Objective A rat model of chronic post-thoracotomy pain is used to study whether acute pain and pre-operative diffused noxious inhibitory controls(DNIC) can predict chronic pain and how DNIC changes when pain maintains.Methods Rats were randomly divided into three groups:naive group,sham group and model group.DNIC was constantly assessed in individual rats,along with each animal's mechanical hyperalgesia and cold allodynia after thoracotomy.Results In model group,the incidence of chronic post-thoracotomy pain was 55%(11 of 20),which was named CPTP group,and the other 9 rats without chronic pain was defined as non-CPTP group.The pre-operative DNIC was significantly weaker in CPTP group with lower mechanical threshold on 6 days after surgery and higher cold sensitivity on 6 days after surgery comparing with non-CPTP group.In the acute pain phase (day 3),DNIC was decreased in both CPTP group and non-CPTP group as compared with pre-operative period.Besides,DNIC was recovered in non-CPTP group while kept impaired in CPTP group on 21 days after surgery.Conclusions Pre-operatively assessed DNIC efficiency and acute post-operative pain intensity were two independent predictors for CPTP.DNIC was decreased both in acute pain and chronic state,while returned to normal when pain sense was normal.

Objective: To explore the value of baseline geriatric nutritional risk index (GNRI) in evaluating the prognosis of patients with end-stage renal disease (ESRD) who underwent peritoneal dialysis (PD). Methods: The clinical data of patients who underwent PD catheterization and started PD therapy at the First Affiliated Hospital of Zhengzhou University from January 1, 2013 to December 30, 2018 were collected retrospectively. The follow-up endpoint was death or hemodialysis. The follow-up deadline was March 1, 2019. The GNRI cut-off value was determined according to the ROC curve, and the patients were divided into GNRI≤90.5 group and GNRI>90.5 group. The differences of clinical data and laboratory tests were compared between the two groups. Kaplan-Meier survival curves were used to compare the difference in PD rate between the two groups during follow-up, and the factors that affecting patients PD withdrawal were analyzed by Cox regression. Results: The GNRI cut-off value was determined to be 90.5 based on the ROC curve. Until the deadline for follow-up, the drop-out rate of GNRI≤90.5 group was significantly higher than the GNRI>90.5 group (35.88% vs 21.58%, P=0.003). Kaplan-Meier survival curves showed a higher rate of maintaining PD in the GNRI>90.5 group than that in GNRI≤90.5 group during follow-up (P=0.021). Cox univariate regression showed that male, GNRI and serum Alb were protective factors for PD patients, and Scr was a risk factor. After multiple factors correction, male and GNRI were also the protective factors for PD patients. Conclusion As an objective indicator of nutritional evaluation, baseline GNRI can be used as a prognostic indicator for PD patients.

ObjectiveTo investigate the association between cumulative triglyceride （cumTG） exposure and the risk of acute pancreatitis （AP）. MethodsA prospective study was conducted for a cohort of 56 883 workers from Kailuan Group who participated in annual physical examination for three consecutive times in 2006-2010 （2006， 2008， and 2010） and had complete TG data without the medical history of AP. According to the quartiles of cumTG calculated， the subjects were divided into four groups （Q1， Q2， Q3， and Q4 groups）， and general information was compared between the two groups. A one-way analysis of variance was used for comparison of normally distributed continuous data between multiple groups， and the Kruskal-Wallis H test was used for comparison of continuous data with skewed distribution between multiple groups； the chi-square test was used for comparison of categorical data between groups. The Kaplan-Meier method was used to plot the survival curve and calculate the cumulative incidence rate of AP， and the Log-rank test was used for comparison between groups； the Cox regression model was used to analyze the effect of different cumTG levels on new-onset AP events. ResultsAfter follow-up for 10.51±1.76 years， there were 158 AP events in total， with a total incidence density of 2.64 per 10 000 person-years， and the number of cases and incidence density in the Q1， Q2， Q3， and Q4 groups were 29 cases （1.93 per 10 000 person-years）， 34 cases （2.27 per 10 000 person-years）， 30 cases （2.01 per 10 000 person-years）， and 65 cases （4.37 per 10 000 person-years）. The Log-rank test showed that there was a significant difference in cumulative incidence rate between groups （χ²=22.41， P<0.001）. The multivariate Cox regression analysis showed that compared with the Q1 group， the Q4 group had a significantly higher risk of AP （hazard ratio ［HR］=1.94， 95% confidence interval ［CI］： 1.20‍ ‍—‍ 3.13， P=0.01）. Compared with cumulative triglyceride exposure for 0 year， cumulative triglyceride exposure for 4 and 6 years significantly increased the risk of AP， with an HR value of 2.04 （95%CI： 1.26‍ ‍—‍ 3.30， P<0.01） and 3.20 （95%CI： 1.98‍ ‍—‍ 5.17， P<0.01）， respectively. After exclusion of the AP cases that occurred during the 2-year follow-up， the repeated multivariate Cox regression analysis showed that the Q4 group had an HR value of 1.96 （95%CI： 1.23‍ ‍—‍ 3.12， P<0.01） for the onset of AP， and after exclusion of the death cases during follow-up， the repeated multivariate Cox regression analysis showed that the Q4 group had an HR value of 1.85 （95%CI： 1.10‍ ‍—‍ 3.14， P<0.05） for the onset of AP. ConclusionThe incidence rate and risk of AP tend to increase with the increase in cumTG exposure.