Objective To evaluate the role of the expression of protein kinase Cγ and Cα in spinal dorsal horn in the metabotropic glutamate receptor subtype 5 (mGluR5)'s participation in the development of morphine tolerance in rats. Methods Thirty-two male SD rats in which the intrathecal (IT) catheter was successfully placed were randomly divided into 4 groups (n = 8 each): control group (group C), morphine tolerance group (group M), antisense oligodeoxynucleotide (ODN) plus morphine group (group ANT) and mismatch ODN plus morphine group (group MIS). Rats in group M received 0.9% normal saline (NS) 5 μl twice a day for 8 days, and IT morphine 15 μg was injected simultaneously at 6, 7 and 8 days twice a day. Rats in group ANT and MIS received IT antisense and mismatch ODN 30 nmol (in 0.9% NS 5 μl) twice a day for 8 days respectively and IT morphine 15 μg was injected simultaneously at 6, 7 and 8 days twice a day. Rats in group C received NS instead twice a day for 8 days. Paw-withdrawl threshold (PWT) to thermal and mechanical stimulation was measured at 6, 7 and 8 days after ODN injection (T1-3). The animals were killed on 9th day (T4) and the lumbar segment of the spinal cord was removed for determination of the expression of mGluR5, PKCα and PKCγ mRNA (by RT-PCR), PKCαand PKCγ ( by Western blot). Results PWT to thermal and mechanical stimulation was significantly higher at T1.2in group M and MIS and at T1.3 in group ANT, the expression of mGluR5 mRNA, PKCα and PKCγ was significantly higher at T4 in group M and MIS, and mGluR5 mRNA expression was significantly lower at T4 in group ANT than in group C ( P ＜ 0.05). PWT to thermal and mechanical stimulation was significantly higher at T2.3, while the expression of mGluR5 mRNA, PKCα and PKCγ lower at T4 in group ANT than in group M ( P ＜ 0.05). Conclusion The expression of protein kinase C in spinal dorsal horn plays an important role in the mGluR5's participation in the development of morphine tolerance in rats.

Objective To evaluate the feasibi1ity and efficacy of transcatheter closure of perimembranous and muscular ventricular septal defects (VSD) using the new Amplatzer membranous and muscular VSD occluder and observe the effect of membranous VSD occluding procedure on atrioventricular(AV) conductive system.Methods Twelve patients (7 males,5 females) with perimembranous VSD and two patients (1 male,1 female) with muscular VSD underwent an catheter closure using the new Amplatzer membranous and muscular VSD occluder.All patients who were eligible for device closure by means of cardiac Doppler echocardiography were routinely measured the parameters of blood dynamics before catheter closure. Artery-venous track was set up under the X-ray fluoroscopy,transesophageal (TEE) or transthoracic echocardiography (TTE) guidance. Devices were released in the right ventricular side.Twelve patients with perimembranous VSD underwent the cardiac electrophysiologic examination,including atrioventricular conductive time (AV interval) and atrioventricular nodal refractory time,before and after catheter closure.A11 patients were followed up at 2 weeks,1 month,3 months and 6 months after the procedures.Results The devices were deployed successfully in 14 patients.There was complete closure in 12 patients immediately,and tiny (

0.05),while the levels of IL-8 and IL-6 declined,but were still significantly higher than that at immediately after induction of anesthesia(P

Objective To study a method for determination of aluminum in food,and to ensure food safety and public health.Methods Microwave digestion-chrome azurol S spectrophotometric method was used to detect the aluminum content in fried dough sticks.Detection limit,linear range,precision,accuracy and maximum absorption wavelength were calculated.Results The method detection limit was 0.08 μg,precision was 0.60％-5.90％,and recovery rate was 96.0％-102.3％,maximum absorption wavelengnth was 620 mm.Aluminum content in 10 samples of fried dough sticks were all exceeded the standard,which were 709.5,980.8,1 010.3,1 151.5,1 214.0,1 243.7,1 318.1,1 374.0,1 435.0 and 1 479.4 mg/kg.Conclusion The method is simple,reliable,reproducible and easy to be used.

Objective To evaluate the efficiency and safety of Percusurge guardwire distal protection system in coronary intervention in patients with acute myocardial infarction. Methods Three male patients with acute myocardial infarction were enrolled in the study. Primary angioplasty was performed for 2 of them, 2 and 7 hours after onset of the infarction symptom, respectively. Selective angioplasty was performed 17 days after infarction for the third case. Percusurge guardwire system was used during the procedure. Results Procedure success was achieved for all of the 3 cases. Lot of thrombus was sucked out. The infarct-related arteries had TIMI 3 flow at the end of the procedures. The patients′ symptoms were resolved soon after the procedure. Minor dissection was seen in one case which did not obstruct the distal flow and was left alone. Conclusion Percusurge guardwire system can be used safely and effectively in coronary intervention in the thrombus-laden arteries such as acute myocardial infarction.

Objective To explore the effect of Dexamethasone(DEX)on the proliferation and the expression of fibroblast growth factor(FGF)- 1,FGF - 2 and interleukin - 6(IL - 6)mRNA in hyperoxia - exposed human em-bryo lung fibroblasts(MRC - 5). Methods High oxygen volume fraction of 950 mL/ L was used to establish hyperoxia -damaged cell models,then treated with different concentrations of DEX(10 - 4 ,10 - 6 ,10 - 8 ,10 - 9 ,10 - 10 ,10 - 11 ,10 - 12 mol/ L),respectively. The proliferation activity of the cells was evaluated by methyl thiazolyl tetrazolium(MTT)at 24 h,48 h,72 h,and the optimal hyperoxia - exposed time and concentration of DEX were chosen;then they were divided into air group,hyperoxia group and hyperoxia + DEX group. The mRNA expressions of FGF - 1,FGF - 2 and IL - 6 were detected by quantitative real - time PCR at 48 h. Results Cell proliferation activity of the hyperoxia group was lower than that of the air group and there were significant differences at 48 h and 72 h(all P ﹤ 0. 05). Compared with the hyperoxia group,cell proliferation activity of the hyperoxia + DEX group increased with the concentration of DEX decreasing,reaching the peak at 10 - 9 mol/ L,and then gradually decreased with the concentration of DEX decreasing. Cells were cultured for 48 h,compared with the air group,the level of FGF - 1 mRNA was lower,FGF - 2 and IL - 6 mRNA were higher in the hyperoxia group(P ﹤ 0. 05). Compared with hyperoxia group,the level of FGF - 1 mRNA was higher,FGF - 2 and IL - 6 mRNA were lower in hyperoxia + DEX group(P ﹤ 0. 05). Conclusions Exposure to high oxygen volume fraction of 950 mL/ L for 48 h can cultivate optimal hyperoxia - damaged cell models,and DEX can protect the cell from hyperoxia injury and 10 - 9 mol/ L was the optimal concentration. Enhanced the expression of FGF - 1 mRNA and inhibited expression of FGF - 2 mRNA may be one of the mechanism that DEX protects the cells from hyperoxia injury.

Objective To evaluate the efficacy of thoracic cavity perfusion with cisplatin combined with mannan peptide in nasopharyngeal carcinoma patients with malignant pleural effusion.Methods 47 cases of nasopharyngeal carcinoma patients with malignant pleural effusion with a median age of 50 years old (41-70 years old) were enrolled.Pleural effusion occurred at 38.5 months on average after diagnosis,unilateral effusion was seen in 45 patients (95.7 ％),bilateral effusion was seen in 2 patients (4.2 ％).Cisplatin combined with mannan peptide was administered through pleural puncture by PICC center vein pipe after drainage.Data of survival complications and response to the treatment were reviewed.Results 17 patients (36.1％) had a complete remission (CR),21 patients (44.6 ％) had partial remission (PR),and the total remission rate (CR+ PR) was 80.9 ％.The median survival time was 10.5 months.Patients with pleural fluid pH ≥ 7.2,glucose ≥ 60 mg/L,and lactic dehydrogenase (LDH) ＜ 600 U/L showed association with good efficacy,the efficacy rates were 85.0 ％ (34/40),86.5 ％ (32/37),89.5 ％ (34/38),the median survival time were 11.5,12.0,12.5 months.Pleural fluid pH ＜ 7.2,glucose ＜ 60 mg/L,and LDH ≥ 600 U/L showed association with poor efficacy,the efficacy rates were 42.8 ％ (3/7),50.0 ％ (5/10),44.4 ％ (4/9),the median survival time were 6.5,6.5,6.0 months (P ＜ 0.05).The curative effect of the patients with bone metastasis and (or) pulmonary metastasis without liver metastasis was more similar with that of the patients with liver metastases [(47.0 ％ (16/34) vs 57.1％ (4/7),x2 =0.01,P =0.29].But median survival time had significant difference (11.0 vs 6.0 months,P =0.02).The Cox multi-factor analysis confirmed that the LDH value of effusion was an independent factor as prognosis evaluation.Major side effects of the treatment included fever,chest pain,nausea and vomiting.Conclusion Thoracic cavity perfusion using cisplatin combined with mannan peptide is effective in the treatment of malignant pleural effusion in nasopharyngeal carcinoma patients with pleural effusion,with relatively low toxicity.LDH value is a predictive factor for survival.The patients with liver metastases appeare poor median survival time.

Objective To identify the key factors triggering medical disputes induced by differences in cognition between doctors and patients in order to control the occurrence and development of medical disputes. Methods From 2002 to 2006,the outpatients,inpatients and medical staff of 3 hospitals in Shanghai(class 3 first level general hospital,n=2;class 3 first level special hospital,n=1) were investigated,and random sampling method was employed for the research analysis. Results There were significant differences between doctors and patients in cognition of influential factors triggering medical disputes such as health law,medical services,rights and obligations. Conclusion The differences in cognition between doctors and patients are important causes for medical disputes,and effective prevention and intervention measures must be taken.

Objective To investigate the effect of clinical nursing pathway on mechanical ventilation effect of ARDS patients. Methods 59 ARDS patients with mechanical ventilation from June 2008 to December 2010 were randomly divided into the observation group (30 cases)and the control group (29 cases). The control group used the traditional care model, conventional mechanical ventilation monitoring,treatment and care according to routine measures; the observation group used clinical nursing pathway. The mechanical ventilation time, complication rate of mechanical ventilation, and the gratification level of patients in the two groups of patients were observed. Results The mechanical ventilation time in the observation group was less than the control group, and incidence of complications was lower, and satisfaction degree of patients and their families was better, the difference was statistically significant. Conclusions The clinical nursing pathway can shorten the time of mechanical ventilation, lower incidence of complications of mechanical ventilation, and it improves satisfaction degree of patients and their families.