Objective To investigate the effects of intrathecal (IT) ketamine on the synapsis remodeling in the spinal dorsal horn during devolopment of morphine tolerance in a rat model of neuropathic pain (NP). Methods Male SD rats weighing 200-250 g were used in this study. IT catheter was placed in the subarachnoid space according to Yaksh. Forty-eight SD rats in which IT catheter was successfully placed were randomly divided into 6groups (n=8 each): group sham operation (group S); group NP; group normal saline 20 μl IT(group NS);group morphine 20 μg IT (group M); group ketamine 50 μg IT (group K) and group morphine 20 μ g + ketamine 50 μg IT (group MK). NP was induced by compression of right L4,5 dorsal root ganglions with steel wire inserted through L4,5 intervertebral foramen in NP,M,K and MK groups. Normal saline or morphine and/or ketamine were injected IT once a day for consecutive 14 days. Paw withdrawal threshold (PWT) to mechanical stimulation and paw withdrawal latency (PWL) to a thermal nociceptive stimulus were measured on 0, 1, 3, 5, 7, 9, 11, 14 days during the consecutive 14 days of administration. The animals were sacrificed after the final IT administration. The lumbar segment of the spinal cord was removed for determination of the number of synapsis in the spinal dorsal horn by immuno-histochemistry in 4 animals in each group and observation of synaptic structure remodeling using electron microscope in another 4 animals in each group. Results Compared with group S, PWT was significantly decreased and PWL was shortened in the other 5 groups, and the number of synapsis was significantly increased and the synaptic structure was thickened in NP, NS, M and K groups (P ＜ 0.05). Compared with group NP,PWT was significantly increased and PWL was prolonged in M, K and MK groups, and the number of synapsis was significantly decreased and the thickness of synaptic structure was significantly reduced in group MK ( P ＜ 0.05).Compared with group M, PWT was significantly increased, PWL was prolonged, the number of synapsis was significantly decreased and the thickness of synaptic structure was significantly reduced in group MK ( P ＜ 0.05). Conclusion IT ketamine can inhibit the synaptic remodeling in the spinal dorsal horn during development of morphine tolerance in a rat model of NP.

AIM: To investigate the effects of dehydroepiandrosterone (DHEA) on experimental osteoarthritis in rats. METHODS: Forty rats were randomly divided into four groups. Group A is normal control group. Osteoarthritic models of rats were established by intraarticular injections of papain into the right knee joints of groups B, C and D. Then the right knee joints of rats in groups C and D, respectively, received 150 ?l intraarticular injections of DHEA at a concentration of 50 ?mol?L~(-1) and 100 ?mol?L~(-1), and the right knee joints of rats in groups A and B both received 150 ?l physiological saline, twice weekly for five weeks. Six weeks later, all rats were sacrificed, and the articular cartilage was assessed by gross morphologic, histologic, biochemical and immunohistochemical methods. RESULTS: The cartilage damage in groups C and D was much less than that in group B through observation under a surgical microscope. The Mankin's score, nitric oxide (NO) in the douche of articular cavity, malondialdehyde (MDA) in synovium, the expression of matrix metalloproteinase-1 and 9 in articular cartilage in groups C and D decreased in comparison with group B, and the foregoing indexes in group D decreased significantly compared with group C. However, the activities of superoxide dismutase (SOD) in the douche of articular cavity and blood serum in groups C and D increased in comparison with group B, and the foregoing indexes in group D increased significantly compared with group C. CONCLUSIONS:DHEA shows a cartilage-protecting effect which is in a dosage-dependent manner. The mechanism probably is to inhibit the expression of matrix metalloproteinases and to decrease the release of (NO and enhance the antioxidation.

Objective:To find out the key demand and connection point of health quality education for students of different stages by analysis of their health quality characteristics and the main contribution path, and then explore strategies to improve health quality. Methods:The stratified random cluster sampling method was carried out to select the sample population in Hangzhou. The variance analysis, curve fitting and multivariate linear regression analysis were used to analyze health quality characteristics and the main contribution path. Results:The health quality of pri-mary school students was best;the difference in quality between college students and junior high school students was not statistically significant ( P>0. 05 );and high school students had the worst health quality. The high school stage is the weakest link of health quality education. The order of the health education path and the means for improving the health quality of college, high school, and primary school students differ. With the improvement of students’ lev-el, the students that require physical quality promotion gradually decreases; the moral quality demand remains sta-ble;and the psychological quality and social adaptation ability present the tendency of a gradual increase. Conclu-sion:Student health quality shows a tendency to decreases with the rise of learning phase. The education departments should foster health consciousness and habits for students, form a healthy lifestyle behavior and ways of thinking for high school students, shape healthy personalities to improve health literacy and social adaptation abilities for college student, which is the key strategy for promoting the health quality of all-round development of the students and a-chieve the primary education goal of “health education”.

[ ABSTRACT] AIM: To investigate the role of anterior thalamic nucleus in trigeminal nerve electrostimulation ( TNS)-induced effects on seizures and hippocampal damage.METHODS: The rats were intraperitoneally injected with pilocarpine to induce chronic epilepsy, and then received sham treatment, TNS treatment and TNS treatment after stereotac-tic lesion to the anterior thalamic nucleus.The TNS treatment lasted for 1 month in each group.Another injection of pilo-carpine was conducted to induce seizures, and the severity and duration of seizures were quantitatively evaluated.TUNEL, Fluoro-Jade B ( FJB) and Nissl staining were applied to determine in situ apoptosis, neuronal degeneration and neuron loss in the hippocampal CA1 area respectively.RESULTS:Compared with TNS group, TNS treatment after stereotactic lesion to the anterior thalamic nucleus significantly increased the severity and duration of seizures (P<0.05), and the numbers of TUNEL positive cells, FJB positive cells and lost neurons in the hippocampal CA1 area (P<0.01).CONCLUSION:Anterior thalamic nucleus plays a role in TNS-induced reduction of seizures and hippocampal damage.The mechanisms might be due to the chronically activation of the cortex through anterior thalamic nucleus pathway induced by TNS, resulting in the down-regulation of neuronal excitatory susceptibility.

Objective To investigate the pathogenicity of late-onset Alzheimer disease from the viewpoint of comparative proteomic technology and to screen it from diseases with related protein markers.Methods Cerebral cortex tissue of temporal layer of 8 cases of late-onset Alzheimer disease and 5 cases of age-matched autopsied controls with normal brain was chosen for this study.Cerebral proteins were run through immobilized pH gradient (IPG) isoelectric focusing electrophoresis as the first dimension and then vertical SDS-PAGE electrophoresis as the second dimension.Differential proteins were identified with visionworks LS and then analyzed with matrix assisted laser desorption ionization time of flight mass spectrometry(MALDI-TOF-MS) and eleetrospray ionization mass spectrometry (ESI-MS).Finally,the protein was identified by searching in the data bank.Results Different 2-dimensional gel electrophoresis maps were obtained for the protein spots in the late-onset Alzheimer disease group and the control group gels.11 protein spots showed a significantly differential expression between the two groups of cerebral cortex samples.It was found that the expression of DJ-1 protein was increased in the late-onset Alzheimer disease group in comparison with the control group after searching in the database.Conclusion DJ-1 protein may be a potential marker related to Alzheimer disease pathogenicity.This finding would be helpful to develop new drugs which focus on this protein and prevent nearodegeneration.

Objective To investigate longitudinal systolic function of transplanted heart using two dimensional speckle tracking echocardiography and tissue Doppler imaging.Methods 56 consecutive patients with heart transplant were recruited,according to myocardial biopsy and 1 year's follow up,they were divided into non-rejection group (group A) and rejection group (group B).36 healthy controls (group C) were also randomly recruited.Left ventricular ejection fraction (LVEF),pulmonary arterial systolic pressure,tricuspid annular plane systolic excursion (TAPSE),tricuspid annular plane systolic velocity (TAS') and global longitudinal strain (GLS) were calculated via Qlab 9.0 analysis software offline.Results Compared with group C,LVEF was reduced in group B (P ＜0.01).Differences of GLS,TAPSE,and TA-S' among groups were all statistically significant (P ＜0.01),group B＜group A＜ group C.LVEF,TAPSE and TA-S' were correlated with GLS (r =-0.64,r =-0.69,r =-0.71 ; all P ＜ 0.01).Conclusions Left and right ventricles were a functional unity,the systolic function of which was impaired in patients with heart transplant.

Objective:To analyse the degree of equality of New Rural Cooperative Medical Scheme (NRCMS) in different economic regions. We provide a reference for equal development of the NRCMS and the reform of the political system and mechanism under the provincial-controlled county fiscal system. Methods:A typical province was chosen with provincial-controlled county fiscal system was fully implemented several years. We collected data on coverage, financing and compensation for the NRCMS from 2005 to 2011. We used the variable coefficient, uniformity coefficient, Theil Index for comprehensive evaluation. Results:Per capita financing has not reached the bottom line. From 2005 to 2011, inter-re-gional and intra-regional variation coefficient, Theil index of service coverage, financing level and hospital actual compen-sation has declined year by year. The degree of inequality in economically developed regions was greater than in less eco-nomically developed regions and economic medium region. Conclusion:The degree of equalization of the NRCMS in the province continuously improved. Innovation of provincial-controlled county fiscal system and mechanism provides a favora-ble environment and forming conditions for equalizing the development of the NRCMS. The paper suggested exploring and building fiscal classification step transfer payment institution and dynamic prediction model of the NRCMS, further optimi-zing financing mechanism, promoting the provincial management system of the NRCMS as soon as possible in order to pro-mote the equalization development.

Objective To observe the clinical effect of propofol combined with sufentanil in laparoscopic ovarian cyst resection.Methods 80 cases who underwent laparoscopic ovarian cyst resection were chosen,they were divided into the observation group and control group with 40 patients in each group according to the random number table method.The observation group was anaesthetized with propofol combined with sufentanil,while the control group was anaesthetized with propofol combined with fentanyl,the recovery status,operation time,intraoperative bleeding volume,recovery time of gastrointestinal function and postoperative complications in the two groups were compared. Results The recovered spontaneous breathing time,recovery time,extubation time of the observation group were (8.4 ±2.3)min,(10.51 ±3.3)min,(12.7 ±2.3)min,which of the control group were (10.11 ±2.2)min, (12.3 ±2.6)min,(15.3 ±3.5)min,there was statistically significant difference between the two groups (t =3.378, 2.710,3.926,all P <0.05);The operation time,operation amount of bleeding,gastrointestinal function recovery time of the observation group were (44.7 ±5.4)min,(19.5 ±3.5)mL,(18.3 ±2.4)h,which of the control group were (67.5 ±7.8)min,(42.7 ±2.8)mL,(42.4 ±3.2)h,there were significant differences between the two groups(t =15.200,32.736,38.105,all P <0.05).Postoperative analgesia,postoperative awareness,emergence delirium inci-dence rates of the observation group were 25%,0%,7.5%,which were significantly lower than 57.5%,12.5%, 37.5% of the control group,the differences were statistically significant(χ2 =8.717,5.333,10.323,all P <0.05). Conclusion The propofol combined with sufentanil in laparoscopic ovarian cyst resection has more significant effect, which can shorten the operation time,promote the postoperative recovery,reduce complications,worthy to be widely used in clinical practice.

Objective To explore the interaction model of social capital, mental health,occupational burnout, turnover intention and the related influence factors on nurses. Methods By random cluster sampling, investigated 723 nurses with Nurses' Turnover Intention Inventory, the Maslach Burnout Inventory, Social Capital Questionnaire and Chinese Health Questionnaire, then explored the interaction model by path analysis. Results Nurses' position can influence their social capital(the path coefficient was 0. 124), social capital and occupational turnout can influence nurses' mental health(the path coefficient were -0. 231,0. 151), the mental health and occupational turnout both can influence nurses' turnover intention directly(the path coefficient were 0. 088,0. 151 ), the model is acceptable(CMIN/DF 1. 645, GFI 0. 984, AGFI 0. 966, IFI 0. 941, CFI 0. 937, RMSEA 0. 037).Conclusion Social capital can provide a new perspective for nurses' management, developing the social capital resources can relieve nurses' mental problems effectively; relieving the turnout and mental problem can decrease nurses' turnover intention finally.

ObjectiveTo assess left ventricular (LV) twist in Beagle dogs with rapid-pacing induced heart failure by 3-dimensional speckle tracking imaging.MethodsSeventeen adult beagle dogs underwent rapid right ventricular pacing (RVP) to induce heart failure.Right ventricles were paced at 260 beats/min for 3 weeks.Apical full-volume acquisition of the LV was obtained in conscious animals at baseline and the end of 3-week rapid pacing.Peak LV apical rotation(AP-Prot) and basal rotation (MV-Prot) accompanied with peak twist (Ptw) and torsion were automatically calculated by TomTec 4D LV Analysis 3.0 software.The relation between LV twist and QRS duration was further studied.Results After 3 weeks of rapid ventricular pacing,AP-Prot,MV-Prot,Ptw decreased significantly [At-Prot:(13.96 ± 2.00) ° vs (5.85 ± 0.58)°；MV-Prot:(3.34± 0.38)° vs (2.13 ± 0.44)°； Ptw:(16.31 ± 2.01)° vs (7.08 ± 1.16)°,all P ＜0.05].Dogs with heart failure were divided into two groups according to the QRS duration:pQRSd group with QRS≥100 ms and nQRSd group with QRS＜100 ms.No significant difference was found in AP-Prot and MV-Prot between two groups ( P ＞0.05).In the pQRSd group,the peak of apical rotation occurred earlier than the peak of basal rotation [(162.89 ± 14.33) ms vs (91.43 ± 15.45) ms,P ＜0.05],which might resulted in further worsening of peak LV twist [pQRSd:(6.02 ± 0.74)° vs nQRSd:(7.91 ± 0.53)°,P ＜0.05].Conclusions LV twist dynamics was a good indicator of LV systolic function and had the potential to evaluate LV systolic dyssynchrony.