Objective To assess the effectiveness and safety of local versus systemic application of opioids for labor analgesia. Methods We searched PubMed (1966 to January 2008), EMBASE (1980 to January 2008), The Cochrane Library (Issue 1, 2008), CBM (1978 to January 2008), CNKI (1979 to January 2008) for randomized controlled trials (RCTs) involving local versus systemic application of opioids for labor analgesia. Quality assessment and data extraction were conducted by two reviewers independently. Meta-analyses were conducted with The Cochrane Collaboration’s RevMan 4.2.10 software. Results A total of 12 trials involving 5909 participants met the inclusion criteria. Meta-analyses showed that local application of opioids was superior to systemic application in terms of maternal satisfaction with pain relief during labor (RR 1.63, 95% CI 1.27 to 2.09). No significant difference was found between the two groups in the incidence of low neonatal Apgar score at 5 minutes (RR 0.63, 95% CI 0.40 to 1.01). Conclusion Local application of opioids for labor analgesia appears to be more effective than systematic use in reducing pain during labor. But as for safety concerns, maternal and neonatal adverse effects are observed in both groups. Thus, more high-quality and large-scale RCTs are needed.
【Abstract】 Objective To establ ish a three-foot weight-bearing canine model to imitate the biomechanical loading environment of the human’s hip joint. To observe and compare the kinetic changes of hind l imbs between normal and three-foot weight bearing canines. Methods Using 10 beagles, three-foot weight-bearing canine models were made by fixing unilateral wrist joints at 90º flexionally. The changes of ground reaction forces and the time of standing phases (Ts) of the hind l imbs were compared by 3-D gait analysis pre- and postoperatively. Results Canines could walk well with three l imbs after the fixation of one fore l imb. However, the gait pattern changed tremendously. The canine walked jumpily by raising its head and neck, and the bilateral hind l imbs kept contacting ground alternately. Ts of ipsilateral hind l imb was (0.48±0.04)s, and Ts of contralateral hind l imb was (0.46±0.06)s. Although, the time durations were increased a l ittle, but there were no significant differences when compared with that of normal canines (0.43±0.05)s (P gt; 0.05). The vertical ground reaction force (Fz) of ipsilateral hind l imbwas (4.63±0.85) body weight, and the Fz of contralateral hind l imb was (4.78±0.49) body weight. There were significant increases when compared with the Fz of normal canines (3.26±0.48) body weight (P lt; 0.05). The peak acceleration force of the ipsilateral hind l imb was (0.80±0.30) body weight. There was significant increase compared with that of normal canines (0.72±0.13) body weight (P lt; 0.05). The peak acceleration force of the contralateral hind l imbs was (0.68±0.22) body weight, there was no difference compared with that of normal canines (P gt; 0.05). The peak deceleration forces of the ipsilateral and contralateral hind l imbs were —(0.26±0.14) body weight and —(0.13±0.05) body weight separately. They decreased significantly when compared with that of normal canines —(0.43±0.13) body weight (P lt; 0.05). In normal canines, the upper l imbs were main load bearingl imbs, they could bear 62.8%±2.4% of body weight. However, the hind l imbs could bear only 37.2%±1.8% of body weight. On the contrary, in three-foot weight-bearing canines, the hind l imbs became the main load bearing l imbs, they could bear 59.1%±6.7% of body weight. Conclusion Three-foot weight-bearing canine model can be used as a candidate animal model to research the effects of biomechanical loading on the progression of hip joint diseases.
Objective To observe the expression of vascular endothelial growth factor A (VEGFA) and its receptors sFlt-1, kinase insert domain receptor (KDR) in lightinjured human retinal pigment epithelial (RPE) cells. Methods Cultured human RPE cells (8th - 12th generations) were divided into normal control group and light damage group. The cells of two groups were exposed to the 18 W cold white light (2200±300) Lux for 12 hours to induce light damage responses, but the cells of normal control group were packed by tinfoil with doubledeck high pressure disinfection. The VEGF-A, sFlt-1 and KDR mRNA and protein expressions were detected by reverse transcriptionpolymerase chain reaction (RT-PCR) and Western blot at 0, 6, 12, 24 hours after light damage. Results The VEGF-A mRNA and protein expressions in light damage group were significantly increased at 6 hours, and reached its peak at 12 hours after light damage which obviously higher than that in normal group (t=2.74, 2.93; P＜0.05), and then went down gradually. The sFlt-1 mRNA and protein expressions in light damage group reached its peak at 12 hours after light damage which obviously higher than that in normal group (t=4.32, P＜0.01), but obviously lower than that in normal group at 24 hours after light damage (t=2.41, P＜0.05). The KDR mRNA and protein expressions in light damage group were obviously higher than that in normal group at 24 hours after light damage （t=2.89, P＜0.05）,but there was no changes at 6, 12 hours after light damage (t=1.84, P＞0.05). Conclusions At 6, 12 hours after light damage, the expressions of VEGF-A and sFlt-1 increases significantly and KDR expression is stable in lightinjured RPE cells. At 24 hours after light damage, the expression of VEGF-A and sFlt-1 decreases, but KDR expression increases in light-injured RPE cells.
The study of neuronal activity with low frequency has shown an increasing interest for its greater stability and reliability recent years. One challenge in analyzing this kind of activity is to find similarities and differences between signals efficiently and effectively. The traditional analysis methods, such as short-time Fourier transform, are easily obscured by background noises and often involve a large number of parameters. Therefore, this paper introduces a novel time-frequency analysis method based on wavelet transformation and half-ellipsoid modeling to extract instantaneous frequency and instantaneous phase information. This method overcomes some shortcomings of conventional time-frequency analysis. In this method, wavelet transformation is used to provide high-level representations of raw signals, and parsimonious half-ellipsoid models are used to extract changes in time domain and frequency domain of neural recordings. The method was validated to local field potentials (LFPs) of olfactory bulb of anesthetized rats during three different odor stimuli. The results suggested that this method could detect odor-relevant features from olfactory signals with large variability. The Odors then were classified with support vector machine (SVM) algorithm and the classification accuracy reached 79.4%.
ObjectiveTo investigate the role of interleukin-25 (IL-25) and its receptor during allergen challenge test in allergic asthmatics as well as its underlining mechanism.MethodsFifteen allergic asthmatic patients with dual response in allergen challenge test were enrolled and blood samples were collected before and after challenge test. The expression levels of IL-25 receptor on the surface of eosinophils, plasma and intracellular IL-25 levels were measured by flow cytometry and enzyme-linked immunosorbent assay. Besides, the function of eosinophils from these patients was evaluated through the expression of type 2 cytokines, degranulation and chemotaxis after stimulation with IL-25.ResultsUpon allergen challenge, the expression of IL-17RB on the surface of eosinophils were increased from (7 426±2 824)/106 white blood cells to (19 446±5 593)/106 white blood cells (P<0.001). The expression of IL-17RA/RB on eosinophils were significantly increased from (4 508±1 360)/106 white blood cells to (9 025±3 166)/106 white blood cells (P<0.001). The plasma level of IL-25 increased from (650±45) pg/ml to (851±43) pg/ml (7 hours after allergen challenge) and (813±56) pg/ml (24 hours after allergen challenge) (P<0.001). The intracellular IL-25 expression of eosinophils was also upregulated from (10 398±1 909)/106 white blood cells to (147 684±46 222)/106 white blood cells (P<0.05). In vitro study, IL-25 (1 ng/ml) stimulated eosinophils for 2 hours promoted its expression of peroxidase [(12.5±4.2) ng/ml compared to control (1.26±0.4) ng/ml, P<0.05). The intracellular expression of IL-5 and IL-13 in eosinophils were also increased after stimulated by IL-25. IL-25 (1 pg/ml) stimulation compared to control could increase eosinophil migration in eotaxin [(36±3) vs. (69±5), P<0.05).ConclusionIL-25 and its receptor play a critical role in eosinophilic aggregation, activation and mobilization during allergic inflammation in allergic asthmatics.
ObjectivesTo comprehensively evaluate the methodological quality and applicability of the results of systematic reviews on acupuncture treatment for primary depression.MethodsWeb of Science, EMbase, PubMed, The Cochrane Library, CNKI, CBM, WanFang Data and VIP databases were electronically searched to collect systematic reviews/meta-analyses on acupuncture treatment for primary depression from inception to December 5th, 2018. Two researchers independently screened and extracted data by using tools of AMSTAR 2 to evaluate the methodological quality, using ROBIS to assess risk of bias, and using CASP-S.R to evaluate the applicability of the results.ResultsA total of 18 systematic reviews/meta-analyses were included, and all focused on acupuncture intervention, including 2 primary outcome indicators. According to AMSTAR 2 evaluation results, there were 4 high quality studies, 12 medium quality studies and 2 low quality studies; ROBIS results found 10 high bias risk studies, 7 low bias risk studies and 1 unclear; CASP-S.R showed only 4 design studies applicable to local individuals, and there were no studies on the relationship between design benefits, hazards and costs.ConclusionsThe quality of systematic reviews/meta-analyses for acupuncture treatment of primary depression is moderate, however with a certain bias. Most studies may not directly benefit local individuals. All studies have no relationship with cost hazards. It is expected for further reviewers to strictly follow systematic evaluation method to improve research quality and reduce bias, while the applicability of the systematic review to individuals from different regions should be considered as well as the relationship between the benefit and cost hazard. In addition, more valid RCTs are required to provide higher quality evidence and explore correlated and comprehensive mechanism.