Objective To investigate the activation of extracellular signal-regulated kinase(ERK) and cAMP-responsive element binding protein(CREB) in the anterior cingulate cortex(ACC) induced by peripheral injection of formalin.Methods 5% formalin was injected subcutaneously into the unilateral hindpaw.The rats were perfused or killed and the ACC dissected at different time points.The activation of phosphorylated ERK(pERK) and phosphorylated CREB(pCREB) in the ACC were observed by immunohistochemical and Western blotting techniques.Results Subcutaneous injection of formalin induced the activation of pCREB and pERK in the ACC.Formalin-induced the activation of pERK and pCREB in the ACC peaked at 3 min and 30 min after stimulation,respectively.The total ERK and CREB had no significant changes.Conclusion The ACC could receive peripheral noxious information and the ERK and CREB in the ACC might involve in the processing of the primary unpleasentness of pain.

Objective To observe the distribtuion of NOS positive neurons in the projecting pathway to the subnucleus reticularis dorsalis(SRD) in the rat. Methods We used a double staining technique combined retrograde tract tracer and NADPH d histochemistry. Results FG/NOS double labeled neurons were found in the laminae Ⅰ,Ⅹ of spinal cord,dorsal raphe nucleus(DR),linear raphe nucleus(LR),and raphe obscurus nucleus(RO).In the periaqueductal gray(PAG),there were many FG labeled or NOS labeled neurons,but no FG/NOS double labeled neurons were found.Conclusion\ NO might play a role in the pathway of afferent projections of the SRD.\;[

Objective To observe the activation of astrocytes,microglia and expression of proinflammatory cytokines in the periaqueductal gray(PAG) by Complete Freunds Adjuvant(CFA)-induced inflammatory pain. Methods Heat hyperalgesia and mechanical allodynia were observed and the expressions of mRNA,protein of glial markers,and proinflammatory cytokines in the PAG were examined following intraplantar administration CFA in right hindpaw of the rat by behavioral testing,reverse transcription polymerase chain reaction(RT-PCR), Western blotting,and immunohistochemistry. Results CFA injection induced chronic thermal hyperalgesia and mechanical allodynia.After injection,the thermal hyperalgesia was recovered on Day 14,but the mechanical allodynia lasted more than 21 days.Microglial marker(Cluster of differentiation 14,CD14) and proinflammatory cytokines(Interleukinin-1?,tumor necrosis factor-?) showed a significant increase in their expression during all phases(acute,subacute and chronic) of inflammation.GFAP was observed only in PAG at subacute and chronic phases of inflammation.Conclusion The activation of microglia and astrocytes may be involved in the initiation and maintenance of inflammatory pain.Enhanced cytokines expression might play a role in eliciting behavioral hypersensitivity.

Mitogen-activated protein kinases (MAPKs) are important kinases involved in the intracellular signaling transduction in mammalian. There are three major MAPK pathways: ERK/MAPK,JNK/SAPK and P38 MAPK. Current studies indicate that all of them play significant roles in the processing of pain especially in the development and maintenance of pathological pain. This review will focus on in the study of MAPK in pain modulation. The further insights into its mechanisms may highlight a nice prospect for the therapies of painful diseases.

ObjectiveTo study the clinical features of stercoral bowel obstruction and perforation of colon in elderly patients MethodsThe data of 22 cases of stercoral bowel obstruction and 6 cases of stercoral perforation of colon in elderly patients in our hosital from January 1994 to December 2003 were analyzed retrospectively ResultsIn the 22 cases with stercoral bowel obstruction, 6 cases were recovered after operation, 6 cases suffered from stercoral perforation in which all cases were misdiagnosed before operation,and 2 cases were dead.ConclusionsThe prevalence of stercoral bowel obstruction and perforation of colon in elderly patients are increasing with population being aged. The cases without perforation are often recovered by non-operative therapy. The perforation case of stercoral bowel obstruction is relatively rare, easy to be misdiagnosed, and in high mortality. The Hartmanns ostomy should be the choice for the perforation.

Objective To investigate the differences in clinical, laboratory and therapeutic aspects of primary Sjogren's syndrome (pSS) between young/middle-age group and old group.Methods The 84 pSS patients were divided into the young and middle-age group (n=54) and the old group (n = 30). The differences in clinical features, laboratory indices and drug therapy were retrospectively analyzed. The chi-square test was used for statistical analysis. Results The positive incidences of xerostomia, dry eye symptom and rampant teeth were 80.0%, 76.7% and 43.3%respectively in the old group. And they were all significantly higher than in young and middle-aged group (57.4%, 51.9% and 20.4%, all P＜0. 05). The positive rates of rheumatoid factor (RF)elevation, antiRo/SSA and antiLa/SSB antibodies were 13. 0%, 36.7% and 16.7% in the old group,and significantly lower than in young and middle-age group (44.4%, 59.3% and 42.6%, all P＜0.05). The incidences of leukopenia and thyroid gland involvement were much lower in the aged group (13.3% and 10.0%) than in the young and middle-age group (48. 1% and 37.0%, P＜0. 05). The percentage of patients receiving hydroxychloroquine as the main medicine was much lower in the aged group than in the young and middle-age group (16.7% vs. 40. 7%, P＜0. 05), while percentage of treatment with exclusive glucosides of Paeony Capsules was much higher (33.3% vs. 14.8%, P＜0.05). There were no statistical differences between two groups in ophthalmological examination,immunoglobulin level and sialography. Conclusions Those pSS patients with late onset exhibit more abnormalities in clinical parameters, but fewer in immunological parameters, which may be helpful in estimating prognosis and pathogenetic factors in pSS.

ObjectiveTo explore the prevalence and clinical features of hyperuricemia and its influencing factors in elderly male people aged 90 years and above. MethodsOne hundred elderly male people aged 90 years and above who underwent routine health examination in our hospital in 2007 were selected in the study. Serum uric acid level was examined by uricase-peroxidase method, and all patients were divided into hyperuricemia group and control group according to the serum uric acid level. Clinical and biochemical indications were compared between the two groups, and logistic regression was used to analyze the influencing factors of hyperuricemia in elderly people. ResultsThe serum uric acid level was increased in 20% of the elderly people, and the prevalence of gouty arthritis was 1%. The levels of blood urea nitrogen and serum creatinine were higher in hyperuricemia group than in control group[(10. 98±4.29) mmol/L vs. (6. 87± 1.86) mmol/L, (125.2±25.9)μmol/L vs. (93. 4±19. 8)μmol/L;both P<0.05)3. The patients in hyperuricemia group had a higher prevalence of hypertension and hypertriglyceridemia, and a higher proportion of diuretic application than patients in control group(P<0. 05). Logistic regression analysis showed that serum uric acid level had the most remarkable correlation with serum creatinine(OR= 1. 969), followed by fasting blood glucose (OR= 1. 310)and blood urea nitrogen(OR = 1.161). There was negative correlation between serum uric acid level and plasma cholesterol level(OR = 0. 802). ConclusionsThe prevalence of hyperuricemia is high in elderly people aged 90 years and above, while the incidence of gouty arthritis is low. Renal function impairment, metabolic syndrome and thiazide diuretic are the major factors for hyperuricemia.

Objective:To study the clinical characteristics and compliance of early-onset gout patients by case-control analysis.Methods:A total of 111 early-onset patients (onset age ≤35 years old) were included as Group A, and 111 non-early-onset patients (onset age >35 years old) with matched disease durationwere included as Group B. The differences ofclinical characteristics, causes of acute gout attack, dairy diet habits, compliance, and misunderstanding of the disease were compared.Results:Compared with the non-early-onsetgoutpatients, the early-onset patients had a higher proportion of obesity (63 cases vs 28 cases), family history (36 cases vs 20 cases) and tophus (39 cases vs 23 cases) and higher level of VAS scores (8.5±1.3 vs 7.6±1.7; χ2=22.988, P<0.01; χ2=5.749, P=0.016; χ2=5.729, P=0.017; t=4.639, P<0.01), lowerproportionof the first metatarsophalangeal joint involvement as the initial joint involvement (45.9%, 51 cases vs 59.4%, 66 cases; χ2=4.066, P=0.044), higher proportion of the ankle involvement as the initial joint involvement (34.2%, 38 cases vs 21.6%, 24 cases; χ2=4.386, P=0.036), higher proportion of alcohol drinkers and high fructose drinkers, which was more likely to relate to alcohol intake, strenuous exercise and high fructose intakeas trigger of the flare ( χ2=6.513, P=0.011; χ2=7.126, P=0.008; χ2=1.978, P=0.160), while the proportion of regular exercisers and on diet in the family was lower ( χ2=22.887, P<0.01; t=-4.917, P<0.01). The proportion of poor diet and medication compliance in Group A was higher than that in Group B(57.7%, 64 cases vs 38.7%, 43 cases; χ2=5.207, P=0.022; χ2=5.867, P=0.015). As for the reason for poor treatment compliance, early-onset gout patients were more worry about the side-effects of drugs than non-early onset patients ( χ2=4.190, P=0.041). There was no significant difference between the two groups in the main misunderstanding of gout. Conclusion:Although early onset gout patients are young, their condition is more serious, and compliance is poorer, this group of patients should be highly valued in clinical diagnosis and treatment.

Objective: To compare the effect of different scanning parameters of cone beam computed tomography (CBCT) on displaying trabecular microstructure in the anterior region of the mental foramen of the mandible, and to provide a basis for the rational selection of CBCT scanning parameters. Methods: This study was approved by the Ethics Committee of the Affiliated Stomatological Hospital, Medical School of Nanjing University. An in vitro study was conducted using CBCT (ProMax 3D Mid) to scan eight dry human mandibular specimens with five scanning protocols: Group A: 90 kV/6.3 mA, Group B: 90 kV/8.0 mA, Group C: 90 kV/10.0 mA, Group D: 75 kV/8.0 mA, and Group E: 60 kV/8.0 mA, resulting in a total of 40 CBCT images. Entrance surface dose (ESD) and computed tomography dose index (CTDI) under different scanning conditions were recorded. The original CBCT images were imported into the image analysis software (Hiscan Analyzer) to measure four trabecular bone microstructural parameters in the region of interest of the mandible: trabecular thickness (Tb.Th), trabecular number (Tb.N), trabecular space (Tb.Sp), and bone volume/tissue volume (BV/TV). A total of 108 CBCT images were retrospectively collected from clinical implant patients using any of the 90 kV/6.3 mA, 90 kV/8.0 mA, or 90 kV/10.0 mA scanning conditions, and the above four parameters of the region of interest of the mandible were also measured. SPSS 26.0 software was used to compare the differences in the four trabecular bone microstructural parameters between the CBCT images of the mandibular specimens in vitro and clinical patients in vivo. Results: The in vitro study results showed that reducing the tube voltage and tube current would lead to a decrease in the ESD and CTDI. When the tube voltage was maintained at 90 kV and the tube current was changed, BV/TV, Tb.N, and Tb.Th values increased with the increase of tube current; Tb.Sp values decreased with the increase of tube current, but there was no statistically significant difference in the four bone morphological parameters (P > 0.05). When the tube current was maintained at 8.0 mA and the tube voltage was altered, BV/TV and Tb.N decreased with the increase of tube voltage, Tb.Sp values increased with the increase of tube voltage, and BV/TV, Tb.N, and Tb.Sp showed statistically significant differences (P < 0.05). In clinical patients undergoing CBCT scanning, when the tube voltage was 90 kV and the tube current was different (6.3, 8.0, 10.0 mA), there was no statistically significant difference in the four bone morphological parameters (P > 0.05). Conclusions In this study, when the tube voltage was fixed at 90 kV, there was no difference in the trabecular microstructure of the anterior region of the mandible when the tube current was increased. When CBCT scanning of clinical patients needs to show the trabecular microstructure of the anterior region of the mandible, the tube current can be appropriately reduced to decrease the radiation dose received by the patient. Thus, it is recommended to use the parameters 90 kV and 6.3 mA for CBCT scanning.

The treatment of articular cartilage (AC) injury caused by various reasons is still a major clinical problem. The emergence of cartilage tissue engineering brings new hope for the treatment of AC injury. In general, AC tissue engineering can be divided into two categories, including cell-based tissue engineering and cell-free tissue engineering. Although cell-based tissue engineering can repair cartilage damage to a certain extent, existing therapeutic strategies still suffer from limited cell sources, high costs, risk of disease transmission, and complex procedures. However, the cell-free tissue engineering avoids these shortcomings and brings hope for in-situ AC regeneration. Non-cellular tissue engineering is mainly used to recruit endogenous stem cells/progenitor cells (SCPCs) to reach the site of cartilage injury, and provide a suitable regenerative microenvironment to promote cell proliferation and chondrogenic differentiation, then the maturation of new cartilage tissue was promoted. Therefore, it is also called as cell-homing in situ tissue engineering. Successful recruitment of endogenous SCPCs is the first step in in-situ cartilage tissue engineering. This review aims to introduce chemokine response of cartilage injury, systematically summarize traditional chemoattractant (chemokines and growth factors etc.) and emerging chemoattractant (functional peptides, exosomes and nucleic acid adapters etc.), evaluate the combination mode between chemoattractant and delivery devices, discuss the prospects and challenges of chemoattractant-mediated in situ tissue engineering and provide theoretical basis for the design of endogenous SCPCs homing-based in situ tissue engineering.