Objective To systemically evaluate the effect of intravesical Botulinum toxin on pain of patientspain syndrom. Methods The following databases as Cochrane Library, PubMed, Web of Science, Embase, Springer, Wiley, Science Direct, OVID were searched to col-lect the randomized controlled trials (RCTs) with the treatment of intravesical Botulinum toxin vs. 0.9%sodium chloride for patients with bladder pain syndrome. Two reviewers screened the trials according to the inclusion and exclusion criterias, extracted the data, assessed the quality, and the changes of Visual Analogue Scales (VAS) before and after treatment were used to conduct Meta analysis with RevMan5.2 software. Results Five studies were included with a total of 218 patients, there were 127 cases in intravesical Botulinum toxin group and 91 cases in 0.9%sodium chloride group. Meta analysis showed that the pain relief effect of intravesical Botulinum toxin was better than that of 0.9%sodium chloride. Conclusion Intravesical Botulinum toxin can relieve the pain of patients with bladder pain syndrome.

Objective To evaluate the protective effect of polysaccharide nucleic acid fraction of bacillus Calmette-Guerin (BCG-PSN) against atopic dermatitis (AD) in Nc/Nga mice,and to explore its possible mechanism.Methods Sixteen Nc/Nga mice were classified into normal control group (n =4),low-concentration BCG-PSN group (n=5) and high-concentration BCG-PSN group (n =7) to be subcutaneously injected with sodium chloride physiological solution,BCG-PSN of 0.1 mg/kg and 0.5 mg/kg respectively,at 1,8,15 and 22 days of age.Dinitrochlorobenzene (DNCB) was repeatedly and topically applied to these Nc/Nga mice to induce AD-like lesions at 49 days of age.The preventive effect of BCG-PSN against AD was evaluated by dermatitis scores,scratching frequency,histopathological manifestations and immunological parameters (including IgE,i nterleukin (IL)-4 and-12,and interferon (IFN)-γ).Results Repeated injection of BCG-PSN within 4 weeks after birth significantly decreased the severity of DNCB-induced AD-like lesions,dermatitis scores and scratching behavior in Nc/Nga mice.There was no statistical difference in scratching frequency between the high-and low-concentration BCG-PSN groups.BCG-PSN treatment reduced the plasma level of IgE in Nc/Nga mice in a dose-dependent manner.BCG-PSN at 0.5 mg/kg increased the number of cells secreting IFN-γ in skin lesions of mice.Both doses of BCG-PSN down-regulated IL-4 level,but up-regulated IL-12 level in the culture supernatant of spleen mononuclear cells from mice.Conclusion Early injection of BCG-PSN could protect Nc/Nga mice against dermatitis by promoting the proliferation of IFN-γ-secreting cells,increasing the synthesis of IL-12,and reducing the levels of IL-4 and IgE.

Objective To explore the application of Airtraq(R) optical laryngoscope combined with bronchofibroscope for endotracheal in-tubation (EI) in patients with cervical spine injury (CSI). Methods 50 patients with CSI undergoing spine surgery under combined general anesthesia were randomly assigned to two groups, group A (n=25) received EI by using Airtraq(R) optical laryngoscope and group AF (n=25) received EI by using Airtraq(R) optical laryngoscope combined with bronchofibroscope. The intubation time (IT), success rate of single intuba-tion (SRSI), hemodynamic changes in endotracheal intubation, and complications related to EI were observed. Results IT was significantly longer in group A than in group AF (P<0.001), and SRSI was significantly lower than in group A in group AF (P<0.05). There was no signif-icant difference in hemodynamic changes in EI and complications related to EI between two groups (P>0.05). Conclusion Airtraq(R) optical laryngoscope combined with bronchofibroscope would be safely and effectively used for EI in patients with CSI.

BACKGROUNDInjectable three-dimensional (3D) scaffolds have the advantages of fluidity and moldability to fill irregular-shaped defects, simple incorporation of bioactive factors, and limited surgical invasiveness. Adipose-derived stem cells (ADSCs) are multipotent and can be differentiated toward nucleus pulposus (NP)-like cells. A hypoxic environment may be important for differentiation to NP-like cells because the intervertebral disc is an avascular tissue. Hence, we investigated the induction effects of hypoxia and an injectable 3D chitosan-alginate (C/A) gel scaffold on ADSCs.

METHODSThe C/A gel scaffold consisted of medical-grade chitosan and alginate. Gel porosity was calculated by liquid displacement method. Pore microstructure was analyzed by light and scanning electron microscopy. ADSCs were isolated and cultured by conventional methods. Passage 2 BrdU-labeled ADSCs were co-cultured with the C/A gel. ADSCs were divided into three groups (control, normoxia-induced, and hypoxia-induced groups). In the control group, cells were cultured in 10% FBS/DMEM. Hypoxia-induced and normoxia-induced groups were induced by adding transforming growth factor-β1, dexamethasone, vitamin C, sodium pyruvate, proline, bone morphogenetic protein-7, and 1% ITS-plus to the culture medium and maintaining in 2% and 20% O2, respectively. Histological and morphological changes were observed by light and electron microscopy. ADSCs were characterized by flow cytometry. Cell viability was investigated by BrdU incorporation. Proteoglycan and type II collagen were measured by safranin O staining and the Sircol method, respectively. mRNA expression of hypoxia-inducing factor-1α (HIF-1α), aggrecan, and Type II collagen was determined by reverse transcription-polymerase chain reaction.

RESULTSC/A gels had porous exterior surfaces with 80.57% porosity and 50-200 üm pore size. Flow cytometric analysis of passage 2 rabbit ADSCs showed high CD90 expression, while CD45 expression was very low. The morphology of induced ADSCs resembled that of NP cells. BrdU immunofluorescence showed that most ADSCs survived and proliferated in the C/A gel scaffold. Scanning electron microscopy showed that ADSCs grew well in the C/A gel scaffold. ADSCs in the C/A gel scaffold were positive for safranin O staining. Hypoxia-induced and normoxia-induced groups produced more proteoglycan and Type II collagen than the control group (P < 0.05). Proteoglycan and Type II collagen levels in the hypoxia-induced group were higher than those in the normoxia-induced group (P < 0.05). Compared with the control group, higher mRNA expression of HIF-1α, aggrecan, and Type II collagen was detected in hypoxia-induced and normoxiainduced groups (P < 0.05). Expression of these genes in the hypoxia-induced group was significantly higher than that in the normoxia-induced group (P < 0.05).

CONCLUSIONADSCs grow well in C/A gel scaffolds and differentiate toward NP-like cells that produce the same extracellular matrix as that of NP cells under certain induction conditions, which is promoted in a hypoxic state.

Adipose Tissue ; cytology ; Alginates ; chemistry ; Animals ; Cell Differentiation ; physiology ; Cells, Cultured ; Chitosan ; chemistry ; Glucuronic Acid ; chemistry ; Hexuronic Acids ; chemistry ; Rabbits ; Stem Cells ; cytology ; physiology ; Tissue Engineering ; methods ; Tissue Scaffolds ; chemistry

Objective To explore the risk factors for postoperative agitation (PA) in patients with cerebral palsy (CP). Methods 199 patients with CP receiving selective posterior rhizotomy or lower limbs orthopedics under combined intravenous and inhalational anesthesia were reviewed. Results 30 patients suffered from PA (15%), who tended to be younger, less body mass, and administered less anesthetics.Conclusion It may prevent PA of sufficient intra-operative and postoperative analgesia, necessary psychological intervention and sedatives.

Objective To observe the effect of ropivacaine in infiltration anesthesia before the end of surgical procedures for postoperative analgesia on patients with spinal cord injury. Methods 60 patients with spinal cord injury undergoing internal fixation of spine fractures under combined general anesthesia were assigned in 3 groups, who received 0.25% ropivacaine in infiltration anesthesia (group RL, n=20),0.5% ropivacaine in infiltration anesthesia (group RM, n=20), or no infiltration anesthesia (group C, n=20) before the end of surgical procedures.The time for post-anesthesia recovery (PART), agitation score (AS), and Visual Analogue Score (VAS) for pain 2 h, 6 h, 24 h, and 48 h post operation were recorded, and related side effects were observed. Results AS within 6 h postoperation was significantly less in group RL and RM than in group C (P<0.05), as well as VAS, PART, mean of arterial pressure and heart rate 2 h, 6 h, and 24 h post operative (P<0.05).There was no significant difference in side effects including postoperative nausea and vomiting, and pruritus among these groups (P>0.05). Conclusion Ropivacaine in infiltration anesthesia would provide better postoperative analgesia, decrease the incidence of postoperative agitation, and increase the safety of patients with spinal cord injury in the postoperative period.

Objective To investigate the effect of TGF-β1/SMAD signaling pathway on K562 cells growth inhibition caused by HMBA. Methods After establishing the in vitro differentiation model with HMBA on K562 cells, the MTT assay was used to detect the proliferation of K562 cells, the cell cycle profile was detected by flow cytometry, and the mRNA expression of TGF-β1, SMAD3, SMAD4 and EVI1 was measured by RT-PCR assay. Results HMBA could inhibit the proliferation and promote the differentiation of K562 cells obviously, which was time and concentration-dependent, and the 72 h corresponding IC50, was about 2 mmol/L. Within 72 h, flow cytometry assay indicated that the ration of G0-G1 phase cells was up-regulated, and the results of RT-PCR showed that relative mRNA expression of TGF-β1, SMAD3 and SMAD4 at mRNA level was increased gradually while that of EVI1 was decreased gradually. Conclusion HMBA can inhibit K562 cells proliferation through TGF-β1/SMAD signaling pathway.

Objective To evaluate the positive effects of cisplatin on sensitivity of human glioma U251 to tumor necrosis factor-related apoptosis inducing ligand and to investigate the potential mechanism. Methods The expression of green fluorescent protein (GFP) in U251 which was transfected with pAdxsi-GFP-TRAIL was observed by inverted fluorescent microscope ×400) and to ascertain the MOI. The proliferation inhibition was studied by MTT method. Morphological change was detected through inverted florescent microscope and the Hoechst33342 staining assay was used to verify whether cell apoptosis could be induced or not. The cell apoptosis was also analyzed by flow cvtometry with propidium iodide staining. Semi-quantitative RT-PCR was introduced to detect the mRNA expression of apoptosis related gene.Results The expression of TRAIL mRN A was significantly upregulated after transfection. Compared with treatment group of cisplatin and TRAIL alone, the proliferation of U2S1 was significantly inhibited in the cisplatin sensitizing TRAIL group (P < 0.05 ). Nuclear shrinkage and pyknosis fragmentation were observed by Hoechst 33342 staining assay; Apoptotic peak was detected from the results of flow cvtometry and there were significant differences between the sensitizing group and the other two groups ( P < 0.05 ) ; Moreover, the relatively high expression of TRAIL, DR5, caspaseS and down - regulated survivin genes were also observed. There was no significant changes in DR4 expression. Conclusion Cisplatin could extremely enhance the sensitivity of U251 cells to TRAIL And the potential mechanism may related to the increase of TRAIL, DRS, caspaseS genes while the reduction of surivivin gene.

ObjectiveTo compare the effect of rehabilitation training after surgical intervention of knee stiffness (SIKS) between femoral nerve block (FNB) and epidural nerve block (ENB).Methods60 patients undergoing SIKS at one knee joint were randomly assigned to two groups: 40 patients accepting a catheter for FNB in group A and 20 patients accepting a catheter for ENB in group B. All patients participated in passive rehabilitation therapy (PRT) and active rehabilitation therapy (ART) at 12 hours, 24 hours, 36 hours, and 48 hours after operation. 10 ml of lidocaine were applied via these catheters before rehabilitation therapy. The visual analogue score (VAS) for pain in PRT, the time needed from the end of PRT to the start of ART, and the incidence of side effects such as hypotension or nausea were recorded.ResultsThere was no significant difference in VAS between groups A and B. The time needed from the end of PRT to the start of ART in group A was significantly less than that of group B. The incidence of hypotension or nausea in group A was significantly less than those of group B.ConclusionFNB provides the same analgesic effect as ENB, has less time needed from the end of PRT to the start of ART, and lowers incidence of hypotension or nausea.

Objective To explore molecular mechanism of expression of vascular endothelial growth factor (VEGF) mRNA and secretion of VEGF protein in HL-60 cells induced by all-trans refinoic acid (ATRA). Methods MTr method was used to detect the proliferation of HL-60 cells induced by ATRA,cell cycle and CD11b expression in HL-60 cells were detected by flow cytometry. Expression of VEGF, c-myc, by-poxia-inducible factor(HIF)-lα, matrix metalloproteinase (MMP)-9 and MMP-2 mRNA were detected by semi-quantitative RT-PCR. VEGF protein in HL-60 cells culture supernatant was measured by ELISA before and after being induced by ATRA. Results After treatment with ATRA,the proliferation of HL-60 cells was obviously inhibited, CD11b expression increased, trend of granulocyte directional differentiation emerged, and differentiation degree was increasd(P <0. 05) ;expression level of c-my and VEGF mRNA was down-regulated (P < 0. 05), but expression level of HIF-1α mRNA was up-regulated (P < 0. 05). VEGF protein level in HL-60 cells culture supernatant was decreased by blocking the expression of MMP-9 or MMP-2(P <0. 05).Conclusion VEGF expression has positive correlation with c-myc expression,but has negative correlation with HIF-1α expression. MMP-9 and MMP-2 may be the main factors regulating VEGF secretion in HL-60 cells.