To observe the expression of cyclooxygenase (COX)-1 and COX-2 in brain after spared nerve injury (SNI) and compare the analgesic effects of COX inhibitors with different selectivity. Radioimmunoassay, RT-PCR and Western blotting techniques were used to evaluate the change of brain COX expression at different time points( before SNI, 1 h, 12 h, 1 d, 3 d, 7 d, 14 d, 30 d and 60 d after SNI); By exploring hot plate test, we observed the reacting time of animals after injection of saline, NS-398, SC-560 and indomethacin at different time points. The results showed that: ( 1 ) The expression of brain COX-1 didn't increase significantly until 14 d after SNI, while that of COX-2 increased significantly and rapidly after SNI and reached peak at the time point of 1 d ( all P ＜0.05 ); (2) NS-398 showed significant analgesic effect on neuropathic pain after SNI at the early phase ( P ＜ 0.05 ), but didn't persist for over 30 d; ( 3 ) Indomethacin and SC-560 didn't show significant analgesic effects until 14 d. These results suggest that brain COX-1 is involved in the late phase of neuropathic pain and may play a role in the persistence of pain, while brain COX-2 is involved in the early phase of neuropathic pain and may play a role in the pain origination.

Peripheral nerve impairment is a common complication in surgery, clinical researchers always do nerve sutrure using microsurgical technique and adjuvant treatment to improve peripheral nerve regeneration. Western medicine used usually adjuvant drugs, such as neurotrophic factors,are limited by their defects in clinical application. Traditional Chinese medicines (TCMs) classifies peripheral nerve impair as flaccidity Zheng and arthromyodynia, and considers that it is the result of stagnant blood block in the meridians and vessels, deficient of Qi and blood and disuse of bones and muscles. So, drugs usually have the function of invigorating vital energy, activating blood circulation and dredging collaterals. Mono-drugs include astragalus, Salvia miltiorrhiza, Astragali Radix, Epimedii Folium and so on. Extracts of TCMs have Ginkgo Folium, Cervi Cornu Pantotrichum, Achyranthis Bidentatae Radix, and so on. To be ready for further study and development, TCMs which can promote the peripheral nerve regeneration were reviewed by the literatures of the latest years.
Animals ; Drugs, Chinese Herbal ; pharmacology ; Humans ; Nerve Growth Factors ; pharmacology ; Nerve Regeneration ; drug effects ; Peripheral Nerves ; drug effects ; physiology

AIM: To compare the expression of three cyclooxygenase (COX) isoforms in the process of inflammatory pain and evaluate the analgesic effects of different protocols about usage of COX inhibitors on inflammatory pain. METHODS: Formalin was injected subplantarly to mice to induce inflammatory pain. The expression of COX-1, COX-2 and COX-3 was evaluated by radioimmunoassay and RT-PCR, respectively. For the analgesic effect assay, animals were divided into 5 groups including control, SC, NS, IN and NS + SC group. The former 4 spectively. In the NS + SC group, animals received NS398 during the first 1 month and SC-560 during the second month in the NS + SC group. RESULTS: The expression of COX-1 was higher at the late phase while that of COX-2 was higher at the early phase of inflammatory pain. The expression of COX-3 did not significantly change in the process of inflammatory pain. Additionally,behavioral assessment showed that using COX-2 inhibitors at the early phase followed by COX-1 inhibitors at the late phase could get better analgesic effect on inflammatory pain compared with single using COX-1 selective or COX-2 selective inhibitors. CONCLUSION: In brain, the expression of COX-2 increases rapidly in the inflammatory pain process while COX-1 expression does not increase till the late phase. Brain COX-3 is poorly involved in the inflammatory process. Combined use of COX-1 and COX-2 selective inhibitors may be a better protocol in inflammatory pain treatment.

Aim To study the preventive and therapeutic effects of Buyang Huanwu Decoction(BYHWD)on denervated tibial muscle atrophy of rats.Methods After 60 Sprague-Dawley rats were subjected to Common Peroneal nerve crush model of 5 mm injury, they were randomly divided into 6 groups for daily intragastric administration of drugs:BYHWD high-dose, medium-dose, low-dose groups, mecobalamin group(positive control), model group, sham operation group.The drug administration lasted for 18 days.18 days after operation, slice, masson staining and analysis morphology were performed. The wet weight ratio and section area of tibial muscle were also measured.Results Tibial muscle section area of sham operation group was large, morphous was regular, while that of model group significantly diminished, structure was chaotic, and connective tissue hyperplasia was more obvious;Tibial muscle section area of BYHWD group and mecobalamin group was fairly diminished, morphous was fairly regular, and connective tissue hyperplasia was not obvious.Compared with model group, the section area of BYHWD group all increased significantly(P <0.01)in a dose-dependent manner.Compared with mecobalamin group, the cross section area of BYHWD high-dose group was significantly larger(P <0.05).Compared with model group, the wet weight ratio of BYHWD high-dose and medium-dose group all increased significantly(P <0.01 or P <0.05)in a dose-dependent manner.Conclusion BYHWD has a significant effect of prevention and therapy on denervated tibial muscle atrophy of rats.

Objective To investigate the influence of continuous veno-venous hemofiltration (CVVH) on cardiac output (CO) value and parameters of hemodynamics monitored by transpulmonary thermodilution technique in critical patients. Methods A prospective cohort study was conduced. Sixty-two critical patients admitted to intensive care unit (ICU) of Zunyi Medical College Affiliated Hospital from January 2011 to October 2015 were enrolled. All of the patients received CVVH through femoral vein puncture catheter. The CO value was monitored before CVVH operation, immediately after CVVH operation (8 ℃ normal saline was injected immediately after the output of blood from the arterial end), 5 minutes after operation, the time at the sudden interruption (press pause key after 10 minutes of operation) and resumed immediately, 15 minutes and 30 minutes after operation by pulse-indicated continuous cardiac output (PiCCO) with transpulmonary thermodilution method. The changes in heart rate (HR), mean arterial pressure (MAP), central venous pressure (CVP), and blood temperature were observed at all time points. Results From CVVH before start to 5 minutes thereafter, CO values were not significantly changed in patients, fluctuating in 6.96 (7.33, 8.67)-6.98 (6.43, 7.45) L/min. When CVVH was suddenly interrupted, CO value was immediately increased to the peak 8.04 (7.36, 8.77) L/min, which showed statistically significant difference as compared with other time points (all P < 0.01). Immediately after the CVVH recovery from interruption, the CO value dropped to 4.71 (4.14, 7.26) L/min, and it was significantly lower than those at other time points (all P < 0.01). With the CVVH recovery, the patients' CO value was gradually restored to the stable operation ahead of interruption [4.71 (4.14, 7.26)-6.85 (6.08, 7.26) L/min]. During CO monitoring, HR, MAP, CVP and blood temperature of the patients were at the same level, and no significant changes were founded. Conclusions CVVH interruption of immediate PiCCO monitoring CO value were significantly increased, immediately after the CVVH recovery the CO value were significantly reduced, and the normal operation of CVVH did not affect the CO value monitoring. Hemodynamics and blood temperature of all patients were stable during CVVH.

Objective A large number of injured earthquake patients were accepted by the hospital whilethe professional surgeons were relatively lack. This article introduced the hospital emergency management in 2008Sichuan Wenchuan Earthquake, China. Method Within 3 days, Central Hospital of Mianyang accepted andtreated over 1000 patients after Wenchuan Earthquake jolted on 12 May 2008,and within 2 weeks, the number ofpatients reached 1500. The hospital carded out emergency management plan: (1) emergency comprehensive treat-ment district was established, which was divided into traumatic surgery district, general surgery district, and gen-eral medical district. Traumatic surgery district is responsible for treating traumatic patients, and most doctors andnurses were in this district. The district also had preview, contamination, operation, isolation, monitoring sec-tions, and the tents were numbered and labeled. General surgery district and general medical district were responsi-ble for patients not from earthquake, and only few doctors and nurses were in the two districts. According to the in-jury degree, all the wounded were classified into acute and severe, moderate and minor injuries, and wore red,yellow and blue label on the wrists, respectively. The name, gender, age and diagnosis of each patient and thename of doctor were written on the label. The infectious patients and non-infectious patients were separated.Results Near 200 operations and near 300 operations were performed at one night and at one day, respectively.Within one week, only 1 patient had the lung infection, and one patient with gangrenous emphysema was effective-ly treated. In-hospital cross infection and epidemic of infection disease didn't happen. Conclusions Emergencymanagement model and mechanism, which referred to the model of the battlefield ambulance, played an importantrole in treating a large number of injured patients.

Objective To investigate the progression of mild cognitive impairment (MCI) to Alzheimer's disease (AD) and the factors influencing the related changes in cognitive ability.Methods Seventy-five subjects with mild cognitive impairment (the MCI group),32 with Alzheimer's disease (the AD group) and 17 others with normal cognition (the NC group) were recruited.The Montreal Cognitive Assessment (MOCA) and the Mini-mental State Examination (MMSE) were used to assess their cognitive ability.At the same time,relevant clinical information such as their general condition and past history of disease were recorded.The subjects were followed up for 20 months on average to evaluate their annual rates of progression (APRs),and logistic regression was used to highlight any influencing factors.Results By the end of the follow-up,9 of the 75 MCI subjects had progressed to AD,with an APR of 5.25％.Thirteen cases had recovered normal cognitive functioning (97.6 per 1,000 person-years).Also,2 cases in the NC group (11.76％) developed MCI (69.1 per 1,000 person-years),but none of them had yet progressed to AD.Both hyperlipidemia and a body mass index (BMI) lower than 24 kg/m2 significantly predicted the deterioration of cognitive functioning.Heart disease was significantly correlated with cognitive improvement,and selfmanagement of cognitive function was also a significant protective factor.Conclusions Patients with MCI are at greater risk of developing AD than normal persons.Prevention and early treatment of hyperlipidemia as well as maintaining a normal BMI may delay the deterioration of cognitive functioning.Self-management of cognitive function can improve cognition.

Objective To observe the effects of 12-week pilates exercise and trunk strength training on the scores of visual analog scale(VAS)and Roland-Morris disability questionnaire(RMDQ),trunk extension/flexion strength and dynamic balance of female college students with chronic non-specific low back pain(CNSLBP),so as to offer a practical-based evidence for the rehabilitation treatment for female college students with CNSLBP.Methods A total of 45 female college students with CNSLBP were randomly divided into pilates(n=22)and strength training groups(n=23).Then,the scores of VAS and RMDQ,trunk extension/flexion strength and dynamic balance were measured before and after the exercise.Results After the 12-week exercise program,compared with the pre-exercise period,the VAS and RMDQ scores in the pilates and strength training groups were significantly decreased;the extensor peak torque(EPT)at 30°/s and 90°/s angular velocities in both groups and the flexor peak torque(FPT)at 90°/s angular velocities in the Pilates group were significantly increased,and the ratio of flexor/extensor(F/E)at 30°/s and 90°/s angular velocities in both groups were significantly decreased.In the eyes-open condition,only the anterior/posterior stability index(APSI)significantly decreased in the Pilates group.With eyes closed,the APSI,stability index(SI),and medial/lateral stability index(MLSI)significantly decreased in the pilates group,and only the APSI significantly decreased in the strength training group.After 12-week exercise,compared with strength training group,the VAS scores and F/E at 30°/s and 90°/s angular velocities decreased significantly in the pilates group,and EPT at 30°/s and 90°/s angular velocities increased significantly.In the eyes-closed condition,the SI,APSI,and MLSI in the pilates group were significantly lower than those in strength training group.Conclusions Compared with strength training,pilates exercise can significantly increase and balance the trunk flexion/extension muscle strength of female college students with NSLBP,enhance dynamic balance ability under eyes-closed conditions,and improve the low back pain of CNSLBP female college students with CNSLBP.

Objective To analyze the clinical and laboratory characteristics of systemic lupus erythematosus (SLE) in children. Methods Fifty-three inpatients, 5 boys and 48 girls with SLE, who aged from 7 to 14 years with a median age at 12 years, were enrolled into this study. A retrospective study was carried out to assess the clinical and laboratory features of these pediatric patients. Results The ratio of male to female patients was 1:9.6. Skin eruption was the most common initial manifestation (41.51%), followed by fever (20.75%) and arthralgia (20.75%). Systemic involvement was common, and 84.90% of these patients had hematological abnormalities, 60.38% renal involvement, 18.87% nervous involvement. The most common manifestation of hematological, renal and nervous involvement was anemia, proteinuria and seizures, respectively. Among the immunologic parameters tested, anti-nuclear antibody showed the highest positivity rate of 90.57%, followed by anti-dsDNA with a positivity rate of 67.92%. There was no significant difference between the male and female patients in the age of onset, SLEDAI score at admission and discharge, duration of hospitalization or the dose of corticosteroid used initially and at the discharge. Conclusion The manifestations of pediatric SLE are various, and multisystem involvement is common in these patients. Early diagnosis and active treatment might benefit the prognosis of pediatric SLE.

Objective To study the relationship between uridine diphosphate glucuronic acid (UGT1A1) gene polymorphism and unexplained neonatal unconjugated hyperbilirubinemia in Jinhua.Method Full-term infants with unidentified non-binding hyperbilirubinemia were selected as hyperbilirubinemia group from January 2016 to December 2017 in the obstetrics or neonatal intensive care unit of Jinhua Central Hospital,healthy full-term neonates and those with physiological jaundice admitted during the same period were selected as control group.Whole blood DNA was extracted and UGT1A1 was sequenced and then annotated with human gene mutation database.The distribution and frequency of UGT1A1 genotype were analyzed.The correlation between different genotypes and unexplained unconjugated hyperbilirubinemia in neonates was also studied.Result Two hundred and forty cases were enrolled in the hyperbilirubinemia group,and 216 cases were enrolled in the control group.Four single nucleotide variation (SNV) sites associated with the disease were found on UGT1A1,which were c.211G＞A (Gly71Arg),c.686C＞A (Pro229Gln),c.1091C＞T (Pro364Leu) and c.1456T＞G (Tyr486Asp),accounting for 83.9％(141/168),1.8％(3/168),8.9％(15/168) and 5.4％(9/168) in the experimental group respectively.The genotype frequency and allele frequency analysis showed that the distribution of the two SNV sites of c.211G＞A and c.1456T＞G were statistically different between the experimental group and the control group (P＜0.05),whereas there was no statistical difference of the other two SNV sites of c.686C＞A and c.1091C＞T between the two groups.Binary Logistic regression analysis showed that c.211G＞A and c.1456T＞G were related to the occurrence of unexplained hyperbilirubinemia,The OR values (95％CI) were 5.412 (3.567～ 8.212) and 8.377 (1.052～66.670) respectively,but no correlation was found of the other two polymorphic loci.At the different genotypes of c.211G＞A locus,the levels of total bilirubin and non-binding bilirubin in infants with homozygous mutant (AA) were higher than those in infants with heterozygous mutant (GA) and wild type (GG),which was statistically significant (P＜0.05).Conclusion The most common mutation site of the UGT1A1 gene in Jinhua is c.211G＞A.The mutations of c.211G＞A and c.1456T＞G are risk factors forunconjugated hyperbilirubinemia in neonates.Of the different genotypes of c.211G＞A locus,the serum bilirubin level of homozygous mutant group was significantly higher than heterozygous mutant group and wild type group.