Objective To evaluate the role of fibroblast growth faetor-2 (FGF-2) in neuropathic pain (NP) in rats.Methods One hundred male Sprague-Dawley rats,aged 7 weeks,weighing 200-250 g,were randomly divided into 4 groups (n=25 each): sham operation group (group S),group NP,phosphate buffer solution (PBS) group and FGF-2 antibody group (group Ab).FGF-2 antibody 18 μg (40 μl) was injected intrathecally at 1,6,9,13,16 and 20 days after operation in group Ab,while the equal volume of PBS was injected intrathecally in group PBS.Spinal nerve injury was produced by exposing the sciatic nerve and its branches and ligation and transection of tibial nerve and common fibular nerve.Pain behavior was assessed at 1 day before operation and at 1,4,7,14 and 21 days after operation.The paw withdrawal mechanical threshold (PWMT) was measured.The animals were then sacrificed and the lumbar segment (L4-6) of the spinal cord was obtained for determination of the contents of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) in the spinal cord.Results Compared with group S,the PWMT was significantly decreased and the contents of TNF-α and IL-6 in the spinal cord was significantly increased in groups NP,PBS and Ab (P ＜ 0.05).The PWMT was significantly higher and the contents of TNF-α and IL-6 in the spinal cord were significantly lower in group Ab than in groups NP and PBS (P ＜ 0.05).Conclusion FGF-2 is involved in the occurrence and development of NP and induction of the inflammatory response in the rat spinal cord in involved in the mechanism.

Objective To investigate the effects of different modes of one-lung ventilation (OLV) on hemodynamies in the patients undergoing thoracic operation.Methods Forty-five adult patients undergoing thoracic surgery,were randomly allocated into 3 groups based on the modes of OLV used ( n =15 each):intermittent positive pressure ventilation ( IPPV,VT 6-8 ml/kg,RR 10-14 bpm,I:E 1:2) group,IPPV + positive end-expiratory pressure (PEEP) group and IPPV + continuous positive airway pressure (CPAP) group.Double-lumen tube was inserted.Conrrect positioning was verified by fiberoptic bronchoscopy.The patients were mechanically ventilated.PETCO2 was maintained at 35-45 mm Hg.In group IPPV + PEEP,OLV was performed for 30 min with PEEP of 5 cm H2O and then for another 30 min with PEEP of 10 cm H2O.In group IPPV + CPAP,OLV was performed with IPPV in the lung on the ventilated side and with CPAP of 5 cm H2O in the lung on the operated side (for 1 h).MAP,HR,cardiac output (CO),cardiac index ( CI),stroke volume (SV),and stnoke volume index (SVI) were recorded before induction of anesthesia,at 10 min after intubation,at 30 min of two-lung ventilation,at 30 min and 1 h of OLV,and at the end of operation ( T1-6 ).Arterial blood samples were taken at T1,2,4-6 for blood gas analysis.The levels of blood glucose and lactate were measured.Oxygen delivery ( DO2 ) and DO2 index ( DO2I) were calculated.Results Compared with IPPV group,SV,SVI,CO,CI,DO2 and DO2I were significantly decreased at T4,5 ( P ＜ 0.05),and no significant change was found in the levels of blood glucose and lactate in group IPPV + PEEP,and no significant change was found in the parameters mentioned above in group IPPV + CPAP ( P ＞ 0.05).Compared with IPPV + PEEP group,SV,SVI,CO,CI,DO2 and DO2I were significantly increased at T4,5 ( P ＜ 0.05),and no significant change was found in the levels of blood glucose and lactate in group IPPV + CPAP ( P ＞ 0.05).Conclusion It exerts no influence on hemodynamics using OLV with IPPV in the lung on the ventilated side and with CPAP of 5 cm H2O in the lung on the operated side,however,OLV with IPPV + PEEP can result in hemodynamic fluctuation,but the degree of fluctuation is lesser and DO2 can be maintained in the patients undergoing thoracic operation.

OBJECTIVETo observe the temporal changes of basic fibroblast growth factor (FGF-2) expression in the spinal cord of a rat model of spared nerve injury (SNI) of the sciatic nerve.

METHODSA total of 100 male SD rats were randomly divided into sham-operated group and SNI group. The paw withdrawal threshold to mechanical stimulation was recorded at 1 day before and at 1, 4, 7, 14 and 28 days after the operation. The expressions of FGF-2, tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) in the L4-6 spinal cord segments of the rats were measured at the specified time points.

RESULTSThe paw withdrawal threshold began to decline at 1 day after SNI, reached the lowest level at 7 days, and maintained a low level till 28 days (P<0.05). The expression of FGF-2 began to increase significantly on postoperative day 4, reached the peak level on day 14 and maintained the high level till day 28 (P<0.05). The rats with SNI showed significantly higher expressions of TNF-α and IL-6A in the spinal cord than those in the sham-operated group at each time point of measurement (P<0.05).

CONCLUSIONSSNI of the sciatic nerve can induce neuropathic tactile allodynia and causes up-regulation of FGF-2 and inflammatory cytokines in the spinal cord.

Animals ; Disease Models, Animal ; Fibroblast Growth Factor 2 ; metabolism ; Hyperalgesia ; Interleukin-6 ; metabolism ; Male ; Pain Threshold ; Rats ; Rats, Sprague-Dawley ; Sciatic Nerve ; injuries ; metabolism ; Sciatica ; metabolism ; Tumor Necrosis Factor-alpha ; metabolism

Objective:To introduce a surgical technique of implant-based immediate breast reconstruction using the "latent orifice" procedure after skin-sparing mastectomy and to investigate the clinical value of this procedure.Methods:Clinical data of 72 patients who underwent immediate breast reconstruction using the "latent orifice" procedure (we placed the silicone prosthesis in a "latent orifice" consisting of fascia and underlying muscles) from Jan. 2016 to Dec. 2019 were collected. Characteristics of surgical technique and the effect of the reconstruction surgery were analyzed.Results:70 patients underwent nipple-areola complex sparing mastectomy (NSM) . Two patients’ nipples were resected due to intraoperative frozen pathology suggesting carcinoma existing in the nipples. The nipple epidermal necrosis occurred in 3 patients. No seroma, incision infection or capsular contracture occurred. According to the evaluation scale, the overall aesthetic score was 9.39 points. The average score of each subscale was: 9.57 points for breast volume, 9.43 for breast contour, 9.84 for placement of implant, 9.38 for scars, 9.27 for lower pole projection and 9.21 for inframammary fold definition. BREAST-Q questionnaires were filled by patients. Scores of psychosocial well-being ranged from 62 to 93 points, with the median score of 77 points. Satisfaction with breasts scores ranged from 58 to 100 points, with the median score of 71 points.Conclusion:The "latent orifice" procedure is a simple, safe, practicable, aesthetic and satisfying type of immediate implant-based breast reconstruction, which is worth practicing and promoting.