Objective To investigate the effects of intrathecally coadministered dexamethasone and spironolactone in trathecally on radicular pain behaviors.Methods Using rat model of radicular pain induced by chronic compression of dorsal root ganglion (CCD) ,48 male SD rats successfully received intrathecal catheter implantation and without motor dysfunction were randomly divided into Sham-operation group (Sham group, n= 12),Control group ( C group, n = 12 ), Dexamethasone group ( D group, n = 8 ), Spironolactone group ( S group, n = 8 )and Dexamethasone plus spironolactone group (DS group, n=8).Rats in D group,S group or DS group were intrathecally treated with dexamethasone 4 μg, spironolactone 3 μg or dexamethasone 4 μg plus spironolactone 3 μg twice daily on day 2 ～4 after CCD respectively,while rats in C and Sham group received 10μl 10% alcohol.Paw withdrawal mechanical threshold(PWMT) and paw withdrawal thermal latency (PWTL) were tested on day 1 before CCD and day 1,4,7,10,14,17 and 21 after CCD.Results Compared with Sham group, both PWMT and PWTL were significantly decreased after CCD surgery on the ipsilateral side(P＜0.01 ＝.Intrathecally administrated with dexamethasone significantly improved pain behaviors (P＜0.01 ＝ and these therapeutic effects lasted up to 10 days after CCD surgery.As with dexamethasone,intrathecal spironolactone also significantly attenuated PWMT (P＜0.01 ＝ and PWTL (P＜0.01 ＝ and the change lasted up to 7 days after CCD surgery.Coadministration spironolactone and dexamethasone exhibited significant synergies( PWMT: ( 13.52 ± 0.72) g vs ( 11.58 ± 1.38 ) g, P ＜0.01; PWTL: ( 19.63 ± 1.68) s vs ( 14.14 ± 1.52) s, P ＜ 0.01 ＝.These effects lasted up to at least 10 days.Conclusion Both dexamethasone and spironolactone intrathecally have therapeutic effects on radicular pain behaviors, combination injection of these two drugs could generate significant synergies.

Objective To investigate the analgesic effects of intraperitoneal lithium chloride injection on radicular pain behaviors in rats.Methods Using rat model of radicular pain induced by chronic compression of dorsal root ganglion(CCD) ,40 male SD rats were randomly divided into model group and Sham-operation group (group S, n= 12) of radicular pain were established.The rats in the model group were subdivided randomly into Control group(group C, n= 12) ,Early treatment group(group E, n=8) and Later treatment group(group L, n= 8 ).Rats in group E were intraperitoneal injected with lithium chloride once daily on day 2 ～ 4 after CCD respectively,while rats in L,group C and S treated with Vehicle(0.9% NaCl).Rats in L group were intraperitoneal treated with lithium chloride on day 12 ～ 14 after CCD respectively,while rats in E,group C and S received Vehicle.The pain ethology indexes such as paw withdrawal mechanical threshold (PWMT) and paw withdrawal thermal latency (PWTL) were tested on day 1 before operation and day 1,4,7,10, 14, 17 and 21 after operation.Results Compared to S group and preoperative level, PWMT and PWTL decreased at Day 1 postoperative in group C (P＜0.05).At day 4 after the operation,compared with group C(7.712 ±0.237)g and (8.190 ±0.382) s,PWMT and PWTL of E group increased to ( 14.607 ± 0,280) g and ( 19.940 ± 0.933 ) s (P ＜ 0.05 ) after intraperitoneal injected lithium chloride.At day 14, compared with group C ( 6.788 ± 0.331 ) g and ( 7.301 ± 0.481 ) s, PWMT and PWTL of group L increased to ( 11.700 ± 0.379) 8 and ( 18.524 ± 1.060) s (P ＜ 0.05 ).This analgesic effect of lithium chloride continued to exist at day 21.However, there was still a significant difference between S group and E,group L(P＜0.05).Conclusion Intraperitoneal lithium chloride injection alleviates pain behavior on radicular pain in rats.

Objective To investigate the role of Ca2+/calmodulin-dependent protein kinase Ⅱ on pain behavior in a mouse model of bone cancer pain. Methods 40 male C3H/HeN mice were divided randomly into 5 groups:sham group (S group, n=8) ,control group (C group, n=8) and KN93 treat group (T1, n=8;T2, n=8;T3, n = 8 ). Group C and T were induced mouse models of bone cancer pain by intra-left-femur inoculations of osteolytic NCTC2472 cells while group S were injected only α-MEM. On the 14 d after inoculations,group S and C received intrathecal injection of 20% DMSO 5 μl . While group T1, T2, T3 received intrathecal injection of KN93 15nmol,30nmol,60nmol which dissolved in 5 μl 20% DMSO respectively. Mice received pain behavior tests including quantification of spontaneous flinches, paw withdrawal mechanical threshold (PWMT) and paw withdrawal thermal latency (PWTL) before and at 0.5 h,2 h,4 h,8 h after administration. Results Treatment with KN93(15 nmol) have no effect on bone cancer pain,while treatment with KN93(30 nmol,60 nmol) can dose-dependently reverse quantification of spontaneous flinches, mechanical allodynia and thermal hyperalgesia which were induced by bone cancer pain, At 0. 5h after administration, the quantification of spontaneous flinches of the two groups ( (7.25 + 1.49 ), (4. 12 + 1.36 ) ) were decreased when compared with control group ( 11.62 + 1.92 ),PWMT((1.28 +0.14)g;(1.75 +0.46)g),PWTL((14.64 +2.12) s; (16.85 + 1.61)s)were increased when compared with control group ( (0.47 + 0. 16) g, ( 11.32 + 1.68 ) s) (P ＜ 0.05 ＝. The effect lasts for at least 4 h and disappears at 8 h. Conclusion CaMK Ⅱ may play an important role in the mechanism of bone cancer pain. Intrathecal KN93 injection can effectively attenuated bone cancer pain.

Objective To observe the primary clinical results of Gore （R） Viabahn endoprosthesis for atherosclerotic stenosis or occlusion in superficial femoral artery (SFA).Methods From March 2013 to November 2013,45 consecutive patients (54 limbs) who had ischemic symptom due to stenosis or occlusion of superficial femoral artery were treated by endovascular deployment of Gore （R） Viabahn endoprosthesis.We observed patency rate,improvement of Rutherford classification and ankle-brachial index,limb salvage rate and survival rate after 1,3 and 6 months.Results 43 patients (52 limbs)were followed-up,among which 32 patients(38 limbs)belonged to TASC Ⅱ type C or type D lesion.The mean (± SD) length of treated segment in 52 limbs was(19 ±4)cm.The rate of postoperative patency on duplex ultrasonography:one month,3 months and 6 months were 96.15％ (50 limbs),92.31％ (48 limbs)and 90.38％ (47 limbs) ; Ankle-brachial index increased from(0.32 ±0.20)to(0.68 ±0.18) (t =3.180,P ＜ 0.005) after 6 months ; at 6 months limb salvage rate was 96.08 percent (49 limbs),and survival rate was 97.67％ (42 patients).Conclusions Implantation of Gore （R） Viabahn endoprosthesis in atherosclerotic stenotic or occluded superficial femoral artery safely achieves a definite primary clinical effectiveness.

Objective To investigate whether there are differences in the detection of biochemical items such as electrolytes , total protein and urea between arterial plasma and venous plasma .Methods Self paired design was used to compare and study the biochemical results of different samples .70 samples ( 36 samples from male patients and 34 from female patients ) that were performed with both arterial blood gas analysis and biochemical item test of venous blood in Clinical Laboratory of Peking Union Medical College Hospital during the period from June to September of 2017 were collected.18 biochemical items like electrolytes in arterial blood and venous blood were synchronously detected by automatic biochemical analyzer.Statistic analyses were carried out by SPSS 18.00.Whether the deviation was of clinic significance was determined by National Health Standards ( WS/T 403-2012 ) and the total error admitted by Royal Society of Pathology of Australia .Regression analysis of Passing-Bablok was performed by MedCalc software . The difference between the results of different samples was investigated by drawing Bland -Altman diagram.Results The results of Ca, Cl, K, Na, P, TP, ALB, ALT, AST, LDH, Glu, Cr, Urea, TG, CHO, UA, CHE, TBA in the samples of arterial blood plasma were 2.46(2.25-2.56) mmol/L,(105.68 ±7.29)mmol/L, 3.81(3.54-4.03) mmol/L, 140.45(137.08-144.20) mmol/L, 0.97(0.77-1.11) mmol/L,(60.39 ±9.40)g/L,(31.23 ±6.81)g/L, 17.4(11.95 -30.05)U/L, 20.85(14.9 -34.03) U/L, 210.1(163.15-342.60) U/L, 7.58(5.95-10.04) mmol/L, 76.35(51.05-110.7) μmol/L, 6.94(3.98-11.08) mmol/L, 1.15(0.84-1.89) mmol/L, 3.31(2.73-4.35) mmol/L, 271.55(187.78-423.30) μmol/L,(4.71 ±2.17)KU/L, 2.19(1.09 -4.19) μmol/L,respectively, and 2.24(2.05-2.35) mmol/L,(103.98 ±7.32)mmol/L, 3.84(3.58 -4.19) mmol/L, 139.30(136.08 -142.33) mmol/L, 0.99(0.78-1.14) mmol/L,(60.37 ±9.67) g/L,(32.62 ±6.89) g/L, 17.6(12.75-31.2) U/L, 20.6(15.28-36.6) U/L, 233.95(176.48-363.75) U/L, 7.55(5.62-9.52) mmol/L, 77.15 (56.08-111.98) μmol/L, 6.94(3.97 -10.53) mmol/L, 1.13(0.83 -1.93) mmol/L, 3.23(2.71-4.37) mmol/L, 273.4(187.30-401.55) μmol/L,(4.74 ±2.21) KU/L, 2.29(1.02 -4.23) μmol/L respectively in the samples of venous blood plasma .The difference of results of TP、Glu、Cr、TG、CHE、TBA between two types of samples were of no statistic significance ( the values of t or Z were 0.121,-0.054,-0.269,-0.480,-1.730 and -1.843 respectively, P>0.05), among these items the difference of Glu was of notable clinical significance (>1/2 TE percentage:50％).The difference of results of Ca , Cl, K, Na, P, ALB, ALT, AST, LDH, Urea, CHO, UA between two types of samples were of statistic significance (the values of t or Z were -7.115,6.794,-2.119,-4.996,-3.483,-8.839,-2.419,-2.742,-3.833,-5.010,-2.060 and -2.467 respectively, P<0.05), among these items the difference of Urea, CHO, UA, Na, P and ALT was of no notable clinical significance ( >total TE percentage: 0％, 2.86％, 0％, 2.9％, 4.3％, 1.43％ respectively), while the difference of Ca, Cl, K, ALB, AST and LDH was of clinical significance (>total TE percentage:90％, 10％, 14.3％, 32.9％, 10.00％, 32.9％respectively).Conclusions The differences in the detected data of some biochemical items between venous plasma and arterial plasma demonstrated clinical significance .When detecting those biochemical items , clinicians should pay attention to the selection of arterial blood sample .It should be considered to establish a reference interval for related biochemical items of arterial blood when necessary .

Objective To investigate the clinical efficacy of double locking mini-plates for fixation of the comminuted fracture of the first metacarpal base.Methods Twenty-four patients with the comminuted fracture of the first metacarpal base were treated by double locking mini-plates in our hospital from January 2013 to January 2016.They were 17 males and 7 females,from 27 to 65 years of age (average,33.5 years).By the Green classification,6 cases were type Ⅰ,13 cases type Ⅱ and 5 cases type Ⅲ.All the fractures were closed.The average time from injury to surgery was 2.3 days (from 8 hours to 7 days).After open reduction via the palmar-radial incision,the fracture was fixated with 2 mini-plates,one locking T-plate on the radial side and one straight locking plate on the dorsal side.Fracture healing time,pain and finger function were followed up postoperatively.Visual analogue scale (VAS) was used to evaluate the pain at 12 months and scoring for digital total range of motion to assess the function of the affected finger at the final follow-up.Results The 24 patients obtained follow-up for 8 to 28 months (average,18 months).All the Fractures healed after 9 to 12 weeks (average,10.5 weeks).The VAS scores at 12 months ranged from 0 to 3 (average,1.5).The function of the affected finger at the final follow-up was excellent in 20 cases and good in 4,giving an excellent to good rate of 100％.Two patients complained of pain after frequent motion of the finger.No complications like skin problems,dislocation of the first metacarpal base,implant failure,necrosis or irritation of the soft tissue were observed during follow-up.No angulation or rotational deformity occurred after fracture union.Conclusion Fixation with double locking mini-plates can effectively treat comminuted fractures of the first metacarpal base,because it can provide rigid stabilization which promotes early functional exercise of the finger,and prevents joint stiffness as well.

Objective:To assess the applicability of fully automatic pipeline automated testing for internal quality control (automated quality control).Methods:Stability, assay efficiency and implementation costs of 18 biochemical tests, 5 immunoturbidimetric tests and 11 chemical illuminescent tests in the Department of Laboratory Medicine of Peking Union Hospital from January 2019 to July 2022 were evaluated using automated quality control implementation methods. The detailed method is as follows: quality control materials for biochemical, immunoturbidimetric and chemiluminescent tests were stored in the refrigerator in the pipeline which was controlled by the intermediate software, and were automatically retrieved and tested as pre-set followed by documenting and storing. The quality control setup for the biochemical tests included refreshing quality control materials daily and weekly,both of which were paralleled for 3 months. The on-line storage stability of quality control materials in the pipeline was evaluated by comparing the coefficients of variation ( CV) of the quality control results between the two patterns. Effect of automated quality control application was evaluated using 6 indicators, including the results′ variation of automatically performed and manually performed quality controls, the out-of-controlled rate, the consumption of quality control materials, the change of staff workload, the impact on the testing time of the first sample, and the failure rate of automated quality control. Results:(1) Storage stability of quality control materials in the pipeline: under the pattern of weekly refresh of the biochemical quality control materials, except for total carbon dioxide (TCO 2) (the CVs of low and high level quality control were respectively 20.24% and 21.82%) and sodium (the CV of low level quality control was 1.51%) that were greater than the allowable variation set by the laboratory, the CVs of the rest tests meet the lab requirements on the allowable variations. (2) The results′ variation of quality control in automatically performed and manually performed control patterns: in the patterns of daily refresh of biochemical quality control materials and weekly refresh of immunoturbidimetric and chemiluminescent quality control materials, the CVs of both low and high levels of quality control were lower in the automatically performed control pattern than that in manually performed pattern for 8 chemiluminescent items of dehydroepiandrosterone sulfate, estradiol, follicle stimulating hormone, luteinizing hormone, serum ferritin, serum folic acid, vitamin B12 and testosterone, 3 immunologic items of complement 3, C reactive protein and immunoglobulin G, and 10 biochemical items of alkaline phosphatase, glucose, calcium, chloride, potassium, lactate dehydrogenase, sodium, urea, low density lipoprotein cholesterol, and adenosine deaminase. The out-of-control rates of biochemistry, immunoturbidimetric and chemiluminescence tests in both quality control patterns conformed with the clinical routine work requirements. (3) Comparison of quality control materials′ consumption: compared with manually performed quality control, weekly consumption of automatically performed chemiluminescent quality control materials decreased 37.5% (from 8 ml to 5 ml); weekly consumption of automatically performed immunoturbidimetric quality control materials decreased 33.3% (from 3 ml to 2 ml). (4)Comparison of staff workload and first sample testing time: compared with manually performed quality control, automatical quality control reduced manual work by about 156 steps per week, and the daily initial testing time was earlier by 15 min on average. The failure rate was 54.5% (37/64) during the early-stage application of the automated quality control which dropped to 10.2% (13/128) in the late-stage. Conclusion:The results of automated quality control detected in the pipeline system meet the quality indicators′ requirements of the laboratory, and the application of automated quality control can improve the quality control, save costs, reduce workload, and improve work efficiency.

Objective:To compare the differences of reference intervals (RI) established by two types of indirect methods for 34 biochemical analytes, and to explore the possible factors that affect the consistency of the two methods.Methods:This was a retrospective study. Based on data of albumin (Alb), alkaline phosphatase (ALP), alanine aminotransferase (ALT), apolipoprotein A1(ApoA1), ApolipoproteinB (ApoB), aspartate aminotransferase (AST), calcium (Ca), cholinesterase (ChE), chloride (Cl), creatinine (Cr), high-sensitivity C-reactive protein (hsCRP), Cystatin (CysC), direct bilirubin (DBil), free fatty acid (FFA), glycated albumin(GA), gamma-glutamyltransferase (GGT), glucose (Glu), high density lipoprotein cholesterol (HDL-C), potassium (K), lactate dehydrogenase (LD), low density lipoprotein cholesterol (LDL-C), lipoprotein a [Lp (a)], sodium (Na), phosphorus (P), prealbumin (PA), superoxide dismutase (SOD), total bile acid (TBA), total bilirubin (TBil), total cholesterol (TC), total carbon dioxide (TCO 2), triglyceride (TG), total protein (TP), uric acid (UA) and urea (UR) of individuals who underwent physical examination at Peking Union Medical College Hospital from January 1, 2018 to December 31, 2019, Box-Cox algorithm was used to improve the data distribution and Tukey method was used to identify outliers. Variance component model was established, and standard deviation ratio (SDR) was calculated to determine whether the RIs of 34 biochemical analytes should be established according to age or sex The non-parametric method and kosmic algorithm were used to establish the RIs and 90% confidence intervals (CIs) of 34 biochemical analytes, and the coincidence of the 90% CIs of the reference limits for two methods was compared. Results:The skewness coefficients of ALP(male, female18-59), ALT, AST, hsCRP, DBil, GGT, Lp (a), TBA, TBil, TG, Glu, HDL-C(male) and CysC, GA, UR in the elderly group deviated from 0, and their kurtosis coefficients also deviated from 3. For these biochemical analytes, the point estimates of the RIs established by the two methods differed greatly and the 90% CIs did not overlap. The analytes with good normality were Alb, ApoA1, ApoB, Ca, ChE, Cl, Cr(E), CysC(18-59), FFA, GA(18-59), HDL-C(female), K, LDL-C, Na, P, PA, SOD, TC, TCO 2, TP and UR. The consistency is good. Except for Ca, 90% CIs of reference limits for some analyte between the two methods coincide with each other. Conclusions:The consistency of different indirect methods is affected by the normality of data.

Objective:To evaluate the association of maternal nutrition status in the first trimester with gestational diabetes mellitus (GDM) and macrosomia.Methods:378 pregnant women who took prenatal care in Shunyi Women′s and Children′s Hospital of Beijing Children′s Hospital were enrolled in the study. Blood samples were collected at first prenatal visit (<12 gestation weeks) to measure the level of hemoglobin and iron status indexes including serum iron, ferritin, transferrin, total iron binding capacity, iron saturation, transferrin saturation. The incidence of GDM and macrosomia were collected and Logistic regression was used to evaluate the associations of maternal nutrients status in the first trimester with GDM and macrosomia.Results:The incidence rate of GDM was16.9%,the incidence of anemia and iron deficiency in the first trimester were2.4% and 2.5%, respectively. After adjustment for variables such as maternal age, pre-pregnancy BMI, family history of diabetes, and parity, Logistic regression showed that in the first trimester, iron saturation>50% ( OR=0.238, 95% CI 0.068-0.831), transferrin saturation>50% ( OR=0.08, 95% CI 0.010-0.677) were protective factors of GDM; iron saturation 25%-50% ( OR=0.361, 95% CI 0.143-0.908); transferrin saturation 25%-50% ( OR=0.383, 95% CI 0.165-0.891); ferritin>30 ng/ml ( OR=0.418, 95% CI0.186-0.939) were protective factors of macrosomia. Conclusion:Maternal iron status in the first trimester might be associated with GDM and macrosomia. Thus, maternal iron status assessment in the first trimester is necessary.

Background: Xylazole (Xyl) is a veterinary anesthetic that is structurally and functionally similar to xylazine. However, the effects of Xyl in vitro remain unknown. Objectives: This study aimed to investigate the anesthetic mechanism of Xyl using fetal rat nerve cells treated with Xyl. Methods: Fetal rat nerve cells cultured for seven days were treated with 10, 20, 30, and 40 μg/ mL Xyl for 0, 5, 10, 15, 20, 25, 30, 45, 60, 90, and 120 min. Variations of amino acid neurotransmitters (AANTs), Nitric oxide-Cyclic GMP (NO-cGMP) signaling pathway, and ATPase were evaluated. Results: Xyl decreased the levels of cGMP and NO in nerve cells. Furthermore, Xyl affected the AANT content and Na+ -K+ -ATPase and Ca2+ -Mg2+ -ATPase activity in nerve cells. These findings suggested that Xyl inhibited the NO-cGMP signaling pathway in nerve cells in vitro. Conclusions This study provided new evidence that the anesthetic and analgesic effects of Xyl are related to the inhibition of the NO-cGMP signaling pathway.