Objective To investigate the microRNAs(miRNAs)expression profiles in the bowels of patients with Hirschsprung disease(HSCR),and to explore the role of differentially expressed miRNAs in the pathogenesis of HSCR. Methods Twenty - seven HSCR tissues,including spastic segments and distending segments,were obtained from patients with HSCR during operation. Then miRNA microarrays were used to investigate the miRNA expression profiles in 6 HSCR specimens. Bioinformatics software was used to predict target genes of miRNA. Three miRNAs (miR - 145 - 3p,miR - 4505 and miR - 1260a)were chosen and quantificational real - time(qRT)- PCR was per-formed to verify the different expression of those three miRNAs in 27 HSCR tissues. Results The expression of 26 miRNAs in an aganglionic colon segment was found to be more than two fold greater than that in ganglionic segment tis-sues,including 19 up - regulated miRNAs and 7 down - regulated miRNAs in patients with HSCR(all P ﹤ 0. 05). Tar-get genes of miRNAs were found,such as SOX10,RET,L1CAM. qRT - PCR showed the expression of miR - 145 - 3p (1. 42 ± 0. 42,aganglionic segment vs 0. 90 ± 0. 31,ganglionic segment)and miR - 4505(1. 30 ± 0. 30,aganglionic segment vs 0. 76 ± 0. 22,ganglionic segment)displayed a statistical difference between groups(all P ﹤ 0. 001). Be-sides,the expressions of miR - 145 - 3p(1. 53 ± 0. 46,long - segment type vs 1. 16 ± 0. 12,short - segment type)and miR - 4505(1. 42 ± 0. 26,long - segment type vs 1. 00 ± 0. 16,short - segment type)showed a statistical difference be-tween different types(all P ﹤ 0. 001),but miR - 1260a(1. 11 ± 0. 25,aganglionic segment vs 0. 99 ± 0. 21,ganglionic segment)did not show differential expression between different groups(P = 0. 064). Conclusions Abnormal expression of miRNAs was found in HSCR spastic segments,suggesting that miRNAs may be involved in the pathogenesis of HSCR.

BACKGROUND: Unilateral spinal epidural anesthesia with ropivacaine can reduce the perioperative pain in the elderly undergoing hip or knee arthroplasty, but choosing which concentration of small dose hypobaric ropivacaine is an issue of concern.OBJECTIVE: To explore the anesthetic and analgesic effects of unilateral spinal epidural anesthesia with different concentrations of low dose hypobaric ropivacaine in senile knee or hip replacement.METHODS: Ninety patients undergoing knee or hip replacement in the Henan Province Hospital of TCM from August 2014 to December 2015 were enrolled, and randomized into 0.15%, 0.5% and 0.25% ropivacaine groups (n=30 per group), followed by spinal epidural anesthesia at L3-4 or L2-3 lumbar interspace, respectively.RESULTS AND CONCLUSION: (1) The order of the flat subsided time and motor block recovery time was as follows:0.15% ropivacaine group < 0.25% ropivacaine group < 0.5% ropivacaine group; the onset time of motor block was longest in the 0.25% ropivacaine group, followed by 0.5% ropivacaine group, and shortest in the 0.15% ropivacaine group (all P < 0.05). (2) The order of the visual analogue scale scores at 1, 5, and 10 hours after anesthesia and 24 hours postoperatively was as follows: 0.5% ropivacaine group < 0.25% ropivacaine group < 0.15% ropivacaine group (P < 0.05). (3) The change levels of heart rate and blood pressure were highest in the 0.5% ropivacaine group, followed by 0.15% ropivacaine group, and lowest in the 0.25% ropivacaine group. (4) The incidence of adverse events was highest in the 0.5% ropivacaine group, followed by 0.15% ropivacaine group, and lowest in the 0.25% ropivacaine group (P < 0.05). (5) To conclude, 3 mL of 0.25% ropivacaine exhibits desired anesthetic effect.