BACKGROUND:Articular injections of opioids are widely adopted for pain management of total knee arthroplasty, with both peri-articular and intra-articular administration routes. Recent studies have indicated that commonly used anesthetics, steroids and non-steroidal anti-inflammatory drugs are associated with potential adverse effects. Peripheral opioids are relatively safe with lower complication rates, but great controversy exits regarding the analgesic effects. OBJECTIVE:To introduce the current clinical application status and basic research progress in peri-articular and intra-articular opioid injections for postoperative analgesia of knee arthroplasties. METHODS:A computer-based search in PubMed and Embase databases was conducted for clinical and basic research articles related to pain management of knee arthroplasties using peri-articular and intra-articular injections of opioids published from January 1967 to May 2015, using the keywords of“opioids;peri-articular injection;intra-articular injection;analgesia;knee arthroplasty”in English. Irrelevant, poorly related and repetitive studies were excluded. RESULTS AND CONCLUSION:Peri-articular and intra-articular opioids injection plans vary greatly between different institutions, which does not support reliable quantitative data synthesis for a meta-analysis. Controversy exists regarding its efficacy, but there are studies supporting the usage of opioids for providing effective analgesia in a dose-dependent manner. The peri-articular administration route is associated with lower complication rates including nausea and vomiting compared to systematic injections. Applications of opioids help to avoid potential chondrocyte and stem cel cytotoxicity caused by other anesthetics, steroids and non-steroidal anti-inflammatory drugs, which is important for pain management of total knee arthroplasties. Future investigations are required to promote articular analgesic effects and time duration by exploring more advanced drug combinations and dosage forms.

Objective To study the immunity suppressive effect of the staphylococcal enterotoxin as a super-antigen and investigate its mechanism.Methods BALB/c mice aged 8-12 weeks were randomly assigned to receive 0.2 ml injection of 50 ?g/ml staphylococcal enterotoxin B(SEB)(n=20) or 0.2 ml physiological saline(n=20).One day later,all mice were sacrifice to collect the splenocytes which were employed to detect the expression of TGF-?1 and to countthe cells expressing CD4 and CD25 by flow cytometry(FCM).Results FMC showed that a remarkable increase of cells that expressed CD4 and CD25 in the SEB-primed splenocytes as compared with the saline primed splenocytes.Conclusion SEB,which is used as a superantigen in vivo,can induce the regulatory cells bearing suppressive activity.This may be partial mechanism of SEB-induced hyporesponsiveness.

BACKGROUND:Current basic and clinical research have showed that increases in bone resorption and bone loss accur earlier after spinal cord injury (SCI) than disuse atrophy, revealing that other mechanisms are involved in the pathogenesis of the SCI-induced osteoporosis (SIO).
OBJECTIVE:To introduce the current lab and clinical research progress in SIO focusing on the functional changes of two major neurotransmitters in the spinal cord, including dopamine (DA), 5-hydroxytryptamine (5-HT) and their receptors, as well as their regulatory functions on bone metabolism, aiming at finding a new treatment strategy for SIO.
METHODS:A computer-based online search in PubMed and Embase databases was conducted for clinical and basic research related to SIO published from January 1967 to August 2016, using the keywords of“spinal cord injury;osteoporosis;dopamine;serotonin;5-hydroxytryptamine”in English. Irrelevant, poorly related and repetitive studies were excluded, and finally 41 eligible articles were included.
RESULTS AND CONCLUSION:DA and 5-HT are major neurotransmitters in the central nervous system, both involving in the regulation of bone remodeling. After SCI, loss of innervation and descending neurotransmitters especially DA, 5-HT and subsequent deregulation of their receptors are responsible for the onset of post-traumatic bone loss. The above research progress, in combination with the emerging clinical and lab investigations targeting 5-HT, DA and their receptors for improving neural functions after SCI, provides possible therapeutic pathways for SIO.

Objective To analyze the correlation between three evaluation methods of middle cerebral artery occlu -sion and focal cerebral ischemia , and to explore a new method and standard for the evaluation of the model .Method Thirty healthy adult male SD rats were randomly divided into a sham-operated group ( n=20 ) and model group .According to Zea-Longa procedure ,we established the disease model to detect the changes in cerebral blood flow before and after sur -gery.The resulted cerebral infarction area was taken as gold standards .Then we analyzed the correlation between the standards and the changes in cerebral blood flow .Results The changes of infarction area ratio were positively correlated with the changes of cerebral blood flow in the model rats .Conclusions The changes of rat cerebral blood flow can be used to evaluate whether the cerebral ischemia model is successful or not .

As a kind of nervous system disease,migraine is more common in female,and has the clinical characteristics of repeated attacks,it is of great significance with standardized treatment in the control of the attacks.Yong female patients with migraine during pregnancy and lactation stage will face lots of special problems because they must first consider the impact of treatment on the mother and fetus.Generally,non-drug therapy is recommended as a first-line treatment,if it is not sufficiently effective,paracetamol is recommended during the pregnancy or sporadic use of sumatriptan,NSAIDs is not recommended during the first or third trimester of pregnancy.Preventive therapy should only be considered in the most severe cases.This review summarized recent documents of the safety of the most used antimigraine medications during pregnancy and breastfeeding,in order to provide treatment recommendations in clinical practice.

Objective Toanalyzethealterationsofplasmaglucocerebrosidase(GBA),protein phosphatase 2A (PP2A)and its degradation product ceramide in patients with ischemic stroke. Methods Atotalof45inpatientswithischemicstrokeattheDepartmentofNeurology,theAffiliated Hospital of Logistics College of the CAPF were enrolled from May to September 2013,and 45 age-and sex-matched healthy subjects at the Physical Examination Center collected at the same time period were used as a control group. Blood samples of the patients and healthy subjects were obtained,anticoagulated, and the plasma was separated. H50 protein chip and laser matrix-assisted laser desorption/ionization top of flymassspectrometrywereusedtotestthelevelsofplasmaceramide.Results TheplasmaGBAand PP2A activities in patients with ischemic stroke were significantly lower than those of the control group;the GBA activities of the ischemic stroke group and the control group were 2 . 4 ± 0 . 8 and 3 . 1 ± 1 . 4 U/L respectively. There was significant difference (P<0. 05);the PP2A activities of the two groups were 6. 5 ± 2. 8 and 14. 5 ± 4. 7 U/L respectively (P<0. 01). The relative level of the plasma ceramide in patients with ischemic stroke was 1. 9 ± 0. 7,and it was significantly lower than 12. 2 ± 5. 0 of the control group (P<0.01).Conclusion ThedecreasedlevelsofplasmaGBAandPP2Aactivitiesaswellasthe ceramide in patients with ischemic stroke suggested that the abnormal phosphorylation of synuclein in the blood of patients with stroke.

Objective Toanalyzethechangesofplasmaphosphorylatedα-synuclein(α-Syn)level andα-Synphosphorylationrateinpatientswithischemicstroke.Methods Theclinicaldataof45 patients with acute stroke admitted to the Department of Neurology,the Affiliated Hospital of Logistics University of People′s Armed Force Police from May 2013 to September 2013 were analyzed retrospectively, and the age and sex matched 45 healthy subjects were recruited as a control group at the same time. The plasma phosphorylatedα-Syn level was measured by a double-antibody sandwich enzyme-linked immunosorbent assay (ELISA),besides,the gene-recombinated α-Syn was added into plasma,and the phosphorylated α-Syn accountingforthetotalratioofα-Synwascalculated.Results Theplasmaphosphorylatedα-Synlevelof patients with ischemic stroke was significantly higher than that of the control group (0. 0472 ± 0.0042μmol/L vs. 0. 0312 ± 0. 0043μmol/L). The plasma α-Syn phosphorylation rate of patients with ischemic stroke was higher than that of the control group (0. 1170 ± 0. 0176 vs. 0. 0364 ± 0. 0098μmol/(100μmol ·h ). Receiver operating characteristic (ROC )curve analysis showed that the specificity and sensitivity of the plasma phosphorylatedα-Syn concentration changes in determining ischemic stroke were 0. 88 and 0. 81 respectively. The area under curve (AUC)was 0. 91 and the cut-off value was 0. 060 mol/L;AUC 95%confidence interval (CI)was 0. 889 to 0. 961;the specificity and sensitivity of the plasma α-Syn phosphorylation rate changes in determining ischemic stroke were 0. 84 and 0. 81 respectively,AUC was 0.90andthecut-offvaluewas0.055mol/L;AUC95%CIwas0.898to0.971.Conclusion Theplasma phosphorylated α-Syn level and plasma α-Syn phosphorylation rate in patients with ischemic stroke were higher than those of the normal control group.

BACKGROUND:The electrospinning technique has been used to prepare biological scaffolds to simulate nano-fiber structure of extracelular matrix; therefore, widespread attention has been paid to the electrospinning technique in the field of regenerative medicine and tissue engineering. OBJECTIVE: To review the articles about increasing electrospun nanofiber scaffold porosity, enlarging pore diameter, promoting cel infiltration with related technologies, in order to discover the most practical and economical technology. METHODS:The first author retrieved CNKI database, Wanfang database and PubMed with the keywords of “cel infiltration, 3D scaffold, electrospinning” in Chinese and English, respectively. Literature retrieval period was from January 2004 to October 2014. RESULTS AND CONCLUSION:Electrospinning technology is the most effective method for preparation of nanofiber scaffolds. Electrospinning scaffolds as tissue engineering scaffolds have become an issue of concern in the basic research year by year. However, the internal nano-scale pore of nanofiber scaffolds limits the cels to grow on the surface, so recent research has been focused on highly porous three-dimensional structure which can promote the permeable growth of cels instead of two-dimensional scaffolds. Several techniques have been used, which go from the adjustment of materials and speed of electrospinning to the applications of various kinds of complicated machines. However, the existing researches are stil not mature and stable, the majority of which are applied onlyin vitro as cel implantation or subcutaneous implantation in smal animals. The above-mentioned methods stil need long-term comparative studies to confirm the feasibility in the tissue-engineered repair of organs.

OBJECTIVE:To improve the hospital workflow and efficiency in temporary drug purchase approval process. METHODS:The approval function for temporary drug purchase was introduced into office automation(OA)system in our hospi-tal,and the effects were evaluated. RESULTS:According to ensuring the administrative approval process,system function permis-sion assignment and approval process design in temporary drug purchase in our hospital,functions for approving temporary drug purchase were established in OA system. It achieved convenient,efficient,timely,networking and paperless approval work,as well as standardized record,checking out at any time and automatic statistics for drug purchase. CONCLUSIONS:Introducing tem-porary drug purchase approval function into hospital OA system can simplify workflow,provide better service for clinic,and pro-mote development of hospital pharmacy management.

Objective: To observe the anatomic variations and lesions of maxillary sinus by CBCT before sinus augmentation in Chinese patients with edentulous posterior maxilla. Methods: 589 participants with 666 sinuses were enrolled in this study. The anatomic variations and lesions of maxillary sinus were examined by CBCT prior to sinus augmentation surgery. Results: In all 666 sinuses, the prevalence of septa was 30. 48％, membrane thickness ≤2 mm was 60. 36％, the average thickness of the lateral wall was (1. 38 ± 0. 05) mm, the prevalence of posterior superior alveolar artery in the sinus was 66. 52％, the average diameter of the artery was (0. 98 ± 0. 03) mm, the discontinuity of the sinus floor was 4. 35％, the mean width of maxillary sinus was (14. 20 ± 0. 19) mm, and the prevalence of cyst was 11. 41％. Conclusion: CBCT can reveal the sinus diversity and provide the information for the safe and effective sinus augmentation.