Objective To investigate the role of ERK signaling pathway in spinal cord in reduction of neuropathic pain (NP) by electro-acupuncture (EA) at Zusanli and Yanglingquan.Methods Fifty male SpragueDawley rats,weighing 180-220 g,in which the intrathecal catheter was successfully placed without complications,were randomly divided into 5 groups (n =10 each):sham operation group (S group),chronic constrictive injury (CCI) group,acupuncture at acupoint group (EA group),acupuncture at non-acupoint group (NA-EA group),and ERK inhibitor U0126 group (U0126 group).NP was induced by CCI in groups CCI,EA,NA-EA and U0126.The animals were anesthetized with intraperitoneal chloral hydrate 300 mg/kg.The right sciatic nerve was exposed and 4 ligatures were placed on the sciatic nerve at 1 mm intervals.EA (intensity ＜ 1.5 mA,frequency 2Hz) of Zusanli and Yanglingquan lasting 30 min was performed once a day for 6 days starting from 4th day after induction of NP in group EA.EA was performed at the points 5 mm lateral to the acupoints of Zusanli and Yanglingquan on the operated side in group NA-EA.Intrathecal U0126 5 μg was started on 4th day after induction of NP twice a day for 6 consecutive days.The mechanical withdrawal threshold (MWT) and thermal withdrawal latency (TWL) were measured at 1 day before CCI (T0,baseline) and at days 3,5,7 and 9 after CCI (T1-4).The rats were sacrificed on 10th day after induction of NP and the right lumbar segment (L4-6) of the spinal cord was removed for determination of the expression of P2X3 receptor protein and mRNA,ERK1/2 and phosphorylated ERK1/2 (p-ERK1/2) in the spinal cord dorsal horn.Results Compared with group S,MWT was significantly decreased,TWL was significantly shortened,the expression of P2X3 receptor protein and mRNA,and p-ERK1/2 was up-regulated in the other 4 groups (P ＜ 0.01).Compared with CCI group,MWT was significantly increased,TWL was significantly prolenged,the expression of P2X3 receptor protein and mRNA,and p-ERK1/2 was downregulated in EA and U0126 groups (P ＜ 0.01),and no significant change in the parameters mentioned above was found in NA-EA group (P ＞ 0.05).Compared with EA group,MWT was significantly increased,TWL was significantly prolonged,the expression of P2X3 receptor protein and mRNA,and p-ERK1/2 was down-regulated in U0126 group (P ＜ 0.01).Conclusion ERK signaling pathway in spinal cord is involved in reduction of NP by EA at Zusanli and Yanglingquan.

Objective To investigate the effects of hemo oxygenase-endogenous carbon monoxide (HO-CO) on mortality of septic shock in rats. Method Eighty healthy Sprague-Dawley rats were randomly divided into four groups (n=20) :group-C,group-Z, group-SS and group-LZ. MAP was monitored continuously,and deaths within 7 days were recorded. Evans blue in lung, ALT, AST, Cr and BUN in plasma, SOD and MDA in kidney, lung and liver,and HO-1 mRNA,HO-2 mRNA,HO-1 protein and HO-2 protein in kidney, lung, femoral artery and liver were measured.Data were analyzed usiny ANOVA. Results ① Mortality in group-SS was lower than that in group-LZ (P<0.05). ②MAP in group-LZ was greater than that in group-SS (P<0.05). ③ Plasma ALT, AST, Cr and BUN,and MDA contents of liver, kidney and lung, and Evans blue content of lung in group-SS were lower than those in group-LZ (P<0.05). Contrarily,the plasma levels of COHb and SOD activity in liver, kid-ney and lung in group-SS were greater than those in group-LZ (P<0.05). ④ HO-1 mRNA and HO-1 protein levels in liver, kidney, femoral artery and lung tissues in group-LZ were lower than those in group- SS (P<0.05). There were no significant difference in HO-2 rnRNA and HO-2 protein found between one another of four groups (P>0.05). Conclusions The up-regulation of HO-1 protein followed by increase CO can reduce the mortality during septic shock, while the hypotension, which is partly attributed to HO-1 protein and CO,matters little to mortality.

Gene chips have been widely applied for the study of lymphoma,involvement discovering tumor-associated genes,assisting classification and investigating cell origin.So far,studies about gene chips detection mainly focus on B-cell lymphomas and T-cell lymphomas.According to those studies,traditional classifications of some kinds of lymphomas have been suspected and cell origin of some kinds of lymphomas have been suggested,which lay the foundation for further study.However,there are still somethings unknown about extranodal NK/T-cell lymphoma,more gene chip detection should be performed for further understanding of the tumor.

Objective To systematically review the effects of air or liquid in a loss of resistance technique for identification of the epidural space. Methods We searched the Cochrane Library, PubMed, EMBASE, Chinese Biomedical Database (CBM), CNKI, VIP and ChinaInfo for studies on the effects of air versus liquid in a loss of resistance technique for identification of the epidural space. The quality of the studies was evaluated by the method recommended by Cochrane Collaboration. Meta-analysis was conducted using the Cochrane Collaboration's RevMan 5.0.1 software. Results Seven prospective randomized controlled trials involving 5183 patients were included in our meta-analysis. The patients were randomly allocated into 2 groups according to the technique by which the epidural space was identified: loss of resistance with air group (group air, n = 2534) and loss of resistance with liquid group (group lidocaine, n = 2649). The results showed that the incidences of difficult catheterization, intravascular catheter insertion, incomplete block and post-operative headache were significantly lower in group liquid than in group air (P ＜ 0.05). There were no significant differences in the incidences of transient abnormal sense and accidental dural puncture between group liquid and air. Conclusion Loss of resistance with liquid can identify the epidural space more correctly than with air, with fewer complications and better analgesic efficacy.

The dynamism and health of the mitochondrial network are regulated by fission and fusion proteins , which help to maintain organelle vitality and the physiological state of the cell .Recently, accumulated evidence has demon-strated that the changes of mitochondrial dynamics have a great effect on inflammation in a variety of diseases .To the con-trary , inflammatory mediators regulate mitochondrial dynamics at the same time .The aim of this reviews is to summarize the relationship between them and to provide new clinical reference for preventing and curing diseases .

Objective To evaluate the effects of acupuncture of acupoints selected on postsurgical gastrointestinal dysfunction in the patients undergoing non-gastrointestinal abdominal surgery.Methods A total of 160 patients of both sexes,aged 18-64 yr,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective non-gastrointestinal abdominal surgery under general anesthesia,were randomly divided into 4 groups (n =40 each) using a random number table:control group (group C),common acupuncture group (group CA),acupuncture of acupoints selected group (group SA),and acupuncture of non-acupoint group (group NA).Acupuncture was performed at 30 min before induction of anesthesia in CA,SA and NA groups.Group CA received acupuncture at bilateral Taichong and Neiguan acupoints,group SA at bilateral Zusanli and Hegu acupoints,and group NA at the points 1 cm lateral to the acupoints of Zusanli and Hegu once every 30 min until the end of surgery.The time when the patients passed flatus,defecating time,and recovery time of bowel sounds were recorded after surgery.The occurrence of nausea and vomiting was recorded within 1 day after surgery.The electrogastrogram (EGG)was performed at 1 day before surgery and 2 days after surgery,and the frequency,amplitude and rhythm of EGG were recorded.At 1 day before and after surgery,the levels of plasma motilin and gastrin were determined using enzyme-linked immunosorbent assay.The recovery of postsurgical gastrointestinal function was assessed,and the recovery rate was calculated.Results Compared with group C,the incidence of postsurgical nausea and vomiting was significantly decreased,the time when the patients passed flatus,defecating time,and recovery time of bowel sounds after surgery were significantly shortened,the recovery rate was significantly increased,the frequency,amplitude and rhythm of EGG were significantly increased at 2 days after surgery,and the levels of plasma motilin and gastrin were significantly increased at 1 day after surgery in CA and SA groups (P＜0.05).Compared with group CA,the incidence of postsurgical nausea and vomiting was significandy decreased,the time when the patients passed flatus,defecating time,and recovery time of bowel sounds after surgery were significantly shortened,the recovery rate was significantly increased,the frequency,amplitude and rhythm of EGG were significantly increased at 2 days after surgery,and the levels of plasma motilin and gastrin were significantly increased at 1 day after surgery in group SA (P＜ 0.05).Conclusion Acupuncture of acupoints selected provides better efficacy than common acupuncture in improving postsurgical gastrointestinal dysfunction in the patients undergoing nongastrointestinal abdominal surgery.

Objective To evaluate the changes in the expression of neuron-restrictive silencer factor (NRSF) in the spinal cord of mice with bone cancer pain.Methods Forty-eight pathogen-free adult male C3H/HeJ mice,aged 4-6 weeks,weighing 20-25 g,were randomly divided into 2 groups (n=24 each) using a random number table:sham operation group (group S) and bone cancer pain group (group BCP).Bone cancer pain was induced by injecting 2× 105 NCTC2472 osteolytic sarcoma cells in α minimal essential medium into the medullary cavity of the right distal femur in group BCP.Only α minimal essential medium was injected into the medullary cavity of the right distal femur in group S.The mechanical and thermal pain thresholds were measured on 5,7,10 and 14 days after inoculation (T1-4).Six mice in each group were randomly selected after measurement of pain thresholds at T1-4 and sacrificed,and the lumbar enlargement segments of the spinal cord were harvested to detect the expression of NRSF.Results Compared with group S,the mechanical pain threshold at T2-4 and thermal pain threshold at T3.4 were significantly decreased,and the expression of NRSF was significantly down-regulated at T1-4 in group BCP (P＜0.05).Conclusion The mechanism underlying the development of bone cancer pain is probably related to down-regulation of NRSF expression in the spinal cord of mice.

Objective To evaluate the effect of electro-acupuncture (EA) at Zusanli (ST-36) and Neiguan (PC6) acupoints on endotoxic shock (ES)-induced myocardial injury in rabbits and the role of heme oxygenase-1 (HO-1).Methods Sixty healthy male New Zealand white rabbits,aged 2 months,weighing 1.5-2.0 kg,were randomly assigned into 6 groups (n =10 each) using a random number table:sham operation group (group S) ; heme oxygenase-1 inhibitor zinc protoporphyrin-Ⅸ (ZnPP-Ⅸ) group (group Z) ; group ES; EA + ES group (group EES); sham EA + ES group (group SEES); EA + ES + ZnPP-Ⅸ group (group EESZ).The rabbits were anesthetized with intravenous 20％ urethane 5 ml/kg.Right common carotid artery was cannulated for BP monitoring.Ear vein was cannulated for drug administration.ES was induced with lipopolysaccharide (LPS) 5 mg/kg injected intravenously in ES,EES,SEES and EESZ groups,while the equal volume of normal saline was given in S and Z groups.ES was confirmed by decrease in MAP to 75 ％ of the baseline value.ZnPP-Ⅸ 10 μmol/kg (in 1 ml of NaHCO3 50 mmol/L) was injected intraperitoneally at 2 h after LPS or normal saline administration in EESZ and Z groups,while the equal volume of NaHCO3 was injected intraperitoneally in the other groups.In EES and EESZ groups,bilateral 30 min EA stimulation (0.2-0.6 ms,2/100 Hz,2-3 mA) of ST36 and PC6 was performed once a day on days 1-4 before induction of ES and on the day of induction of ES (from the onset of LPS injection until the end of induction of ES).In SEES group,electro-stimulation was performed at the points 0.5 cm lateral to the acupoints of ST36 and PC6 and the method was similar to those previously described in group EES.Blood samples were taken from the right common carotid artery at 6 h after LPS or normal saline administration for measurement of serum tumor necrosis factor-alpha (TNF-α),creatine kinase (CK),and lactic dehydrogenase (LDH) levels.Then the rabbits were sacrificed by exsanguination,and the myocardial tissues were removed for microscopic examination of the pathological changes which were scored and for determination of HO-1 protein (by Western blot) and mRNA (using fluorescence quantitative PCR) expression.Results Compared with group S,the pathological scores and concentrations of serum TNF-α,CK,and LDH were significantly increased,and the expression of HO-1 protein and mRNA was up-regulated in ES,EES,SEES and EESZ groups (P ＜ 0.05),and no significant change was found in the parameters mentioned above in group Z (P ＞ 0.05).Compared with group ES,the pathological scores and concentrations of serum TNF-α,CK,and LDH were significantly decreased,and the expression of HO-1 protein and mRNA was up-regulated in group EES (P ＜ 0.05),while no significant change in the parameters mentioned above was found in SEES and EESZ groups (P ＞ 0.05).Compared with group EES,the pathological scores and concentrations of serum TNF-α,CK,and LDH were significantly increased,and the expression of HO-1 protein and mRNA was down-regulated in group EESZ (P ＜ 0.05).Conclusion EA at ST-36 and PC6 acupoints can attenuate ES-induced myocardial injury in rabbits and upregulation of HO-1 expression and inhibition of inflammatory responses may be involved in the mechanism.

Objective To evaluate the role of spinal extracellular signal-regulated kinase (ERK) signaling pathway in reduction of remifentanil-induced hyperalgesia by electro-acupuncture (EA) at Zusanli in rats with incisional pain.Methods Fifty male adult Sprague-Dawley rats, weighing 250-280 g, in which the intrathecal catheter was successfully placed without complications, were randomly divided into 5 groups (n=10 each) using a random number table: control group (group C), remifentanil + incisional pain group (group RI), EA at acupoint group (group E) , EA at non-acupoint group (group NE), and 1/2 ERK inhibitor U0126 + EA at acupoint group (group UE).Normal saline 0.1 ml · kg-1 · min-1 was infused intravenously for 60 min in group C.In RI, E, NE and UE groups, after the model of incisional pain was established, remifentanil 1.0 μg · kg-1 · min-1 was infused for 60 min, and in addition, EA (intensity 10 mA, frequency 4 Hz) of Zusanli lasting for 60 min was performed at the same time in E and UE groups, and EA was performed at the points 5 mm lateral to the acupoints of Zusanli on the operated side simultaneously in group NE.ERK1/2 inhibitor U0126 5 μg (in 5％ dimethyl sulfoxide 10 μl) was injected intrathecally in group UE, and 5％ dimethyl sulfoxide 10 μl was injected intrathecally in the other groups.The mechanical paw withdrawal threshold (MWT) was measured before remifentanil or normal saline infusion (T1) , and at 2 h, 1, and 2 days after the end of infusion (T2-4).After MWT was measured at T4, the expression of ERK1/2 and phosphorylated ERK1/2 (p-ERK1/2) in spinal cord dorsal horns was measured by Western blot.Results Compared with group C, the MWT was significantly decreased at T2-4 in RI, E, NE and UE groups, and the expression of p-ERK1/2 was up-regulated in RI, E and NE groups (P＜0.05).Compared with group RI, the MWT was significantly increased at T2-4 , and the expression of p-ERK1/2 was down-regulated in E and UE groups (P＜0.05);and no significant change was found in the parameters mentioned above in group NE (P＞0.05).Compared with group E, the MWT was significantly increased at T2-4, and the expression of p-ERK 1/2 was down-regulated in group UE (P＜0.05).Conclusion The mechaism by which EA at Zusanli reduces hyperalgesia induced by remifentanil in rats with incisional pain is related to inhibited activation of ERK signaling pathway in the spinal cord.

Objective To systematically review the changes in the intensity of postoperative pain under ketamine anesthesia in children.Methods We searched the Cochrane Library,PubMed,OVID,EMBASE,and Chinese Biomedical Database for prospective randomized controlled trials involving the changes in the intensity of postoperative pain under ketamine anesthesia in children.The quality of the studies was evaluated by the method recommended by Cochrane Collaboration.Evaluation indexes included pain score and analgesic consumption during 6 h after operation,pain score and analgesic consumption during 6-24 h after operation,duration of sensory block (caudal block),side effects during 24 h after operation (postoperative nausea and vomiting and psycho-mimetic manifestations).Meta-analysis was conducted using the Cochrane Collaboration's RevMan 5.0 software.Results Fifteen prospective randomized controlled trials involving 955 patients were included in our Meta-analysis.The patients were divided into 2 groups:control group ( n =455) and ketamine group ( n =500).The pain score and analgesic consumption during 6 h after operation were significantly decreased after general anesthesia with ketamine.The pain score during 6-24 h after operation and analgesic consumption during 6 h after operation were significantly decreased after local anesthesia with ketamine.The duration of sensory block was prolonged and the analgesic consumption during 6 h after operation was significantly reduced after caudal block with ketamine.There was no significant difference in the incidence of postoperative nausea and vomiting and psycho-mimetic manifestations between the two groups.Conclusion The intensity of pain and analgesic requirement during 6 h after operation are significantly reduced under ketamine anesthesia in children.