Risk factors of moderate to severe pain in patients with non-small cell lung cancer within 3 days after lobectomy / 中国基层医药

Objective:To investigate the risk factors of moderate to severe pain in patients with non-small cell lung cancer within 3 days after lobectomy.Methods:The clinical data of 297 patients with non-small cell lung cancer who underwent lobectomy in the Department of Thoracic Surgery, Sun Yat-sen University Cancer Center from December 2020 to June 2021 were retrospectively analyzed. A numerical rating scale was used to score the most severe pain within 3 days after surgery. Pain score ≥ 4 was defined as moderate to severe pain. The risk factors for moderate to severe pain were analyzed by binary Logistic regression. General linear model repeated measures and linear mixed models were used to analyze the trend of risk factors influencing postoperative pain with time.Results:The incidence of moderate to severe pain was 34.2% (102/297), 59.8% (178/297), 66.4% (198/297), and 28.2% (84/297) on days 0, 1, 2, and 3 after surgery respectively. The risk for moderate to severe pain was significantly higher in patients undergoing thoracotomy than patients undergoing thoracoscopic surgery on days 1 ( OR = 1.99, P = 0.009), 2 ( OR = 3.08, P < 0.001), and 3 ( OR = 3.88, P < 0.001) after surgery. However, the risk for moderate to severe pain in patients undergoing thoracotomy was slightly, but not significantly, higher than that in patients undergoing thoracoscopic surgery ( OR = 1.53, P = 0.087). The risk for moderate to severe pain was higher in female patients than male patients on day 2 ( OR = 1.62, P = 0.077), and in particular on day 3 after surgery ( OR = 2.39, P = 0.002). Prophylactic use of parecoxib significantly reduced the risk of moderate to severe pain on day 0 ( OR = 0.32, P = 0.004), 1 ( OR = 0.20, P < 0.001), 2 ( OR = 0.36, P < 0.001) and 3 ( OR = 0.56, P = 0.047). Conclusion:The incidence of moderate to severe pain on days 1 and 2 after lobectomy was relatively high in patients with non-small cell lung cancer. Patients undergoing thoracotomy have a higher risk of moderate to severe pain than those who underwent thoracoscopic surgery. Female patients have a higher risk for moderate to severe pain on days 2 and 3 after surgery than male patients. Prophylactic use of parecoxib can decrease the risk for moderate to severe pain in patients with non-small cell lung cancer.

Mechanism of Huangqisan Regulating Autophagy by AMPK/mTOR Signaling Pathway Against Hepatic Steatosis / 中国实验方剂学杂志

ObjectiveTo explore the mechanism of Huangqisan （HQS） in regulating autophagy to alleviate hepatic steatosis and improve non-alcoholic fatty liver disease （NAFLD） based on adenosine 5'-monophosphate-activated protein kinase （AMPK）/mammalian target of rapamycin （mTOR） signaling pathway. MethodThe main chemical components and targets of HQS and NAFLD-related targets were collected from database and the intersection targets were used for Gene Ontology （GO） functional enrichment analysis and Kyoto Encyclopedia of Genes and Genomes （KEGG） pathway enrichment analysis. The protein-protein interaction （PPI） network was constructed， and in vivo experimental verification was conducted. Sixty C57BL/6J male mice were randomly divided into normal control group （NCD）， model group high-fat diet （HFD）， metformin group （MET， 0.25 g·kg-1）， low-dose Huangqisan group （HQS-L， 0.5 g·kg-1）， and the high-dose Huangqisan group （HQS-H， 1 g·kg-1）， with 12 mice in each group after a one-week acclimatization period. NAFLD model was induced by HFD， and intragastric administration was performed at the same time， once a day for 13 weeks. Random blood glucose， serum total cholesterol （TC）， triglyceride （TG）， non-esterified fatty acid （NEFA）， low density lipoprotein-chdesterol （LDL-C） levels， and liver TG content were determined. The liver weight was weighed， and liver index was calculated. Hematoxylin-eosin （HE） staining， oil red O staining， transmission electron microscope （TEM）， real-time fluorescence quantitative polymerase chain reaction （Real-time PCR）， and Western blot were used to verify the effect and reveal the potential mechanism of C57BL/6J mice in vivo. ResultThrough network pharmacology analysis， combined with previous studies， it was predicted that HQS may improve NAFLD by regulating autophagy via the AMPK/mTOR signaling pathway. The result of in vivo experiment showed that， as compared with NCD group， random blood glucose， body weight， serum TC， LDL-C， NEFA， liver weight， liver index， and liver TG content of mice in the HFD groups were significantly increased （P<0.01）. HE staining showed massive lipid droplets （LDs） vacuolated， oil red O staining showed lipid accumulation in liver cells， and no obvious autophagosomes and autolysosome were observed under TEM. The relative mRNA expression of LC3A、LC3B、AMPKα1 and protein expression of AMPK， phosphory phosphorylated（p）-AMPK， and p-AMPK/AMPK were significantly down-regulated （P<0.01）， while the protein expression of microtubule-associated protein 1 light chain 3 （LC3）Ⅱ/Ⅰ and p-mTOR was significantly up-regulated （P<0.01）. As compared with HFD groups， liver weight， serum TG， and NEFA levels in HQS-L and HQS-H groups were significantly deceased （P<0.05， P<0.01）. HE staining and oil red O staining showed the improvement of liver pathological changes after HQS administration. Under TEM， a small amount of autophagosome and autolysosome were observed. Besides， liver index was significantly decreased in the HQS-L group （P<0.01）， and random blood glucose， serum TC level and liver TG content were significantly decreased in the HQS-H group （P<0.05）. The results of Western blot and Real-time PCR showed that the mRNA expression of LC3A and LC3B and the protein expression of LC3Ⅱ/Ⅰ， p-AMPK， and p-AMPK/AMPK were significantly up-regulated （P<0.01）， while the mRNA expressions of p62 and protein expression of p62 and p-mTOR were significantly down-regulated （P<0.05， P<0.01）. ConclusionHQS may promote autophagy and restore autophagy flux via the AMPK/mTOR signaling pathway to alleviate hepatic steatosis improving NAFLD.

Research progress on the role of short-chain fatty acids in the treatment of ulcerative colitis / 中华临床营养杂志

Short-chain fatty acids (SCFAs), as the main energy source for colonic epithelial cells, are becoming one of the important nutritional agents in the treatment of E1 (proctitis) and E2 (left-sided) subtypes of ulcerative colitis. To date, the therapeutic effects of topical SCFAs as primary or adjuvant induction therapy have been studied. However, the specific mechanism of action for SCFAs in the pathogenesis and progression of ulcerative colitis needs further investigation. High-quality prospective studies are required to verify current opinions on the selection of SCFA mixtures and the choice of topical or systemic routes of administration. In addition, SCFA is considered as a promising agent to prevent the occurrence and progression of ulcerative colitis-related colorectal cancer. Therefore, the optimal timing to integrate SCFAs into the treatment of ulcerative colitis represents another future research direction.

A cohort study of nutritional metabolic risk factors associated with recurrence in patients with initially diagnosed ulcerative colitis / 中华临床营养杂志

Objective:To investigate the nutritional and metabolic risk factors associated with recurrence in patients with newly diagnosed ulcerative colitis (UC), so as to allow better clinical prediction of recurrence.Methods:A retrospective cohort study was conducted. Patients newly diagnosed with UC (mild and moderate) from the People's Hospital of Xinjiang Uygur Autonomous Region were screened based on prespecified inclusion and exclusion criteria from January 2016 to January 2019. Patients were followed up regularly for three years. Subgroups were determined according to the presence or absence of recurrence. The patients in the UC recurrence group were further stratified according to the time to recurrence into short-term (0-6 months), mid-term (6-12 months) and long-term (12-36 months) recurrence groups. The nutritional and metabolic risk factors related to recurrence were evaluated by univariate analysis and multifactorial logistic regression analysis, and the predictive value was evaluated via receiver operating characteristic curve. The risk factors were then compared across the 3 subgroups with recurrence.Results:A total of 210 patients newly diagnosed with UC (mild and moderate) were included, including 38 experiencing recurrence within 0-6 months, 27 within 6-12 months, 24 within 12-36 months, and 121 without recurrence. There were no statistically significant differences in gender, age, smoking history, and family history in the recurrence group compared with the non-recurrence group. Univariate analysis suggested significant differences in homocysteine, folate, total cholesterol, triglycerides, high-density lipoprotein (HDL), low-density lipoprotein (LDL), apolipoprotein A/B (ApoA/B), 25-hydroxy vitamin D 3, and body mass index (BMI) between recurrence and non-recurrence groups ( P < 0.05). Multifactorial binary logistic regression analysis suggested that homocysteine ( OR = 0.869, 95% CI: 0.782 to 0.965, P = 0.009), triglycerides ( OR = 0.176, 95% CI: 0.060 to 0.519, P = 0.002), LDL ( OR = 0.256, 95% CI: 0.089 to 0.733, P = 0.011), 25-hydroxy vitamin D 3 ( OR = 0.937, 95% CI: 0.895 to 0.0.982, P = 0.006), and BMI ( OR = 1.319, 95% CI: 1.162 to 1.498, P < 0.01) were independent risk factors for UC recurrence. The predictive efficiency of individual risk factors in descending order was as following: LDL (AUC = 0.762, Youden's index [YI] = 0.42, cut-off value = 2.345), triglycerides (AUC = 0.718, YI = 0.361, cut-off value = 1), homocysteine (AUC = 0.666, YI = 0.283, cut-off value = 13.265). There were no statistically significant differences in gender, age, smoking history, and family history across the short-term, mid-term and long-term recurrence groups. There were significant differences in HDL and ApoA/B levels between the short-term and the long-term recurrence groups ( P < 0.05). Conclusions:Recurrence of the disease in UC patients results from the combined effects of multiple factors. The changes in homocysteine, triglycerides, LDL, 25-hydroxy vitamin D 3, and BMI in UC patients should be proactively monitored to prevent recurrence.

Effect of nursing checklist in posterior surgery for patients with thoracolumbar fracture with general anesthesia under prone position / 中华创伤杂志

Objective:To explore the value of nursing checklist in posterior surgery for thoracolumbar fracture with general anesthesia under prone position.Methods:A retrospective case series study was conducted to analyze the clinical data of 106 patients with thoracolumbar fracture admitted to Sir Run Run Shaw Hospital，Zhejiang University School of Medicine from June 2018 to May 2020. There were 80 males and 26 females，with age range of 25-57 years［（48.6 ± 11.9）years］. Segments of injury were located at T 11 in 18 patients，at T 12 in 26，at L 1 in 21，at L 2 in 25 and at L 3 in 16. All patients were treated with thoracolumbar posterior screw fixation under general anesthesia. Of all，51 patients received conventional postural nursing from June 2018 to May 2019（control group），and 55 patients received prone position nursing scheme for general anesthesia on the basis of conventional postural nursing from June 2019 to May 2020（verification group）. The incidence of postoperative complications including stress injury，brachial plexus injury，ulnar nerve injury and ocular discomfort as well as length of hospital stay and patients’ satisfaction were compared between the two groups. Visual analogue scale（VAS）and Oswestry disability index（ODI）were also used to measures outcome at postoperative 3 months. Results:All patients were followed up for 8-12 months［（10.5±0.9）months］. Verification group and control group showed significant differences in the incidence of stress injury（4%∶29%），brachial plexus injury（4%∶16%）and ocular discomfort consisiting of tears（2%∶12%），foreign body sensation（0%∶4%）and dryness（4%∶16%）（ P < 0.05），not in ulnar nerve injury and blurred vision. Length of hospitalization in verification group was（7.0±1.3）days，significantly shorter than that in control group［（9.9±1.9）days］（ P < 0.05）. Satisfaction of patients in verification group and control group was 85%（47/55）and 69%（35/51），respectively（ P < 0.05）. At 3 months postoperatively，VAS in verification group［（1.9 ± 0.8）points］was significantly lower than that in control group［（3.5±1.1）points］（ P < 0.05），and ODI was similar between the two groups（ P > 0.05）. Conclusions For patients with thoracolumbar fracture treated by posterior surgery with general anaesthesia under prone position，nursing checklist helps reduce occurrence of the related complication，shorten length of hospital stay，improve patient satisfaction，reduce postoperative pain and promote rehabilitation.

Application of coding navigation index and specialized placement scheme for surgical instruments / 中华医院管理杂志

As the operation volume in hospitals is increasing year by year, surgical instruments are widely used, which pose a great challenge to the daily management of surgical instruments. The authors investigated the existing problems which occurred in the management of surgical instruments, and came out with instruments coding navigation index and specialized placement scheme for the operating room as solutions. The specific measures included dividing sterile items into specialized categories, setting cabinets respectively for specialized and general subjects, building equipment coding and identification, establishing surgical instruments navigation index and carrying out training program, to serve as reference for efficient and fine management of surgical instruments.

Teaching reform of ultrasound imaging on integrated medical curriculum / 中华医学教育探索杂志

Recently, the integrated medical curriculum with main line of organ system and with core of disease has played an important role in medical educational reform. During the teaching reform of ultrasonic imaging in the First Affiliated Hospital of Chongqing Medical University, there existed some main problems: simply considering the "integration" as "combination"; unreasonable arrangement of ultrasonic courses; different emphasis on teaching goals between the traditional and integrated teaching; deficient ultrasonic knowledge of clinical teachers, etc.. To solve those problems, teachers participated in the reform must take some measures: firstly, totally understand the spirit of integrated medical reform, and the goal of reform which is improving the clinical ability and quality of medical students but not the pure teaching of medical knowledge; secondly , adjust the curriculum establishment and content of ultrasonic imaging;thirdly, fully utilize the Picture Archiving and Communication System (PACS) system to complement the problem of deficient ultrasonic knowledge of clinical teachers.

Progresses of ultrasonography in assessing capacity status of acute severe patients / 中国医学影像技术

Circulatory instability is one of the most common acute emergency conditions,and rapid assessment of capacity status is the key to guide treatment.At present,measuring of central venous pressure (CVP) is a commonly used method,but it is an invasive operation which may bring some recent and long-term complications.Recently,as a noninvasive examination,ultrasound has been widely used in monitoring of hemodynamics,and emergency ultrasound assessment of patient's capacity status and directing fluid therapy has become popular.The application progresses of ultrasonography in assessment of capacity status in acute severe patients were reviewed in this paper.

Targeting ability and photoacoustic imaging of novel nanoparticle probe loaded with ZnPc and docetaxel: An in vitro study / 中国介入影像与治疗学

Objective To investigate the targeting ability and photoacoustic imaging of novel nanoparticle probe loaded with ZnPc and docetaxel.Methods The polymeric nanoparticles probe loaded with ZnPc and docetaxel were fabricated using double emulsion method.RGDfK was modified on the surface for breast carcinoma targeting by carbodiimide method.The encapsulating ratio (ER) and drug loading (DL) of ZnPc and docetaxel were assessed.The modification rate and targeting ability of molecular probe were tested in vitro,and the photoacoustic imaging and drug release profiles were observed.Results The probes were loaded with ZnPc and docetaxel efficiently and successfully.The size of novel nanoparticle loaded with ZnPc and docetaxel was (266.00 ± 65.85)nm,and the surface potential was (-29.20± 6.27)mV.ER and DL of docetaxel was (88.00±0.32)％ and (34.92±0.02)μg/mg,of ZnPc was (97.25±0.22)％ and (30.87±0.11)μg/mg,respectively.The probes had certain sustained slow release effect and showed obvious photoacoustic signals,which enhanced with the increase of the content of ZnPc.Flow cytometry detection results showed that the RGDfk modification rate was 89.19％.The apoptotic rate of novel nanoparticle loaded with ZnPc and docetaxel targeting breast carcinoma increased after the laser irradiation in vitro.Conclusion The new polymeric multifunctional nanoparticles probe has an ideal size and good photoacoustic signals,also the ability to target breast carcinoma cells and inhibit the proliferation of breast carcinoma cells efficiently.

Carcino-embryonic antigen targeted and drug loaded ultrasound nanoparticle agents inhibit growth of ovarian cancer cells in vitro / 中国医学影像技术

Objective To prepare carcino-embryonic antigen (CEA) targeted and paclitaxel loaded phase-shifting PLGA nanoparticles (Ab-PTX-NPs),and investigate the targeting capability and inhibition to the ovarian cancer cell in vitro.Methods Single-emulsion/solvent evaporation (O/W) and carbodiimide method were used to prepare the Ab-PTX-NPs.The size of nanoparticles was determined by Malvern analyzer.The encapsulation and drug loaded efficiency of paclitaxel were detected by high performance liquid chromatography.And the drug release characteristics was measured by dialysis method in constant temperature shaker.The targeting ability of Ab-PTX-NPs to the ovarian cancer SKOV3 cell was evaluated by the laser scanning confocal microscope and flow cytometry.And the inhibition ability of Ab-NPs was investigated by the CCK-8 assays.Results The size of Ab-PTX-NPs was (397.70±99.95)nm.The encapsulation efficiency and drug loading capacity of PTX were (67.26±4.15) ％ and (6.31±0.39) ％,respectively.The conjugating rate of Anti-CEA antibody was (92.74 ± 5.75) ％.The targeting study in vitro showed that such a number of contrast agents landed around the SKOV3 cells in targeting group,and the mean fluorescence intensity of ovarian cells in targeting group was significantly higher than other groups (P＜0.05).After 24 h,the viability rate of ovarian cells in targeting group was lower than the non-target group (P＜0.05),only higher than that of the pure PTX group (P＜0.05).But there was no significant difference between the targeting group and the pure PTX group (P＞0.05) at 48 h.Conclusion The CEA targeted and paclitaxel loaded phase-shifting PLGA nanoparticles are successfully prepared.It can enhance ultrasound imaging well after activated by LIFU.With high drug-loading efficiency and fast drug release velocity,the Ab-PTX-NPs appeares great targeted ability.

Understanding of hierarchical medical mode in chronic diseases management among medical staff and residents in Xiamen / 中华全科医师杂志

Objective To estimate the status of understanding hierarchical medical mode in chronic disease management among medical staff and residents in Xiamen .Methods The multi-stage sampling was used in the study to select 49 physicians from the tertiary hospitals , 58 general practitioners ( GPs ) and health managers from 5 community health services centers , and 499 residents from 5 communities in Xiamen.We conducted a face-to-face survey to estimate their basic information , recognition for hierarchical medical mode , and patients'willingness for community first contact care .The data was described by mean value of frequency and constituent ratio , the chi-square test or Fisher's exact test was used for comparison among groups .Logistic regression was performed to analyze the factors influencing the residents 'preference for treatment in community medical institutions . Results The physicians from tertiary hospitals or community health service centers were almost all familiar with Xiamen mode (91/107, 85%), and more than half of them knew about the hierarchical medical system (67/107, 62.6%), 86.9% (93/107) of them knew about the guide of hierarchical medical system , 58.9%(63/107) of them received the relative training before .The physicians from community had higher knowledge , more frequency training , more referral experiences and more effective evaluation than the physicians from hospitals (all P<0.05).In our study, 86.2%(344/399) of residents were willing to see doctors in community health centers and 77.9%(311/399) of them were willing to return to community health service centers from tertiary hospitals for disease convalescence or chronic disease management;53.6% (214/399) of residents preferred to utilize community first contact care when they got chronic diseases , and they were more satisfied with the consultation and diagnosis process in community .The residents who knew about the hierarchical medical system were more likely to utilize community first contact care and return to community for medical care . However, the female or the higher-income residents were less likely to see doctors in community .Patients who had experienced transfer to community or had higher satisfaction to community care were more willing to return from hospitals to community for disease convalescence .The mode showed that the system was more effective in measuring and controlling blood pressure or blood glucose for patients who joined the patients 'network than for those did not join.(P<0.05).Conclusion Medical staff are familiar with hierarchical medical system , and the residents are likely to use community health service as their first contact care in Xiamen.The utilization of community first contact care is influenced by sex , family income, previous experience, knowledge of the system , and satisfaction to the system of patients .

Gas chromatography-mass spectrometry based urinary metabolomics in very low birth weight premature infants / 中华儿科杂志

Objective@#To investigate the urinary metabolic spectrum and pathways in very low birth weight (VLBW) premature infants.@*Method@#A prospective case-control study was conducted to collect and compare the data of VLBW premature infants and full term infants from the Sixth Affiliated Hospital of Sun Yet-Sen University in 2014. Within 24 hours after birth, urine specimens in each group were collected. Metabolites of urine samples including amino acid, fatty acid and organic acid were detected using the urease pre-processing and gas chromatography mass spectrometry (GC-MS) technology. Using the orthogonal partial least squares discriminant analysis (OPLS-DA), the biomarkers and differences between the two groups were found. The online metabolic pathway website was explored and multivariable analysis was conducted to investigate the valuable pathways and biomarkers related to the prematurity.@*Result@#A total of 20 VLBW premature infants were enrolled, among whom 11 were male, 9 were female; and 20 full term infants were enrolled, among whom 9 were male, 11 were female. The urinary metabolites were established and compared between the VLBW premature and term infants. The investigation showed that the following nine pathways were enriched: amino-acyl-tRNA biosynthesis(P=0.000), lysine degradation(P=0.007), fatty acid biosynthesis(P=0.008), pyrimidine metabolism(P=0.014), pantothenate and CoA biosynthesis(P=0.022), valine, leucine and isoleucine biosynthesis(P=0.022), lysine biosynthesis(P=0.031), glycerolipid metabolism(P=0.046), and valine, leucine and isoleucine degradation(P=0.031). Almost all the metabolites decreased except for the glyceric acid exhibiting a higher content in the VLBW premature infant. 12 potential biomarkers were explored with the most significant covariance and correlation, within which stearic acid, palmiticacid, myristic acid, β-amino-isobutyric acid, and uric acid were lower, while myo-inositol, mannitol, glycine, glucose1, glucose2, glyceric acid and N-acetyl-tyrosine were higher in the VLBW premature group compared with the control group.@*Conclusion@#There is a significant difference between the VLBW premature infants and full-term infants in the metabolic state and pathways. The urease pre-processing and GC-MS technology followed by the OPLS-DA and multivariable analysis to investigate VLBW premature infants′ urinary metabolites is a valuable method to evaluate the patients′ metabolism.

The relationship between resilience and cognitive function of older adults / 中华行为医学与脑科学杂志

Objective To investigate the role of resilience on cognitive function in older adults.MethodsBy random sampling,a total of 321 older adults participated the present study and were investigated by Connor-Davidson Resilience Scale,Mini Mental State Examination and self-designed general questionnaire.ResultsThe score of resilience in older adults (82.75±15.13) was significantly higher than that of Chinese community people (65.40±13.90) (t=20.68,P<0.01).Older adults with poor resilience performed significantly lower on all dimensions of cognitive abilities than the other two groups (middle & higher resilience group) (all P<0.05).With both age and educational level controlled,tenacity and strength were of positive prediction for the cognitive abilities of older adults (β=0.25,0.17,P<0.05).ConclusionThere is a close relationship between resilience and cognitive function of older adults.The training of tenacity,strength and optimism will help delay the decline of cognitive function.

Effects of p-hydroxyacetophenone on bile secretion and blood lipid levels in rats / 药学实践杂志

Objective To study the effects and mechanism of p-hydroxyacetophenone (PHA ) on bile secretion ,choles-terol metabolism and blood lipids .Methods Cystic duct cannula was cannulated and bile were collected in SD rats .PHA was administrated in the high cholesterol rats .The activity of HMG-CoA reductase was determined by spectrophotometry in reac-tion system .Samples of liver were obtained in experiment hypercholesterolemia rats and Real-time PCR test was conducted for AQP8 ,CYP7A1 ,OATP and NTCP .Results Secretion of bile were increased ,cholesterol in bile were reduced and secretion of total bile acid were increased in rats by PHA .The level of serum cholesterol in hyperglycemia rat model was reduced signifi-cantly and inhibitory ability had been limited in the activity of HMG-CoA reeducates by PHA ,but the gene transcription inclu-ding AQP8 ,CYP7A1 ,OATP ,and NTCP were promoted ,which are related to function of excretion of biliary acid and trans-formation of cholesterol .Conclusion These results suggest that PHA ,as a lead compound ,might be of significance for fur-ther development for a bile secretory and lipid lowering agent .

Effects of age factors on sedation induced by dexmedetomidine / 中华麻醉学杂志

Objective To evaluate the effects of age factors on sedation induced by dexmedetomidine.Methods One hundred and thirty-nine patients,aged 18-103 yr,with body mass index ≤ 30 kg/m2,scheduled for elective surgeries on lower abdomen or lower extremities,were divided into4 groups according to the age:group Ⅰ (18 yr≤age≤44 yr,n=40);group Ⅱ (45 yr≤age≤59 yr,n=38);group Ⅲ (60 yr≤age≤89 yr,n=39);group Ⅳ (≥90 yr,n=22).A catheter was placed in the subarachnoid space at L3,4 interspace,and ropivacaine 10-20 mg was injected via the catheter.At 20 min after ropivacaine injection,dexmedetomidine 1 μg/kg was infused via a pump over 10 min.The onset time and duration of sedation were recorded,and the occurrence of adverse effects such as hypoxemia,bradycardia and hypotension was observed.Results There was no significant difference in the onset time of sedation and incidence of bradycardia among the 4 groups (P＞0.05).Compared with group Ⅰ,the duration of sedation was significantly prolonged in Ⅱ-Ⅳ groups (P＜0.05).Compared with Ⅱ and Ⅲ groups,the duration of sedation was significantly prolonged in group Ⅳ (P ＜ 0.05).The incidence of hypoxemia and hypotension was significantly higher in group Ⅳ than in Ⅰ-Ⅲ groups (P＜0.05).Conclusion Dexmedetomidine-induced sedation is influenced by age factors,the duration of sedation induced by dexmedetomidine is prolonged,and the occurrence of adverse effects is increased,especially if the patients ≥ 90 yr of age.

Bioequivalence of levetiracetam extended-release tablets in Beagle dogs / 药学实践杂志

Objective To study the bioequivalence of two kinds of levetiracetam extended‐release tables including the ref‐erence product of Keppra XR in Beagle dogs .Methods Dogs were administrated orally with single dose of levetiracetam tablets (1 000 mg) .The concentration of levetiracetam in dog plasma was detected by LC‐MS/MS .All parameters of pharmacokinetics were performed by WinNonlin 5 .2 software .Results Main pharmacokinetic parameters of test and reference tablets were as follow :tmax were 1.67 h and 3 .0 h ,Cmax were 89 .50 μg/ml and 71 .18 μg/ml ,t1/2 were 3 .68 h and 3 .50 h ,AUC(0‐48) were 826 .57 μg?h/ml and 757 .84 μg?h/ml ,AUC(0‐∞ )were 826 .68 μg?h/ml and 757 .93 μg?h/ml .The relative bioavailability of test tablets was 109 .07% to reference products of Keppra XR .Conclusion Therefore ,the two kinds of levetiracetam extended‐release tablets were bioequivalent in Beagle dogs .

Effect of dexmedetomidine on spinal p38MAPK expression during remifentanil-induced postopera-tive hyperalgesia in rats with incisional pain / 中华麻醉学杂志

Objective To evaluate the effect of dexmedetomidine on spinal p38 mitogen?activated protein kinase ( p38MAPK) expression during remifentanil?induced hyperalgesia in rats with incisional pain. Methods Forty?eight healthy male Sprague?Dawley rats, aged 6 weeks, weighing 220-250 g, were ran?domly divided into 4 groups ( n= 12 each) using a random number table: control group ( group C) , inci?sion pain group ( group IP ) , incision pain + remifentanil group ( group IP+R ) , and incision pain +remifentanil + dexmedetomidine group ( group IP+R+D) . After successful establishment of the model of in?cisionsal pian, remifentanil 1?0μg∕kg was infused for 4 h via the tail vein in group IP+R; remifentanil 1?0μg∕kg was infused for 4 h via the tail vein, and dexmedetomidine 10μg∕kg was simultaneously infused for 4 h via the jugular vein in group IP+R+D; the equal volume of normal saline was infused for 4 h via the tail and jugular veins in C and IP groups. The mechanical paw withdrawal threshold ( MWT) was measured at 24 h before operation ( T0 ) , and at 4, 6, 24 and 48 h after the end of drug infusion ( T1?4 ) . After meas?urement of MWT at T4 , the expression of p38MAPK was determined using immuno?histochemistry. Results was up?regulated at T4 in IP and IP+R groups ( P0?05). Compared with group IP, the MWT was signifi?cantly decreased at T1?4, and the expression of p38MAPK was up?regulated at T4 in group P+R, and the MWT was significantly increased at T1?4, and the expression of p38MAPK was down?regulated at T4 in group IP+R+D (P<0?05). Compared with group IP+R, the MWT was significantly increased at T1?4, and the expression of p38MAPK was down?regulated at T4 in group IP+R+D ( P<0?05) . Conclusion The mecha?nism by which dexmedetomidine reduces hyperalgesia induced by remifentanil is related to down?regulation of spinal p38MAPK expression in the rats with incisional pain.

Age and carotid remodeling: a quantitative study of vascular structure with three dimensional ultrasound / 中华超声影像学杂志

Objective To investigate the vessel structure changes of carotid artery with age in normal adults with a newly-developed 3-dimensional ultrasound imaging modality.Methods One hundred and twenty-five normal adult volunteers were divided into five groups:group A,20-29 years old,25 cases;group B,30-39 years old,27 cases;group C,40-49 years old,28 cases;group D,50-59 years old,23 cases;group E,older than 60 years old,22 cases.The straight sections of common carotid arteries were scanned by full-volume three-dimensional ultrasound probe.With a vessel plaque quantification software (VPQ),the following parameters were obtained:intima-media thickness (IMT),vessel total area (VTA),vessel lumen area (VLA),vessel wall area (VWA),and normalized wall index (NWI).Results IMT,VTA,VWA,VLA and NWI were all positively correlated with age (r =0.79,0.48,0.77,0.27 and 0.67 respectively,P =0.00),and there was significant difference among age groups (P ＜0.01).IMT,VTA,VWA increased with age gradually whereas VLA increased only in group E and NWI showed no significant difference between group E and D.VWA and VTA of males were significantly greater than those of females in group A,B and C,and VLA of males was significantly greater than females in group A and B.There was no significant difference in IMT and NWI between gender groups.Conclusions Age is an important factor to carotid remodeling,and IMT,VTA and VWA increase with age,but VLA keeps constant in people under 60-year-old while NWI becomes stable in people over 50-year-old.It is essential to consider the physiological changes of carotid with age when pathophysiological process of atherosclerosis is involved.

Community-based intensive health management for type Ⅱ diabetics / 中华健康管理学杂志

Objective To discuss the effectiveness of community-based intensified health management on type Ⅱ diabetes patients.Metbods From June 2010 to December 2011,1 024 type Ⅱ diabetes patients in Mishi Lane community were enrolled and assigned to the intervention group (n=501,obtaining intensive health management) and the control group (n=523,obtaining routine community health management).Fastingbloodglucose (FBG),2-hour postprandial blood glucose (PBG2h),HbA1c,blood pressure (BP),triglyceride (TG) and body mass index (BMI) were tested and recorded before and after the intervention.Student's t test or Chi-square test were used for data analysis.Results Differences of age (t=0.124,P＞0.05) and gender (x2=2.0,P＞0.05) were not statistically significant (both P＞0.05).Following the intensive health management,the control rates of HbA1c,BP,TG and BMI were increased to 75.4％,30.4％,85.6％ and 49.0％,respectively (x2 values were 4.54,4.71,6.54 and 3.67; all P＜0.05).TG,FBG and PBG2h of the intervention group were (1.5 ± 0.9),(6.2 ± 1.3) and (8.3 ± 2.4) mmol/L,respectively,which were significantly lower than those of the control group (all P＜0.05).Conclusion Community-based intensive health management could be effective for diabetes patients.

Knowledge-attitude-practice(KAP)-based health management of type 2 diabetes among community residents / 中华健康管理学杂志

Objective To discuss the effectiveness of knowledge-attitude-practice(KAP)-based health management on type 2 diabetes in community residents.Methods From June 2010 to December 2011,930 type 2 diabetes patients living in Mishi Lane Community were enrolled and assigned to the intervention group(n=494) and the control group(n=436).The KAP mode was used for the intervention group,and the routine management mode was applied to the control group.Fasting blood glucose(FBG),PBG2 h,HbAlc,blood pressure(BP),triglyceride(TG) and body mass index(BMI) were tested and recorded.Student's t test or Chi-square test was used for data analysis.Results Age(t=0.124,P＞0.05),gender(x2=2.0,P＞0.05) and other demographics showed no statistically significant difference between the two groups(all P＞0.05).After one-year KAP-based health management,HbA 1 c of the intervention group reduced to(6.1 ± 1.2)％,FBG and PBG2 h reduced by 1.7 and 3.23 mmol/L,respectively(t=4.926,P＜0.05; t=4.306,P＜0.05; t=4.523,P＜ 0.05).Diet,physical exercises,medication,regular inspection,unhealthy habits and questionare test awaveness of the intervention group were improved(86.03％,82.19％,85.63％,70.45％ 76.11％ and 88.46％,respectively.Drinking,dietary structure,overweight and physical exercises of the intervention group were also improved(14.17％,15.79％,70.65％ and 68.83％,respectively; all P＜0.001).Conclusion The KAPbased health management is proved to be effective in the control of community diabetic patients.