NMDA(N-Methyl-D-Aspartate)receptor is a kind of ionotropic receptors, which have been widely localized in peripheral somatic tissues and visceral pain pathways. The activation or expression changes of peripheral NMDA receptor may play an important role in pain occurrence. Peripheral administration of NMDA receptor antagonist can alleviate or prevent pain and enhance the analgesic effect of opiate. This method of administration can reduce the side effect of central action induced by the drug. It will be an important research direction of pain management.

Objective:To explore the clinical effect of glucocorticoid methylprednisolone combined with the conventional treatment on severe hand-foot-mouth disease ( HFMD) in children. Methods:One hundred and twenty children with severe HFMD from our hos-pital were randomly divided into the hormone group and non-hormone group with 60 cases each. The non-hormone group was treated with western routine therapy, and the hormone group was treated with glucocorticoid methylprednisolone 2mg·kg-1 ·d-1 additionally. The changes in such symptoms as fever, rash, surprised and chatter, drowsiness and shock were recorded in all cases. The disappear-ance time of febrile, shock and herpes and hospital stay were compared between the two groups. Results:The clinical effect of the hor-mone group was better than the non-hormone group;it could shorten the disappearance time of febrile, shock, herpes and pharyngeal buccal redness (P<0. 05), while showed no effect on the hospital stay. Conclusion:Glucocorticoid combined with the routine thera-py in the treatment of severe HFMD in infants exhibits better clinical effect.

Humans ; Infant, Newborn ; Infant, Premature ; Propranolol ; therapeutic use ; Retinopathy of Prematurity ; drug therapy

Objective To evaluate the effects of vitamin C combined with low dose of gabapentin on neuropathic pain (NP) in rats.Methods Fifty male Sprague-Dawley rats,weighing 225-275 g,aged 6-7 weeks,were randomly assigned into 5 groups (n =10 each):sham operation group (group Sham),NP group,vitamin C group (group VitC),gabapentin group (group Gap),and vitamin C combined with gabapentin group (VitC + Gap group).NP was induced by chronic constrictive injury in the rats anesthetized with pentobarbital sodium.The sciatic nerve was exposed and 4 silk ligatures were placed on the sciatic nerve at 1 mm intervals.In VitC,Gap and VitC+ Gap groups,vitamin C 500 mg/kg,gabapentin 30 mg/kg,and vitamin C 500 mg/kg + gabapentin 30 mg/kg diluted in normal saline 1 ml were injected intraperitoneally,respectively,twice a day for 7 consecutive days starting from 7 days after NP.Normal saline 1 ml was given in Sham and NP groups.Before NP and at 3,7,and 14 days after NP,the paw withdrawal threshold to mechanical stimuli (PWMT) and paw withdrawal latency to thermal stimuli (PWTL) were measured.At 14 days after NP,the blood samples were drawn from the carotid arteries.The rats were then sacrificed and the spinal cord was removed for determination of concentrations of malondialdehyde (MDA) in serum (by using Thiobarbituric acid method) and Slc23a2 mRNA expression (by RTPCR).Results Compared with Sham group,PWMT and PWTL in left paws were significantly decreased in NP,VitC,Gap ard VitC + Gap groups,the concentrations of MDA in serum were increased and Slc23a2 mRNA expression was down-regulated in NP group,Slc23a2 mRNA expression was down-regulated in VitC and Gap groups,and no significant change in Slc23a2 mRNA expression was found in VitC + Gap group.Compared with NP group,PWMT and PWTL in left paws were significantly increased,the concentrations of MDA in serum were decreased,and Slc23a2 mRNA expression was up-regulated in VitC + Gap group,the concentrations of MDA in serum were decreased in VitC group,and no significant changes were found in PWMT and PWTL in left paws in VitC and Gap groups.There were no significant differences in PWMT and PWTL in fight paws at each time point between the five groups.Conclusion Vitamin C combined with low dose of gabapentin can relieve NP effectively,and up-regulation of Slc23a2 mRNA expression,increased trafficking of vitamin C to neurons and inhibition of oxidative stress may be involved in the mechanism.

Objective To investigate the interrelations of ALOX5AP SG13S114A/T , COX-2 765G/C , COX-1-50C/T polymorphisms and cerebral infarction. Methods The ALOX5AP SG13S114A/T, COX-2 765G/C and COX-1 50C/T polymorphisms in 411 cases with cerebral infarction and 411 controls were measured by Polymerase Chain Reaction-Restriction Fragment Length Polymorphism method. The generalized multifactor dimensionality reduction (GMDR) method was employed to detect gene-gene interactions. Results Single-gene analysis showed that there were no significant differences in the genotype and allele frequency distributions of ALOX5AP SG13S114A/T, COX-2 765G/C and COX-1 50C/T between two groups. However, in those cases carrying ALOX5AP SG13S114AA as well as COX-2 765CC , the risk of cerebral infarction increased significantly by 2.842 times. Conclusions The combinational analysis among genes used in this study may be helpful in the elucidation of genetic risk factors for common and complex diseases.

AIM: To observe the effects of ketamine on preventing the increase of postoperative morphine requirement induced by fentanyl.METHODS: Sixty women undergoing total abdominal hysterectomy by spinal anaesthesia were assigned to 4 groups consisting of placebo(normal saline,C),fentanyl(3 bolus of 1 ?g/kg,at 15 min intervals,F),ketamine(infusion of 15 ?g?kg-1?min-1 ketamine from the skin incision until 20 min before the end of the surgery,K),ketamine and fentanyl(infusion of 15 ?g?kg-1?min-1 ketamine from the skin incision until 20 min before the end of the surgery plus 3 bolus of 1 ?g/kg fentanyl,at 15-min intervals,FK).The cumulative morphine consumption,pain score,and adverse effects(nausea, vomiting,hallucination,dizziness and itching) were recorded at 1,3,6,12,24,48 h postoperatively.RESULTS: There were no significant differences in age,weight,duration of surgery and the post-operative sensory block time.The cumulative morphine consumption in group F was significantly higher than those in group C at 3,6,12 h postoperatively(P

Objective To investigate the anesthesia and perioperative blood management of patients with Marfan syndrome (MS) undergoing scoliosis surgery.Methods The clinical data of MS patients underwent scoliosis surgery from January 2013 to December 2015 in Peking Union Medical College Hospital were collected and compared with patients received the same surgery but without MS.Perioperative information and data on anesthesia and blood management were analyzed.Results Compared with control group,MS patients were found with more preoperative comorbidities with statistical significance,including eye disease,echocardiographic abnormalities,and ventilatory defects.MS patients had significantly more blood loss,more intraoperative and postoperative allogeneic and autologous blood transfusion.The operation time,anesthesia time,and length of postoperative hospital stay were all significantly longer in MS patients.Conclusions MS patients are common with multi-system involvement and comorbidities.Considering the high risk of perioperative bleeding,the anesthesia and blood management for MS patients undergoing scoliosis surgery should be with extra caution.Blood management should be applied and appropriate invasive monitoring methods should be considered when necessary.

Objective To analyze the practicability of using ELISA kit for the detection of hepati-tis E virus antigen ( HEV-Ag) in plasma donations and Biomex HEV seroconversion panels. Methods The HEV-Ag positive samples were screened out from 36 340 donated blood plasma samples. Real-time fluores-cent PCR was performed for the detection of HEV RNA in HEV-Ag positive samples. The open reading frame 2 (ORF2) in HEV RNA was amplified by nested RT-PCR and the amplified products were confirmed by sequencing analysis. Phylogenetic tree was constructed for HEV genotyping. Five Biomex HEV serocon-version panels were used in this study for the detection of HEV-Ag, anti-HEV antibody and HEV RNA as well as the correlation analysis between HEV-Ag and HEV RNA. Results Twenty-six out of 36 340 plasma samples (0. 07%) were positive for HEV-Ag. Of the 26 samples, 25 samples were positive for HEV RNA as indicated by the results of nested RT-PCR and 23 positive samples were confirmed by sequencing analysis. The positive rate of HEV RNA in blood plasma donators was 1 ∶ 1 580 (0. 06%). There were 17 samples of genotype 1 (74%) and 6 samples of genotype 4 (26%) according to the phylogenetic tree analysis. All of the HEV-Ag positive samples were also positive for HEV RNA as indicated by the analysis of Biomex sero-conversion panels. HEV-Ag was consistent with the peak of the HEV RNA concentration. Conclusion A close relationship between HEV-Ag and HEV RNA was observed. HEV-Ag screening could be used as a measure to reduce the risk of HEV transmission by blood transfusion.

Objective To evaluate the effect of gabapentin for treatment of neuropathic pain induced by bilateral sciatic nerve chronic constriction injury (bCCI) of rats.Methods Forty-eight female SPF Sprague-Dawley rats,weighing 180-200 g,aged 7-9 weeks,were randomly divided into 4 groups (n =12 each) using a random number table:control group (C group),sham operation group (S group),bCCI group,and bCCI + gabapentin group (G group).Gabapentin 100 mg/kg was intraperitoneally injected once at 15 min before operation and twice a day during 7-13 days after operation for 7 consecutive days.The bilateral mechanical paw withdrawal threshold (MWT),thermal paw withdrawal latency (TWL) and number of cold-stimulated paw withdrawal were measured before operation (baseline) and at 1,3,6,8,10,14 days after operation.Results Compared with C group,the bilateral MWT was significantly decreased,and the bilateral TWL was shortened in bCCI and G groups,and no significant change was found in MWT and TWL in S group.Compared with bCCI group,the bilateral MWT was significantly increased,the bilateral TWL was prolonged,and no significant change was found in the number of cold-stimulated paw withdrawal in G group.Conclusion Gabapentin can relieve thermal and mechanical hyperalgesia induced by bCCI,however,it exerts no effect on cold allodynia in rats.

Objective Observe the effect of Total paeony glycoside(TPG)has on the T-cell immune action and apoptosis process of Oral lichen planus patients and analyze the mechanism.Methods 20 OLP patients are recruited into this experiment, each is treated with TPG,and their clinical effect is taken notes of.Observe the apoptosis of OLP lesions from each of the patients before and after the treatment,compare the apoptosis condition and the expression of CD4 + ,CD8 + ,and the CD4 +/CD8 + ratio,to analyze the role TPG plays on the immune expression of T-cell and the effect on apoptosis process.Results TPG improve the clini-cal manifestation of OLP patients significantly,resulting in the decrease of reticulum and erosive areas,and the pain index is de-creased obviously.The expression of CD4 + and CD8 + are decreased in OLP lesions after the treatment of TPG.Conclusion TPG may induce the apoptosis of the T-cell in lamina propria of the OLP lesions to regulate the T-cell immune action of OLP patients, and slow the development of inflammatory process of OLP,and in that way,TPG shows its potential in treating OLP,and this ex-periment can provide the primary evidence.