Objective To investigate the effects of different afferent nerve injury on development of neuropathic pain and its relationship with brain-derived neurotrophic factor (BDNF) in spinal cord and dorsal root ganglion (DRG) in rats. Methods Twenty-four male SD rats aged 2 months weighing 200-250 g were randomly divided into 3 groups:group Ⅰ sham operation (group S); group Ⅱ sural nerve injury (group SUR) and group Ⅲ gastrocnemius-soleus nerve injury (group GS). Sural nerve and gastrocnemius-soleus nerve were transected in group SUR and GS respectively. Paw withdrawal threshold to von Frey filament stimulation was measured the day before and at day 3 and 7 after operation. The animals were killed at postoperative day 7 after the measurement of paw withdrawal threshold. The ipsllateral L5 DRG and L5 segment of the spinal cord were removed. BDNF expression in the spinal dorsal horn was determined. The percentage of BDNF positive neurons and ATF-3 positive neurons in the total DRG neurons and the percentage of BDNF positive neurons in the damaged neurons (ATF-3 positive) were calculated. Results Mechanical hyperalgesia developed after transection of gastrocnemius-soleus muscle in group GS. Mechanical pain threshold was sinificantly lower, while BDNF expression in the spinal dorsal horn and the percentage of BDNF positive neurons in total DRG neurons were significantly higher in group GS than in group S and SUR (P ＜ 0.01). There was no significant difference in all variables between group SUR and S (P＞0.05). There was no significant difference in the percentage of ATF-3 positive neurons in the total DRG neurons between group GS and SUR (P ＞ 0.05), but the percentage of BDNF positive neurons in the damaged neurons (ATF-3 positive) was significantly higher in group GS than in group SUR (P ＜ 0.05). Conclusion Transection of the afferent nerve innervating muscle can produce neuropathic pain through up-regulation of BDNF expression in spinal dorsal horn and DRG in rats, while transection of the afferent nerve innervating skin can not.

The leading cause of drug withdrawal from market and clinical trials failure is drug-induced liver injury (DILI). Varying clinical, histological and laboratory features of DILI, as well as undefined underlying mechanisms, hinder patients to be diagnosed in the early-stage of the disease and receive effective treatments. Conventional indicators, like serum transaminases and bilirubin, have inevitable limitations referring to sensitive prediction and specific detection of DILI. In order to reduce the occurrence of DILI, researchers have attempted to discover potential biomarkers with higher specificity and sensitivity from blood and urine in recent years. This article aims to review recent advances in biomarkers of DILI.
Biomarkers ; blood ; urine ; Chemical and Drug Induced Liver Injury ; diagnosis ; Humans ; Sensitivity and Specificity

Objective To investigate the effects of remote ischemic postconditioning (RIPoC) on global cerebral ischemia-reperfusion (I/R) injury in rats.Methods One hundred and twenty-eight male adult SD rats weighing 200-250 g were randomly divided into 4 groups ( n =32 each):sham operation group (group S),group I/R,group I/R + RIPoC and remote I/R group (group RI/R ).Global cerebral I/R was induced by four-vessel occlusion.Group I/R + RIPoC received 3 cycles of 15 min reperfusion followed by 15 min ischemia in bilateral femoral arteries at the beginning of cerebral reperfusion.The rats were sacrificed at 24 and 48 h of cerebral reperfusion,and brains were removed for determination of neuronal apoptosis (by TUNEL method) in hippocampal CA1 region and the parietal cortex,Bcl-2 and Bax expression (by Western blot) in hippocampal CA1 region.The superoxide dismutase (SOD) and catalase (CAT) activity and malondialdehyde (MDA) content in hippocampal CA1 region and the parietal cortex were also measured at 48 h of cerebral reperfusion.Morris water maze task was used to test the learning and memory function at 4 d of cerebral reperfusion,and the rats were sacrificed at 7 d of cerebral reperfusion,and brains were removed for determination of neuronal density in hippocampal CAl region and the parietal cortex.Results Cerebral I/R significantly increased the number of apoptotic neurons and MDA content,upregulated Bcl-2 and Bax expression,decreased neuronal density,SOD and CAT activity and learning and memory function in group I/R as compared with group S.RIPoC significantly attenuated these cerebral I/R-induced changes.Conclusion RIPoC could protect brain against global cerebral I/R-induced injury,and the mechanism may be related to inhibiting lipid peroxidation,regulating the balance between Bcl-2 and Bax and inhibiting apoptosis.

Objective Toanalyzetheclinicalcharacteristicsandtreatmentoutcomesofspinalfilum terminalevascularmalformation.Methods Theclinicaldataof6patientswithfilumterminalevascular malformation diagnosed and treated from January 2008 to December. 2013 were analyzed retrospectively. The definition of filum terminale vascular malformation is anterior/posterior spinal artery feeding arteriovenous fistula or arteriovenous malformation and located below conus medullaris,and does not complicate with spinal vascular lesions in the other part. The Aminoff & Logue score and MRI of spinal cord function were performedatoneyearaftermicroneurosurgeryand/orendovascularembolization.Results Allpatients were males. Their clinical presentations were the weakness of both lower extremities and sphincter disturbance. The mean course of disease was 17. 1 ± 5. 2 months. The pathological type of the 6 patients were all arteriovenous fistulas. The feeding arteries included lumbar artery,internal iliac artery,and median sacral artery. Two of the 6 patients underwent Onyx glue embolization,3 were treated with microneurosurgery,and 1 was treated with embolization in combination with microneurosurgery. They were all achieved anatomic cure. The Aminoff & Logue scores were improved after 1 year (3. 8 ± 1. 9 scores before procedure,2. 8 ± 2. 0 scores after procedure),there was no significant difference (P >0. 05). The myodynamia scores were improved in 3 patients,2 did not change,1 got worse. The urinary and bowel functions were improved in 2 patients,and4didnotchange.Conclusion Filumterminalevascularmalformationisararevascular malformation of spinal cord. Both embolization and surgical treatment can achieve anatomic cure. Although the spinal cord function can be only partially restored,but continuous deterioration can be prevented.

OBJECTIVETo evaluate the safety and effectiveness of GreenLight 120-W laser photoselective vaporization of the prostate (PVP) versus transurethral resection of the prostate (TURP) for benign prostatic hyperplasia (BPH).

METHODSWe searched PubMed, Medline, Embase, Cochrane Library, Wanfang, CNKI, and VIP for randomized control trials and their references addressing 120-W PVP versus TURP in the treatment of BPH. Based on the inclusion and exclusion criteria, two reviewers independently accomplished the screening, quality assessment, and data extraction of the identified studies and performed meta-analyses using RevMan 5.2.

RESULTSTotally, 6 randomized control trials were included in this analysis, involving 703 cases, 351 treated by PVP and 352 by TURP. Compared with TURP, PVP showed significantly decreased time of catheterization (by 32. 55 hours, 95% CI 15.3 -49.8, P < 0.01), hospital stay (by 1.85 days, 95% CI 1.2-2.5, P < 0.01), and intraoperative blood loss (by 15.6 g/L, 95% CI 10.0-21.2, P < 0.01), but increased time of operation (by 9.37 minutes, 95% CI 5. 1-13.6, P < 0.01). There was also a significant reduction in blood transfusion, TUR syndrome, and capsular perforation in the PVP group. At 12 months after surgery, no statistically significant differences were found between the two groups in the improvement of maximum urinary flow rate, IPSS, postvoid residual, and sexual function.

CONCLUSIONGreenLight 120-W laser PVP is a safe and effective procedure for the treatment of BPH, with similar effectiveness to TURP but less blood loss, shorter time of catheterization and hospital stay, and lower incidences of blood transfusion, TUR syndrome and capsular perforation.

Blood Loss, Surgical ; Humans ; Laser Therapy ; adverse effects ; methods ; Length of Stay ; Male ; Prostate ; surgery ; Prostatic Hyperplasia ; surgery ; Randomized Controlled Trials as Topic ; Treatment Outcome

OBJECTIVETo explore the effective and safety of carotid endarterectomy (CEA) in the treatment of severe stenosis of internal carotid artery.

METHODSThe clinical data of 95 patients with internal carotid artery stenosis and treated by CEA in our hospital from October 1998 to October 2006 were retrospectively analyzed. Transient ischemic attack (TIA) was found in 65 patients and cerebral infarction in 21 patients before operations. Diagnoses were confirmed by selective angiography, and > 70% stenosis of internal carotid artery was found in all patients and > 95% stenosis was found in 50 patients. Stenosis or occlusion of the contralateral carotid artery was also found in 35 patients. Coronary artery stenosis was confirmed in 43 patients with preoperative coronary angiography. CEA and coronary artery bypass grafting (CABG) were simultaneously performed in 18 patients.

RESULTSAfter the operation, the clinical symptoms significantly improved in all patients. One case experienced hypoglossal nerve injury. One patient died of heart attack during follow-up.

CONCLUSIONCEA is an effective and safe treatment for severe stenosis of internal carotid artery.

Aged ; Aged, 80 and over ; Carotid Artery, Internal ; surgery ; Carotid Stenosis ; surgery ; Endarterectomy, Carotid ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Retrospective Studies

PURPOSE: The aim of this study is to evaluate the incidence of de novo malignancy after liver transplantation (LT) and compare with those among the general Chinese population. METHODS: A total of 466 patients who had a minimum follow-up time of 6 months were enrolled in the study. All data of medical records and follow up were retrospectively reviewed. RESULTS: The incidence rate of de novo malignancy was 3.0% (14 in 466 patients). The median elapsed time from transplant to the diagnosis of de novo malignancy was 42 months (range, 6 to 106 months). The cumulative risk for development of de novo malignancy was 1.6%, 2.7%, and 8.2% at 3, 5 and 10 years after LT, respectively. The patients were all male. The types of de novo tumors included digestive system tumor (8 in 14), lung cancer (2 in 14), urologic neoplasm (2 in 14), and hematologic malignant tumor (2 in 14). Over a mean follow-up of 24 months after diagnosis of de novo malignancy, 7 patients (50.0%) died; the overall 5-year patient survival rate was 54.5%. The relative risk of malignancy following LT was 9.5 folds higher than the general Chinese population. CONCLUSION: The relative risk of malignancy following LT was much higher than the general Chinese population. Digestive system tumor is the most common type of de novo malignancy after LT in China.
Asian Continental Ancestry Group ; China ; Diagnosis ; Digestive System ; Follow-Up Studies ; Humans ; Incidence ; Liver Transplantation* ; Lung Neoplasms ; Male ; Medical Records ; Retrospective Studies ; Survival Rate ; Transplantation ; Urologic Neoplasms

OBJECTIVETo offer both the accurate three-dimensional anatomical information and algorithmic morphology of perforators in the lower leg for perforator flaps design.

METHODSThe cadaver was injected with a modified lead oxide-gelatin mixture. Radiography was first performed and the images were analyzed using the software Photoshop and Scion Image. Then spiral CT scan was also performed and 3-dimensional images were reconstructed with MIMICS 10.01 software.

RESULTSThere are (27 +/- 4) perforators whose outer diameter > or = 0.5 mm ( average, 0.8 +/- 0.2 mm). The average pedicle length within the superficial fascia is (37.3 +/- 18.6) mm. The average supplied area of each perforator is (49.5 +/- 25.5) cm2. The three-dimensional model displayed accurate morphology structure and three-dimensional distribution of the perforator-to- perforator and perforator-to-source artery.

CONCLUSIONSThe 3D reconstruction model can clearly show the geometric, local details and three-dimensional distribution. It is a considerable method for the study of morphological characteristics of the individual perforators in human calf and preoperative planning of the perforator flap.

Arteries ; Cadaver ; Humans ; Image Processing, Computer-Assisted ; methods ; Imaging, Three-Dimensional ; Leg ; blood supply ; Perforator Flap ; blood supply ; Surgical Flaps

OBJECTIVETo explore the mid-term surgical results of arterial revascularization for femoro-popliteal arterial occlusive disease (lesion type C and D).

METHODSFrom January 2005 to February 2009, 191 arterial bypass had been performed on 170 patients (21 cases bilateral). There were 108 male and 62 female, age ranged from 45 to 85 years old with an average of 67 years old. The operative indication was claudication in 78 cases, rest pain in 62 cases, ischemic ulcer in 19 cases, and distal tissue necrosis in 11 cases. Arterial angiography were performed on all cases. According to TASC II document, type C lesions were seen in 127 limbs, type D lesions were seen in 64 limbs. Autogenous greater saphenous vein bypass in situ were done on 15 limbs, autogenous greater saphenous vein bypass reversed in 20 limbs, revascularization with artificial prosthesis in 128 limbs, composite grafts consisting of a prosthetic conduit with a distal venous segment in 28 limbs.

RESULTSThere were no 30-day mortality. Follow-up periods ranged 6 to 36 months with an average of (24 + or - 6) months. Seventy-three cases were lost during follow-up periods, follow-up rate was 57% (109/191). Primary patency rate was 84.4% (92/109). The patency rate was 88.2% with artificial prosthesis, 70.8% with greater saphenous vein (in situ or reversed). Secondary patency rate was 89.9%.

CONCLUSIONSArterial revascularization with artificial prosthesis is main treatment for diffused superficial femoral artery occlusive disease (TASC II type C and D lesion) with satisfied surgical results.

Aged ; Aged, 80 and over ; Arteriosclerosis Obliterans ; surgery ; Blood Vessel Prosthesis Implantation ; Female ; Femoral Artery ; surgery ; Humans ; Male ; Middle Aged ; Popliteal Artery ; surgery ; Retrospective Studies ; Saphenous Vein ; transplantation ; Treatment Outcome

OBJECTIVEWe aim to investigate the sonodynamic effect induced by hydroxyl acetylated curcumin (HAC) on THP-1 macrophages.

METHODSTHP-1 derived macrophages (1 x 10(5) per milliliter) were cultured with HAC at a concentration of 5 µg/mL for 4 h and then exposed to pulse ultrasound treatment (0.5 W/cm2) for 5 min. Six hours later, cell viability analysis was performed with CCK-8 assay, apoptosis and necrosis analysis were detected with Annexin V/PI staining by flow cytometery.

RESULTSThe cell viability of THP-1 macrophage decreased significantly in the group treated with the combination of HAC and ultrasound (P < 0.01), and HAC-SDT induced both apoptosis and necrosis in THP-1 macrophages, the apoptotic rate was higher than the necrotic rate with appropriate conditions, the maximum apoptosis/necrosis ratio was detected in sonodynamic therapy (SDT) group (P < 0.01).

CONCLUSIONhAC-SDT was effective to induce THP-1 macrophages apoptosis.

Apoptosis ; Cell Line ; Cell Survival ; Curcumin ; pharmacology ; Humans ; Macrophages ; cytology ; drug effects ; Necrosis ; Ultrasonics