Objective To study the effect of dexmedetomidine(DEX)intrathecal administration on formation of chronic neuropathic pain induced by chronic constriction injury(CCI)in rats. Methods One hundred and twenty healthy adult male Sprague-Dawley(SD)rats were divided randomly into four groups(each n=30):sham group, model group,30μg/kg and 60μg/kg DEX intrathecal injection group(D30 group,D60 group). The CCI model was installed by left sciatic nerve ligaturing,sham surgery was done by exposing the sciatic nerve without ligation,and 30 μg/kg,60 μg/kg DEX(each,10 μl)and 10 μl normal saline were given intrathecally in D30,D60 and model groups respectively,all kinds of injection being once a day for 7 days. Hind paw mechanical contraction reflex threshold(MWT),heat-shrinkable reflex latency(TWL)and the score of motor dysfunction of hind extremity in rats were recorded on 1 day before ligation and 1,3,7 days after operation,and before ligation and 1,7,14 and 21 days after operation,the contents of tumor necrosis factor-α(TNF-α),interleukin(IL-1βand IL-6)in intumescentia lumbalis were measured by enzyme linked immunosorbent assay (ELISA). Results Compared with before operation,there were no significant differences in values of MWT,TWL,the motor function evaluation,TNF-α, IL-1β,and IL-6 at each time points(all P>0.05);however,with the prolongation of time,MWT and TWL were decreased,and the motor function evaluation,TNF-α,IL-1β,and IL-6 were increased in all the other groups. Compared with those of the sham group,MWT and TWL were declined,and the motor function evaluation,TNF-α, IL-1β,and IL-6 were elevated in model group. Compared with those of model group,30μg/kg and 60μg/kg DEX could significantly raise MWT(g)and TWL(s),obviously improve motor function and remarkably decrease the contents of TNF-α(pg/mg),IL-1β(pg/mg)and IL-6(pg/mg)in the spinal cord of CCI rats from 1 day after operation. And the changes in 60 μg/kg DEX group were more significant than those in 30 μg/kg DEX intrathecal injection group〔postoperative 1 day MWT:39.3±1.3 vs. 20.3±2.2,TWL:10.9±0.4 vs. 8.2±1.1,motor function score:2.00±0.00 vs. 2.00±0.75,TNF-α:33±7 vs. 125±18,IL-1β:108±12 vs. 203±34,IL-6:156±39 vs. 405±75,all P<0.05〕. Conclusions The DEX intrathecal administration has certain degree of dose-dependent therapeutic effect on hyperalgesia in CCI rat models. The mechanism is related to the amelioration of inflammatory reaction at the lumbar segment of spinal cord.

[ ABSTRACT] AIM: To investigate the protective effect of autophagy on oxidized low density lipoprotein ( ox-LDL)-induced macrophage apoptosis and the underlying molecular mechanisms .METHODS:The RAW264.7 macropha-ges were pretreated with 3 mmol/L 3-methyladenine (3-MA), 1 μmol/L rapamycin (Rap) or 4 mmol/L 4-phenylbutyric acid ( PBA) respectively for 1 h and then treated with ox-LDL (100 mg/L) for 12 h.The cell viability and apoptosis were determined by MTT assay and flow cytometry with Annexin V-FITC/PI staining, respectively.The activities of lactate de-hydrogenase ( LDH) in the medium and caspase-3 in the cells were determined by detection kits .The protein levels of bec-lin-1 (a molecular marker of autophagy ), glucose-regulated protein 78 (GRP78, an endoplasmic reticulum stress marker) and C/EBP homologous protein ( CHOP, a key-signaling component of endoplasmic reticulum stress-induced apoptosis ) were examined by Western blot .Microtubule-associated protein 1 light chain 3 (LC3, another molecular marker of autoph-agy) was observed under laser scanning confocal microscope .RESULTS: Treatment of the RAW264.7 macrophages with ox-LDL at 100 mg/L for 12 h resulted in significant decrease in cell viability , and dramatic elevation in LDH leakage , cell apoptosis and caspase-3 activity, which were promoted by 3-MA (an autophagy inhibitor) and inhibited by Rap (an autoph-agy inducer ) .ox-LDL induced autophagy in the macrophages as assessed by beclin-1 upregulation and frequent granulation of LC3, which were inhibited by 3-MA and promoted by Rap.Interestingly, 3-MA enhanced, while Rap blocked, the CHOP upregulation induced by ox-LDL.Moreover , PBA ( endoplasmic reticulum stress inhibitor ) significantly inhibited ox-LDL-induced GRP78 upregulation and autophagy as determined by the attenuation of beclin-1 upregulation and frequent granula-tion of LC3.CONCLUSION: Endoplasmic reticulum stress mediates ox-LDL-induced autophagy in macrophages , and moderates activation of autophagy may protect macrophages from ox-LDL-induced apoptosis by inhibiting CHOP expression .

Objective:To analyze the clinical characteristics and influencing factors on postoperative emotional and cognitive function for elderly versus non-elderly male patients with laryngeal carcinoma.Methods:The patients with laryngeal cancer hospitalized in the Department of Otorhinolaryngology-Head and Neck Surgery were selected for a questionnaire survey in two Grade III-A Hospital in Shanxi Province from January 2018 to December 2019.There were 105 patients with laryngeal cancer, including 60 in the elderly and 45 in the non-elderly group.Negative emotion and cognitive function were investigated by using Self-rating Anxiety Scales(SAS), Self-rating Depression Scale(SDS), and Montreal Cognitive Assessment(MOCA)before surgery, 10 days after surgery, and 1 year after surgery, respectively.The clinical characteristics of the elderly versus non-elderly groups were analyzed and compared.Results:One year after surgery, there were 52 cases(86.7%)and 27 cases(45.0%)of depression and cancer-related cognitive impairment(CRCI)in the elderly group, which were higher than 30 cases(66.7%)and 4 cases(8.9%)in the non-elderly group, with statistically significant difference( χ2 = 6.013, χ2 =16.115 and P<0.05, P<0.01). The elderly group showed much more anxiety and CRCI 10 days after surgery(60.50±4.31 vs.55.84±3.81, 27.47±1.08 vs.28.31±1.08, P<0.01)and showed much more depression and CRCI(57.20±5.66 vs.62.60±5.37, 27.36±1.37 vs.26.08±1.42, P<0.01)than did the non-elderly group 1 year after surgery.The results of multiple linear regression analysis in the elderly group showed that the mode of operation and the pronunciation one year after surgery significantly affected their anxiety; the marriage and the educated level significantly affected their depression; the marriage, the educated level and operation mode significantly affected their cognitive function.Clinical stage of tumor significantly affected anxiety and depression, the educated level significantly affected cognitive function in the non-elderly group. Conclusions:Postoperative negative emotion and cognitive function in patients with laryngeal cancer continues to deteriorate after surgery, which were affected by many factors, especially in elderly patients.It is necessary to conduct active and effective interventions as soon as possible.

Objective:To explore the status of "socialized hospitalization" of chronic obstructive pulmonary disease (COPD) patients and its influencing factors, and propose constructive coping strategies.Methods:From June 2018 to June 2020, convenience sampling was used to select 256 COPD patients admitted to Hangzhou First People's Hospital as the research object. The self-designed Socialized Hospitalization Status and Influencing Factors Questionnaire was used to investigate patients. Single factor analysis and multivariate Logistic regression analysis were used to analyze the influencing factors of the "socialized hospitalization" of COPD patients.Results:Among 256 COPD patients, 239 effective samples were finally obtained, and 61 cases (25.52%) were "socialized hospitalization". The hospitalization time of patients with "socialized hospitalization" was longer than those with non-"socialized hospitalization", and the difference was statistically significant ( t=16.510, P<0.01) . Hospitalization expenses were higher than those with non-"socialized hospitalization", and the difference was statistically significant ( t=17.820, P<0.01) . The results of single factor analysis showed that there were statistically significant differences in the age, course of illness, type of medical insurance, hospital admission method, hospital-acquired infection, mental status score, dyspnea score, and basic life activity ability in patients with "socialized hospitalization" and non-"socialized hospitalization" ( P<0.05) . The results of multivariate Logistic regression analysis showed that the patient's age, type of medical insurance, hospital admission method, hospital-acquired infection, mental status, dyspnea, and basic life activity ability were the influencing factors of COPD patients' "socialized hospitalization", and the difference was statistically significant ( P<0.05) . Conclusions:Various physiological and pathological conditions and family conditions are the influencing factors of "socialized hospitalization" in COPD patients. The allocation of medical resources should be balanced, the nursing system should be perfected, and the technical level and quality of medical and nursing staff should be improved to ease the pressure of "socialized hospitalization".