Aim To investigate the role of T type calcium channel of spinal cord and supraspinal on the pain threthold of the rats following chronic constriction injury(CCI) of the sciatic nerve.Methods Intrathecal and lateral ventricle injection were employed in this study.With Von Frey hair and radiant thermal stimulator,we measured the mechanical withdrawal threshold(MWT) and thermal withdrawal latency(TWL)of the rats after injected mibefradil.Results The rats of CCI group formed steady mechanical and heat hyperaglsia from the third day after operation to the end of this study.Administered intrathecally mibefradil 50,100,200 ?g can increase the CCI rats MWT and TWL.However,mibefradil administered lateral ventricle can reduce the CCI rats MWT and TWL.Conclusion Blocking T type calcium channel of spinal can inhibit mechanical and heat hyperalgesia of the CCI rats,However,bloking the T type calcium channel of supraspinal can enhance the mechanical and heat hyperalgesia of the CCI rats.

Objective To observe the clinical effects of Dexmedetomidine in combination with Sevoflurane for hysteroscopic resection. Methods 72 patients underwent hysteroscopic resection from January 2014 to December 2015 were divided into study group and control group according to the anesthesia mode. Patients in study group were in combination anesthesia mode of intravenous infusion of Dexmedetomidine and Sevoflurane inhalation, while patients in control group received Sevoflurane inhalation only. The clinical parameters and adverse reactions were observed and studied. Results Compared with control group, significant differences were shown in patients heart rate at T2, T3 and T4 and breathing rate at T2 in observation group (P < 0.05). Compared with T1 phase, there was statistical significance in study group patients systolic blood pressure (SBP), diastolic blood pressure (DBP), RR at T2, HR at T3, T4 (P < 0.05); Compared with control group, patients in study group had short onset time of anesthesia and long recovery of consciousness, while there has no statistical significance of the two groups (P > 0.05). Compared with control group, the respiratory depression, sedative effect of Ramsay sedation score, wakefulness, alertness / sedation score of observation method (OAA/S), digital pain score (NPRS), postoperative uterine contraction pain score, postoperative nausea and vomiting of study group had significant statistical differences (P < 0.05). Conclusion Combination anesthesia mode of intravenous pumping Dexmedetomidine and inhalation of Sevoflurane has good clinical effects for patients undergoing hysteroscopic resection.

Objective To discuss the value of preoperative C-reactive protein (CRP) and eryth-rocyte sedimentation rate (ESR) in predicting postoperative infections following multiple fractures. Methods A study was conducted in 78 patients with multiple fractures (complicated with pelvic frac-ture, ISS > 18) treated in our department from December 2006 to March 2009. CRP and ESR levels be-fore second damage control operation as well as postoperative infections were recorded. Meanwhile, the optimal cut-off value was determined by receiver operating characteristic curve and analyzed. Results There were 11 patients with postoperative infection. The preoperative optimal cut-off value of CRP was 50 mg/L, with a sensitivity of 0.909 and a specificity of 0.821. The preoperative optimal cut-off value of ESR was 27.5 mm/h, with a sensitivity of 0.818 and a specificity of 0.791. The combination tests showed the sensitivity and specificity of 0.875 and 0.900 respectively. Conclusion CRP (50 mg/L) can be a sensitive predictive index for postoperative infection in the multiple fractures (complicated with pelvic fractures). Combination test of CRP and ESR can benefit diagnosis of postoperative infection.

Objective To investigate the clinical diagnosis and treatment of children's relapsesable intussusception by Peutz-Jeghers syndrome.Methods 5 cases of relapsesable intussusception result from Peutz-Jeghers syndrome which confirmed by operation and pathological diagnosis in children were analyzed retrospectively.Results All patients were diagnosed definitely by operation and pathological diagnosis and recovered well postoperatively.Conclusions Treated with the intussusception and resected polypus is effect to Peutz-Jeghers syndrome because it caused intussusception recurred easily,and patients should be followed up and examined regularly.

Objective To investigate the expression of programmed cell death-1(PD-1)ligands on HepG2 cell and 2.2.15 cell.Methods Culture HepG2 cell and 2.2.15 cell in vitro and stain the cells with fluorescence-labeled monoclonal antibodies specifically against PD-L1 and PD-L2,respectively.Isolate total RNA of HepG2 cell and 2.2.15 cell and detect the mRNA expressions of PD-L1 and PD-L2 by RT-PCR.Results The expression of PD-L1 on 2.2.15 cell was upregulated on the levels of both proteins and mRNA.The expression of PD-L2 in 2.2.15 cell was not detected.And neither the PD-L1 nor PD-L2 was detected in HepG2 cell.Conclusion HBV infection can upregulate the expression of PD-L1 on hepatocyte,which might contribute to the immune evasion of HBV.

Objective To investigate the perioperative treatment and reduce the surgical risk in patients after pancreaticoduodenectomy (PD).Methods We retrospectively analyzed the clinical data of 213 PD patients operated at the PLA General Hospital from January 2012 to December 2012.Results The postoperative complications included pancreatic fistula (51 cases,24％),biliary fistula (8 cases,3.8％),intestinal fistula (8 cases,3.8％),gastroparesis (35 cases,16.4％),abdominal infection (16 cases,7.5％),and postoperative bleeding (16 cases,7.5％).The perioperative mortality was 1.9％ (4/213).Conclusion Strengthening the perioperative management of PD patients plays an important role in improving surgical safety and reducing postoperative complications.

Objective To investigate the effect of intrathecal(IT)mibefradil on the mechanical and thermal hyperalgesia following chronic compression of dorsal mot ganglion(CCD)in rats,trying to elucidate the role of T-type calcium channels in the nociceptive signal transmission at spinal level.Methods Forty-eight male SD rats weighing 230-250 g were randomly divided into 6 groups(n=8 each):group Ⅰ sham operation;group Ⅱ CCD;group Ⅲ CCD+normal saline(N.S.)and group Ⅳ,Ⅴ,Ⅵ CCD+mibefradil 50 ?g(Ⅳ),100 ?g (Ⅴ),200 ?g(Ⅵ).The animals were anesthetized with intraperitoneal(IP)1% pentobarbital 40 mg?kg~(-1). Intrathecal catheter was placed according to the technique described by Yaksh et al.Five days after IT catheter placement L_4 and I_5 dorsal root ganglion(DRG)compression(CCD)was performed in group Ⅱ-Ⅵ.In sham operation group(Ⅰ)only L_(4-5) transverse processes and intervertebral foramina were exposed but DRGs were not compressed.In group Ⅳ,Ⅴ,and Ⅵ 5 days after CCD model was established a bolus of mibefradil 50,100 and 200 ?g in 10 ?l NS was given IT.In group Ⅲ NS 10 ?l was given IT instead of mibefradil.Mechanical withdrawal threshold(MWT)using Von Frey filament and thermal withdrawal latency(TWL)using radiant heat applied to the plantar surface were measured before CCD(baseline)and 1,3,5,7,14 and 21 days after CCD in group Ⅰ and Ⅱ and before and 30,60,120,240 and 480 min after IT mibefradil in group Ⅲ-Ⅵ.Results The animals in group Ⅱ(CCD group)developed mechanical and thermal hyperalgesia from the 1st day after operation to the end of the experiment.IT mibefradil 50,100 and 200 ?g can all attenuate both mechanical and thermal hyperalgesia induced by CCD.Conclusion Spinal T-type calcium channel may play an important role in the pathogenesis of neuropathic pain.

Objective To investigate the relationship between the neuroprotective effect of epigallocatechin gallate ( EGCG ) for PC12 cells induced by 1-methyl-4-phenyl-pyridinium ( MPP+ ) and activating nuclear factor-related factor 2 ( NRF2 ).Methods Well differentiated PC12 cells treated with MPP+ were used as the in vitro cell models,and PC12 cells were pretreated with different concentrations of EGCG.MTT assay was used to investigate the cell viability.Western blot was used to observe the expression of NRF2 in cells and distribution in the nucleus and the cytoplasm.Real-time PCR was used to observe the antioxidant enzymes,HO-1 and NQO1 mRNA expression.Results Pretreatment of PC12 cells with different concentrations of EG CG for an hour could restore cell viability.Western blot showed that expression of NRF2 in cells treated with MPP+ for 24 hours was increased 148％ +5％ compared with the control group (t =6.102,P ＜0.01 ).The level of NRF2 in EGCG pretreated group was 188％ + 6％ compared with the control group(t =11.172,P ＜0.01 ).Moreover the NRF2 protein level in the nuclear was also increased.Western blot showed that the NRF2 protein level in the nuclear was 258％ +2％ compared with the control group (t =21.995,P ＜ 0.01 ).Further research found U 120,an inhibitor of ERK,could inhibit the effect of EGCG.The levels of NRF2 in both samples were 148％ ± 15％ and 158％ ± 1％ compared with their respective control groups(t =6.118,8.058,both P ＜0.01 ).In accordance with the NRF2 data,real-time PCR indicated that the levels of HO-1 and NQO1 mRNA expression increased obviously in the group pretreated with EGCG.Likewise,U120 could also inhibit HO-1 and NQO1 mRNA expression induced by EGCG.Conclusions EGCG can repair oxidative damage to PC12 cells induced by MPP+.The protective effect may be related through the ways to activate ERK-NRF2 and induce downstream of antioxidant enzyme expression,such as HO-1 and NQO1.

Objective to measure peripapillary atrophy(PPA)in glaucoma with high-resolution spectral domain-optical coherence tomography (SD-OCt)and conventional color fundus photograph,and compare the consistency of the results between the two imaging methods. Methods A to-tal of 30 patients(54 eyes)with glaucoma from Department of Opthalmology,the First Hospital,China Medical University were prospectively includ-ed for the study. SD-OCt images and color fundus photographs taken through the region of PPA were qualitatively analyzed. the average width of β-PPA area in 6 reference lines centered optic nerve were measured using SD-OCt and color fundus photograph. Correlation and agreement between the two measuring methods were analyzed. Results the average width of β-PPA was 229.89±99.82 μm using color fundus photographs and 224.14±97.10 μm using SD-OCt,respectively. there was no significant difference(P = 0.280). the correlation coefficient was 0.825 between re-sults measured by SD-OCt and color fundus photographs for β-PPA area(P < 0.001),and agreement between the two methods was good(ICC=0.923,95% CI 0.870-0.954). Conclusion the correlation and consistency is good between SD-OCt and conventional color fundus photograph measuring β-PPA area. β-PPA area can be estimated with SD-OCt.

OBJECTIVE To evaluate the effect of lamivudine on prophylaxis against hepatitis B virus(HBV) reinfection following orthotopic liver transplantation(OLT).METHODS The clinical data of 14 CLT recipients with HBV-related diseases received lamivudine(100mg/day) were retrospectively analyzed in our hospital.Hepatitis B serum markers,serum HBVDNA,and YMDD district variation were detected every two weeks.HBsAg and HBcAg in the liver specimens were examined by immunohistochemistry.Liver biopsy was conducted from the donor during operation and from the recipient postoperatively in a regular interval.RESULTS The reinfection took place in 4 patients and postoperatively(28.6%),HBV-DNA was transfered to the positive in 2 cases,and among them was 1 YMDD district produced and made a variation. Two cases with positive HBV-DNA before liver transplantation had higher HBV reinfection rate postoperatively.CONCLUSIONS Lamivudine monotherapy can effectively and definitely;preven HBV reinfection after liver transplantation HBV reinfection can produce YMDD district and make a variation again;HBV relevant diseases patient should negatively turn the HBV-DNA at the time of competent liver transplantation.