AIM: To compare the blocking effect of ropivacaine and bupivacaine on sodium channels of rat dosal root ganglia(DRG) using whole cell recording technique. METHODS: Rat DRG neurons were enzymatically isolated , tetrodotoxin-sensitive(TTX-s) and tetrodotoxin-resistant (TTX-r) sodium currents of DRG were recorded by whole cell recording.Drugs were given in bath solution.The concentrations of ropivacaine were 10,30,100, 1 000 ?mol?L~ -1 and bupivacaine were 10,30,100,300 ?mol?L~ -1 . The recording number in each dose group was six. RESULTS: CsCl in extracellular fluid and TEA in intracellular fluid were used to block the potassium channels. Sodium currents were recorded when the holding potential was - 70 mV and a serials of pulse with step 10 mV and duration 70 ms was given.TTX-s sodium channel was recorded in 80.1 % large DRG cells and TTX-r sodium channel was recorded in 92.4 % medium and small DRG cells,of which 56.3 % cells had no response to 1 ?mol?L~ -1 TTX. The half-maximal blocking concentrations of ropivacaine on TTX-r sodium channel was 65.7 ? 6.1 ?mol?L~ -1 , which was much lower than that on TTX-s sodium channel 246.8 ? 11.2 ?mol?L~ -1 (P 0.05 ). CONCLUSION: Ropivacaine preferentially blocks TTX-r sodium channel.Selective blocking of TTX-r and TTX-s sodium channel was one of the reasons of seperation of sensation and motion when it is used in epidural anesthesia.

With the frequent occurrence of natural disasters, incidence rate of PTSD and sleep-disorder is rising. So, how to treat them effectively has become a hot spot. This article analyzed the literature about improvement of PTSD and sleep-disorder based on the perspective of soothing and regulating liver, and primarily discussed the effectiveness and feasibility of treating PTSD from liver, with a purpose to lay work foundation for improving common diagnosis and treatment system of PTSD and sleep-disorder.

Objective:To examine the correlations of microRNA-34c(miR-34c) expression in the peripheral blood with the onset of diabetic foot ulcer(DFU)and diabetic foot osteomyelitis(DFO)in patients with type 2 diabetes mellitus(T2DM).Methods:Sixty newly-diagnosed T2DM patients without DFU(T2DM group), 112 T2DM patients with DFU(DFU group), and 60 healthy controls with normal glucose tolerance(NC group)were included. The 112 T2DM patients with DFU were further divided into DFO( n=64)and NDFO( n=48)groups. The levels of miR-34c were determined by quantitative real-time PCR, while clinical features and risk factors of DFU and DFO were explored. Results:A significant increase in the expression level of miR-34c in peripheral blood was observed in T2DM group compared with NC group[2.99(1.45-6.22) vs 1.01(0.89-1.52), P<0.05], and a markedly increased miR-34c expression level was noted in DFU group compared with T2DM group [9.65(6.15-18.63) vs 2.99(1.45-6.22), P<0.01]. Additionally, the expression level of miR-34c in peripheral blood significantly increased in DFO group compared to NDFO group [13.46(8.89-19.11) vs 6.02(5.93-14.72), P<0.01]. Moreover, there was a positive correlation between the expression level of miR-34c in peripheral blood and the amputation rate in patients in DFU group( P=0.030), and a negative correlation in the expression level of miR-34c( P=0.025)with healing rate of DFU after eight weeks. The multivariate logistic regression analysis confirmed that a high expression of miR-34c was an independent risk factor for DFU and DFO( OR=3.52, 4.13; both P<0.01). Conclusion:An increased expression of miR-34c in peripheral blood of T2DM patients might be closely related to the occurrence, development, and prognosis of DFU and DFO.

Objective To study the MSCT appearances of thymic neuroendocrine tumors (NETs)and its correlation with the WHO histological grade.Methods MSCT features of 16 patients with thymic NETs confirmed by pathology were analyzed retro-spectively.The patients were divided into 2 groups according to tumor's grade,i.e.low and intermediate grade,high grade.Results There were 8 patients in low and intermediate grade,8 in high grade.No difference was found among tumor location,size,tumor morphology,calcification,pericardiac thickening,pericardial effusion,pleural thickening,pleural effusion,disappearance of fat line around tumor and mass-pulmonary interface with irregular shape,but significant difference was detected in lymph node metastasis. On enhanced MSCT scanning,statistical difference was detected in linear enhancement of the blood vessels in the tumors,but no difference was found between necrosis and peripheral vessel invasion.Conclusion MSCT findings of different grades in thymic NETs have some characteristics and can be helpful in the grades of predictability.

Objective To investigate the correlation of CT features and pathological characteristics with epidermal growth factor receptor(EGFR)gene mutations in invasive peripheral pulmonary adenocarcinoma.Methods The amplification refractory mutation system was used to determine EGFR mutations in 1 9 3 surgically resected invasive peripheral pulmonary adenocarcinomas.CT features and pathological characteristics were analyzed retrospectively.Results The total EGFR mutation rate was 62.2% (120/193).Among the features on CT,the maximum tumor diameter (Dmax)in axial plane CT images was significantly smaller in patients with EGFR mutations than that with wild-type EGFR patients [(2.52 ± 1.01)cm vs (3.11 ± 1.34)cm,P<0.05].Receiver operating characteristic (ROC)results indicated that Dmax=2.01 cm was the diagnosis threshold in forecasting EGFR gene mutations,with the sensitivity and specificity of 79% and 64%,respectively.The frequency of EGFR mutations was significantly greater in tumors with ground-glass opacity(GGO)than that without GGO (78.0% vs 56.6%,P<0.05),and in tumors without cystic airspaces than that with cystic airspaces (65.5% vs 40.0%,P<0.05).No correlations were observed between EGFR mutations and other CT features,including GGO/tumor ratio(G/T),lobulation,spiculation,pleural retraction,vascular convergence,air bronchograms,and vacuole signs (P>0.05).Among pathological characteristics,compared with other subtypes,EGFR mutations occurred most frequently in lepidic predominant adeno-carcinomas (77.5% vs 58.2% in other subtypes,P<0.05),and the least frequently in solid predominant adenocarcinomas(26.3%vs 66.1% in other subtypes,P<0.05).The EGFR mutation rate was significantly higher in tumors without lymph node metastases than that with lymph node metastases (66.9%vs 50.9%,P<0.05).Conclusion The CT features and pathological characteristics may be useful indicators to predict EGFR mutation status in invasive peripheral pulmonary adenocarcinoma.

Objective To review our experiences on perioperative anesthetic management for patients who received percutaneous nephroscopic peripancreatic necrectomy for acute necrotizing pancreatitis.Method The clinical data on 18 patients with acute necrotizing pancreatitis who received percutaneous nephroscopic peripancreatic necrectomy in our hospital from August 2008 to January 2011 were retrospectively analyzed.Results There was a marked fluctuation in hemodynamic status of the patients which required the use of vasoactive drugs during perioperative period.PETCO2 significantly increased after pneumoperitoneum.Tracheal extubation was possible in 11 patients immediately after surgery in the operation room,while 7 patients required tracheal intuhation to be transported back to the surgical intensive care unit (SICU).Conclusion Most patients who underwent percutaneous nephroscopic peripancreatic necrectomy had a varying degree of shock and multi-organ injury before operation.Proper anesthetic induction and maintenance,correct use of vasoactive drugs and lung protective ventilation strategy,and active fluid resuscitation are the keys to good perioperative anesthetic management and to improve treatment results.

Objective To determine the content of ferulic acid, water and extract of Angelica formula particles, provide a reliable method for evaluation and quality control, and compare the quality of Angelica formula particles and Angelica pieces. Methods HPLC method was used with Kromasil C18 column (4.6 mm×250 mm, 5μm), flow rate of 1.0 mL/min, detection wavelength of 316 nm, column temperature at 28 ℃. The mobile phase was acetonitrile-0.05%phosphoric acid in water gradient elution system. Results Ferulic acid showed good linear relationship in the range of 0.033-0.165 μg (r=0.999 8). The average recovery was 98.78% and RSD=0.99%. Angelica formula particles met the quality requirement in the content indicators, the content of ferulic acid was higher than Angelica pieces. Conclusion The HPLC method for determination of ferulic acid in Angelica formula particles is simple and reliable, with good reproducibility, and can be used as the quality control method of Angelica formula particles.

Abstract This paper summarizes the psychological impacts of passive social media use on adolescents by systematically reviewing the existing domestic and foreign literature about passive social media use. The results showed that the psychological impacts of passive social media use included cognitive outcomes (self concept clarity, self esteem), affective outcomes (depression, anxiety, envy, loneliness), subjective well being (life satisfaction), more types of social media (social short form video), detailed information on forms of passive use, as well as possible impacts (positive psychological, social, and behavioral outcomes) on teenagers and college students should be exlpored by utilizing multiple methods(longitudinal study, the grounded theory) are expected in future studies.

Objective To explore the MSCT features of airway-invasive pulmonary aspergillosis.Methods MSCT features of 27 cases of airway-invasive pulmonary aspergillosis confirmed by pathology or clinical experience were analyzed retrospectively.Results The lesions in 27 cases were distributed along the blood vessel and bronchus and located mainly in the upper and middle lung field in 19 cases.Multiple centrilobular nodules and tree-in-bud sign were found in 27 cases and bronchial wall thickening and patchy opacities around the bronchi were in 25 cases.Bronchiectasis was seen in 17 cases,and cavity-like change and inter-cavity separation were in 15 cases.In 22 cases of follow-up,the lesion progressed within 1 week after diagnosised and treatmented in 20 cases and recurred in slow recovery stage in 5 cases.Conclusion MSCT findings of airway-invasive pulmonary aspergillosis are various which may rapidly progress within a short time.MSCT palys an important role in the evolution and follow-up of airway-invasive pulmonary aspergillosis.

Objective To analyze the relationship between CT image characteristics and the pathological subtypes of small lung adenocarcinoma (≤3 cm) with ground-glass opacity(GGO).Methods Two hundred and three cases of small lung adenocarcinoma proved by pathology were collected.Use the 2015 World Health Organization(WHO) classification of lung cancers as pathology standard.The relationship between CT findings and pathologic classification were analyzed statistically.Results There was a positive correlation between CT type and pathological type (rs =0.756).The size of atypical adenomatous hyperplasia(AAH),adenocarcinoma in situ(AIS) and minimally invasive adenocarcinoma(MIA) lesions were smaller than invasive adenocarcinoma(IAC).AAH lesions were smaller than MIA(P＜0.008 3).However,there were no significant size differences in AAH and AIS lesions,or in AIS and MIA lesions (P＞0.008 3).The critical point of non-or-little-invasive (AAH,AIS and MIA) and IAC was 15.35 mm (sensitivity 80.8％,specificity 90.4 ％).Differences in lobulation,air bronchogram,vacuole sign,pleural indentation and vascular convergence among pathological types were statistically significant (P ＜0.05).Differences in shape,speculation and cavity among groups were not significant (P ＞0.05).Conclusion The higher CT type,lower GGO content and bigger lesion size are all associated with increasing tumor degree of malignancy.The size of IAC lesion is usually greater than 15.35 mm.Lobulation,air bronchogram,vacuole sign,pleural indentation and vascular convergence can help to diagnose IAC.