Objective To investigate the effect of competitive N-methyl-D-aspartate (NMDA) receptor antagonist LY274614 [(?)-6-phosphonomethyl-decahydroisoquinolin-3-carboxylic acid] on the development of morphine tolerance and dependence.Methods Male Spraque-Dawley rats were rendered tolerant and dependent by subcutaneous injection of morphine(15mg/kg body weight) three times a day for 10 consecutive days. LY274614 (2, 4, 6 mg/kg body weight) was also given subcutaneously by subcutaneous injection. Antinociception was measured by tail-flick (TF) test. Tail was exposed to the heat source(a beam of high intensity light). The time from the beginning of exposure to removal of tail from the path of the heat source was taken as latency. The baseline TF latency without medication was 4-5 seconds. A ten-second maximum exposure to the heat source was used to minimize damage to tissue during the multiple measurements. Morphine prolonged TF latency. With the development of tolerance TF latency gradually returned to baseline value. Physical dependence on morphine was assessed by abstinence syndrome precipitated by subcutaneous injecting naloxone 10 mg/kg on the tenth day. According to method of Blasig, the number of jumping/30min after naloxone injection was recorded as an index pf abstinence syndrome. Rats were randomly divided into 8 groups (n=6-8). Each group received morphine 15 mg/kg or normal saline (NS) 1.5 ml/kg+LY274614 (2.0,4.0,6.0 mg/kg) or NS, group 1: morphine+NS; group 2: NS+NS; group 3:morphine+LY274614 (2mg/kg); group 4: NS+LY274614 (2mg/kg); group 5: morphine+LY274614 (4mg/kg); group 6: NS+LY274614 (4mg/kg); group 7: morphine+LY274614 (6mg/kg); group 4: NS+LY274614 (6mg/kg).Results LY274614 itself did not have analgesic action, but if used with morphine, it did inhibit the development of tolerance. In group 5 and 7 the decrease in TF latency was more gradual than that in morphine+saline group. 4 and 6 mg/kg LY274614 reduced the number of jumping/30min following naloxone injection.Conclusions LY274614 can inhibit morphine tolerance and dependence rendered by consecutive subcutaneous morphine injection.

Purpose: To study the clinical application of intensity modulation radiation therapy (IMRT) in patients with prostate cancer. Methods: From May 2000 to June 2001, 14 patients with prostate carcinoma were treated . 12 patients underwent orchiectomy before IMRT. All patients were treated by IMRT with PEACOCK-MIMiC system ( CORVUS 3. 0 NOMOS CORPORATION) and VARIAN 6MV-photons. The prescription dose-time- fraction was 2.5 to 3. 0 Gy per fraction, 5 times per week , the total was 25 to 30 fractions, the total IMRT dose was 72 to 77 Gy, 5 to 6 weeks. Results: 3 months after IMRT , PR: 10(71.4%), NC: 4 cases and 6 month after IMRT CR: 6,PR: 8 cases. The overall response( CR + PR) rate were 100% . No Grade Ⅲ ,Ⅳ gastrointestinal ( GI) and genitourinary ( GU) toxicity occurred in any of the patients. Conclusions: IMRT is an effective approach for patients with prostate carcinoma. The dose of 72 to 77 Gy was safe.

From March 1980 to December 1987, 650 patients with non-small cell lung cancers were treated by radiotherapy alone, chemotherapy alone, operation alone, Chinese medicine therapy alone, radiotherapy combined with chemotherapy, operation with radiotherapy operation with chemotherapy. The survival rates of the patients who received operation were obviously higher than radiotherapy alone, chemotherapy alone and Chinese medicine therapy alone groups. No relationship was found between the survival rates and pathological classification, but there was a close relationship between the survival rates and stages.

OBJECTIVE:To evaluate the economics of penehyclidine hydrochloride and atropine in the treatment of acute organophosphorus poisoning (AOPP).METHODS:The information of 118 AOPP patients were collected and divided into group A (59 cases) and B (59 cases) according to therapy plan.There were 22 cases of mild poisoning,20 cases of moderate poisoning and 17 cases of severe poisoning in group A.There were 21 mild cases,21 moderate cases and 17 severe cases in group B.Based on routine treatment,group A was given Penehyclidine hydrochloride injection intramuscularly with initial dose of 1 mg (mild),2 mg (moderate) and 4 mg (severe).Group B was given Atropine sulfate injection intravenously,with initial dose of 2 mg (mild),5 mg (moderate) and 10 mg (severe).Both received maintenance treatment according to patients condition and stopped taking medicine after symptoms disappeared.Clinical efficacies,the time of acetylcholinesterase recovery and ADR were observed in 2 groups.The economics of therapy plans for mild,moderate and severe poisoning were evaluated in 2 groups by cost-effectiveness analysis.RESULTS:There was no statistical significance in total response rate of mild poisoning or the time of acetylcholinesterase recovery between 2 groups (P＞0.05).Total effective rates of moderate and severe poisoning in group A were significantly higher than group B,and the time of acetylcholinesterase recovery was significantly shorter than group B,with statistical significance (P＜0.05).There was no statistical significance in the incidence of ADR in mild,moderate and severe poisoning patients (P＞0.05).Cost-effectiveness ratio of penehyclidine hydrochloride was similar to that of atropine in mild poisoning patients;that of penehyclidine hydrochloride were significantly lower than that of atropine in moderate and severe patients.It was inline with the results of sensitivity analysis.CONCLUSIONS:Based on routine treatment,penehyclidine hydrochloride is similar to atropine in therapeutic efficacy of AOPP and the time of acetylcholinesterase recovery.For moderate and severe AOPP patients,penehyclidine hydrochloride is significantly better than atropine in improving therapeutic efficacy and the time of acetylcholinesterase recovery.The safety of 2 drugs are satisfactory;penehyclidine hydrochloride possesses cost-effectiveness advantage.

Objective To explore the clinical manifestations,diagnosis,misdiagnosis and treatment of primary hyperparathyroidism.Methods The clinical data of 36 patients with primary hyperparathyroidism admitted into the First Affiliated Hospital of Chongqing Medical University from January 2009 to October 2014 were reviewed and analyzed retrospectively.Results The manifestations of primary hyperparathyroidism were various and atypical.Primary hyperparathyroidism was often misdiagnosed as other diseases by 25.0％ (9/36).Among the patients,the ratio of male to female was 1:1,and median age was 58 years old.Of all patients,there were 9 persons with joint pain,digestive system symptoms in 7 cases,cervical mass discovered in 6 cases(3 cases were found when B ultrasonic examination),urinary calculus in 5 cases,fatigue symptoms in 4 cases,osteoporosis and urinary calculus in 2 cases,1 case with fracture,2 cases without any symptoms.Their calcium and parathyroid hormone level were increased by various degree.The accuracy rates of level diagnosis of Color Doppler ultrasound combine with CT or 99Tcm-MIBI were improved obviously,85.2％ and 93.1％ respectively.Twenty-eight patients received surgical treatment and pathology examination confirmed the accurate pathological types after surgery.There were 23 cases of parathyroid adenoma,1 case parathyroid hyperplasia,1 case parathyroid carcinoma,2 cases of parathyroid adenoma with nodular goiter,parathyroid adenoma merged thyroid carcinoma in 1 case.Serum calcium and parathyroid hormone level declined obviously after operation.The other 8 patients received non-surgical treatment,7 cases were alleviated and 1 case died due to irreformable high blood calcium crisis.Conclusion There should be pay attention to recognize primary hyperparathyroidism,check the blood calcium,and about suspected cases should be performed as early as parathyroid tested,neck color Doppler ultrasound.Early surgical treatment can significantly improve the prognosis and quality of life.

AIM To observe the protective effects of mangiferin on the inflammatory injury and expression of the inflammatory factor in the cerebral tissue of spontaneously hypertensive rats and on MCP-1/CCR2 signal pathway.METHODS Forty spontaneously hypertensive rats were randomly divided into model,benazepril [10 mg/(kg · d)] and mangiferin high,middle and low dose [40,20,10 mg/(kg · d)] groups and other eight rats of same week age served as control group.After consecutive intragastric administration for eight weeks,morphology of the rats' cerebral tissue was observed;their levels of ICAM-1,IL-6 and TNF-α in cerebral tissue were determined by ELISA;their expressions of MCP-1 and CCR2 protein in brain tissue of rats were detected by immunohistochemistry and Western blot and the detection of mRNA expressions of MCP-1 and CCR2 in cerebral tissue of rats were carried out by RT-PCR.RESULTS Compared with the model group,the blood pressure of mangiferin in each dosage group decreased slightly,but there was no significant statistical difference.In the control group and the model group,there was no obvious morphological change in the cerebral tissue.The morphology of rats in the benazepril group,each dose of mangiferin group were all normal.The contents of IL-6,TNF-α,ICAM-1 and MCP1,CCR2 protein and mRNA expression were significantly decreased in the cerebral tissues of spontaneously hypertensive rats.CONCLUSION Mangiferin has obvious anti-inflammatory effects on inflammatory reaction in spontaneously hypertensive rats,its mechanism may be related to inhibiting the expression of MCP/CCR2 signaling pathway.

Objective To explore the mechanism of plasma circulating miRNA-126 and miRNA-28-3p in diabetes mellitus (DM) patients,and to identify the related bioinformatics analysis.Methods Randomly selected 80 DM patients as the observation group and 80 non-DM patients as the control group.The plasma circulating miRNA-126 and miRNA-28-3p were analyzed by qRT-PCR,and its target genes,biological information,related lncRNA and circRNA were predicted.Results The circulating miRNA-126(0.115 0±0.014 4 vs.0.0019±0.000 6) and miRNA-28-3p(0.1386±0.01724 vs.0.000 6±0.000 05) levels in the observation group were significantly higher than those in the control group,and the differences were statistically significant (P<0.01).Pearson correlation coefficient of miRNA-126 and miRNA-28-3p was 0.433 5(P<0.01).ROC curve analysis of miRNA-126 and miRNA-28-3p showed that the differences of the area under curve were statistically significant between the two groups (P<0.01).Bioinformatics prediction showed that miRNA-126 and miRNA-28-3p may be involved in regulation of the insulin signaling pathway,insulin receptor signaling pathway,insulin/insulin growth factor signaling pathway,mitogen-activated protein kinase (MAPK) signaling pathway and angiogenesis.And it may be associated with a variety of lncRNA and circRNA.Conclusion Circulating miRNA-126 and miRNA-28-3p can be a novel biomarker of DM as it may participate in the mechanism of DM by regulating insulin and insulin growth factor related signaling pathways and be associated with some related lncRNA and circRNA.

Objective To analyze the clinical and CT characteristics of pancreatic metastasis to improve the correct diagnosis rate.Methods The clinical and CT data of 14 patients with pancreatic metastasis were reviewed retrospectively.Results Among the 14 patients,the primary malignancy was lung cancer in 6 cases,renal carcinoma in 3 cases,colon carcinoma in 2 cases,laryngeal cancer in 1 case,gastric cancer in 1 case and ovarian carcinoma in 1 case.Pancreatic metastases from renal carcinomas often developed a long period after initial nephrectomy and survived for a relatively long time.Abdominal CT plain scan and enhanced scan was performed in all cases.Four cases were of solitary type,9 cases were of multiple types and 1 was of diffuse type.Totally 28 lesions were found,which were usually located in the neck and body of the pancreas,the diameter of 28 pancreatic lesions was ranging from 0.5 cm to 11 cm,with a mean diameter of 2.3 cm.On CT plain scan,there were 19 hypodense lesions,7 slightly hyperdense lesions and 2 isodense lesions,5 necrotic lesions.On enhanced CT,the lesions showed moderate enhancement in 7 cases,circular enhancement in 6 cases,moderate and circular enhancement in 6 lesions,obvious enhancement in 8 lesions and no enhancement in 1 lesion.All patients had extra-pancreatic metastases,and 2 cases had peripheral vascular invasion.Conclusions Pancreatic metastases are rare,often accompanied with multiple lesions and extra-pancreatic metastases.The CT features of pancreatic metastases from renal carcinomas are slightly hyperdense and obvious enhancement; in other metastases,there are hypodense,morderate and/or circular enhancement lesions.Accurate diagnosis can be achieved by knowledge of patients' medical history.

Objective To investigate the influence of self-management and education on behaviors of medical compliance of patients undergoing vitrectomy combined with tamponade.Methods Sixty-four patients undergoing vitrectomy combined with tamponade were randomized equally into the control group and observation group in the order of admission.The control group received routine care and health education,while the observation group received self-management education follow-ups besides the routine nursing.The two groups were compared in terms of the cumulative time of the correct position,compliance behavior and the incidence of postoperative complications.Results The cumulative time of the correct position of observation group was longer than that of the control group after operation.The observation group did better in compliance behavior than the control group and the incidence of postoperative complications in the former group was lower than the latter(P<0.05).Conclusion Self-management and education can enhance patients’behaviors in medical compliance and decrease postoperative complications and promote the success of the surgery.

Objective To evaluate the clinical effect,the changes of pulmonary hypertension,serum D-dimer and side effect of irbesartan combined with low molecular weight heparin in the treatment of pulmonary hypertension in COPD patients.Methods 49 patients of COPD were randomly allocated into two groups:the control group( n =22 )and the treatment group( n =27).The patients of the control group were treated with common treatments,for the treatment group,irbesartan 80mg qd combined with low molecular weight heparin 0.4ml IH bid were additionally administered for 14 days.To evaluate the clinical effect,the changes of pulmonary hypertension,serum D-dimer and side effects.Results The treatment group and the control group could reduce the pulmonary artery pressure.The clinical effects of the former were statistically significant better than the control(P ＜0.01 ).Side effect had no statistically significant difference between two groups.Conclusion Irbesartan combined with low molecular weight heparin have better clinical effects in the treatment of pulmonary hypertension in COPD patients and it was convenient,safe and worthy of extending in clinic.