BACKGROUND:Both local infiltration analgesia and femoral nerve block are used for the pain management after total knee arthroplasty. Controversy stil remains regarding the optimal technique for pain relief. OBJECTIVE:To systematical y evaluate analgesic effects of local infiltration analgesia and femoral nerve block after total knee arthroplasty. METHODS:Databases including PubMed, EMBASE, the Cochrane Library, Web of Science and CBM, were comprehensively searched to identify randomized control ed studies comparing local infiltration analgesia with femoral nerve block. Two reviewers independently selected trials, included literatures, extracted data, and assessed the methodological qualities of included studies according to Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0. When there were different opinions, it was decided by the third author. Data were analyzed by RevMan 5.3 software. RESULTS AND CONCLUSION:(1) Eleven randomized control ed trials involving 566 patients were included. (2) At 24 and 48 hours (h) after surgery, there were no significant differences between the local infiltration analgesia and femoral nerve block groups, in Visual Analog Scale scores [MD24 h=0.15, 95%CI (-0.26, 1.28), P>0.05;MD48 h=0.19, 95%CI (-0.06, 0.44), P>0.05] in the resting state, and [MD24 h=-0.01, 95%CI (-0.51, 0.48), P>0.05;MD48h=0.18, 95%CI (-0.45, 0.82), P>0.05] in the active state, amount of analgesic drug use [MD24 h=-2.23, 95%CI (-5.63, 1.16), P>0.05;MD48 h=2.44, 95%CI (-1.08, 5.95), P>0.05], hospital stay [MD=0.05, 95%CI (-0.40, 0.50), P>0.05], postoperative nausea and vomiting [OR=1.09, 95%CI (0.39, 3.04), P>0.05] and postoperative infection [OR=0.99, 95%CI (0.44, 2.59), P>0.05]. (3) These results indicated that the analgesic effect of local infiltration analgesia was identical to that of femoral nerve block after total knee arthroplasty. Due to its simple operation, local infiltration analgesia can be used as a standard analgesia method after total knee arthroplasty.

Objective:To explore the role of Semaphorins 3A(Sema 3A) and its receptor Neuropilin-1 (Nrp1) in the development of chronic periodontitis of rats and clinical samples.Methods:20 SD rats were divided into 2 groups.Rats in the experimental group were induced into chronic periodontitis models.Rats in control group were not treated.After 8 weeks,maxilla of all the rats were collected for micro-CT scanning and IHC staining.The distance from cementoenamel junction to alveolar bone crest(CEJ-ABC) and the IOD of Sema3A/Nrp1 positive staining in rats were analyzed.20 clinical samples of chronic periodontitis(n =10) and normal periodontal tissues (n =10) were collected for immunofluorescence and qRT-PCR analysis.Results:The CEJ-ABC distance of chronic periodontitis group was higher than that of the control group(P ＜ 0.05).The IOD of Sema3A/Nrp1 in experimental group was lower than that of the control group (P ＜ 0.05) and with a negative correlation with bone loss (P ＜ 0.05).Immunofluorescence and qRT-PCR analysis showed that the expression level of Sema3a/Nrpl in clinical samples with chronic periodontitis was also lower than that of the healthy subjects(P ＜ 0.05).Conclusion:The reduced Sema3A/Nrp1 plays an important role in the development of bone destruction in chronic periodontitis.

Objective To investigate the changes of serum bilirubin level in elderly patients with acute cerebral infarction and its significance.Methods 164 hospitalized elderly patients,who suffered from acute cerebral infarction within 1 week after onset,were divided into 2 groups according to age:group A aged over 60 years(n=85) and group B aged 40-60 years(n=79),and 66 healthy subjects aged over 40 years were collected as controls(group C).Serum bilirubin levels in all subjects were determined.The ratio of pulse pressure over mean arterial pressure(PP/MAP) in group A and B was calculated.Nerve function scores in the three groups were detected before and after 2 weeks of treatment.Meanwhile,the data of risk factors including blood glucose,blood pressure,blood lipids,smoking and drinking in group A and B were collected.Results Compared with group C,serum total,direct,indirect bilirubin levels were increased in group A and B(both P＜0.01),and the change was smaller in group A than in group B(P＜0.05).The nerve function scores was lower in group A than in group B before and after treatment [(35.2±12.6) vs.(44.3±7.9),(40.7±9.1) vs.(51.3± 4.1),t=5.58,9.73,both P＜0.01],but PP/MAP and the numbers of risk factors were higher in group A than in group B [(0.46±0.06) vs.(0.38±0.06),93.01 vs.71.20,both P＜0.01].There were no significant correlations of serum total,direct and indirect bilirubin levels with nerve function scores in group A or B(all P＞0.05).Conclusions Serum bilirubin level is increased in patients with acute cerebral infarction,but the endogenous antioxidant capacity is decreased because of aging,multiple risk factors and more serious atherosclerosis in elderly patients,and the increment of bilirubin level is relatively smaller in acute cerebral ischemia,leading to the reduced protective effect against stress.Serum bilirubin level may influence the prognosis in patients with acute cerebral infarction.

A new kind of curcin (curcin 2), induced by several kinds of stresses from Jatropha curcas leaves, under the control of the 35S CaMV (cauliflower mosaic virus) promoter, was introduced into tobacco genome by Agrobacterium tumefaciens-mediated transformation method. Curcin 2 protein was only detected in the transgenic tobacco plants transformed with the cur2p fragment (coding premature curcin 2 protein), but not in the plants transformed with cur2m fragment (coding mature curcin 2 protein). The transgenic lines expressing curcin 2 showed increased tolerance to tobacco mosaic virus (TMV).

The clinical thinking modes of "integrative disease and Syndrome" and "integrative macroscopical Syndrome-differentiation and microscopical Syndrome-differentiation" formed in the past half century were merely the primary train of thought and methodology of integrative traditional Chinese and Western medicine. In order to develop them to a higher level, stress should be put on the unity and holism of disordered organism and unity of function, structure and metabolism. It has long been ignored that a parallel and correlated relationship exists between the TCM Syndrome and pathological process of Western medicine, which is a common, set-formed and regular pathophysiological changes with certain development phase, presented in various diseases. Both have common features as that the same pathological process can be seen in different diseases and several pathological progresses can present in one disease, the same Syndrome also can be seen in different diseases and several Syndromes can present in a disease. Moreover, they have the compatible connotation and denotation. The author deduced that pathophysiological basis of main Syndrome is indeed the basic pathological process. Essence of Syndrome is the related pathological processes including abnormal changes in function, metabolism and morphological structure.
Biomedical Research ; methods ; Clinical Medicine ; methods ; Drug Therapy, Combination ; Holistic Health ; Humans ; Medicine, Chinese Traditional ; methods ; Pathology, Clinical ; methods

Objective To investigate the effect of excessive all-trans retinoic acid (atRA) on mouse embryonic palatal fusion and the mechanism. Method Palatal shelves from embryonic D 13 embryonic mice were cultured in BGJb medium and treated with vehicle control only or 5 ?mol/L atRA for 72 h. Palatal fusion was examined by hemagglutinin esterase. Apoptosis and laminin were detected by TUNEL and immunohistochemistry, respectively. The level of Smad2 phosphorylation (pSmad2) was analyzed by Western blot. Results atRA led to failure of palatal fusion and inhibited the migration and apoptosis of medial edge epithelial cells (MEE) and degradation of basal lamina within, compared with control palatal shelves in cultures. Additionally, apoptosis was detected in mesenchyme of atRA-treated palatal shelves. Further experiment revealed that pSmad2 was abrogated by atRA. Conclusion atRA induced failure of palatal fusion through inhibition of apoptosis of the MEE cell and degradation of basal lamina within medial edge epithelial seam. Inhibition of pSmad2 may account for the failure of palatal fusion by atRA.

Objective To investigate the adverse effects of taurine on rabbit corneal endothelial cells. Methods Six rabbits (12 eyes) were selected, and 6 histologic sections were prepared from each of the eyes. Rabbit corneal endothelial cells were cultured by explant culture method. Cells were innoculated on a 12-well tissue culture plate, 2%, 4%, 6%, 8% and 10% taurine solutions were added respectively (cells from the right and left eyes of the same rabbit were added the same concentration of taurine solution), and blank control was established. The growth of corneal endothelial cells was observed by inverted microscopy, and cell morphology on the 1st, 2nd, 4th, 6th and 8th day of culture was observed with Wright staining. Results Corneal endothelial cells cultured with 2%, 4% and 6% taurine solutions and those of blank control formed endothelial cell layers after culture for one week, and the cells exhibited hexagonal or round-like morphology. Corneal endothelial cells cultured with 8% taurine solution appeared to be undergrowth with small cell body on the 4th day, and cell death occurred on the 8th day. Corneal endothelial cells cultured with 10% taurine solution turned out to be undergrowth with small cell body on the 2nd day, and cell death had occurred. The same growth velocity and cell morphology were observed in the corneal endothelial cells from the right and left eyes of the same rabbit. Conclusion Taurine with concentration between 2% and 6% has no adverse effects on the growth of rabbit corneal endothelial cells.

Objective To prokaryotically express the valosin-containing protein(VCP)of Schistosoma japonicum,and ana-lyze its VCP mRNA expressions in the cercaria,schistosomulum,adult worm(female and male worms)and egg. Methods RNA of S. japonicum eggs were extracted,and reversely transcribed into cDNA. The VCP gene of S. japonicum was amplified by using polymerase chain reaction(PCR),and subcloned into the prokaryotically expressed vector pET15b. The recombined plasmid was transformed into BL21 cells,and the expression of the target gene was induced with isopropyl-beta-D-thiogalactopyranoside (IPTG). The recombinant protein was yielded through the purification of inclusion body,and identified by using sodium dodecyl sulfate polyacrylamide gel electrophoresis(SDS-PAGE). The RNA(s)of cercaria,schistosomulum,female adult worm,male adult worm,and egg of S. japonicum were extracted,digested with DNase,purified,and reversely transcribed into cDNA. The mRNA expressions of the VCP gene in various developmental stages of S. japonicum were determined by using fluorescence-based quantitative real-time PCR. Results The VCP gene of S. japonicum was yielded by PCR amplification,and the recombinant pro-tein was obtained through recombinant plasmid expression and purification of inclusion body. The highest VCP mRNA expression in S. japonicum cercaria was detected by the fluorescence-based quantitative real-time PCR,while low expressions were found in the schistosomulum,egg,female and male adult worms. Conclusion The recombinant protein encoded by the VCP gene of S. ja-ponicum is successfully obtained,and the VCP mRNA expression is determined in various developmental stages of S. japonicum.

Objective To study the expression of Ca-A/K channel-related molecules glutamate receptor 2 and 1(GluR2/1) in hippocampus tissues of neonatal rats with hypoxic-ischemic brain damage (HIBD). Methods A total of 60 7-day-old Sprague-Dawley rats were randomly divided into sham operation group and HIBD group. Hippocampal tissues were obtained at 0 h, 1 h, 6 h, 24 h, 48 h and 72 h after HIBD. The expression of GluR2, GluR1 and autophagy marker protein Beclin-1, LC3 were detected by Western blot assay. Results Edema and focal softening and necrosis were observed 6 h after HIBD in the brains of neonatal rats. Compared with Con group, at each time point, the expression levels of GluR2 were lower while the levels of GluR1, Beclin-1 and LC3 were higher significantly in HIBD group (P<0.05). The protein levels of LC3, Beclin-1, GluR1 and GluR2 in hippocampus tissues of HIBD group were significantly different among different time points after the estab-lishment of HIBD model (F=10.65~701.14, P<0.01). The protein level of GluR2 was decreased from 1 h to 24 h after HIBD and reached the lowest level at 24 h. The levels of GluR1, Beclin-1 and LC3 were increased at 6 h, plateaued at 24 h and remained there until 48 h. The levels of these proteins returned back to the initial level at 72 h. Conclusions Ca-A/K channel-related mol-ecules GluR2 and GluR1 play important roles in the autophagic cell death of hippocampus tissues in neonatal rats with hypoxic-ischemic brain damage.

Objective To evaluate the immuno-potentiating effects of CpG-ODN plus alum as a composite adjuvant on influenza split virion vaccine.Methods BALB/c mice were immunized with various amounts of 2009 H1N1 influenza split virion vaccine,alone or in combination with CpG-ODN,alum,or both (composite adjuvant).Antigen-specific humoral immune responses were evaluated by ELISA,hemagglutination inhibiting (HI) assay and neutralizing assay.Antigen-specific cellular immune responses were evaluated by ELISPOT assay,intracellular cytokine staining assay and in vivo CTL assay.Results Compared with the control group immunized with antigen alone,a single use of either adjuvant weakly enhanced the humoral immune responses,as indicated by the increase of antigen-specific IgG titers,HI titers and neutralizing titers by 3-6 folds,2-4 folds and 4-8 folds,respectively,after two immunizations.In contrast,the composite adjuvant induced more potent humoral immune responses; the antigen-specific IgG titers,HI titers and neutralizing titers were increased by 23-57 folds,9-20 folds and 16-64 folds,respectively.Consequently,the composite adjuvant achieved antigen-sparing by at least 16 folds.In addition,the composite adjuvant significantly enhanced the antigen-specific cellular immune responses,as revealed by the increase of IFN-γ-secreting CD4+ T cells and the enhancement of CTL activity in immunized mice.Conclusion CpG-ODN plus alum as a composite adjuvant can enhance the immunogenicity of influenza split virion vaccine and achieve the antigen-sparing effect.