Objective To analyze the effect of intrathecal injection of dexmedetomidine on the behavioral activity, pain degree and expression of protein kinase C in spinal dorsal horn of rat models of chronic neuropathic pain, and to investigate the analgesic mechanism of dexmedetomidine.Methods 75 healthy male rats were randomly divided into observation group, model group and control group, 25 rats in each group.Chronic sciatic nerve injury model was established in the observation group and model group.After modeling, intrathecal dexmedetomidine intervention was used in the observation group.The model group was treated with saline injection and there was no intervention in the control group.Before the modeling (BM)and at 3(D3), 5(D5), 7(D7), and 14 (D14)days after medicine administration, the behavioral capacity was evaluated by cumulative evaluation method and movement function evaluation, and the assessment of pain degree (mechanical withdrawal method and thermal withdrawal latency pain threshold detection method), PKC staining score (immunohistochemical SABC method), PKC mRNA assay (RT-PCR method) and PKC protein expression (Western blot) were conducted and the data were statistically analyzed.Results ① Before modeling, the behavior, the cumulative scores of motor function, MWT, and TWL showed no significant differences between the different groups (P>0.05).After modeling, the model group and observation group showed that the cumulative scores and motor function scores were increased significantly, MWT and TWL decreased significantly, and the changes in the observation group were significantly lower than those in the model group (P<0.05).After modeling, the cumulative scores, motor function scores, MWT, and TWL were significantly different between the groups (P<0.05).② The expression of PKC was negative in the control group and positive in the model group.In the observation group, after the initial establishment of model, the PKC was strongly positive, and along with the prolonged treatment, the PKC expression intensity was decreased, and only weakly positively expressed at 14 d.③ After modeling, the observation group and model group showed that the PKC mRNA and PKC protein expression levels were significantly higher than that of the control group (P<0.05).With the continuous drug administration, the PKC mRNA and PKC in the observation group were decreasing, and reached a level close to that of the control group at 14 d of drug administration.From the third day after modeling, at the same time points, the amount of PKC expression in the observation group was significantly lower than that in the model group (P<0.05).Conclusions Intrathecal injection of dexmedetomidine can improve the behavior of rat models with chronic neuropathic pain, and reduce the degree of pain.It may be related to the inhibition of protein kinase C expression in the spinal dorsal horn.

Objective To investigate the significance and surgical skill for lymphadenectomy around common hepatic artery in gastric cancer.Methods Two hundred and fifty-seven cases with undergoing lymphadenectomy around common hepatic artery in gastric cancer between January 2001 and December 2006 were retrospectively reviewed.Experiences and understanding of dealing with this procedure in curative gastrectomy for gastric cancer were concluded.Results The number of dissected No.8 lymph node was 2.2?1.7,and the positive rate of No.8 lymph node was 30.35%.There were no lymphadenectomy related complications,such as anastomotic leakage,lymphatic fistula and postoperative hemorrhage in this series.Dissection around common hepatic artery lymph nodes along artery intrathecal space,division and ligation of left gastric vein at its root,and sufficient exposure of anatomic structures were important to dissection lymph nodes around the common hepatic artery.The exposure of anatomic structures included liberation of common hepatic artery by traction with the band,and the exposure of posterior side of pancreas by Kocher incision.Conclusion Being familiar with the anatomy around common hepatic artery,careful dissection,and attention to the surgical skill of lymphadenectomy are very important to improve the effectiveness of lymphadenectomy around common hepatic artery in gastric cancer.

Objective To compare dual-energy X-ray absorptiometry T-score concordance between hip and lumbar spine, and to estimate the value of T-score of the hip for diagnosing osteoporosis in the elderly. Methods From September 2000 to May 2002, 123 males aged 60-89 years (average 72.0?7.4) and 137 females aged 60-88 years (average 67.3?6.1) were selected in the study based on the exclusion of subjects with apparent abnormalities affecting bone mass or taking medications which might affect bone metabolism. Detailed questionnaire included lifestyle factors such as smoking, drinking, exercise and dietary habits, etc. Radiographs of the thoracic and lumbar spine were taken. Patients' BMD were measured by DEXA (DMS, Challenger) at lumbar spine (L 2-4) and left hip in posterior-anterior projection. The right hip was scanned if patients had a history of fractures or any bone disease in the left hip. All data were statistically analysed using SPSS 8.0 system. Results The average T-scores of bone mineral density of the lumbar spine were higher than that of the hip in all male patients and in 65-, 85- age groups of female patients(P

Objective To assess the characteristics of abdominal hernia and summarize the therapeutic efficacy of mesh plug tension-free hernioplasty in elderly ventral hernia. Methods All 207 elderly patients with abdominal hernia who were admitted to our hospital during January 1999 to December 2001 and received the mesh plug tension-free hernioplasty were analyzed retrospectively. Results There were 405 patients receiving the mesh plug tension-free hernioplasty from 1999 to 2001, in whom 207 had elderly ventral hermia. Among the 207 elderly patients, 144 had inguinal oblique hernia, 38 direct hernia, 11 direct and indirect hernia, 6 sliding hernia, 6 incisional hernia, 1 femoral hernia, and 1 femoral and inguinal direct hernia. Postoperative complications were urinary retention(8 cases), hypoincisional hematoma(4), scrotal hydroceles(1), and incisional infection (1). One hundred eithty-seven patients were followed-up for 4-40 months and no recurrence was found. Conclusions The mesh plug tension-free hernioplasty is of advantages for elderly abdominal hernia, such as simpleness in performance and a good therapeutic effect. It is especially suitable for the elderly patients due to less trauma and low recurrence rate. It is also important to pay attention to the postoperative complications to the elderly.

Objective To investigate the value of procalcitonin (PCT) on predicting the severity and prognosis in patients with early acute respiratory distress syndrome (ARDS).Methods A prospective observation study was conducted. A total of 113 patients with ARDS undergoing mechanical ventilation admitted to intensive care unit (ICU) of Affiliated People's Hospital ofJiangsu University from October 2012 to April 2016 were enrolled. Based on oxygenation index (PaO2/FiO2), the patients were classified into mild, moderate, and severe groups according to Berlin Definition. Twenty-five healthy volunteers were served as controls. Demographics, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score, and Murray lung injury score were recorded. Within 24 hours after diagnosis of ARDS, the serum levels of PCT and C-reactive protein (CRP) were determined by enzyme-linked fluorescence analysis (ELFA) and immune turbidimetric method, respectively. The patients were also divided into survival and non-survival groups according to clinical outcome within 28-day follow-up, and the clinical data were compared between the two groups. Spearman rank correlationwas applied to determine the correlation between variables. The predictive value of the parameters on 28-day mortality was evaluated with receiver operating characteristic curve (ROC). Kaplan-Meier survival curve analysis was used to compare different PCT levels of patients with 28-day cumulative survival rate. Results After excluding patients who did not meet the inclusion criteria and loss to follow-up, the final 89 patients were enrolled in the analysis. Among 89 ARDS patients analyzed, 27 of them were mild, 34 moderate, and 28 severe ARDS. No significant differences were found in age and gender between ARDS and healthy control groups. Infection and trauma were the most common etiology of ARDS (55.1% and 34.8%, respectively). Compared with healthy control group, both CRP and PCT in serum of ARDS group were higher [CRP (mg/L): 146.32 (111.31, 168.49) vs. 6.08 (4.47, 7.89), PCT (μg/L): 3.46 (1.98, 5.56) vs. 0.02 (0.01, 0.04), bothP < 0.01], and the two showed sustained upward trends with the ARDS course of disease. Compared with mild group, severe group had significantly higher APACHE Ⅱ and Murray scores. Spearman rank correlation analysis showed that both serum PCT and CRP in patients with ARDS was correlated well with APACHE Ⅱ score (r values were 0.669 and 0.601, respectively, bothP < 0.001), while PCT was weakly but positively correlated with Murray score (r = 0.294,P = 0.005), but not the case of CRP (r = 0.203,P = 0.052). APACHE Ⅱ score and serum PCT in non-survival group (n = 38) were significantly higher than those of the survival group [n = 51; APACHE Ⅱ score: 26.00 (23.00, 28.50) vs. 21.00 (17.00, 25.00), PCT (μg/L): 6.38 (2.82, 9.49) vs. 3.09 (1.08, 3.57), both P < 0.01], but Murray score and CRP level were similar between survivors and non-survivors. The areas under ROC curve (AUC) of APACHE Ⅱ score and PCT for predicting 28-day mortality were 0.781 and 0.793, respectively, which were better than those of AUC of Murray score and CRP (0.606 and 0.561, respectively, allP < 0.05). The AUC of APACHE Ⅱ score combined with PCT was significantly higher than that of PCT (0.859 vs. 0.793,P = 0.048) or APACHE Ⅱ score alone (0.859 vs. 0.781,P = 0.038). Using a PCT cut-off value of > 4.35μg/L for predicting 28-day mortality, the sensitivity and specificity was 92.2% and 63.2%, respectively, and the positive and negative likelihood ratios were 2.50 and 0.12 respectively. Kaplan-Meier survival curve analysis indicated that the patients whose PCT more than 4.35μg/L, had lower 28-day cummulative survival rate as compared with those with PCT ≤ 4.35μg/L (log-rank test: χ2 = 5.013,P = 0.025).Conclusion The elevated serum PCT level in patients with ARDS seems to be correlated well with the severity of lung injury, and appears to be a useful prognostic marker of outcome in the early phases of ARDS.

Ascending and descending efferent projections of superior coUiculus were indentified by means of the anterograde horseradish peroxidase technique in the cat.Following injections of HRP into the rostral superior colliculus, a large number of labeled terminals were found mainly in several of the ipsilateral thalamic nuclei:ventromedial division of the ventral nucleus of the lateral geniculate body, zona incerta,lateral posterior nucleus, parafasciculus nucleus and centromedian nucleus. The mediodorsal nucleus and thalamic reticular nucleus were also found mildly labeled.Labeling were most heavily concentrated in the ipsilateral dorsolateral division of pontine nucleus and caudal region of parabigeminal nucleus. The dorsal part of medial accessory olivary was the only nucleus labeled contralaterally. After injecting HRP into the caudal superior colliculus, only the dorsolateral division of pontine nucleus was densely labeled, while labeled terminals of caudal parabigeminal nucleus signifcantly reduced in amount. No labeled terminals were found in the thalamus as well as medial accessory olivary nucleus. These results indicate that the efferent connections of superior colliculus are topographically organized.

The afferent connections and topographical organization of the central lateral nucleus were studied with HRP retrograde tracing technique in 10 adult cats. The central lateral nucleus received projections from the forebrain, brainstem and cerebellum. The nuclei, projected to the caudal region of the central lateral nucleus, included the dorsal division of the ventral lateral geniculate nucleus, the thalamic reticular nucleus and the deep layers of superior colliculus, primarily on the ipsilateral side. The intralaminar thalamic nucleus, the lateral hypothalamus and the reticular part of substantia nigra sent axons to terminate in the rostral region of the central lateral nucleus, with an ipsilateral predominance. The nuclei, projected to the whole length of the central lateral nucleus, were the vestibular neuclei, the reticular formation of brainstem, zona incerta, pretectal area, cells surrounding the occulomotor complex, principal sensory trigeminal, cuneatus, gracilis as well as cerebellar dentate. The vestibular nuclei and the reticular formation of brainstem were found bilateral projection, the former predominantly in contralateral, the latter mainly in ipsilateral part. Except the zona incerta, pretectal area and cells surrounding the occulomotor, the rest were labeled primarily on the contralateral side. If HRP was injected into the central lateral nucleus and spread to the ventral anterior nucleus of thalamus, a lot of HRP-positive cells were found in the entopeduncular nucleus, while the ventral tegmental nucleus of Gudden was filled with densely labeled terminals mainly on the ipsilateral side. These findings indicate that the central lateral nucleus of thalamus may be involved multiple sensory and motor functions.

[Objective] To study the relationship between syndrome patterns of traditional Chinese medicine and bcl- 2 oncogene, p53 suppression gene mRNA expressions in precancerous lesions of gastric cancer (PIGC). [Methods] Forty PLGC cases were endoscopically and pathologically confinned, including 24 cases of moderate dysplasia of gastric mucosa, 9 cases of severe dysplasia, 7 cases of incomplete colonic intestinal metaplasia. Of the 40 cases, 10 were complicated with Qi stagnation, 12 with stomach-heat, and 18 with blood stasis, mRNA expression of bcl- 2 oncogene and p53 suppression gene were detected in situ by molecular hybridization method. [Results] The mRNA overexpression of bcl- 2 oncogene and p53 suppression gene were found in PLGC, and the expression was gradually increased with the progress of lesions. In the complicated cases, the mRNA expression of bcl- 2 oncogene and p53 suppression gene were the least in the cases with Qi stagnation and less in the cases with stomach- heat than in the cases with blood stasis. [Conclusion] Abnormal mRNA expression of bcl- 2 oncogene and p53 suppression gene were found in PLGC cases and related with different complicated cases, indicating the specificity of different syndrome patterns.

Object To study the glycosides from Swertia erythrosticta Maxim Methods The glycosides were isolated on silica gel column and purified by Sephadex LH20, their structures were identified by spectral data and chemical properties Results Seven compounds were obtained from aqueous extract and identified as swertianolin (Ⅰ), norswertianolin (Ⅱ), norswertiaglucoside (Ⅲ), isoorientin (Ⅳ), loganic acid (Ⅴ), gentiopicroside (Ⅵ) and ? gentiobiose (Ⅶ) Conclusion Compounds Ⅲ, Ⅳ, Ⅴ, and Ⅶ were first obtained from this plant

The topographical projection between the parabigeminal nucleus and the superiorcolliculus in the cat was investigated by retrograde and anterograde HRP tracingtechnique.Following HRP injection in the rostral superior colliculus,the labeledsomata were found predominantly in the rostral region of contralateral parabigeminalnucleus,but labeled terminals were heavily distributed in the ipsilateral parabigeminalnucleus,mainly in the caudal region.Following injection of HRP into caudal superiorcolliculus,the labeled somata and terminals were seen in ipsilateral parabigeminalnucleus,chiefly in caudal part,but their number was significantly decreased.It wasnoted that the labeled somata were sparse but labeled terminals were not found inthe parabigeminal nucleus,when the injection was restricted to superficial layers ofsuperior colliculus.After HRP injection into deeper layers of superior colliculus,there existed not only the labeled somata but also the labeled terminals in theparabigeminal nucleus,the former was distributed in bilateral parabigeminal nucleus,the latter in ipsilateral nucleus,chiefly in the caudal part.These results show thatthere are topographical connections between the parabigeminal nucleus and superiorcolliculus,and the parental somata contributing axons to the parabigeminal nucleusare located in deeper layers of the ipsilateral superior colliculus.