OBJECTIVETo observe the analgesic effect of electroacupuncture (EA) on collagen-induced arthritis (CIA) rats and its regulating effect on inflammation reaction and the endogenous opioid system of synovial tissues. Methods A total of 30 healthy male Wistar rats were randomly divided into a control group, a model group and an EA group, 10 rats in each one. The chronic pain model of CIA rats was made by cattle type-II collagen in the model group and EA group. Rats in the EA group were treated with EA at "Zusanli" (ST 36) and "Kunlun" (BL 60) for 30 min from 16th day after model establishment, once a day for consecutive 10 days. Rats in the control group did not receive any treatment. Rats in the model group were treated with fixation as the EA group. Threshold of pain, arthritis index, paw swelling were measured before model establishment and 16 d, 20 d, 23 d and 25 d after model establishment. The levels of beta-endorphin (β-END), met-enkephalin (met-ENK), dynorphin A (Dyn A) were measured by radioimmunoassay; the mRNA expressions of mu opioid receptor (MOR), kappa opioid receptor (KOR) and delta opioid receptor (DOR) in synovial tissues of CIA rats were detected by I quantitative polymerase chain reaction (qPCR).

RESULTSCompared with the control group, threshold of pain was reduced (all P<0. 01), arthritis index was increased (all P<0. 01) and paw swelling was increased (all P<0. 01) in the model group on the 16th day, 20th day, 23rd day, 25th day after model establishment. Compared with the model group, the threshold of pain was increased in the EA group (all P<0. 01), arthritis index and paw swelling were reduced (all P<0. 01) on the 23rd day and 25th day after model establishment. Compared with the control group, the level of Dyn A in synovial tissues of CIA rats was increased in the model group (P<0. 01); the mRNA expressions of MOR, KOR and DOR were down-regulated lower than 0. 5 fold of normal level. Compared with the model group, the level of β-END in synovial tissues of the knee joint was increased in the EA group (P<0. 05), and the mRNA expressions of MOR, KOR and DOR in synovial tissues of CIA rats were up-regulated more than 2 folds of normal level.

CONCLUSIONThe intervention of EA on chronic pain of CIA rats is superior, which is likely to be related with effects of EA on anti-inflammation and up-regulation of synovial tissue β-END and MOR, KOR, DOR.

Acupuncture Analgesia ; Acupuncture Points ; Analgesics, Opioid ; immunology ; Animals ; Arthritis, Rheumatoid ; immunology ; therapy ; Cattle ; Chronic Pain ; immunology ; therapy ; Dynorphins ; genetics ; immunology ; Electroacupuncture ; Enkephalin, Methionine ; genetics ; immunology ; Humans ; Male ; Rats ; Rats, Wistar ; Receptors, Opioid, mu ; genetics ; immunology ; Synovial Fluid ; immunology ; beta-Endorphin ; genetics ; immunology

Long terms of chronic pain may induce emotional disorder such as depression,anxiety and aversion.It is worthy of studying the mechanism and therapy on pain emotional disorder.The animal model is important in basic researches,and the quantitative evaluation methods on the psychiatric factors are gradually applied in the pain research.The methods of evaluating the psychiatric disorder of pain are discussed in this paper,which will provide theory basis in the relevant fields.

Objective To assess the anesthesia efficacy of remifentanil-propofol or remifentanil-desflurance in patients undergoing video-assisted thoracoscopic surgery(VATS).Methods Forty ASA Ⅰ-Ⅱpatients. undergoing VATS were randomly divided into remifentanil-propofol group(group P,n=20)and remifentanil-desflurance group (group D,n=20).MAP and HR were monitered during the entire procedures. Conscious recovery, spontaneous breathing recovery, the endotracheal extubation time and OAAS score were recorded and compared between two groups. Results During the operation, MAP was decreased significantly in group D (P＜0.05).There was no significant difference in conscious recovery, spontaneous breathing recovery, the endotracheal extubation time and OAAS score between two groups. Conclusions The anesthesia efficacy of remifentanil-propofol or remifentanil-desflurance in patients undergoing VATS were both with quick recovery, but the fronter has more stable hemodynamics.

Objective To investigate the efficacy and safety of immediate intravesical instillation combined with short-term maintained intravesical instillat.ion chemotherapy of pirarubicin (THP) after operation for preventing postoperative recurrence of superficial bladder tumor.Methods One hundred and seven patients with superficial bladder tumor were divided by random digits table method into two groups:group A (50 cases ) was treated with immediate intravesical instillation combined with short-term maintained intravesical instillation chemotherapy after operation,and group B (57 cases) was treated with conventional intravesical instillation chemotherapy.Patients in group A underwent intravesical instillation of THP within 24 hours,maintained intravesical instillation once a week for 8 weeks.Patients in group B underwent intravesical instillation of THP in one or two weeks after operation,once a week for 8 weeks.And then once a month for 10 months.All patients were followed up with regular cystoscopy examination.Results Patients were followed up for 13-84 months,the incidence of partial vesical toxic reaction in group A was 26.00 ％ (13/50),general symptom rate was 4.00％ ( 2/50 ),the rate of recurrency was 16.00％ ( 8/50 ).The incidence of partial vesical toxic reaction in group B was 22.81％( 13/57 ),general symptom rate was 1.75％( 1/57 ),the rate of recurrency was 19.30％ (11/57).There was no significant differences between two groups (P ＞ 0.05 ).Conclusions Immediate intravesical instillation of THP after operation is safe and effective,but it is not suitable for patients with obvious bladder perforation and large wound surface of bladder mucosa after transurethral rescection.Immediate intravesical instillation combined with short-term maintained intravesical instillation chemotherapy of THP after operation for preventing postoperative recurrence of superficial bladder tumor is effective and well tolerated.

Objective To evaluate the valuations of the intracranial vertebrobasilar arteries using CT angiography (CTA) in order to improve the understanding of various variants in intracranial vertebrobasilar arteries.Methods The CTA images of 435 subjects were analyzed retrospectively.The data were collected by a 16-slice CT scanner.All the CTA images were processed technically by the maximum intensity projection and volume rendering.The intracranial vertebrobasilar arteries were measured and analyzed.Results Among the 435 subjects,bilateral intracranial vertebral arteries (V4) showed symmetry in 183 (42.07％) and dissymmetry in 252 (57.93％).Hypoplasia were found in 27 subjects (6.21％) on the left V4 segments and 36 (8.28％) on the right V4 segments,and a total of 21 (4.83％) were directly continued as the ipsilateral posterior inferior cerebellar arteries on the unilateral V4 segments.There were 2 subjects (0.46％) with vertebrobasilar dolichoectasia.There were 32 subjects (7.36％) had fenestration variation,3 of them (0.69％) were on the V4 segments,10 (2.30％) at the junctions,and 19 (4.37％) in the basilar arteries.Two subjects (0.46％) had persistent trigeminal arteries.Conclusions The variations of intracranial vertebrobasilar arteries mainly include angiodysplasia,vertebrobasilar dolichoectasia,fenestration variation,and persistent trigeminal artery.As a noninvasive vascular imaging method,CTA may accurately and visually assess the anatomic variation of intracranial vertebrobasilar artery,and provide imaging guidance for the preoperative evaluation of posterior fossa surgery.

Objective To investigate the change of mu opioid receptor ( MOR) in dorsal root ganglion ( DRG) in rat chronic inflammatory pain model and the effect of MOR agonist and antagonis tintraplantarly ( i.pl.) injected on pain threshold, so as to determine the role of peripheral MOR in chron in inflammatory pain .Methods Chronicin flammatory pain model was established by i .pl.injection of CFA in rats.The expression of MOR in DRG was detected by immunohistochemistry .Pain threshold before and after i .pl.injection of MOR agonist and antagonist was measured by radiant heat method .Results Rats suffered from an intraplantar injection of CFA developed chronic inflammatory pain , and the painthreshold still reduced on 18 day after CFA injection compared to that in the normal group . Immunohistochemistry staining revealed that compared with the normal group , the expression of MOR in DRG of CFA rats was increased ( P<0.01 ) .After the paw dorsal surface injection of MOR agonist , the pain threshold of CFA rats was increased, while that of normal rats exhibited no significant change .After the paw dorsal surface injection of MOR antagonist, the pain threshold of CFA rats was reduced , while that of normal rats had no significant change .Conclusion Under chronic inflammatory pain condition , DRG MOR expressionis enhanced , which participates in the regulation of chronic inflammatory pain , and may contribute to the prevention of further more serious pain .

Diabetic neuropathic pain(DNP)is one of the most common complications in clinical, which influenced patients’ daily functions greatly, without clear mechanisms and effective methods.P2X3 receptors play a pivotal role in the formation, transmission and conduction of pain under neuropathic pain models, associated with peripheral sensory nerve excitability enhancement.This paper focuses on the establishment of DNP models, and the effects of P2X3 receptors in diabetes mellitus.

Objective To investigate the effects of low frequency electroacupuncture on the P2X3 receptor expres-sion in dorsal root ganglion ( DRG) of rats with type II diabetic neuropathic pain. Methods Part 1:Fifty normal SD rats were randomly divided into normal group (8 rats) and model group (42 rats). The rat model of type II diabetic neuropathic pain was generated by high fat and high sugar diet with a single intraperitoneal injection of streptozotocin ( STZ, 35 mg/kg) . 2 Hz electroacupuncture was administered at ipsilateral acupoints Zusanli and Kunlun for consecutive 7 days. Insulin sensitivity index ( ISI) was measured at 0 w and 5 w, and fasting plasma glucose ( FPG) was measured at 0 w, 5 w, and 7 w. Paw withdrawal threshold (PWT) was measured by mechanical pain threshold, and P2X3 receptor was determined by immunofluorescence. Part 2:Twelve rats with diabetic neuropathic pain (DNP) were divided into EA + vehicle group (6 rats) and EA + αβ?meATP group (6 rats). Rats in the two groups received the same EA treatment as Part 1. Rats in the EA + αβ?meATP group were injected with P2X3 receptor agonistαβ?meATP (0. 6μmol/L, 100μL) into the ventral sur?face of each hind paw every time before EA treatment. Rats in the EA + vehicle group received the same dose of vehicle ( PBS buffer) as a control. Pain threshold of the rats were measured. Results ① Compared with the normal group, the ISI levels of the rats in DNP group was significantly decreased after 5 weeks of the high?fat high?sugar diet (P < 0. 01). Two weeks after STZ injection, the fasting plasma glucose levels in the rats receiving STZ were significantly elevated ( P <0. 01 ) . The type 2 diabetes model was established with a successful rate of 69. 04%. ②PWTs:The PWTs of rats in DNP group were reduced compared with rats in the normal group (P < 0. 01), indicating that the type 2 DNP model was suc?cessfully established. Compared with the PWTs of DNP?controlled rats, the 2 Hz electroacupuncture significantly increased bilateral PWT of rats subjected to DNP from day 3 after treatment (P < 0. 01). P2X3 receptor agonistαβ?meATP greatly reduced bilateral PWT of EA?treated DNP rats compared with that of the EA + vehicle group (P < 0. 01). ③The immu?nofluorescence essay showed that P2X3 receptor expression in bilateral L5 DRGs in the DNP group was significantly in?creased as compared with that in the normal group ( P < 0. 01 ) . The increases were inhibited by 2 Hz EA in L5 DRGs compared with the DNP group (P < 0. 01). Conclusions 2Hz electroacupuncture can effectively treat the type II diabet?ic neuropathic pain by decreasing the expression of L5 DRG P2X3 receptors in rats.

[Objective] Based on the resting state functional magnetic resonance imaging to investigate the abnormal features of the functional connectivity of resting brain neural network in the patients with primary insomnia,by using voxel-wise whole-brain finctional networks analysis of degree centrality (DC) for imaging evidence of neural mechanisms underlying primary insomnia.[Methods] The resting state fMRI were performed in 59 PI patients and 47 age,education,and sex-matched normal healthy subjects.Analysis of DC map changes between the two patient groups and the control group were performed by two sample t test.(threshold at P ＜ 0.05).[Results] Compared with the control group,the patients with PI showed significantly reduced DC value in bilateral medial frontal gyrus (MFG),bilateral anterior cingulate gyrus (ACG),and right insula;and increased DC value in right middle temporal gyrus (MTG),and left cuneus,(CUN),P ＜ 0.05.[Conclusion]Changes of DC value occurred in some region of brain in the P[patient groups when compared with the control group.It was indicated that DC,as a novel resting-state fMRI parameter in the voxel-wise whole-brain functional networks,might be an appealing alternative approach for further study on pathologic and neuropsychological states of PI.

[Objective]To investigate the value of degree centrality(DC),a novel resting-state fMRI parameter,in voxel-wise whole-brain functional networks analysis in primary insomnia(PI)after acupuncture therapy.[Methods]The resting state fMRI were performed in 29 PI patients and 22 age,education,and sex-matched normal healthy subjects. Analysis of DC map changes between the two patient groups and the control group were performed by two sample t test.(threshold at P<0.05).[Results]Compared with the control group,patients with PI showed significantly reduced DC value in middle temporal gyrus(MTG. R);hippocampus(HIP. B);parahippocampal gyrus(PHG. R);putamen(PUT. R);cuneus(CUN. L).[Conclusions]Changes of DC value occurred in some region of brain in the PI patient groups when compared with the control group. It was indicated that DC ,as a novel resting-state fMRI parameter in the voxel-wise whole-brain functional networks ,might be an appealing alternative approach for further study on pathologic and neuropsychological states of PI.