Nitric oxide, an intracellular messenger molecule linked to activation of N Methyl D aspartate(NMDA) receptor, plays a role in morphine tolerance and dependence. Nitric Oxide Synthase (NOS) inhibitors attenuate or block morphine actions. NO/NOS system has an effect on morphine induced place preference. Actions of NO/NOS system are involved in the activation of opioid receptors. The effect of NO/NOS system on the expression of morphine withdrawal symptoms may be partially mediated by noradrenergic neuron system. Thus reviews on interactions between NO/NOS system and opioid system are very important towards applications of opioid analgesic as well as treatment against opioid tolerance and withdrawal.

Objective To investigate the stiffness of lumbar spine after the injury caused by percutaneous diskectomy and evaluate the efficiency of percutaneous lumbar diskectomy by biomechanical study. Methods Four fresh lumbar specimens were used to analyse load-displacement curves in the intact lumbar spine and vertical disc-injured lumbar spine. The concepts of average flexibility coefficient (f) and standardized average flexibility coefficient (fs) were also introduced. Results The load-displacement curves showed a good stabilization effect of the intact lumbar spine and disc-injured lumbar spine in flexion, extention, right and left bending. The decrease of anti-rotation also can be detected (P

OBJECTIVETo investigate the changes in the expression of phospholipase C-gamma1tyr783 (PLC-γ1tyr783) in the condylar cartilage of a young rat during functional mandibular protraction. This work also explores the function of PLC-γ1tyr783 in the rat mandibular condylar cartilage bone remodeling, which could provide experimental evidence for clinical bone ortho- pedic work.

METHODSA total of 60 four-week-old male Sprague-Dawley (SD) rats were used in this study. The rats were divided equally and randomly into experimental group and control group. The functional appliances that were fitted to the upper incisors of the animals in the experimental group were worn 24 h a day after the rats were fed for 7 d with homemade pellet feed. The animals in the experimental group, along with their matched controls, were sacrificed after 1, 3, 7, 14, 21, and 28 d. The bilateral condylar was fixed, decalcified, dehyded, and then conventional paraffin embedded. Immunohisto- chemistry of PLC-γ1tyr783 was applied to observe its express distribution and variation.

RESULTSThe expression of PLC-γ1tyr783 decreased gradually in the control group, which showed age-related changes (P > 0.05). On the 14th day, PLC-γ1tyr783 expres- sion in the experimental group was significantly higher than that in the control group. PLC-γ1tyr783 expression began to appear statistically and significantly different between the two groups (P < 0.01).

CONCLUSIONPLC-γ1tyr783 is involved in the bone remodeling process of the rat condylar cartilage after functional mandibular-protraction.

ObjectiveTo compare the effects between laparoscopic cholecystectomy (LC) +laparoscopic common bile duct exploration(LCBDE) and endoscopic sphincterotomy(EST) + laparoscopic cholecystectomy( LC ) for secondary choledocholithiasis.MethodsThe clinical data of patients with secondary choledocholithiasis receiving LC + LCBDE or EST + LC from January 2008 to December 2009 were retrospectively compared. Parameters included operation time, postoperative complication, length of stay,cost of hospitalization. All patients received follow up of 1 year. Enumeration data was analyzed by chisquare test and measurement data was analyzed by t test.ResultsIn this study 87 patients received LC +LCBDE,76 patients received EST + LC.Patients in LC + LCBDE group had shorter hospital stay, less hospital charges and less complications. There was not difference in the procedure success rate and stone remanent rate between the two groups.ConclusionsLC + LCBDE could be used as the first choice for patients with gallstones and secondary choledocholithiasis.

Objective To research the chronic respiratory infectious diseases caused by Pseudomonas aeruginosa need to objectively the reflection of the real environment in the body, so established a mouse model of chronic pulmonary infection with Pseudomonas aeruginosa and analyzed it's inflammatory response. Methods Establishment of chronic bronchial infection mice model that were inoculated with Pseudomonos aeruginosa-laden agarose beads, and analyzed its inflammatory response by detected the cytokines and MMP-2, and a differential cell count and a total leukocytes count were performed as well. Results Pseudomonas aeruginosa had been detected after infection, and there were changes in pathological. Pulmonary inflammation appeared in 1 d and reached near baseline levels by 7 d after inoculation. It was verified that the peak of inflammatory reaction in Pseudomonas aeruginosa infection is in 2-3 d; the mice did have detectable levels of circulating matrix metalloproteinase-2 ( MMP-2 ) after infection with Pseudomonas aeruginosa. MMP-2 concentrations in the blood serum peaked at 3 d after inoculation. It is indicated that Pseudomonas aeruginosa can initiate a certain degree of pulmonary fibrosis on the basis of the pulmonary inflammation. Conclusion In this study, chronic bronchial infection animal model affected by Pseudomonas aeruginosa was established successfully. Base on this animal model, we can do the pathogenicity and drug resistance of Pseudomonas aeruginosa further study.

In the present study, the specifically knockdown models of P-gp or MRP2 were constructed by using a series of chemically synthesized small interfering RNA (siRNA) in vitro. The expression of P-gp and MRP2 was measured by real-time PCR and Western blot, and the function was evaluated by applying P-gp and MRP2 substrate, rhodamine and methotrexate. The results showed that MRP2 siRNA-3 or P-gp siRNA-2 significantly decreased the mRNA expression of MRP2 or P-gp, the inhibition ratio was 68% or 84%; MRP2 siRNA-3 or P-gp siRNA-2 at a dose of 80 nmol x L(-1) significantly reduced the protein expression of MRP2 or P-gp at 48 h after treatment, the inhibition ratio was 62% or 70%. Meanwhile, other transporters were not influenced by siRNA. When pretreatment with MRP2 siRNA-3 or P-gp siRNA-2, the efflux of methotrexate or rhodamine decreased significantly and the intra-cellular concentration increased. The results suggested that chemically synthesized siRNA could significantly inhibit the expression and function of MRP2 and P-gp, and the model of RNAi in vitro could be used to evaluate the role of efflux transporters in transportation of drugs.

Objective To observe the effect of inhaled glucocorticoids combined with theophylline in smoking patients with bronchial asthma.Methods Seventy-three patients with bronchial asthma were enrolled in this study and they were divided into observation group (34 cases,smoker) and control group(39 cases,no-smoker).They all accepted inhalation of budesonide 200 μ g/suck,bis in die,plus aminophylline tablet (0.1 g,ter in die,per os) for 3 months.After treatment for 3 months,the basal control rate was compared between two groups.The levels of asthma control test (ACT) score,peak expiratory flow (PEF),the first second forced expiratory volume accounted for the percentage of prediction (FEV1％pred),eosinophil leukocyte (EOS) count and immunoglobulin E(IgE) in two groups before and after treatment for 3 months were compared too.Results After treatment for 3 months,the basal control rate in observation group was 88.24％ (30/34),in control group was 92.31％(36/39),and there was no significant difference(P＞ 0.05).After treatment for 3 months,the levels of ACT score,PEF and FEV1％pred in two groups were increased and the levels of EOS count and IgE were decreased than those before treatment,and there were significant difference (P ＜0.05).After treatment for 3 months,the levels of ACT score,PEF,FEV1％ pred,EOS count and IgE in observation group were (22.43 ± 2.64) scores,(292.52 ± 98.64) L/min,(74.87 ± 4.83)％,(270 ± 180) × 106/L,(68.25 ± 13.89) U/L,in control group were(22.81 ± 2.27) scores,(300.34 ± 100.45) L/min,(75.26 ± 5.04)％,(210 ± 170) × 106/L,(65.47 ± 11.28) U/L,and there were no significant differences (P ＞ 0.05).Conclusions Low dose inhaled glucocorticoids combined with theophylline in treatment smoking and non-smoking asthmatics patients are equal.It can improve asthma symptoms and lung function,improve hormone sensitive and reduce airway inflammation.

Objective:To study the clinicopathologic features of IgG4-related pulmonary inflammatory pseudotumor (IRPIP), and its correlations with CD4+T lymphocytes and interleukin-10 (IL-10) expression,and to investigate the immunopathological factors in the disease of IgG4-related pulmonary inflammatory pseudotumor .Methods: Expressions of IL-10, CD3, CD20, CD4, CD8 were examined by immunohistochemistry in 17 cases of IgG4-related pulmonary inflammatory pseudotumor tissues and 15 cases of IgG4-nonrelated pulmonary inflammatory pseudotumor tissues ( INPIP) .To analyze the differences of these indexes expression between IRPIP and INPIP.Results: In group of IRPIP, the CD4+T lymphocytes number and the ratio of CD 4+T lymphocytes number/CD8+T lymphocytes number were all apparently higher than those in the group of INPIP (P=0.006,0.023,respectively).The cells numbers of CD3,CD8,IL-10 positive expression in IRPIP were higer than those in INPIP ,and the cells number of CD20 positive expression in IRPIP was lower than that in INPIP,but these differences all had no statistical significance (P>0.05).In IRPIP,the number of IgG4+plasmacytes was positively related to the number of IL-10+cell (r=0.517),the correlation had statistical significance (P=0.033). Conclusion:The number of CD4+T lymphocytes increased in addition to the increased number of IgG 4+plasmacytes in the lesion back-ground of IRPIP,and the number of IgG4+plasmacytes was positively related to the number of IL-10+cells.It is suggested that the increased number of Th 2 lymphocyte and the increased secretion of cytokine IL-10were are immunopathological factors participated in the disease of IRPIP .

Objective To observe the effect of long-term intensive glucose control therapy on diabetic retinopathy in outpatients with type 2 diabetes mellitus.Methods Forty-nine patients with type 2 diabetes mellitus were randomly assigned to participate in the trial from 2002 to 2007,receiving either intensive (24 cases) or standard glucose control (25 cases).The patients were examined by the same ophthalmologists to identify any new diabetic retinopathy (DR).After 5 years of intensive glucose control,all of the patients were asked to attend our clinic every 6 months,but no attempts were made to maintain their previously assigned therapies.Hemoglobin A1c (HbA1 c) was measured regularly.In November of 2009,a retinal examination was carried out by the same ophthalmologist who worked in the trial.The visual acuity,lens,vitreous body and fundus were examined after pupil dilation to identify diabetic retinopathy (DR).Fundus fluorescein angiography and retinal laser photocoagulation were carried out when necessary.Results In the second year after enrollment in the trail,the median HbA1c level of the intensive-therapy group was significantly lower than that of the standard-therapy group [(6.3 ± 0.6) ％ vs.(7.2 ± 1.2) ％,t =2.09,P ＜ 0.05],and was maintained in a controlled level throughout the following 4 years.During the post-trial monitoring,no new case of of macula edema or diabetic associated blindness occurred in either intensive or standard-therapy group,the whole occurrence of micro-aneurysms,fundus hemorrhage,as well as those who needed retinal laser photocoagnlation and lowering in visual acuity in intensive-therapy group was lower than that in the standard-therapy group (3 vs.14,1 vs.7,2 vs.4,3 vs.11,respectively ;9 vs.36,totally,x2 =4.719,P ＜ 0.05).During the first post-trial monitoring,there was no difference in median HbAlc level between intensive-therapy group and standard-therapy group [(7.2 ± 1.1) ％ vs.(7.3 ± 1.3) ％,t =0.25,P =0.806],which was sustained in the following years.In the trail,no new case of fundus hemorrhage or diabetic associated blindness occurred in intensive-therapy group during the five-year period of therapy.Number of new episodes of micro-aneurysm,macula edema were less in intensive-therapy group than that in standard-therapy group,number of new episodes of lowering in visual acuity,and those who needed retinal laser photocoagnlation,were significantly less in intensive-therapy group than that in standardtherapy group(15 vs.25,4 vs.23,Z =-4.459,P ＜ 0.05) during five-year follow-up.Conclusions The benefit of reduced incidence of diabetic retinopathy in intensive glucose can be maintained because of the legacy effect.

Objective To compare the effects of salmeterol and fluticasone propionate combined montelukastin the treatment of patients with bronchial asthma.Methods Ninety-eight bronchial asthma patients from April 2014 to March 2016 in the Fourth People's Hospital Sichuan Province were selected anddivided into observation group and control group with 49 patients in each group according to the above principles by prospective study.The control group was given salmeterol treatment,and the observation group was added given montelukast treatment based on the control group.The treatment days were 15 d recorded the prognosis of the two groups.Results The total effective rates of the observation group and the control group were 95.9％ and 81.6％ respectively,the total effective rate of the observation group was significantly higher than that of the control group (P ＜ 0.05).The FEV1 and FVC values after treatment in the observation group and control group were significantly higher than before treatment (P ＜ 0.05),while the FEV1 and FVC values in the observation group after treatment were significantly higher than those in the control group (P ＜ 0.05).The scores of ACT scale after treatment of two groups were obviously higher than before treatment,and the score of observation group was statistically higher than control group after treatment (P ＜ 0.05).During treatment,there was no statistical significance on adverse reaction between two groups.Conclusion Salmeterol and fluticasone propionate combined montelukast in the treatment of patients with bronchial asthma can promote the improvement of lung function,so as to improve the quality of life and clinical treatment.