Objective To investigate the effects of minocycline,a selective microglia inhibitor on dorsal GABAB receptor expression in the spinal cord in a rat model of neuropathic pain and the possible mechanism.Methods Forty-eight male SD rats weighing 220-260 g were used in this study.Neuropathic pain was induced by ligation of L5 spinal nerve(SNL).The animals were randomly divided into 4 groups(n=12 each):Ⅰ sham operation;Ⅱ SNL;Ⅲ sham operation+intrathecal(IT)minocycline 50 μg;IV SNL+IT minecycline 50 μg.Paw withdrawal threshold to von Frey hair stimulation was measured before operation(baseline)and at post-surgery days 1,2,4,6,8,10,12,14,16,18 in 6 animals in each group.The GABABR2 expression in dorsal horn of spinal cord was detected by Western blot at the time point when paw withdrawal threshold to mechanical stimulation was the lowest in another six animals which did not undergo yon Frey hair stimulation test.Results The paw withdrawal threshold to mechanical stimuli and the GABABR2 expression in the dorsal horn of spinal cord were significantly lower in SNL group than in sham operation group.The decreased paw withdrawal threshold to von Frey hair stimulation and the down-regulated GABABR2 expression in the spinal cord induced by SNL were ameliorated by intrathecal administration of micmglia inhibitor- minocycline in group Ⅳ.Conclusion The mechanism of neuropathic pain mediated by microglia activation may be related to the inhibition of GABAB receptor activation.

Objective:To analyze the characteristics of immune status in patients with different types of oral lichen planus(OLP). Methods:197 cases of OLP,61 with reticular OLP(ROLP)and 136 with hyperaemia erosion OLP(HEOLP)were included.The im-mune status of the patients were investigated by flow cytometry (FCM)for the expression of CD3 +,CD4 +,CD8 +,CD19 +,CD16 ++56 +and CD4 +/CD8 +cells,and nephelometry for the measurements of IgG,IgA,IgM,C3 and CH50 in peripheral blood.The la-brotary norm was used as the reference and the characteristics of immune status in patients with different clinical characters of OLP were analyzed by SPSS 16.0.Results:CD3 +,CD4 +,IgA and C3 decreased,CD19 +cells,IgG,IgMand CH50 increased in patients with OLP.CD16 ++56 +,CD4 +/CD8 +cells decreased in the cases with ROLP(P<0.05);CD8 +cells decreased in the cases with HE-OLP.CD3 +,CD8 +cells were fewer in HEOLP patients than that in ROLP,CD4 +/CD8 +cells were more in HEOLP than that in ROLP(P<0.05).Conclusion:There are defects of cellular immune function and increase of humoral immune in patients with OLP. The patients with different clinical types of OLP may have different immune fuction changes.

Objective To discuss the value of Valsalva experiment combined with improved MRI tilt tomography applying on the pharyngeal ostium of eustachian tube opening function of patients with nasopharyngeal carcinoma.Methods 1 7 cases with patholog-ically proved NPC underwent conventional MRI plain and enhanced scan.In the eustachian tube area oblique transection T2 WI and T1 WI scanning was done before and after the Valsalva experiment.The invasion of eustachian tube and its surrounding structures was analyzed and the eustachian tube function was evaluated.Results Valsalva experiments combined with improved MRI trans-verse oblique scan could clearly display the whole structure of the eustachian tube and surrounding tissue invasion compared with conventional scanning MR scan.And it could better evaluate the eustachian tube opening function for patients suffered nasopharynge-al carcinoma.Conclusion Valsalva experiments with improved MRI oblique transverse imaging could achieve individualized scan of the eustachian tube,and could be used for evaluating the pharyngeal opening function of eustachian tube in patients with nasopharyn-geal carcinoma.

Objective To investigate the protective mechanism of Salvianolic acid B (Sal B) on experimental in-vivo myocardial ischemia-reperfusion injury (MIRI)in rats. Methods Rats model of myocardial ischemia-reperfusion injury was induced by ischemia for 60 min and then reperfusion for 60 min. After treatment,endothelin (ET) levels in plasma and the homogenate of myocardial tissue,and serum levels of nitric oxide (NO) and NO synthase were measured. Meanwhile,the pathological changes of myocardial tissue were also observed. Results Compared with the model group,middle-dose and high-dose Sal B could depress the ET levels in the plasma and the myocardial tissue,and increase the content of serum NO and NOS (P

Objective To explore the relationship between disorders of lipid metabolism and avascular necrosis of femoral head after operation of femoral neck fracture .Methods 160 patients with a diagnosis of fresh femoral neck fractures treated with AO cannulated compressed screws in orthopedic department of our hospital from January 2007 to January 2012 were involved .All the patients were divided into two groups :ANFH or non ANFH group according to the features of femoral head .The levels of blood lipid were examined .Then ,Logistic regression was used to screening risk factors and evaluate the influence of blood lipid factors ac-cording to βrisk factor .Results The levels of TC ,TG ,LDL and Apo B in ANFH group were (5 .99 ± 1 .05)mmol/L ,(2 .63 ± 0 .85)mmol/L ,(4 .16 ± 1 .21)mmol/L ,(0 .99 ± 0 .28)g/L respectively ,which increased remarkably compared with the control group ;while HDL ,Apo A1 levels in the ANFH group were (0 .88 ± 0 .19)mmol/L ,(1 .20 ± 0 .17)g/L ,which was remarkably lower compared with the control group ,and there were statistically significant difference (P=0 .000) .Serum TC and LDL levels were risk factors impacted on postoperative ANFH .Conclusion Postoperative ANFH was related to disorders of lipid metabolism .Serum TC and LDL levels could be diagnostic values on postoperative ANFH .Early control of blood lipid levels may prevent the development of ANFH in patients treated with AO cannulated compressed screws .

The levels of low-density lipoprotein(LDL)glycation from control group,diabetic HbA1C < 7.0%,and HbA1C>7.0% groups were(17.7±2.31),(34.29±5.73),and(48.79±7.82)Glycogroups/LDL by fluorimetry.The LDL binding to its receptor in three groups were(37.65±5.20),(27.36±4.34),and(15.07± 2.23)ng/mg cell protein measured by enzyme-linked immunoreceptor assay.The glycated levels in two diabetic groups were higher than that in control group,and higher in HbA1C>7.0% group than in HbA1C<7.0% group(all P< 0.01).The results of LDL binding capacity to its receptor were just the opposite.

OBJECTIVETo determine the mutational profile and clinical implications of the viral reverse-transcriptase (rt)A 181T mutation in hepatitis B virus (HBV) through population-based analysis of clinical samples.

METHODSSerum samples from 3, 013 patients who visited The 302 Hospital (Beijing, China) were investigated.HBV DNA was extracted and HBV mutations and genotypes were determined by direct sequencing.Recombinant plasmids harboring the rtA181T/sW172* mutant or wild type sequence were constructed and transfected into the HepG2 cell line. The levels of HBsAg in culture supernatants were compared and statistically analyzed.

RESULTSThe incidence of rtA181T across the study population was 4.1% (165/3, 013), and most of the rtAl 81T-positive patients had received adefovir and/or lamivudine.Forty percent (66/165) of the rtA 181T cases were single mutants and treatment responsive, 46.1% (76/165) included the adefovir-resistant mutation rtA 181 V/N236T, 12.1% (20/165) included the lamivudine-resistant mutation rtM204V/rtM2041, and 1.8% (3/165) included multidrug-resistant mutations.Interestingly, 73.9% (122/165) of the rtA181T-positive samples were detected with co-existing wild-type nucleotides at the site. The rates of HBV/C to HBV/B were 92.1% to 7.9% in the rtA181T-positive patients, but 82.1% to 17.9% in the rtA181T-negative paticnts (P less than 0.01).Almost all (98.2%; 129/165) of the rtA181T led to sW172*, while only 1.8% of the rtA181T (3/165) led to sW172L or sW172S.HBsAg secretion in vitro was reduced from the rtA181T/ sW172* strain, but there was no significant difference observed in the average serum HBsAg and HBV DNA levels of patients who carried or did not carry the mutant.

CONCLUSIONThe HBV rtA181T mutation is closely associated with adefovir and lamivudine exposure.rtA181T may led to sW172*, culminating in suppression of HBsAg secretion.However, co-existence of the mutant with wild-type sequences was common among our patient population, suggesting that the mutation had little impact on serum HBsAg and HBV DNA levels across the clinical study population.

Adenine ; analogs & derivatives ; Antiviral Agents ; China ; Genotype ; Hepatitis B Surface Antigens ; Hepatitis B virus ; Humans ; Lamivudine ; Mutation ; Organophosphonates

Objective:To investigate the cost-effectiveness of Helicobacter pylori ( H. pylori) antimicrobial susceptibility testing-guided therapy versus an effective empiric modified bismuth quadruple therapy for first-line H. pylori treatment. Methods:This cost-effectiveness analysis was based on the data from a multicenter prospective randomized controlled clinical trial (NCT02935010), which included 382 patients with H. pylori infection. Among them, 286 cases were in the antimicrobial susceptibility testing group, which were diagnosed by biopsy under endoscopy. And according to the results of antimicrobial susceptibility testing of H. pylori, patients were treated with triple or quadruple therapy of eradicating H. pylori for 14 days. A total of 96 patients were in empirical therapy group, which were diagnosed by biopsy under endoscopy (96 cases, endoscopy empirical group), who were treated with 14-day empiric bismuth quadruple therapy. At the same time, based on the patients of empirical group, a simulated 13C-urea breath test (UBT) empirical group (UBT empirical group) was set up (96 cases, H. pylori infection was first diagnosed by 13C-UBT examination) and in the cost accounting the expenses related to endoscopy, biopsy and drug sensitivity test were removed and the expense of 13C-UBT was added. The information of patients of endoscopy empirical group was kept. Taking the eradication rate of H. pylori as an effectiveness indicator, the cost, cost-effective ratio (CER), incremental cost-effective ratio (ICER) among antimicrobial susceptibility testing group, endoscopy empirical group and UBT empirical group were compared by intention-to-treat (ITT) analysis and per-protocol (PP) analysis. Sensitivity analysis was conducted based on the results of ITT analysis to evaluate the reliability of the research results. Results:The results of ITT analysis indicated that the cost of antimicrobial susceptibility testing group, endoscopy empirical group and UBT empirical group were (1 747.41±149.30), 1 032.71 and 657.71 Yuan, respectively. The cost of antimicrobial susceptibility testing group was (714.70±149.30) and (1 089.70±149.30) Yuan higher than that of the endoscopy empirical therapy group and UBT empirical therapy group, respectively. The CER of antimicrobial susceptibility testing group, endoscopy empirical group and UBT empirical group were (19.08±1.49), 12.09 and 7.70 Yuan/%, respectively. ICER of antimicrobial susceptibility testing group was (115.27±1.49) and (175.76±1.49) Yuan /% in comparison with the endoscopy empirical group and the UBT empirical therapy group. Compared with that of empirical group, the ICER of antimicrobial susceptibility testing group was more likely to be affected by H. pylori eradication rate and the cost of antimicrobial susceptibility testing. When the H. pylori eradication rate decreased in the empirical group, the ICER of the antimicrobial susceptibility testing group also decreased; when the H. pylori eradication rate increased in antimicrobial susceptibility testing group, the ICER decreased, and vice versa. When the cost of antimicrobial susceptibility test was upregulated or downregulated by 20%, for every 1% increase in the eradication rate of H. pylori in comparison with that of the endoscopy empirical group, the cost of the antimicrobial susceptibility testing group increased by 99.15 and 131.40 Yuan; in comparison with that of the UBT empirical group, the cost of the antimicrobial susceptibility testing group increased by 159.63 and 191.89 Yuan. Conclusions:For patients diagnosed with H. pylori infection by 13C-UBT and without indications for endoscopy examination, the empirical quadruple therapy is the first choice. For patients intended to do endoscopy to confirm H. pylori infection, with additional affordability of 115.27 Yuan for every 1% increase in the eradication rate of H. pylori, antimicrobial susceptibility testing can be conducted and personalized. H. pylori eradication therapy can be carried out based on the results of antimicrobial susceptibility test. Reduced cost of the antimicrobial susceptibility test will be more conductive to the promotion of personalized treatment after antimicrobial susceptibility test.

Objective:To preliminary explore the changes in blood system in pyrrolizidine alkaloids (PAs)-related liver damage.Methods:General situation, liver function, biochemical blood test, routine blood test, coagulation function markers, etc., of 77 cases with drug-induced liver damage admitted to the Zhongshan Hospital Affiliated to Fudan University from 2012 to 2019 were retrospectively analyzed. Patients’ were divided into PA group, other traditional Chinese medicine group and Western medicine group according to their medication history. Simultaneously, the changes in liver function were observed in the established mice model of monocrotaline-induced liver damage. Liver tissues HE staining and blood routine indexes were observed.Results:24 cases received PA, 24 cases received other traditional Chinese medicine, and 29 cases received western medicine. Alanine aminotransferase was lower in PA group than the other two groups ( P < 0.05), and the total bilirubin and direct bilirubin were significantly lower than the other traditional Chinese medicine group ( P < 0.05). The peripheral platelet count of the PA group was (84.11 ± 26.91) ×10 9/L, which was significantly lower than the lower limit of normal, and had statistically significant difference with other traditional Chinese medicine and western medicine group ( P < 0.01). Thrombocytocrit, mean platelet volume and platelet indices of PA group were statistically different from the other two groups ( P < 0.05). The D-dimer level in patients with PA group was (2.62 ± 1.93) mg/L, which was higher than the upper limit of normal, and significantly higher than the D-dimer level of the other two groups of patients ( P < 0.01). Meanwhile, prothrombin time was longer in PA group than that of the other two groups ( P < 0.01), and platelets count were decreased significantly in the mouse model of monocrotaline-induced liver damage after alanine aminotransferase and aspartate aminotransferase elevation ( P < 0.01). Conclusion:PA-related liver damage has lower peripheral platelet counts, and the peripheral platelet counts of these patients are lower than other types of drug-induced liver damage. In addition, increased D-dimer in patients with PA-related liver damage indicate a potential risk of thrombosis.

Objective To evaluate the clinical effects of the laparoscopic Roux-en-Y gastric bypass (LRYGB) on patients with type 2 diabetes mellitus (T2DM).Methods From Dec.2013 to Dec.2015,83 cases with T2DM received LRYGB were enrolled to this study.They were divided into low body mass index group (LBMI,25≤BMI＜28),intermediate body mass index group (IBMI,28≤BMI＜32) and high body mass index group (HBMI,BMI≥33).Meanwhile,the clinical effects and side-effects were evaluated among three groups.The factors of adverse effects were evaluated by Cox multivariate analysis.Results Only one patient in HBMI was conversed to open surgery,all the others received LRYGB.The surgery time,intraoperative blood loss and complica tion were positively related to BMI,and the difference was statistically significant between the 3 groups(P＜0.05).The main side-effect of LRYGB was gastrointestinal reaction.The level of fasting blood-glucose,postprandial 2 hours blood sugar,HbA1c and cholesterol total in three groups were lower than baseline (P＜0.05),however,there was no significant difference among the three groups (P＞0.05).The rate of clinical effects in three groups was 89.5％,89.3％ and 91.7％.There was no significant difference among the three groups(P＞0.05);In Cox multivariate analysis,cholesterol total and BMI were independent prognostic indicator for LRGB adverse.Conclusions LRYGB is a safe and effective method for patients with T2DM,which can effectively improve glucose and lipid metabolism.The increased BMI can increase the incidence of LRYGB complications.Total cholesterol is an independent prognostic indicator for the adverse of LRYGB.