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Objective To understand the current status of medication compliance in the patients with postherpetic neuralgia (PHN)and its influencing factors.Methods The cross-sectional survey method was adopted to investigate the status quo of medi-cation compliance among PHN patients in the pain clinic of the Southwest Hospital of Army Military Medical University from Janu-ary of 2014 to March of 2015.Then the influence factors of medication compliance were analyzed by using the using the Logistic re-gression method.Results A total of 396 PHN patients were included 52.3% of patients had good medication compliance,while 47.7% had poor compliance.The univariate analysis showed that the age,educational level,marital status,living condition,economic status,degree of pain,disease course,medical insurance reimbursement,adverse drug reactions and complicating other diseases were the factors affecting the medication compliance(P<0.05).The multivariate Logistic regression analysis results showed that the age,educational level,marital status,living condition,economic status,degree of pain,disease course,medical insurance reimburse-ment,adverse drug reactions and complicating other diseases were the factors affecting the medication compliance.Conclusion The medication compliance in the patients with PHN is not high,there are many factors affecting the medication compliance.It is recom-mended to carry out the health education,strengthen the psychological intervention of the patients and establish the follow-up medi-cation compliance system for improving the medication compliance.
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Objective To evaluate the effects of fentanyl transdermal system on intractable postherpetic neuralgia .Methods 30 patients(after 1 course of conventional drugs with nerve block therapy ,VAS score>5 points)were randomly divided into tramadol group(group T ) and fentanyl group(group F) ,15 cases in each group .Results VAS of the two groups decreased after treatment (P0 .05) .The incidence of dysuria was 26 .67% in group T ,and there was no dysuria in group F(P<0 .05) .Constipation of group T was 40% after treatment(P<0 .05) .The incidence of somnolence of group F was higher than T group(P<0 .05) .The two groups were no respiratory depression .Conclusion Fentanyl transdermal system for intractable postherpetic neuralgia has good analgesic effect ,less side effect ,and well-tolerated .
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Objective To explore the feasibility and safety of massive lung lavage to dogs in the early stage after acute serious smoke inhalation. Methods A total of 16 dogs were inflicted with smoke inhaled injury and then divided into group A (n=5) without lung lavage, group B (n=6) in which left lung lavage was followed by lavage on the right 30 min later, and group C (n=5) in which the interval of the lavages on the left and right lung was 4 h. Massive lung lavage was carried out in 1 h after the injury under the guiding fiberoptic bronchoscopy and a special ventilation jet was served to supply enough oxygen to the dogs. The stability of pulmonary function and blood circulation were observed at different time points in every group. Results The average operating time of unilateral lung lavage was about 15 minuted and the liquid volume left in every lung after operation was from 100 ml to 140 ml when the total lavaging volume was kept in 250 ml. The changes of hemodynamic parameters were identical in Group B and Group C. Inhalation injury had certain negative effect while lung lavage almost had no effect on the blood circulation of the animals in 2 lavage groups. No serious cardiac arrythemia was found in them during the lavaging. Pulmonary function in Group C was better than that in Group B but worse than that in Group A. In the 2 lavaging groups, PaO2 remained higher than 9.33 kPa（FiO2=0.4）during and after the lavaging. Conclusion The ventilation mode and the lavage method introduced here ensure the safety of massive lung lavage in dogs with acute smoke serious inhalation injury.
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Objective To investigate the characteristic changes in the mRNA and protein of complement 3 in spinal dorsal horn of rats with neuropathic pain,and the role of abnormal activation of complement protein in the mechanism of pain production.Methods Eighty-four healthy male SD rats were divided randomly into seven groups(n=12 for each group):normal control group,sham-operation 1d,3d and 7d groups,and chronic constriction injury of the sciatic nerve(CCI)1d,3d and 7d groups.The left sciatic nerve was ligated loosely in CCI groups,while it was only exposed but not ligated in rats in sham-operation groups.The mechanical and thermal pain thresholds were measured on 1,3 and 7 days after operation,and the mRNA and protein of complement 3 in the dosal horn of the spinal cord were determined respectively by RT-PCR,immunoturbidimetry and immunohistochemistry.Results The mechanical and thermal pain thresholds were observed to be lowered in rats one day after the sciatic nerve ligation,and a state of hyperalgesia was found to be persistent up to 7 days after CCI.This symptom was not observed in sham operation group.The expression of mRNA and protein of complement 3 in spinal dorsal horn were increased on 1,3 and 7 days after CCI.Interestingly,a high expression of mRNA of complement 3 was also observed in rats one day after sham-operation.Both mRNA and protein of complement 3 were not obviously elevated in rats of sham operation 3d,7d groups and normal control group.Conclusion The mRNA and protein of complement 3 in spinal dorsal horn are highly up-regulated in rats with neuropathic pain,suggesting that the characteristic dynamic changes in complement may contribute to the establishment and maintenance of hyperalgesia.
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Objective To study the effect of acute serious smoke inhalation injury to unilateral lung on contralateral lung and the therapeutic efficacy of massive bronchoscopic lavage with saline to the primary injured bronchoalveolus at early stage after smoke inhalation on mitigating the secondary damage of the other lung and so as to confirm the therapeutic validity of lung lavage to smoke inhalation injury. Methods Fifteen mongrel dogs were insufflated with sawdust smoke into left lung and then randomized into 2 groups. The dogs in group A were maintained intravenous glucose saline transfusion and breathed air freely for 24 h after injury. Those in group B received a massive bronchoscopic lavage with 250 ml of saline to injured lung at 1 hour after injury and then were administrated similarly to those in group A. Gas exchange function of bilateral lungs in the process were observed and pathologic and phyiopathologic changes of the lung specimen were examined after the process. Results While the total lavaging volume was kept to 250 ml, the liquid volume remained in left lung after each operating was from 90 ml to 140 ml. All animals had a significant decline in pulmonary function after smoke inhalation injury. PaO2 in group B decreased significantly soon after the lavage and then increased gradually to exceeding that in group A. The left lung showed serious edema similarly in two groups but in right lung the water content was less, dynamic and static compliance was more in group B than in group A. Conclusion Bronchoalveolar massive lavage at early post-injury stage to injured lung after unilateral lung smoke inhalation injury can mitigate secondary damage of the non-injured lung. Lung lavage can decrease the intensity of secondary systemic inflammatory reaction and show a therapeutic validity to smoke inhalation injury.
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Objective To investigate the existence, intensit y and persisting time of biologic activity of bronchoalveolar lavage fluid (BALF ) collected from dogs with acute severe smoke inhalation injury in early post-i njury stage. Methods BALF was collected 1 h after the est ablishment of acute severe sawdust smoke inhalation injury in 5 dogs, and the fl uid was perfused into the lungs of Wistar rats in the amount of 5 ml/kg (gro up C). Normal saline (group A) and BALF from normal dog (group B) were perfused into the lungs of rats and served as control. The respiratory rate, PaO2, lung water content and the expanding stability of lungs in all rats were determ ined at the time points of 4,12 and 24 h after the purfusion. Results Compared with the rats in group A and B, the rats in group C had higher mortality, wider range in RR, higher lung water content, PaO2 decreased obviou sly and lower lung expanding stability. The rats in control groups showed sl i ght mechanic obstruction in their airways in the course of experiment. Meanwhile ，the rats in group C showed higher oxidative activities and lower total anti-o xidative activities in lung tissues. Conclusion It is certai n that the BALF collected from dogs with acute severe smoke inhalation injury in early post-injury stage could induce obvious injury in lung structure of norma l rats, showing certain mechanic obstruction in small airways. The injuring act ivity of the BALF can be alleviated ultimately 24 h after the perfusion of the B ALF.
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Pulmonary circulation and gas exchange were observed during and after prostaglandin E_1-indueed hypotention in 9 adult mongrel dogs undergoing procaine balanced anesthesia. Cardiac index decreased from 12.5% to 13% (P0.05) during hypotension but the effective ratios of oxygen increased(P
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0.05) in both groups. In group B,cardiac output decreased by 13% at 15th min following deliberated hypotension (P0.05). It is suggested that PaCO_2 can be evaluated continuously and noninvasively by monitoring end-tidal CO_2 tension during SNP-induced hypotension.
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0. 05),cardiac index decreased from 12. 5% to 13. 3 % during hypotension (P 0. 05 ). It was concluded that PaCO2 can still be followed continuously and noninvasively by monitoring end-tidal CO2 tension during hypotension induced by PGE,