ABSTRACT
Objective:To compare the effects of different anesthesia methods on postoperative analgesia, short-term cognitive function and deep venous thrombosis(DVT) in patients undergoing hip replacement.Methods:From March 2017 to March 2019, 96 patients with hip replacement were divided into group A (48 cases) and group B (48 cases) according to the random digital table method.Epidural anesthesia was used in group A, and general anesthesia was used in group B. The perioperative conditions, anesthesia effect, visual analogue scale (VAS) at postoperative 3, 12 and 24 hours, postoperative cognitive dysfunction (POCD) and DVT at postoperative 1, 3 and 7 days were compared between the two groups.Results:The operation time, intraoperative bleeding volume and time to get out of bed between the two groups had no statistically significant differences (all P>0.05). The recovery time[(14.98±2.31)min]and extubation time[(17.35±3.54) min]of group A were faster than those of group B[(19.13±3.42)min and (22.18±2.87)min]( t=6.967, 7.343, all P<0.05). The VAS scores of group B at postoperative 3 h[(3.27±0.73)points], postoperative 12 h[(2.45±0.38)points]and postoperative 24 h[(1.98±0.45)points]were higher than those of group A[(2.34±0.56)points, (1.65±0.43)points and (1.07±0.31)points]( t=7.003, 9.659, 11.538, all P<0.05). The incidences of POCD in group A at postoperative 3d(10.42%) and 7d(2.08%) were lower than those in group B (33.33% and 14.58%) (χ 2=7.357, 3.909, all P<0.05). The incidences of DVT in group A at postoperative 3d(4.17%) and 7d(8.33%) were lower than those in group B (20.83% and 29.17%) (χ 2=7.357, 3.909, all P<0.05). Conclusion:Epidural anesthesia is superior to general anesthesia in hip replacement.Postoperative analgesia is superior to general anesthesia, and can reduce the occurrence of short-term POCD and DVT, which is worthy of clinical reference.
ABSTRACT
IL-6 is an important cytokine that plays an important role in the pathogenesis of rheumatoid arthritis. We summarized the clinical efficacy and safety of tocilizumab, the IL-6 receptor monoclonal antibody in rheumatoid arthritis, and compared tocilizumab with TNF-α blocking mAbs. The efficiency of tocilizuamb is equivalent to that of TNF-α blockers, and each of the drugs has its advantages and disadvantages. We also summarized the clinical trials of the mAbs blocking IL-6 pathway in development. According to the results of recent studies by several research teams including our research group, IL-6 is another key target for the treatment of rheumatoid arthritis after TNF-α. The listing of the IL-6 blockers provides more choices for personalized treatment of rheumatoid arthritis in the future.
ABSTRACT
OBJECTIVE:To determine the plasma mycophenolic acid concentration by HPLC, and study the multidoses pharmacokinetics character of mycophenolic acid in Chinese kidney transplantation patients. METHODS: The samples were precipitated with acetonitrile before injection. Diamonsil C18 column was used. The mobile phase consisted of acetonitrile-10 mmol?L-1 KH2PO4 (5∶6) at a flow rate of 1.1 mL?min-1. The detection wavelength was 254 nm and the column temperature was 40 ℃. This method was used to determine the multidoses pharmacokinetics in 12 kidney transplantation patients. RESULTS: MPA was well-separated from internal standard in chromatography, and endogenous foreign substance in plasma had no interference on the determination. The liner range for MPA was 0.38～59.00 ?g?mL-1,and the lowest detectable concentration of MPA was 0.38 ?g?mL-1. The recovery rate stood at 89.32%～97.63%; Both intra-day and inter-day RSD were less than 8.00%. Significant individual difference was noted among the patients treated with MMF in pharmacokinetic results, which was in line with the literature. CONCLUSION: This method is accurate and simple and applicable for the pharmacokinetics study of mycophenolic acid.