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.

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.

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 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 investigate and determine the dietary intake level and food source of elements in Kashin-Beck disease(KBD) and non-endemic KBD areas in parts of Aba Autonomous Prefecture , Sichuan Province. Methods Three KBD villages were selected from each county including the counties of Songpan , Jiuzhaigou and Ruoergai in Aba Autonomous Prefecture with multi stage random sampling method in 2010 , and 122 KBD patients who were diagnosed at county-level or higher-level hospitals were selected from villages. One non-KBD village was selected randomly from each county and 43 controls without KBD or other bone and joint disease were selected in proportion to the number of investigated KBD patients. Dietary intake of each object was recorded 24 hours before the survey using a 24 hour dietary survey method and intake of each kind of food(cooked food) was recorded. Three day dietary intake of each surveyed object was recorded in continuous and the average value was calculated. The local resident representative food samples were collected and 20 kinds of elements in these samples were determined with inductively coupled plasma mass spectrometry ( ICP-MS ) and inductively coupled plasma atomic emission spectrometry(ICP-AES), and daily elements intake was calculated and compared with the relevant intake standards. Results Daily intakes of vegetables and meat were 126.72, 28.25 g, respectively, in patients with KBD. More than 3 times of brick tea was drank by KBD patients than non-KBD people (P<0.05). Per capita daily intakes of Ca, Fe, Mg, K, Na, Zn, I, Cu and Co were less than recommended nutrient intake or allowable daily intake in both groups. More than 80% patients with KBD overtook more Al and Pb than tolerable upper intake levels. Conclusion There is a single dietary structure and a serious shortage of a variety of essential elements intake in parts of Aba Autonomous Prefecture, and the dietary intake level of elements is different between two groups.

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 evaluate the performance of surgical approaches in the treatment of linear scleroderma of the head and face. Methods Forty-three patients with stable linear scleroderma of the head and face were included in this study. Surgical approaches, which included direct suture,skin flap translocation, soft-tissue augmentation and filling operation with dermal tissues, were selected and utilized alone or in combination according to the size, location and degree of atrophy and depression of lesions. Results After surgical treatment, wound dehiscence developed in one of these patients, but the wound healed after two sessions of suture. During one year of follow up, all the patients achieved favorite color, feeling and blood supply in the filling areas as well as good facial profile and visual appearance with no obvious convexity and concavity. Skin flaps matched well with surrounding tissues, incision lines were inconspicuous, and hairline looked naturally with well-distributed hairs in these patients after treatment. Patients were satisfied with treatment results. Conclusion Satisfied cosmetic outcomes can be achieved by using surgical approaches in patients with stable linear scleroderma of the head and face.