Neuropathic pain arises as a direct consequence of a lesion or disease affects the somatosensory.Its symptoms include spontaneous,hyperalgesia and allodynia pain.Pain management is not satisfied through merely analgesics.To manage pain effectively is difficult in clinic.The paper is to review the progress of the mechanism of neuropathic pain.

Objective To investigate the effect of lliac fascia compartment block on early analgesia of patients during performed the whole knee replacement.Methods Forty patients undergoing single whole knee replacement were randomly divided into group A and B,20 cases in each group.Before anesthesia,patients in group A underwentthree in one femoral nerve block guided by nerve stimulator with 20 ml of 0.5％ ropivacaine.Patients in group B underwent lliac fascia compartment block with 25 ml of 0.5％ ropivacaine.Visual analogue score (VAS) during rest and movement were recorded at 0 (T0),0.5 (T1),1 (T2),2 (T3),4 (T4),6 (T5),and 8 h (T6) after a patient fully awoke from surgery.Results In group B,Resting VAS scoresofpatientswere(4.5±0.7),(4.5 ±0.6),(4.2 ±0.8),(4.4 ±0.5),(4.3 ±0.7),(4.4 ±0.6),(5.2 ±0.6) at T0-T6 time point,and moving VAS were(4.7 ±0.6),(4.4 ±0.7),(4.4 ±0.5),(4.3 ±0.6),(4.4±0.6),(5.0 ±0.7),(5.1 ±0.6),all higher than that of group A((1.5 ±0.6),(1.7 ±0.6),(1.7 ± 0.6),(1.7 ±0.6),(1.9 ±0.6),(2.0 ±0.6),(2.2 ± 0.5) and(1.6 ±0.6),(2.0 ±0.6),(1.8 ±0.6),(1.7 ± 0.6),(2.0 ± 0.6),(2.3 ± 0.6),(2.5 ± 0.7),and there was significant difference (resting VAS∶ F (between group) =17.672,P ＜ 0.05,F(within group) =5.062,P ＜ 0.001,F(interaction) =1.443,P =0.143) ; Moving VAS:F (between group) =8.183,P ＜ 0.001,F (within group) =7.742,P ＜ 0.001,F (interaction) =0.85,P =0.424).Conclusion Iliac fascia compartment block had proved with early analgesic effect in patients with total knee replacement.Iliac fascia block is simple,safe,and can be performed without nerve stimulator.Therefore iliac fascia block has a certain clinical application.

Objective To discuss the relationship between traditional Chinese medicine (TCM ) syndromes and the laboratory in-dexes in chronic hepatitis B .Methods According to the TCM syndrome differentiation ,145 cases of chronic hepatitis B were divid-ed into the 5 syndromes :the stagnation of damp-heat in middle-jiao ,the stagnation of liver-QI and deficiency of the spleen ,the spleen-kidney Yang deficiency ,the collaterals obstruction by blood stasis and the liver-kidney Yin deficiency .The correlation be-tween the TCM syndromes and the laboratory indexes was observed .Results The research found that the stagnation of damp-heat in middle-jiao and the stagnation of liver-QI and deficiency of the spleen had the highest proportion in the five kinds of the CM syn-dromes ,which accounted for 53 .8% and 31 .7% ,respectively ;The positive rates of total bile(TBil) and indirect bile(IBil) in the stagnation of damp-heat in middle-jiao were 69 .4% and 68 .8% respectively ,which were significantly higher than those in other 3 groups (P<0 .05);However ,the positive rates of total bile acid (TBA) ,alanine aminotransferase(ALT ) and HBeAg in the liver-kidney Yin deficiency were higher than those in other 3 groups .The HBV-DNA viral load in the stagnation of damp-heat in middle-jiao was significantly higher than that in other 3 groups (HBV-DNA>105 copies/mL) ,and the HBV replication was most active . Conclusion There are some relationships between the TCM syndromes and the laboratory indexes in chronic hepatitis B ,therefore the laboratory indexes have more important clinical significance for the syndrome differentiation and treatment of chronic hepatitis B .

Objective:Mechanical ventilation has been the regular equipment or the therapy equipment in the hospital. In order to establish a safe condition of using ventilator, not only standard operations are required, but also high quality of ventilators should be ensured. This article will introduce a kind of ventilator detection system made in Switzerland, especially the portable device which supports the technology to detect ventilator at any time and every place. These detection equipments provide the protection of high risk medical equipment. Methods: According to the requirement of mechanical ventilation detection and the instruction of imtmedical ventilator detection system, the application methods of imtmedical detection system were introduced. Results: Compared the difference with other ventilator detectors, the priority, portability, stability and accuracy of the Citrex H4 detection were understood. Conclusion:The Citrex H4 ventilator detector is satisfactory for quality testing of ventilator, ion evaluate can make the output performance parameters more accurate and the quality higher.of the ventilators.

Objective To investigate the effect of parecoxib on hippocompal inflammation following partial hepatectomy in aged rats.The effects of selective COX-2 inhibitor (parecoxib) on hippocampal inflammation were also evaluated.Methods Seventy male rats,aged 20 months,weighing 500-600 g,were randomly divided into three groups: control (n=10),surgery (n=30),and parecoxib (n=30).Control animals received sterile saline to control for the effects of injection stress.Rats in the surgery group received partial hepatectomy under isoflurane anesthesia and sterile saline injection.Rats in the parecoxib group received surgery and anesthesia similar to surgery group rats,and parecoxib treatment.On postanesthetic day 1,3 and 7,animals were euthanized to assess the hippocampal COX-2 expression,PGE2 production and caspase-3 expression.Results Surgery significantly increased the expression of COX-2 mRNA and protein expression,PGE2 production and caspase-3 protein expression on day 1 postoperatively (P<0.01),until day 3 (P<0.05) compared to control group.Parecoxib treatment group significantly suppressed COX-2 mRNA and protein expression,PGE2 production and caspase-3 protein expression on postoperative day 1 and day 3 (P<0.05 or P<0.01),in comparison with the surgery group.There was no significant difference between control group and other groups of the expression of COX-2 mRNA and protein expression,PGE2 production and caspase-3 protein expression on day 7.Conclusion Partial hepatectomy induces a short-term hippocampal inflammatory response in the rats.Parecoxib suppressed the hippocampal inflammation via the down-regulation of COX-2 mRNA and protein,PGE2 and caspase-3 protein in rats following partial hepatectomy.

Diaphragm is the principal respiratory muscle.Diaphragm dysfunction resulting from mechanical ventilation,chronic cardiopulmonary disease,medicine,cardio-thoracic surgery,septic shock and chronic malnutrition predisposes to weaning failure from mechanical ventilation and prolongs intensive care unit (ICU) stay.Traditionally,the method of assessment of diaphragm structure and function was invasive,lacking specific,and was difficult to be used bedside.A number of recent studies have been suggested that ultrasonographic evaluation has been proposed as an accurate,safe and noninvasive method of quantification of diaphragm structure and function.This article reviews the related researches of technique and the clinical applications of ultrasonography in the evaluation of diaphragmatic structure and function,which may possibly result in timely identification of patients with diaphragm dysfunction and improve the assessment of recovery from diaphragm weakness.

There are a wide variety of spiders on the earth and most them can secrete venom,which contains a variety of chemi-cal compositions that have multiple influences on organism be-sides toxic effects.The pharmacological efficiency includes cardi-ovascular and cerebrovascular activities,analgesic activities,an-tibacterial and anticancer activities etc.Ion channels are one of the important targets of spider toxins.They act on different ion channels,such as potassium channel,calcium channel and differ-ent subtypes of sodium channels.Therefore the spider toxins pres-ent different pharmacological activities and potential medicinal value.The venoms of spiders are less well studied than those from other venomous taxa such as conotoxin,scorpions and snakes etc. However,in recent years,spider toxins are turning to a new hot subject in related research areas.This review summarizes the lat-est progress in biological activities of spider toxins as well as its application in medical practice and development.

Objective To explore the imaging features and its correlation with pathological findings of giant cell tumor of the ten-don sheath (GCTTS).Methods The clinical data,radiographic images and pathological characteristics of sixteen cases of GCTTS confirmed by pathology were retrospectively reviewed.Plain CT,pre and post-contrast MR were performed in all patients.HE stai-ning was used to investigate the histological characteristics of GCTTS,and immunohistochemistry was employed to detect the ex-pression of CD68.Results There were nine cases of local type GCTTS and seven cases of diffuse type GCTTS in our present study. Nine cases were located in the knee joint,four cases in the foot,and three cases in the hand.Compared with normal skeletal muscle signals,lesions showed isointensity or low intensity on T1 WI and inhomogeneous low intensity on T2 WI.Three cases caused adja-cent bone destruction,one case lead to adjacent bone absorption,and no abnormality was found in other twelve cases.Six cases were injected Gd-DTPA for enhanced scan,in which four cases showed significantly heterogeneous enhancement,one case mild heteroge-neous enhancement,and one case no heterogeneous enhancement.Pathology examination results revealed that GCTTS parenchyma cells were mainly formed by histocyte-like monocytes,and scattered multinuclear giant cells.GCTTS mesenchyme was rich in gelat-inous fiber and hemosiderin pigmentation.Conclusion MR has a significant advantage in detecting specific hemosiderin pigmentation and determining lesions area of GCTTS.Combination of MR with pathology results may improve the diagnosis accuracy.

Objective To explore the value of spectral curve in the differential diagnosis of benign and malignant tumor of the musculoskeletal system.Methods 100 patients with mass of the musculoskeletal system which were found by MRI underwent Dis-covery HD750 Gemstone CT scan ,and the images acquired were processed.Areas with homogenous density which did not contain necrosis,cyst,hemorrhage and calcification were chosen as region of interest(ROI).The optimal Kev on single energy images was selected,then the Kev-CT curve was automatically generated.All 100 patients proved by histological examination were divided into four groups,38 cases were as group A with benign tumor,10 cases as group B with borderline tumor,49 cases as group C with ma-lignant tumor and 3 cases of lipoma(that were analyzed separately since its curve was arc shaped).Average slope rate of every group was calculated according to the formula:K=(HU40keV-HU80keV)/40.Kruskal Wallis test was applied for statistical analysis,P value of less than 0.05 was considered statistical significant.Results The spectral curve of group C was sharply falling type with a mean slope rate of 1.64±1.00,that of group A was gradually falling type with a mean slope rate of 0.75±0.30,and that of group B was 1.34±0.45.The difference of slope rate between group A and C and between A and B were of statistical significance(P<0.05).The spectral curve of 3 lipomas showed arc shaped rising type with a mean slope rate of-2.00.Conclusion Spectral curve is useful in the differential diagnosis of benign and malignant tumor of the musculoskeletal system.Arc shaped curve is a specific sign for tumors containing abundant fat.

Objective High mobility group box 1 (HMGB1) mediates the inflammatory immune response as well as the prolif-eration, differentiation and migration of cells , neverthless, little study has been done on the changes of HMGB 1 expression in hepatoma tissues.The aim of the article was to investigate the changes of HMGB 1 mRNA and protein expression in hepatocellular carcinoma (HCC) tissues. Methods Real-time fluorescence quantitative PCR and Western blotting were applied to detect HMGB 1 mRNA and protein expression in HCC tissues and their paracancerous tissues of 13 cases.Immunofluorescence localization was used to analyze the changes of HMGB1 distribution in hepatic cells . Results The expression of HMGB1 mRNA and protein in HCC tissues (4.01 ±0.81) and (1.37 ±0.34) increased significantly in comparison with those in paracancerous tissues (5.76 ±1.28) and (0.52 ±0.12) ( P<0.01).Nucleo-cytoplasmic translocation of HMGB1 was observed in hepatocarcinoma cells . Conclusion There is increased expression of HMGB1 in HCC tissues, which shows HMGB1 mediates the carcinogenesis of HCC .