Objective To investigate the role of nitric oxide(NO)in the spinal cord sensitization in a rat model of neuropathic pain.Methods Thirty-two male adult Wistar rats weighing 200-300 g were randomly divided into 4 groups with 8 animals in each group:group Ⅰ sham operation;group Ⅱ L-NAME pretreatment + sham operation;group Ⅲ CCI and group Ⅳ L-NAME pretreatment + CCI.Neuropathic pain was induced by chronic constrictive injury(CCI).The animals were anesthetized with intraperitoneal pentobarbital 40 mg/kg.The right sciatic nerve was exposed and 4 loose ligatures were placed on the sciatic nerve at 1 mm intervals with 3-0 silk thread.In group Ⅰ and Ⅱ the sciatic nerve was exposed but not ligated.In group Ⅲ and Ⅳ L-NAME 250 μg in normal saline 10 μl was injected into subarachnoid space over 30 seconds at 15 min before sham operation or CCI.The paw-withdrawal threshold to nociceptive thermal stimuli(PWTT)was measured before operation(baseline)and on the 3rd day after operation.Four rats in each group were killed on the 4th and 7th day after operation,and lumbar segment of the spinal cord(L4-5)was removed for determination of expression of pCREB in the dorsal horn of spinal cord by immuno-histochemical technique.Results The paw-withdrawal threshold to nociceptive thermal stimuli(PWTT)was significantly decreased on the 3rd day after operation as compared with the baseline before operation in all 4 groups.The PWTT on the 3rd day after operation was significantly higher in group Ⅰ,Ⅱ and Ⅳ than in CCI group(group Ⅲ),but there was no significant difference in the PWTT after operation among the 3 groups(Ⅰ,Ⅱ,Ⅳ).The expression of pCREB in the dorsal horn neurons of spinal cord was significantly upregulated in CCI group (Ⅲ) as compared with the other 3 groups.Conclusion Spinal cord NO induces hyperalgesia in neuropathic pain through release of pCREB in spinal cord dorsal horn.

Objective To explore the feasibility of tubular model based segmentation method for cystic artery and three-dimensional (3D) reconstruction model of Calot's triangle.Methods A tubular model based 3D region growing algorithm was proposed for the segmentation of cystic arteries and its adjacent vessels from 13 patients' CT images in DICOM format.The data was transferred to 3D visualization workstation based on a set of CalotShow1.0 software for 3D reconstruction.Results The method could effectively segment cystic artery and obtain the 3D model of Calot's triangle.Conclusions The 3D reconstruction model based on tubular model related vessel segmentation method and CalotShow1.0 can accurately display the spatial positions and adjacent relationships of cystic artery and Calot's triangle.

Objective To investigate the effect of NR2B antisense oligonucleotide on naloxone-induced withdrawal responses in morphine-dependent rats. Methods Famale SD rats weighing 230-270 g were anesthetized with intraperitoneal pentobarhital 60 mg/kg. Intrathecal (IT)catheter was placed at L3,4 interspace.Thirty-two rats in which FT catheter was successfully placed were randomly divided into 4 groups ( n = 8 each) : group C control; group MD morphine dependence; group AO NR2B antisense oligonucleotide (aNR2B) and group SO NR2B sense oligonucleotide (sNR2B) . In group MD, AO, SO chronic morphine dependence was induced by increasing doses of subcutaneous morphine for 6 days. The initial dose of morphine was 10 mg/kg twice a day and was increased by 10 mg/kg twice every other day and reached 50 mg/kg on the 6th day. In group AO and SO IT aNR2B or sNR2B 15 nmol was administered simultaneously with subcutaneous morphine. Morphine withdrawal responses was induced by IT naloxone 4 mg/kg and scored based on the responses (0 = normal; higher scores signify severer responses) . The weight loss was calculated.The expression of NR1, NR2A and NR2B mRNA in hippocampus was determined by RT-PCR. Results The morphine withdrawal syndrome and weight loss were significantly incresed in group MD, AO and SO, while NR2B mRNA expression in hippocampus was up-regulated in group MD and SO compared with group C. The morphine withdrawal syndrome and weight loss were significantly decreased, NR2A mRNA expression in hippocampus was up-regulated and NR2B mRNA expression was down-regulated in group AO compared with group MD. There was no significant difference in NR1 mRNA expression between the 4 groups . Conclusion NR2B antisense oligonucleotide can suppress morphine withdrawal responses through the regulation of NMDA receptor level and construction in hippocampus.

Objective To investigate the effects of surgical trauma on synaptic structure in hippocampal CA3 area in aged rats.Methods Fifty-six healthy SD rats aged 18 months were randomly divided into 3 groups: control group (group C, n = 8) , anesthesia group (group A, n = 24) , and operation group (group O, n - 24) . Anesthesia was performed with intraperitoneal ketamine 40 mg/kg but no operation was carried out in group A. Anesthesia was also performed with intraperitoneal ketamine 40 mg/kg, and splenectomy was performed after loss of righting reflex in group O. Eight animals from group A and O selected on 1, 3, and 7 d after anesthesia or operation respectively underwent Morris water maze test for assessment of the cognitive function. The animals were . then decapitated. Hippocampal CA3 area was isolated for examination with electron microscope and the synaptic structure in the polymorphic layer of hippocampal CA3 area was measured. Results Compared to group C and A, the times of passing through the original platform and number of synapses were significantly reduced, the width of synaptic cleft was significantly increased, the thickness of the postsynaptic density was significantly decreased, the length of the active zones was significantly shortened, and the curvature of the synaptic interface and percentage of perforated synapses were significantly decreased at T_(1,2), ( P < 0.05 or 0.01) , but no significant change was found in the indices mentioned above at T_3 in group O(P > 0.05). Compared to group C, the latency and swimming distance were significantly prolonged at T_1 in group A and at T_(1,2) in group O ( P < 0.01) . Compared to group A, the latency at T_(1,2) and the swimming distance at T_2 were significantly prolonged in group O ( P < 0.05) . Conclusion Surgical trauma can induce early postoperative cognitive impairment through changing synaptic structure in hippocampal CA3 area in aged rats.

Objective To observe the clinical efficacy of acupuncture plus moxibustion at Baihui (GV 20) in treating post-stroke insomnia.Method Sixty-five patients with post-stroke insomnia were randomized into a treatment group of 33 cases and a control group of 32 cases. The treatment group was intervened by acupuncture plus moxibustion at Baihui (GV 20), while the control group was by conventional acupuncture. The SPIEGEL scale and Stroke-specific Quality of Life (SS-QOL) were evaluated before and after intervention, and the clinical efficacies were compared between the two groups.Result The SPIEGEL and SS-QOL scores were significantly changed after intervention in both groups (P<0.05). After intervention, the SPIEGEL and SS-QOL scores of the treatment group were significantly different from that of the control group (P<0.05). The total effective rate was 93.9% in the treatment group, versus 68.8% in the control group, and the difference was statistically significant (P<0.05).Conclusion Acupuncture plus moxibustion at Baihui (GV 20) is an effective method in treating post-stroke insomnia.

The paper elaborates on the construction concept ofHealthy Henan Health Service Cloud and introduces the project goals and system architecture.This platform effectively promotes the application and popularization of achievements in health informatization in Henan,enables the basic mass to experience the efficiency and convenience brought about by health informatization,and facilitates the monitoring and management by health administrative departments.

Objective To analyze the clinical features and laboratory data of 10 patients with macrophage activation syndrome (MAS) complicating systemic onset juvenile idiopathic arthritis (soJIA),which were characterized by acute severe liver injury.Methods Data of 10 patients with soJIA/MAS from Nanjing Children's Hospital were collected retrospectively.The clinical features,laboratory findings,treatment,outcomes and prognosis were analyzed.Results In the total 10 patients,female (6/10) outnumbered male.Their age ranged from 1.5 to 9.5 years old (average 5.2±2.6).The most remarkable clinical manifestations were severe liver injury without systemic features,representing as hepatomegaly (10/10),splenomegaly (2/10) and strikingly increased transaminase (10/10,median:ALT 1 445 U/L,AST 885 U/L).Central nervous system dysfunction and hemorrhages were recorded in 20％ of the patients.Two patients had pulmonary infection.Laboratory data showed that platelet count was less than normal or precaution value (10/10,≤262×10g/L).Hyperferritinaemia (10/10,median:17 329 mg/ml) and soluble CD25 elevation (median:3 140 U/ml) were common in the soJIA/MAS patients.Evidence of macrophage hemophagocytosis was found in 90％ of the patients (9/10) who underwent bone marrow aspiration.Pathological findings of liver biopsy from 1 patient revealed massive infiltration of mononuclear cells in the portal tracts.Nearly all patients (9/10) received intravenous pulse methylprednisolone therapy,combined with cyclosporine A and high-dose intravenous immunoglobulin.Eight patients had good outcome.Only 2 patients were complicated with severe interstitial lung disease during 12-months follow-up.Conclusion MAS should be considered when patients with soJIA represents acute severeliver injury without systemic features combined with other laboratory data.Intravenous pulse methylprednisolone and cyclosporine A therapy may improve the prognosis of soJIA/MAS.

Objective To investigate the safety and therapeutic effects ot a novel multi-layer flat-plate bioartificial liver (BAL) for patients with liver failure.Methods Thirty-eight patients with liver failure from Dec.2010 to Dec.2011 were treated with a novel BAL based on multi-layer flatplate bioreactor and the co-cultured cells of the porcine hepatocytes and mesenchymal stem cells.A total of 48 treatments was performed,4 h each time.The clinical signs and symptoms,liver function,ammonia,coagulation function and complete blood count were evaluated before,during and after the treatment.DNA in the collected PBMCs was extracted for PCR with PERV specific primers and the porcine specific primer Sus scrofa cytochrome B.The RT activity was detected as well.Levels of xenoantibodies (IgG,IgM) were determined by using ELISA kit. Titers of complement were quantified by CH50 kit.Results All treatment procedures were completed successfully without any adverse reaction. All samples presented negative PERV DNA and RT activity. The levels of antibodies were similar before and after treatment.Treatment was associated with a temporary decline in levels of complement,and then the levels were recovered quickly.The clinical symptoms such as acratia,anorexia and abdominal distension were improved.The stage of hepatic encephalopathy in 16 patients was decreased. The liver function and ammonia was reduced disproportionately. Seven patients in all were bridged to liver transplantation,2 patients died and 2 patients gave up the treatment,and the others were turned better.After the outcome judgment according to the standard developed by the Artificial Liver Group,and Chinese Association of Infectious and Parasitic Diseases,there were 9 patients with clinical healing,25 patients with improvement and 4 patients with no effect,and the cure-improvement rate was 89.5％.Conclusion The novel multi-layer flat-plate BAL could be used as a safe and effective therapy for patients with liver failure.

BACKGROUND:Several reports have demonstrated that metabolic disorders and physiopathologic changes accompany with urinary diversion.But these metabolic disorders caused by bladder reconstruction using intestinal tract are related to type and length of intestinal canal.OBJECTIVE:To investigate the histological change of reservoir mucosa and to assess effects on metabolic state in patients with a Roux-y sigmoid neobladder.DESIGN,TIME AND SETTING:A retrospective case analysis was performed at the Department of Urinary Surgery,the 184 Hospital of Chinese PLA between June 2000 and November 2008.PARTICIPANTS:The experimental group comprised 33 bladder carcinoma patients,21 males and 12 females,averaging 64 years of age.The control group consisted of 25 subjects who had no sigmoid colon diseases confirmed by gastroenterological endoscopy.METHODS:Patients with bladder carcinoma received radical cystectomy and bladder reconstruction using Roux-y sigmoid neobladder which controlled urination with anal sphincter.Prior to and after neobladder drainage tube removal,serum levels of electrolyte,creatinine,and urea nitrogen were detected.Before and 36 months after surgery,reservoir mucosa from 13 patients with bladder carcinoma was pathologically examined.For the control group,the thickness of sigmoid colon mucosa and the numbers of intestinal glands were determined.MAIN OUTCOME MEASURES:Electrolyte,renal function,acid-base balance,mucosal layer thickness,numbers of intestinal glands prior to and after surgery,as well as prior to and after drainage tube extraction.RESULTS:After surgery,electrolyte,creatinine,and urea nitrogen were all normal in 30 patients.There was no significant difference in serum electrolyte,creatinine,and urea nitrogen between prior to and after surgery.Mild acid poisoning was found in 3 patients.Microscopic observation results revealed that sigmoid colon mucosa in the control group did not change significantly after surgery,and it basically kept the normal tissue structure;in the experimental group,sigmoid colon mucosa that was(577.6±169.4)μm prior to surgery was thinned(412.5±114.7)μm(P＜0.05),intestinal glands were loosely arranged,interstitial substance became less,and the number of intestinal glands per high-fold visual field that was(26.4±3.5)/high-fold visual field prior to surgery was decreased(15.2±2.7)/high-fold visual field(P＜0.05),after surgery.In addition,intestinal villus in the neobladder was gradually atrophied,and no enterocyte proliferation and malignant changes were found after surgery.CONCLUSION:After Roux-y sigmoid neobladder application,colon mucosa was gradually thinned,intestinal glands were loosely arranged,interstitial substance became less,the number of glands per high-fold visual field was decreased,and body metabolism produced no changes.

Objective To assess metabolic state in patients with Roux-y sigmoid neobladder.Methods The study comprised 33 patients(21 men and 12 women) with Roux-y sigmoid neobladder after oneological sur-gery.All enrolled patients were treated by the same protocol.Before and after withdrawing the catheter , serum e-lectrolytes, ereatinine and urea were analysed and used to assess the effect.Results All 33 patients were evalu-able.Before and after withdrawing the catheter , serum electrolytes, creatinine and urea were normal values and there was no signifcant difference(P >0.05).Three patients developed mild metabolic acidosis.Conclusions The Roux-y sigmoid neobladder is a feasible , safe and effective method for continent urinary diversion.This surgi-cal technique had no signifcant effect on metabolic state.