Endomorphins(EMs),two tetrapeptides, were discovered in 1997 and believed to be endogenous ligands of μ-opioide receptor(MOR). They mediated various physiological processes by binding to MOR that couple with G-proteins. Based on our works and literatures, we reviewed the distribution in nerve system, receptor binding properties, analgesis, effects on ion channels, conformation and struction-activity relationship of EMs.

AIM　To analyze the effects of endomorphins (EMs) and their analogs (［D-Pro2］EM-1, ［D-Ala2］EM-1, ［D-Pro2］EM-2 and ［D-Ala2］EM-2) on the cardiovascular system of anesthetized rats and to study its mechanism. METHODS　Responses to EMs and their analogs were investigated in the systemic vascular bed of rats and the mesenteric microarteria of Bufo gargarizans. Responses to EMs were investigated on the hindquarters of the rat vascular bed under constant-flow conditions and on the isolated rabbit thoracic aorta strips. RESULTS　The EMs and their analogs showed dose-related (10-9-10-6 mol*L-1, iv) and naloxone-sensitive (2 mg*kg-1, iv) hypotension in mean arterial pressure of rats with similar duration and vasodilatation in mesenteric microarteria of Bufo gargarizans. The sequence of potencies was EMs > ［D-Pro2］EM-2 > ［D-Ala2］EM-2 > ［D-Ala2］EM-1 > ［D-Pro2］EM-1. EMs were shown not to relax the isolated rabbit thoracic aorta strips without endothelium. EMs, however, relaxed them with endothelium significantly. This action was blocked by Nx (10-5 mol*L-1) and L-NNA (10-4 mol*L-1). CONCLUSION　The significant hypotensive activity of EMs and their analogs is mainly associated with their vasodilatation, which is related to the release of NO from vascular endothelium, and their potency is not completely related to their affinity for μ-opiate receptor.

Clinical data of 83 patients with obscure gastrointestinal bleeding (OGIB) undergoing capsule endoscopy were reviewed retrospectively.The results showed that the overall detection rate of gastrointestinal lesions for OGIB by capsule endoscopy was 81.9％ (68/83), most lesions (77. 1％, 64/83 )were located in small intestine. Of all the small intestinal lesions, arteriovenous malformation (AVM) was the most common (22 cases, 26.5％ ),followed by small intestinal space-occupying lesion (18 cases,21.7％ ) and single or multiple ulcers of small intestine ( 16 cases, 19. 3％ ). Four cases (4. 8％ ) had lesions outside of the small intestine. Small intestinal AVM was the leading cause of OGIB in patients ＞ 50 y,space-occupying lesion was the most common in patients aged 30 -50 y, while ulcer was the leading cause in patients ＜ 30 y. Bowel obstruction was not found in this group of patients. The results indicate that capsule endoscopy has great diagnostic value in detecting causes of OGIB. Small intestinal AVM is the most common cause of OGIB, followed by space-occupying lesion and ulcer.

ObjectiveTo explore the particular inner world of the children with attention deficit hyperactivity disorder (ADHD)with the sandplay therapy and the initial sandtray's clinical diagnosis role and value on the ADHD.MethodsThe differences of the initial sandtrays between 28 children with ADHD and 24 normal children were compared.Results 1.On the use of toys,the experimental group was significantly higher in transports ((5.04 ±6.60),(1.38 ±2.12),t=2.73) and lower in stones((0.00 ±0.00),(8.00 ± 12.33),t=-3.18).2.On the scene of sandtrays,the experimental group was significantly higher in the fight( x2 =12.96,P ＜ 0.01 ),dynamic scenes ( x2 =13.37,P ＜ 0.01 ).3.On the use of self-images,the experimental group was lower than the normal children,and the differences were significant ( x2 =4.75,P ＜ 0.05 ).4.There were no significant differences in the use of sand between two groups( x2 =3.46,P ＞ 0.05).ConclusionThe results show that the children with ADHD have significantly characteristics in sandtrays.Initial sandtray is valuable to be an aid to clinical diagnosis and intervention means.

Objective To investigate the risk factors which indicate behavior problems and degree of conflict function defects in different subtypes of attention deficit hyperactivity disorder( ADHD),and to compare behavioral problems,family environment and conflict function in children with and without ADHD.Methods 87children with ADHD and 38 matched controls performed Simon-Stroop task while questionnaires (Parent Symptom Questionnaire and Family environment Scale)were acquired from their parents.Results Questionnaire indicated that children with ADHD-combined(ADHD-C) had the highest score of conduct problem( 1.05 ± 0.44),learning problem ( 1.97 ± 0.52 ),hyperactivity-impulsion ( 1.56 ± 0.60) and hyperactivity index ( 1.45 ± 0.40 ) than ADHDⅠ(0.65±0.32,1.58 ±0.58,1.06 ±0.46,1.01 ±0.31) and matched controls ( 0.42 ±0.24,0.77 ±0.49,0.58±0.40,0.55 ±0.34) in PSQ.ADHD-Ⅰ and ADHD-C had higher score of contradiction(3.28 ± 1.70,4.61 ±2.56 ) and lower score of family cohesion (6.75 ± 2.27,6.61 ± 2.03 ),emotional expression (5.03 ± 1.54,5.06 ±1.91 ),knowledge (3.83 ± 2.30,3.61 ± 1.81 ) and entertainment (3.70 ± 2.12,3.47 ± 2.32 ) than matched controls (2.36 ± 1.44,8.06 ± 1.71,6.03 ± 1.54,4.86 ± 1.91,4.83 ± 2.29) in FES-CV.Behavior data indicated that the correct rate of children with ADHD-Ⅰ and ADHD-C in Simon-incongruent trials( Siin:0.76 ± 0.13,0.69 ±0.13 ) and Stroop-inconsistent trials( Stin:0.82 ± 0.10,0.78 ± 0.08 )were lower and reaction time of children with ADHD-Ⅰ and ADHD-C in the Siin ( (876.4 ± 97.34) ms,( 893.8 ± 130.1 ) ms) and Stin ( ( 864.4 ± 91.82 ) ms,(860.2 ± 125.0) ms) were longer than matched controls ( (Siin (0.81 ± 0.11 ) ms,(810.4 ± 136.1 ) ms; Stin (0.87 ± 0.08 ) ms,(797.4 ± 136.1 ) ms).Pearson correlation analysis suggested that some factors in the FES-CV had correlation with behavioral problems.Conclusion This finding indicates that poor family environment is the risk factor that indicate behavioral problems in children with ADHD and behavioral problems,conflict function defeet of ADHD-C are more serious than ADHD-Ⅰ and matched controls.

Aluminum ; toxicity ; Animals ; Animals, Newborn ; Calcium ; metabolism ; Cerebral Cortex ; drug effects ; metabolism ; Dose-Response Relationship, Drug ; Female ; Male ; Rats ; Rats, Wistar

Objective To evaluate MRI diagnostic value for single lesion characteristics in the splenium of corpus callosum.Methods MRI features,clinical data,and parts of follow-up results of 9 cases with single lesion in the splenium of corpus callosum were analyzed retrospectively.Results (1)Clinical manifestations:headache and dizziness occurred in 4 cases,syncope in 3 cases,fever in 2 cases, physical activity barriers in 2 cases.(2)Clinical diagnosis:hypoglycemic encephalopathy were rescaned one month later in 3 cases, in which the previous lesion completely disappeared.Clinical experience of encephalitis were improved after treatment in 2 cases. Cerebral infarction,epilepsy,brain injury and degeneration were diagnosed respectively in each one case,in which lesion still existed after treatmented.(3)Image findings:despite the different clinical manifestations,image features of all cases were quite similar. Round or foliated like lesions of slightly long T1 and long T2 signals in the splenium of corpus callosum were presented in all cases. High signals on diffusion weighted imaging and low signals on the ADC were showed with same lesions,andno obvious enhancement after contract media injected was seen.Conclusion Single lesions in the splenium of corpus callosum are showed in many diseases. The image features of hypoglycemic encephalopathy or encephalitis have certain characteristics (single lesion is reversible).Accurate diagnosis need to combine with clinical data and medical history.

Objective:To study the effects of endothelial progenitor cells(EPCs)on the osteogenesis of bone marrow mesenchymal stem cell (BMSCs)sheet-implant complex.Methods:EPCs were added to the BMSC sheets,and the expression of osteogenesis-relat-ed genes was examined by real time PCR.Cell sheets were wrapped around implants to construct cell sheet-implant complexes and the complexes were subcutaneously transplanted into SCID mice.The complexes were harvested 8 weeks after operation and observed by micro-CT and histological examination.Results:The BMSC sheet with EPCs showed higher expression of Runx2,ALP,BMP2 and VEGF in the in vitro test;higher bone volume ratio,greater amount of new bone tissue and higher expression of Runx2 and BMP2 in the in vivo test.Conclusion:EPCs can improve the osteogenesis of BMSC sheet-implant complex.

Objective:To evaluate the treatment strategy of primary shortening plus secondary lengthening for Gustilo ⅢC open fractures in the lower limb.Methods:From January 2010 to January 2018, 12 patients (8 males and 4 females) with complex Gustilo ⅢC open fracture in the lower limb received emergency treatment at Department of Orthopaedic Surgery, Wuhan Fourth Hospital. Their ages ranged from 22 to 67 years (average, 41.2 years). All patients were complicated with bone and soft tissue defects associated with nerve and vascular injury in the lower limb. The sizes of soft tissue defects ranged from 4 cm × 2 cm to 17 cm × 12 cm; the main arteries were shortened after debridement by an average of 4.2 cm (from 1.2 cm to 8.3 cm); the broken nerves were shortened after debridement by an average of 4.0 cm (from 1.0 cm to 8.1 cm); the tibial shaft defects averaged 6.3 cm in length (from 2.0 to 9.6 cm). All cases were treated at the first stage by emergency debridement and shortening at the fracture site to directly repair the damaged bone, blood vessels and nerves before the wound was covered. After the limb survived and the wound completely healed, an Ilizarov external fixator was installed to lengthen the limb by bone transport. Recorded were speed of bone lengthening, time with external fixation and complications. The lower limb functions were evaluated at the last follow-up by Paley criteria.Results:The 12 patients were followed up for 14 to 32 months (average, 19.1 months). All the limbs survived with no serious infection. The shortening ranged from 2.0 to 8.2 cm (average, 3.6 cm); the mean speed of bone transport was 0.87 mm/day; the time with external fixation ranged from 11 to 16 months (average, 13.2 months); the bony union was achieved after 10 to 14 months (average, 11.2 months). Postoperative horseshoe inversion was reported in 7 patients, and needle tract infection below Dahl grade 3 in 2 cases. According to Paley criteria, the function of lower limb was rated as excellent in 8 cases, as good in 3 cases, and as fair in one.Conclusion:The treatment strategy of primary shortening plus secondary lengthening using Ilizarov technique has lowered the risk for limb salvage and the surgical difficulty, leading to fine clinical outcomes.

Objective To dynamically investigate the effects of aluminum on the concentration of free intracellular Ca2+([Ca2+]i) and the expression of calcium channels in the hippocampus of rats. Methods Healthy 64 Wistar rats were taken as the experimental objects. And these rats were randomly divided into 16 groups according to their weights, and were instilled with AlCl3 at 0(control),37.3,74.7 and 248.7 mg/kg respectively. The experimental time exposed to AlCl3 was 45,75,120 d, among which the rats were given AlCl3 for 120 d fed normally for 30 d. The hippoeampus were segregated on day 45,75,120 and 150 d and the[Ca2+]i of hippocampus of rats were detected by fluorospectrophotometer. The expression of Ryanodine receptor 2 (RyR2) mRNA and α1C ubunit of L-type calcium ehannels(L-Ca2+α1C) mRNA were detected by RT-PCR analysis. Results [Ca2+]i was increased by AlCl3 in a dose-and time-dependant manner(F=23.136 and 19.089, P<0.01). There was a synergistic effect between the dose and time in [Ca2+]i (F=2.270, P<0.05). In time of 120,150 days, the [Ca2+]i of rats hippocampus in 37.3[(299.3±48.7), (342.7±35.3)nmol/L], 74.7[(391.2±47.9), (408.1±42.8)nmol/L] and 248.7 mg/kg group[(397.9±55.8), (405.2±22.7)nmol/L] significantly increased compared with control group [(195.1±29.9), (209.1±30.6)nmol/L; P<0.01]. The expression of RyR2 mRNA and L-Ca2+α1C mRNA were increased by AlCl3(F=23.301 and 60.812, P<0.01). The experimental time could lower the expression of L-Ca2+ α1C mRNA (F=6.088, P<0.01), but had no influences on the expression of RyR2 mR NA (F=1.361, P>0.05). There was interaction between the dose of AlCl3 and the time in the expression of L-Ca2+α1C mRNA (F=5.876,P< 0.01). On day 75,120 and 150 of the experiment, the expression of L-Ca2+α1C mRNA in rat hippocampus of 74.7 (1.03±0.16,1.18±0.18,0.92±0.11) and 248.7 mg/kg group(1.89±0.26, 1.25±0.10, 1.07±0.14) also increased compared with control group(0.63±0.09,0.78±0.16,0.69±0.11; P<0.05 or <0.01). On day 45,75, 120 and 150 of the experiment, the expression of RyR2 mRNA in 74.7(0.49±0.06,0.51±0.07,0.57±0.11, 0.47±0.11), 248.7(0.47±0.03,0.52±0.09, 0.70±0.10, 0.78±0.09)mg/kg AlCl3 groups was highly increased compared with control group (0.24±0.07, 0.32±0.04, 0.30±0.06, 0.27±0.06; P<0.05 or<0.01). Conclusion Al increases [Ca2+]i by increasing the expression of the RyR2 mRNA and L-Ca2+α1C mRNA, thus exerts an irreversible neuronal toxicity.