Objective: To investigate the effects of morphine,tramadol and lornoxicam on the secretion of inflammatory mediators by rats'peripheral blood mononuclear cells(PBMC) at their analgesic concentrations. Methods: Mononuclear cells were isolated from peripheral blood of male SD rats by the Ficoll-Hypaque method,and treated with Morphine(50 ng/ml),Tramadol(500 ng/ml) or Lornoxicam(300(ng/ml)) respectively with or without stimulation by Lipopolysaccharide(LPS) 2 ?g/ml.After incubation for 24 h,concentrations of TNF-?,IL-6 and IL-10 were determined in the cell culture supernatants by ELISA. Results: Levels of TNF-?,IL-6 and IL-10 were reduced significantly in morphine groups with or without LPS;Tramadol reduced levels of these inflammatory mediators significantly in the groups stimulated with LPS,while it had no effects on the cells cultured in normal conditions;Lornoxicam reduced IL-6 and increased IL-10 levels in either groups. Conclusion: Morphine nonselectively suppressed mediator secretions either under inflammatory or physiological conditions;Tramadol reduced inflammatory mediator secretion in LPS stimulating group,thus could benefit patients with potential sepsis;Lornoxicam significantly reduced proinflammatory cytokine IL-6 secretion and increased anti-inflammatory cytokine IL-10 secretion,and may be a choice for postoperative hyperinflammation.

Objective To explore the effect of mon-suturing peritoneum in perforating purulent infection of incisional wound of appendicitis. Methods907 patients suffered purulent perforating and gangrenous appendicitis were divided randomly into two groups:the non-suturing group of 355 patients and the control group of 552 patients.Of the non-suturing group,peritoneum was not sutured when his/her abdominal cavity was closed.It was just on the contrary to the control group.Then examined whether eoncotic rythrogenic or tender incision occurred,or whether purulent secretion flowed outside from the operative incision.These items below were also been recorded carefully:the average number of days when the temperature was abnormal,the grades of healing of incision and the average hospital stay. ResultsIn the non-suturing group,21(5.9%)patients suffered postoperative infection,the number of days of abnormal temperature was(3.8 ± 1)d on average,and the average hospital stay was(7.5 ± 1)d;in the control group,119(21.6%)patients suffered postoperative infection,the number of days of abnormal temperature was(4.3 ± 1)d on average,and the average hospital stay was(12.9 ± 1)d.First rate healing of incision in the non-suturing group was far higher than that in the control group(P＜0.05). ConclusionNon-suturing peritoneum could help internal drainage peritoneum,which was an efficient way to guard against the postoperative infection.And non-suturing was also of great significance to reduce the average number of days of abnormal temperature and hospital stay.Meanwhile,the probability of ankylenteron and incisional hernia was not increased.

Methods A cluster random sampling method was used to select left-behind students in Grade 3 to 6 in 5 primary schools in the southern rural area of Ningxia Hui Autonomous Region. Their general information were collected, their social anxiety and loneliness were evaluated by the Child Social Anxiety Scale ( SASC ) and Children's Loneliness Scale ( CLS ). The multivariate linear regression model was used to analyze the influencing factors for the social anxiety of left-behind children.

Perioperative stroke refers to acute ischemic or hemorrhagic stroke that occurs before operation,during operation and within 30 days after operation.Although the levels of anesthesia and surgical treatment have improved in recent years,there is no significant decrease in the incidence of perioperative stroke.The traditional vascular risk factors,such as advanced age,hypertension,and diabetes,are also the risk factors for stroke onset.In addition,perioperative stroke is closely associated with the operation site,operation mode,anesthesia,and other perioperative events.The treatment and prevention of perioperative stroke is attracting more and more attention,including surgery,anesthesia,neurology and other clinicians.This article reviews the risk assessment,prevention,and treatment of perioperative stroke.

SUMMARY A 61-year-old male patient, with the history of premier myocardial infarction and CABG surgery, experienced recurrent unstable angina. Angiography showed triple vessel disease and vein grafts obstruction. The patient underwent a re-do OPCAB + TMLR + bone marrow mononuclear cell (BM-MNCs) transplantation on Nov. 8, 2004. BM-MNCs were isolated with standard gravity gradient method and the final implanted cell number was 12.06?108. Peri-operative data were similar to those of single OPCAB or re-CABG. The patient recovered promptly without recurrence of angina or infarction. Six-minute walking distance increased significantly (366 m to 493 m). Several imaging examinations reveal improved left cardiac function (LVEF improved from 23.75% to 52% in MRI) and diminished MI area. The results reveal that bone marrow cell transplantation, combined with TMLR and OPCAB is safe and might be effective in improving heart function for patients with IHD.

Objective:To compare the clinical and imaging characteristics between central nervous system vasculitis(CNSV)and mitochondrial encephalomyopathy(ME),so as to analyze the differential diagnosis of the two disorders.Methods:Clinical data on seven patients with CNSV and five with ME were retrospectively analyzed.The clinical manifestations,laboratory parameters,imaging features and histological characteristics were compared to screen for the evidence of their differential diagnosis.Results:The MRI results of both CNSV patients and ME patients(MELAS type)showed a multi-lesion pattern.The symptoms of CNSV patients included headache,limbs weakness,and erythrocyte sedimentation rate(ESR)increase.The symptoms of MELAS patients included epilepsy and increased serum lactic acid.The electroencephalographic manifestations of both diseases were abnormal:CNSV patients mainly had diffused lesions accompanied with limited alterations;ME patients had evidence of epileptic discharge,which was consistent with the clinical symptoms.Conclusion:Clinical manifestations of CNSV and ME patients are more valuable than imaging findings in the diagnosis of the two diseases.CNSV is characterized by vascular disorders and inflammatory reactions;ME is characterized by abnormal energy metabolism and severe damage of gray matter.The final diagnosis should depend on laboratory and histological examinations.

Objective To compare expression and distribution of CD68 protein and TRAP positive protein in ankylosing spondylitis (AS), rheumatoid arthritis (RA), osteoarthritis (OA), and normal synovial tissues to study the differentiation of osteoclast in synovial tissues obtained from AS patients and its role in the pathogenesis of bone destruction in AS. Methods Immunohistochemical analysis was performed using CD68 monoclonal antibody to detect CD68 expression, and the distribution of TRAP positive cells in the synovial tissues was examined by enzyme histochemistry in 13 AS, 16 RA, 17 OA patients and 6 healthy controls. The above two variables were quantified in the labeled sections by digital image analysis and semiquantitative analysis to compare the expression of CD68 positive cells in different patient groups and normal subjects. Results Positive CD68 staining was seen in synovial cells from all the patients with AS, RA, OA and normal subjects, and the expression levels of CD68 from patients with AS and RA were higher than those from OA patients and healthy subjects. The CD68 positive cells were abundant mainly in lining layer. In areas where elevated RANKL expression levels were present, the number of TRAP positive cells was found significantly increased in AS and RA synovium. TRAP positive cells were rarely observed in synovium from OA patients and normal controls. There was positive correlation between the number of TRAP positive cells and the RANKL expression (r=0.442, P=0.043) in RA patients. Conclusions An obvious increase in the number of CD68 positive cells and TRAP positive cells in synovium may provide a main source of osteoclastogenesis in AS patients. The up-regulation of activity and quantity of osteoclast may have an important role in peripheral articular destruction in patients with AS.

Objective: To observe the clinical effects of comprehensive treatmenton cutaneous region for low back pain.
Methods: One hundred and twenty outpatients with low back pain who met the diagnostic criteria were randomly divided into a cutaneous region group or a medication group, 60 cases in each group. The cases in the cutaneous region group were treated by Nie-pinching up the skin of the lumbosacral region, cupping and acupuncture. Those in the medication group were treated by oral administration of Celecoxib capsule. The visual analogue scale (VAS) and Oswestry disability index (ODI) were used to assess the therapeutic effects.
Results: After treatment, the VAS scores of both groups were different from those before treatment, showing statistical significances (allP<0.01). The D-valuse of VAS scores of both groups were different from those before treatment, showing statistical significances (allP<0.01). The D-value of OID scores in the cutaneous region group was significantly different from that in the medication group(P<0.01). After treatment, the total effective rate was 91.7% in the cutaneous region group versus 76.7% in the medication group, there was a significant difference in comparing the clinical effect (P<0.01).
Conclusion: Both comprehensive treatment on the cutaneous region and Celecoxib capsule can obviously relieve low back pain. But comprehensive treatment on the cutaneous region is better than Celecoxib capsule in the therapeutic effects.

BACKGROUND:Autologous peripheral blood stem cels have pluripotent characteristics, promote ischemic limb angiogenesis, improve and restore the blood supply to the affected limb.
OBJECTIVE:To observe the therapeutic effect of autologous peripheral blood mononuclear cel transplantation in rats with thromboangitis obliterans.
METHODS:Twenty-four rats were randomized into control, model and granulocyte colony stimulating factor (G-CSF) groups. In the latter two groups, animal models of thromboangitis obliterans were established by femoral arterial injection of sodium laurate. In the G-CSF group, rats were injected with recombinant human G-CSF for 5 successive days for peripheral blood mononuclear cel mobilization, and then underwent peripheral blood mononuclear cel transplantation at day 7. In the control and model groups, rats were given normal saline injection.
RESULTS AND CONCLUSION:After modeling, foot dorsum temperature and the percentage of CD4+CD25+ regulatory T cels decreased significantly in the model and G-CSF groups, and the area of leg ulcers was enlarged notably in these two groups. In the G-CSF group, the number of white cels and percentage of CD34+ cels to mononuclear cels were increased at 6 days after mobilization; the foot dorsum temperature and the percentage of CD4+CD25+ regulatory T cels increased significantly at 1 month after peripheral blood mononuclear cel transplantation, which were close to the normal values. These findings indicate that autologous peripheral blood mononuclear cel transplantation folowing cel mobilization increases the percentage of CD4+CD25+ regulatory T cels in rats with thromboangitis obliterans, thus promoting relief of symptoms and ulcer healing.

BACKGROUND:Studies have shown that neural stem cel transplantation has a certain effect on neuropathic pain, but the efficacy of transplanted cel number on neuropathic pain is not exactly understood. OBJECTIVE:To observe the effect of different amount of neural stem cels administered intrathecaly on the neuropathic pain and expression of glial-derived neurotrophic factor in the spinal cord dorsal horn and dorsal root ganglion in rats after partial sciatic nerve transaction. METHODS:A Sprague-Dawley rat at 14-16 days of pregnancy was used to prepare neural stem cel suspensions that were injected intrathecaly into rat models of partial sciatic nerve transaction at doses of 1×103, 1×104, 1×105, 1×106, 1×107cels per 30 μL, respectively. Additionaly, model group and sham-operated group were set up. Threshold values of mechanical and thermal pain were recorded 1 day before operation, 1, 3, 7, 14, 21 days after operation. Expressions of glial-derived neurotrophic factor protein and mRNA in the ipsilateral spinal cord dorsal horn and dorsal root ganglion were detected by immunohistochemistry and RT-PCR, respectively, at 7 and 21 days after partial sciatic nerve transaction. RESULTS AND CONCLUSION: Pain threshold values were decreased in al the groups except the sham-operated group at 1 day after operation, and reached the peak at 7 and 14 days after operation (P < 0.05). Compared with the model group, the pain threshold values and the expression of glial-derived neurotrophic factor protein and mRNA in the ipsilateral spinal cord dorsal horn and dorsal root ganglion were increased gradualy in a dose-dependent manner in the 1×104, 1×105, 1×106, 1×107 groups at 7 days after operation (P < 0.05). At 21 days post-operation, the pain threshold values showed no differences from the preoperative findings in the 1×105, 1×106, 1×107 groups, but the expression of glial-derived neurotrophic factor was significantly higher in the 1×105 group than the other groups (P < 0.05). Taken together, intrathecal transplantation of neural stem cels at a dose of 1×105 is the most effective in aleviating partial sciatic nerve transaction-induced neuropathic pain in rats.