ObjectiveTo investigate the role of NO and extracellular signal-regulated kinase (ERK) signaling pathways in the spinal cord in naloxone-induced withdrawal response in morphine-dependent rats.Methods Ninety male adult SD rats weighing 200-250 g in which IT catheters were successfully implanted without complication were randomly divided into 9 groups (n ＝ 10 each):group control (group C); group morphine dependence (group MD); group morphine withdrawal (group MW); group N(G)-nitro-L-arginine methyl ester (eNOS inhibitor) (L-NAME group) ; group 7-nitroindazole (nNOS inhibitor) (group 7-Ni) ; group aminoguanidine(iNOS inhibitor) (group AG); group U0126 (ERK signaling pathway blocker); group cremophor (solvent for 7-Ni) and group DMSO (solvent for U0126).Morphine dependence was induced by increasing doses of subcutaneous morphine for 6 days.The initial dose of morphine was 10 mg/kg twice a day and was increased by 10 mg/kg twice every other day until 50 mg/kg on the 6th day in groups MD,MW,L-NAME,7-Ni,AG,U0126,cremophor and DMSO.Morphine withdrawal response was induced by intraperitoneal (IP) naloxone 4 mg/kg at 4 h after last morphine administration in groups MW,L-NAME,7-Ni,AG,U0126,cremophor and DMSO.L-NAME 400 μg,7-Ni 400 μ g,AG 400μg,U0126 150 μg,cremopher 10 μl and DMSO 10 μl were administered IT at 30 min before naloxone administration in groups L-NAME,7-Ni,AG,U0126,cremophor and DMSO respectively.Morphine withdrawal response (0 ＝ no withdrawal response,3 ＝ severe response) and touch evoked agitation (0 ＝ no agitation,2 ＝ severe agitation) were observed and scored during 1 h after naloxone administration.The animals were then sacrificed and the spinal cord was removed for determination of the expression of iNOS,nNOS and phosphor-ERK (p-ERK) by immunohisto-chemistry and Western blot.ResultsMorphine withdrawal significantly increased withdrawal response score and touch evoked agitation score in group MW as comparedwith group MD.L-NAME,7-Ni,AG and U0126 pretreatment significantly attenuated naloxone-induced increase in withdrawal response score and touch evoked agitation score in groups L-NAME,7-Ni,AG and U0126 as compared with group MW.Morphine withdrawal significantly up-regulated the nNOS and iNOS expression in group MW compared with groups C and MD.L-NAME,7-Ni and AG pretreatment significantly down-regulated p-ERK expression in groups L-NAME,7-Ni and AG as compared with group MW.ConclusionThe interaction between NO and ERK signaling pathways may be involved in morphine withdrawal response in morphine-dependent rats.

BACKGROUND: Lung transplantation can improve quality of life of patients who get terminal pulmonary disease and also it can help to get better survival.Now it has become one of the best therapeutic methods for terminal pulmonary disease.However,limited donors leave the development of lung transplantation in dilemma.The emergence of living lobar transplantation and cadeveric lobar transplantation let this procedure much easier.OBJECTIVE: To evaluate the clinical probability of bilateral lobar transplantation.METHODS: Sequential bilateral lobar transplantation was performed for one 26 years old cystic fibrosis female.Cardiac pulmonary bypass was used during operation.Anti-rejection(Tacrolimus,mycophenolate,etc)and anti-infection was used postoperatively.RESULTS AND CONCLUSION: The recovery course postoperatively was smooth,and the recipient got out of hospital 7weeks later.Bilateral lobar transplantation could offer satisfied short-term pulmonary function.The long term results should be further evaluated.

Objective To investigate the diagnostic value of combining carotid intima-media thickness(cIMT)with serum Galectin-3(Gal-3)and Pentraxin 3(PTX3)in patients with psoriasis complicated with cardiovascular disease(C VD).Methods Thirty-eight patients with psoriasis com-plicated with CVD were included in CVD group,51 patients with psoriasis alone were included in pso-riasis group,and 60 healthy subjects were selected as control group.Clinical data were collected from each group.The cIMT was measured using carotid ultrasound,and serum Gal-3,PTX3,and inflamma-tory markers[high sensitivity C-reactive protein(hs-CRP),procalcitonin(PCT),tumor necrosis fac-tor-α(TNF-α)]were detected using enzyme-linked immunosorbent assay.Multivariate Logistic regression analysis was used to identify the influencing factors of CVD in patients with psoriasis.The receiver operating characteristic(ROC)curve was plotted to evaluate the diagnostic value of serum Gal-3,PTX3,and cIMT for CVD.Results The cIMT was greater in the CVD group and the psoriasis group than in the control group,and the CVD group was greater than the psoriasis group(P＜0.05).The serum levels of Gal-3,PTX3,hs-CRP,PCT,and TNF-α were higher in the CVD group and the psoriasis group than in the control group,and their levels were higher in the CVD group than in the psoriasis group(P＜0.05).The psoriasis area and severity index(PASI)score was higher in the CVD group than in the psoriasis group(P＜0.05).Pearsons correlation analysis showed that cIMT,Gal-3,and PTX3 were separately positively correlated with hs-CRP,PCT,and TNF-α(P＜0.05).Multivariate Logistic regression analysis showed that PASI score,cIMT,Gal-3,PTX3,hs-CRP,and TNF-α were independent influencing factors for CVD in patients with psoriasis(OR=1.250,1.451,1.432,1.365,1.413,1.465;P＜0.05).The diagnostic model based on cIMT combined with serum Gal-3 and PTX3 had higher diagnostic value for CVD in patients with psoriasis than single diagnosis.The area under the curve was 0.922,with sensitivity and specificity of 0.91 and 0.85,respectively.Conclusion The cIMT,serum Gal-3,and serum PTX3 are inde-pendent influencing factors for CVD in patients with psoriasis.The combination of the three indica-tors has higher diagnostic value for CVD in patients with psoriasis.

Objective To investigate the diagnostic value of combining carotid intima-media thickness(cIMT)with serum Galectin-3(Gal-3)and Pentraxin 3(PTX3)in patients with psoriasis complicated with cardiovascular disease(C VD).Methods Thirty-eight patients with psoriasis com-plicated with CVD were included in CVD group,51 patients with psoriasis alone were included in pso-riasis group,and 60 healthy subjects were selected as control group.Clinical data were collected from each group.The cIMT was measured using carotid ultrasound,and serum Gal-3,PTX3,and inflamma-tory markers[high sensitivity C-reactive protein(hs-CRP),procalcitonin(PCT),tumor necrosis fac-tor-α(TNF-α)]were detected using enzyme-linked immunosorbent assay.Multivariate Logistic regression analysis was used to identify the influencing factors of CVD in patients with psoriasis.The receiver operating characteristic(ROC)curve was plotted to evaluate the diagnostic value of serum Gal-3,PTX3,and cIMT for CVD.Results The cIMT was greater in the CVD group and the psoriasis group than in the control group,and the CVD group was greater than the psoriasis group(P＜0.05).The serum levels of Gal-3,PTX3,hs-CRP,PCT,and TNF-α were higher in the CVD group and the psoriasis group than in the control group,and their levels were higher in the CVD group than in the psoriasis group(P＜0.05).The psoriasis area and severity index(PASI)score was higher in the CVD group than in the psoriasis group(P＜0.05).Pearsons correlation analysis showed that cIMT,Gal-3,and PTX3 were separately positively correlated with hs-CRP,PCT,and TNF-α(P＜0.05).Multivariate Logistic regression analysis showed that PASI score,cIMT,Gal-3,PTX3,hs-CRP,and TNF-α were independent influencing factors for CVD in patients with psoriasis(OR=1.250,1.451,1.432,1.365,1.413,1.465;P＜0.05).The diagnostic model based on cIMT combined with serum Gal-3 and PTX3 had higher diagnostic value for CVD in patients with psoriasis than single diagnosis.The area under the curve was 0.922,with sensitivity and specificity of 0.91 and 0.85,respectively.Conclusion The cIMT,serum Gal-3,and serum PTX3 are inde-pendent influencing factors for CVD in patients with psoriasis.The combination of the three indica-tors has higher diagnostic value for CVD in patients with psoriasis.

Objective:To compare the effects of expansion screw with maxillary protractor and clear aligners combined with maxillary protractor on the maxilla and maxillary dentition of mixed dentition patients with class Ⅲ skeletal malocclusion using finite element analysis, further providing clinical guidance for clear aligner treatment.Methods:A finite element model was established based on maxillofacial cone-beam CT data of a 10-year-old boy with mixed dentition, class Ⅲ skeletal malocclusion, who visited Department of Orthodontics, School of Stomatology, The Fourth Military Medical University in January, 2024. The expander with protractor group (group A) and the clear aligners with protractor group (group B) were divided. The arch was extended by 0.25 mm in both groups, and the forward pull force was 2.94 N (working condition 1) and 4.90 N (working condition 2), respectively. The initial displacement trend of maxilla and maxillary dentition in two groups under two working conditions were evaluated.Results:Under two working conditions, the maxilla of both groups showed clockwise rotation and labial inclination. The labial inclination of maxilla was more significant in clear aligners with protractor group, about 2.2-3.0 times that of expander with protractor group under the same working condition. Maxillary dentition showed mesial and buccal displacement, with anterior teeth extrusion and posterior teeth intrusion in two groups under two working conditions. Under the working condition 1 and 2, the labial displacement of central incisor of clear aligners with protractor group (-0.065, -0.089 mm) were greater than that in expander with protractor group (-0.024, -0.024 mm). Under two working conditions, the posterior teeth of expander with protractor group moved close to the buccal bodily direction, while those of clear aligners with protractor group moved tilted towards the buccal direction in the horizontal direction. The forward displacement trend of maxilla and maxillary dentition in clear aligners with protractor group was more obvious than expander with protractor group with the increase of the forward pull force. Under two working conditions, the anterior teeth’ s hydrostatic stress of periodontal membrane and the equivalent stress of alveolar bone in clear aligners with protractor group were higher than those in expander with protractor group, mainly concentrated on the labial cervical region of the incisor.Conclusions:Clear aligners combined with maxillary protractor can produce forward force on the maxilla, but labial inclination occurs in the anterior teeth. It can be an effective orthopedic treatment strategy for mixed dentition patients with class Ⅲ skeletal malocclusion.