BACKGROUND:How does the peripheral nerve block work to inhibit the functions? What effects does it do to the spinal cord and the cerebral center? How does it regulate the peripheral nerve and how does it change anatomy of brain center? Al above are stil unknown.
OBJECTIVE:To observe the effect of peripheral nerve block on the biology of spinal cord nerve cel s.
METHODS: Sixty New Zealand rabbits were selected and randomly divided into three groups: ischiadic nerve block group, subarachnoid block group and extradural nerve block group. Each group had 20 rabbits which were sub-divided into experimental group and control group with 10 rabbits in each subgroup. The rabbits in the three experimental groups were injected with lidocaine, bupivacaine and lidocaine at the middle point between femoral head and ischiadic tuberosity in ischiadic nerve block group, subarachnoid block group and extradural nerve block group, respectively. The rabbits in each control group were injected with normal saline at the same position.
RESULTS AND CONCLUSION:After ischiadic nerve block, extradural nerve block or subarachnoid block for 30 minutes, the Nigeria’s bodies of the little round cel s in the poliomyelia posterior horn laminaeⅢandⅣand the polyhedral cel s in the anterior horn laminaeⅨwere less than those in the control groups. Nuclei leaned towards one side. c-Fos protein expression was decreased or showed no expression, suggesting that the cord nerve cel function of corresponding spinal segments was inhibited. The spinal pia mater of spinal cord had a hierarchical or fracture phenomenon after subarachnoid block.

Objective To analyze experimentally the compressive strength of veneers on mottled teeth after Dul8e Nd:YAG laser irradiation.Methods Sixty motded teeth were extracted,including thirty maxdlary central incisors and thirty maxillary lateral incisors and each were divided equally into two groups randomly(experimental groups and control groups).The former were irradiated by pulse Nd:YAG lafer and then etched by 37%phosphorus acid.The latter only etched by 37%phosphorus acid.All the teeth were restored by composite resin veneers and tested with Instron 4505 electronic testing machine.The average collapse loads of the veneers of incisors were tested. The maximal compressive loads of the samples were obtained,then the experimental results were analyzed.Results The average collapse loads of central incisors of test groups and control groups were(0.342±0.053),(0.289±0.041) kN respectively,with a signiticant difference(t=3.16,P<0.05).The average collapse loads of lateral incisors of test groups and control groups were(0.321±0.041),(0.208 ±0.032)kN respectively.There was a significant difference when they were compared(t=7.66,P<0.05).Conclusions The compressive strength of the veneers incneases significandv when the mottled teeth are irradiated by pulse Nd:YAG laser.This method is worthy of recommending.

Objective To compare the clinical result of Da Vinci robot-assisted distal pancreatectomy(RDP) and laparoscopic distal pancreatectomy(LDP), and to evaluate the clinical application experience of Da Vinci robotassisted spleen-preserving distal pancreatectomy.Methods From March 2013 to June 2015, totally 12 patients undergone RDP and 22 patients undergone LDP in our department were analyzed retrospectively.Results Intraoperative blood loss, hospitalization duration and postoperative fast time in RDP group was less than that in LDP group, the spleen-preserving rate and hospitalization expenses were higher in RDP group(P ＜ 0.05).There was no statistically significant difference in the rate of surgery duration and incidence of postoperative complication between two groups (P ＞ 0.05).The following-up period was 1-28 months with a mean of (9.94 ± 8.99) months, 1 case of peritoneal infection occurred in RDP group, 1 case of survival with tumor recurrence and 3 case suffered peritoneal infection in LDP group.Others were no metastasis, recurrence or death.Conclusions RDP is safe and feasible, the short-term prognosis is better than that of LDP.It has advantages of cleat 3 D visual field, stability in control,less invasive,and quick recovery.It is worth further clinical use.

Objective To investigate the effect of palliative surgical treatment and minimally invasive biliary drainage of hilar cholangiocarcinoma.Methods Retrospectively collected 244 hilar cholangiocarcinoma patients clinical data in Affiliated Hospital of Qiingdao University between Jan.1,2008 to Dec.31,2011.Survival accoding to different treatment methods was compared using Kaplan-Meier method.The continuous measurement data were analyzed using the one-way ANOVA and the U test.The categorical variable were analyzed using the chi-square test or Fisher exact test.Result Among 244 patients, the R1/R2 resection group in 93 patients, the endoscopic retrograde biviar drainage group in 69 patients, the percutaneous transhepatic cholangial drainage group in 82 patiens.Three groups of median survival time and l-, 2-, 3-year survival rate and median survival time were (13.5 months, 8.9 months, 8.6 months), (63.0％, 24.7％, 7.4％), (33.3％, 3.3％, 0), (32.4％,4.2％, 0), respectively.There was significant difference in the survival time between R1/R2-resections and endoscopic retrograde biviary drainage treatments (P ＜ 0.001).R1/R2-resections and percutaneous transhepatic cholangial drainage treatments were statistical differences in survival time (P ＜ 0.001).Endoscopic retrograde biviary drainage and percutaneous transhepatic cholangial drainage treatments were no statistical differences in survival time (P =0.971).Conclusions Palliative surgical treatment for hilar cholangiocarcinoma patients had a more significant effect.Endoscopic retrograde biviary drainage and percutaneous transhepatic cholangial drainage of minimally invasive jaundice reducing method for prognosis in patients with hilar cholangiocarcinoma was same.

Contents in orthopaedic are independent relatively and finding out the internal relations during them is helpful to improving the effect of orthopaedic teaching.Transfer theory is important tools for clinical teaching practice,and finding out the common characteristics between the orthopaedic chapters is primary for the theory.This research focuses on the following fields:fractures,nerve injury,infection,tumor and deformity.After the common characteristics between these chapters were analyzed and discussed,we concluded that the transfer theory is helpful in orthopaedic teaching practice,especially for students' comprehension and memory,but still we should avoid some negative effects in teaching process.

Antineoplastic Agents ; administration & dosage ; therapeutic use ; Cladribine ; administration & dosage ; therapeutic use ; Humans ; Leukemia, Hairy Cell ; drug therapy ; Male ; Middle Aged

Objective:To get specific monoclonal antibodies ( mAbs) against PD-L1 which can block PD-1/PD-L1 binding, and explore the feasibility of its application on the treatment of chronic HBV infection preliminarily by in vitro and in vivo model. Methods:E. coli expression and series chromatography purification system were employed to get human and mouse PD-1/PD-L1 that had binding activity in vitro. By immunizing BALB/c mouse with purified recombination proteins of PD-L1,mAb hybridoma cell lines against PD-L1 were obtained. The reactivity with human/mice PD-L1 of individual antibody and the interaction blocking activity of the mAbs to PD-1/PD-L1 in vitro were examined by indirect chemiluminescence immune assay. Results: 8 cell lines against PD-L1 were obtained and 2 Anti-PDL1 mAbs (Ab5 &Ab6) performed strong immune activity to human/mice PD-L1 and blocking activity to PD-1/PD-L1. In the PBMC stimulation experiment of chronic HBV patient,Ab5 and Ab6 could promote theγ-IFN levels. With HBV in-fecting mice model,intravenous injections of these mAbs induced dramatically decrease of HBV DNA copies about 20 times, HBsAg levels in serum reduced to 30% of the baseline level. Conclusion:We obtained 2 PD-L1 mAbs with the reactivity to human/mice PD-L1 and blocking activity to PD-1/PD-L1. The 2 mAbs can promote T cell function in PBMC stimulation culture of chronic HBV patient, have significant antiviral effect in HBV transgenic mice and can be candidates for immunotherapy applications.

Objective To study the risk factor of postoperative acute lung injury(ALI)after liver transplantation.Methods The clinical data of I00 patients with end-stage liver diseases who re- ceived liver transplantations were retrospectively reviewed.The risk factors of postoperative ALI after liver transplantation were analyzed by using single variance analysis and multiple variance regression analysis.Results Thirteen patients(13 %,13/11t0)altogether were diagnosed as ALI after liver transplantation.Binary logistic analysis revealed that massive transfusion during operation(more than 5000 ml)and severity of reperfusion injury(ALT above 600 U/L)were two independent risk factors of postoperative ALI following liver transplantation.Massive transfusion significantly increased the risk of ALI by 12.7 times,whereas the severe reperfusion significantly increased the risk of ALI by 7.0 times.Conclusions ALl is a serious multifactoral complication after liver transplantation with high mortality and fatality.Massive transfusion and the severe reperfusion injury are two independent risk factors with high morbidity and mortality.

Objective To study the relationships between hepatocellular carcinoma (HCC) and the polymorphisms,promoter methylation,and expression of glutathione S-transferases P1 gene (GST) P1 gene.Methods Using methylation-special PCR (MSP),the methylated status of CpG islands of GSTP1 gene in tumor tissues of 53 HCC and its adjacent nontumor tissues were studied.The enzyme activities of GSTP1 were evaluated by ultraviolet colormetry.And using PCR-RFLP,the genetic polymorphisms of the GSTP1 genes of 74 healthy controls and 53 HCC patients were studied.Results The diffe-rences of the frequency of GSTP1 Ile/Ile,Ile/Val and Val/Val genotypes between HCC patients and the normal controls did not reach statistical significance (X~2=0.84,v=2,P=0.656).The frequency of methyla- tion of CpG islands of GSTP1 gene was significantly higher among the HCC tumor tissues when com- pared to the corresponding nontumor tissues (X~2=19.08,P＜0.001),and significantly higher in stageⅢ-Ⅳcases when compared to the stageⅠ-Ⅱcases (X~2=4.84,P=0.028).GSTP1 enzyme activities of cytoplasm in tumor cells were lower significantly than that in the adjacent nontumor tissues (t=2.49, P=0.014),and significantly higher in stageⅠ-Ⅱcases when compared to the stageⅢ-Ⅳcases (t= 2.31,P=0.025).On the other hand,the GSTP1 enzyme activities of cytoplasm in tumor cells with methylated status of GSTP1 gene were significantly lower than that in tumor cells with unmethylation (t=3.50,P=0.001).Conclusion GSTP1 inactivation via CpG island hypermethylation may contrib- ute to the pathogenesis of HCC.

AIM: To study the expression of endostatin in ischemic myocardium of myocardial infarction(MI) rats in various periods and the correlation with VEGF expression and microvascular density(MVD).METHODS: Thirty-two male Sprague-Dawley rats after myocardial infarction were randomly divided into 7,14,21 and 28 days group.The sham group was normal control group(eight rats in each group).The expression of endostatin,VEGF and MVD in ischemic myocardium were observed by immunohistochemistry.RESULTS: The expression of endostatin significantly increased in the ischemic myocardium after MI,peaked at 7 days,then gradually decreased at 14,21 and 28 days.The endostatin level at 28 days was the same as the shams.The changing trends of expression of endostatin in ischemic myocardium after MI were similar to that of VEGF and were significantly correlated with the MVD.CONCLUSION: The expression of endostatin increased in ischemic myocardium of myocardial infarction rats.The changing trends of endostatin were similar to that of VEGF and positively correlated with the MVD.These data suggest that endostatin may modulate ischemic myocardium angiogenesis after myocardial infarction.