FM Group Research Articles

Perioperative analgesia after intrathecal fentanyl and morphine or morphine alone for cesarean section: A randomized controlled study.

Intrathecal morphine is used in the postoperative management of pain after caesarean section (CS), but might not be optimal for intraoperative analgesia. We hypothesized that intrathecal fentanyl could supplement intraoperative analgesia when added to a local anesthetic and morphine without affecting management of postoperative pain. This prospective, randomized, double-blind, parallel-group study included 60 parturients scheduled for elective CS. Spinal anesthesia consisted of bupivacaine with either morphine 100 μg (M group), or fentanyl 25 μg and morphine 100 μg (FM group). The frequency of intraoperative pain and pethidine consumption in the 24 hours postoperatively was recorded. Fewer patients in the FM group required additional intraoperative analgesia (P < .01, relative risk 0.06, 95% confidence interval [CI] 0.004-1.04). The FM group was noninferior to the M group for 24-hour opioid consumption (95% CI -10.0 mg to 45.7 mg, which was below the prespecified boundary of 50 mg). Pethidine consumption in postoperative hours 1 to 12 was significantly higher in the FM group (P = .02). Postoperative nausea and vomiting (PONV) were more common in the FM group (P = .01). Visual analog scale scores, effective analgesia, Apgar scores, and rates of pruritus and respiratory depression were similar between the groups. Intrathecal combination of fentanyl and morphine may provide better perioperative analgesia than morphine alone in CS and could be useful when the time from anesthesia to skin incision is short. However, an increase in PONV and possible acute spinal opioid tolerance after addition of intrathecal fentanyl warrants further investigation using lower doses of fentanyl.

Effects of guanidinoacetic acid supplementation in all-plant protein diets on growth, antioxidant capacity and muscle energy metabolism of bullfrogRana(Lithobates)catesbeiana

Effects of guanidinoacetic acid (GAA) supplementation in all-plant protein diets were evaluated on growth, antioxidant capacity and muscle energy metabolism of Rana (Lithobates) catesbeiana. Six diets were prepared: a basal fish meal diet (FM), an all soybean meal diet (SM) and four GAA-supplemented diets by adding 0.2, 0.4, 0.6 and 0.8 g GAA/kg to the SM diet (GAA2, GAA4, GAA6 and GAA8 diets). Triplicate groups of bullfrog (45 ± 0.2 g) were fed the diets to apparent satiation for 8 weeks. Total substitution of FM with SM led to significantly (p < .05) reduced growth and feed utilization. Adding 0.4 g GAA/kg to the SM diet significantly improved growth performance, and the values were comparable to those of FM group. SM and GAA2 groups showed drastically lower serum total antioxidant capacity than FM, GAA4 and GAA6 groups. Also, SM and GAA2 groups showed significantly lower catalase activity than FM and GAA8 groups. A remarkable increase in serum malondialdehyde concentration was detected in SM and GAA2 groups. FM and GAA6 groups exhibited significantly higher serum creatinine concentration than other groups. Muscle creatine kinase activity and glycogen content were significantly decreased in SM group and application of 0.4–0.6 g GAA/kg significantly improved their values. GAA4 group showed significantly lower pyruvate kinase activity than FM and GAA6 groups. Also, GAA2 and GAA4 groups had significantly lower succinate dehydrogenase (SDH) activity than other treatments. These findings show that supplementing 0.4 g/kg GAA to SM-based diets improves growth, antioxidant capacity and muscle energy metabolism.

The role of precisely matching fascicles in the quick recovery of nerve function in long peripheral nerve defects.

Peripheral nerve injury therapy in the clinic remains less than satisfactory. The gold standard of treatment for long peripheral nerve defects is autologous nerve grafts; however, numerous clinical complications are associated with this treatment. As tissue engineering has developed, tissue-engineered nerve grafts (TENGs) have shown potential applications as alternatives to autologous nerve grafts. To verify the important role of the biomimetic pathway of fascicle design in TENGs, we designed an animal model to study the role of the precise matching of fascicles in the effectiveness of nerve function recovery. 24 Sprague-Dawley rats were divided randomly into three groups (eight/group) that corresponded to 100% fascicle matching (100%FM), 50%FM and 0%FM. We selected Sprague–Dawley rat long-gap (15 mm) sciatic nerve defects. In the 6 weeks after surgery, we found that the 100%FM group showed the most effective functional recovery among the three groups. The 100%FM group showed better functional recovery on the basis of the sciatic functional index than the 50%FM and 0%FM groups. According to histological evaluation, the 100%FM group showed more regenerating nerve fibres. Moreover, in terms of the prevention of muscle atrophy, the 100%FM group showed excellent physiological outcomes. The 100%FM as tissue-engineered scaffolds can enhance nerve regeneration and effective functional recovery after the repair of large nerve defects. The results of this study provide a theoretical basis for future TENG designs including biomimetic fascicle pathways for repairing long nerve defects.

Impact of Chiropractic Manipulation on Bone and Skeletal Muscle of Ovariectomized Rats.

Evidence suggests that chiropractic manipulation might exert positive effects in osteoporotic patients. The aim of this study was to evaluate the effects of chiropractic manipulation on bone structure and skeletal muscle in rats with bone loss caused by ovariectomy (OVX). The 6-month old Sprague-Dawley rats at 10 weeks following OVX or sham operation (Sh) did not suffer chiropractic manipulation (NM group) or were submitted to true chiropractic manipulation using the chiropractic adjusting instrument Activator V® three times/week for 6weeks as follows: Force 1 setting was applied onto the tibial tubercle of the rat right hind limb (TM group), whereas the corresponding left hind limb received a false manipulation (FM group) consisting of ActivatorV® firing in the air and slightly touching the tibial tubercle. Bone mineral density (BMD) and bone mineral content (BMC) were determined in long bones and L3-L4 vertebrae in all rats. Femora and tibia were analyzed by μCT. Mechano growth factor (MGF) was detected in long bones and soleus, quadriceps and tibial muscles by immunohistochemistry and Western blot. The decrease of BMD and BMC as well as trabecular bone impairment in the long bones of OVX rats vs Sh controls was partially reversed in the TM group versus FM or NM rats. This bone improvement by chiropractic manipulation was associated with an increased MGF expression in the quadriceps and the anterior tibial muscle in OVX rats. These findings support the notion that chiropractic manipulation can ameliorate osteoporotic bone at least partly by targeting skeletal muscle.

Fermented Moringa oleifera Decreases Hepatic Adiposity and Ameliorates Glucose Intolerance in High-Fat Diet-Induced Obese Mice.

Metabolic diseases, such as glucose intolerance and nonalcoholic fatty-liver disease (NAFLD), are primary risk factors for life-threatening conditions such as diabetes, heart attack, stroke, and hepatic cancer. Extracts from the tropical tree Moringa oleifera show antidiabetic, antioxidant, anti-inflammatory, and anticancer effects. Fermentation can further improve the safety and nutritional value of certain foods. We investigated the efficacy of fermented M. oleifera extract (FM) against high-fat diet (HFD)-induced glucose intolerance and hepatic lipid accumulation and investigated the underlying mechanisms by analyzing expression of proteins and genes involved in glucose and lipid regulation. C57BL/6 mice were fed with normal chow diet (ND) or HFD supplemented with distilled water (DW, control), nonfermented M. oleifera extract (NFM), or FM for 10 weeks. Although body weights were similar among HFD-fed treatment groups, liver weight was decreased, and glucose tolerance test (GTT) results improved in the FM group compared with DW and NFM groups. Hepatic lipid accumulation was also lower in the FM group, and expressions of genes involved in liver lipid metabolism were upregulated. In addition, HFD-induced endoplasmic reticulum (ER) stress, oxidative stress, and lipotoxicity in quadriceps muscles were decreased by FM. Finally, proinflammatory cytokine mRNA expression was decreased by FM in the liver, epididymal adipose tissue, and quadriceps of HFD-fed mice. FMs may decrease glucose intolerance and NAFLD under HFD-induced obesity by decreasing ER stress, oxidative stress, and inflammation.

Different preference is modulated by the feeding stimulants supplementation in different Chinese soft-shelled turtle (Pelodiscus sinensis ) basic diets

Five 2-week feeding trials were conducted to investigate five stimulants on P. sinensis. Two isonitrogenous and isoenergetic diets were formulated, one contained 600 g kg–1 fishmeal (FM diet) and the other contained 420 g kg–1 fishmeal and 225 g kg–1 animal protein blend (APB diet), and each tested one stimulant with four levels. The feeding stimulant candidates were betaine, 2-carboxy-ethyl dimethyl sulphonium bromide (DMPT), inosine-5′-monophosphate (IMP), taurine and squid extract. In the experiment on each stimulant, turtles (10.85 ± 0.10 g) were equally divided into FM and APB groups and fed with an equal mixture of corresponding diets containing four levels of stimulants, respectively. Each diet contained a unique rare earth oxide as inert marker. Turtles were fed twice daily (8:00 and 17:00), and faeces were collected. Preference for each diet was estimated based on the relative concentration of each marker in the faeces. In the FM group, only IMP showed the enhanced attraction. But in APB groups, all the stimulants, except IMP, showed higher preference than basal diets for at least one inclusion level, and the optimum level was 10 g kg–1 for betaine, 0.1 g kg–1 for DMPT, 0.1 g kg–1 for IMP, 5 g kg–1 for taurine and 10 g kg–1 for squid extract, and the squid extract had the strongest stimulating effect among the stimulants.

Rheumatoid arthritis seems to have DMARD treatment decision influenced by fibromyalgia

ObjectiveTo compare DMARD use in patients with and without FM over time, including overtreatment and undertreatment rates in both groups. MethodsA prospective cohort study with patients attending an RA outpatient clinic was conducted. Participants were consecutively recruited between March 2006 and June 2007 and were followed through December 2013. Data on DMARD use (prevalences, doses and escalation rates), DAS28, HAQ and radiographic progression were compared among RA patients with FM and without FM. Mistreatment clinical scenarios were allegedly identified and compared between groups. Results256 RA patients (32 with FM) were followed for 6.2±2.0 (mean±SD) years comprising 2986 visits. At baseline, RA duration was 11.1±7.4 years. DAS28 and HAQ were greater in RA with FM group, and were closer to RA without FM group towards the end. RA patients with FM used higher doses of tricyclic antidepressants, leflunomide and prednisone, and lower doses of methotrexate. When compared to RA patients without FM, participants with RA and FM used more often tricyclic antidepressants, leflunomide, prednisone, continuous analgesics and less often methotrexate. Groups presented similar 7-year biologic-free survival, and radiographic progression-free survival in Cox regression. RA patients with FM had greater proportions of visits in mistreatment scenarios when compared to RA patients without FM (28.4 vs. 19.8%, p<0.001). ConclusionsRA patients with FM used more leflunomide and prednisone, and RA mistreatment was more frequent in FM patients. Certainly, RA patients with FM will benefit from a personalized T2T strategy, including ultrasound (when suitable) and proper FM treatment.

Effects of facial mask treatment are attributed to accelerated maxillary growth and inhibited counter-clockwise total rotation of the mandibular corpus: A structural superimposition study

PurposeTo test the hypothesis that facial mask treatment influences maxillary sutural growth, condylar growth, and total rotation of mandibular corpus, using a structural superimposition analysis by Björk et al. Materials and methodsSubjects consisted of 28 girls with Angle Class III malocclusion treated with facial mask (FM group). Eleven girls with pseudo-Class III malocclusion (pseudo-III group) were also examined. Pre- and posttreatment lateral cephalograms were analyzed to evaluate skeletal changes. Cephalometric structural superimposition analysis was also performed. ResultsThe FM group exhibited significantly larger forward maxillary growth and negative total rotation of the mandibular corpus as compared to the pseudo-III group. In the FM group, forward maxillary skeletal growth correlated significantly with maxillary counter-clockwise rotation. Negative mandibular total rotation correlated significantly with inhibition of the forward position of the mandible. ConclusionAccelerated maxillary sutural growth and inhibited counter-clockwise total rotation of mandibular corpus growth attributed to facial mask treatment may contribute to improvements in Class III malocclusion. The greater the acceleration of maxillary sutural growth due to facial mask treatment, the greater the increase in maxillary counter-clockwise rotation.

As decisões de tratamento com DMARD na artrite reumatoide parecem ser influenciadas pela fibromialgia

ObjectiveTo compare DMARD use in patients with and without FM over time, including overtreatment and undertreatment rates in both groups. MethodsA prospective cohort study with patients attending an RA outpatient clinic was conducted. Participants were consecutively recruited between March 2006 and June 2007 and were followed through December 2013. Data on DMARD use (prevalences, doses and escalation rates), DAS28, HAQ and radiographic progression were compared among RA patients with FM and without FM. Mistreatment clinical scenarios were allegedly identified and compared between groups. Results256 RA patients (32 with FM) were followed for 6.2±2.0 (mean±SD) years comprising 2,986 visits. At baseline, RA duration was 11.1±7.4 years. DAS28 and HAQ were greater in RA with FM group, and were closer to RA without FM group towards the end. RA patients with FM used higher doses of tricyclic antidepressants, leflunomide and prednisone, and lower doses of methotrexate. When compared to RA patients without FM, participants with RA and FM used more often tricyclic antidepressants, leflunomide, prednisone, continuous analgesics and less often methotrexate. Groups presented similar 7‐year biologic‐free survival, and radiographic progression‐free survival in Cox regression. RA patients with FM had greater proportions of visits in mistreatment scenarios when compared to RA patients without FM (28.4 vs. 19.8%, p<0.001). ConclusionsRA patients with FM used more leflunomide and prednisone, and RA mistreatment was more frequent in FM patients. Certainly, RA patients with FM will benefit from a personalized T2T strategy, including ultrasound (when suitable) and proper FM treatment.

Performance of different cantilever designs of implant-supported metal fixed dental prostheses

Objective The aim of this randomized controlled trial was to assess the effect of cantilever design on implant-supported metallic fixed dental prostheses after 3 years of function. Patients and methods Twenty patients were randomly allocated to two groups: the 3 mm (TM) group (n=10), in which patients had one cantilever implant-supported fixed partial denture (CISFPD) with 3 mm distal extension measured from the most distal end of the fixture to the most distal end of the fixed partial denture; and the 5 mm (FM) group (n=10), in which patients had one CISFPD with 5 mm distal extension measured the same way as in the first group. All CISFPDs were supported by one implant (4.5 mm diameter, 10 mm length). The studied outcomes were survival, frequency of complication occurrence, bone loss, and pocket probing depth. All data were collected, tabulated, and statistically analyzed. Descriptive data were summarized as mean and SD, and differences were considered significant when P value up to 0.05. Results The total percentage of success with the CISFPD was 100% in the two groups. In this 3-year study, six noticed effects needing consequent treatment were found. In five patients (four in the FM group and two in the TM group). The amount of bone loss and pocket probing depth of implant abutments were the same in the two groups (P>0.05) and were within permissible limits. Conclusion After 3 years of assessment, the TM-CISFPD and FM-CISFPD showed accepted results. Studies on a larger number of patients will be needed to confirm the results of performance of implant-supported cantilever Fixed Dental Prosthesis.

Torque and Muscle Activation Impairment Along With Insulin Resistance Are Associated With Falls in Women With Fibromyalgia.

Góes, SM, Stefanello, JMF, Homann, D, Lodovico, A, Hubley-Kozey, CL, and Rodacki, ALF. Torque and muscle activation impairment along with insulin resistance are associated with falls in women with fibromyalgia. J Strength Cond Res 30(11): 3155-3164, 2016-Fibromyalgia (FM) is a chronic pain condition associated with reduced muscle strength, which can lead to functional incapacity and higher risk of falls. The purpose of the study was to compare maximal ankle joint torque, muscle activation, and metabolic changes between women with and without FM. In addition, the relationship between those aspects and retrospectively reported falls in women with FM was determined. Twenty-nine middle-aged women with FM and 30 controls were recruited. Fall history, pain intensity, and pain threshold were assessed. Plasma glucose levels and insulin resistance (IR) were determined. Peak torque and rate of torque development (RTD) were calculated, and muscle activation was assessed from maximum isometric voluntary ankle dorsiflexion and plantar flexion contractions. In addition, voluntary muscle activation failure of the anterior tibialis muscle during maximal dorsiflexion was calculated. When compared to controls, women with FM reported higher number of retrospectively reported falls, exhibited higher IR, showed reduced plantar flexion and dorsiflexion RTD, had lower plantar flexion peak torque, and demonstrated more antagonist coactivation and higher muscle activation failure (p ≤ 0.05). Higher muscle activation failure was explained by glucose level and pain intensity (adj R = 0.28; p ≤ 0.05). Reduced plantar flexion and dorsiflexion peak torque explained 80% of retrospectively reported falls variance; also, high antagonist coactivation (odds ratio [OR] = 1.6; p ≤ 0.05) and high IR (OR = 1.8; p ≤ 0.05) increased the chance of falls in the FM group. A combination of metabolic factors and muscle function increased the odds of retrospectively reporting a fall in FM. Both aspects may be considered in interventions designed for reducing falls in this population.

Environmental remediation potential of Perinereis aibuhitensis (Polychaeta) based on the effects of temperature and feed types on its carbon and nitrogen budgets

ABSTRACTThe effects of three temperatures (15°C, 20°C and 25°C) and four feed types (artificial feed, AF; sediment, SM; fish faeces, FF; and fish meat, FM) on the growth, carbon budget and nitrogen budget of the polychaete Perinereis aibuhitensis were evaluated over a 35 day period. The final body weight and specific growth rate (SGR) of P. aibuhitensis were significantly affected by temperature and feed types (T, F = 15.831, P = 0.000; Feed, F = 81.827, P = 0.000), but the interaction between these factors was not significant (F = 0.435, P = 0.848). The worms achieved the highest SGR in the AF group at 20°C. However, the SGR in the SM group was only half that of the other groups. The food conversion efficiency (FCE) was significantly lower at 25°C than at 15°C and 20°C (P < 0.05). The FCE was highest in the FM group (P = 0.000), with a mean of 39.83%. The apparent digestibility rate (ADR) at 25°C was significantly higher than at 15°C and 20°C (P < 0.05). These findings suggest that the higher FCE coupled with ADR (78.48%) resulted in higher SGR in worms that were fed artificial feed at 20°C. The slow growth in the SM group was attributed to the lower organic content in sediment and the higher expenditure of carbon and nitrogen in faeces and metabolism. The proportion of total C and N deposited was lower in groups fed with the higher-quality feed used for fish cage farming. Most of feed carbon and nitrogen were released into the water by polychaetes, which was good for the sediment environment recovery under the fish cages.

Comparison of Combined Intrathecal Morphine and Sonar-guided Singleshot Femoral Nerve Block vs. Either Technique Alone for Postoperative Analgesia in Patients Undergoing Total Knee Replacement Surgery

Background: Postoperative pain associated with total knee replacement surgery (TKR) is considerable and requires adequate analgesia. Objectives: To study the additive effect of femoral nerve block (FNB) and 0.2 mg intrathecal morphine (ITM) compared with either technique alone for postoperative analgesia in patients undergoing (TKR) under spinal anesthesia. Design: Prospective double-blind randomized comparative study. Setting: University hospital. Methods: Sixty ASA I–III subjects undergoing unilateral TKR were enrolled in a randomized, parallel group, double-blind study receiving 15 mg hyperbaric bupivacine spinal anesthesia plus 0.2 mg ITM (Group M), FNB (Group F), or 0.2 mg ITM and FNB (Group MF) for postoperative analgesia. Assessment parameters included; postoperative morphine PCA consumption in first 48 h postoperative, time to first request for rescue analgesia, pain scores, length of hospital stay and adverse effects. Results: The time to the first administration of rescue intravenous morphine PCA, was longer in the MF group (8.21 ± 0.85 h) compared with the M (6.31 ± 1.45 h, P<0.001) and F (4.99 ± 1.0 h, P<0.001) groups. Morphine consumption was lower in MF group [6.3 ± 0.47 (6-7) mg] vs. [11.2 ± 1.32 (9-14) mg] and [13.75 ± 0.72 (13-15) mg] in M and F groups, respectively (P<0.001). From the fourth till the 48th h postoperatively, VAS scores were significantly decreased in the FM group compared with M and F groups (p<0.001). There were no recorded differences among groups in the length of hospital stay or postoperative adverse effects. Limitations: This study is limited by its small sample size. Conclusion: The combination of 0.2 mg ITM and single-shot FNB provided superior postoperative analgesia after TKR compared with either technique alone.

The Effects of Maxillary Protraction with or without Rapid Maxillary Expansion and Age Factors in Treating Class III Malocclusion: A Meta-Analysis.

We conducted a comprehensive meta-analysis of 12 studies to examine whether maxillary protraction face mask associated with rapid maxillary expansion (FM/RME) could be an effective treatment for Class III malocclusion and to evaluate the effect of timing on treatment response. Patients with a maxillary deficiency who were treated with FM with or without RME were compared with those who had an untreated Class III malocclusion. In both treatment groups, forward displacement of the maxilla and skeletal changes were found to be statistically significant. In addition, posterior rotation of the mandible and increased facial height were more evident in the FM group compared with the control group. However, no significant differences were observed between the early treatment groups and late treatment groups. The results indicated that both FM/RME and FM therapy produced favorable skeletal changes for correcting anterior crossbite, and the curative time was not affected by the presence of deciduous teeth, early mixed dentition or late mixed dentition in the patient.

Ageing influence in the evolution of strength and muscle mass in women with fibromyalgia: the al-Ándalus project.

Fibromyalgia is associated with physical disabilities in daily activities. Moreover, patients with fibromyalgia present similar levels of functional capacity and physical condition than elderly people. The aim of this study was to analyse the evolution of strength and muscle mass in women with fibromyalgia along ageing. A total sample of 492 fibromyalgia patients and 279 healthy control women were included in the study. Participants in each group were further divided into four age subgroups: subgroup 1: 30-39years old, subgroup 2: 40-49years old, subgroup 3: 50-59years old and subgroup 4: 60-69years old. Standardized field-based fitness tests were used to assess muscle strength (30-s chair stand, handgrip strength and arm curl tests). Fibromyalgia patients did not show impairment on muscle mass along ageing, without values of skeletal muscle mass index below 6.76kg/m(2) in any group. However, in all variables of muscle strength, the fibromyalgia group showed less strength than the healthy group (p<0.05) for all age groups. As expected, handgrip strength test showed differences along ageing only in the fibromyalgia group (p<0.001). Age was inversely associated with skeletal muscle mass (r=-0.155, p<0.01) and handgrip strength (r=-0.230, p<0.001) in the FM group. Women with fibromyalgia showed a reduction in muscle strength along ageing process, with significantly lower scores than healthy women for each age group, representing a risk of dynapenia.

Continuous femoral nerve against psoas compartment block for analgesia in total knee arthroplasty

Background Total knee arthroplasty (TKA) is a surgical procedure that often demands potent analgesia. Anesthetists commonly rely on continuous epidural analgesia or psoas compartment block. After the American Society of Regional Anesthesia (ASRA) recent recommendation against the implication of deep regional blocks in the setting of perioperative anticoagulation, femoral nerve block might be a suitable alternative technique. Its effectiveness in TKA is a questionable issue. Our study is hypothesizing that continuous femoral block could provide an analgesic profile similar to continuous psoas compartment block. Patients and method Sixty patients undergoing TKA were randomly assigned into two groups to receive continuous femoral block or continuous psoas compartment block using ultrasound and nerve stimulation guidance. A bolus of 20 ml 0.25% levobupivacaine was injected through a perineural catheter in each group before surgery followed by a 5 ml bolus of 0.125%, and then 5 ml/h infusion at completion of surgery. A bolus of 5 ml 0.125% levobupivacaine was injected when numerical rating scale (NRS) was at least 5. In the first 24 h postoperatively, the median value and the interquartile range of the NRS at 1, 6, 12, and 24 h and after the first physiotherapy session were recorded as the primary end point. The total levobupivacaine and morphine consumption during the same 24-h period were the secondary end points, apart from patient's satisfaction with analgesia during hospitalization. Results The median and interquartile range of the NRS were 4.00 and 2.00 in the first hour, 4.00 and 1.5 in the sixth hour, 4.00 and 1.5 in the 12 th hour, 4.00 and 2.00 in the 24 th hour, and 4.00 and 2.00 after the first physiotherapy session, respectively, in the Fm group, and 3.00 and 3.00 in the first hour, 4.00 and 2.00 in the sixth hour, 4.00 and 1.5 in the 12 th hour, 3.00 and 2.5 in the 24 th hour, and 3.00 and 2.00 after the first physiotherapy session, respectively, in the Ps group. The total mean levobupivacaine and morphine consumption in the Fm and the Ps groups were 218. ± 7.89 vs. 216.6 ± 8.42 and 15.5 ± 4.01 vs. 13.50 ± 4.38, respectively, with no statistically significant difference between both the groups. The catheter insertion time was significantly shorter in the Fm group (8.53 ± 3.1 min) compared with (10.5 ± 3.2 min) the Ps group ( P = 0.021). Conclusion Continuous femoral nerve block provides a suitable alternative analgesic technique in patients undergoing TKA when psoas compartment block is unwarranted in the setting of perioperative anticoagulation as recommended by ASRA.

Stimulation technologies for Longwangmiao Fm gas reservoirs in the Sichuan Basin and their application results

The Longwangmiao Fm group gas reservoirs in the Moxi structure in central Sichuan Basin feature high temperature, high pressure and high H2S content. The thickness of such high permeable reservoirs with great homogeneity is a geologic basis for a high-productivity gas well, and good match of natural fractures and vugs is the key factor to high well productivity. Overbalance drilling is likely to cause the opening-up of natural fractures, which will lead to the leakage of drilling fluid and severe damage to the reservoir. Experimental evaluation results show that the damage rate of the drilling fluid to the rock sample is between 82.2% and 89.2%, which severely restricts the productivity of gas wells. Therefore, it is necessary to deepen the experimental evaluation technologies and methods to promote the design pertinence of technical parameters. The study shows: first, the optimized gelling acid and steering acid are effective in slowing down speed and removing blockage, forming acidizing wormholes and effectively eliminating the blockage effect caused by drilling liquid pollution; second, the self-developed fiber steering agent and soluble temporary blocking ball can divert the acid, increasing the processing pressure at the well bottom by 5–15 MPa, realizing the even stimulation of heterogeneous reservoirs; third, based on experimental evaluation such as the acid penetration and acid rock reaction, it is recommended that the pumping rate be 3.0–3.5 m3/min in acidizing treatment and the acid intensity for blockage removal be 3.0–5.0 m3/m; fourth, the established blockage removal and steering acidizing technology have been applied in more than 20 wells with a remarkable productivity-increase effect, which gives full play to the natural productivity of gas wells and decreases the acid application scale. All these technologies and measures effectively enhance the development quality and profit of the gas reservoir.

Wheat cultivars selected for high Fv /Fm under heat stress maintain high photosynthesis, total chlorophyll, stomatal conductance, transpiration and dry matter.

The chlorophyll fluorescence parameter Fv /Fm reflects the maximum quantum efficiency of photosystem II (PSII) photochemistry and has been widely used for early stress detection in plants. Previously, we have used a three-tiered approach of phenotyping by Fv /Fm to identify naturally existing genetic variation for tolerance to severe heat stress (3 days at 40°C in controlled conditions) in wheat (Triticum aestivum L.). Here we investigated the performance of the previously selected cultivars (high and low group based on Fv /Fm value) in terms of growth and photosynthetic traits under moderate heat stress (1 week at 36/30°C day/night temperature in greenhouse) closer to natural heat waves in North-Western Europe. Dry matter accumulation after 7 days of heat stress was positively correlated to Fv /Fm . The high Fv /Fm group maintained significantly higher total chlorophyll and net photosynthetic rate (PN ) than the low group, accompanied by higher stomatal conductance (gs ), transpiration rate (E) and evaporative cooling of the leaf (ΔT). The difference in PN between the groups was not caused by differences in PSII capacity or gs as the variation in Fv /Fm and intracellular CO2 (Ci ) was non-significant under the given heat stress. This study validated that our three-tiered approach of phenotyping by Fv /Fm performed under increasing severity of heat was successful in identifying wheat cultivars differing in photosynthesis under moderate and agronomically more relevant heat stress. The identified cultivars may serve as a valuable resource for further studies to understand the physiological mechanisms underlying the genetic variability in heat sensitivity of photosynthesis.

Prevalence of primary hyperparathyroidism in a referred sample of fibromyalgia patients

The objective of this study is to determine the prevalence of primary hyperparathyroidism in a referred sample of fibromyalgia patients. Consecutively, referred patients with confirmed fibromyalgia (FM group) had measurements of serum levels of vitamin D, alkaline phosphatase, total calcium, magnesium, phosphate, creatinine, total protein, albumin, and parathyroid hormone. The same measurements were also conducted in a group of patients with widespread pain (WP group) who did not meet the 2010 Modified ACR criteria for fibromyalgia and a group with localized musculoskeletal pain (MSK group). A case of primary hyperparathyroidism was defined as a subject whose results showed any of the following: (1) parathyroid hormone levels above 6.8 pmol/L; (2) an ionized calcium above 1.25 mmol/L; or (3) both elevated, in the presence of normal range creatinine, alkaline phosphatase, vitamin D, phosphate, and magnesium. The mean age and the proportion of subjects who met the case definition of primary hyperparathyroidism were calculated for all groups. There were 125 subjects in the FM group, 127 in the WP group, and 138 in the MSK group. The prevalence rates of primary hyperparathyroidism were 6.4, 5.5, and 6.1%, respectively, for these groups. Comparison of these prevalence rates to published figures for general clinical and non-clinical populations reveals no differences. The prevalence of primary hyperparathyroidism in fibromyalgia patients is not different than that in other patients with WP or those with localized pain, nor is it likely different than that seen in the general population.

THU0320 Concomitant Fibromyalgia in Rheumatoid Arthritis is Associated with Increased Use of Biological Therapy

BackgroundFibromyalgia (FM) affects 12-17 percent of patients with Rheumatoid Arthritis (RA). It is previously shown that the DAS-28 score is significantly higher in RA patients with concomitant FM compared to...