Objective To investigate the effects of parecoxib sodium injection combined with dexmedetomidine hydrochloride injection on postoperative cognitive function and stress response in patients with osteoporotic compression fractures.Methods The patients with osteoporotic compression fractures were divided into treatment group and control group according to the treatment plan.The control group was given intravenous injection of dexmedetomidine hydrochloride injection 0.2 μg·kg-1load dose,then micro pump injection 0.2 μg·kg-1·min-1 maintenance dose,until 30 min before the end of the operation;patients in the treatment group were intravenously injected with parecoxib sodium injection 20 mg before local anesthesia and 30 min before the end of operation on the basis of the control group.The pain,sedation,hemodynamics[mean arterial pressure(MAP),heart rate(HR)],cognitive function and safety evaluation were compared between the two groups before operation(T0),2 h after operation(T1),6 h after operation(T2),12 h after operation(T3)and 24 h after operation(T4).Results There were 39 cases in the treatment group and 41 cases in the control group.Visual analogue scale(VAS)scores in treatment group and control group were(3.09±0.55)and(3.41±0.62)scores at T1;VAS scores were(3.02±0.57)and(3.35±0.48)scores at T2;VAS scores were(2.64±0.44)and(2.90±0.46)scores at T3;VAS scores were(2.02±0.41)and(2.35±0.47)scores at T4;MMSE scores were(25.28±1.57)and(24.33±1.42)scores at T2;MMSE scores were(28.16±1.01)and(27.25±0.89)scores at T4;MoCA scores were(24.63±1.60)and(23.59±1.25)scores at T2;MoCA scores were(27.20±0.97)and(26.48±0.83)scores at T4.There were statistically significant differences in the above indexes between the treatment group and the control group(all P＜0.05).Adverse drug reactions in the treatment group included bradycardia,hypotension,nausea vomiting and hypokalemia;adverse drug reactions in the control group included bradycardia,hypotension and nausea vomiting.The total incidence rates of adverse drug reactions were 12.82％and 9.76％,without statistically significant difference(P＞0.05).Conclusion Compared with using dexmedetomidine alone,parecoxib sodium combined with dexmedetomidine is beneficial for relieving postoperative pain in patients with osteoporotic compression fractures,improving postoperative cognitive function.

This article introduces the clinical experience of professor CHEN Gui-Zhen in treating premature ovarian insufficiency(POI).According to professor CHEN Gui-Zhen,the etiology and pathogenesis of POI is congenital insufficiency of kidney essence,failure of acquired source of production and transformation of spleen and stomach,and failure of liver to maintain free movement of qi,which leads to failure of production and transformation source of sex-stimulating essence,disharmony of Chong and Conception Channels.Therefore,professor CHEN Gui-Zhen emphasizes the principle of"tonifying kidney and replenishing sex-stimulating essence,invigorating the spleen and dispersing the stagnated liver-energy,regulating Chong and Conception Channels"during treatment.As for the clinical acupoint selection,the combination of back-shu and front-mu points method is valued,as for the acupuncture technique,professor CHEN uses the flying needle therapy to calm mind,and straight-side acupuncture to strenghthening qi,and acupoint catgut embedding therapy skillfully,she trinity the above treatment methods,and combined use of acupoint catgut embedding and medicine.The treatment of POI is based on syndrome differentiation,and the purpose of harmony of Chong and Conception Channels is finally achieved.

Objective:To explore the role of macrophage polarization on pericyte-to-myofibroblast transition and renal allograft fibrosis after kidney transplantation(KT).Methods:Allograft tissues were harvestedfrom recipients with chronic allograft dysfunction(CGD)and normal kidney tissues.The expression and distribution of M1/M2 macrophages in kidney tissues were detected by routine and immunofluorescent staining; mRNA of CD68, CD206 and iNOS detected by polymerase chain reaction(PCR); Murine vascular pericytes subjected to TGF-β1 in vitro and the expressions of α-SMA and PDGFR-β in perivascular cells detected by immunoblotting and cellular fluorescence; The co-culturing models of vascular pericytes and M1/M2 macrophages were constructed.The expressions of α-SMA and PDGFR-β in pericytes were detected by immunoblotting, cellular fluorescence and PCR.Results:A marked infiltration of CD68+ iNOS+ M1 macrophages was present in allograft tissues of recipients with CGD while no obvious infiltration of CD68 + CD206 + was observed.The mRNA levels of CD68, iNOS and CD206 were significantly higher in CGD group than those in control group( P<0.05); In CGD allograft tissues, protein expressions of α-SMA and PDGFR-β spiked markedly( P<0.05)while cells with double staining of α-SMA and PDGFR-β were markedly infiltrated in interstitial area of CGD allograft.TGF-β1 could induce a marked elevation of PMT-related markers in a time-dependent manner( P<0.05); Immunoblotting and cellukar fluorescence indicated that M1 macrophages could promote the elevations of α-SMA and PDGFR-β in pericytes in vitro while M2 macrophages showed no effect on pericyte-to-myofibroblast transition in pericytes. Conclusions:M1 macrophage polarization may promote the formation of renal allograft interstitial fibrosis through promoting PMT.

Adrenalectomy ; methods ; Adult ; Aged ; Female ; Humans ; Laparoscopy ; methods ; Male ; Middle Aged

The present study was designed to target fish for potential bioactive components contained in a Huang Lian Jie Du decoction (HLJDD) and identify the underlying mechanisms of action for the treatment of sepsis at the molecular level. he bioactive components database of HLJDD was constructed and the sepsis-associated targets were comprehensively investigated. The 3D structures of the PAFR and TXA2R proteins were established using the homology modelling (HM) method, and the molecular effects for sepsis treatment were analysed by comparing the bioactive components database and the sepsis targets using computational biology methods. The results of the screening were validated with biological testing against the human oral epidermal carcinoma cell line KB in vitro. We found that multiple bioactive compounds contained in the HLJDD interacted with multiple targets. We also predicted the promising compound leads for sepsis treatment, and the first 28 compounds were characterized. Several compounds, such as berberine, berberrubine and epiberberine, dose-dependently inhibited PGE2 production in human KB cells, and the effects were similar in the presence or absence of TPA. This study demonstrates a novel approach to identifying natural chemical compounds as new leads for the treatment of sepsis.
Anti-Inflammatory Agents, Non-Steroidal ; pharmacokinetics ; Berberine ; analogs & derivatives ; pharmacokinetics ; Dinoprostone ; biosynthesis ; Drugs, Chinese Herbal ; chemistry ; pharmacokinetics ; Humans ; KB Cells ; Platelet Membrane Glycoproteins ; drug effects ; Protein Transport ; Receptors, G-Protein-Coupled ; drug effects ; Receptors, Thromboxane A2, Prostaglandin H2 ; drug effects ; Sepsis ; drug therapy ; metabolism ; Tetradecanoylphorbol Acetate ; pharmacokinetics

Adult ; Asymptomatic Diseases ; China ; Chondromatosis, Synovial ; diagnostic imaging ; pathology ; physiopathology ; surgery ; Hip Joint ; diagnostic imaging ; pathology ; physiopathology ; surgery ; Hospitals ; Humans ; Male ; Tomography, X-Ray Computed

OBJECTIVETo explore the role of glucocorticoid (GC) receptor (GR) in rapamycin's reversion of GC resistance in human GC-resistant T-acute lymphoblastic leukemia (ALL) CEM-C1 cells.

METHODSCEM-C1 cells were cultured in vitro and treated with rapamycin at different concentrations with or without 1 μmol/L dexamethasone (Dex). 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide (MTT) test was performed to assess cell proliferation. The cell cycle and cell apoptosis were analyzed by flow cytometry. The expression of GRα mRNA was determined by real-time quantitative RT-PCR. The expression of GR, p-70S6K, Mcl-1, and Bim proteins was detected by Western blot.

RESULTSWhen incubated with rapamycin at different concentrations, CEM-C1 cells showed significant growth inhibition in a time- and concentration-dependent manner. The growth inhibition was synergistically increased when CEM-C1 cells were treated with rapamycin plus 1 μmol/L Dex. CEM-C1 cells treated with rapamycin alone showed no apparent apoptosis, and were arrested at G0/G1 phase. After the treatment with Dex plus rapamycin, CEM-C1 cells demonstrated apparent apoptosis and increased the cell cycle arrested at G0/G1 phase. Rapamycin combined with Dex up-regulated GRα, phosphorylated GR(p-GR), and pro-apoptotic protein Bim-EL in CEM-C1 cells, but inhibited the expression of p-p70S6K, a downstream target protein of mTOR (mammalian target of rapamycin).

CONCLUSIONAfter the treatment with rapamycin plus Dex, Dex resistant CEM-C1 cells induce growth inhibition and apoptosis. The underlying mechanism may involve inhibition of the mTOR signaling pathway and also be associated with up-regulation of GR expression and activation of GC-GR signaling pathway.

Apoptosis ; drug effects ; Base Sequence ; Blotting, Western ; Cell Line ; DNA Primers ; Dexamethasone ; pharmacology ; Glucocorticoids ; pharmacology ; Humans ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; metabolism ; pathology ; Real-Time Polymerase Chain Reaction ; Receptors, Glucocorticoid ; metabolism ; Sirolimus ; pharmacology ; Up-Regulation ; drug effects

Myxoid adrenocortical neoplasms are rare. Surgical resection of the mass is the first-line therapy. Here we reported a total of four patients, aged 44–66 years, diagnosed with myxoid adrenocortical tumor. The clinical characteristics and immunohistochemical features of the tumor are discussed in the current literature.
Adrenal Cortex Neoplasms ; diagnosis ; metabolism ; surgery ; Adult ; Aged ; Biomarkers, Tumor ; metabolism ; Female ; Humans ; Male ; Middle Aged

OBJECTIVETo evaluate the efficacy and safety of endoscopic mucous resection with transparent cap (EMR-Cap) and endoscopic multi-band mucosectomy (MBM) in the treatment of early esophageal cancer and precancerous lesion.

METHODSA retrospective study was performed to review 30 EMR-Cap cases from December 2008 to December 2009 and 32 MBM cases from January 2010 to January 2011 of early esophageal cancer and precancerous lesions. The differences between these two techniques in efficacy, safety, and cost were compared.

RESULTSIn EMR-Cap group, the median resection time was 26(10-56) min and median procedure time was 43(22-81) min, significantly longer than those in MBM group [10(7-18) min and 32(28-45) min, P=0.036 and 0.038, respectively]. There were no significant differences between the two groups in total thickness and depth of resected lesions (P>0.05). In EMR-Cap group, the median cost was significantly higher than that of MBM group [(5466±354) vs. (4014±368) RMB, P=0.008)].

CONCLUSIONSEMR-Cap and MBM are minimally invasive, safe and effective methods in the treatment of early esophageal cancer and precancerous lesions. Compared to the EMR-Cap, MBM is simple with shorter treatment time and lower cost.

Aged ; Endoscopy ; methods ; Esophageal Neoplasms ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Mucous Membrane ; surgery ; Precancerous Conditions ; surgery ; Retrospective Studies ; Treatment Outcome

BACKGROUNDIn 2008, infants in some areas of China suffered from stones of the urinary system which were caused by melamine-contaminated milk formula. Most of the infants were asymptomatic, and a few suffered from acute renal failure induced by urinary obstruction by stones. This study aimed to assess the significance of blood purification therapy in treatment of infants with acute obstructive oligo-anuric renal failure. Corrective perception, timely diagnosis, and active treatment of this complex disease are critical factors that guarantee a quick recovery of renal function of infants and help them to prevent multiple organ system failure.

METHODSThirteen infants with acute renal failure induced by urinary multiple obstruction caused by melamine-containing stones who had been admitted to Beijing Children's Hospital Affiliated to Capital Medical University in 2008 were investigated for the epidemiological characteristics, image features and indications of dialysis. All these infants were treated with dialysis. The efficacy of dialysis was compared with that of two control groups treated with cystoscopic retrograde catheterization into the ureter and medical treatment for the recovery of renal function.

RESULTSThe 13 infants with life-threatening complications treated with dialysis showed a blood urea nitrogen (BUN) level of (30.9+/-7.9) mmol/L and a creatinine (Cr) level of (572+/-173) micromol/L. Of these infants, 8 were treated with peritoneal dialysis (PD), and 5 with hemodialysis (HD). Ten infants recovered to urinate 24-72 hours after dialysis and 3 infants with persistent ureteral obstruction were further treated with cystoscopic retrograde catheterization into the ureter for drainage, and urination resumed soon after the operation. The average time of PD and HD were (2.1+/-0.8) days and (1.2+/-0.4) days, respectively. The total average time of PD and HD dialysis was (1.77+/-0.83) days. The recovery time of renal function of infants after dialysis was (3.08+/-1.20) days, comparable to that of the two control groups treated with catheterization with a cystoscope or by medication. There was no significant difference in the recovery time of renal function among the three groups (P>0.05).

CONCLUSIONSMelamine-contaminated milk formula may cause urinary stones and obstructive acute renal failure in infants. Dialysis is suggested to treat life-threatening complications such as hyperkalemia, oliguria or anuria if surgical intervention fails. If possible, hemodialysis or peritoneal dialysis can be performed early. Blood purification is feasible to help the infants overcome the critical stage of acute renal failure. Surgical measures can be taken to remove the obstruction if necessary.

Acute Kidney Injury ; chemically induced ; surgery ; therapy ; Child, Preschool ; China ; Cystoscopy ; methods ; Female ; Humans ; Infant ; Kidney Function Tests ; Male ; Peritoneal Dialysis ; methods ; Renal Dialysis ; methods ; Treatment Outcome ; Triazines ; poisoning