Objective To explore the reliability and validity of the simplified Chinese version of the Oswestry disability index (SCODI) and the curative effect of community-based rehabilitation for patients with lumbar disc herniation (LDH). Methods 165 patients with LDH received community-based rehabilitation according to the severity of their LDH. Before treatment and after 3 months, the SCODI, the Roland-Morris disability questionnaire (RMDQ) and a visual analogue scale (VAS) were used to evaluate the effects. The reliability and validity of the SCODI was thus tested. The reliability analysis included internal consistency as measured by Cronbach's coefficient,and test-retest reliability as measured by an interclass correlation coefficient (ICC). The validity analysis used Spearman's correlation coefficient (for concurrent efficacy validity) and factor analysis (for construct validity). The correlation between SCODI, RMDQ and VAS results was analyzed. Results There was statistically significant functional improvement and better QOL in LDH patients after community-based rehabilitation. The SCODI showed good validity and reliability. There was significant correlation among the SCODI, RMDQ and VAS results. Conclusion Community-based rehabilitation can significantly alleviate symptoms for patients with LDH and improve their QOL.The SCODI is a reliable and valid instrument for measuring the curative effect of community-based rehabilitation on patients with LDH.

Objective To investigate the effect of dezocine combined with sufentanil on postop-erative analgesia and side effects in the upper-abdominal surgery and hip replacement surgery,and ex-plore the potential mechanisms.Methods One hundred patients scheduled for selective upper-abdomi-nal operation and hip replacement surgery were randomly divided into group dezocine (group D), dezocine 0.3 mg/kg combined with sufentanil 1 μg/kg group(group DS1),dezocine 0.3 mg/kg com-bined with sufentanil 1.5 μg/kg group(group DS2)and dezocine 0.3 mg/kg combined with sufentanil 2 μg/kg group(group DS3).Analgesia was maintained by remifentanil 6-8 μg·kg-1·h-1 under total intravenous anesthesia.Patients were administered 5 μg sufentanil during sewing the skin.Visual Analogue Score (VAS)of both silence and 90°turn over situation,Ramsay score,and adverse effects at 1 h (T1 ),4 h (T2 ),8 h (T3 ),12 h (T4 ),24 h (T5 ),36 h (T6 ),48 h (T7 )after the operation were recorded respectively.Results The total amount of sufentanil and dezocine of group DS1 group showed a significant higher than the other three groups (P <0.05).The VAS in silence of group DS1 were higher than group DS3 at T1-T3 (P <0.05).There was no significant difference in VAS under 90°turn over situation.The side effect of group DS3 were higher than the other three groups (P <0.05).Conclusion Dezocine combined with sufentanil for postoperative patient-controlled intravenous analgesia(PCIA)is effective and safe in patients undergoing upper-abdominal surgery and hip replace-ment surgery,and while dezocine 0.3 mg/kg combined with sufentanil 1.5 μg/kg,it has the best effect of postoperative analgesia and least side effects.

ObjectiveTo explore the effects of different doses of PcTx1,a specific blocker of acid-sensing ion channel 1a,on global cerebral ischemia/repedfusion (I/R) injury in rats,MethodsSixty adult male Sprague Dawley rats (weighing 250-300 g) were randomly divided into 6 grups ( n =10 each):sham operation group (group S),I/R group,different doses of PcTx1 ( 10 ng/ml,group P1 ; 25 ng/ml,group P2 ; 50 ng/ml,group P3 ;and 500 ng/ml,group P4 ) groups.Global cerebral ischemia was induced by the modified procedure of Pulsinelli 4-vessel occlusion.In groups P1,P2,P3 and P4,different doses of PcTx1 ( 10,25,50 and 500 ng/ml),6 μl each,were respectively injected into the lateral cerebral ventricle at the initiation of reperfusion,while equal volume of double distilled water was injected instead in group I/R.Six rats in each group were sacrificed at 24 h of reperfusion,and the brains were immediately removed,Thereafter,the contents of malondialdehyde (MDA),reduced glutathione (GSH) and ritric oxide (NO),the activities of constitutive NO synthase (eNOS) snd inducible NO synthase (iNOS) were detected in hippocampus.Four rats in each group were sacrificed at 72 h of reperfusion,and hematoxylin and eosin staining was used to observe the pathomorphological changes of the hippocampal neurons.ResultsCompared with group S,the other groups showed decreases in the contents of GSH,while increases in the contents of MDA and NO and the activities of cNOS and iNOS ( P ＜ 0.05 or 0.01 ).The contents of GSH increased,while the contents of MDA and NO and the activities of cNOS and iNOS decreased in groups P2,P3 and P4 compared with group I/R ( P ＜ 0.05 or 0.01).Compared with group P1,the contents of GSH increased,the contents of MDA and the activities of cNOS decreased in groups P2,P3 and P4,and the contents of NO and the activities of iNOS decreased in groups P3 and P4 ( P ＜ 0.05 or 0.01 ).Compared with group P2,the activities of iNOS decreased in groups P3 and P4(P ＜ 0.05 or 0.01).The damage to neurons in hippocampal CAI was severe in groups I/R and P1,but it was attenuated in groups P3 and P4.ConclusionPcTx1 25,50 and 500 ng/ml (6 μl)injected into lateral cerebral ventricle can attenuate global cerebral I/R injury in rats,and the dose 50 ng/ml (6 μl) is more suitable.

Objective To evaluate the effects of hydrogen-rich saline on the expression of miR-210 and miR-21 in hippocampus during global cerebral ischemia-reperfusion (I/R) in rats.Methods Seventy-two healthy male Sprague-Dawley rats,aged 9-10 weeks,weighing 250-300 g,were randomly divided into 3 groups (n =24 each):sham operation group (group S),group I/R,and hydrogen-rich saline group (group H).Global cerebral I/R was produced by 4-vessel occlusion method.In group H,0.6 mmol/L hydrogen-rich saline 5 ml/kg was injected intraperitoneally at 0 and 6 h of reperfusion,while the equal volume of normal saline was injected instead of hydrogen-rich saline in the other two groups.Rats were sacrificed at 24 and 72 h of reperfusion,and then the bilateral hippocampi were removed for detection of the expression of miR-210 and miR-21 using RT-PCR.The global brain tissues were also obtained and stained with HE for examination of the changes in pyramidal cells in the CA1 region of hippocampus.Results Compared with group S,the expression of miR-210 and miR-21 was significantly up-regulated,and the number of pyramidal cells was decreased in group I/R (P ＜ 0.05).Compared with group I/R,the expression of miR-210 and miR-21 was significantly down-regulated,and the number of pyramidal cells was increased in group H (P ＜ 0.05).The pathological changes were significantly ameliorated in group H.Conciusion The mechanism by which hydrogen-rich saline attenuates global cerebral I/R injury is related to downregulation of the expression of miR-210 and miR-21 in rat hippocampus.

Objective To evaluate the effect of mild hypothermia combined with hydrogen-rich saline on cerebral injury after cardiac arrest and resuscitation in rats.Methods Healthy male Sprague-Dawley rats,aged 7-8 weeks,weighing 280-320 g,were divided into 5 groups (n=33 each) using a random number table method:sham operation group (group S),cardiac arrest and resuscitation group (group CAR),hydrogen-rich saline group (group H2),mild hypothermia group (group MH),and mild hypothermia plus hydrogen-rich saline group (group MH+H2).Cardiac arrest was induced with transoesophageal cardiac pacing followed by cardiopulmonary resuscitation to establish the cerebral injury model.Hydrogen-rich saline 5 ml/kg was intraperitoneally injected immediately after return of spontaneous circulation (ROSC) in H2 and MH+H2 groups,while the equal volume of normal saline was given instead in the other groups.The body temperature of rats was cooled down to 32-34℃ within 15 min starting from the time point immediately after ROSC and maintained for 4 h in MH and MH+H2 groups.Fifteen rats were selected at 24 h after ROSC to assess the neurological function score (NDS).Eighteen rats in each group were sacrificed at 24 h after ROSC,and brains were removed for microscopic examination of the pathological changes in hippocampal CA1 region after hematoxylin and eosin staining and for determination of pyramidal cell count and expression of glucose-regulated protein 78 (GRP78),C/EBP-homologous protein (CHOP),caspase-12,caspase-3,Bcl-2 and Bax in hippocampal CA1 region (by Western blot).Results Compared with group S,the NDS was significantly decreased,the pyramidal cell count was reduced,the expression of GRP78,CHOP,caspase-12,caspase-3 and Bax was up-regulated,and the expression of Bcl-2 was down-regulated in the other four groups (P＜0.05).Compared with group CA-R,the NDS and pyramidal cell count were significantly increased,the expression of GRP78 and Bcl-2 was up-regulated,and the expression of CHOP,caspase-12,caspase-3 and Bax was down-regulated in H2,MH and MH+H2 groups (P＜0.05).Compared with group H2 or group MH,the NDS and pyramidal cell count were significantly increased,the expression of caspase-3 and Bax was down-regulated,the expression of Bcl-2 was up-regulated (P＜0.05),and no significant change was found in the expression of GRP78,CHOP and caspase-12 in group MH+H2 (P＞ 0.05).Conclusion Combination of mild hypothermia and hydrogen-rich saline offers enhanced efficacy in reducing cerebral injury after cardiac arrest and resuscitation over mild hypothermia or hydrogen-rich saline alone in rats.