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.

ObjectiveTo explore the role of activation and expression of absent in melanoma 2 (AIM2) in pathogenesis of hepatitis B virus (HBV) associated glomerulonephritis (HBV-GN).MethodsFifty-four patients with HBV-GN were recruited into the investigational group,and 25 patients with chronic glomerulonephritis (CGN) and 6 patients with chronic hepatitis B (CHB) were included as negative control group and positive control group,respectively.Immunohistochemistry was used to detect AIM2,Caspase-1 and interleukin (IL)-1β expressions in both kidney tissues from the investigational group and negative control group and liver tissues from positive control group.The differences between groups were compared by chi-square test,and the correlation analysis was conducted by Spearman correlation test.ResultsThe positive expression rates of AIM2 in 54 patients of HBV-GN group and 25 of CGN group were 81.4 ％ and 4.0％,respectively (x2 =38.746,P＜ 0.01).AIM2 was found to be expressed in all 6 CHB patients.In HBV-GN group,the expression of AIM2 was positively correlated with Caspase-1 (rs =0.444,P＜0.01),and the expression of IL-1β was also positively correlated with Caspase-1 (rs =0.515,P＜0.01 ).In HBV-GN group,the expression of AIM2 in patients with HBV DNA≥1 ×105 copy/mL was significantly higher than that in those with HBV DNA＜1 × 105 copy/mL (x2 =6.097,P＜0.05).ConclusionThe activation of AIM2 may play a role in the pathogenesis of HBV-GN through Caspase-1 activation and inflammatory factor IL-1β release.

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.

OBJECTIVETo explore the clinical efficacy of acupoint catgut embedding therapy on chronic pelvic cavity pain syndrome differentiated as kidney deficiency and stagnation of damp heat, and explore the impacts on plasma P substance (SP), plasma beta-endorphin (β-EP).

METHODSOne hundred and eighty cases were randomly divided into a catgut embedding group (90 cases) and a western medication group (90 cases). In the western medication group, tamsulosin capsules 0. 2 mg were prescribed for oral administration, once a day; indometacin sustained release tablets, 25 mg, three times a day. Totally, the oral administration for 8 weeks was required. In the catgut embedding group, the acupoint catgut embedding therapy was applied to Qugu (CV 2), Shenshu (BL 23), Zhibian (BL 54), Huiyin (CV 1) and Sanyinjiao (SP 6), once every two weeks; the treatment of 4 weeks made one session, and two sessions were required. Before and after treatment, TCM symptom score, NIH-CPSI (the National Institute of Health Chronic Prostatitis Symptom Index) score, lecithin body numbers in prostatic fluid, score in SAS (self-rating anxiety scale), score in SDS (self-rating depression scale), the levels of SP and β-EP, etc. were observed in the two groups, and the clinical efficacy was assessed in the two groups.

RESULTS(1) Ten cases were dropped in either group. The total effective rate was 91. 25% (73/80) in the catgut embedding group, higher than 78. 75% (63/80) in the western medication group (P<0. 05). (2) After treatment, TCM symptom score, total score in NIH-CPSI, pain score and the scores in SAS and SDS were all reduced as compared with those before treatment in the two groups (all P<0. 05). After treatment, TCM symptom score, total score and pain score in NIH-CPSI, and the scores in SAS and SDS in the catgut embedding group were both lower than those in the western medication group (all P<0. 05). (3) After treatment, the lecithin body numbers were both increased as compared with those before treatment in the two groups (both P<0. 05), and the result in the catgut embedding group was higher than that in the western medication group (P<0. 05). (4)After treatment, the SP level was lower than that before treatment in the two groups (both P<0. 05); the level of p-EP was increased as compared with that before treatment (both P<0. 05). The SP level in the catgut embedding group was lower than that in the western medication group (P<0. 05); the level of β-EP was higher than that in the western medication group (P<0. 05).

CONCLUSIONThe acupoint catgut embedding therapy apparently relieves the clinical symptoms of chronic pelvic cavity pain syndrome differentiated as kidney deficiency and stagnation of damp heat as well as the condition of anxiety and depression, increases lecithin body numbers in prostatic fluid and β-EP level and reduces SP level.

Acupuncture Points ; Acupuncture Therapy ; Adolescent ; Adult ; Catgut ; utilization ; Chronic Disease ; therapy ; Humans ; Male ; Pelvic Pain ; etiology ; metabolism ; therapy ; Prostatic Diseases ; complications ; metabolism ; Young Adult ; beta-Endorphin ; metabolism

Objective:To observe the levels of serum endothelin(ET),nitric oxide(NO),tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)in prehypertension and hypertension patients.Methods:Three groups were recruited from 3050 subjects of regular health checkup in Tangshan Railway Hospital from June to September,2007. Prehypertension (PH) group: n=106,Essential hypertension (EH) group: n=91,and Normotensive (NT) control group: n=98.The levels of ET,TNF-α,IL-6 and NO were compared by radioimmunoassay and biochemical tests. Results: ①Compared with NT group,body mass index (BMI) and serum lipids (TC,TG,LDL-C) were significantly increased in PH and EH groups (P<0.05),high-density lipoprotein cholesterol (HDL-C)was decreased in EH groups (1.59±0.15 vs. 1.77±0.19,P<0.05). ②Compared with NT group,ET,IL-6,TNF-α were increased in PH and EH groups (P<0.05).NO was increased in PH group (6.55±0.94 vs. 5.87±0.80,P<0.05) while decreased in EH group (5.28±0.81 vs. 5.87±0.80,P<0.05). ③Logistic analysis indicated that BMI,ET,NO,TNF-α and IL-6 were related to the hypertension. Conclusion: ET,NO,TNF-α,IL-6 were elevated in prehypertension patients and those might be used to predict the risk of hypertension.