Objective To discuss the effect of the sustained releasing agent FK506 on the ultrastructure of the regenerative nerve fibers.Methods The new fusiform-shaped double channel nerve conduit was used for bridge the sciatic nerve defects for 10 mm in 32 Sprague-Dawley rats.The rats were divided into Group A(100μl chitin for both channels)and Group B(chitin plus FK506 for B1 and chitin plus normal saline for B2)according to different addition of the drugs.At 8 and 12 week after operation,the middle line of the regenerated nerve was observed under the transmission electron microscope.In the meantime,an analysis was done on the area of the regenerated nerve fibers(myelinated and unmyelinated),diameter and myelin thickness of the myelinated fiber axon at 8 and 16 months.Results There was not significant difference in aspects of type and number of the regenerative nerve fibers between two channels in Group A.However,the myelinated and unmyelinated fibers of the regenerative nerves were increased in Group B1,with larger area than Group B2(P ＜ 0.05).Conclusion FK506 can significantly promote the regeneration of both the myelinated and unmyelinated fibers.

ObjectiveTo investigate the role of NRM in the antinociceptive effect of muscle spindle afferents, the influence of NRM lesion on the inhibitory effect of muscle spindle afferents on the nociceptive responses of wide dynamic range (WDR) neurons and the effects of the muscle spindle afferents on the NRM neuronal activities were observed. MethodsThe single units of WDR neurons in the spinal dorsal horn were recorded extracellularly, and the inhibitory effects of activating muscle spindle afferents by intravenous administration of succinyicholine (SCH) on the C-fibers evoked responses (C-responses) of WDR neurons were tested before and after lesion of NRM. The ef- fects of the muscle spindle afferents activated by administrating SCH on the single NRM neurons were also examined. Results①lt was found that the C-responses of WDR neurons were significantly inhibited by intravenously adminis- tration of SCH, and the inhibitory effect was reduced after lesion of NRM ;②The activities of most of the NRM neu- rons could be changed significantly by administrating SCH. According to their responses, NRM neurons could be classified into three types:excitatory, inhibitory and non-responsive neurons, and the responses were dose-depen- dent. ConclusionThese results suggest that the muscle spindle afferents evoked by SCH may activate the NRM neu- rons, which plays an important role in the antinociception of muscle spindle afferents.

Objective:To investigate the changes of serum neopterin (NPT) level in adults patients with Kashin-Beck disease (KBD) in Qinghai Province.Methods:In July 2018, according to the "Diagnosis of Kashin-Beck Disease" (WS/T 207-2010), in KBD endemic region of Xinghai and Guide counties in Hainan Tibetan Autonomous Prefecture of Qinghai Province, adult KBD patients and healthy people over 20 years old were selected as KBD group and internal control group, respectively. At the same time, healthy people over 20 years old were selected as the external control group in non-KBD endemic region of Xunhua County with similar production scale and lifestyle. Fasting elbow vein blood samples of the 3 groups of people were collected, serum NPT levels were determined by enzyme linked immunosorbent assay (ELISA).Results:Totally 272 people were enrolled in the study, 104 cases (50 males and 54 females) in KBD group, aged (47.61 ± 12.72) years old; 95 cases (35 males and 60 females) in internal control group, aged (48.28 ± 14.87) years old; and 73 cases (35 males and 38 females) in external control group, aged (51.88 ± 13.93) years old. There were no significant differences in gender composition and age among the 3 groups (χ 2 = 3.135, F = 2.236, P > 0.05). The serum NPT levels of KBD, internal control, and external control groups were (504.35 ± 413.92), (417.34 ± 109.90) and (397.49 ± 118.07) ng/L, respectively, and the difference among the 3 groups was statistically significant ( F = 4.129, P < 0.05). Among them, the serum NPT level of KBD group was significantly higher than that of internal control group and external control group ( P < 0.05); there was no significant difference in the serum NPT level between internal control group and external control group ( P > 0.05). Conclusion:The serum NPT level of adult KBD patients in Qinghai Province is elevated.

Objective:To investigate the effects of celecoxib and anti-osteogenesis tablets on urinary biomarkers pyridinoline (PYD) and deoxypyridinoline (DPD) in adult patients with Kashin-Beck disease (KBD) in Qinghai Province, and to provide scientific basis for treatment of adult KBD.Methods:According to the "Diagnosis of Kaschin-Beck disease" (WS/T 207-2010), in July 2017, 120 cases of adult KBD that were selected from the KBD area in Qinghai Province were divided into non-drug treatment group ( n = 66) and drug treatment group ( n = 54), and 89 healthy adults were selected as control group. The drug treatment group was taken celecoxib and anti-osteogenesis tablets for 6 months. Morning urine samples were collected from the three groups. The contentss of PYD and DPD in urine were detected by enzyme linked immunosorbent assay (ELISA), and the test results were corrected with creatinine (Cre). Results:There were no statistically significant differences in gender ratio and age among non-drug treatment group, drug treatment group and control group (χ 2 = 0.820, F = 0.379, P > 0.05). The medians of urinary PYD in the three groups were 1 106.39, 812.18, 702.53 ng/μmol Cre, and the medians of DPD were 1 325.58, 802.54, 752.38 ng/μmol Cre, respectively. The differences were statistically significant among the three groups ( H = 13.849, 34.621, P < 0.01). The contents of PYD and DPD in drug treatment group were lower than those in non-drug treatment group ( P < 0.05). Conclusion:Celecoxib and anti-osteogenesis tablets can reduce the urinary levels of PYD and DPD in adult patients with KBD.

Objective To investigate the clinical efficacy of bromhidrosis with botulinum toxin A by needle free injection.Methods A total of 40 patients with bromhidrosis were collected and divided into needle free group and needle group.A comparative study was carried out in those subjects.Patients in needle free group received needle free injection of botulinum toxin A by INJEX30;Needle group received traditional injection by 26 G needles.Results In needle free group,16 cases were cured,3 cases were effective,1 case was ineffective,no significant pain,hematomas or necrosis were found.In needle group,15 cases were cured,4 cases were effective,and 1 case was ineffective;localized hematoma occurred in 2 cases.And cases in group needle experienced pain more intensely than cases in needle free group.Conclusions The INJEX30 improves the security,comfort and therapy compliance of botulinum toxin A injection in the bromhidrosis patients,with similar efficacy with traditional injection.

Objective To prepare nerve growth factor gradient release system,and explore the promotion of the clinical effects of peripheral nerve regeneration.Methods All 57 cases with peripheral nerve injuries were treated with emergency nerve repair from July 2010 to August 2012,a nerve repair,with meanwhile randomly were divided into group A (19 cases),group B (19 cases) and group C (19 cases).The NGF was used to partial release by using the homemade gradient release system in group A,the same amount of NGF was partial injeced to Gelatin sponge surrounding peripheral nerve in group B.The NGF wasn't injected in group C.All patients respectively underwent neurophysiological examination after 4 weeks and 8 weeks.Comparising with the somatosensory evoked potentials (SEP) and muscle action potential (MAP) between different groups,meanwhile analyzing nerve conduction velocity (NCV).The sensory and motor function evaluation score of BMRC were performed after 24 weeks.Results The peak latency of the SEP after 4 weeks in A,B and C groups were (34.80 ± 3.45) ms,(42.85 ± 2.58) ms,and (51.05 ±3.652) ms,respectively; the volatility were (10.673 ± 2.35) μV,(6.30 ± 1.22) μV,and (4.10 ±0.83) μV,the peak latency of the MAP after 4 weeks in A,B,C groups were(5.29 ±0.82) ms,(7.63 ± 1.35)ms,and (9.98 ± 1.15) ms,the volatility were (485.75 ±65.83) μV,(262.510 ±59.90) μV,and (185.64 ±38.35) μV,the NCV were (25.50 ±3.65) m/s,(19.80±2.35) m/s,and (15.50 ±2.61) m/s.The peak latency of the SEP after 8 weeks in A,B,C groups were (24.68 ±4.50) ms,(31.08 ±4.24) ms,and (39.25 ±4.83) ms,the volatility were (21.22 ± 4.63) μV,(13.68 ± 4.14) μV,and (8.90 ± 1.25) μV.The peak latency of the MAP after 8 weeks in A,B,C groups were (4.71 ±0.35) ms,(6.10±1.54) ms,and (8.86±0.75) ms,the volatility were (839.81 ± 111.07) μv,(512.25 ±46.82) μv,and (312.65 ±47.52) μv,the NCV were (26.24±3.22) m/s,(21.23 ±2.40) m/s,and (16.34 ±2.55) m/s.Compared with the group C,the peak latency of the SEP,MAP was shortened significantly and the Volatility was increased significantly in group A and B,the NCV was faster significantly in group A and B (P ＜ 0.05).Compared with the group B,the peak latency of the SEP,MAP was shortened significantly and the Volatility was increased significantly in group A,the NCV was faster significantly in group A (P ＜ 0.05).The good rate of the A,B,C groups in BMRC sensory function score were 78.95％,63.15％ and 52.63％ respectively.The good rate in BMRC motor function score were 84.21％,68.42％and 47.37％ respectively.The group A and B were higher than group C,and the good rate of group A was higher than group B(P ＜ 0.05).Conclusion The nerve growth factor gradient release system is safe and effective for early treatment of peripheral nerve injuries.

Objective To investigate the effects of different magnitudes of mechanical stress on human interverte-bral disc degeneration. Methods The human intervertebral disc cells were subjected to different magnitudes of mechanical stress (0, 6%, 12%, or 18%elongation) for 24 h using a Flexercell Strain Unit. The mRNA expressions of anabolic genes (col-lagen-1A1, collagen-2A1, aggrecan and versican) and catabolic genes (MMP-3, MMP-13, ADAMTS-4 and ADAMTS-5) were examined by real-time PCR and Western blot methods. Results The expression levels of collagen-1A1 and collagen-2A1 were increased at 12%of mechanical stress, and collagen-2A1 was decreased at 18%of mechanical stress compared with those of control. The mRNA expressions of catabolic genes, MMP-13 and ADAMTS-5, were increased at 12%and 18%of mechanical stress than those of control. The mechanical stretch induced a magnitude-dependent increase in ADAMTS-4 synthesis, which was finely tuned by stretching-triggered activation of distinct mitogen-activated protein kinase cascades. Specifically, an ERK1/2 specific inhibitor, U0126, significantly inhibited the stretching-induced ADAMTS-4 expression, whereas the inhibitors of p38 and JNK, SP6000125 and SB203580, showed only slightly effect on the stretching-induced ADAMTS-4 expression. Conclusion The different magnitudes of mechanical stretch exhibited different effects on the bio-logical behavior of intervertebral disc cells, which profoundly affects the intervertebral disc degeneration.

Objective To investigate drug resistance and clinical efficacy of second-line anti-tuberculosis drugs in patients with multidrug-resistant pulmonary tuberculosis.Methods A total of 183 multi-drug resistant pulmonary tuberculosis (MDR-PTB) patients received standard anti-tuberculosis treatment in Zhejiang Provincial Center for Diagnosis and Treatment of Tuberculosis during March 2011 and March 2013.Patients were divided into four groups according to the results of first-line anti-tuberculosis drugs susceptibility test:group A (n =30) resistant to isoniazid (H) and rifamipicin (R) ; group B (n =28) resistant to HR and ethambutol (E) ; group C (n =53) resistant to HR and streptomycin (S) ; groups D (n =72) resistant to HRES.Drug susceptibility tests of second-line drugs kanamycin (Km),protionamide (Pto),paraaminosalicylic acid (PAS) and levofloxacin (Lfx) were performed.Negative conversion rates of mycobacterium tuberculosis in sputum culture were also observed and compared among different groups with x2 test.Results Among 183 MDR-PTB patients,49 cases (26.8％) were resistant to Lfx,which was significantly higher than that of Km (8.7％,n =16),Pto (13.1％,n =24) and PAS (6.6％,n=12) (x2 =37.983,P＜0.05).The resistant rate to Lfx in group D was 45.8％ (33/72),which was higher than that in group A (2/30,6.7％),group B (6/28,21.4％) and group C (8/53,15.1％) (x2 =14.413,5.047 and 13.087,P ＜0.05).The occurrence of pre-extensively drug resistance (Pre-XDR) in group D was 34.7％ (25/72),which was higher than that in group A (3/30,10.0％) and group C (9/53,17.0％) (x2 =6.499 and 4.852,P ＜ 0.05).Among 157 MDR-PTB patients who received standard anti-tuberculosis treatment for one year,the negative conversion rate of mycobacterium tuberculosis in sputum culture was 87.3％ (137/157).The negative conversion rate in group D was lower than that in other groups,but the difference was not of statistical significance (x2 =1.899,P ＞ 0.05).Conclusions The efficacies of second-line anti-tuberculosis drugs vary among MDR-TB patients resistant to different firstline anti-tuberculosis drugs.The sensitivity tests results of the first-line drugs may serve as reference for MDR chemotherapy regimen in lack of test results of second-line drugs.

Objective To study the morphological changes of soleus muscle spindle and electrical activity of neurons in Red Nucleus(RN) of the rat after 2 weeks' simulated weightlessness, and to reveal the interaction between proprioceptive inputs of muscle spindles and reciprocal alterations in RN under simulated weightlessness. Methods Twenty female rats were exposed to weightlessness simulated by tail-suspension for 14 days (SW-14d). Body weight(200-220g) matched female rats were control group(Con). The morphological changes in isolated muscle spindle of soleus muscle, the discharges of red nucleus neurons were observed after 14d tail-suspensions by silver staining and extracellular recording respectively. Results Compared with control group ,the nerve ending of muscle spindle in SW-14d was distorted, degenerated and dissolved; the diameters of intrafusal fibers and capsule in equatorial region of soleus muscle spindles were diminished(P＜0.05). The spontaneous cell activity and discharge of RN neurons (spikes/s) induced by afferent firing from muscle spindles after injection of succinylcholine were reduced after 2 weeks' simulated weightlessness respectively (18.44±5.96 vs. 10.19±6.88, 32.50±8.08 vs. 16.86±5.97, P＜0.01). Conclusion The degeneration of muscle spindle induced by simulated weightlessness may be one of the causes that led to alterations in discharges of RN.

Abstact: Objective To investigate the diagnostic value of endoscopic sphineter Oddi manometry (SOM) in patients with recurring abdominal pain and observe the value of endoscopic sphincterotomy (EST) in treatment of patients with sphincter of Oddi dysfunction (SOD).MethodsClinical data of 30 patients with chronic abdominal pain after cholecystectomy who were suspected SOD from 2012 October to 2014 September were collected and retrospectively analyzed. These patients received SOM in ERCP examination and the observation of Oddi sphincter basal pressure, contraction amplitude, frequency and mode of transmission were carried out. The EST were carried out in patients with basal pressure of Oddi sphincter higher than 40.0 mmHg or higher than 30.0 mmHg, and the presence of serum amylase, lipase, ALT, AST, AKP increased more than 2 times of the normal value and (or) of common bile duct, pancreatic duct widening.ResultThe SOM of all the 30 patients were all abnormal. The basal pressure of Oddi sphincter, the contraction amplitude, the contraction frequency and the reverse shrinkage were (36.6 ± 21.1) mmHg, (210.6 ± 25.7) mmHg, (10.1 ± 3.1) times/min and (55.0 ± 8.0)%. All the patients were treated with EST, of which 27 cases (90.0%) received good results.Conclusion SOM is helpful in evaluation of Oddisphincter function, it is of great value in diagnosis of SOD. EST treatment obtained satisfactory effect in patients with elevated basal pressure of Oddi sphincter.