Objective To investigate the effects of NO synthesis inhibition on pain threshold and binding capacity of NMDA receptor of hippocampus in rats. Methods Sixty-six SD rats of both sexes weighing (210 ? 20)g were randomly divided into 11 groups of six. Group I was used for determination of baseline values of pain threshold and binding capacity of NMDA receptor. In the five L-NAME groups (group Ⅱ-Ⅵ) 1% L-NAME in normal saline 50mg?kg-1 was given intraperitoneally (IP) . In the acute experiment pain threshold was determined 15 min (group Ⅱ ) and 30 min (group Ⅲ) after L-NAME IP injection. In the chronic experiment L-NAME 50mg?kg-1 was given IP twice a day for 1 day (group Ⅳ), 4 d (group Ⅴ) and 7 d (group Ⅵ) and pain threshold was measured 12h after last L-NAME administration. Group Ⅶ-Ⅺ served as control groups in which normal saline was given IP instead of L-NAME. Pain threshold was measured by response latencies following CO2 laser stimulation which was delivered to the medial surface of the ear. After determination of pain threshold the animals were decapitated and hippocampus was removed. The binding capacity of NMDA receptor with [3H] MK-801 was determined. Bmax and KD were determined by Scatchard analysis. Results There was no significant difference in pain threshold and binding capacity of NMDA receptor between group Ⅱ ,Ⅲ (acute experiment) and their control groups ( Ⅻ,Ⅷ). In chronic experiment pain threshold significantly increased after 1 and 4 d of L-NAME administration (group Ⅳ and Ⅴ) but return to the baseline value on the 7th day. NMDA receptor binding capacity increased in all three groups of chronic experiment. Bmax was significantly higher than the baseline value on the 4th and 7th day (group Ⅴ and Ⅵ). KD was significantly higher than the baseline value on the 4th day (group Ⅴ) but returned to the baseline on the 7th day (group Ⅵ) . Conclusions In chronic experiment NO synthesis inhibition can increase pain threshold to laser thermal nociceptive stimulation and induce changes in the affinity and density of NMDA receptor.

Objective To assess the biomechanical stability and vertebra strain distribution of asymmetrical posterior internal fixation for minimally invasive transforaminal lumbar interbody fusion ( MI-TLIF) . Methods Range of motion ( ROM) and strain distribution testing were performed in 8 fresh-frozen calf lumbar spine motion segments in flexion/extension, lateral bending, and axial rotation using 5. 0 Nm torques at the L4-5 motion segment. The sequential test configurations included intact motion segment, TLIF with unilateral pedicle screw ( UPS) , TLIF with UPS plus transfacet pedicle screws ( UPS+TFPS) , and TLIF with bilateral pedicle screw ( BPS) . The ROM was deter-mined to assess the construct stability. Strain distribution was recorded along with flexion and lateral bending configurations. Results In flexion/extension, lateral bending, and axial rotation, there was no significant difference in the ROM between BPS and UPS+TFPS fixation after TLIF. After TLIF, the UPS construct provided less segment stability than BPS and UPS+TFPS fixation in flexion, lateral bending. Strain distribution under UPS+TFPS fixation was respectively 21. 8% and 24. 2% higher than that under BPS fixation along with flexion and lateral bending. Conclusion UPS+TFPS fixation provides stability comparable to that of MI-TLIF with bilateral PS, with better load share with the vertebrae body.

OBJECTIVE:To study whether Radix Inulae can replace Radix Aristolochiae as medicinal material.METHO_ DS:Comparison was made between Radix Inulae and Radix Aristolochiae in terms of plant resources,functions and indications,chemical compositions,pharmacologic actions,clinical applications,etc.by reviewing literature.RESULTS&CONCLUSIONS:Radix Inulae and Radix Aristolochiae were different in every aspect,thus the two can’t be replaced by each other as medicinal material.

Objective To observe the efficacy and adverse reaction of raltitrexed combined with irino-tecan as first-line chemotherapy for recurrent or metastatic gastric cancer.Methods From January 201 4 to March 201 5,39 patients of recurrent or metastatic gastric cancer who received treatment in the First People′s Hospital of Zhangjiagang of Jiangsu Province were collected.All patients received raltitrexed (3.0 mg/m2 , 1 5 min intravenous drip)on the first day and irinotecan (1 80.0 mg/m2 ,90 min intravenous drip)on the first day.One cycle lasted 21 days.The efficacies were evaluated every 2-cycle.Adverse reactions were evaluated every cycle.Results The efficacies and adverse reactions could be evaluated in 39 patients.The study received 0 complete remission,1 6 partial remission,1 1 stable disease,1 2 progression disease.The objective response rate was 41 .03% (1 6 /39).The disease control rate was 69.23% (27 /39).The median overall sur-vival time was 9.3 months (95%CI:8.8-1 1 .1 months).The median progression-free survival time was 6.0 months (95%CI:5.1 -6.8 months).The adverse reactions were mainly neutropenia,anemia,liver dysfunc-tion,the incidence of them were 35.90%,33.33% and 28.21 % respectively.Conlusion Raltitrexed com-bined with irinotecan as first-line chemotherapy for recurrent or metastatic gastric cancer acquires an definite efficacy,and the adverse reactions can be tolerated,which is worthy of further clinical research.

Objective:To investigate the influence of 3 methods of fiber posts on fracture resistance of maxillary anterior teeth with flared root canals.Methods:32 human maxillary central incisors were assigned randomly to 4 groups(n =8).The crowns of the teeth were removed at a level 2 mm incisal to the cementoenamel junction(CEJ).After root canal therapy,flared canals were simula-ted in 3 groups.The flared canals were reinforced with resin cement(group A),resin composite(group B)and accessory posts (group C)respectively.In group D flared canals were not created.The same size fiber posts were cemented with resin cement in all groups.After posts cementation and composite resin core formation,all teeth were restored with metal crowns.Then the roots of the teeth were embedded in acrylic resin blocks up to 2 mm below the CEJ.The samples were loaded in a testing machine until failure occurred.Results:The maximum load value(N)for fracture of group A,B,C and D was 295.94 ±69.11,450.51 ±54.68, 479.37 ±77.81 and 618.51 ±87.42 respectively(F =118.127,P =0.000);group B vs C,P >0.05,between each 2 of the other groups,P <0.05.No significant differences were found among the groups in the number of repairable fracture patterns(P >0.05). Conclusion:Reinforcement of flared canal with resin composite and accessory posts can increase the fracture restance of the tooth root and the most of fracture patterns are beneficial for the second repair.

Aim To pick out the siRNA which could most effectively inhibit the expression of brain-derived neurotrophic factor( BDNF) in microglial cells,to detect the cytotoxicity of the transfection complex,and to ob-serve the change of OX-42 expression,the microglial marker,after BDNF siRNA treatment. Methods Four siRNAs were chemically synthesized: three of them were used to inhibit BDNF expression in microglial cells,the rest was fluorescence-labeled mismatch siRNA as a negative control. They were all transfected into microglial cells,respectively. BDNF mRNA was detected 24 h after transfection by Real-Time PCR and itsprotein expression was observed done by Western blot 48 h later. The Sulforhodamine B( SRB) assay was used to investigate the drug-induced cytotoxicity. Co-expres-sion pattern of BDNF and OX-42 was determined by double-labeling immunofluorescence. Results ① The BDNF siRNA1588 was the most effective siRNA,compared with the vehicle or mismatch siRNA-treated group( P

Objective To explore the relationship between the rs18004197 polymorphism in the 3'-untranslated region of adenomatous polyposis coli (APC) gene and colorectal cancer susceptibility.Methods Firstly,we collected the peripheral venous blood of 573 colorectal cancer cases and 588 controls,and then extracted DNA from blood samples,genotyped rs1804197 polymorphism using real-time PCR and assessed its association with the susceptibility of colorectal cancer.Results There were 387 CC (67.5％),153 AC (26.7％) and 33 AA (5.8％) genotypes in the colorectal cancer cases.In the control group,there were 427 CC (72.6％),144 AC (24.5％) and 17 AA (2.9％) genotypes.The AA genotype odds ratio (OR =2.14,95％ CI:1.17-3.91,P =0.011) and the A allele frequency (P =0.011) were significant difference in case and control groups.Further subgroup analysis showed that the differences of the frequency distribution in the male (P =0.048) and non-drinking (P =0.020) groups were statistically significant.In the male group,the risk of colorectal cancer was increased by 0.41 (OR =1.41,95％ CI:1.01-1.98) for individuals bearing the A allele.In the non-drinking group,the risk of colorectal cancer was increased by 0.22 (OR =1.22,95％ CI:0.91-1.64) for individuals bearing the A allele,but the result was not statistically significant.Conclusion The rs18004197 polymorphism in the 3'-untranslated region of APC gene is related to the susceptibility of colorectal cancer.The AA genotype may increase the susceptibility of colorectal cancer.

Objective To evaluate the efficacy of anesthesia with etomidate administered by TCI in combination with continuous iv remifentanil infusion titrated to maintain BIS values at 40-60 for non-cardiac surgery in a prospective randomized single-blinded multicenter controlled clinical study.Methods Two hundred and forty-four ASA Ⅰ or Ⅱ patients of both sexes aged 20-60 yr undergoing non-cardiac surgery lasting less than 3 h were randomly allocated into 2 groups:etomidate group (group E,n =123) and propofol group (group P,n =121 ).The patients were unpremedicated.A bolus of midazolam 0.03 mg/kg was injected iv immediately before induction of anesthesia.Anesthesia was induced with sufentanil 0.3-0.4 μg/kg and TCI of etomidate (effect-site concentration (Ce) =0.5-1.0 μg/ml) or propofol (Ce =3-4 μg/ml).Tracheal intubation was facilitated with rocuronium 0.9 mg/kg.The patients were mechanically ventilated (VT 8-10 ml/kg,RR 10-12 bpm,FiO2 =1 ).PETCO2 was maintained at 35-40 mm Hg.Anesthesia was maintained with TCI of etomidate ( Ce =0.3-0.8 μg/ml ) or propofol ( Ce =3-4 μg/ml) in combination with continuous iv infusion of remifentanil at 0.1-1.0 μg· kg-1 ·min-1 and intermittent iv boluses of rocuronium.BIS values were maintained at 40-60 during operation.Sufentanil 0.1 μg/kg was administered iv before skin closure.Ce at loss of consciousness,during maintenance of anesthesia and at emergence,the consumption of remifentanil and vasoactive agents,the emergence time and extubation time were recorded.The incidences of injecton pain,post-operative nausea and vomiting (PONV) and emergence agitation were measured.Results Ce of etomidate at loss of consciousness,at emergence and during maintenance of anesthesia was (0.50 ± 0.22),(0.16 ± 0.09) and 0.22-0.39 μg/ml respectively.The incidence of injection pain and the consumption of vasoactive agents were significantly lower but more remifentanil was needed in group E than in group P (P ＜0.05 or 0.01).There was no significant difference in emergence time and extubation time between the 2 groups (P ＞ 0.05).The incidence of PONV and emergence agitation were significantly higher during recovery in group E than in group P ( P ＜ 0.05 ).Conclusion The hemodynamics is stabler during operation,but the incidence of PONV and emergence agitation are significantly higher during recovery in group E than in group P.Etomidate induces little injection pain.

Objective:To evaluate the association between thrombus composition and mechanical recanalization,operation procedure and clinical outcome.Methods:One hundred and ninety-two consecutive stroke patients with large-vessel occlusion treated by mechanical thrombectomy using a stent retriever and (or) aspiration catheter in the Affiliated Huaian No.1 People′s Hospital of Nanjing Medical University between January 2018 and January 2020 were collected. The retrieved thrombi were quantitatively analyzed for red blood cells, white blood cells, platelets, and fibrin. The patients were divided into two groups, a erythrocyte-rich group and a fibrin-rich group based on the predominant composition in the clot. The clinical prognosis, CT value of thrombus, procedure time,number of recanalization maneuvers, and degree of vascular recanalization were compared between the two groups.Results:The retrieved clot from 138 patients with acute ischemic stroke from internal carotid artery occlusion ( n=56), middle cerebral artery occlusion ( n=62), intracranial segment of vertebral artery or basilar artery occlusion( n=20) were histologically analyzed. Erythrocyte-rich clots were present in 59 cases, while fibrin-rich clots were present in 79 cases. Cardioembolic thrombi had higher proportions of fibrin/platelets [77.2%(61/79)], less erythrocytes than noncardioembolic thrombi [45.8%(27/59), χ2=8.115, P=0.004]. Patients with erythrocyte-rich thrombi had a smaller number of recanalization maneuvers [2 (1, 2) vs 3 (2, 4), Z=-7.613, P<0.001], shorter procedure time [45 (30, 60) min vs 80 (60, 90) min, Z=-6.944, P<0.001], higher thrombus CT value [42 (32, 53) vs 36 (31, 41), Z=-2.003, P=0.045], good clinical prognosis (the ratio of modified Rankin Scale score ≤2, 62.7% (37/59) vs 39.2% (31/79), χ2=7.444, P=0.006). There was no significant difference in the location of vascular occlusion between the two groups. Conclusion:For patients whose thrombotic components are mainly red blood cells, the cause of stroke may be non cardiogenic cerebral embolism, the CT value of embolus is relatively high, the embolus is easy to remove, and the clinical prognosis is relatively good.

Objective To analyze the effect of circLRP6 on high glucose-induced renal tubular epithelial cell injury via miR-31-5p/high mobility group protein A1(HMGA1)axis regulation.Methods Human renal tubular epithelial HK-2 cells were cultured in vitro and divided into eight groups:control,high glucose,high glucose+si-NC,high glucose+si-circLRP6,high glucose+si-circLRP6+miR-NC,high glucose+si-circLRP6+miR-31-5p inhibitor,high glucose+si-circLRP6+miR-31-5p inhibitor+si-NC,and high glucose+si-circ-LRP6+ miR-31-5p inhibitor+si-HMGA1.The circLRP6,miR-31-5p,and HMGA1 mRNA levels were determined using real-time quantitative PCR.Cell supernatant IL-6 and tumor necrosis factor-α(TNF-α)levels,lactate dehydrogenase(LDH)activity,and malondialdehyde(MDA)content were also determined.Furthermore,flow cytometry was used to observe cell apoptosis.HMGA1,Bax,and Bcl-2 protein expression was detected by Western blotting.Finally,dual luciferase assay was used to report the targeting relationship of miR-31-5p with circLRP6 and HMGA1.Results Compared with the high glucose group,the HK-2 cell proliferation inhibition rate;cell superserum IL-6,TNF-α,LDH,and MDA levels;apoptosis rate;and Bax protein expression in the high glucose+si-circLRP6 group decreased significantly,whereas Bcl-2 protein expression increased significantly(all P＜0.05).Consequently,miR-31-5p downregulation possibly weakened the protective effect of si-circLRP6 on high glucose-induced renal tubular epithelial cell injury.HMGA1 expression inhibition reversed the effect of the si-circLRP6+miR-31-5p inhibitor on high glucose-induced renal tubular epithelial cell injury.Finally,miR-31-5p exhibited a targeting relationship with circLRP6 and HMGA1.Conclusion Si-circLRP6 protects high glucose-induced renal tubular epithelial cell injury via miR-31-5p upregulation and HMGA1 expression inhibition.