Objective To investigate the effect of intrathecal morphine preconditioning (ITMP) on the excitability of substantia gelatinosa (SG) neurons in the dorsal horn of the spinal cord in a rat model of myocardial ischemia-reperfusion (I/R).Methods Thirty-six adult male Sprague-Dawley rats,weighing 200-300 g,in which intrathecal catheters were successfully placed without complications,were randomly divided into 3 groups (n =12 each) using a random number table:sham operation group (group S),group I/R,and group ITMP.Myocardial I/R injury was produced by occlusion of the left anterior descending branch of the coronary artery for 30 min followed by 120 min reperfusion.In group ITMP,the rats received intrathecal morphine 3 μg/kg (10 μl) by three cycles of 5 min infusions interspersed with 5 min infusion-free periods starting from 30 min before ischemia,and the equal volume of normal saline was given instead of morphine in group I/R.At 10 min of reperfusion,6 rats randomly selected in each group were sacrificed,and the T2-6 segments of the spinal cords were acutely isolated to prepare spinal cord slices.The resting potential,threshold of action potential (APT),peak of action potential (APP) and action potential duration in SG neurons in the dorsal horn of spinal cord slices were determined using the whole-cell patch-clamp technique,and the number of action potentials evoked by currents of 40,60,80 and 100 pA was recorded.At 120 min of reperfusion,6 rats randomly selected in each group were sacrificed,and myocardial specimens were obtained for determination of myocardial infarct size (IS) and area at risk (AAR),and IS/AAR ratio was calculated.The expression of c-fos in the T2-5 dorsal horns of the spinal cords was detected by Western blot.Results Compared with group S,the IS/AAR ratio was significantly increased,the expression of c-fos was up-regulated,the number of action potentials in SG neurons in dorsal horns of spinal cord was increased,APT was decreased,and APP was increased in group I/R (P＜0.05).Compared with group I/R,the IS/AAR ratio was significantly decreased,the expression of c-fos was down-regulated,the number of action potentials in SG neurons in dorsal horns of spinal cord was decreased,APT was increased,and APP was decreased in group ITMP (P＜0.05).Conclusion The mechanism by which ITMP attenuates myocardial I/R injury is related to decrease in the excitability of SG neurons in the dorsal horn of the spinal cord and reduction of responses to nociceptive stimuli in rats.

Objective To investigate the effect of intrathecal morphine preconditioning on the expression of nerve growth factor (NGF) in the dorsal root ganglia (DRG) in a rat model of myocardial ischemia-reperfusion (I/R).Methods Thirty healthy adult male Sprague-Dawley rats in which intrathecal catheters were successfully placed without complications,weighing 250-350 g,were randomly divided into 5 groups (n =6 each) using a random number table:sham operation group (S group),I/R group,intrathecal morphine preconditioning group (ITMP group),μ receptor antagonist CTOP + intrathecal morphine preconditioning group (CTOP + ITMP group),and CTOP control group (CTOP group).Myocardial ischemia was induced by 30 min of occlusion of the anterior descending branch of the left coronary artery followed by 120 min of reperfusion in all the groups except S group.Intrathecal morphine preconditioning was produced by 3 cycles of 5 min intrathecal injection of morphine 3 μg/kg (10 μl) at 5 min intervals within 30 min before ischemia in ITMP group.In CTOP+ITMP and CTOP groups,1 μg/μ1 CTOP 10 μl was injected intrathecally at 10 min before morphine preconditioning and 40 min before ischemia,respectively.At 120 min of reperfusion,the rats were sacrificed,and myocardial specimens were obtained for determination of myocardial infarct size,and DRGs were removed for determination of the expression of NGF by using immunohistochemistry and Western blot.Results Compared with S group,the myocardial infarct size was significantly increased,and the expression of NGF in DRGs was significantly up-regulated in I/R group (P＜0.05).Compared with I/R group,the myocardial infarct size was significantly decreased,and the expression of NGF in DRGs was significantly down-regulated in ITMP group (P＜ 0.05),and no significant change was found in the parameters mentioned above in CTOP group (P＞0.05).Compared with ITMP group,the myocardial infarct size was significantly increased,and the expression of NGF in DRGs was significantly up-regulated in CTOP+ITMP and CTOP groups (P＜0.05).Conclusion The mechanism by which intrathecal morphine preconditioning reduces myocardial I/R injury is related to activation of spinal μ receptors,inhibition of NGF expression in DRGs,and reduction of responses to noxious stimulation in the rats.

Objective: To explore the effect of salvianolate combined with the conventional therapy on acute ischemic stroke and observe the influence on serum inflammatory cytokines of interleukin-6(IL-6).Methods: According to the random number table, 70 patients were randomly divided into the observation group (n =35) and the control group (n =35), and both were given the conventional therapy for acute ischemic stroke.The observation group was given intravenous injection of 200mg salvianolate in 250ml normal saline once a day additionally.The treatment course was 2 weeks.Another 30 persons with physical examination were in the healthy control group.The neurologic damage deficiency score (NIHSS score) was evaluated after the 3-, 7-,10-and 14-day treatment in the groups, the serum IL-6 in 24 h after onset, and after the 3-, 7-,10-and 14-day treatment was detected and compared with that in the healthy control group.Results: After the 7-day treatment, NIHSS score in the observation group decreased significantly when compared with that on admission (P＜0.05), and remained the decreasing trend.After the 10-day treatment, NIHSS score in the control group decreased significantly when compared with that on admission (P＜0.05).After the 7-day treatment, NIHSS score in the observation group was lower than that in the control group (P＜0.05).Compared with that in the healthy control group, the serum level of IL-6 in the observation group and the control group was higher in 24 h of admission (P＜0.05).The serum level of IL-6 in the observation group decreased after the 7-day treatment, and was similar to that in the healthy control group after the 14-day treatment (P＞0.05).The serum level of IL-6 in the control group decreased after the 10-day treatment, while was higher than that in the healthy control group during the whole study period (P＜0.05).The serum level of IL-6 in the observation group was lower than that in the control group after the 7-day treatment (P＜0.05), and the peak value in the observation group was notably lower than that in the control group (P＜0.05).Conclusion: Salvianolate combined with the conventional therapy can effectively decrease the NIHSS score and the content of IL-6 in the patients with acute ischemic stroke, which shows better effect than the conventional therapy alone.

OBJECTIVE To estimate the cost of concentrated disinfectant supply of medical appliances,so as to provide the primary basis for improving the concentrated disinfectant supply model,along with regional integration.METHODS Using contrasting methodologies,the cost level before and after the concentrated disinfectant supply with regional integration was compared,and the individual cost and total cost were analyzed.RESULTS Material and human resource cost was the core of total cost.Concentration management of regional medical appliances disinfection supply could significantly reduce costs.CONCLUSIONS Integrated management of concentrated disinfectant supply could reduce cost and economize expenses.Actually,this model is worth promoting.

Objective:To explore the relationship between the length of cervical spinous process and cervical motion and affected segment of cervical spondylotic myelopathy(CSM).Methods:Retrospective analysis was performed on 375 patients who underwent cervical surgical treatment due to single-segment cervical spondylotic myelopathy from January 2015 to January 2019. There were 200 males and 175 females, aged 50.72±9.39 (range 40 to 60) years. Several parameters, including the sagittal diameter of vertebral body, the sagittal diameter of cervical canal, the length of cervical spinous process, C 3-C 7 lordotic angle, range of motion (ROM) at C 3-C 7 and segmental ROM were measured via preoperative plain radiographs. All parameters were tested via Shapiro-Wilk method. Pearson correlation analyses was used to quantify the relationship between the lengths of C 3-C 7 spinous process and segmental ROMs. Receiver operating characteristic (ROC) curve was mapped to obtain the cut-off points according to the length of cervical spinous process which had significant differences. Patients were divided into two groups based on the cut-off points. χ2 test and t test were used to exclude the interference of age, gender and other anatomical factors and compare the differences in the affected segment of cervical spondylotic myelopathy between groups, so as to analyze the relationship between the length of cervical spinous process and affected segment of cervical spondylotic myelopathy. Results:There were significant differences of C 6 spinous process 27.82±6.01 mm and significantly negative correlation between the length of C 6 spinous process and the ROM at C 6,7 segment ( r=-0.338, P<0.001), while no significant correlations were found in other segments. ROC curves were mapped to obtain the cut-off points, and the cut-off point was 0.76. Group I: the ratio of the length of spinous process of C 6/C 7 (C 6/C 7 ratio, range 0.49 to 1.01) under 0.76, Group II: C 6/C 7 ratio more than 0.76. Compared with patients with longer-type C 6 spinous process (C 6/C 7 ratio ≥0.76), patients with shorter-type C 6 spinous process (C 6/C 7 ratio <0.76) had significantly bigger ROM at C 6,7 segment (10.11° vs 7.10°, P<0.001) and higher incidence of C 6,7 spinal cord compression ( χ2=16.642, P<0.001, OR=2.521), while differences in age, sex, sagittal diameters of vertebral body and spinal canal between two groups were not significant. Conclusion:The length of C 6 spinous process was significantly correlated with ROM at C 6,7 segment and the incidence of C 6,7 degenerative myelopathy. The length of C 6 spinous process can be considered as a predictor of development of C 6,7 degenerative myelopathy.

BACKGROUND:Estrogen signaling pathway for interaction between aromatase and estrogen-related receptor may exist in bone marrow mesenchymal stem cel s, which is used for regulating biological activity of bone marrow mesenchymal stem cel s. OBJECTIVE:To observe the expression of aromatase and estrogen-related receptors in adult bone marrow mesenchymal stem cel s during osteogenic differentiation. METHODS:Bone marrow mesenchymal stem cel s were respectively cultured in low-glucose DMEM medium (control group) and osteogenic induction medium (induction group). Cel proliferation and calcium deposition were determined by MTT assay and alizarin red staining, respectively. The expression of aromatase, estrogen receptorα, estrogen receptorβ, and estrogen-related receptorαduring osteogenic differentiation were determined by real-time PCR and western blot analysis. Estradiol levels in supernatants and lysates were detected by ELISA method. RESULTS AND CONCLUSION:In the induction group, the proliferation ability of bone marrow mesenchymal stem cel s was the strongest at 72 hours of culture;while there were a great amount of calcium nodules formed at 21 days of culture. Results from PCR and western blot assay showed that the expression of aromatase and estrogen receptorαwas improved in the induction group, but the expression of estrogen-related receptorαwas inhibited. There was no difference in the expression of estrogen receptorβbetween the two groups. ELISA results indicated that the level of estradiol in the supernatant of induction group was the highest. These findings indicate that aromatase, estrogen receptorα, estrogen receptorβand estrogen-related receptorαare al involved in osteogenesis of bone marrow mesenchymal stem cel s. Moreover, estradiol can be synthesized and secreted in bone marrow mesenchymal stem cel s, and most likely, promote the osteogenic differentiation of bone marrow mesenchymal stem cel s by related receptor pathway.

BACKGROUNDLung cancer is the leading cancer of malignant tumor in China.It is the direction that poeple make efforts to seek gene therapy of lung cancer. The aim of this study is to explore the effects of transfected growth arrest-specific homeobox gene (Gax gene) on the proliferation and expressions of c-fos and c-jun mRNA in A549 cells.

METHODSA549 cells were transfected with Gax gene by adenovirus. Expressions of Gax mRNA and protein were detected by RT-PCR and immunocytochemistry. The expressions of c-fos and c-jun mRNA were evaluated by RT-PCR. The proliferation inhibition effect of Gax transfection on A549 cells was evaluated by MTT assay.

RESULTSOnly in the A549 cells transfected with Gax gene the Gax expression was confirmed by RT-PCR and immunocytochemistry. Compared with that in the control group, c-fos and c-jun mRNA level decreased significantly in Gax-transfected A549 cells (t=7.755, P < 0.01; t= 5.938 , P < 0.01). MTT assay showed that the proliferation inhibition rates of A549 cells transfected by Ad-Gax for 24h, 48h and 72h were (47.35±5.36)%, (54.96±1.78)%, and (65.39±5.11)% respectively. And these proliferation inhibition rates were significantly higher than those in the control group (Chi-Square=7.152, 9.431 and 12.847, P < 0.01).

CONCLUSIONSGax gene can inhibit the proliferation of A549 cells. Its molecular mechanism may be through down-regulating the expressions of c-fos and c-jun.

Objective:To compare the clinical features, X-ray, CT, MRI imaging findings of C 3, 4 single segment cervical spondylotic myelopathy among the elderly group, the middle-aged group and the young group. Methods:The medical records and imaging data of 51 cases of single segment C 3, 4 cervical spondylotic myelopathy treated from January 2017 to December 2021 were retrospectively reviewed. There were 10 cases in the young group, including 8 males and 2 females, 23-44 years, with an average age of 35.8±7.62 years; 14 cases in the middle-aged group, including 9 males and 5 females, 48-60 years, with an average age of 53.21±4.14 years; 27 cases in the elderly group, including 24 males and 3 females, 61-84 years, with an average age of 68.04±5.97 years. Based on the medical record data, the differences in clinical manifestations among the three groups (initial symptoms, symptom distribution, pathological sign distribution and JOA score) were analyzed. Based on the imaging data, the static factors (cervical osteophyte, alignment and thickness of cervical ligamentum flavum) and dynamic factors [overall cervical range of motion (ROM), individual segment cervical ROM, cervical instability and cervical nuchal ligament calcification] were analyzed. Anatomical factors (C 2-C 7 Cobb angle, C 4-C 7 Cobb angle, C 3 vertebral canal diameter, C 4 vertebral diameter, C 3 Pavlov ratio, C 4 Pavlov ratio) and spinal cord compression (spinal cord signal, compression position and compression nature) were also analyzed. Results:There were no statistically significant difference in gender distribution and height in three groups of patients ( P>0.05). In terms of clinical manifestations, there were statistically significant differences among the three groups in initial symptoms and chief symptoms ( P<0.05). The elderly group had upper limb weakness as the first symptom, lower limb weakness and abnormal gait as the chief complaint; the middle-aged group had upper limb numbness as the first symptom, upper limb numbness and weakness as the chief complaint; the young group had upper limb pain as the first symptom, upper limb numbness as the chief complaint. There were statistically significant differences in Hoffmann sign and Babinski sign among the three groups ( P<0.05). Hoffmann sign and Babinski sign were more common in the elderly group than in the young group ( P<0.05). There were significant differences among the three groups in total JOA score, JOA score of motor and lower limb motor JOA ( P<0.05). The total JOA score in the elderly group was lower than that in the young group ( P<0.05), especially for motor JOA score ( P<0.05), and lower limb motor JOA score ( P<0.05). There were no significant differences in first symptoms distribution, symptoms distribution, biceps reflex, triceps reflex, radial reflex or knee tendon reflex among the three groups ( P>0.05). In terms of static factors, there was significant difference in alignment and thickness of cervical ligamentum flavum among the three groups (P<0.05). The elderly group was more prone to slip than the young and middle aged groups ( P<0.05). The thickness of ligamentum flavum in the elderly group (2.18±0.68 mm) was thicker than that in the young group (1.60±0.30 mm) and the middle-elderly group (1.60±0.62 mm) ( P<0.05). There was no significant difference in cervical osteophyte among the three groups ( P>0.05). In terms of dynamic factors, there were statistically significant difference in C 3-C 7 ROM, C 4-C 7 ROM, C 3, 4 ROM and ossification of nuchal ligament among the three groups ( P<0.05). In the elderly group, C 3-C 7 ROM (22.18°) was larger than that in the young group (21.27°) ( P<0.05), while in the elderly group C 4-C 7 ROM (9.60°) was smaller than that in the young group (14.19°) ( P<0.05). In the elderly group, C 3, 4 ROM (15.30°) was larger than that in the young group (9.97°) ( P<0.05), and the elderly group was more prone to nuchal ligament calcification than the young and the middle-elderly group ( P<0.05). There were no significant difference among the three groups in C 4, 5 ROM, C 5, 6 ROM, C 6, 7 ROM or cervical instability ( P>0.05). For spinal cord compression, there were statistically significant differences among the three groups in the compression nature, compression location and MRI T2WI spinal cord signal ( P<0.05). The elderly group was more prone to anterior and posterior bony compression. The elderly group was more likely to show high signal intensity on spinal cord MRI T2WI than the young group ( P<0.05). For anatomical factors, there were statistically significant differences in C 2-C 7 Cobb, C 3 vertebral diameter and C 3 Pavolv among the three groups ( P<0.05) . The C 2-C 7 Cobb of the elderly group (21.06°) was larger than that of the young group (16.45°) ( P<0.05), and the C 3 diameter of the elderly group (9.61±0.33 mm) was smaller than that of the young group (10.38±1.19 mm) ( P<0.05). The C 3 Pavolv of the elderly group (0.52±0.03) was lower than that of the young group (0.59±0.11) ( P<0.05). In the presence of lordosis, C 4-C 7 Cobb in the elderly group (4.96°±4.05°) was smaller than that in the young group (12.42°±4.83°) and the middle-aged group (10.07°±6.14°) ( P<0.05). In the presence of kyphosis, C 4-C 7 Cobb in the elderly group (4.02°±1.19°) was larger than that in the young group (0.06°±0.01°) and the middle-aged group (1.83°±0.93°) ( P<0.05). There were no significant differences in C 3-C 7 Cobb, C 4 vertebral diameter or C 4 Pavolv among the three groups ( P>0.05). Conclusion:Young patients mostly have anteriorly soft compression of disc herniation, and most of them complain of neck and upper limb pain, while spinal cord compression and clinical manifestations are relatively mild. For the elderly patients, most of them have C 3 retrolisthesis, with the pinching type bony compression of spinal cord from both anteriorly and posteriorly, and their complaints are usually upper limb numbness, mostly accompanied by radiographically severe spinal cord compression and clinically gait abnormalities. In the middle-aged patients, the rigid compression of anterior calcified disc herniation is the main reason, and the numbness of upper limb is the chief complain.