Objective To evaluate which b value is the best to distinguish the glioma recurrence and radiation-induced brain injury using DWI when b value were at 1 000 s/mm2、3 000 s/mm2 and 5 000 s/mm2 respectively.Methods Retrospective analysis the DWI of 21 patients who suffered from glioma recurrence and radiation-induced brain injury obtained on a 3T MRI scanner.Results (1)All recurrent glioma (100%)showed hyper-intense signal,while most radiation-induced brain injury patients (80%)showed hypo-in-tense signal when b=5 000 s/mm2 .The sensitivity and specificity were high (100% and 80% respectively)when hyper-intense sig-nal was taken as a diagnostic point of glioma recurrence and radiation-induced brain injury.(2)The receiver operating characteristic (ROC)curve analysis suggested that the minimum ADC resulted in a highest sensitivity to differentiate glioma recurrence from radi-ation-induced brain injury when b=5 000 s/mm.Conclusion High b-value is more accurate to reflect cell density,and the minimum ADC is better to differentiate the glioma recurrence and radiation-induced brain injury when b=5 000 s/mm2 on DWI.

Objective To evaluate the effect of PKC? antisense oligonucleotide (ASODN) administered intrathecally on the hyperalgesia induced by chronic constructive injury (CCI) and to investigate the underlying mechanism.Methods Twenty four female SD rats weighing 150-180 g were used. CCI was produced by 4 loose ligatures placed on the right sciatic nerve. A catheter was inserted into subarachnoid space at L3-4 for intrathecal drug or normal saline(NS) administration. Three days after intrathecal catheter implantation when the function of the animal's lower limbs recovered, NS or drug was injected through the catheter every day for 6 days. Then the animals were decapitated and the lumbar segment (L2-6 ) of the spinal cord was removed. The animals were randomly divided into 4 groups of 6 animals : Ⅰ CCI + NS (group C); Ⅱ CCI + PKC? sense oligonucleotide (SOON) 20 ?g (group S); Ⅲ CCI + ASODN 5 ?g (group A1) and Ⅳ CCI + ASODN 20 ?g(group A2). The mechanical withdrawal threshold was assessed by Von Frey hair stimulation. The expression of PKC? and PKCa protein in the spinal cord was determined using Western blot. Results The threshold to Von Frey hair stimulation was significantly reduced after sciatic nerve ligation. Intrathecal ASODN administration significantly reduced the hyperalgesia induced by CCI in group A1 and A2 in a dose-dependent manner as compared with group C. The expression of PKCy protein in lumbar spinal cord was significantly lower in group A1 and A2 than in group C. There was no significant difference in PKCa protein expression among the four groups. Conclusion The hyperalgesia induced by CCI can be decreased by intrathecal administration of PKCy antisense oligonucleotide. The reduction in expression of PKCy protein may be involved in the mechanism.

Objective To investigate the effect of PKC? antisense oligonucleotides injected intrathecally on the hyperalgesia and expression of PKC? protein in rats with chronic morphine tolerance. Methods Twenty-four female SD rats weighing 150-180 g were randomly divided into 4 groups ( n = 6 each): group Ⅰ control; group Ⅱ morphine (M); group Ⅲ sense oligonucleotides (S) and group Ⅳ antisense oligonucleotide (A) . An intrathecal catheter was placed in the lumbar subarachnoid space to allow for bolus injections. Chronic morphine tolerance was induced by intrathecal morphine 20 ?g twice a day (at 8:00 and 16:00) for 5 consecutive days. Intrathecal morphine (20 ?g twice a day) was continued in group M, S, and A and normal saline 20 ?l (in group M) or sense oligonucleotide 20 ?g (in group S) or antisense oligonucleotide 20 ?g (in group A) was given intrathecally between the two morphine doses (at 12: 00) for 6 consecutive days. Pain threshold was assessed by measuring the withdrawal response of the hindpaw to radiant heat with a thermal plantar testing apparatus 2 days before intrathecal catheter was placed and on the 2nd, 4th and 6th day after morphine tolerance was induced. The animals were killed on the 6th day of intrathecal NS/oligonucleotide administration after pain threshold was measured. The L2-6 segment of spinal cord was removed for determination of the expression of PKC? mRNA (RT-PCR) and PKC? protein (Western blot) .Results The establishment of morphine tolerance was confirmed by significant shortening of response latency to radiant heat. The thermal withdrawal latency was significantly prolonged in group S and A after intrathecal administration of sense or antisense oligonucleotide as compared with group M but was significantly shorter in group S than in group A. The expression of PKC? protein in spinal dorsal horn was significantly decreased in group S and A as compared to group M, but was significant lower in group A than in group S. The PKC? mRNA expression was significantly lower in group A than in group M but there was no difference in PKC? mRNA expression between group S and M. Conclusion The hyperalgesia induced by chronic morphine tolerance can be reversed by intrathecal PKC? antisense oligonucleotide through reduction of PKC? protein expression in the spinal dorsal horn.

BACKGROUND: Nuclear factor-kappa B (NF-κB), as a promoter of inflammatory reaction, stimulates injured parts or transcription of local inflammatory gene, promotes generation of inflammatory factors, and induces pain onset; however, the mechanism on chronic inflammatory pained spinal cord has been less reported.OBJECTIVE: To explore the NF-κB expression in spinal dorsal horn and behavioral hyperalgesia by preparing rat models of complete Freurd's adjuvant arthritis.METHODS: A total of 24 SD rats were randomly divides into sham-surgery group and complete Freund's adjuvant group, with 12 rats in each group. Adjuvant arthritis model was produced by injection of 50 pL complete Fraund's adjuvant (CFA) to the right ankle joint after anesthesia. The same volume saline was injected to the rat right ankle joint in sham-surgery group. The mechanical pain threshold, paw withdrawal thermal latency (PWTL), the diameter of ankle, and NF-kB expression in spinal dorsal horn were investigated 2 days before and 4, 7, 14, 21, and 28 days after CFA injection.thermal symptoms were not obvious. The inflamed symptoms significantly appeared on right ankle joint and developed to food to before injection and sham-surgery group, the mechanical pain threshold was significantly decreased at 4 days after CFA injection, and reached the lowest value at 21 days (P ＜ 0.01). The PWTL was significantly decreased at 4 days after CFA injection significantly increased in Ⅰ-Ⅵ in spinal dorsal horn in the complete Fraund's adjuvant group, which was higher than sham-surgery group (P ＜ 0.01). The results indicated that we could gain stable monoarthritis model by injecting CFA with oil-contained water intorat ankle joint space, and the model shown prolong and significant hyperalgesia to radial thermal and mechanical pressure;meanwhile, the NF-kB expression increased significantly in lamber Ⅰ-Ⅵ in spinal dorsal horn after the ankle joint arthritis.

Objective To evaluate the efficacy for patient controfled intravenous analgesia(PCIA) of butorphanol combined with fentanyl in the patients underwent thoracic surgery .Methods Ninety ASA I --1I patients scheduled for elective thoracic surgery under general anesthesia were randomly allocated into three groups,each group including 30 patients.Group B received butorphanol O.15 mg/ml,group F received fentanyl 20μg/ml,group BF received butorphanol 0.1 mg/ml combined with fentanyl 10μg/ml.PCIA was initiated just before the beginning of skin suturing with a loading dose of 1 ml,continuous rate was 1 ml/h,bolus was 0.5 ml,and lockout time WaS 10 minutes.VAS,sedative scores,respiratory frequency,saturation of blood oxygen,press times,pain-killer dose,side effects and satisfaction to analgesia at 1,4,8,12,24 and 48 hours after operation were recorded. Results VAS in group B WaS significandy higher than that in group F and group BF at 1,4,8 and 12 hours after operation(P＜0.05),and there WaS no significant differ-ence betweengroup Fand group B F(P＞0.05).Thesedative scoresin group B and B Fwere higherthanthat in group F,but no excess sedation WaS found in the former two groups.At the same time,the satisfaction to analgesia was the lowest in group B,the highest in group BF and higher in group F.There were no incidence of nausea,vomiting and pruritus in group B and group BF,but pruritus WaS 16.7%and nausea,vomiting was 23.3%in group F.Conclusions Butorphanol combined with fentanyl Can improve analgesia efficacy and reduce fentanyl adverse incidence.It Can provide the better balance between pain relief and side effects after thoracic surgery.

Objective To investigate the risk factors for postoperative nausea and vomiting (PONV) in spinal anesthesia patients.Methods A total of 841 patients received spinal anesthesia were visited after operation.Data were analyzed using univariate analysis and multivariate Logistic regression to identify risk factors related to PONV.Results PONV occurred in 94 patients (11.2％,94/841).Univariate analysis showed that PONV was unrelated with gender,age,ASA classification,anesthesia mode (P ＞ 0.05),related with operation department (P =0.026),body mass index (P =0.020),education level (P =0.000),history of previous surgery anesthesia (P =0.005),history of PONV (P =0.000),history of kinesia (P =0.002),smoke (P =0.019),intraoperative using of tramadol (P =0.018).Multivariate analysis showed that operation department (OR =4.039,95％ CI 1.331-12.259,P=0.048),education level (OR =3.504,95％ CI 1486-8.260,P=0.015),history of PONV (OR =5.113,95％ CI 1.790-14.606,P =0.002),intraoperative using of tramadol (OR =5.316,95％ CI 1.091-25.908,P =0.039) were identified as independent risk factors for PONV.Conclusions The independent factors associated with PONV following spinal anesthesia include operation department,education level,history of PONV,intraoperative using of tramadol.Identifying patients who are at high risk for PONV will enable the formation of more timely management project.

This study examined the analgesic effect of diprospan in rats with trigeminal neuralgia. Rat model of trigeminal neuralgic pain was established by loosely ligating the left infraorbital branch of the trigeminal nerve. After allodynia developed, the rats were randomly divided into 2 groups (n=20 in each): diprospan group, in which the rats received diprospan (7 mg/mL, 0.1 mL) injected to the left infraorbital foramen area; control group, in which saline (0.1 mL) was administered as the same manner as the diprospan group. The pain threshold (PT) in the left infraorbital area was measured before and 2, 6, and 8 weeks after the administration. The expression of neuropeptides [substance P, preprotachykinin A (PPTA), calcitonin gene-related peptide (CGRP)] in the trigeminal nerve was detected at the same time points as the PT measurement by immunohistochemistry or in situ hybridization method. The results showed that in the diprospan group, the PT was 10.65±1.26, 10.77±1.19 and 14.13±1.34 g 2, 6, and 8 weeks after the administration respectively, significantly higher than that before the administration (PT value: 0.36±0.11) (P<0.05 for each). In the saline group, the PT was 0.37±0.13, 0.66±0.09, 4.45±1.29 and 13.72±1.72 g before and 2, 6, and 8 weeks after the administration respectively with differences being significant between before and 6, 8 weeks after the administration (P<0.01). No significant difference existed in the PT between the diprospan group and the saline group at pre-administration (P>0.05). The PT in the diprospan group was significantly greater than that in the saline group 2 and 6 weeks post-administration (P<0.05). In the diprospan group, the expression levels of neuropeptides were significantly reduced as compared with those in the saline group 2 and 6 weeks post-administration (P<0.05). It was concluded that diprospan has an obvious analgesic effect on the trigeminal neuropathic pain partly by reducing the expression of neuropeptides in the trigeminal ganglia.

BACKGROUND:In recent years, the technical parameters about hurdle athletes are mainly obtained through video analysis and DLT algorithm. However, the gait and surface electromyography (sEMG) characteristics during normal walking are little reported. OBJECTIVE: To explore the changes of the gait and lower limb sEMG signals relative to gait period in hurdle athletes. METHODS:Eight male professional hurdlers were selected to perform gait and lower limb sEMG tests on the trail, and the differences in gait and sEMG signals were analyzed by mathematical statistics. RESULTS AND CONCLUSION: The gait parameters of hurdlers showed no significant differences (except step length). In the total gait cycle, along with the gait changing, the right and left side muscles of the same name moved alternately. The median frequency and average power frequency of the tapping leg in the lower limb muscles were greater than those of the swinging leg (except biceps femoris, tibialis anterior and lateral gastrocnemius), but the mean EMG and EMG integral values of the tapping leg were smaller than those of the swinging leg. At the stand phase, the median frequency and average power frequency of the tapping leg in the lower limb muscles were greater than those of the swinging leg (except tibialis anterior), but the mean EMG and EMG integral values of the tapping leg were smaller than those of the swinging leg (except soleus). At the swing phase, the median frequency and average power frequency of the tapping leg in the lower limb muscles were greater than those of the swinging leg (except tibialis anterior and lateral gastrocnemius), but the mean EMG and EMG integral values of the tapping leg were smaller than those of the swinging leg (except soleus). To conclude, there are different degrees of differences in the frequency domain and time domain of the lower limb muscles between tapping and swinging legs. Additionally, the muscle strength of the tapping leg is less than that of the swinging leg.

Objective To investigate the median effective dose (ED50) of cisatracurium priming accelerating the onset of neuromuscular block in patients of different genders. Methods Ninety ASA Ⅰ or Ⅱ patients aged 18-55 yr undergoing elective abdominal operation under general anesthesia were divided into 2 groups ( n = 45 each): male group (group M) and female group (group F). Neuromuscular block was monitored with accelerograph F (TOF-Watch SX). A single twitch stimulation of ulnar nerve was used to monitor neuromuscular function.Anesthesia was induced with midazolam 0.04 mg/kg and fentanyl 1 μg/kg. Accelerograph F was opened after the patients lost consciousness. The priming dose of cisatracurium was injected intravenously, then fentanyl 5 μg/kg and propofol 2 mg/kg were injected intravenously 3 min later and the left dose of cisatracurium for intubation was injected intravenously 4 min later. Tracheal intubation was performed when the ratio of the single twitch stimulation value to control value (T/Tc). decreased to 10%. Anesthesia was maintained with iv infusion of propofol and remifentanil and inhalation of isoflurane. The priming dose of cisatracurium was determined by up-and-down sequential trial. The initial priming dose was set at 5 μg/kg. The ratio of two successive doses was 1.2. T/Tc, time to 90% block, onset time, maximal neuromuscular block and clinical duration were recorded 4 min after the administration of the priming dose. The ED50 and 95% confidence interval (CI) of cisatracurium priming required to accelerate the onset were caculated. Results Time to 90% block was significantly longer-in group M than in group F (P ＜0.05). No significant difference was found in the other parameters among the groups. The ED50 and 95% CI of cisatracurium priming required to accelerate the onset were 21.36 μg/kg (95% CI 20.52-22.23 μg/kg)in group M and 14.53 μg/kg (95% CI 13.77-15.33 μg/kg) in group F. The ED50 was significantly higher in group M than in group F ( P ＜ 0.05). Conclusion The ED50 of cisatracurium priming accelerating thd onset is 21.36 and 14.53 μg/kg in male and female respectively and it is significantly higher in male than in female.

Objective To investigate the characteristics and risk factors of anemia in renal transplant recipients over 60 years old.Methods Clinical data of one hundred and sixty-eight renal transplant recipients over 60 years old were retrospectively analyzed.Logistic regression analysis was used to determine the risk factors of anemia.Results In 168 cases of renal transplant recipients,the incidence of anemia was 45.2％(76/168).Forty cases were normocyte and normochromic,26 cases were microcytic hypochromic,10 cases were hemolytic anemia.In these anemic recipients,51 cases were short of erythropoietin (EPO),25 were EPO resistance.The incidence of malnutrition and cardia-cerebrovascular complication was higher in recipients with anemia than those without anemia (P＜0.01).The incidence of anemia in CsA+Aza+Pred treatment was 57.1％,which was significantly higher as compared to other three treatments (P＜0.01).Unconditional multivariate Logistic regression analysis revealed that male,creatinine level,acute reject reaction,delayed graft function (DGF) were the independent predictors of anemia,the corresponding OR values were 1.089,5.156,6.345,1.876.Conclusions Anemia is a common and serious complication in renal transplant recipients over 60 years old.Male,creatinine level,acute reject reaction,DGF are the independent risk factors of anemia in renal transplant recipients over 60 years old.