Objective To observe the effect of intrathecal injection (IT) of oxycodone hydrochloride on neuropathic pain and spinal cord level of microglial c-Jun N-terminal kinase/chemokine (C-X-C motif) ligand 1 (c-JNK/CXCL) 1signal in rat model of chronic constriction injury (CCI).Methods Male Sprague-Dawley rats were randomly divided into five groups (n =40 per group):sham group (intrathecal normal saline,IT NS),CCI group (CCI + IT NS),oxy group (CCI + IT 5 μg/30 μl oxy),mino group (CCI + IT 5 μg/30 μl Minocycline),and c-JNK inhibitor group (SP group,CCI + IT 5 μg/30 μl SP600125).The lumbar intrathecal catheters were implanted in L5-6 of rats and CCI models were established as previously described.The thermal and mechanical nociceptive thresholds were assessed by paw withdrawal latency (PWL) to radiant heat and von Frey filaments.The oxycodone,minocycline and SP600125 were administered intrathecally for 3 days before surgery.The spinal cord expression of Ⅰ ba-1,p-c-JNK and CXCL1 proteins assessed by Western blot.Immunofluorescence staining was performed to examine microglia morphology and the number of Ⅰ ba-1 positives cells in dorsal horn of injured spinal cord at 7 days post-IR.Results Compared to sham group,rats in CCI group had significantly lower mechanical and thermal pain thresholds,but higher spinal proteins expression of Ⅰ ba-1,and p-c-JNK and CXCL1 (P ＜0.05).Rats in oxy group,mino group and SP group had significantly higher mechanical and thermal pain thresholds and significantly lower proteins expression of Ⅰ ba-1,p-c-JNK and CXCL1 compared to those in CCI group (at any observed time-point after ligation,but most significantly at 7days,P ＜ 0.05).At the 7days after surgery,microglial cells in CCI group transformed from the ramified shape to amoeboid macrophage-like shape by immunofluorescence staining with the increases of Ⅰ ba-1 positive cells;while the other three groups exhibited hypertrophic morphology with less number Ⅰ ba-1 positive cells (P ＜ 0.05).There were no significant differences between these three groups at any observed time (P ＞ 0.05).Conclusions Intrathecal injection of oxycodone hydrochloride can relieve CCI-induced neuropathic pain by down-regulation microglial c-JNK/CXCL1 signal in spinal cords.Provide new therapeutic targets for clinical treatment of neuropathic pain.

Objective To investigate the effects of intrathecal injection (IT) of agonist and antagonist of N-methyl-D-aspartate receptor subunit 1 (NMDA NR1) on pain threshold and spinal levels of glutamate and glutamate transporter-1 (GLT-1) in rat model of chronic constriction injury (CCI) induced neuropathic pain.Methods Sprague-Dawley (SD) rats were randomly divided into 4 groups (Sham,CCI,NM-DA,and Humanin).The CCI model was established by right sciatic nerve constriction.The thermal and mechanical thresholds were assessed by paw withdrawal latency (PWL) to radiant heat and yon Frey filaments at 1,3,5,7,10 and 14 days as well as behavior after CCI.The NMDA and Humanin groups were administered intrathecally for 3 days before surgery.Spinal expression of GLT-1 assessed by Weston blotting and levels of glutamate were measured by enzyme-linked immunosorbent assay (ELISA).Results Compared to Sham group,the rats in CCI group gradually appeared the symptoms of toe close together,foot valgus and repeated licking to the operative side of the hind legs after surgery,and the paw withdrawal threshold (PWT),and PWL were greatly decreased,reaching the lowest level on the 7th day.Meanwhile,the glutamate content was increased,and the GLT-1 expression was decreased in spinal cord (P ＜ 0.05).Compared to CCI group,the rats in NMDA group were observed with further decrease in PWT,PWL and GLT-1 expressions at all observed timepoints (P ＜ 0.05),but increase in glutamate content in spine cord (P ＜0.05).Compared to CCI group,the rats in Humanin group were observed with increase in PWT,PWL and GLT-1 expressions at all observed timepoint (P ＜ 0.05),but decrease in glutamate content in spine cord (P ＜ 0.05).Conclusions NMDA receptor NR1 subunit participated in regulating neuropathic pain,inhibiting NMDA receptor NR1 subunit can alleviate neuropathic pain by down-regulating of glutamate and GLT-1.

Objective To observe the effects of intrathecal injection(IT)of agonist and antagonist of cannabinoid receptor 1 on pain threshold in rat model of sciatic nerve ligation(SNL)induced neuropathic pain,and investigate the role and mechanism of CB1 in neuropathic pain. Methods Male Sprague-Dawley rats were randomly divided into 4 groups:sham group( intrathecal normal saline,IT DMSO),SNL group(SNL+IT 30μL DMSO),AM841 group(SNL+IT 5μg AM841,dissolved in 30μL of DMSO)and AM281 group(SNL+IT 5μg AM281,dissolved in 30μL of DMSO). IT was given 3 days before surgery. Sham group only had sciatic nerve exposure but without ligation. SNL model in the other three groups were established by right sciatic nerve ligation. The thermal and mechanical thresholds were assessed by paw withdrawal latency(PWL)to radiant heat and von Frey filaments at 1,3,5,7,10 and 14 days as well as behavior after SNL. Spinal expressions of CB1 were assessed by West-ern blotting. Results Compared with the sham group,symptoms of rats in SNL group,such as heat hyperalgesia,mechanical allodynia and poste-rior paws prone to close together,were gradually appeared in the observation time points,with lower spinal proteins expression of CB1(P<0.05). AM841 group exhibited increased proteins expression of CB1 and inhibited SNL-induced heat hyperalgesia and mechanical allodynia(P<0.05). AM281 group further decreased expression of CB1 and amplified the pain abnormality(P<0.05). Conclusion Spinal CB1 participates in the regulation of neuropathic pain,and exogenous cannabinoid CB1 agonists can alleviate the SNL-induced neuropathic pain.

Objective To compare the curative effect with high frequent oscillation ventilation (HFOV) and with HFOV + inhaled nitric oxide (iNO) in the treatment of neonatal hypoxic respiratory failure (NRHF).Methods Data of 60 NHRF patients in the People's Hospital of Dehong Prefecture from January 2015 to December 2016 were retrospectively analyzed.The patients were divided into HFOV group (32 cases) and HFOV + iNO group (28 cases) according to the treatment methods.The comparison between the 2 groups was established as following:oxygenation index(OI),arterial partial pressure of carbon dioxide [Pa (CO2)] and complications.Results There was no significant difference between the 2 groups in time of birth,gestational age,birth weight,gender ratio and original diseases (all P ＞ 0.05).As for OI there was no significant difference at 0 h between the 2 groups (27.8 ± 3.5 vs.27.6 ± 3.7) (t =0.04,P ＞ 0.05);OI of HFOV + iNO group (11.2 ± 3.4,7.3 ± 3.0,7.0 ± 2.6,respectively) was more significantly decreased than that in the HFOV group (14.5 ± 3.3,9.6 ± 3.0,8.5 ± 2.8,respectively) at 8 h,16 h,24 h,and there were significant differences between the 2 groups (t =3.81,5.16,2.14,all P ＜ 0.05).As for P a (CO2) there was no significant difference at 0 h [(65.14 ± 14.97) mmHg vs.(64.79 ± 13.40) mmHg] (t =0.095,P ＞ 0.05);the changes in Pa (CO2) had no statistically significance difference between HFOV + iNO group and HFOV group at 8 h,16 h,24 h [8 h:(50.71 ± 10.49) mmHg vs.(49.02 ± 11.74) mmHg,16 h:(40.99 ± 12.38) mmHg vs.(40.02 ± 12.04) mmHg,and 24 h:(39.01 ±9.80) mmHg vs.(38.00 ±7.85) mmHg,all P ＞0.05].As for the complications,there was no difference between the 2 groups in pulmonary air leak,pneumorrhagia,intracranial hemorrhage,blood platelet ＜100 × 109/L,methemoglobin concentration ＞ 3％,or dysfunction of blood coagulation (all P ＞ 0.05).Conclusion Both HFOV and HFOV + iNO methods are effective for NRHF.Treatment with HFOV + iNO method is more effective.Treatment for NHRF with HFOV + iNO is safe,effective,without complication increase in a short term.

Objective To evaluate and analyze the drug-drug interactions(DDI)of different antidiabetic drugs.Methods DDI database Lexi-InteractionTMwas used to evaluate DDI for 28 commonly used antidiabetic medications(including insulin and 27 non-insulin preparations).Results 882 DDIs were identified for 28 drugs.Category C was the top rated DDI(69.8%). Category C,D,X were accounted for 91.2% of the total DDI.28 medication combinations belonged to category X,which should be avoided to use together.Sulfonylureas had the most DDI,followed by metformin.Alpha-glucosidase inhibitors had least DDI.Conclusion Hypoglycemic drugs with less DDI,such as α-glycosidase inhibitors,glucagon-likepeptide1(GLP-1)an-alogs and sodium-dependent glucose transporters 2 inhibitor(SGLT2i)should be considered with high priority for patients tak-ing multiple antidiabetic medications,elderly patients and patients with liver-kidney dysfunction.

Objective To explore the safety and effectiveness of bridging therapy in elderly patients with acute stroke due to posterior circulation large vessel occlusion.Methods A total of 160 eld-erly patients with acute stroke caused by posterior circulation large vessel occlusion admitted to our department were prospectively recruited and randomly divided into bridging group(n=80)and control group(n=80).The bridging group received thrombolysis treatment and then mechan-ical thrombectomy.The control group received mechanical thrombectomy directly.Prognosis and adverse reactions were compared between the two groups.Results The NIHSS score and BATMAN score after treatment were significantly decreased in both groups(P＜0.01),and the two scores were obviously lower in the bridging group than the control group(6.54±1.23 vs 7.12± 0.98,2.12±0.34 vs 2.87±0.44,P＜0.01).There was no statistical difference in the conversion rate of bleeding after cerebral infarction between the two groups(5.00％vs 3.75％,P＞0.05).The number of intraoperative thrombus removal was significantly lower in the bridging group than the control group(2.43±0.33 vs 2.98±0.41,P＜0.01).Remarkable difference was observed in the mRS score between the two groups after treatment(P＜0.05),with the proportion of mRS score ranging from 0 to 1 larger in the bridging group than the control group(52.50％vs 27.50％,P＜0.05).Conclusion Bridging thrombolysis can significantly improve the neurological function in elderly patients with acute stroke due to posterior circulation occlusion.

The incidence of coronary heart disease is increasing year by year,with the mortality rate rank-ing first.Early prevention,diagnosis,and treatment are crucial to reduce the mortality rate.Coronary angiography is the gold standard for diagnosing coronary heart disease and is widely used in clinical practice,but it cannot accu-rately reflect the degree of coronary artery disease.Blood flow reserve fraction(FFR)is currently the reference standard for evaluating coronary artery stenosis function.However,it is an invasive examination that is limited in clinical application due to factors such as complex operation,high cost,multiple side effects related to vasodila-tors,and poor reproducibility.In recent years,non-invasive blood flow reserve scores related to imaging have been increasingly applied in clinical practice.Quantitative flow fraction(QFR)and optical coherence tomography based flow reserve fraction(OCT based optical flow ratio OFR)have become research hotspots.OFR,as a relatively new technology,has received increasing attention.Therefore,this article will describe the basic principles,clinical value,and research progress of the above-mentioned technologies.

Objective:To explore the diagnostic value of magnetic resonance(MR)high-resolution imaging of vascular wall on vertebrobasilar artery tortuosity prolongation complicated by multiple cerebral infarction in posterior circulation.Methods:Regression analysis was used in this research.A total of 138 patients with vertebrobasilar artery tortuosity prolongation who admitted to Hengshui City People′s Hospital from January 2020 to January 2023 were selected.Among of them,54 patients who complicated with multiple cerebral infarction in posterior circulation were divided into the occurrence group,and 84 patients without multiple cerebral infarction in posterior circulation were divided into the non-occurrence group.All patients underwent high-resolution MR imaging of vascular wall,and the basilar artery(BA),hemodynamic indicators such as systolic peak(Vs),average peak(Vd),diastolic peak flow velocity(Vm),pulsatile index(PI),blood flow resistance index(RI),as well as intracranial responsibility plaque characteristics and vertebral basilar artery grading between two groups were compared.Results:The Vs,Vd,Vm,PI and RI indicators of patients in the non-occurrence group were significantly higher than those in the occurrence group,and the differences were statistically significant(t=11.742,4.323,7.367,4.824,2.351,P<0.05),respectively.The degree(60.31±4.24)%of intracranial plaque stenosis in the non-occurrence group was significantly lower than(73.67±5.96)%in the occurrence group,and the difference was statistically significant(t=15.376,P<0.05).There were no statistically significant differences in plaque area,plaque load,arterial remodeling index and eccentricity index between the two groups(P>0.05).The height level of vertebral basilar artery bifurcation and the degree of vertebral basilar artery deviation in the non-occurrence group were significantly lower than those in the occurrence group,with statistically significant differences(x2=3.907,6.419,P<0.05).Conclusion:MR high-resolution imaging of vascular wall can clearly display the blood flow velocity and intracranial plaque situation in patients with vertebrobasilar artery tortuosity prolongation,and conduct the grade for the vertebrobasilar artery,which has significant application value in predicting the occurrence of vertebrobasilar artery tortuosity prolongation complicated by multiple cerebral infarction in posterior circulation.

Objective To observe the nutritional status of patients with Parkinson's disease (PD) and investigate the influences of some non-motor symptoms in nutritional status. Methods One hundred and nineteen PD patients, admitted to our hospital from May 2016 to May 2017, and followed up for a long time, were chosen in our study. General clinical data, as age, gender, disease history, and Hoehn-Yahr (H-Y) grading, were collected, and the nutritional status of the patients was evaluated by subject global assessment (SGA) and patient generated subject global assessment (PG-SGA). According to the PG-SGA results, groups of grading A (well-nourished status), grading B (moderately malnourished status), and grading C (severely malnourished status) were divided. The proportion of each type of symptoms appeared in each group was compared and the risk factors of malnutrition in PD patients were determined by Logistics regression analysis. Results Among the 119 PD patients, 86 (72.26％) were classified as grading A, 33 (27.73％) as grading B, and none as grading C. There were statistically significant differences in body mass, body mass index, PG-SGA total scores and H-Y grading between patients from grading A and grading B groups (P<0.05). Among the 82 grading A patients, the common symptoms were dry mouth (n=49, 56.98％), constipation (n=43, 50.00％) and abnormal taste (n=25, 29.07％); among the 33 grading B patients, the common symptoms were dry mouth (n=23, 69.70％), constipation (n=21, 63.64％) and abnormal taste (n=18, 52.90％); there were statistically significant differences in the frequencies of anorexia, abnormal taste or no taste, bad smell, early satiety, pain and dietary intake between patients from the two groups (P<0.05). Anorexia (OR=10.76, 95％CI:2.00-57.894, P=0.006), early satiety (OR=4.539, 95％CI: 1.633-11.491, P=0.003), and pain (OR=4.608, 95％CI: 1.038-20.452, P=0.045) were independent risk factors for malnutrition in PD patients. Conclusion PD patients are prone to malnutrition; when patients have anorexia, early satiety and pain symptoms, timely intervention should be given or nutritional support should be further strengthened.

Objective To observe the digestive system related symptoms in patients with early-middle stage Parkinson's disease (PD) and healthy subjects,and investigate the incidence of the symptoms and the influencing factors.Methods One hundred and eight PD patients with early and middle stage (Hoehn-Yahr staging 1-3) were admitted to Xuzhou Central Hospital and followed up for a long time.A questionnaire,including seven items of digestive system related symptoms selected from the PD Non-Motor Symptom Scale and the Scale for Outcomes in PD for Autonomic Symptoms (taste abnormalities,swallowing disorders,salivation,easy or early satiety,constipation,loose stools,fecal incontinence),and additional five items of digestive system related symptoms (loss of appetite,dry mouth,oral pain,nausea,vomiting),totally 12 items,was used in a survey on PD patients.Seventy-six healthy subjects in the physical examination center of the hospital served as control group,and conducted the same questionnaire survey.Results There was no statistically significant difference in age,gender,height,weight,body mass index (BMI) between the PD and control groups.In 108 PD patients,dry mouth accounted for 64 cases (59.26％),constipation 53 cases (49.07％) and taste abnormalities 40 cases (37.04％),followed by loss of appetite 35 cases (32.41％) and early satiety 26 cases (24.07％),swallowing disorders 20 cases (18.52％),nausea 11 cases (10.19％),salivation 10 cases (9.26％),oral pain seven cases (6.48％),vomiting four cases (3.70％),loose stools one case (0.87％).In 76 controls,taste abnormalities accounted for 13 cases (17.11％),early satiety six cases (7.89％),loss of appetite six cases (7.89％),nausea five cases (6.58％),salivation three cases (3.95％),oral pain one case (1.32％),and the rest zero.The incidence of constipation (x2=52.390,P＜0.01),dry mouth (x2=69.050,P＜0.01),early satiety (x2=8.128,P=0.004),loss of appetite (x2=16.010,P＜0.01),taste abnormalities (x2=8.642,P=0.003) and swallowing disorders (x2=15.790,P＜0.01) showed statistically significant difference between the two groups.Analysis of the influencing factors showed that male had an effect on constipation (95％CI 1.371-7.495,OR=3.205),early satiety (95％CI 4.227-282.913,OR=34.582),taste abnormalities (95％CI 6.620-88.942,OR=24.260) and swallowing disorders (95％CI 2.784-88.475,OR=22.906),while other factors such as age,body mass index,disease duration and motor symptom types had no effect on the occurrence of digestive system related symptoms.Conclusions Digestive system related symptoms in patients with PD include dry mouth,constipation,taste abnormalities,loss of appetite,early satiety,and swallowing disorders,which may be their unique symptoms.Male is a risk factor for taste abnormalities,swallowing disorders,early satiety and constipation.