Chronic pain is a common clinical disease,which brings great burden to the patients.However,the pathogenesis underlying of chronic pain is complicated,which is affected by many factors,such as physiology,psychology and society.Therefore,the treatment of chronic pain has been a problem in clinical practice.Considering its complexity,a single way of treatment usually could not reach satisfactory results,so combination therapy is often used to treat chronic pain at present.The combination therapy includes pharmacological treatment,psychological approaches,interventional treatment,self management and so on.The treatment plans are distinct for different types of chronic pain,even the individual patients with the same kind of pain.The emergence of interdisciplinary rehabilitation programs shed light upon the treatment of chronic pain recent years.This paper reviewed the research on chronic pain treatment,in order to provide theoretical basis for clinical practice.

ObjectiveTo explore the difference of the oxytocin Levels and cortisol levels between major depression patients and normal controls,and the relationship of symptoms severity of major depression with oxytocin levels and cortisol levels.MethodsTwenty 18 ～ 45years old major depression patients and twenty six normal controls were tested by an enzyme-linked immunosorbent assay to evaluate the oxytocin levels and cortisol levels,and the Hamilton Rating Scale for Depression-17 item was used to evaluate the symptoms severity of depression in patient group.ResultsMann-Whitney test showed there were significantly differences in oxytocin level between patients and controls ( ( 213.60 ± 164.29 ) pg/ml vs ( 112.27 ± 101.21 ) pg/ml,z =- 2.306,P =0.021 ),but there were no significantly differences in cortisol level between two groups.Within the depressive sample( (0.131± 0.089) vs (0.107 ± 0.077 ) pg/ul,z =- 0.920,P =0.358 ),the severity of depressive symptom was positive correlated to the value of oxytocin ( r=0.599,P=0.005) and cortisol( r=0.691,P=0.001 ),the value of oxytocin was also positive correlated to the value of cortisol( r =0.743,P ＜ 0.01 ),Multiple liner regression analyses showed that the value of oxytocin is an impact factor of the severity of depression.( adjusted R2 =0.358,F =11.578,P =0.003 ).ConclusionThis study indicated that the value of plasma oxytocin maybe significantly differences between depression and normal controls and the plasma oxytocin level maybe a factor which influence the severity of major depression,the relationship of the cortisol value and the severity of depression can not be confirmed.

OBJECTIVETo modify biomacromolecules, such as chitosan and collagen, to synthesize a mineralized template that will induce self-growing remineralization of tooth enamel.

METHODSNatural polycation polysaccharide chitosan was modified through phosphorylation to synthesize the polyanion derivative ofphosphorylated chitosan. Parent hydrogels com- bined with chitosan and collagen I were built through peptide binding reaction using genipin as a crosslinker. The gels self- assembled on the tooth's inert surface, which was stimulated by ultraviolet radiation. The bionic saliva provided mineralized ion, and then the hydroxyapatite assembled and grew in situ on the tooth.

RESULTSThe functional group P04(3-) (3,446 cm(-1)) was grafted on chitosan as confirmed by the Fourier transform infrared spectroscopy. The porous polyelectrolyte complex hydrogel formed by the interaction between the polycation chitosan and the polyanion phosphorylated chitosan could induce hydroxyapatite crystal nucleation and growth on the hydrogel fiber surfaces. The neonatal crystal was hydroxyapatite as confirmed by X-ray diffraction and was tightly connected to the tooth. A continuous structure of column crystals with sizes ranging from 30 nm to 60 nm was observed. The structure was in parallel direction similar to the direction of the enamel rod, and its hardness was close to dentin.

CONCLUSIONThe parent hydrogels that were easily obtained and controlled could mimic the template of the enamel mineralization and induce a self-growing hydroxyapatite, which is an important step in the structural bionics of enamel.

Biocompatible Materials ; Chitosan ; Collagen ; Dental Enamel ; Durapatite ; Microscopy, Electron, Scanning ; Polymers ; Spectroscopy, Fourier Transform Infrared ; Tooth ; Tooth Remineralization ; Ultraviolet Rays ; X-Ray Diffraction

Objective To evaluate the clinical value of epicardial echocardiographic examination in cardiac valve surgery.Methods Epicardial echocardiography were performed in 46 patients undergoing valvular plasty or valvular replacement surgery to estimate the function of valve and left ventricle and residual shunt during cardiac surgery.Results Twelve cases of 46(26.1％)showed abnormality during cardiac surgery.Two cases of 15 patients performed valvuloplasty were changed to valvular replacement because of remarkable regurgitation of native valves.There was 1 case of periprosthetic leakage,3 cases of left atrial appendage thrombus,1 case of patent foramen ovale and 5 cases of low ejection of left ventricle in all 31 cases of valvular replacement.Conclusions Epicardial echocardiograpyc examination is an effective examination in cardiac valve surgery with clearly image,simplicity operation and promptness.

Objective To study the clinical effect of minimally invasive percutaneous nephrolithotomy in patients with diabetes mellitus and non-diabetic patients. Methods A retrospective analysis was performed to look into the clinical data of 2,796 patients undergoing downward F18minimally invasive percutaneous nephrolithotomy during May 2007 to June 2016 under X-ray guidance Among them,582 diabetic patients were assigned as the diatetes group,aged 26-82 years,279 male,303 female, 174 with pelvic stones,255 with multiple calculi,153 with staghorn calculi,fasting blood glucose 5.4~20.3 mmol/L,postprandial and 2 hours blood glucose 9.1~28.9 mmol/L. In the group,the results of preoperative fasting blood glucose,glycosylated hemoglobin,meal 2 hours blood glucose,diabetes mellitus immune and two others,were in line with diabetes diagnosis and typing standard, and the stones were tested by infrared spectrum analyzer for determination of chemical composition(P<0.05). The rest 2,214 diabetic patients were set as non-diabetic group. The two groups were compared in terms of the operation duration,the rate of stone removal,surgical complications and hospital stay. Results There were no significant differenices in the operation duration,rate of stone removal and operative complications between the two groups(P>0.05),but the hospital stay in the diabetic group was significantly longer than that of the control group. In comparison of the stone compositions,therate of uric acid stones in the diabetic group was significantly higher than that of the control group (P < 0.05). Conclusion Minimally invasive percutaneous nephrolithotomy is safe and effective for the treatment of renal calculi in patients with diabetes mellitus. Diabetic patients are susceptive to uric acid stones and those patients at the poor control of blood glucose suffer from a higher recurrence of renal stones , which reminds the importance of doctors to educate the patients on the prevention of kidney stones.

Objective To investigate the characteristic of sequences of WLAX gene in Campylobacter jejuni(C.jejuni)strains.Methods WLAX gene and the neighbouring sequences were amplified by polymerase chain reaction(PCR).The PCR products were cloned into the vectors of plasmid.The positive recombinants were sequenced and the results were processed by software DNAstar.Results The variation frequency of WLAX sequences in GBS-related C.jejuni was higher than that in non-GBSrelated C.jejuni.The nucleotide sequences of WLAX gene in all the strains in the present study differed from that in genome sequencing strain NCTC11168.The phylogenic tree reflected the regional feature of C.jejuni.Conclusions The probability of sequence variation of WLAX in GBS-related C.jejuni is significantly higher than non-GBS-associated C.jejuni strains,the relation between the variation and GBS-pathogenesis remains to be further confirmed.

Objective To investigate the echocardiographic features of complete transposition of the great arteries (TGA)in fetuses.Methods Prenatal echocardiographic data of 9 fetuses diagnosed as TGA by autopsy or postnatal echocardiography during January 2010 to January 2017 were retrospectively analyzed.Results All of 9 fetuses showed normal cardiac axis and atrioventricular connection on four-chamber view.Eight of them showed the baby bird's beak sign on left ventricular outflow tract view.On left and right ventricular outflow tracts view,the two great arteries were parallel in 8 fetuses.Totally 6 fetuses showed just 2 vessels on three vessels and tracheal (3VT) view.On aortic arch view,the radian of aortic arch had increased in different degrees in 7 fetuses.There were 4 fetuses with ventricular septal defect observed by both of four-chamber and left ventricular outflow tract views.Conclusion The echocardiographic features of fetuses with TGA are characteristic in left ventricular outflow tract,left and right ventricular outflow tracts,3VT and aortic arch views,including baby bird's beak sign,2 great arteries' parallel relations,only 2 vessels on 3VT view,and increased radian of aortic arch.Of these features,baby bird's beak sign is the most common.

AIM: To investigate the clinical effects of intravitreal Bevacizumab for 26 cases with retinopathy of prematurity (ROP) in Zone Ⅰ.
METHODS:A retrospective study. Totally 26 ROP infants between September 2013 and October 2014 diagnosed as high - risk ROP in Zone Ⅰ had been treated with intravitreal bevacizumab. They were divided into three groups, pre - threshold ROP, threshold ROP and acute posterior ROP ( APROP ). Postoperative effects were compared.
RESULTS:There were 26 infants (52 eyes) diagnosed as ROP in Zone Ⅰ, including 3 infants( 6 eyes) with pre -threshold ROP, 15 infants (30 eyes) with threshold ROP and 8 infants (16 eyes) with APROP. The first operation recovery rate of three groups respectively were 100% (6 /6), 60% ( 18 / 30 ) and 75% ( 12 / 16 ), which were not significantly different (P>0. 05).
CONCLUSION:Intravitreal bevacizumab for ROP in ZoneⅠ seems effective and has some advantages over conventional laser treatment, which could be first line treatment for high-risk ROP in Zone Ⅰ.

Acidolysis kinetics on the process of the hydrolysis acidification by using glucose as the only energy sources was researched.It was concluded that the acidolysis kinetics constants are V_(max)=8.45d~(-1) and K_s=1089mg/L,under the circumstances of a temperature 37℃?0.5℃and the influent pH value 6.5.The results show that the rate of anaerobic acidification process is greater than that of completed an- aerobic or anoxic process.

ObjectiveTo discuss the selection of surgical approach,operative methods,and stability of reconstitution of affection of cervicothoracic junction.MethodsFrom January 2001 to February 2009,86cases with affection of cervicothoracic junction were treated surgically.The mean age of patients at the time of surgery was 43.1 years (range,17-70).Fifty-seven patients were treated with anterior approach (fixation with autologous bone grafts was done in 38 patients,Cage fixation in 5,titanium mesh in 14),21 with posterior approach(the fixation of lateral mass screw combined with pedicle screw was used in 12 patients,fixation with pedicle screw in 9),and 8 with anterior combined posterior approach.The neurological function of 53 cases of injury of cervicothoracic junction was assessed by American Spinal Injury Association (ASIA) criteria,and the rest was assessed by Japanese Orthopaedic Association(JOA) criteria; bone arthrodesis and restoring lordosis of cervical spine were assessed by Bohlman radiographic criteria.ResultsSixty-nine cases were followed up for an average of 12.4 months(range,3-45).ASIA score increased from 1.8 preoperatively to 2.3 postoperatively,and JOA score increased from 10.3 preoperatively to 12.8 postoperatively.Bone fusion reached in all patients,and lordosis of the cervical spine of 62 cases was restored.One case with respiratory dysfunction,1 case with cerebrospinal fluid leakage,2 cases with hoarseness,and 1 case with loose lateral mass screw were found after the surgery.ConclusionThe advantages of surgical reconstitution of the cervicothoracic junction included promoting recovery of neurological function,restoring the alignment and lordosis of the cervical spine,decreasing the rate of complication,which were dependent on the suitable surgical indications,surgical approach,and way of surgical reconstitution.The selection of reconstituted methods depends on disease,lesion site,type and degree of injury,experience of doctor,decompression and spinal stabilization synthetically.