Objective To investigate the interaction between NMDA receptor subunit 2B (NR2B) and metabotropic glutamate receptor 5 (mGluR5) in the spinal cord of morphine-tolerant rats. Methods Sixteen male SD rats weighing 220-280 g were randomly divided into 2 groups with 8 rats in each group: control group (C) and morphine group (M). In group M morphine 10μg was administered intrathecally (IT) twice a day for 7 consecutive days. In group C equal volume of normal saline was given instead of morphine. Tail flick latency (TFL) (a segment of tail 4-5 cm long was immersed in 52-53℃ hot water) was used to measure the antinocicepitve effect of morphine before and 30 min after morphine administration every morning. MPE (percentage of maximal possible effect) was calculated (pain threshold after drug administration - baseline pain threshold)/(10- baseline pain threshold)× 100% . The animals were killed at the next day after last IT administration and the dorsal half of L4-5 spinal cord was isolated and homogenized for determination of NR2B and mGluR5 protein expression by Western blot and CO-IP. Results MPE was significantly increased at 1-5 d of drug administration and returned to baseline at 7 d in group M as compared with group C. The mGluR5 protein expression was significantly up-regulated in group M as compared with group C but there was no significant difference in NR2B protein expression between the 2 groups. Conclusion There is interaction between NK2B and mGluR5 in the spinal cord of morphine-tolerant rats.

In order to explore the objective rule and the key factors in the development of diseases, the process from quantitative change to qualitative change, and from health through sub-health to disease, a new thinking of research, enitled by "Constitution-Subhealth-Disease Relation Developing Axis" is offered by the author. This axis took the CM theory on body constitution as a core, with the coordinates composed of physiological and pathological indices concerning the quantitative changes of illness accumulated under sub-health state. Meanwhile, the key factors for advancing the access and inducing qualitative change of illness were denoted. The orientation of the research is starting from two aspects, horizontally on the crowd possessing the same body constitution, and longitudinally on the same person in different conditions. The research sum-up the general rule of disease occurrence through individually studying the process in persons with different body constitutions, then the commonness of diseases developed from the bottom was explored by applying the outcomes of the foregoing global study on the sorted researches of different constitutions.
Humans ; Medicine, Chinese Traditional ; methods

Objective To explore effects of heat stress response on neutrophil apoptosis and respiratory burst function. MethodsNeutrophils from each of 18 healthy volunteers were divided into 3 parts,and one part was served as control group,and the other two parts were induced by heat shock or cadmium chloride for heat stress response and named as heat shock group and cadmium chloride group.The neutrophils were incubated in culture medium.At 0,2,3,4,and 6 h following heat stress induction,the heat shock protein(HSP70) expression and the respiratory burst were detected in the neutrophils respectively by using PCR technique and flow cytometer.Level of apoptosis was observed by immuno-fluorescence and flow cytometer DNA ploid at 24 h after heat stress induction. Results In the heat shock and cadmium chloride groups,HSP70 expression at each time point and cell apoptosis at 24 h were significantly higher than those of control group(P

Objective To explore the extent of axillary lymph node dissection in breast cancer patients with positive sentinel lymph nodes.Methods In this series,95 patients underwent complete axillary lymph node dissection (CALND) following positive sentinel lymph nodes identified and 97 patients underwent partial axillary lymph node dissection (PALND) at the absence of positive sentinel lymph nodes.The influence of different extent of axillary lymph node dissection was evaluated.Results The positive rate of level(Ⅰ + Ⅱ) non-sentinel lymph nodes (NSLN) and level Ⅲ lymph nodes was 68.4％ and 29.5％,respectively,in CALND group.In PALND situation,57.9％ CALND cases would have changed pathologic stage from pN1 to pN2 or pN3.But with level Ⅲ lymph node dissection followed PALND,only 2.1％ cases had changed pathologic stage from pN2 to pN3.Multivariate logistic regression showed that the number of positive SLNs (OR =2.157) and positive rate of SLNs (OR =10.374) were risk factors for having positive level Ⅲ lymph nodes.CALND needed longer operation time and larger postoperative drainage volume.Conclusions In cases of breast cancer with ≥ 3 positive sentinel lymph nodes,complete axillary lymph node dissection should be considered.

OBJECTIVETo explore effective approaches of treating elderly patients with distal tibiofibular fractures.

METHODSFrom August 2008 to October 2012,175 elderly patients with distal tibiofibular fractures were treated with locking compression plate (LCP) through anterior tibial. There were 112 males and 63 females with an average of 71.3 (ranged 60 to 83) years old. Of them,89 cases were treated by anterior tibial tension reduced incision with LCP,including 62 males and 27 females with a mean age of (71.8 +/- 6.4) years old. Eighty-six patients were treated by distal tibial incision with LCP,including 58 males and 28 females with a mean age of (70.3 +/- 6.7) years old. Swelling time, operation time, intraoperative blood loss, hospital stay, healing time, complications and AOFAS scores were compared between two groups after operation.

RESULTSSwelling time in anterior tension reduced incision with LCP and distal tibial incision with LCP was (5.6 +/- 1.3) and (9.7 +/- 2.1) days, healing time was (4.2 +/- 1.4) and (5.4 +/- 1.9) months,and complications were found 3 in tension reduced incision and 10 in distak tibial incision respectively;and all data shown statistically significant differences between two groups (P < 0.05). At 12 months after operation,AOFAS score was 89.0 +/- 9.7, 87.9 +/- 9.4; and there was no statistically significant difference between two groups (P > 0.05).

CONCLUSIONTension reduced incision through anterior tibial combined with locking compression plate fixation in treating elderly patients with distal tibiofibular fractures can provide good clinical effects with quick fracture healing and low complications.

Adult ; Aged ; Aged, 80 and over ; Bone Plates ; Female ; Fibula ; injuries ; surgery ; Fracture Fixation, Internal ; instrumentation ; methods ; Humans ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; Tibia ; injuries ; surgery ; Tibial Fractures ; surgery ; Treatment Outcome

OBJECTIVETo evaluate the applicability of immune-related response criteria (irRC) in treating non-small cell lung cancer (NSCLC) by Chinese medicine (CM).

METHODSTotally 97 stage III a-IV NSCLC patients were predominantly treated with comprehensive CM. Curative effects were evaluated by three methods such as Response Evaluation Criteria in Solid Tumors (RECIST), Oncologic Curative Effect Evaluation Criteria of Chinese Medicine in Solid Tumor (draft, abbreviated as CM criteria), and irRC. The correspondency and consistency between irRC, RECIST and CM criteria were analyzed and compared. The objectivity of irRC in evaluating curative effect of Chinese medical treatment for NSCLC was assessed.

RESULTSThe correspondency rate of irRC to RECIST was 59. 79% with Kappa value of 0. 379 (U test, P <0. 01). The two criteria had certain correspondence, but with an unsatisfactory consistency. The correspondency rate of irRC to CM criteria rate was 83. 51% with Kappa value of 0.751 (U test, P <0. 01). The two criteria had good correspondence and consistency.

CONCLUSIONSCM criteria had good consistency with CM criteria in evaluating curative effect for Chinese medical treatment of advanced NSCLC. Its results could objectively reflect features and advantages of CM for treating advanced NSCLC.

Asian Continental Ancestry Group ; Carcinoma, Non-Small-Cell Lung ; drug therapy ; immunology ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Lung Neoplasms ; drug therapy ; immunology ; Medicine, Chinese Traditional ; standards ; Treatment Outcome

Adenocarcinoma ; metabolism ; pathology ; Adenocarcinoma, Mucinous ; metabolism ; pathology ; Adult ; Aged ; Aged, 80 and over ; Carcinoma, Signet Ring Cell ; metabolism ; pathology ; Erythropoietin ; metabolism ; Humans ; Hypoxia-Inducible Factor 1, alpha Subunit ; metabolism ; Immunohistochemistry ; Lymphatic Metastasis ; Microvessels ; chemistry ; pathology ; Middle Aged ; Stomach ; chemistry ; pathology ; Stomach Neoplasms ; metabolism ; pathology ; Tissue Array Analysis ; methods

Objective To compare the curative effect of high ligation+exfoliation and subfascial endoscopic perforator surgery(SEPS)for superficial varicose veins in calf+invagination spot-striping surgery in great venous varicosity.Methods Study group(42 patients)accepted SEPS+invagination spot-striping surgery and control group (42 patients)accepted traditional surgeries.Operation duration,bleeding volume in operation,the time of beginning movement away from bed after operation,hospitalization duration,the degree of pain,the scar,the recrudescence af- ter operation and the instance of the ulcer heals of two groups were compared.Results Operation duration,bleeding volume in operation,the time of begin movement away from bed after operation and hospitalization durations of study group were significantly lower than those of control group(P0.05).All of the patients in study group recovered without severe syndromes such as venous thrombosis,skin necrosis,lower limb functional disorder etc.They had no recrudesce after 4～16 months and were satisfied with the curative effect.Con- elusions The clinical curative effect of SEPS+invagination spot-striping surgery in great venous varicosity is superi- or to that of traditional operation and it has the advantages such as minor wound,few scars,light pains,short hospi- talization duration,without recrudescence,the ulcer heals quickly and so on.

Objective To investigate the effect of electrical stimulation of S_3 nerve root on improvement of intestinal mucosal barrier function in rabbits with acute complete spinal cord injury. Methods Model of paraplegia was built by injuring spinal cord in rabbits. Then, the rabbits with electrical stimulation of S_3 nerve root were set as experimental group and those without set as control group. Normal rabbits were set as normal group. Under aseptic condition, portal vein blood was collected for quantitative determination of endotoxin and bacterial culture ; and liver, spleen and mesenteric lymph nodes were collected for bacterial culture and strain identification. Liver, spleen, mesenteric lymph nodes and small intestines were collected from experimental group and control group for pathological HE staining; while small intestine were observed by light and electron microscopes. Results In control group, the intestinal mueosal barrier and the other organs were destroyed obviously, with higher level of Serum endotoxin and higher rate intestinal flora translocation than that in experimental group and normal group. In the experimental group, the electrical stimulation of S_3 nerve root could improve motility of the denervated intestine, with more defecation content, less destruction of the intestinal mucosa and lighter other organ damage compared with control group, serum endotoxin level was significantly reduced compared with control group but showed no statistical difference compared with normal group, with obvious decrease of bacterial translocation rate. Conclusions After spinal cord injury in rabbits, electrical stimulation of S_3 nerve root can facilitate intestinal tract motility, improve intestinal mucosal barrier function and hence alleviate endotoxemia and intestinal bacterial translocation, as is beneficial to reducing SIRS and MOBS.

OBJECTIVETo summarize the complications and the early clinical effect of less invasive stabilization system and the femoral condylar support plates in the treatment of AO type C distal femoral fractures.

METHODSFrom September 2007 to February 2012, 46 patients with AO type C distal femoral fractures were retrospectively studied. Of all patients 25 were treated with less invasive stabilization system including 14 males and 11 females with a mean age of (56.3±4.2) years old; according to AO classification, there were 14 cases of C1, 8 cases of C2 and 3 cases of C3 with a mean hospital stay of (15.6±1.7) days. While 21 cases were treated with femoral condylar support plates fixation including 12 males and 9 females with a mean age of (53.8±5.1) years old;there were 13 cases of C1, 6 cases of C2 and 2 cases of C3 with a mean hospital stay of (17.8±2.2) days. Comparative analysis was performed from the operation related index,postoperative complications and Evanich score of the knee joint function between the two groups at follow-up.

RESULTSAll 46 patients were followed up from 13 to 38 months with a mean time of 19.6 months after surgery. Complications included 1 case with infection,3 cases with internal fixation failure, 1 case with nonunion and 1 case with activity limitation of the affected knee. The differences in the incision length, blood loss, fracture healing time were significant between two groups (P<0.05), while there was no significant difference in the duration of operations, hospital stays and the incidence of postoperative complications between two groups (P>0.05). The statistical significance was also found in the Evanich score at last follow-up between two groups (P<0.05).

CONCLUSIONPatients with less invasive stabilization system fixation had the characteristics of less trauma, shorter fracture healing time and better functional recovery. Less invasive stabilization system had became one of the ideal internal fixations in the treatment of AO type C distal femoral fractures.

Adult ; Aged ; Bone Plates ; Female ; Femoral Fractures ; surgery ; Fracture Fixation, Internal ; adverse effects ; instrumentation ; Fracture Healing ; Humans ; Length of Stay ; Male ; Middle Aged ; Postoperative Complications ; epidemiology