ObjectiveTo evaluate the effect and safety of dezocine and sufentanil in intravenous analgesia for postoperative pain. Methods60 patients with ASA Ⅰ～Ⅲ,underwent general anaesthesia operation were divided into two groups randomly,with 30 cases for each group:dezocine 0.6mg/kg and sufentanil 0.6mg/kg was applied to PCIA in group A and B.PCIA was administered with subsequent bolus of 1 ml with lockout time 15 minutes and background infusion of 2ml/h.The analgesic effect was evaluated by VAS,BCS and Ramsay at 1、2、4、12、24、48 hours after operation.The changes of vital sign were also assessed. ResultsThere was no significant difference between two groups in analgesia effect(all P＞0.05)and adverse reaction incidence rate(P＞0.05). ConclusionThe effect of dezocine in intravenous analgesia for postoperative pain could be as satisfaction as that of sufentainyl.

Objective To investigate the value of pathological examination in the diag-nosis of lethal cases due to acute poisoning.Methods The macroscopic and microscopic find-ings in 28 autopsy cases (10 cases of toxic gas,7 cases of pesticide,6 cases of drug,3 cases of alcohol and 2 cases of chinese herbal medicine) died of acute poisoning during the period from October,2001 to June,2012 were retrospectively reviewed.Results Gross Changes were found on gross examination in 22 of the 28 cases studied.Of them,7 cases died of acute carbon mono-xide poisoning had showed cherry red of Shiban,muscle,visceral organs and blood.In addition,11 and 8 cases had been found gastric mucosa hemorrhage and epicardium petechial hemorrhage respectively.Histologically,myocardial interstitial hemorrhage was observed in 9 cases,pulmonary hemorrhage in 18 cases,bronchospasm in 12 cases,cerebral hemorrhage in 4 cases,hepato-cyte necrosis in 11 cases,renal tubular necrosis in 7 cases and gastric mucosa hemorrhage in 11 cases.In 6 cases of oral pesticides poisoning,besides they had all gastric mucosa hemorrhage,the change of character of gastric contents was found in 3 cases and pesticide odor from stomach in 3 cases.In addition,acute inflammatory and necrosis of gastric wall in 6 cases of oral pesticides poisoning were observed under the light microscope.Drug addicts often suffered from chronic lesions in multiple organs,such as chronic liver disease,fatty infiltration of the myocardium with myocardial atrophy,interstitial lung disease and pulmonary foreign body granuloma.Conclusions Pathology examination is helpful in the diagnosis of some lethal cases due to acute ooisoning,and it can provide pathological basis to study on treatment of acute poisoning.

Objective To investigate the expression of inflanmatory cytokines such as interlukin-1β (IL-1 β),interlukin-6 (IL-6),tumor necrosis factor-α (TNF-α) and intercelluar adhesion molecule-1 (ICAM-1),and explore their relationships with neuronal function score after fluid percussion brain injury in rats.Methods The experimental models were established in 48 adult rats.The water content of edematous brain and the expression of IL-Iβ,IL-6,TNF-α and ICAM-1 were measured with dry-wet measure,immunohistochemistry at 6 h,12 h,24 h,3 d,7 d after operation respectively.Results Compared with animals of shame operation (SO) group,neuronal function score decreased in TBI group from 6h (3.78±0.84),reached to the lowest level at 24h (2.65±0.32),and gradually increased at 3d (4.75±0.71).IL-6,IL-1β,TNF-α and ICAM-limmunoreactive expression increased from 6h,reached its maxmum at 24h,lasted to 3th day,and began to decrease at 7d.The linear regression analysis indicated that expression of IL-1β,IL-6,TNF-α and ICAM-1 had negative correlations with change of neuronal function score(r=-0.912,r=-0.892,r=-0.794,r=-0.887 respectively,P＜0.05).Conclusion IL-6,IL-1β,TNF-α and ICAM-1 expression is upregulated following fluid percussion injury in rats,and shows negative correlations with neuronal function score.The possible mechanisms is that inflammatory cytokines are involved in nerve function impairment by inducing secondary brain injury.

Objective To investigate the expression of Toll-like receptor 4 (TLR4),and explore its relationship with neurological function after fluid percussion brain injury in rats.Methods 56 adult rats were randomly divided into traumatic brain injury group(TBI group,n=48) and sham operation group(SO group,n=8).The experimental models were established.The water content of edematous brain and the expression of TLR4 were measured with dry-wet measure,immunohistochemistry and Western Blot at 1 h,6 h,12 h,24 h,3 d,7 d after shock respectively.Results Compared with SO group,neuronal function score decreased in TBI group from 6 h(3.86±0.42),reached to the lowest level at 24 h(2.65±0.32),and gradually rose at 3rd day (3.25±0.17).TLR4 immunoreactive expression increased from 6 h,reached its maxmum at 24 h,lasted to 3rd day,and then began to drop at 7th day.The linear regression analysis indicated that expression of TLR4 had negative correlation with change of neuronal function score (r 1 =-0.824,r w =-0.867,P＜0.05).Conclusion TLR4 expression is upregulated following fluid percussion injury in rats and involved in neurological function impairment by inducing secondary inflammatory brain injury.

OBJECTIVE: To investigate the expression of EBV-encoded latent membrane protein 2A (LMP2A) and epithelial-mesenchymal transformation(EMT) associated markers (E-cadherin and fibronectin) in nasopharyngeal carcinoma (NPC) and its clinical significance. METHOD: The expression of LMP2A, E-cad-herin and fibronectin proteins in 32 cases of chronic nasopharyngeal inflammation, 56 cases of NPC and 18 cases of NPC lymph node metastasis were examined byimmunohistochemical SP method. RESULT: (1)The positive rates of LMP2A in NPC and its lymph node metastasis were significantly higher than those of chronic nasopharyngeal inflammation (89. 3%vs 37. 5%o and 77. 8% vs 37. 5%) respectively (both P<0. 01); The normal expression rates of E-cadherin in NPC and its lymph node metastasis were significantly lower than those of chronic nasopharyngeal inflammation (33. 9% vs 90. 6% and 5. 6% vs 90. 6%) respectively (both P<0. 01); The positive rates of fibronectin in NPC and its lymph node metastasis were significantly higher than those of chronic nasopharyngeal inflammation (83. 9% vs 28. 1% and 72. 2% vs 28. 1%) respectively (both P<0. 01). (2) ZLMP2A expression were negatively correlated with normal expression of E-cadherin (r= -0. 387, P<0. 01), and were positively correlated with fibronectin (r= 0. 421, P<0. 01). (3)LMP2A, E-cadherin and fibronectin expression were significantly correlated with N stage and clinical stage (both P<0. 05), but the three proteins were not significantly correlated with M stage (both P> 0. 05). In addition, LMP2A and E-cadherin expression were significantly correlated with T stage (both P<0. 01). CONCLUSION LMP2A and fibronectin expressions were increased in NPC, but normal expression of E-cadherin were decreased. LMP2A may promote lymph node metastasis and malignant progression of NPC by induce EMT through downregulation of E-cadherin and upregulation of fibronectin.
Cadherins ; biosynthesis ; Carcinoma ; Epithelial-Mesenchymal Transition ; Fibronectins ; biosynthesis ; Humans ; Lymphatic Metastasis ; Membrane Proteins ; biosynthesis ; Nasopharyngeal Carcinoma ; Nasopharyngeal Neoplasms ; metabolism ; pathology ; Nasopharynx

Objective To study the application and significance of constructivism theory in pathological experiment teaching.Methods Six classes in total of 198 students majoring in clinical medicine were selected from grade 2009 of Guangdong medical college for research and were divided into experimental group (n=99) and control group (n=99) using random number table.Various teaching methods based on constructivism theory were used in experimental group while conventional teaching methods were applied in control group.The observing ability for specimen and slices,theoretical level and learning behavior of students were assessed with the same standard and anonymous homemade questionnaire survey was executed for students.SPSS 13.0 statistical software was used to analyze the results.The examination results of the two groups were compared using independent samples t-test.The questionnaire survey results of the two groups were compared using Wilcoxon rank-sum test.P＜0.05 represented the difference having statistical significance.Results The observing capability for specimen and slices,theoretical level and learning behavior of students in experimental group were significantly improved (P＜0.01)and the questionnaire survey results demonstrated that there were statistical difference in feedbacks between the two groups and the satisfaction rate was significantly improved in experiment group (P＜0.01).Conclusions Applying comprehensive teaching methods based on constructivism theory can stimulate students' interest and initiative in learning,improve students' learning behavior and learning strategies,and significantly improve the teaching quality.

Twenty-three patients with pain from osteoporotic vertebral fractures,aged 65-90 yr,weighing 51-78 kg,received an image intensifier-assisted nerve-root block with a 6-8 ml mixture of 0.5 ％ lidocaine,mecobalamine 0.5 mg and betamethasone sodium phosphate injection 5.26 mg in a prone or lateral position.The VAS scores before operation,at 0,1 week,1 and 3 months after operation were 8.6 ± 0.9,1.5 ± 0.7,2.8 ± 0.9,1.6 ± 0.5 and 2.5 ± 0.7,respectively.VAS scores were significantly lower at each time pint after operation than before operation (P ＜ 0.05).According to modified MacNab standard,the effectiveness of treatment was rated as excellent/good in 87％ of the patients.No complication such as bleeding,hematoma,infection,pneumothorax,hemopneumothorax,headache was found during or after operation.Selective nerve-root block is effective in the treatment of pain resulting from osteoporotic vertebral fractures in patients.

OBJECTIVE: To observe the clinical effect of perforated bovine amnion combined with recombinant bovine basic fibroblast growth factor (rb-bFGF) on degree Ⅱ burn wounds.METHODS: A total of 43 patients with small and medium-size thermal burn were collected, and the area of testing wound was 1% -2%. The wounds with the same nature were divided into three groups: perforated bovine amnion (treatment group), bovine amnion (control 1 group), and vaseline gauze dressing (control 2 group). All the three groups combined with rb-bFGF. RESULTS: Compared with control 1 group (P < 0.01) and control 2 group (P < 0.05), the treatment group could obviously decrease the healing time of deep degree Ⅱ burn wounds. For superficial degree Ⅱ burn wounds, compared with the control 2 group, the treatment group could also decrease the healing time; however, there was no significant difference between treatment group and control 1 group (P > 0.05). Dressing was not changed frequently, and the pain was relieved. Rash or other adverse effects were not detected in the three groups.CONCLUSION: The combination of perforated bovine amnion and rb-bFGF can obviously promote the healing of burn wounds.

Objective To investigate the expressions of interleukin-33 (IL-33),soluble growth stimulation expressed gene 2 (sST2) and transforming growth factor β1 (TGF-β1) in the patients with systemic sclerosis (SSc) and their correlations.Methods Serum IL-33,sST2 and TGF-β1 levels from 25 SSc patients and 25 healthy controls were determined by an enzyme linked immunosorbent assay (ELISA).The expressions of IL-33 in the damaged skin tissue of SSc patients and normal skin tissue were detected with the immunohistochemical staining.Results Serum IL-33 and TGF-β1 levels in SSc patients were significantly higher than that in healthy controls (P ＜ 0.05),and serum IL-33 levels were positively correlated with TGF-β1 levels in SSc patients (P ＜ 0.05).Immunohistochemical staining results showed that the expression level of IL-33 in the damaged skin tissue of SSc patients were significantly higher than that in normal skin tissue (P ＜ 0.05).However,there was no significant difference in the expression level of sST2 between SSc patinets and healthy controls.Conclusion Serum IL-33 levels in SSc patients increase significantly,which is correlated with the expression of TGF-β1,indicating that IL-33 may play an important role in the process of inflammation and fibrosis of SSc via the regulation of TGF-β1.

OBJECTIVE: To study the ultrastructure change and cell apoptosis in the olfactory mucosa of rats suffering from chronic sinusitis, and aim to elucidate the possible mechanism and provide a novel concept of therapy approach to olfactory disease caused by chronic sinusitis. METHOD: Light microscope and transmission electron microscope were used to observe the ultrastructure changes in the olfactory mucosa of 20 rats suffering from chronic sinusitis and that in 20 cases of normal olfactory mucosa. By the method of TUNEL (TdT-mediated dUTP nick end labeling), we studied the apoptosis index (AI) in the olfactory mucosa of 20 rats suffering from chronic sinusitis and that in 20 cases of normal olfactory mucosa. RESULT: (1) Observation by transmission electron microscope: In the olfactory epithelium of the rats group suffering from chronic sinusitis, the ultrastructure of the olfactory epithelium showed some abnormal changes: Olfactory epithelium cells showed a variety of degeneration ornecrosis, the olfactory epithelium were quite disorganized. Supporting cell nuclei were oval, the nuclei of the cell aggregated as the plaque and fringe collection, the density of cytoplasm decreased. Surface microvillus of the olfactory cells reduced and disappeared, part of the karyolemma defected like morphology change about cell apoptosis. Inflammatory cells infiltrated. Basement membrane was exposed and cells were quite disorganized. Olfactory gland cells were prismatic, cell spaces were widen and secretion increased in the cavosurface. In the olfactory mucosa of normal group, the ultrastructure of olfactory epithelium showed some normal changes: Olfactory epithelium were quite regularity, supporting cells and olfactory cells were radial arrangement, basement membrane were integrated, the structure of olfactory gland were completed, microvirus were in richet in cavosurface and slight of serositim were in the cavosurface; (2) The apoptosis index (AI) in the olfactory epithelium of the rats group suffering from chronic sinusitis was higher than that in normal group (P < 0.05). CONCLUSION There is a ultrastructural change from the surface to the inner of olfactory mucosa in rats suffering from chronic sinusitis. There is notable apoptosis in the olfactory epithelium and propria lamina of rats suffering from chronic sinusitis.
Animals ; Apoptosis ; Chronic Disease ; Female ; Male ; Microscopy, Electron, Transmission ; Olfactory Mucosa ; cytology ; pathology ; ultrastructure ; Rats ; Rats, Sprague-Dawley ; Sinusitis ; pathology