the determination of coagulation level with plasma separators ( Z=-0.15, P=0.216). There were different degrees of bleeding complications in both groups. In the first-dose heparin anticoagulation group, there were two cases (2.4%) of central venous catheter bleeding and one case (1.2%) of epistaxis. In the first-dose plus maintenance heparin anticoagulation group, there were five cases (9.1%) of central venous catheter bleeding, two cases (3.6%) of skin bleeding, one case (1.8%) of epistaxis, and one case (1.8%) of upper gastrointestinal bleeding. The incidence of bleeding complications was lower in the first-dose of heparin anticoagulation than first-dose plus maintenance heparin anticoagulation group, and the difference was statistically significant ( P<0.001). The activated partial thromboplastin time of the two groups was prolonged after therapy withdrawal than with therapy, and the difference was statistically significant (first-dose heparin anticoagulation group: t=3.850, P=0.022; first-dose plus maintenance heparin anticoagulation group: t=6.733, P=0.007). The activated partial thromboplastin time was prolonged in patients with first-dose plus maintenance heparin anticoagulation than first-dose heparin anticoagulation group, and the difference was statistically significant ( P=0.025). The total bilirubin of the two groups before and after PA was significantly changed (the first-dose heparin anticoagulation group: Z=-2.455, P=0.017; the first-dose plus maintenance heparin anticoagulation group: Z=-2.307, P=0.024), and there was no statistically significant difference between the two groups ( P=0.412). There was no statistically significant difference in platelet changes before and after PA therapy between the two groups (the first dose of heparin anticoagulation group: Z=-0.529, P=0.480; the first-dose plus maintenance heparin anticoagulation group: Z=-0.276, P=0.362). Conclusion:Anticoagulation scheme without maintenance medication is feasible with prothrombin activity before ≤20-40%, activated partial thromboplastin time of ≤87 s (2 times the upper normal value), platelet count before treatment (excluding contraindications to heparin) ≥50×10 9/L, and the first dose of heparin administration of 0.2 mg/kg during PA therapy in patients with liver failure.

Purpose To explore the diagnostic value of multiple image technique derived from dual-energy CT in arterial+parenchymal phase scan mode in detecting pancreatic adenocarcinoma so as to provide more valuable information for clinical treatment.Materials and Methods Thirty two patients with pancreatic adenocarcinoma proved pathologically underwent dual-phase scan with dual-source CT.Linear blend image,non-linear blend image and iodine map were acquired.The absolute enhancement value of tumor (AEV),the relative enhancement value of tumor (REV),enhancement ratio (ER) of tumor to pancreatic parenchyma,and the image contrast to noise ratio (CNR) were also calculated,so that the diagnostic value and the ability image in two phases to display the pancreatic adenocarcinoma lesions could be assessed.Results On arterial phase,the differences in AEV,REV and CNR value were significant among the three groups images (P＜0.05).On parenchymal phase,the difference in REV,ER,and CNR value were also significant among the three groups (P＜0.05).When the three sequences on the 2 phases were compared with each other,the differences in AEV and REV value of tumor tissues were significant among the groups (P＜0.05).Moreover,the differences of ER value in linear blend image and CNR in the iodine map were significant in dual phase enhancement (P＜0.05).Conclusion Dualenergy CT enhanced scan mode on dual phase combined with multiple sequences can improve the sensitivity in detection of pancreatic adenocarcinoma lesions.

Objective:Setting up a queuing simulation model to study the allocation and usage of MRI in certain regional hospital in East China. To find out the causes and put forward suggestions. Methods: Statistical method was used for statistical analysis of MRI inspection time. Queuing simulation model was used to analyzing MRI allocation and used in 7 top hospitals. The waiting queue length, average queue length, sojourn time and waiting time was calculated.Results: The average MRI examination waiting time of the 7 top hospitals in the whole region is 0.403 h. The waiting time of 2 hospitals is more than 40 min while which is less than 20 min in 3 hospitals. The equipment utilization rate is higher in 2 hospitals (vacancy rate is 11.9%-16.4%) while which is lower in 2 other hospitals (vacancy rate is 52.3%-58.9%).Conclusion: The problem of health allocations of resources could be solved by establishing regional MRI examination center radiation regional around.

Objective To investigate the features and neural mechanisms of sustained attention and executive function in patients with acute mild traumatic brain injury (mTBI) by comparing and analyzing behavioral and event-related potentials of patients and healthy controls.Methods Seventeen patients with acute mTBI and seventeen healthy controls participated in a cued continuous performance test.Behavioral data and event-related potentials were collected and analyzed.Results 1.There were significant differences between the mTBI group and the control group in hitting number ((66.76±3.27), (69.12± 1.41)) ,reaction time((533.66±144.20) ms, (413.03±94.57) ms) and the number of errors of omission ((3.24±3.27), (0.88± 1.41)) (P＜0.05), but no significant differences in the number of false errors ((0.35±1.00), (0.53±0.87)) (P＞0.05).2.The amplitude of Go-N2 and Nogo-N2 were significantly smaller in mTBI group than that in control group (P＜0.05).The main effect of group was significant of N2 amplitude (P＜0.05), but main effect of condition and the interaction effect were not significant(P＞0.05).Group and condition had no significant main effect and interaction effect on the latency of N2 (P＞0.05).The amplitude of Go-P3 was significantly smaller in mTBI group than that in control group (P＜0.05),while not on the amplitude of Nogo-P3(P＞0.05).The main effect of group and condition were significant on P3 amplitude (P＜0.05),but the interaction effect was not significant(P＞0.05).Group and condition had no significant main effect and interaction effect on the amplitude of P3 (P＞0.05).Conclusion Patients with mTBI show impairments in sustained attention and conflict monitoring, but not in response inhibition.

Objective:To develop an information management system for equipment archives management, maintenance, measuring and statistics for hospital medical equipment.Methods:VS 2008 and SQL Server 2008 were used as the development tools. B/S software architecture was applied to the design of system function modules.Results: The system structure of B/S model could satisfy the requirements form the equipment archives management, maintenance, measuring and statistics of hospital medical equipment. The desired functional modules were implemented, which adapted to the acquisition and utilization of hospital medical equipment management.Conclusion: The information management system for hospital medical equipment can acquire and maintain medical equipment information, with digitalizing information of equipment archives, measuring and statistics, and networked the maintenance flow of medical equipment. The information sharing has been realized and the management level of hospital medical equipment has been improved.

Objective To test the effects of Vitamin D (VitD) on endothelial nitric oxide(NO) production and to study the signal pathway leading to NO release.Methods In vitro cultured human umbilical vein endothelial cells (HUVEC) were treated with various concentrations of VitD(0 mmol/L,0.01 mmol/L,0.10 mmol/L,1.00 mmol/L,10.00 mmol/L) for 60 min,and VitD at concentration of 1.00 mmol/L at different time points (30 min,60 min,90 min,120 min).The effect of VitD on NO production in presence of VitD receptor(VDR) agonist(ZK191784) or antagonist(ZK159222) for 60 min were examined in cell culture supernatant with kit for the detection of nitric oxide fluorescent probe(DAF-FM DA).HUVEC was cultured with VitD in presence of VDR agonist or antagonist for 60 min,and the effect of VitD on NO production with DAF-FM DA and the protein expression and phosphorylation of Caveolin-1 and endothelial nitric oxide synthase(eNOS) were detected by Western blot,respectively.Results VitD caused a concentration-dependent increase in NO production.The maximum effect was observed at a concentration of 1.0 mmol/L and the optimal time of stimulation was 60 min.Effects induced by VitD were enhanced by VDR agonist,and abolished by antagonist.VitD and VDR agonist maintained the expression of Caveolin-1 at the same low phosphorylation level the same as normal,increased the phosphorylated level of eNOS.However,VDR antagonist increased the phosphorylation of caveolin-l,but reduced the level of eNOS phosphorylation,respectively.Conclusions VitD can induce a significant increase in endothelial NO production through VDR.VitD interaction with VDR causes the low phosphorylation of caveolin-1 leading to eNOS activation and NO production.

Aim ADS-J1 is a low molecular HIV entry inhibitor targeting HIV transmembrane subunit gp41 through virtual screening from a compound library containing 20 000 molecules.This study is to investigate the binding sites of ADS-J1 on gp41.Methods Acid native polyacrylamide gel electrophoresis (AN-PAGE) assay was applied to test the binding ability of ADS-J1 with the peptides derived from gp41 N-terminal heptad repeat (NHR) region.Results It was reported previously that ADS-J1 could block the gp41 six-helix bundle (6-HB) formation using native polyacrylamide gel electrophoresis (N-PAGE).However,the binding sites could not be found because positive charged N-peptides derived from gp41 NHR could not show bands on the gel.In the present study,the AN-PAGE assay which could show N-peptides in the gel was established,and it was found that ADS-J1 could inhibit the gp41 6-HB formation.Moreover,ADS-J1 bound directly to the gp41 cavity region of NHR.The positively charged residue (K574) located in this region was critical for the binding of ADS-J1.Conclusions ADS-J1 inhibits HIV entry by targeting the cavity region of gp41 NHR,whereas K574 in the cavity plays a critical role for the binding.Furthermore,the AN-PAGE assay provides a simple method for studying the mechanism of action of virus entry inhibitors targeting the transmembrane protein of type I enveloped virus.