Objective:To assess whether intrathecal orphanin FQ can develop the antinociceptive effect tolerance,and whether there is a cross tolerance between the antinociceptive effect of intrathecal orphanin FQ and the ? opioid receptor agonist morphine.Methods: Tail flick test was used to observe the change of antinociceptive effect after orphanin FQ/morphine intrathecal microinjection into the rats tolerant to acute or chronic morphine/orphanin FQ.Results:Like morphine,large dosage of continuous intrathecal orphanin FQ microinjection produced tolerance to the antinociceptive effect,but there was no apparent cross tolerance between the orphanin FQ and morphine; Hyperalgesic response was found in morphine tolerant rats,but not in orphanin FQ tolerant rats.Conclusion:Lack of cross tolerance between the antinociceptive effect of intrathecal orphanin FQ and morphine indicates that the mechanism of tolerance to orphanin FQ may differ from that to morphine; The antinociceptive effect of intrathecal orphanin FQ may be largely related with its specific receptor in the spinal cord.

With the understanding of autoimmune encephalitis many novel types of autoimmune encephalitis and related antibodies have been identified. There are some cases of autoimmune encephalitis with autoantibody overlapping syndromes or phenotype overlapping syndromes, which bring challenges to diagnosis and treatment in practice. The relevant literature was reviewed and the clinical characteristics, pathological mechanism and treatment of overlapping syndromes associated with autoimmune encephalitis were summarized, in order to provide a reference for the management of autoimmune encephalitis with overlapping syndromes.

Objective To investigate the different changes in the regulation and gene expression of mu opioid receptor (MOR) in rat brain after acute and chronic morphine dependence.Methods Forty male SD rats weighing (210?35)g were randomly divided into five equal groups of eight animals each: (1) control; (2) acute dependence: (3) chronic dependence;(4) acute abstinence; (5) chronic abstinence. In acute dependence group rats received eight consecutive subcutaneous injection of morphine 5mg?kg-1 at 2h interval. In chronic dependence group morphine was injected subcutaneously three times a day(8:00, 15: 00, 22:00) for six days. The doses of morphine were 5, 10, 20, 40, 50, 60 mg? kg-1?day-1 from the 1st day to the 6th day respectively. In the two abstinence groups, the withdrawal syndromes were induced by intraperitoneal naloxone 5 mg ? kg-1. The rats in control group received saline. 30 min after the end of all procedures the animals were decapitated on ice. Brain was removed immediately and kept in liquid nitrogen. The Bmax and Kd values of 3H-DAMGO saturation binding to MOR were measured by Scatchard analysis. The gene expression of MOR was appraised by RT-PCR. Results (1) In the acute dependence group the Bmax value(the specific binding capacity of MOR) significantly increased and the affinity decreased. After abstinence the Bmax value returned to normal, but the affinity was still low. In chronic dependence and abstinence groups Bmax value decreased significantly and there was no change in Kd value. (2) The level of MOR mRNA increased significantly in acute dependence group and returned rapidly to normal after abstinence . In chronic dependence and abstinence groups the transcription of MOR was significantly lower than in control group. Conclusions The modulation of MOR in rat brain is different between acute and chronic dependence and there must be similar post-receptor mechnism involved.

Objective To explore the misunderstanding and comprehension of hybrid operation for treating aortic dissection involving aortic arch.Methods From March 2009 to November 2013,13 patients received hybrid operation for aortic dissection involving aortic arch in the People's Hospital of Xinjiang Urgur Autonomous Region were enrolled,including male 11 and female 2,and aged 36 ～ 60 years old with a mean age (44 ± 6.8) years old.All patients were type-B aortic dissection.All of them were not suitable to be treated with endovascular exclusion monotherapy.The ascending aorta-brachiocephalic artery bypass and left carotid artery bypass was established with median sternotomy approach and neck incision in 13 patients,and 2 patients did left subclavian artery bypass additionally,then retrograde endovascular stent graft implantation was used.Computed tomography angiography (CTA) scanning at 3-month,9-month,1-year and every-year after operation showed no stent grafts translocation and bypass graft obstruction.Results The surgical operation and stent grafts implantation were completely successful.Angiography showed 1 case had end leakage and other cases no obvious displacement or end leakage of stent grafts in operation.Blood flow in true lumen of aortic dissection was recovered and all of bypass grafts were unobstructed.No death and severe complications occurred.All patients were followed-up with 3 to 56 months [(29.0 ± 10.2) months],and all patients resumed normal life.Enhanced CT scanning after operation showed 1 case had endoleak and other cases no endoleak,stent grafts translocation and bypass graft obstmction.No signs of brain and limb ischemia were observed.Conclusions To summarize misunderstanding and experience by continuous explore feature of hybrid operation for treating disease involving aortic arch,we developed a more reasonable surgical treatment options that can improve the success rate of complex aortic dissection surgery,and ultimately achieve better surgical results.

Objective Retrospective analysis of experience of distal upper limb autologous arteriovenous fistula for hemodialysis access and treatment of arteriovenous fistula occlusion was conducted.Methods To summarize the clinical data of 214 cases of initial autologous arteriovenous fistula and 22 cases of treatment of arteriovenous fistula occlusion were carried out from Aug.2007 to Mar.2011,comparing the success rate and long-term patency rate.Results Two hundred and fourteen cases of initial autologous arteriovenous fistula,in which 168 cases were cephalic vein-radial artery side-to-side anastomosis at snuffbox,46 cases were cephalic vein-radial artery end-toside anastomosis at proximal wrist,the success cases were 203 (94.8％),the failed cases were 11 (5.2％),limb edema in 82 cases and there was no steal syndrome and heart failure.The primary patency rate was 95.2％ at 1 year and 91.3％ at 2 years.There were 22 patients accepted treatment of arteriovenous fistula occlusion,in which,8 cases were embolectomy due to acute occlusion,8 cases were thrombectomy and balloon dilation because of anastomotic stricture and thrombosis and 1 failed,5 cases were proximal anastomosis again after chronic occlusion.Conclusions Autologous arteriovenous fistula of the distal upper limb,especially from the place of snuffbox which is the preferred method for autologous arteriovenous fistula.And deal with arteriovenous fistula occlusion actively can often extend the usage time of the autologous blood vessels and improve the life quality of patients.

Objective To evaluate thoracic endovascular aortic repair for type B aortic dissection.Methods Chnical data were reviewed on 126 cases with type B aortic dissection undergoing endovascular aortic repair in our hospital from January 2006 to April 2011.There were 86 male patients and 40 female patients,age from 32 to 82 years.The stent- grafts were introduced via femoral arteriotomy.Stent-grafts were implanted to blockade tears of aortic dissection under the guidance of DSA.Postoperatively patients were followed-up by angiography and imiging for endoleak,stent migration,and fracture of stent-graft.Results In all cases,the aortic dissection tears were closed,true lumens were opened,and organ function was restored.There were not complications such as internal hemorrhage due to trauma or stent displacement on CTA from 3 to 63 months after endovascular therapy.Procedure was successful in all 126 cases,157 stents were released,2 cases died in the perioperative period,1 case died during the followed-up.A breach was found at the end of the stent in 12 cases,endovascular aortic repair redone successfully with a retrograde type A dissection found during follow-up.Conclusions Endovascular aortic repair is safe and effective for patients with Stanford type B aortic dissection with a favorable outcomes.

OBJECTIVETo compare the efficacy difference of analgesia and detumescence on ankle sprain among acupuncture at Xiaojie point combined with tendon regulation manipulation, acupuncture at Xiaojie point and tendon regulation manipulation.

METHODSSixty cases of ankle sprain were randomized into a combined therapy group, a Xiaojie point group and a tendon-regulation manipulation group, 20 cases in each one. The combined therapy of acupuncture at Xiaojie point and tendon regulation manipulation, the acupuncture at Xiaojie point and the simple application of tendon-regulation manipulation were applied respectively in the three groups, once a day, 3 treatments were required. The symptom score such as pain, ecchymosis, swelling and motor dysfunction and the total score were observed before and after treatment in the three groups. The different values of pain and swelling scores were compared before and after treatment in the three groups. The efficacy was compared among the groups.

RESULTSThe total effective rate was 100.0% (20/20) in each group. But the curative rate was 85.0% (17/20) in the combined group, 65.0% (13/20) in the Xiaojie point tion manipulation group. After treatment, the symptom scores of pain, ecchymosis, swelling and motor dysfunction and the total score were all improved as compared with those before treatment in the three groups (P < 0.01, P < 0.05). The pain score in either the combined therapy group or Xiaojie point group was lower than that in the tendon-regulation manipulation group after treatment (0.20 -/+ 0.41, 0.15 +/- 0.37 vs 0.60 +/- 0.50, both P < 0.05). Swelling score in the Xiaojie point group was different significantly from that in the tendon-regulation manipulation 0.49 vs 06.4 vs. 20+0.41, P < 0.05). The different value of pain score in either the combined therapy group or Xiaojie point group was higher than that in the tendon-regulation manipulation group before group after treatment (0.65 bined therapy group or Xiaojie point group was higher than that in the tendon-regulation manipulation group before and after treatment (2.35 +/- 0.59, 2.45 +/- 0.51 vs 2.00 +/- 0.46, both P < 0.05). The different value of swelling score in the tendon-regulation manipulation group was higher than that in the Xiaojie point group before and after treatment (2.30 +/- 0.57 vs 1.60 +/- 0.60, P < 0.05).

CONCLUSIONAcupuncture at Xiaojie point combined with tendon-regulation manipulation achieve an apparent effect of analgesia and detumescence on ankle sprain.

Acupuncture Analgesia ; Acupuncture Points ; Acupuncture Therapy ; Adolescent ; Adult ; Aged ; Ankle Injuries ; physiopathology ; therapy ; Combined Modality Therapy ; Female ; Humans ; Male ; Tendons ; physiopathology ; Therapy, Soft Tissue ; Young Adult

Objective To explore the distribution characteristics and clinical typing methods in distal crevasses of Stanford B aortic dissection.Methods Review of the cases in the People's Hospital of Xinjiang Urgur Autonomous Region from 2010 January to 2013 June were diagnosis of Stanford type B aortic dissection with computed tomographic angiography data,Observed its distal crevasses distribution and statistical its number,then summarizes the distribution characteristics of the distal crevasses and further put forward a method of clinical typing.Results Refer to 115 cases with Stanford type B aortic dissection computed tomographic angiography data,including 101 cases with distal crevasses (87.83％) and a total of 240 distal crevasses,an average of 2.37 per case.Conclusions The distal crevasses more often appear in the area involving visceral artery,combined with its different in distribution characteristics and processing methods,we put forward the classification method,namely:Type Ⅰ:the distal crevasses are located in the zone of the thoracic artery; Type Ⅱ:the distal crevasses are close to the visceral artery or involvement it; Type Ⅲ:the distal crevasses are lower than the renal artery,not involving the visceral artery; Type Ⅳ:the distal crevasses are located in the zone of the iliac artery.

AIM To develop a murine model for investigating the effects of prenatal cocaine exposure on the development of fetal nerve system. METHODS A nutritionally paired control group of dams injected with saline and pair fed with the COC dams were set up. Another two groups were COC groups injected with cocaine HCl and SAL group administrated with saline. After injection twice daily during gestation days 8～17,mice were decapitated on E17 and blood and brain samples were collected for pharmacological analysis and neurotransmitter analysis by HPLC.RESULTS Pharmacological analysis revealed that cocaine was found in maternal and fetal plasma at 15 min following ip administration to embryonic day E17 pregnant mice. Though COC dams and SPF dams had the same feeding condition, compared with the latter, the former had higher maternal concentrations of DA and 5 HT, lower fetal weight, brain weight, striatum weight and higher concentrations of DA and 5 HT in striatum, P

AIM To investigate the effects of in utero cocaine exposure on the fetal development, when fetuses were exposed to equal total dose but different dose and timing. METHODS Pregnant dams were randomly separated into three groups: SAL, COC20 and COC40. On E17, recorded body weight, brain weight and striatum weight of all groups, and examined the concentrations of DA and 5 HT in fetal striatum by HPLC. RESULTS Body weight of SAL, COC40, COC20 groups decreased progressively in turns. Brain weight of COC20 group and COC40 group was lower than that of SAL. Only the brain/body ratio of COC40 was decreased ( P