Neuropathic cancer pain (NCP) arises from physical or chemical damage to peripheral or central neurons or in the neural conduction system.The mechanisms of NCP include pain directly related to tumor involvement,pain associated with chemotherapy,radiotherapy and surgery,neuropathic syndromes associated with paraneoplastic syndromes,inflammation and other factors.A detailed history and careful physical examination are important means of diagnosis of NCP.The clinical evaluation of NCP should use standardized pain assessment scale.Till now,the treatments of NCP include opioid combined with auxiliary analgesic drugs,interventional treatment and gene treatment.Deciding treatment strategies according to the pathogenesis of NCP,multidisciplinary collaboration,combined therapy with different analgesic drugs and technologies are the therapeutic directions for NCP.

The article analyzed the impact of cultural differences factors and non-cultural factors on cross-cultural adaptation of Pakistani medical students from the following aspects:daily habits,language,religion,values,China's laws and regulations,service mode of social life,curriculum setting,universities' management mode,adolescent growth factors,learning methods and learning ability,higher education and primary education teaching methods,difference between traditional and modern Chinese.Some recommendations were given from several aspects,such as enrollment,management,policy formulation and adolescent education.

Objective Carboxypeptidase E ( CPE) is one of the most important carboxypeptidases in-volved in the biosynthesis of numerous peptide hormones and neurotransmitters and plays an important role in en -docrine regulation .A splice variant of CPE ( CPE-ΔN) has been detected and the mechanism of CPE -ΔN action in tumorigenesis has been studied in many different cancers .The aim of this study is to examine CPE -ΔN ex-pression in human colorectal cancer ( CRC) and to evaluate its possible application as a potential prognostic mark-er.Methods In the present study ,we have analyzed isoform expression of CPE -ΔN by qRT-PCR and West-ern blot in 219 CRC patients .Results Our results showed that CPE -ΔN was overexpressed in colorectal tumor tissue and that high CPE -ΔN mRNA expression was closely correlated with tumor differentiation ,pT classifica-tion,pN classification,tumor recurrence and lymph node metastasis .High CPE-ΔN expression was also identi-fied as an independent prognostic factor using a multivariate analysis (P=0.011).Conclusion Based on these results,we can conclude that CPE -ΔN expression might be a potential prognostic marker for CRC patients .

Objective To detect the TNFSF13 expression and to evaluate its possible use as a potential prognostic marker in breast cancer .Methods We analyzed TNFSF13 expression by Western blot and qRT -PCR in 93 breast cancer patients .Results Our results showed that TNFSF 13 was overexpressed in breast cancer tis-sue.High TNFSF13 mRNA expression was closely correlated with tumor differentiation , pN classification ( P=0.003,0.022).In addition,patients with high TNFSF13 expression had a significantly shorter survival analyzed by Kaplan-Meier(P=0.04,log-rank test).Cox proportional hazards regression multivariable analysis revealed that high expression of TNFSF13 was identified as an independent prognostic factor (P=0.03).Conclusion TNFSF13 expression might be a novel target for prognosis and intensive therapy in breast cancer patients .

Objective To determine the relationship between dietary fiber intake and risk of prostate cancer.Methods Electronic databases including PubMed,EMBase,Cochrane library,China National Knowledge Internet (CNKI),Wanfang and CBMwere searched to find eligible studies.Random-effects relative risk (RR)and its corresponding 95%CI were used.Besides,random-effects dose-response analyses were also performed to clarify the dose-response relations.Results Ten studies,including five cohort studies and five case-control studies,were eligible and included in this Meta-analysis.The pooled RR of prostate cancer for the highest compared with the lowest dietary fiber intake was 0.87 (95%CI:0.77-0.99,Z =2.10,P =0.035). In addition,pooled estimated data showed that risk of prostate cancer was significantly associated with soluble fiber (RR =0.78,95%CI:0.64-0.95,Z =2.45,P =0.014)and insoluble fiber (RR =0.65,95%CI:0.45-0.88,Z =2.79,P =0.005),but not with fruit,vegetable and cereal fiber intake.However,in dose-response analysis,no significant association was reported (RR =0.996,95%CI:0.989-1.002).Sensitivity analysis showed that the overall results were relatively stable,and omission of any single study had little effect on the combined results.Conclusion Dietary fiber intake is negative related to the risk of prostate cancer. Intake of dietary fiber is recommended to prevent prostate cancer.Considering the limitations of the included studies,more well-designed prospective studies will be needed to confirm our findings.

OBJECTIVE:To provide reference for the medication safety in elderly patients with chronic diseases. METHODS:Elderly inpatients with chronic diseases and nursing staff in affiliated hospital of shaoyang medical college,from Mar. 2014 to May 2015 were randomly selected for a questionnaire survey to analyze the influential factors of drug safety and health education de-mand,and the difficulty sources of nursing staff in developing health education was explored. RESULTS:Totally 500 questionnaire was sent out to elderly patients with chronic diseases,500 were effectively received with effective recovery of 100%;and totally 200 were sent out to nursing staff,200 were effectively received with effective recovery of 100%. In the 500 surveyed patients, 193 had ADR,which was affected by age,educational background,monthly income,disease course,whether received health edu-cation,etc.(P<0.05),patients with older age,lower educational background and monthly income,longer disease course and no receiving health education showed higher incidence of ADR;the influential factors for health education demands included education-al background,occupational status,disease course,quality evaluation of nursing staff,etc.(P<0.05),patients with higher educa-tional background,lower disease course,higher occupational status and quality evaluation of nursing staff showed stronger health education demands. The difficulty sources of surveyed nursing staff in developing health education were busy work,being afraid of misunderstanding,embarrassing,cognitive and skill deficits. CONCLUSIONS:The drug safety of elderly patients with chronic dis-eases is related to many influential factors,as well as the health education demands. Nursing staff should continuously improve their ability and quality,combined with the above influential factors,carry out health education with physicians and pharmacists to ensure the medication safety.

AIM To research the antiasthmatic effects of Zuogui Pills,Yougui Pills and Yupingfeng Powder and their mechanism of action.METHODS Male Brown Norway rats were randomly divided into five groups.OVA was used to induce the model of chronic asthma.Five groups of asthmatic rats were given Zuogui Pills,Yougui Pills,Yupingfeng Powder by gavage once daily for 14 d,respectively.The normal and the model group were given normal saline.Penh value,serum Thl,Th2 inflammatory cytokines,and CROT and ACTH protein levels were determined.Pathological changes of airway remodeling were measured.RT-PCR method was used to measure the expression of CRH mRNA in hypothalamus,and TGF-β1 and Smad3 mRNA in lung tissues.RESULTS Penh values of Yupingfeng Powder group and Yougui Pills group were significantly lower than that of Zuogui Pills group.The Thl inflammatory cytokine of Yupingfeng Powder group was significantly higher than that of Zuogui Pills group,while the Th2 cytokine was significantly lower than that of Zuogui Pills group.In Yougui Pills group,only IL-5 was significantly lower than that of Zuogui Pills group.Serum CROT,ACTH protein and CRH mRNA of Yupingfeng Powder group were significantly higher than those in Zuogui Pills group.No significant difference was found between Yupingfeng Powder group and Zuogui Pills group with regard to TGF-β1 and Smad3 mRNA.Smad3 mRNA of Yougui Pills group was significantly higher than that of the model group.Airway remodeling was significantly reduced by Yupingfeng Powder and Zuogui Pills.The number of goblet cells in Yougui Pills group was significantly lower than that in Zuogui Pills group.CONCLUSION All the three formulaes possess significant antiasthma effects.Regulation effects of Yupingfeng Powder on Thl/Th2 balance,HPA and TGF-β1/Smad3 pathway are strong.Compared with Zuogui Pills,Yougui Pills possesses weaker TGF-β1/Smad3 regulative effects and stronger HPA regulative effects.

AIM:To investigate the effect of hydrogen sulfide ( H2 S) on high glucose ( HG)-induced injury of the mouse podocyte cell line MPC5.METHODS: The cultured MPC5 cells were randomly divided into 4 groups: HG group, normal glucose (NG) group, NG+DL-propargylglycine (PPG) group, and HG+NaHS group.After treated for a certain time, the cells were collected for further detection .The expression of zonula occludens-2 (ZO-2), nephrin,β-cate-nin and cystathionine γ-lyase ( CSE) was determined by Western blotting .RESULTS:High glucose significantly reduced the expression of nephrin, ZO-2 and CSE (P<0.05), while the level of β-catenin was elevated obviously (P<0.05), all in a time-dependent manner.NG+PPG inhibited the levels of ZO-2 and nephrin significantly (P<0.05), and increased the level of β-catenin (P<0.05), all in a PPG concentration-dependent manner.HG+NaHS induced a more significant increase in the levels of ZO-2 and nephrin as compared with HG group (P<0.01), whereas a severe reduction of β-cate-nin in HG+NaHS group was observed as compared with HG group .Compared with NG group , the expression of ZO-2 and nephrin was decreased obviously , and the level of β-catenin was increased in HG +NaHS group.CONCLUSION:Down-regulation of CSE contributes to hyperglycemia-induced podocyte injury .Exogenous H 2 S protects against hyperglycemia-in-duced podocyte injury , possibly through up-regulation of ZO-2 and subsequent suppression of Wnt/β-catenin pathway .

Objective To analyze the normal hepatic contrast perfusion blocked by ultrasound excited microbubble cavitation using the visual scoring method. Methods Twenty-four healthy New Zealand rabbits were divided into the microbubbles group (MB + US), the simple ultrasound group (US) and the sham group. The MB + US group was insonated by US and intravenous injection of lipid microbubbles. Microbubble was replaced by saline in the US group and sham US exposure was used in the sham group. US contrast liver perfusion imaging was performed before and 0 min,15 min,30 min,45 min,60 min,24 h after treatment in each group. Results The visual perfusion scores of each group before treatment were no statistical difference ( P >0. 05). The visual score of pre-treatment significantly higher than that of post 0 min, 15 min in the MB+ US group ( P<0. 05), but no difference with post 30 min,45 min,60 min and 24 h ( P >0. 05). There were no statistical significance between all the time points of the US and the sham groups. Conclusions Ultrasound excited microbubble cavitation can temporarily and significantly interrupt liver blood perfusion in the visual score analysis.

Objective To study the detection rate of contrast-enhanced ultrasound (CEUS) with different perfusion methods on rabbit VX2 small hepatocellular carcinoma less than 10.0 mm. Methods VX2 tumor cells were inoculated into the subcutaneous tissue of New Zealand rabbit′s thigh. Then the plant tumor were cut into small blocks under sterile conditions and transplanted into hepatic parenchyma in 30 New Zealand rabbits. The contrast media was injected through peripheral vein by single and double perfusion methods. The detection rate of two methods were compared. Results There were 41 hepatocellular carcinoma lesions in the 30 rabbits. There were 15 lesions with size between 3.0 mm and 5.0 mm, and 26 lesions between 5.0 mm and 10.0 mm in diameter. On CEUS, the VX2 tumor presented fast-in and fast-out pattern. In arterial phase, the lesion was enhanced rapidly. In portal venous phase, contrast began to wash out from the carcinoma. In delay phase, the enhancement of lesion was signiifcantly lower than the surrounding normal liver parenchyma. A total of 32 lesions were detected by single perfusion method, including 7 lesions ranging 3.0-5.0 mm and 25 lesions ranging 5.0-10.0 mm. A total of 39 lesions were detected by double perfusion method, including 13 lesions ranging 3.0-5.0 mm and 26 lesions ranging 5.0-10.0 mm. The detection rate of micro-hepatocellular carcinoma by single and double perfusion method was 78% and 95% respectively. The difference was statistically signiifcant (χ2=5.150, P=0.023). The detection rate of 3.0-5.0 mm lesions by single and double perfusion method was 47%and 87%, respectively. The difference was statistically signiifcant ( χ2=5.400, P=0.025). The detection rate of 5.0-10.0 mm lesions by single and double perfusion method was 96% and 100%, respectively. There was no statistically signiifcant difference (χ2=1.020, P=0.500). Conclusion The double perfusion method greatly promotes the detection of micro hepatocellular carcinoma, especially for the lesions less than 5.0 mm in diameter.