ObjectiveTo investigate the role of proinflammatory cytokines tumor necrosis factor alpha （TNFα） and interleukin-1β （IL-1β） in rostral ventromedial medulla （RVM） in chronic postsurgical pain （CPSP） induced by skin/muscle incision and retraction （SMIR）. MethodsSD rats were randomly divided into 5 groups： ① Sham group； ② SMIR group； ③ SMIR+TNFα/IL-1β neutralizing antibody group； ④ SMIR+TNFα/IL-1β group and ⑤ SMIR+vehicle group. 50% paw mechanical withdrawal threshold （MWT） was measured by the up-down method， immunofluroscence was used to detect the TNFα and IL-1β expression and ELISA for the 5-Hydroxytryptamine （5-HT） level. ResultsSMIR elicited persistent nociceptive sensitization， upregulated TNFα and IL-1β expression in RVM neurons and astrocytes. Microinjection of TNFα or IL-1β neutralizing antibody into RVM inhibited the development of nociceptive sensitization and decreased the level of 5-HT in both RVM and spinal dorsal horn. While microinjection of recombinant TNFα or IL-1β into RVM enhanced the development of nociceptive sensitization and increased the level of 5-HT in both RVM and spinal dorsal horn. ConclusionUp-regulation of proinflammatory cytokines in RVM may contribute to SMIR induced CPSP by promoting 5-HT release.

Objective To explore clinical effect of Jiawei Sangju decoction combined with oseltamivir in the treatment of influenza B complicated with benign acute childhood myositis(BACM).Methods Sixty children with influenza B complicated with BACM hospitalized in the Department of Pediatrics,Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine from January 2021 to January 2024 were selected and divided into control group and study group according to random number table method,with 30 cases in each group.The control group was treated with oseltamivir,and the study group was treated with Jiawei Sangju decoction combined with oseltamivir.The clinical efficacy,symptom improvement time and aspartate transaminase(AST),alanine transaminase(ALT),creatine kinase(CK),creatine kinase isozyme(CK-MB),lactate dehydrogenase(LDH)and myoglobin(Mb)before and after treatment were compared between two groups.Results After treatment,the total effective rate of study group was significantly higher than that of control group(χ2=5.455,P=0.020).The duration of fever and leg pain relief in study group were significantly shorter than those in control group(P<0.05).After 5 days of treatment,the levels of AST,CK,CK-MB,LDH and Mb in two groups were significantly lower than before treatment(P<0.05),and the levels of AST,CK,CK-MB,LDH and Mb in study group were significantly lower than those in control group(P<0.05).Conclusion Jiawei Sangju decoction combined with oseltamivir can improve the symptoms of influenza B with BACM,reduce the levels of muscle enzyme and Mb,and have a positive effect on the prognosis of children.

Objective To explore the relationship of the systemic immune-inflammation index (SII) with heart failure incidence in elderly people with hypertension and its nursing implications. Methods According to the data of the National Health and Nutrition Examination Survey (NHANES) database from 1999 to 2010, a total of 5 607 hypertension patients aged 60 and above were screened out and divided into heart failure group with 437 cases and non-heart failure group with 5 170 cases. All the participants were divided into Q₁ to Q₄ groups based on their SII levels by using the quartile method, with Q₁ as the reference group. After gradually adjusting for potential confounding factors, the differences in prevalence rate of heart failure among four groups were explored by Logistic regression analysis, and subgroup analyses were conducted as well. Results There were significant differences in race, age, education level, income level, smoking history, drinking history, body mass index (BMI), C-reactive protein, estimated glomerular filtration rate (eGFR), hemoglobin, diabetes history and coronary heart disease history between the two groups (P < 0.05). Compared with the non-heart failure group, the heart failure group had significant lower lymphocyte and platelet counts, while the neutrophil count and SII were significantly higher (P < 0.05). The result of multiple Logistic regression analysis showed a positive correlation between the increase of SII and the prevalence rate of heart failure (P < 0.05). After adjusting for related confounding factors, the values of odds ratio (OR) and 95% confidence interval (95%CI) for prevalence rate of heart failure in patients with SII from the second to the fourth quartiles were 0.80 (0.57 to 1.11), 1.14 (0.84 to 1.56) and 1.38 (1.02 to 1.87) respectively (P_trend=0.006). Subgroup analyses were carried out according to gender, diabetes, coronary heart disease, hyperlipidemia and eGFR, and the results showed that among women without coronary heart disease, with eGFR≤90 mL/(min·1.73 m²) and with or without hyperlipidemia, participants with the highest quartile of SII (Q₄) had a significant higher risk of heart failure than those with Q₁ (P_trend < 0.05). Conclusion SII may be independently associated with the prevalence rate of heart failure in elderly people with hypertension, and has guiding significance for clinical and nursing work.

Objective:To investigate the status of viral reservoirs in prostate tissue of patients with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), and to investigate the effect of highly active anti-retroviral therapy (HAART) on HIV-1 DNA in prostate tissue of HIV/AIDS patients.Methods:Twelve patients with HIV infection and hyperplasia of prostate who required surgical treatment and admitted to Guangzhou Eighth People′s Hospital from July 2017 to October 2019 were included. Blood and prostate specimens of these patients were collected, and HIV-1 RNA in plasma, CD4 + T lymphocyte count in peripheral blood and HIV-1 DNA level in prostate tissue were tested respectively. The independent sample t test or Mann-Whitney U test was used for statistical analysis. Results:Among the 12 patients, the CD4 + T lymphocytes was (519.8±121.5)/μL and HIV-1 DNA in the prostate tissue was 2 602 (365, 10 700) copies/10 6cells in six patients who had not started HAART. The CD4 + T lymphocytes was (182.8±69.7)/μL and the HIV-1 DNA in the prostate tissue was 144 (36, 563) copies/10 6cells in the six patients who underwent HAART for over six months. There were statistically significant differences in CD4 + T lymphocytes and HIV-1 DNA in the prostate tissue between the two groups ( t=-5.889 and Z=-2.082, respectively, both P<0.05). Conclusion:Prostate tissue can be used as an HIV-1 virus repository with or without HAART, and the size of the prostate tissue virus repository can be reduced by HAART after immune reconstitution.

Objective Toanalysisandcomparison MRImanifestationsofthepigmentedvillonodularsynovitis(PVNS)andgiant celltumoroftendonsheath(GCTTS),andfurthertoimprovethediagnosticaccuracyofthem.Methods 10patientswithPVNSand 20patientswithGCTTSconfirmedbyoperationandpathologywereanalyzedretrospectively.Allpatientswereexaminedwith MRI. Results Among10casesofPVNS,8caseswerelocatedinkneejoint,2infoot.5casesshoweddiffuseform,othersshowedfocal form.Comparedwiththesignalofskeletalmuscle,theproliferativesynovialappearedasisointensityonT1WI,mainlyisointensityor slighthyperintensityonT2WI.NodularhypointensityofT1andT2signalwereseenwithinthesynovialmembrane.Among20casesof GCTTS,18werelocalizedlesions,2werediffuselesions.Therewere3casesinkneejoint,8casesinhandsandfeetrespectively,1case inshoulderjoint.Among20casesofGCTTS,11caseswerenodularlesions,9caseswereirregularGshaped.Thelumpsappearedas isointensityorhypointensityonT1WI,andmostofthem wereslighthypointensityonT2WI.Conclusion The MRIsignalofPVNS andGCTTShaveoverlappinganddifference.Thelocation,morphologyoflesionscombinedwith MRIfindingscanimprovethediagnostic accuracyofthem.

Objective To investigate the incidence of extra intestinal organ damage in infants with acute rotavirus (RV) infection,the relative risk factors in patients with extra intestinal organ damage,the significance of procalcitonin(PCT)in those infants with multiple organ injury.Methods One hundred and three infants with acute diarrhea whose rotavirus antigens were positive and 65 negative ones were divided into two groups.The differences between these two groups in incidences of extra intestinal organ damage were analyzed.Meanwhile,variables from the clinical data that may lead to extra intestinal organ damage were analyzed.Then,the relationship of multiple organ damage and serum concentration of PCT was also analyzed.Results There were significant differences between positive group and negative group in the rates of respiratory system injury,myocardial damage and hepatic involvement (P ＜ 0.05).High fever was the only high risk factor in myocardial damage through multi factor Logistic regression analysis.There were also significant differences among the group with multiple organ damage and only one extra intestinal organ damage and no extra intestinal organ damage in serum concentration of PCT(P ＜ 0.05).Conclusion It is common to be attacked by extra intestinal organ damage in infants with acute rotavirus infection.High fever is the risk factor for RV enteritis complicated with myocardial damage.The elevation of PCT concentration suggest that multiple organ injury out of the intestinal tract may take place in infants with acute RV infection.

Background The pathogenesis and management of human autoimmunity uveoretinitis is a focus in ophthalmology.For decades,a traditional experimental autoimmunity uveoretinitis (EAU) induced by pertussis toxin (PTX) was used for the basic investigation,which was thought to have a large deviation from the natural course of human autoimmunity uveoretinitis.Objective This study was to establish a new mice model of autoimmunity uveoretinitis which mimics the human autoimmunity uveoretinitis pathogenesis and offer a basis for the investigation and treatment of uveoretinitis.Methods Twenty 6-8 weeks old specific pathogen-free female C57BL/6 (H-2b) mice were randomized into normal control group,only endotoxin (lipopolysaccharide,LPS) induced uveitis group (endotoxin induced uveitis [EIU] group),interphotoreceptor retinoid-binding protein (IRBP1-20) +complete Freund adjuvant (CFA) induced uveoretinitis group (EAU group) and IRBP+CFA+LPS induced uveoretinitis group (LPS-EAU group).The mice of the EAU were only immunized with IRBP emulsified in CFA,and LPS-EAU group firstly were immunized with IRBP emulsified in CFA and then LPS was injected in the footpad of the mice on 7 days following immunization.The ocular pathological examination,histopathological scoring,delayed-type hypersensitivity and specific lymphocyte proliferating response were evaluated and compared with the EIU models,traditional EAU models without PTX and LPS-EAU models.The use and care of experimental animals complied with Regulation for the Administration of Affair Concerning Experimental Animals by State Science and Technology Commission.Results No inflammatory response was found in the iris,cilliary body and retina of mice in the normal control group.However,mild blood vessels dilation and fibrin exudation were seen in the iris and cilliary body of mice in the EIU group.In the EAU group,mild vasculitis and swelling of nerve fiber layer were exhibited in the retinas; while in the LPS-EAU group,severe disorder of retinal structure,infiltration of inflammatory cells and damage of photoreceptor were found under the optical microscope.The pathological score was 0 in the models of the normal control group and EIU group,0.5 score in the EAU group and 3.0 scores in the LPS-EAU group,with a significant difference in the pathological scores between the EAU group and the LPS-EAU group (U=16.246,P =0.001).The earthickness of the mice was (35.60±0.55) μm in the LPS-EAU group,and this value was significantly higher than (12.60±0.55) μm of the EIU group (q =23.003,P＜0.01),but closed to (34.80±0.84) μm of the EAU group (t =0.820,P＞0.05).The obvious cloning were seen and theradiation count per minute was (8 540.00 ±54.77)/min in the model mice of the LPS-EAU group,and that in the EAU group was (8 484.00±47.75)/min,without significant difference between them (q =56.634,P =0.069).Compared with the β particle number (2 050.00±50.00)/min in the EIU group,that of the LPS-EAU group was significantly elevated (q =195.683,P =0.000).Conclusions LPS injection can induce EAU in mice,and this model can better imitate the pathogenesis of human autoimmunity uveoretinitis.

Background Researches indicated that etiology and epidemiology of pertussis toxin (PTX)dependent experimental autoimmune uveoretinitis(EAU)model are very different with human uveoretinitis owing to the influence of PTX on immune.Our previous study has established lipopolysaccharide (LPS),an endotoxin,which instesad of PTX,mediated EAU model.However,the exact roles of LPS and PTX in EAU still remained unclear.Objective This study was to investigate the roles of LPS and PTX in EAU model.Methods Twenty SPF C57BL/6(H-2b) mice were assigned to 0 d-PTX-EAU group,7 d-PTX-EAU group,0 d-LPS-EAU group and 7 d-LPS-EAU group using random number table method.The mice were immunized with interphotoreceptor retinoid-binding protein 1-20(IRBP 1-20) emulsified in complete Freund adjuvant (CFA),and concurrently with or on day 7 postimmunization,LPS or PTX was injected in the footpad or intraperitoneally respectively.Delayed-type hypersensitivity (DTH) of the mice was evaluated by measuring the ear thickness 48 hours after IRBP was injected into the ear pinna,and lymphocyte proliferation was assessed by tritiated thymidine uptake.Retinal histopathological examination was performed and scored based on criteria of Caspi.The use and care of experimental animals complied with Regulation for the Administration of Affair Concerning Experimental Animals by State Science and Technology Commission.Results Serious infiltration of inflammatory cells,disorder of entire retinal structure and retinal folds were seen in the mice of the 0 d-PTX-EAU group and 7 d-LPS-EAU group on 21 days after injection of PTX or 14 days after injection of LPS,and severe vitritis and a few granuloma-like lesions were found in the 0 d-PTX-EAU group.However,only mild vasodilatation or less retinal folds were found in the 7 d-PTX-EAU group and 0 d-LPS-EAU group.The pathological scores in the mice of the 0 d-PTX-EAU group and 7 d-LPS-EAU group were higher than those of the 7 d-PTX-EAU group and 0 d-LPS-EAU group (all at P ＜ 0.05).The ear thickness was (62.600 ± 3.362) μm,(60.000±2.345) μm,(30.400± 1.817) μm and (32.800 ± 1.643) μm in the 0 d-PTX-EAU group,7 d-PTX-EAU group,0 d-LPS-EAU group and 7 d-LPS-EAU group,showing a significantly difference among the 4 groups (Fgroup =259.751,P=0.000),and the ear thicknesses of 0 d-PTX-EAU group and 7 d-PTX-EAU group were significantly higher than those of the 0 d-LPS-EAU group and 7 d-LPS-EAU group (all at P＜0.05).The lymphocyte proliferation was strongly enhanced in PTX-EAU groups,and the radiation count per minute (cpm) was (16 150.000±799.218)/min and (16 120.000±729.383)/min in the 0 d-PTX EAU group and 7 d-PTX EAU group,and (8 348.000±258.979)/min and (8 540.000±81.548)/min in the 0 d-LPS EAU group and 7 d-LPS EAU group respectively,with a significant difference among the PTX-EAU groups and LPS-EAU groups (Fgroup =316.978,P=0.000).Conclusions LPS and PTX play different roles during the EAU formation.LPS may be involved in the breakdown of blood-retina barriers (BRB).

Objective To explore the influence of nifedipine controlled release tablets com-bined with indapamide on renal function of elderly patients with refractory isolated systolic hyper-tension.Methods 96 elderly patients with isolated systolic hypertension were randomly divided in-to two groups according to the admission odd and even day,48 cases in each group.Control group was treated with nifedipine controlled release tablets,while the observation group was treated with nifedipine controlled release tablets combined with indapamide on the basis of control group.Result After treatment,blood pressure in both groups decreased,and decreasing range of blood pressure in observation group was significantly greater than the control group(P <0.05).There were signif-icant differences of serum creatinine,creatinine clearance rate and microalbuminuria detection result before and after treatment in observation group (P <0.05).Conclusion Nifedipine controlled re-lease tablets combined with indapamide can effectively reduce blood pressure and promote renal func-tion in elderly patients with refractory isolated systolic hypertension,so it is worthy of clinical popu-larization.

Objective To explore the influence of nifedipine controlled release tablets com-bined with indapamide on renal function of elderly patients with refractory isolated systolic hyper-tension.Methods 96 elderly patients with isolated systolic hypertension were randomly divided in-to two groups according to the admission odd and even day,48 cases in each group.Control group was treated with nifedipine controlled release tablets,while the observation group was treated with nifedipine controlled release tablets combined with indapamide on the basis of control group.Result After treatment,blood pressure in both groups decreased,and decreasing range of blood pressure in observation group was significantly greater than the control group(P <0.05).There were signif-icant differences of serum creatinine,creatinine clearance rate and microalbuminuria detection result before and after treatment in observation group (P <0.05).Conclusion Nifedipine controlled re-lease tablets combined with indapamide can effectively reduce blood pressure and promote renal func-tion in elderly patients with refractory isolated systolic hypertension,so it is worthy of clinical popu-larization.