Objective To evaluate the role of autophagy in the development of neuropathic pain (NP) in rats.Methods Thirty male Sprague-Dawley rats,weighing 200-220 g,were randomly divided into 3 groups (n =10 each) using a random number table:sham operation group (sham group),NP group and rapamycin (autophagy inducer) group (Rap group).Intrathecal catheter was inserted into the subarachnoid space and advanced caudally until the tip reached L4,5 segment.NP was induced by ligation of the left L5 spinal nerve (SNL) in NP and Rap groups.The L5 spinal nerve was only exposed,but not ligated in group sham.At 30 min before ligation and 2 days after operation,rapamycin 60 μg was injected intrathecally via the intrathecal catheter in Rap group,while the equal volume of vehicle (5％ dimethyl sulfoxide) was injected in sham and NP groups.The mechanical and thermal pain thresholds were measured on 1,3,5 and 7 days after ligation (T-4).The rats were sacrificed after the last measurement of pain threshold at T4.The ipsilateral L5 segment of spinal dorsal horn was removed for examination of autophagosomes (using transmission electron microscope) and for determination of the expression of LC3 Ⅱ and p62 (by Western blot) and content of IL-1β (by ELISA).Results Compared with sham group,the mechanical pain threshold at each time point and thermal pain threshold at T2-4 were significantly decreased,and the LC3 Ⅱ and p62 expression and IL-1β content were increased at T4 in group NP (P ＜ 0.05).Compared with NP group,the mechanical pain threshold at each time point,thermal pain threshold at T2-4 and LC3 Ⅱ expression at T4 were significantly increased,and the p62 expression and IL-1β content were decreased at T4 in group Rap (P ＜ 0.05).Microscopic examination showed that autophagosomes were observed in the spinal dorsal horn in NP and Rap groups,and the damage to organelles was lighter in Rap group than in NP group.Conclusion The development of NP is related to autophagic dysfunction in rats.

Objective To evaluate the diagnosis and surgical treatment of pancreatic trauma(PT). Methods The clinical data of 41 cases of PT admitted into our hospital in recent 10 years were retrospeclively analysed. Results There were 8cases of PT in grade 1, 16 in grade2, 8 in grade 3, 5 in grade 4, 4 in grade 5 in this series. 12 patients had PT only, 29 (70.7%) had PT with other organs injury. Operation was performed on all 41 cases, of them. 34 cases are recovered; 7 died including 4 with multiple injuries. The mortality was 17.1% . There were 16 complications in this series, including fistula of pancreas and intestinal fistula(39.0%). Preoperative correct diagnosis was made only in 7 cases(17.1%). Conclusions The diagnosis of PT needs analysis and determination of all clinical materials. The exploration laparotomy must be done as early as possible. The chioce of operation should be made according to the condition of the PT to improve the survival rate.

Objective To examine the effects of trunk exercises performed using a Swiss ball on functional balance and walking in the early stage of recovering from a stroke.Metbods Sixty hemiplegic stroke patients were randomly assigned to a control group or an experimental group,each of 30.Both groups were treated with routine physical training.Those in the control group did conventional trunk exercises,while the patients in the experimental group were given trunk exercises performed using a Swiss ball.The trunk control test (TCT) and the Berg Balance Scale (BBS) were used to assess the patients' trunk and balance function.Gait and balance function training and assessment apparatus (model AL-080) was used to measure and compare the scope of movement of the patient's center of pressure in static sitting over 30 seconds (LOM),the limits of stability (LOS),velocities and a gait asymmetry index (GAI).Results Significant improvements in TCT,BBS,LOM and LOS were observed in both groups after the training,but all of the measures improved significantly more in the experimental group than in the control group.Conclusions Swiss ball trunk exercise can obviously improve the trunk control,functional balance and walking of stroke patients in the early stages of recovery.

Objective To find new way to reduce non-recurrent laryngeal nerve (NRLN) injuries by applying intraoperative neuromonitoring(IONM) to identify NRLN in thyroidectomy. Methods Records of 279 patients who underwent complex thyroidectomy by applying IONM to identify and monitor RLN from Mar. 2009 to Jan. 2010 were veviewed. We proposed the skills to identify and monitor NRLN and predict RLN varition through exploring vagus nerve and RLN before RLN dissection. Results 6 cases NRLN located on the right side were all accurately identified by IONM, thus no injury of NRLN occurred during thyroid operations. Conclusions NRLN is difficult to be predicted preoperatively and identified by naked eyes. The application of IONM to predict, identify and monitor NRLN could remarkably reduce the possibility of NRLN injury.

Information-based teaching was applied in the experimental teaching of nuclear protection medicine based on its own features.The teaching content was sent to students as micro-video via an information platform before class for preview;during the class,the teaching was performed in the form of lectures by students and experiments in groups;after class,students were required to submit reports of experimental improvement or innovative experimental design.A comprehensive assessment was performed for preview,classroom operation,question answering in class,and experimental reports.The results of teaching practice showed that this teaching mode can effectively stimulate the students' interests in learning,enhance their research and innovation abilities,and improve the experimental teaching effect of nuclear protection medicine.

Objective To reveal the change trend of malignant tumor after renal transplantation in China based on the epidemiological and clinical features that were publicly reported in China in recent 10 years. Methods The search terms ‘renal transplantation’and ‘tumor’were searched on China Academic Journal Network Publishing Database and China Science Periodical Database to screen out the qualified researches strictly.General conditions,tumor sites and regional differences of malignant tumors were analyzed.Results Fifteen thousand one hundred and twenty cases from nine literatures published from 2003 to 2014 and a single-center experience of renal transplantation in Beijing Friendship Hospital of Capital Medical University were screened out.Four hundred and fourty-six cases had malignant tumor after renal transplantation with the total tumor incidence of 2.95% (446 /15 120) and the tumors were mainly urinary system tumors after transplantation (55.8%).Conclusions The total incidence of malignant tumor in renal transplant recipients is 2.95% and the urinary system tumors are most common.Thus,tumor screening after renal transplantation should be taken as the routine examination during follow-up.