OBJECTIVETo explore the possible pain mechanism of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS).

METHODSThe models of CP/CPPS were established in male Wistar rats by the autoimmune method. The paw withdrawal threshold (PWT) was detected using Von Frey filament. The expressions of the substance P and c-fos in the prostate and spinal L5-S2 segments were determined by immunohistochemistry followed by analysis of their correlation with CP/CPPS.

RESULTSCompared with the control rats, the CP/CPPS models showed significantly decreased PWT (P < 0.05), remarkable prostatic inflammation, enlarged scope of lesions, and obvious interstitial lymphocytic infiltration (P < 0.05). Both the expressions of substance P and c-fos were markedly elevated in the prostate and spinal dorsal horn (L5-S2) of the rat models (P < 0.05), but the expression of substance P in the prostate exhibited no correlation with that in the spinal cord (r = 0.099, P = 0.338), nor did that of c-fos (r = 0.027, P = 0.454).

CONCLUSIONThe upregulated expressions of substance P and c-fos in the spinal cord L5-S2 sections may be associated with the pain mechanism of CP/CPPS.

Animals ; Chronic Disease ; Immunohistochemistry ; Male ; Pelvic Pain ; etiology ; metabolism ; Prostate ; metabolism ; Prostatitis ; complications ; metabolism ; Proto-Oncogene Proteins c-fos ; metabolism ; Rats ; Rats, Wistar ; Spinal Cord ; metabolism ; Substance P ; metabolism ; Syndrome ; Up-Regulation

Objective:To evaluate the prognostic value of post-mastectomy radiation therapy (PMRT) in patients with axillary lymph node-positive breast cancer treated with breast conservation surgery and to establish the candidates for PMRT based on different pN stages and lymph node ratios (LNR). Methods:A retrospective analysis of the clinical data of the patients was conducted. The pa-tients had positive lymph nodes (n=152) between 1998 and 2007 and underwent breast conservation surgery. A comparison of the dis-ease-free survival (DFS) and overall survival (OS) rates was conducted based on LNR and pN staging and with PMRT as a prognostic factor. Results:A total of 152 cases were studied, of which 114 were pN1, 23 were pN2, and 15 were pN3. Among these cases, 114 had an LNR ranging from 0.01 to 0.20, 26 had an LNR from 0.21 to 0.65, and 12 had an LNR>0.65. Univariate analysis showed that the number of dissected lymph nodes, LNR, pN stage, estrogen and progesterone receptor status, and radiotherapy were the prognostic fac-tors for DFS and OS rates (P<0.05). Age and chemotherapy were prognostic factors only for OS rate (P<0.05). Multivariate analysis in-dicated that PMRT and LNR were independent prognostic factors of DFS and OS (P<0.05). The pN staging had no significant effect on DFS or OS (P>0.05). In the subgroup analysis, PMRT had significant effect on DFS and OS (P<0.05) in patients with pN1 and LNR<0.21. Conclusion:LNR is an independent prognostic factor in axillary lymph node-positive breast cancer patients treated with breast conservation surgery, and a candidate for PMRT should be established based on different LNR risks.

Objective To preliminarily explore the delineation of clinical target volume in intensity-modulated radiotherapy for para-aortic lymph node metastases in patients with gynecological malignancies.Methods A retrospective analysis was performed on 56 gynecological tumor patients with para-aortic lymph node metastases who were admitted to our department from January 2010 to September 2016.The number and distribution of metastatic para-aortic lymph nodes were determined by imaging method.Results A total of 108 positive para-aortic lymph nodes were found in the 56 patients,with 1-4(mean,2) positive para-aortic lymph nodes per patient.The mean diameter of positive para-aortic lymph nodes was 2.3 cm (1.2-4.0 cm).A total of 20 metastatic lymph nodes (19%) were located at the L4 level,38(35%) at the L3 level,44(41%) at the L2 level,and 6(5%) at the L1 level.There were 71 metastatic lymph nodes (66%) at the left side of the para-aortic region,20 metastatic lymph nodes (19%) between the abdominal aorta and the vena cava,and 17 metastatic lymph nodes (15%) at the right side of the inferior vena cava.Conclusions For patients with gynecological malignancies,nodal contouring for the para-aortic region should not be defined by a fixed circumferential margin around the vessels.The left side of the para-aortic region should be covered adequately;the upper target should be extended up to the renal artery,and needs to be further extended for patients who have nodal involvement near the renal arteries and veins.

Objective To explore the feature and the optimal treatment of kidney stones in children associ-ated with infant formula which had been aduherated with melamine.Method Total of 47 cases of urinary stone and 31 cases of acute renal failure caused by urinary multiple obstruction in children associated with infant formula which had been adulterated with mlelamine in Beijing Children's Hospital University of Medical Science,form Jan-uary to November,2008 were retrospectively analyzed.Results Infant formula which had been adultemted with melamine may lead to kindey stones in 15 days.The mean age was 11-month and the ratio of male to female was 2.6:1.The kindey stones were usually multiple and mostly located either in the ureteropelvic junction or all through the ureter.In the view of the renal function resuming duration,there was no statistic difference among the acute renal failure group,operation group and the conservative group(P=0.683～0.846).In children with uri-nary obstruction and acute renal failure,hemedialysis or peritoneal dialysis was performed.83.9%were relieved by posting catheter through panedoseope and blood purification.100% of the patients resumed normal renal func-tion.81.3% of the patients without acute renal failure had recovered after conservative therapies such as infusion.Conclusions The patients associated with infant formula which had been adulterated with melamine were Usually little infants.Male were more vulnerable than female.Most of them had recovered smoothly and the renal function resumed normal after effcient therapies.

OBJECTIVETo study the possible mechanisms of chronic nonbacterial prostatitis (CNP) pain.

METHODSCNP models were established in male Wistar rats by the autoimmune method. Then the paw withdrawal threshold (PWT) was detected using the Von Frey filament, prostate pathological examination was conducted, the expressions of substance P (SP) and transient receptor potential vanilloid 1 (TRPV1) in the prostate tissue and L5-S2 spinal segments were determined by immunohistochemistry and their correlations were analyzed.

RESULTSCompared with the control group, the CNP model rats showed markedly decreased PWT (P < 0.05) and obvious inflammation in the prostate tissue, with significant differences in the scope of lesion and interstitial lymphocyte infiltration (P < 0.05). The expressions of SP and TRPV1 in the prostate and spinal cord dorsal horn L5-S2 were remarkably upregulated in the models as compared with the control rats (P < 0.05). However, the expression of SP in the prostate was not correlated with that in the spinal cord (r = 0.099, P = 0.338), nor was that of TRPV1 (r = 0.000, P = 0.5).

CONCLUSIONSP and TRPV1 were involved in the formation and persistence of pain in CNP rats through their upregulated expressions in the L5-S2 spinal segments.

Animals ; Lumbosacral Region ; Male ; Neuralgia ; metabolism ; physiopathology ; Pain ; metabolism ; physiopathology ; Prostate ; metabolism ; Prostatitis ; metabolism ; physiopathology ; Rats ; Rats, Wistar ; Spinal Cord ; metabolism ; Substance P ; metabolism ; TRPV Cation Channels ; metabolism

OBJECTIVETo observe the clinical efficacy of transcutanclus electrical acupoint stimulation (TEAS) on prevention and treatment of orthodontic toothache and oral dysfunction.

METHODSA total of 85 patients of malocclusions in the preliminary diagnosis were randomly divided into a control group (20 cases), a psychological intervention group (22 cases), a medication group (20 cases) and a TEAS group (23 cases). Orthodontics treatment was given in all the groups. Patients in the control group received no further treatment; patients in the psychological intervention group received comprehensive psychological intervention, including cognitive education and music therapy; patients in the medication group received oral administration of ibuprofen; patients in the TEAS group received TEAS at Juliao (ST 3), Jiachengjiang (Extra) and auricular point Ya (LO1). The treatment was given twice a day, one in morning and one at night, for 7 days. The pain scores of orthodontic toothache and changes of oral dysfunction were observed in all groups.

RESULTS(1) At 5 time points from the 12th hour to the 4th day, the scores of spontaneous pain in TEAS group were lower than those in the control group (all P < 0.01); during the time points, the scores in TEAS group were lower than those in the psychological intervention group (P < 0.05, P < 0.01), which were similar to those in the medication group (all P > 0.05). (2) During the peak cycle of spontaneous toothache, the scores of irritation pain in TEAS group were significantly lower than those in the control group (all P < O.01), regardless of time-point statistics or general statistics; the scores of irritation pain in the TEAS group were also significantly lower than those in the psychological intervention group (all P < 0.01), which were similar to those in the medication group (all P > 0. 05). (3) Compared with control group, the grading of talking disorder in the remaining groups did not change significantly (P > 0.05). (4) Compared with control group, the grading of moderate-severe eating disorder in TEAS group was significantly reduced (P < O.05), which was not different from that in the medication group (P > 0.05). The differences of the grading of moderate-severe eating disorder were not significantly different between the psychological intervention group and control group (P > 0.05). (5) There were 3 cases of digestive system adverse reactions in the medication group.

CONCLUSIONTEAS can efficiently prevent orthodontic toothache and oral dysfunction, which is superior to psychological intervention and similar to medication. In addition, it can avoid possible side-effect of medication.

Acupuncture Points ; Acupuncture Therapy ; Adolescent ; Adult ; Electric Stimulation ; Female ; Humans ; Male ; Mouth ; physiopathology ; Mouth Abnormalities ; therapy ; Orthodontic Brackets ; adverse effects ; Orthodontics ; instrumentation ; Toothache ; physiopathology ; prevention & control ; psychology ; therapy ; Young Adult

Objective To investigate the effects of hydrogen rich water on the expression of nuclear factor erythroid 2-related factor 2 (Nrf2) and oxidative stress in rats with traumatic brain injury (TBI).Methods Ninety healthy male Sprague-Dawley (SD) rats were randomly divided into sham operation group, TBI group and hydrogen rich water treatment group (HW group), with 30 rats in each group.TBI model was reproduced by the modified Feeney weight dropping method.The skulls of rats in sham operation group underwent only craniotomy without direct hit.The rats in HW group received brain injury by hitting after craniotomy, followed by injection of hydrogen rich water (5 mL/kg) intraperitoneally once a day for 5 days after successful reproduction of the model.The rats in sham operation group and TBI group were given an equal amount of normal saline in same manner.Six rats from each group were sacrificed at 6, 12, 24, 48 hours and 5 days after evaluating neurological severity scores (NSS).The brain tissue in injured ipsilateral cortex was harvested.The activity of catalase (CAT), glutathione peroxidase (GSH-Px), and content of malondialdehyde (MDA) were determined by spectrophotometry.The expressions of mRNA and nucleoprotein of Nrf2 were determined by quantitative real-time polymerase chain reaction (RT-qPCR) and Western Blot.The pathological changes were observed with microscopy after hematoxylin and eosin (HE) staining.Results ① NSS score:compared with TBI group, NSS in HW group at 12, 24, 48 hours and 5 days were significantly decreased (12 hours: 9.83±2.32 vs.13.17±2.71, 24 hours: 9.83±2.79 vs.13.50±2.43, 48 hours: 7.50±2.07 vs.11.83±2.14, 5 days:5.50 ± 1.87 vs.10.50 ± 2.43, all P ＜ 0.05).② Compared with sham operation group, the activity of GSH-Px and CAT in TBI group were markedly declined after operation, while the MDA content was elevated significantly, especially at 24 hours [CAT (kU/g): 1.080±0.312 vs.3.571 ±0.758, GSH-Px (kU/g): 9.195±3.173 vs.32.385± 10.619, MDA (μmol/g): 12.282±2.896 vs.4.349± 1.511, all P ＜ 0.01].Compared with TBI group, the parameters in HW group were improved, and they were similar as sham operation group.③ RT-qPCR: no significant difference was found in the expression of Nrf2 mRNA at each time point in three groups.④ Western Blot: the expression of Nrf2 nucleoprotein (gray value) in TBI group was apparently higher than that in sham operation group, and peaked at 24 hours (0.703 ± 0.262 vs.0.238 ± 0.120, P ＜ 0.05), and the expression in HW group was obviously higher than that in TBI group, especially at 24 hours (1.110 ± 0.372 vs.0.703 ± 0.262, P ＜ 0.05).⑤ HE staining: the brain structure in sham operation group was found to be intact.However, there were different degrees of pathological changes at each time in TBI group, especially at 24 hours.The pathological damage of brain tissue in HW group was significantly milder.Conclusions Hydrogen rich water can up-regulate the expression of Nrf2, and reduce oxidative damage of traumatic brain injury in rats.Nrf2 can up-regulate the expression of its downstream antioxidant enzymes, which may be the mechanism of the upregulation expression of Nrf2 in the study.

Objective To evaluate the expression and the relativity of PMS2,Akt1 and P-AktS473 protein in A2780,Caov3,C13* and ES2 ovarian cancer cell lines .Methods The expression of PMS2 ,Akt1 and P-Akt S473 protein in A2780 ,Caov3 ,C13*and ES2 ovarian cancer cells was detected by Western Blot .After treated with IGF-1 (Akt1 activator) and API-2 (specific Akt1 in-hibitor) ,Caov3 ,ES2 and A2780 cells were collected and the level of PMS2 was detected by Western Blot .Results PMS2 ,Akt1 and P-Akt S473 proteins were detected in all of the four ovarian cancer cell lines with varied expression levels ,and the activity of Akt1 was inversely related to PMS2 expression in ovarian cancer cells .Exposed to Akt kinase stimulator IGF-1 ,ES2 and Caov3 cells were detected with a dramatically PMS2 decreasing .Meanwhile ,the decreasing of PMS2 protein was time-dependent on IGF-1 .Treated with API-2 ,Akt kinase specific inhibitor ,A2780 was detected with PMS2 dramatically increasing ,and the increasing of PMS2 pro-tein was time-dependent on API-2 .Conclusion In ovarian cancer cells ,PMS2 expression could be directly regulated by activated Akt1 .

Objective To investigate the effect of hydrogen-rich water on cerebral edema and aquaporin 1 (AQP1) expression in rats with traumatic brain injury (TBI).Methods Ninety male Sprague-Dawley (SD) rats were randomly divided into sham operation group,TBI model group,hydrogen-rich water treatment group (H group),with 30 rats in each group.TBI model was reproduced by weight dropping method.The skulls of rats in sham operation group underwent only craniotomy without direct hit and with bone wax sealed suture.5 mL/kg of hydrogen-rich water injection was given intraperitoneally after model reproduction in H group,and equal amount of normal saline was given in sham and TBI groups,once a day for both groups for 5 days.Six rats from each group were sacrificed at 6,12,24,48 hours and 5 days after evaluating neurological severity scores (NSS).The cerebral cortex was harvested,and the pathological changes in morphology of brain tissue were observed with light microscope.The positive expression of AQP1 in cerebral cortex was observed with immunohistochemistry by light microscopy,the AQP1 mRNA expression in cerebral cortex was determined by real-time fluorescent quantization reverse transcription-polymerase chain reaction (RT-PCR),and the AQP1 protein expression in cerebral cortex was determined by Western Blot.Results ① All rats in sham operation group had a NSS of zero at each time point.NSS of TBI group was obviously raised with time prolongation,and peaked at 24 hours followed by a lower tendency,while the score in H group was significantly lower than that of TBI group,and the difference was the most obvious at 24 hours as compared with TBI group (9.83 ± 2.78 vs.13.50± 2.42,P ＜ 0.05).② It was shown by light microscope that in the TBI group there were pathological changes in cerebral cortex,including obvious irregular arrangement of nerve cells,cerebral edema,obvious bleeding,especially at 24 hours,then the cerebral edema became vanished gradually;and the positive expression of AQP1 in the pia mater at all the time points in the TBI group was significantly increased,and it was most obvious at 24 hours.Compared with TBI group,the pathological changes at time points of 12 hours to 5 days in H group was significantly lessened,and the positive expression of AQP1 in the cerebral pia mater was reduced obviously.③ Compared with sham operation group,the mRNA and protein expressions of AQP1 in cerebral cortex in TBI group were significantly elevated,peaked at 24 hours [AQP1 mRNA (2-△△Ct):7.50±0.26 vs.1,AQP1 protein (gray value):1.986±0.110 vs.0.336±0.034,both P ＜ 0.05],then they gradually declined.The mRNA and protein expressions of AQP1 in cerebral cortex were significantly decreased after hydrogen-rich water treatment [24-hour AQP1 mRNA (2-△△Ct):5.40±0.21 vs.7.50±0.26,24-hour AQP1 protein (gray value):1.246±0.137 vs.1.986±0.110,both P ＜ 0.05].Conclusions The up-regulation of AQP1 mRNA and protein in ratst cerebral cortex after TBI perhaps participates in edema formation which might be involved in the pathophysiology of cerebral edema in TBI.Early treatment with an intraperitoneally injection of hydrogen-rich water is capable of attenuating the extent of TBI-induced up-regulation of AQP1 mRNA and protein,alleviating cerebral edema,and achieving its protective effects.

AIM:To evaluate treatment value of Xihuang Pill combined gemeitabine for advanced pancreatic cancer patients.METHODS:Thirty-two patients with advanced pancreatic cancer were randomly divided into A group and B group,treated with gemcitabine chemotherapy and traditional Chinese medicine Xihuang Pill+chemotherapy treatment,respectively.The changes of the solid tumor,serum CA19-9,physical status,clinical symptoms and toxicity were observed.RESULTS:B group(Xihuang Pill combined with gemcitabine)clinical return ratio (CR+PR+NC)was better than A group(gemcitabine).There was significant difference between two groups in the reduction of serum CA19-9 level,Karuofsky score increased,the rate of symptom improvement,Leukopenia reduction(P＜0.05).CONCLUSION:Integrating Xihuang Pill and gemcitabine in the treatment of advanced pancreatic cancer:delaying of tumor growth,reducing of CA19-9 level,improving of the clinical symptoms and life quality of patients,reducing of neutropenia in patients(chemotherapy-induced toxicity),shows good clinical benefit response.