Neuropathic pain is a common chronic pain with complicated underlying mechanisms and difficult to treat, which badly disturbs the daily life of the patient and presents a significant burden to society by increasing healthcare resource utilization and costs. In the recent years, the pivotal role of glia-centered neuroinflammation and neuroimmunity in the development and maintenance of neuropathic pain has been recognized gradually. This review presents the current understanding of the role of glia in neuropathic pain and therapies of glia modulation.

To assess the clinical effect of HA regimen on newly diagnosed patients in chronic phase of chronic myeloid leukemia (CML). Ninety four cases of CML patients were grouped in accordance with the requirements on the basis of treatment regimens and Sokal risk index, and the clinical effects of HA regimen wer evaluated. We found that HA regimen showed satisfactory immediate effect on CML in chronic phase. CR rates achieved in high risk and medium risk groups(77 4%,20 0%) with HA were higher than that with Hu regimen(35 0%,0%). However, HA regimen was incapable of extending the duration of CML. So HA should not be used as first line treatment in the treatment on newly diagnosed patients in chronic phase of CML, except for high risk group whose symptoms could not be controlled with other regimens.

ObjectiveTo investigate the prevalence and distribution of 16S rRNA methylase gene and research the relationship with drug resistant spectrum.And preliminary explore its role in molecular epidemiology analysis.MethodsCollected 69 clinical isolates of non repetitive ESBL-producing Klebsiella pneumoniae in our hospital from Mar to Sep 2010.Detection 16S rRNA methylation enzyme gene by PCR,and analyze ESBL genetype and integron gene of the positive strains.All PCR products were sequenced for determination.Plasmid conjugation test and plasmid elimination method to determine dissemination of 16S rRNA methylase gene.Then we used ERIC-PCR genotyping technology for the establishment of DNA fingerprinting.ResultsIn sixty-nine strains,twenty isolates were rmtB positive (28.9％),two isolates were armA positive,and two strains coproduce rmtB and armA.All positive isolates carried the CTX-M gene,detemined by sequencing,14 strains of CTX-M-14 gene,6 strains of CTX-M-15 gene,14 strains carried TEM1 gene,8 strains carried SHY gene,sequencing showed that 5 strains of SHV-12 gene,3 strains of SHV-11 gene,3 strains carried OXA-10 gene,3 strains carried VBE-1 gene.In addition,the intl gene was found in 12 isolates of 20 rmtB positive strains.All the intl gene positive strains were divided into five kinds gene cassettes,which contained drfA25,drfA1,drfA12,aadA1,aadA2,sat and blaVEB-1 genes.Respectivily,16S rRNA methylase gene positive strains were divided into five genetypes using ERIC-PCR technology.A genetype was the advantage popular clones.Conjugative plasmid and elimination test found that rmtB gene was located in a plasmid in KP5 and KP16 isolates with A genetype,and can disseminate by conjugation.ConclusionA high prevalence of 16S rRNA methylase gene-rmtB was found among clinical ESBL-producing K.pneumoniae isolates in our hospital,which could lead to resistant to almost all aminoglycoside at a high level.Both horizontal gene transfer and clonal spread were responsible for the dissemination of the rmtB gene.In addition,K.pneumoniae co-producing ESBLs,16S rRNA methylation enzymes and class Ⅰ integron existed and were spreading.

Objective To explore the value of cardiac troponin-I (cTnI), B-type natriuretic peptide (BNP) and blood lactic acid (Lac) on evaluation of severity and prognosis in patients with septic myocardial dysfunction (SMD). Methods According to retrospective analysis of clinical data,161 cases with sepsis were divided in to SMD group and non-SMD group. And the SMD group was further divided in to death group and survival group. Blood cTnI, BNP and Lac value in each group were detected respectively. The ROC curve was used to evaluate the forecast value of cTnI, BNP and Lac on prognosis for patients. Results The value of cTnI, BNP and Lac in SMD group were significantly higher than those in non-SMD group(P<0.05);The value of cTnI, BNP and Lac in death group among the SMD patients were significantly higher than those in survival group(P<0.05);cTnI, BNP and Lac contribute to predict the 28 day mortality rate of SMD. Conclusions Blood cTnI, BNP and Lac contributes to the assessment of the severity and the prognosis of septic patients with myocardial dysfunction.

Objective Beta platelet-derived growth factor receptor ( PDGFR-β)-mediated signaling plays a key role in mor-phine tolerance , but its molecular mechanisms are not yet completely understood .The present study aims to investigate whether the ex-tracellular signal-regulated kinase ( ERK) and cyclic AMP response element binding protein ( REB) signaling pathways are involved in the development of PDGFR-βactivation-induced morphine tolerance in rats . Methods Thirty-six adult male SD rats were randomly divided into six groups of equal number:normal saline (20μL), morphine (15μg), morphine +imatinib (morphine 15μg +ima-tinib 10μg), morphine +PDGF-BB (morphine 15μg +PDGF-BB 10 ng), imatinib (10μg), and PDGF-BB (10 ng), all treated intrathecally at 20μL once daily for 7 consecutive days .Paw withdrawal latency ( PWL ) was measured 1 d before and 30 min after medication at 1, 3, 5, and 7 days, respectively, followed by calculation of the maximal possible effect of analgesia (MPE).On the 8th day, PWL was again obtained from all the rats at 30 min after intrathecal injection of morphine (15μg).Then, all the animals were sacrificed and the L4-5 segment of the spinal cord was isolated for determination of the expressions of ERK , phosphorylated ERK ( p-ERK) , CREB, and phosphorylated CREB ( p-CREB) by Western blot. Results At 5 and 7 days after medication, MPE was significant decreased in the morphine group ([52.90 ±8.20] and [15.12 ±3.80] %) and the morphine +PDGF-BB group ([43.51 ±5.42] and [14.81 ±3.60] %) as compared with (100.00 ± 0.00) %in both groups at 1 day (P<0.05), but had no significant changes in the morphine +imatinib group at 1, 3, 5, and 7 days.After intrathecal injection of morphine on the 8th day, MPE was (16.22 ±2.51) %in the morphine group, (15.22 ±3.50) %in the morphine +PDGF-BB group, and (35.21 ±4.51) %in the PDGF-BB group, all remarkably lower than (100.00 ±0.00) %in the control group (P<0.05).There were no significant differences in the expression levels of ERK and CREB among the six groups.The expressions of spinal p-ERK and p-CREB were markedly increased in the morphine , morphine +PDGF-BB, and PDGF-BB groups as compared with the control group (P<0.05), but significantly decreased in the morphine +imatinib group in compari-son with the morphine group, (P<0.05). Conclusion The PDGFR-βsignaling pathway plays an important role in the develop-ment of tolerance to morphine-induced analgesia and its underlying mechanisms may be associated with the activation of the ERK and CREB pathways .

Objective: To investigate the analgesic effect and impact of lornoxicam on the expression of plasma IL-6 and IL-10 in patients undergoing upper abdominal surgery.Methods:Sixty patients undergoing upper abdominal surgery were randomly allocated into three groups,morphine group(M,n=20),postoperative lornoxicam group(L,n=20) and preemptive lornoxicam group(P,n=20).For group M the subjects received patient controlled intravenous analgesia(PCIA) with morphine(loading dose 0.05 mg/kg,bolus 1 mg,lockout time 10 min,background dose 0 mg) after the surgery.While in group L,8 mg lornoxiam was administered at the end of the surgery,then the same morphine PCIA scheme as in group M was used in combination with intermittent intravenous lornoxiam(8 mg per injection) at 12,24 and 36 h after the surgery.Except that the first 8 mg lornoxicam was injected 30 min before the operation,the analgesic paradigm of group P was similar to group L.The analgesic effect assessed by VAS at rest,the consumed dosage of morphine,and the adverse effects as nausea and vomiting,were recorded at 4,8,12,24 and 48 h.Furthermore,2 ml of the venous blood was drawn before the induction of anesthesia 2,6,12,and 24 h after the surgery to measure the levels of interleukin 6(IL-6) and interleukin 10(IL-10).Results: During the 48 h observation,the VAS at rest was not statistically significant in the three groups,but more morphine was consumed in group M than in group L and group P.There was no difference among the three groups in the incidence of such adverse effects as nausea or vomiting.The basic levels of IL-6 and IL-10 were too low to be measured.The concentrations of IL-10 and IL-6 reached the peak at 2 and 6 h after surgery respectively,and the level of IL-10 in group M was significantly lower than in groups L and P at 2 h.In contrast,the level of IL-6 in group M was significantly higher than in group L and group P at 6 h,and even higher than in group P at 12 h. Conclusion: Lornoxicam,especially when administered before upper abdominal operation,could significantly decrease the dose of morphine for postoperative analgesia and attenuate the inflammatory cytokine response after surgery.

Objective: To investigate a moderate dose of levobupivacaine in spinal anesthesia for caesarean section.Methods: Eighty parturients undergoing caesarean section were randomly divided into 4 groups: GroupⅠ(0.75% levobupivacaine 1.00ml+10% glucose 1.00ml+cerebrospinal fluid 1.00ml),GroupⅡ(0.75% levobupivacaine 1.33ml+10% glucose 1.00ml+ cerebrospinal fluid 0.67ml),Group Ⅲ(0.75% levobupivacaine 1.67ml+10% glucose 1.00ml+ cerebrospinal fluid 0.33ml) and Group Ⅳ(0.75% levobupivacaine 2.00ml+10% glucose 1.00ml).The spinal puncture sites were all located at L_2,3.The onset time of sensation block,the highest plane of analgesia,the time to reach the highest plane of analgesia,the time of regression to the L_1 segment,the degree of motor block,VAS scores,the degree of muscle relaxation,the rate of hypotension incidents and neonatal Apgar scores were recorded. Results: There were no statistically significant differences in the onset time of sensation block,the time to reach the highest plane of analgesia and the highest plane of analgesia among the 4 groups.But the durations of regression to the L_1 segment were dramatically shorter in GroupⅠand Ⅱthan in Group Ⅲ and Ⅳ(P

Objective:To observe the development of tolerance and dependence to endomorphin 1(EM 1) and its regulation on ? opioid receptor(MOR) in rat brain,providing references for the mechanism of the EM 1 dependence. Methods: Totally 60 SD rats were randomly divided into saline, acute EM 1 treatment and chronic EM 1 treatment groups. For acute EM 1 treatment, rats were injected intracerebroventricularly with 10 ?g/kg EM 1 30 min prior to sacrifice. The chronic group were treated with EM 1 daily administration at 8:00 and 15:00 starting with 10 ?g/kg on day 1 to 50 ?g/kg on day 9. After chronic EM 1 treatment on day 1, 3, 6 and 9, the antinociceptive AD 50 or catatonic ED 50 values were determined by modified Dixon's method. The B max and K d 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) EM 1 chronic treatment produced a high degree of tolerance to the antinociceptic and catatonic effects on the 3rd day (3.1 fold and 1.9 fold) and the 9th day (28.4 fold and 8.5 fold). The jumping times, weight lost and withdrawal score of rats were significantly higher than that of the control group after 9 d chronic EM 1 treatment. (2) After 9 d of administration with EM 1, the specific binding capacity and mRNA expression of MOR in rat cortex, midbrain and striatum were all decreased compared with those of the control and acute treatment groups, but the K d values were not significantly altered. Conclusion:Endomorphin 1 has the tolerant and dependent potent. For long term chronic treatment, Endomorphin 1 induces downregulation of the binding capacity and mRNA of MOR, which may be related to the dependence development.

Objective To investigate the curative effect of mammotome minimally invasive operation in the treatment of benign breast disease and analyse its characteristics.Methods Two hundred and five cases of benign breast disease patients admitted to the hospital in time sequence were divided into the observation group (105 cases) and control group(100 cases).Observation group used mammotome minimally invasive rotary cutting operation,and the control group used conventional breast tumor resection.The surgical results of two groups of patients,tumor complete resection or not,whether the patients for surgery satisfaction were observed.Patients of two groups were compared with intraoperative and postoperative relevant indicators,and the postoperative complications.Results In the observation group,105 patients with mammotome spiral cutting knife surgery of breast masses were completely resected,the satisfaction of patients for surgery was 96.2％ (101/ 105),significantly higher than that of control group(81.0％ (81/100),x2 =4.187,P＜0.05).The operative time,blood loss,length of incision values of observation group were significantly lower than those in the control group((17.30±6.70) min vs (57.23 ± 8.96) min,(10.43 ± 5.14) ml vs (109.16 ± 13.45) ml,(10.27 ±0.06) cm vs (1.43±0.12) cm;t=18.741,26.167,11.421;P＜0.05),the postoperative recovery time and the scar length were significantly lower than the control group((4.1±2.5) d vs (8.0±3.5) d,(0.15±0.03) cm vs (1.21±0.46) cm;t =5.176,2.647;P＜0.05),breast deformation cases,tumor residual proporation were 1.9％(2/105) and 0(0/105),fewer than that in the control group(12.0％(12/100),9.0％(9/100);x2=6.721,11.470;P＜0.05).In control group breast deformation subcutaneous hematoma and ecchymosis,wound infection,skin damage,pain,pigment calm incidence were 2.9％ (3/105),5.7％ (6/105),1.9％ (2/105),2.9％(3/105),8.6％(9/105),2.9％(3/105),significantly lower than those in the observation group(9.0％(9/100),12.0(12/100),7.0％ (7/100),16.0％(16/100),23.0％(23/100),8.0％(8/100);x2 =2.164,3.071,2.467,6.194,6.177,2.642;P＜ 0.05).Conclusion Mammotome minimally invasive rotary cut scalpel compare with conventional breast tumor excision undoubtedly has a more significant curative effect and patient satisfaction and have the characteristics of operation safety,efficiency,beautiful,fewer complications,humanized.

Objective:To explore the association between different urbanization levels and non-commu-nicable diseases (NCDs)in China and provide suggestions on designing relevant health policies in the ur-banization process.Methods:We obtained health-related data from China Health and Retirement Longi-tudinal Study (CHARLS)201 1 .This study used multistage sampling in design stage and covered 1 50 districts/counties,representative at the levels of the country.Geo-information system (GIS)method was used to get district areas data,and in combination with the Sixth National Census population data,we computed the population density which was regarded as the proxy variable of urbanization level in every city.The Logistic model was used to explore the effect of urbanization level on hypertension,diabetes, smoking,drinking,overweight and obesity.Results:Compared with other cities in China,Shanghai and Shenzhen,with the population density of more than 3 000 people per km2 ,were the cities with highest urbanization level.From the map of urbanization distribution across China,it was found that the urbani-zation levels of the northwestern districts were lower than those of the southeastern and coastal districts. The hypertension rate increased with the development of urbanization but there was no statistical signifi-cance.The proportion of patients with diabetes went up first and then saw a decrease trend in the process of urbanization.Drinking rate,overweight rate and obesity rate had similar trends,falling to their lowest point when urbanization level equaled 737,1 1 86 and 1 353 people per km2 respectively and then ex-perienced upward trends.By contrast,smoking rate declined first and then went up (the turning point was 1 029 people per km2 ).Conclusion:Different urbanization levels have different effects on NCDs, health-related behavior,overweight and obesity.Low urbanization level may create negative impact on health while high level can pose positive effect and increase people’s health condition possibly due to the improvement of health care accessibility and the quality of living environment.Policy-makers should spe-cially focus on different residents’health problems in different periods of urbanization,such as the impact of environmental pollution,health resources’allocation and accessibility of health services.It is necessa-ry to reduce or avoid the negative effect of urbanization on NCDs during the local development process to face the NCDs’threat.