Effects of Different NSAIDs Combined with PICA on Postoperative Analgesia in Patients Undergoing Gynecolo- gical Laparoscopic Surgery and Its Effect on Serum Related Factors / 中国药房

OBJECTIVE：To investigate the effects of parecoxib sodium ，flurbiprofen axetil and lornoxicam combined with patient controlled intravenous analgesia （PICA） on postoperative analgesia in patients undergoing gynecological laparoscopic surgery and its effect on serum related factors. METHODS ：A total of 280 patients who underwent gynecologic laparoscopic surgery in the Second Affiliated Hospital of Hainan Medical University from Mar. 2017 to Mar. 2019 were randomly divided into control group （group C ），parecoxib sodium group （group P ），and flurbiprofen axetil group （group F ）and lornoxicam group （group L ）acording to random number table ，with 70 patients in each group. Four groups of patients received Sodium chloride injection 5 mL，Parecoxib sodium for injection 40 mg，Flurbiprofen axetil injection 50 mg and Lornoxicam for injection 8 mg （added 8 mg when the effect was not good ）intravenously at 30 min before the end of surgery. At the end of surgery ，they were given PICA of Sufentanil citrate injection and Dizosin injection for analgesia. The situation of pain and nausea symptom were evaluated at 6，12，24 and 48 h after surgery by using numerical rating scale （NRS）. The levels of serum CRP ，IL-6，SP and PGE 2 were detected by chemiluminescence method and ELISA. The times of pressing PICA pump and the dosage of analgesic were recorded in 4 groups within 24 h after surgery. The ADRs of patients within 48 h after surgery were recorded ，such as bloating ， dizziness，itchy skin ，respiratory depression and urinary retention. RESULTS ：At different time points ，the NRS scores of pain of group P ，F and L were significantly lower than those of group C ；and 48 h after surgery ，NRS score of pain of group L was significantly lower than those of group P and F （P＜0.05）. There was no statistical significance in the level of CRP ，IL-6，SP and PGE2 of 4 groups before surger （P＞0.05）. The CRP ，IL-6，SP and PGE 2 levels at each time point after surgery of group P ，F and L were significantly lower than those of group C ；compared with group P ，serum level of SP at 48 h after surgery as well as serum levels of PGE 2 at 12，24 and 48 h after surgery were significantly decreased in group F ，and serum level of IL- 6 at 48 h after surgery，serum levels of SP at 24 and 48 h after surgery ，serum levels of PGE 2 at 12，24，48 h after surgery were decreased significantly in group L ；compared with group F ，serum level of SP at 48 h after surgery as well as serum levels of PGE 2 at 12， 24，48 h after surgery were all decreased significantly in group L （P＜0.05）. There was no statistical significance in the incidence of anausea and vomiting among 4 groups（P＞0.05）. CONCLUSIONS ：Parecoxib sodium ，flurbiprofen axetil and lornoxicam combined with PICA can effectively relieve the pain of patients after gynecological laparoscopic surgery and reduce the levels of serum related factor ，and lornoxicam has the most obvious effect.

Radiation-related neoplasms, circulatory diseases, and cataracts among radiological technologists

Background: In response to the need for diagnosis and treatment, medical radiation has been increasingly used worldwide. This study investigated the medical utilization of radiation-related diseases among radiological technologists [RTs] and factors that influence such diseases

Materials and Methods: Data were collected from the Taiwan National Health Insurance Research Database. A panel study was conducted with a sample of 3,432 RTs obtained in 2007 and followed up until 2011. Logistic regression applying generalized estimating equations was used for investigating the relationship between RTs and radiation-related diseases

Results: Among the RTs, the annual medical utilization rate of hospitalization for radiation-related neoplasms was 1.17%o-4.43%0, that for circulatory diseases was 4.68%o-11.50%o, and the annual medical utilization rate of outpatient visits for cataracts was 2.91%o-7.38%0. After sex, age, hospital accreditation level, and hospital ownership were controlled, the odds of hospitalization for neoplasms and circulatory diseases among the RTs were nonsignificantly higher than those of pharmacists, and the odds of outpatient visits for cataracts among the RTs were nonsignificantly lower than those of pharmacists

Conclusion: No sufficient evidence exists to substantiate the argument that the exposure of RTs to current doses of radiation could increase the risk of neoplasms, circulatory diseases, and cataracts. Considering the increased use of radiation treatment in current medical facilities, all speculation on occupational radiation-induced diseases must be further investigated and verified

Liver transplantation in patients with portal vein thrombosis: comparing pre-MELD and MELD era

Portal vein thrombosis [PVT] used to be a relative contraindication for liver transplantation [LT]. This obstacle has been dealt with following the improvement of LT-related techniques. To compare the outcome of adult patients with PVT who underwent LT before and after adopting MELD. We retrospectively searched our database for deceased donor LT recipients who had PVT, were operated between 1990 and 2009, and were 18 years old or more. The outcome of patients operated in pre-MELD era [1990-2001] was then compared with that of those operated in MELD era [2002-2009]. The incidence of patients undergoing LT with PVT has increased from 1.2% [491/40,730] in pre-MELD era to 6% [2540/42,601] in MELD era [p<0.01]. Patients with PVT in MELD era were older [53.6 vs 50.5], had higher calculated MELD [21.3 vs 18.9], shorter length of hospital stay after LT [25 vs 21.7 days], more likely to develop HCC [14.8% vs 0], and more likely to receive DCD allograft [3.9% vs 0.8%]. Donor risk indices were comparable in both groups [1.9 vs 1.9]. The median waiting time before transplantation decreased during MELD era [71 vs 99 days]. Allograft and patients survival was comparable between the two eras. However, allograft and patients survival rates were lower in patients with PVT compared to those without. In Cox regression analysis, PVT was associated with worse allograft [HR=1.3, 95% CI: 1.2-1.4, p<0.001] and patient survival [HR=1.3, 95% CI: 1.2-1.5, p<0.001] compared to non-PVT patients. The incidence of patients with PVT has increased in MELD era without improvement in outcomes. Donor and recipients characteristics changed in MELD era. PVT is still associated with poor outcomes compared to patients without PVT

Dynamics of ecosystem service value caused by land use changes in manas river of xinjiang, China

This study aims to quantify the impacts of land use changes on ecosystem service value during large scale land development, and to provide key information for both economic development and policy makers for eco-environmental protection. The study area locates in Manas river watershed which is a typical land development region in northwest China. Landsat MSS/TM/ETM+ images in 1976, 1989, 1999 and 2008 were applied to estimate ecosystem service value based on land use, and subsequently ecosystem service value dynamics were analyzed in response to land use changes. It is found that the built-up area and cultivated land increased significantly from 1976 to 2008. The decreasing ecosystem service value [from 17362.2 million Yuan in 1976 to 16975.0 million Yuan in 2008] is mainly caused by the reduced grassland. The combined ecosystem service value of water body and grassland is over 60% of the total value. Functions of water supply, waste treatment, soil formation and retention and biodiversity protection contributed to over 70% of the total service value. The results suggest that a reasonable land use plan should emphasize protection of water body, woodland and grassland as they have the highest ecosystem service value

Tuberculosis infection control in a high drug-resistance setting in rural South Africa: Information, motivation, and behavioral skills

Tuberculosis [TB] is transmitted in resource-limited facilities where TB infection control [1C] is poorly implemented. Theory-based behavioral models can potentially improve 1C practices. The present study used an anonymous questionnaire to assess healthCare worker [HCW] TB IC information, motivation, and behavioral skills [1MB] implementation in two resource-limited rural South African hospitals with prevalent behavioral skills drug-resistant TB. Between June and August 2010, 198 surveys were completed. Although the respondents demonstrated information proficiency and positive motivation, 22.8% did not consider TB IC to be worthwhile. Most tasks were rated as easy by survey participants, but responding HCWs highlighted challenges in discrete behavioral skills. The majority of responding HCWs reported that they always wore respirators [54.3%], instructed patients on cough hygiene [63.0%], and ensured natural ventilation [67.4%] in high-risk areas. Most respondents [74.0%] knew their HIV status. Social support items correlated with the implementation of the first three aforementioned practices but not with the respondents' knowledge of their HIV status. In most cases, motivation and behavioral skills, but not information, were associated with implementation

Determination of retardation effect of SOM on aqueous leaching of poly cyclic aromatic hydrocarbons using confocal laser scanning microscope

Influence of soil organic matter [SOM] on the adsorption, desorption and transport of polycyclic aromatic hydrocarbons [PAHs] has already been given full investigation in soils. In this paper, confocal laser scanning microscope [CLSM] was used to elucidate aqueous leaching of PAHs in different types of soil with soil columns, which enhanced understanding on transport of PAHs appreciably. Four typical soils in China including fluvo-aquic soil [FAS], aquic brown soil [ABS], red soil [RS] and black soil [BS] were selected in the experiment. Target pollutants of phenanthrene and pyrene were extracted from the leachate by solid phase extraction [SPE] and then determined by high performance liquid chromatography [HPLC]. The experimental results showed that the retardation ability of pollutants to the four selected types of soil increased in the order: FAS H" ABS < RS < BS. To better expatiate the dissimilar ability of the PAHs transported in the four typical soils, the retardation factor [R], distribution constant [K[d]] and partition coefficient [K[oc] were evaluated based on the observed breakthrough curves [BTCs]. Furthermore, CLSM was used to visualize the effects of SOM on the transport ability of PAHs in different types of soil. All the results provided vivid understanding with mathematical and especially optical measures that SOM was considered the single most important factor limiting the availability and mobility of PAHs in soil over the duration of the experiment