Objective To evaluate the relationship between hydrogen sulfide (H2S) and P2X3 receptors in dorsal root ganglions (DRGs) of rats with neuropathic pain (NP).Methods Thirty-six healthy male Sprague-Dawley rats,aged 4-6 weeks,weighing 180-200 g,in which IT catheters were successfully implanted,were divided into 3 groups (n=12 each) using a random number table method:sham operation group (group S),group NP and endogenous H2S synthase (cystathionine beta-syntheses [CBS]) inhibitor animooxyacetic acid (AOAA) group (group A).NP was induced by chronic constriction injury (CCI) to the sciatic nerve at 3 days after IT catheters were successfully implanted.AOAA (10 μg/kg) 10 μl and normal saline 10 μl were intrathecally injected once a day for 14 consecutive days starting from 1 day after CCI in group A,and normal saline 20 μl was intrathecally injected instead in S and NP groups.At 1 day before CCI and 1,3,7,10 and 14 days after CCI,the thermal paw withdrawal latency (TWL) and mechanical paw withdrawal threshold (MWT) were measured at 30 min after intrathecal injection.The animals were sacrificed at 7 and 14 days after CCI,and ipsilateral DRGs of the lumbar segment (L4-6) were removed for detection of the expression of CBS and P2X3 receptors by Western blot.Results Compared with group S,the TWL was significantly shortened,MWT was decreased,and the expression of CBS and P2X3 receptors in DRGs was up-regulated at each time point after CCI in group NP (P＜0.05).Compared with group NP,the TWL was significantly prolonged,the MWT was increased,and the expression of CBS and P2X3 receptors in DRG s was down-regulated at each time point after CCI in group A (P＜0.05).Conclusion H2S in DRG s can up-regulate the expression of P2X3 receptors,which may be involved in the pathophysiological mechanism of NP in rats.

Objective:To study the willingness of the medical staff of tertiary hospitals to be dispatched to work for a long time at the district hospitals under the " municipal trusteeship of district-ownership hospitals" mode, and explore the key factors that affect their long-term willingness, for references of optimizing the incentive system of the model.Methods:A questionnaire was designed as guided by the two-factor theory. In May 2019, a typical sample survey was made to investigate 103 medical staff of two tertiary hospitals in Beijing on their willingness to be dispatched to hospitals of district ownership. The survey covered such aspects as their basic personal information, hygiene factors(family responsibility, interpersonal connections expansion, mobilization and encouragement of leaders, etc.), and incentive factors(personal career development, greater potential giving play to their own talents, self-achievement, etc.). Descriptive analysis and univariate hypothesis testing were used to compare the differences of the dispatch willingness of staff of different characteristics. Meanwhile, an ordinal multinomial logistic regression model was built to analyze the influence factors of long-term dispatch willingness of these staff along with individual in-depth interviews.Results:The medical staff when they were dispatched to work at the entrusted hospitals for a long time, were concerned mostly with top six factors. These factors refered to a reasonable incentive(rewards)mechanism, family responsibility, colleague evaluation of the entrusted hospital, interpersonal connections expansion, personal career development, and potential unlocking. Those staff with dispatch experience had higher willingness to be dispatched than those without( P <0.05). The former saw higher of their personal career development resulting from the dispatch(3.91 points), while the latter saw higher their post-dispatch salary incentive mechanism(3.95 points). Compared with common medical staff, medium and high level management staff were more willing to be dispatched for a long time( H=14.536, P<0.001). Leadership mobilization in hygiene factors and personal career development in incentives factors were the key drivers for the long-term willingness of medical staff to be dispatched( P<0.05). Conclusions:The willingness of medical staff to be dispatched for a long time needs to be strengthened in the " municipal trusteeship of district-ownership hospitals" mode. Managers of the district-ownership hospitals should take into full consideration, the needs of different categories and levels of medical staff dispatched, guarantee the remuneration and performance pay of these staff, and enable their career track planning, hence mobilizing their incentives, and increase their willingness to work at such hospitals for a long time.