Objective To investigate the change in 5-hydroxytryptomine (5-HT) content in spinal dorsal horn in a rat model of tibial bone cancer pain (BCP). Methods Sixty female SD rats weighing 160-180 g were randomly divided into 3 groups ( n = 20 each): control group (group C), sham operation group (group S) and BCP group. BCP was induced by intra-tibial inoculation of 10 μl Walker 256 breast cancer cell suspension in group BCP, while group S received intra-tibial inoculation of 10 μl D-hank solution. Paw withdrawal threshold to mechanical stimulation with yon Frey filaments (MWT) was measured 1 d before (baseline) and at 3, 5, 7, 9, 11,14, 16, 18 and 21 d after breast cancer cell inoculation. At 1 d before and 7, 14 and 21 d after breast cancer cell inoculation, four animals in each group were sacrificed after measurement of MWT. Their lumber segments of the spinal cord were removed for assay of 5-HT content in spinal dorsal horn using HPLC with fluorescence detector.HE staining was used to detect the damage to the tibia. Correlation between the 5-HT content and MWT was analyzed. Results MWT was significantly decreased after breast cancer cell inoculation in group BCP ( P ＜ 0.05).Microscopic examination showed serious bone destruction of tibia at the injection site in group BCP, while no bone destruction was found in groups C and S. 5-HT content in spinal dorsal horn was significantly higher in group BCP than in groups C and S (P ＜ 0.05). There was strong negative linear correlation between 5-HT content in spinal dorsal horn and MWT ( r = - 0.973, P ＜ 0.05 ). Conclusion The 5- HT content in spinal dorsal horn is significantly increased in rats with tibial BCP and is involved in the development of BCP.

Objective To investigate the effects of protocadherin 20 (PCDH20) in the spinal cord in the development of bone cancer pain (BCP) in rats.Methods Thirty-six SPF female Sprague-Dawley rats,weighing 180-200 g,were randomly divided into 4 groups (n =9 each):sham operation group (group S),BCP group,lentivirus control group (group LC) and PCDH20 siRNA lentivirus group (group P).Control lentivirus and lentivirus containing PCDH20 siRNA 4 μl were injected into the ipsilateral spinal cord in groups LC and P,respectively.One week later,BCP was induced by injection of Walker 256 breast cancer cells into the upper segment of bone marrow of right tibia.The mechanical paw withdrawal threshold (MWT) was measured at 1 day before injection of lentivirus (T1),1 day before BCP (T2),and 7,14 and 21 days after BCP (T3-5).Three rats in each group were sacrificed after measurement of the MWT at 21 day after BCP and the tibia on the operated side was obtained for examination of invasion of the cancer cells with light microscope.The spinal cord was removed for determination of the expression of PCDH20 and postsynaptic density 95 (PSD95) protein (by Western blot) and mRNA (by RTPCR).Results In groups BCP,LC and P,the cancer cells grew out of the bone and destroyed the cortical bone seriously.Compared with group S,the MWT was significantly decreased at T3-5 in groups BCP,LC and P,the expression of PCDH20 and PSD95 protein and mRNA was up-regulated in groups BCP and LC,and the expression of PCDH20 was up-regulated in group P (P ＜ 0.05).Compared with BCP group,no significant change was found in the MWT and expression of PCDH20 and PSD95 protein and mRNA in group LC (P ＞ 0.05),and the MWT was significantly increased at T4,5 and the expression of PCDH20 and PSD95 protein and mRNA was down-regulated in group P (P ＜ 0.05).Conclusion PCDH20 is involved in the development of BCP through regulating the expression of PSD95 in the spinal cord and adjusting the function of excitatory synapse in rats.

Objective To evaluate the efficacy of oxycodone in preventing catheter-related bladder discomfort (CRBD) during recovery from anesthesia in the patients undergoing general anesthesia.Methods A total of 155 male patients, aged 18-60 yr, weighing 46-75 kg, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ , scheduled for elective spinal surgery performed under general anesthesia, were randomly divided into 3 groups: control group (group C, n =52), oxycodone group (group O, n=51), and sufentanil group (group S, n=52).After induction of anesthesia, the patients were tracheally intubated and mechanically ventilated.At 15 min before the end of surgery, oxycodone 0.07 mg/kg was injected intravenously in group O, sufentanil 0.10 μg/kg was injected intravenously in group S, and the equal volume of normal saline was given in group C.The emergence time and extubation time were recorded.Riker sedation-agitation scale (SAS) score was recorded at 5, 15 and 30 min, and 1, 2 and 4 h after extubation (T1-6).The occurrence and severity of CRBD within 4 h after surgery, and occurrence of nausea and vomiting and respiratory depression were observed and recorded.Results Compared with group C, the SAS score at T1-4 and incidence and severity of CRBD were significantly decreased, and the emergence time and extubation time were prolonged in group S, and the SAS score at T1-6 and incidence and severity of CRBD were significantly decreased (P＜0.05) , and no significant change was found in emergence time and extubation time in group O (P＞0.05).Compared with the group S, the SAS score at T1-4 was significantly increased, the SAS score at T5-6 and incidence and severity of CRBD were decreased, and the emergence time and extubation time were shortened in group O (P＜0.05).There was no significant difference in the incidence of nausea and vomiting and respiratory depression between the three groups (P＞0.05).Conclusion Oxycodone 0.07 mg/kg injected intravenously at 15 min before the end of surgery can prevent the occurrence of CRBD during recovery from anesthesia in the patients undergoing general anesthesia.

Objective To construct lentivirus vector expressing antigene RNA and ferritin gene.Methods Intermediate plasmid pGC-FU-HF was constructed by transfecting lentivirus vector pGC-FU with heavy chain ferritin subunit gene.The target plasmid pGC-agRNA-HF was subsequently constructed by transfecting the intermediate plasmid with β-arrestin 2 antigene RNA.The NG108-15 cells were transfected with the target plasmid.The titre of lentivirus vector was measured by RT-PCR.The expression of antigene RNA and ferritin gene was determined by Western blot and RT-PCR.Results Lentivirus vector was successfully transfected with antigene RNA and ferritin gene.The titre of lentivirus vector was 2.00 × 109 TU/ml.The expression of β-arrestin2 protein was down-regulated and the expression of ferritin protein up-regulated in the NG108-15 cells after being transfected with the lentivirus vector.Conclusion Lentivirus vector expressing antigene RNA and ferritin gene has been successfully constructed.

Descending nociceptive modulation from the supraspinal structures plays an important role in cancer-induced bone pain (CIBP). Rostral ventromedial medulla (RVM) is a critical component of descending nociceptive facilitation circuitry, but so far the mechanisms are poorly known. In this study, we investigated the role of RVM glial activation in the descending nociceptive facilitation circuitry in a CIBP rat model. CIBP rats showed significant activation of microglia and astrocytes, and also up-regulation of phosphorylated p38 mitogen-activated protein kinase (p38 MAPK) and pro-inflammatory mediators released by glial cells (IL-1β, IL-6, TNF-α and brain-derived neurotrophic factor) in the RVM. Stereotaxic microinjection of the glial inhibitors (minocycline and fluorocitrate) into CIBP rats' RVM could reverse the glial activation and significantly attenuate mechanical allodynia in a time-dependent manner. RVM microinjection of p38 MAPK inhibitor (SB203580) abolished the activation of microglia, reversed the associated up-regulation of pro-inflammatory mediators and significantly attenuated mechanical allodynia. Taken together, these results suggest that RVM glial activation is involved in the pathogenesis of CIBP. RVM microglial p38 MAPK signaling pathway is activated and leads to the release of downstream pro-inflammatory mediators, which contribute to the descending facilitation of CIBP.

Objective To understand the present situation of occupational low back pain of clinical nurses, and analyze its influence factors.Methods A questionnaire survey was conducted among 1300 clinical nurses from 7 Class Ⅲ Grade A general hospitals in 5 provincial capital cities, in the region of north China, central China, southern China, southwest and northwest, from April to December 2016. The survey tools included general demographic characteristics questionnaire, Visual Analogue Scale (VAS) and Chinese version of Fear-Avoidance Belief Questionnaire (FABQ-CHI). A total of 1300 questionnaires were distributed, and 1279 valid were collected. SPSS 21.0 was applied for statistical analysis.Results In the 1279 nurses, 115 (8.99％) had no low back pain, and 1164 (91.01％) was positive. The majority of nurses suffered with mild pain, account for 64.69％. The average score of FABQ-CHI in negative nurses was (50.11±17.5), and that in positive nurses was (55.24±8.2), the difference was statistically significant (t=14.56,P< 0.001). Univariate analysis showed that there were significant differences in VAS scores among nurses of different ages, marital status, fertility status, professional titles, working years, and whether or not they participated in training (P<0.01). Multivariate analysis showed that age (OR=1.40) and professional title (OR=1.84) were the influencing factors of low back pain.Conclusions The incidence of occupational low back pain in nurses is high, and it is related to individual factors, work related factors and psychological factors. It is suggested that great attention should be paid to the popularization of knowledge on prevention and treatment of low back pain and the training of occupational protection skills for clinical nurses. Especially, we should pay attention to the correlation between psychological factors and nurses' occupational low back pain, gradually improve the working environment and bad living habits of nurses, reduce the occurrence of low back pain, and improve the job satisfaction of clinical nurses.

Objective To investigate the transitional care needs of ischemic stroke patients when they were discharged and analyze the influencing factors.Methods Transitional care needs of stroke patients questionnaires were conducted in 136 ischemic stroke patients in the department of neurology from April 2014 to December 2014.Results Telephone follow-up was the easiest way of transitional care to be accepted by patients. The transitional care needs included five aspects:safe medication(86.0%),blood pressure self monitoring(83.1%),diet guiding(83.1%),rehabilitating exercise(80.1%) and stroke knowledge(75.7%). The influencing factors of transitional care needs were:the patients with previous medical history demanded much more on the safe medication intervention than the patients without history disease. The demand of the patients with previous medical history was 7.17 times as much as that of the patients without previous medical history (OR=7.15,95%CI:1.83-27.94).The demand of the patients with previous medical history on "rehabilitation exercise" was 4.68 times as much as that of the patients without previous medical history (OR=4.68,95%CI:1.40-15.63). The demand of the patients over 60 years old on "diet guiding" was 11.41 times as much as patients under 50 years old (OR=11.41,95%CI:1.75-74.46).Conclusions For ischemic stroke patients,telephone follow-up can be used as the method of transitional care. Older patients and patients with previous medical history are the main patients who need transitional care.

Descending nociceptive modulation from the supraspinal structures plays an important role in cancer-induced bone pain (CIBP).Rostral ventromedial medulla (RVM) is a critical component of descending nociceptive facilitation circuitry,but so far the mechanisms are poorly known.In this study,we investigated the role of RVM glial activation in the descending nociceptive facilitation circuitry in a CIBP rat model.CIBP rats showed significant activation of microglia and astrocytes,and also up-regulation of phosphorylated p38 mitogen-activated protein kinase (p38 MAPK) and pro-inflammatory mediators released by glial cells (IL-1β,IL-6,TNF-a and brain-derived neurotrophic factor) in the RVM.Stereotaxic microinjection of the glial inhibitors (minocycline and fluorocitrate) into CIBP rats' RVM could reverse the glial activation and significantly attenuate mechanical allodynia in a time-dependent manner.RVM microinjection of p38 MAPK inhibitor (SB203580) abolished the activation of microglia,reversed the associated up-regulation of pro-inflammatory mediators and significantly attenuated mechanical allodynia.Taken together,these results suggest that RVM glial activation is involved in the pathogenesis of CIBP.RVM microglial p38 MAPK signaling pathway is activated and leads to the release of downstream pro-inflammatory mediators,which contribute to the descending facilitation of CIBP.

Objective: To investigate the serotype distribution and antimicrobial susceptibility pattern of Streptococcus pneumoniae (S. pneumoniae), Haemophilus influenzae (H. influenzae) and Moraxella catarrhalis (M. catarrhalis) isolates collected from nasopharyngeal swabs from Uygur children in Kashi. Methods: Nasopharyngeal swabs were collected from inpatient Uygur children aged from 1 month to 5 years with respiratory infections from the pediatric department, the First People's Hospital of Kashi, Xinjiang Uygur Autonomous Region. Antimicrobial susceptibilities of the isolates were determined with E-test and KB disk diffusion methods. The production of β-lactamase was detected for H. influenzae and M. catarrhalisisolates using nitrocefin disc method. Quellung test and latex agglutination test were adopted to identify serotypes of S. pneumoniae and H. influenzae isolates. Results: Forty-seven S. pneumoniae, 13 H. influenzae and 16 M. catarrhalis isolates were detected. All of the 47 S. pneumoniae isolates were sensitive to parenteral penicillin, amoxicillin-clavulanic acid, vancomycin and levofloxacin; the susceptibility rates to cefotaxime, imipenem and chloramphenicol were 94% (44/47), 89% (42/47), and 98% (46/47). The resistance rate to erythromycin was 74% (35/47). The most common serotype of S. pneumoniae was serotype 19A (10 strains, 21%). The coverage rate of 13-valent conjugate vaccine (PCV13) was 70% (33/47). None of the 13 H. influenzae isolates could be typed. They were highly susceptible to tested β-lactams antibiotics, except ampicillin. Only one H. influenzae isolate could produce β-lactamase, and two isolates were identified as β-lactamase-negative-ampicillin-resistant ones. The sixteen M. catarrhalis isolates were all positive in β-lactamase detection, but sensitive to amoxicillin-clavulanic acid, cephalosporins and meropenem. Conclusions In Kashi, Xinjiang Uygur Autonmous Region, S. pneumoniae isolates from Uygur children were highly sensitive to parenteral penicillin and other β-lactams antibiotics. H. influenzae isolates from Uygur children were highly susceptible to amoxicillin-clavulanic acid, cephalosporins and ciprofloxacin. All M. catarrhalis isolates from Uygur children could produce β-lactamase, but were sensitive to the enzyme inhibitors and cephalosporins.

Objective To understand the basic information on radiological health technical service institutions in Shaanxi Province, China and analyze the main problems, and to strengthen the capacity building of radiological health technical service institutions in Shaanxi Province. Methods The radiological health technical service institutions registered in Shaanxi Province were investigated and analyzed by means of a questionnaire and literature review. Results There were 20 radiological health technical service institutions in Shaanxi Province, including 7 state-owned ones and 13 privately owned ones; of all the institutions, there were 3 disease control institutions, and 15 institutions obtaining the qualification of radiation protection evaluation, radiation health protection testing, and individual dose monitoring at the same time. The total number of radiation workers in the institution was 237, including 48.5% aged less than 35, 68.8% with bachelor degree or above, 54.4% with intermediate professional title or above, 26.5% with a major related to radiation protection, and 79.3% with national and provincial training. The institutions were equipped with 309 testing instruments, of which the radiation diagnostic performance testing equipment accounted for the largest proportion (52.4%). Conclusion The service scope and capacity of radiological health technical service institutions in Shaanxi Province can meet the current needs of the province, but the institutions need to be improved in terms of personnel, equipment, and service quality. The quality control of institutions needs to be strengthened to standardize the service behavior in the whole province.