To investigate epidural morphine(M) combined with triamcinolone A(TA) for advanced cancer pain and to study pharmacokineties of TA. Method.. TA 40mg/w was epidually combined with M3.84?3.94mg/d in 104 advanced cancer patients and TA blood concentration was measured with high performance liquid chromatography. Result: The rate of adverse reaction was 7.69% and visual analog scale was 3.16?2.83. The plasma elimination half life (t_(1/2)) was 1.63?0.36d; plasma accumulation coefficient (R) was 1.06-1-0.04?g/ml. Conclusion: The analgesic effect of M is potentiated by TA and there is no TA accumulation in plasma following long-term epidural administration.

0.05). Conclusion: With slow absorption rate and long half life of elimination, the epidural administration at one week interval can avoid the accumulation of triamcinolone A.

Objective To compare the efficacy of different doses of intrathecal administration of morphine and fentanyl before operation for postoperative analgesia in patients undergoing abdominal hysterectomy.Methods Forty ASA Ⅰ or Ⅱ patients,aged 19-60 yr,undergoing abdominal hysterectomy under combined spinal-epidural anesthesia,were randomly divided into Ⅰ and Ⅱ groups (n =20 each).Morphine 0.5 mg+ fentanyl 15 μg and morphine 0.2 mg+ fentanyl 25 μg were injected intrathecally in groups Ⅰ and Ⅱ respectively.VAS score ≤2was considered as effective analgesia.When VAS score≥ 3,morphine 0.05 mg/kg was given intravenously as rescue analgesic.The incidence of nausea and vomiting and pruritus was recorded after operation.Results Compared with group Ⅰ,no significant change was found in the percentage of patients requiring rescue morphine after operation (P ＞ 0.05),the incidence of nausea and vomiting and pruritus was significantly decreased after operation and the time when the patients passed the flatus was significantly shortened after operation in group Ⅱ (P ＜ 0.05).Conclusion Intrathecal administration of morphine 0.2 mg and fentanyl 25.μg before operation is safer and more helpful to recovery of gastrointestinal function than intrathecal administration of morphine 0.5 mg and fentanyl 15 μg before operation if they can provide the equivalent postoperative analgesia.

Objective To study the relationship between serum trace elements and renal cell carcinoma.Methods The serum concentrations of multi-elements in 34 patients with renal cell carcinoma and 28 healthy volunteers were determined by inductively coupled plasma mass spectrometry(ICP-MS).The results were analyzed by partial least square discriminant analysis (PLS-DA) and Fisher discriminant.Results Compared with healthy voluteers,the levels of vanadium (5 034.56 ng/L:4 401.23 ng/L ),cobalt (211.34 ng/L:158.67 ng/L),nickel(l 850.55 ng/L:1 587.12 ng/L),manganese(1 873.35 ng/L:932.68 ng/L) and cadmium(95.63 ng/L:36.43 ng/L) were significantly higher in patients with renal cell carcinoma (P ＜ 0.05 ).While,the concentrations of calcium( 10.83 mg/L:11.78 mg/L) and zinc(67.11 μg/L:70.92 pg/L)were significantly lower ( P ＜ 0.05 ).Discriminant analysis showed that the serum elements levels in the patients with renal cell carcinoma were significantly different from the healthy volunteers.The scores plot showed distinct clustering between patients and controls,the points of patients were obviously offset from the controls.The classification accuracy of Fisher discriminant function was 97.61％.Conclusion Trace elements in serum are significantly different in patients with renal cell carcinoma and healthy volunteers.Discriminant analysis of serum samples based on trace element levels is possible.Thus,it is feasible for early diagnosis of renal cell carcinoma by determination of trace elements and discriminant analysis.

Objective To investigate effects of intrathecal injection of morphine and fentanyl combined with low-dose naloxone on the pain behavior and the expression of blood motilin (MTL) in the rat model of incisional pain.Meth?ods A total of 72 healthy male Sprague-Dawley rats (weight 180-220 g), successfully intrathecally catheterized, were ran?domly divided into 6 groups (n=12 ):normal saline group (NS group), incisional pain group (P group), morphine (5μg/kg)+fentanyl (0.25μg/kg) group (MFP group), morphine+fentanyl+naloxone (0.2 ng/kg, 1 ng/kg, 5 ng/kg) group (MFPN1, MF?PN2 and MFPN3 groups). All groups except NS group were made the model of incisional pain on the right plantar surface. At 24-hours before intrathecal cathetherization (T0), 24-hours before modelling (T1), 1-hours (T2), 3-hours (T3) , 6-hours (T4), 24-hours (T5) , 48-hours (T6) and 72-hours (T7) after modelling respectively, paw withdrawal mechanical threshold (PWMT) and paw withdrawal thermal latency (PWTL) were detected in right hind paw in 6 rats of each group. The other 6 rats in each group were sacrificed 6-hour after operation. The plasma expression of motilin was detected by ELISA. Re?sults Compared with NS group, the PWMT was not significantly different in all time points in MFPN2 group. The values of PWTL were significantly longer at T2 and T5 in MFPN2 group than those of NS group (P<0.05). The PWMT and the PWTL were significantly decreased at T2, T3 and T4 in P and MFPN3 groups than those of NS group (P<0.05).Compared with P group, the PWMT at T6, and PWTL at T3 and T4 were significantly decreased in MFPN3 group (P<0.05). The MTL at T6 was significantly decreased in P, MFP, MFPN1 and MFPN3 groups compared with that of NS group (P<0.05). There was no significant difference in MTL between MFPN2 group and NS group (P>0.05).Conclusion In the rat model of incision?al pain, intrathecal injection of naloxone at 1 ng/kg can inhibit the down-regulation of blood motillin caused by morphine and fentanyl, and which can up-regulate the PWTL, enhancing the analgesic effects of opioids.

Objective To evaluate the changes in the levels of motilin in the duodenum in a rat model of incisional pain.Methods Eighty-four healthy male Sprague-Dawley rats,aged 6-8 months,weighing 180-220 g,were randomized into 2 groups (n =42 each) using a random number table:control group (group C) and incisional pain group (group P).The animals were anesthetized with sevoflurane.In group P,a 1 cm long incision was made in the plantar surface of right hindpaw.Six rats were chosen from each group and mechanical paw withdrawal threshold (MWT) and thermal paw withdrawal latency (TWL) were measured at 24 h before operation (T0) and 1,6,24,48 and 72 h after operation (T1-5).Six rats were chosen from each group at T0-5 and sacrificed and the duodenal mucosal tissue was prepared for measurement of motilin levels by ELISA.Pearson linear correlate analysis was performed between the motilin level and pain threshold at each time point in group P.Results Compared with group C,MWT was significantly decreased,TWL was shortened,and motilin levels were significantly increased at T1-4,and no significant change was found at T0 and T5 in group P.The motilin levels were negatively correlated with MWT (r =-0.8 910) and TWL (r =-0.8 463) in group P.Conclusion Incisional pain can promote the secretion of motilin in the duodenum.

Objective To eveluate the pancreatic injury induced by smoking alone or combined with alcohol consumption,and its possible mechanism.Methods The Wistar rats were divided into control group (n=10),smoking group (n=30),drinking group (n=42) and smoking combined with drinking group (combination group,n=48).Serum levels of interleukin (IL)-6,superoxide dismutase (SOD) activities,monocyte chemoattractant protein-1 (MCP-1) and hydroxyproline were determined at 4th-,8th- and 12th- week.The pathohistological changes of the pancreas were examined using HE staining and the expression of α-smooth muscle actin (α-SMA) were measured by immunohistochemistry.ResultsIn contrast to control group,pancreatic changes including cytoplasmic vacuolation and increased levels of α-SMA and hydroxyproline were found in both smoking and drinking groups at the 8th-week (P<0.01).Whereas these changes were aggravated in combination group (P<0.05).Serum level of IL-6 and MCP-1 expression in pancreatic tissue were significantly increased in smoking group when compared with control group.But MCP-1 expression was lower in drinking group than control group.Moreover,the SOD activity in pancreatic tissue decreased in smoking and drinking groups,especially in combination group.Conclusions Long-term smoking can induce cytoplasmic vacuolation in pancreatic acinar cells,enhance inflammatory factors and chemokine expression and aggravate oxidative stress response in pancreas.These changes are aggravated when smoking and drinking coexisted.The mechanism behind it may be associated with increased oxidative stress response in pancreas.

Objective To investigate the effects of paravertebral injection of different concentrations of adriamycin on motor conduction function in rats. Methods Eighty healthy male Wistar rats weighing 250-300 gwere randomly divided into 4 groups (n = 20 each): 3 adriamycin groups receiving paravertebral injection of 0.3%, 0.5% and 1.0% adriamycin 10 μl respectively (group A1, A2, A3) and control group (group C)receiving equal volume of normal saline (NS) instead of adriamycin. The animals were anesthetized with intraperitoneal 3% pentobarbital 40 mg/kg. A right paramedian incision was made in the back from L3 to S1.L4,5,5,6 intervertebral foramina were exposed. 0.3%, 0.5% and 1.0% adriamycin and NS 10 pl were injected into the intervertebral foramina in group A1, A2, A3 and C respectively. Spinal motor evoked pontential (SMEP)was measured at 1, 2, 4 and 8 weeks (T1-4)after paravertebral injection. Results The latent period of SMEP was significantly prolonged and the amplitude decreased at T1-4 in group A3 as compared with group A1, A2 and C.Conclusion Paravertebral injection of 1.0% adriamycin can significantly depress motor conduction function.

Objective To investigate the changes in the levels of motilin in the gastric body in a rat model of incisional pain.Methods Eighty-four healthy male Sprague-Dawley rats,weighing 180-220 g,were randomized into 2 groups (n =42 each):normal saline group (NS group) and incisional pain group (P group).In group P an 1 cm long incision was made in the plantar surface of right hindpaw under sevotlurane anesthesia.Six rats were chosen from each group and paw withdrawal threshold to mechanical stimulation (MWT) and paw withdrawal latency to nociceptive thermal stimulation (TWL) were measured at 24 h before operation (To) and 1,6,24,48 and 72 h after operation (T1-5).Six rats were chosen from each group at T0-5 and sacrificed and the gastric mucosal tissues were prepared for measurement of motilin levels by ELISA.Results Compared with group NS,MWT,TWL and motilin levels were significantly decreased at T1-4 (P ＜ 0.05) and no significant change was found at T0 and T5 in P group (P ＞ 0.05).Compared with the baseline value at To,MWT,TWL and motilin levels were significantly decreased at T1-4,and no significant change was found at T5 in group P (P ＞ 0.05).MWT,TWL and motilin levels were significantly higher at T3-T5 than at T1 in group P (P ＜ 0.05).MWT,TWL and motilin levels were increased gradually at T3-T5 in P group (P ＜ 0.05).The motilin levels were positively correlated with MWT and TWL (r =0.9597 and 0.9231,respectively,P ＜ 0.01) in group P.Conclusion The levels of motilin in the gastric body is significantly decreased in a rat model of incisional pain and the decreasing range is positively corre lated with the degree of incisional pain.

Objective To evaluate the efficacy of lumbar discectomy,radiofrequency ablation and annuloplusty performed with Disc-FX system under the guidance of C-arm in treatment of discogenic low back pain.Methods Twenty-eight patients with discogenic low back pain,with VAS score greater than 7,aged 27-73 yr,underwent lumbar discectomy,radiofrequency ablation and annuloplusty performed using Disc-FX system under the guidance of C-arm.The patients were followed up for 2 months after surgery and pain was assessed using VAS score.VAS scores were recorded before surgery,and at 7 and 14 days and 1 and 2 months after surgery.The effective analgesia was recorded according to VAS scores.The therapeutic effect was evaluated according to Macnab standard 2 months after surgery.Results VAS scores were significantly lower at each time point after surgery than before surgery (P ＜ 0.05).The rate of effective analgesia was 93 % at 2 months after surgery.The excellent and good rate of the therapeutic effect evaluated was 93 %.One female patient developed injury to lumbar venous plexus,and no patients developed infection of intervertebral disk,nerve root injury or spinal cord injury.Conclusion The excellent and good rate is 93 % when lumbar discectomy,radiofrequency ablation and annuloplusty performed using Disc-FX system is used for treatment of discogenic low back pain under the guidance of C-arm,with fewer side effects.