Objective:To evaluate the analgesic effect of botulinum toxin type A (BTX-A) in osteoarthritis model and the changes of Nav1.8 protein expression in spinal ganglia changes.Method:Animal model of knee osteoarthritis (KOA) was established by intra-articular injection of 4％ papain solution 0.3ml into SD rat right knee.After the formation of arthritis,they were randomly divided into two groups at the 2nd day:BTX-A group (n=10):intra-articular injection of 5μl BTX-A 0.1IU;WFI group (n=10):intra-articular injection of 5μl water.No papain or BXT-A was given to the sham group (n=10).At the 1st,3rd,5th day after injection,we tested the pain behavior,thermal pain threshold,and sodium channel 1.8 (Nav1.8) protein expression in spinal ganglion by using immunohistochemistry.Result:Analysis of spontaneous pain behavior showed abnormal gait caused by rat osteoarthritis.Comparing with the WFI group,abnormal gait caused by osteoarthritis improved significantly in BTX-A group.At day 5 it improved more significantly than day 1 and day 3.Thermal pain threshold of BTX-A group increased more than that of WFI group (P＜0.05) at any time point.Abnormal high Nav1.8 protein in model rats decreased in spinal ganglia for BTX-A group.Conclusion:The intra-articular injection of BTX-A may play the analgesic effect in the model of KOA by down-regulating of the expression of Nav1.8 protein in spinal ganglia and reduction in the central sensitization to pain stimulation.

Complete video-assisted thoracic surgery (cVATS) for lung cancer has the advantages of significantly minimal trauma, markedly light postoperative pain and rapid post-operative recovery, which has been increasingly applied in clinic.Its main operation methods consist of lobectomy, segmentectomy, pneumonectomy and sleeve lobectomy.cVATS for lung cancer can achieve the same radical tumor resection and lymph node dissection as the open thoracotomy, which contributes to a satisfactory long-term outcome.

Objective:To examine the utilization and cost of outpatient care and their influencing fac-tors among middle and aged peasant-workers in China. Methods:The data of China Health and Retire-ment Longitudinal Study ( CHARLS) collected in 2011-2012 were used and the data on peasant-workers aged 45 years and older were analyzed with Two-part Model. Results: The four-week outpatient rate of middle and aged peasant-workers was 13. 7% (407/2 974). The determinants of the rate included gen-der, marital status, economic level, household size, the place of insurance enrollment, self-assessed health and having or having no chronic diseases. The average outpatient cost was (400. 3 ± 56. 7) yuan (RMB) and the median was 138. 0 yuan. Multivariate analyses showed that outpatient costs were higher for those males who lived in Eastern China and worked at the same place with insurance enrollment, with fair to bad self-assessed health and chronic diseases. Conclusion:Allowing higher flexibility for migrants to transfer the new rural cooperative medical system ( NCMS ) between rural and urban areas and thus making reimbursement for medical services provided by undesignated providers received immediately could increase the use of outpatient services.

Objective To know the blood lead level of children aged 3-14 years in some areas of Guangdong province. Methods Stratified-clustered-random sampling and simple random sampling were used. 1905 children aged 3-14 years were chosen from Guangzhou,Shenzhen,Shaoguan,Zhaoqing and Lianping and the blood lead level was tested by ICP-MS. Results The mean lead level of children aged 3-14 years was 69.55 ?g/L. The rate of exceed standard limit of blood lead was 16.4% (≥100 ?g/L). The differences of the blood lead level and the rate of lead poisoning of children among different areas were significant. The blood lead level and the rate of lead poisoning of children in Shaoguan were highest in the investigated areas. The blood lead level and the rate of lead poisoning of children aged 3 years were higher than those in the other age groups. The blood lead level of boys was higher than that of girls. Conclusion The blood lead level and the rate of children lead poisoning in the underdeveloped cities and rural areas are higher.

Objective The purpose of the study was to explore influence of family factors on dietary behavior of primary and secondary studen t s in Guangzhou city, in order to provide suggestions for intervention of dietary behavi or. Methods The study population included 1 539 student-parent s pairs selected from Guangzhou city by using the method of stratified multistage cluster random sampling, and data were collected through questionnaires. Results The ratio of parents who often reminded and forced the ir children to eat some fo od they thought of as nutrition were 56.0% and 7.7%, and 39.7%, 29.2% of ch ildren complied with their parents, respectively. At dinner, 14.8% and 27.5% of parents often and sometimes criticized their children, and the ratio of childre n couldn't eat anything and only eat a little food were 5.9%,19.3%, respectively . Forty-two point three of primary and secondary school students watched televi sion wh en they had a dinner, which made 39.4% of students not eat seriously. C onclusions Dietary behavior of primary and secondary school students is influenced strongly by their parents and family environment, it is necessary for parents and themselves to grasp enough nutritional knowledge.

Objective To study the reconstructive treatment of the different types of neurofibroma and neurofibromatosis in different locations. Methods 37 patients with neurobibroma or neurofibromatosis were reviewed, including 8 cases with simple suture after excision, 9 cases with skin grafting in situ, 12 cases with skin flap grafting. The main points of the treating methods for different types of neurofibroma and neurofibromatosis were discussed, and the chief clinical manifestations, therapeutic principle and notices of the operation were then summarized.Results These 37 patients, including 25 cases of neurofibroma, 11 cases of neurofibromatosis typeⅠ and 1 case of neurofibromatosis type Ⅱ, were satisfied with the results after reconstructive operation. Conclusion The methods of reconstructive operation of neurofibroma and neurofibromatosis, such as simple suture after excision, skin grafting in situ, skin flap grafting, the use of skin soft tissue expansion, microskin grafting and so on, must be selected according to the different type and location of the neurofibroma and neurofibromatosis. The reconstructive operation must guarantee the best recovery of the visage and the function on the basis of the most degree of tumor excision.

Objective To explore the effect of positive end expiratory pressure (PEEP) on arterial oxygenation and intrapulmonary shunt during one-lung ventilation (OLV) and pulmonary function during perioperation. Methods Forty patients with normal pulmonary function,ASA I - II :scheduled for pulmonary lobectomy, were divided into control group and PEEP group by random digits table with 20 cases each. Patients were induced by double-lumen tubes under intravenous anesthesia and were received 10 ml/kg tidal volume, 12 frequents/min breathing rate during the two-lung ventilation (TLV), secondary reduced to 6 ml/kg tidal volume, 16-18 frequents/min breathing rate without PEEP (control group) or with 5 cm H2O cm H2O =0.098 kPa) PEEP (PEEP group) during OLV.Hemodynamics and respiratory mechanical parameters were continuously monitored, lung function before operation and at 72 h after operation was detected. Results Compared to before OLV,arterial oxygen tension (PaO2), arterial oxygen saturation (SpO2), oxygenation index (OI) were decreased and intrapulmonary shunt ratio (Qs/Qt) was increased in control group and PEEP group at 30 min after OLV (P < 0.01 or < 0.05). However,PaO2 and SpO2 and OI were higher and Qs/Qt was lower in PEEP group than that in control group at the same time point (P<0.05). In addition, FEV1%, FVC% and FEV1/FVC were (121.8 ± 25.0% ,(117.2 ± 24.3)% , (87.6 ± 15.7)%before operation and (84.9 ± 21.6)%, (77.2 ± 18.3)% , (70.5 ± 12.5)% at 72 h after operation respectively in control group, (116.9 ±24.5)% , (112.1 ±23.6)% , (85.3 ± 13.8)% before operation and (96.3 ± 20.4)%, (88.1 ± 19.8)% , (78.4 ± 10.2)% at 72 h after operation respectively in PEEP group. Although decreased in control group and PEEP group at 72 h after operation comparing with preoperation (P< 0.01 or < 0.05 ), FEV1%, FVC% and FEV1/FVC were higher in PEEP group than those in control group at 72 h after operation (P<0.05). Conclusion Appropriate PEEP increases arterial oxygenation,reduces Qs/Qt and improves pulmonary function during OLV,reduces the risk of hypoxernia and lung injury induced by OLV during perioperation.

Objective To evaluate the potential association of CD4+CD25+ T cells with alopecia areata.Methods Totally,this study enrolled 23 patients with progressive alopecia areata,25 patients with stable alopecia areata,and 25 healthy controls.Peripheral blood was isolated from these subjects followed by isolation of CD4+ CD25+ regulatory T cells,which were then cuhured with the presence of anti-CD3 and-CD28 monoclonal antibodies for four days.Subsequently,enzyme-linked immunosorbent assay was performed to measure the levels of interleukin (IL)-10 and transforming growth factor (TGF)-β1 in the culture supematant of these T cells.Results The levels of IL-10 and TGF-β1 were (31.68 ± 6.78) pg/ml and (32.29 ± 6.8) pg/ml respectively in the culture supernatant of CD4+CD25+ regulatory T cells from patients with progressive alopecia areata,significantly lower than those from the healthy controls ((57.34 ± 14.15) pg/ml and (57.43 ± 15.16) pg/ml,both P ＜ 0.05) and patients with stable alopecia areata ((52.56 ± 13.02) pg/ml and (61.75 ± 14.10) pg/ml,both P ＜ 0.05).However,no significant difference was observed in the supernatant levels of IL-10 or TGF-β1 between the healthy controls and patients with stable alopecia areata.Conclusions The secretion of IL-10 and TGF-β1 by CD4+CD25+ T cells is decreased in patients with progressive alopecia areata,which may contribute to the pathogenesis of alopecia areata.

Objective To learn the disease status and living conditions of Kaschin-Beck disease (KBD) patients and implementation of related control measures in Aba Autonomous Prefecture,Sichuan Province.Methods A total of 26 KBD villages and 12 non-KBD villages nearby were selected in Aba Autonomous Prefecture with stratified cluster sampling method in the year of 2009 to 2011.One thousand three hundred and forty-seven KBD patients from KBD villages and 447 residents from non-KBD villages were interviewed with a self-designed questionnaire.The investigation includes:①General demographic characteristics such as name,gender,age,educational level,family income,marital status and so on.②The basic information about KBD patients including the time and location of diagnosis,treatment,hand X ray diagnosis taken or not and suffering from dental fluorosis and skeletal fluorosis.③The basic living habits such as drinking water,staple food sources,staple food types,grain storage places,tea-drinking habits and so on.Results A total of 522 (38.8％,522/1 347) KBD patients and 12 (2.7％,12/447) controls were confirmed that their parents were KBD patients.The vast majority of KBD patients (99.0％,1 334/1 347) were diagnosed in county of Chinese Center for Disease Control and Prevention or county level hospitals within 2-5 years after onset of the disease and 97.6％ of them (1 314/1 347) treated their disease by taking painkillers,sodium selenite or vitamin E.Most KBD patients had suffered from dental fluorosis (66.3％,893/1 347) and skeletal fluorosis (59.9％,807/1 347).Both the KBD patients and the controls mainly drank river water and 96.7％ of them (1 716/1 774) took locally grown food,93.5％ of them (1 660/1 775) took barley and corn as staple food in the past (before the year of 2004).But now (from the year of 2004 until now) they mainly drink tap water and 96.9％ of them (1 727/1 783) take commodity grain or two kinds of source food,98.4％ of them (1 765/1 794)changed their staple food to rice and flour.94.1％ of KBD patients (1 267/1 347) used to drink tea.Conclusions The measures of changing water and grain are well implemented in Aba Autonomous Prefecture.The government should improve the overall local KBD disease status and the quality of life of KBD patients by taking health promotion and prevention in key families,strengthening the local medical security system and targeted treatment combined with specific local conditions.

Objective To investigate the relationships between seven single nucleotide pdymorphisms(SNPs), including 6788895(SIAH2 gene), rs10941679(5p12), rs889312(MAP3K1), rs13387042(2q35), rs6504950(17q23), rs17530068(6q14) and rs2284378(20q11), and female breast cancer of Hui and Han nationalities.Methods A hospital-based case-control using age and nationallity as frequency matching conditions was conducted in Affiliated General Hospital of Ningxia Medical University.Results ①A total of 225 breast cancer patients and 225 controls were enrolled in this study.There was no significant differentce between case group and control group in age(48.27±9.27 vs 48.48±9.36, t=0.238,P=0.812) or nationallity (181 Han people and 44 Hui people vs 184 Han people and 41 Hui people, x2=0.131, P=0.718).②The subjects of study conformed to Hardy-Weinberg equilibrium principles.③The genotype and allele distribution of the above seven SNPs were not significantly different between cases group and control group of Hui and Han nationalities.Conclusion The seven SNPs mentioned above may not be related to breast cancer among people Hui and Han nationalities.