After brachial plexus avulsion (BPA), microglia induce inflammation, initiating and maintaining neuropathic pain. EZH2 (enhancer of zeste homolog 2) has been implicated in inflammation and neuropathic pain, but the mechanisms by which it regulates neuropathic pain remain unclear. Here, we found that EZH2 levels were markedly upregulated during BPA-induced neuropathic pain in vivo and in vitro, stimulating pro-inflammatory cytokines (IL-1β, TNF-α, and IL-6) secretion in vivo. In rats with BPA-induced neuropathic pain, mechanical and cold hypersensitivities were induced by EZH2 upregulation and inhibited by EZH2 downregulation in the anterior cingulate cortex. Microglial autophagy was also significantly inhibited, with EZH2 inhibition activating autophagy and reducing neuroinflammation in vivo. However, this effect was impaired by inhibiting autophagy with 3-methyladenine, suggesting that the MTOR signaling pathway is a functional target of EZH2. These data suggest that EZH2 regulates neuroinflammation and neuropathic pain via a novel MTOR-mediated autophagy signaling pathway, providing a promising approach for managing neuropathic pain.

BACKGROUND: Hemorrhoids are one of the most common conditions that lead to surgery, and until now surgical hemorrhoidectomy has been the major effective treatment. Post-operative pain from hemorrhoidectomy has been experienced by thousands of patients and remains a major inconvenience of the operation. OBJECTIVE: This study evaluates the clinical efficacy of the pestle needle therapy, an acupoint stimulation method, for relief of post-hemorrhoidectomy pain. DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS: This was a single-center, patient-assessor-blinded and randomized controlled trial with 154 patients receiving Milligan hemorrhoidectomy surgery. Eligible patients were randomly assigned to either a treatment group or a control group at a ratio of 1:1. The treatment group received the pestle needle therapy, with manual stimulation at Yaoshu (DU2), Mingmen (DU4), Changqiang (DU1), Chengshan (BL57), Erbai (EX-UE2) and the perianal points (1, 3, 5, 7, 9, and 11o'clock around the lesion); while the control group received a sham treatment with very light pressure. Three sessions of treatment were performed at 30 min, 4 h and 12 h after the surgery, and each lasted for 15 min. MAIN OUTCOME MEASURES: The primary outcome was post-operative pain measured with the visual analogue scale (VAS) at 12 h after surgery. The secondary outcomes included the VAS scores measured at 0.5, 2, 4, 6, 8, 24 and 48 h after surgery, the analgesic dose, the time and the VAS score of the patients' first defecation after surgery, as well as the Hamilton Rating Scale for Anxiety (HAMA) evaluated before discharge. RESULTS: The mean pain score of the treatment group was significantly lower than that of the control group (3.10 ± 1.27 vs 4.82 ± 1.29; P < 0.001) at 12 h after surgery. Compared with the control group, patients in the treatment group needed a smaller dose of analgesic within the first 24 hours after surgery (P = 0.002); and their HAMA scores before discharge were lower (4.07 ± 2.40 vs 5.10 ± 2.45, P = 0.009). Compared to the treatment group, patients in the control group had a greater time to the first defecation after surgery ([52.34 ± 15.72] h vs [27.08 ± 13.68] h; P < 0.001), but there was no difference in their VAS scores at the first defecation (P = 0.092). CONCLUSION The pestle needle therapy was effective for relieving pain, reducing anxiety and improving bowel function after hemorrhoidectomy, and it is worthy of clinical application.

Objective To study the impact of entecavir (ETV) combined with adefovir dipivoxil (ADV) on efficacy and nephritic function in the treatment of patients with hepatitis B virus (HBV)-related cirrhosis,to provide the basis for monitoring and optimizing HBV drug.Methods A total of 110 patients who diagnosed with HBV-related cirrhosis were randomly divided into control group (n =55) and treatment group (n =55).Control group was orally given telbivudine 600 mg,qd.Treatment group was given orally entecavir 0.5 mg,qd,combined with adefovir dipivoxil 10 mg,qd.Both groups were lasted for 48 weeks.The HBV DNA level,virologic,serologic and biochemical response,liver fibrosis index and eGFR levels before and after treatment were compared between the two groups.Results After 48 weeks treatment,HBV DNA levels were reduced 4.73 log10 U · mL-1,5.32 log10U · mL-1 in control group and treatment group (P ＜0.05).The HBV DNA negative conversion rate,HBeAg negative conversion rate and alanine aminotransferase (ALT) normalization in control group were 69.09％,20.00％,85.45％,had no significant difference with those in treatment group,which were 74.55％,14.55％ and 78.18％.The levels of hyaluronic acid (HA) and procollagen type Ⅲ (PC Ⅲ) were (140.20 ±20.65),(182.10 ± 12.00) ng · mL-1 after treatment in control group,had significant difference with before treatment (P＜0.05).The levels of HA,laminin and PC Ⅲ in treatment group after treatment were (122.40 ± 18.27),(130.90 ± 13.62),(112.10 ± 16.73) ng · mL-1,had significant difference with before treatment (P ＜ 0.05).The level of PC Ⅲ in treatment group had significant difference with control group after treatment (P ＜ 0.05).After 48 weeks treatment,eGFR level in control group was(112.00 ± 16.17)mL/1.73 m2 · min,had no significant difference with those in treatment group,which were (103.00 ± 13.02) mL/1.73 m2 · min (P ＞ 0.05).No obvious drug resistance,adverse drug reaction and renal function change were observed in two groups.Conclusion Compared with telbivudine,entecavir combined with adefovir dipivoxil can show a stronger efficacy for improving liver function in patients with HBV-related cirrhosis.Telbivudine had no significant difference compared with entecavir combined with adefovir dipivoxil in improving nephritic function.

Medicinal almonds have been used for over 2 000 years and its clinical efficacy includes relieving cough and asthma. The domestic market in China is flooded with different kinds of dried almonds, such as bitter almond (Armeniacae Semen Amarum, AAS), sweet almond (Armeniacae Semen Dulce, ADS), salted almond (Armeniacae Semen Salsa, ASS), and their sulfur-fumigating products (Armeniacae Semen Sulphur Fumabat, ASFS). Wide varieties of almonds may lead to uncertain efficacy, aberrant quality, and even increased safety risk. However, the authentication method for medicinal almonds has not been reported, although imposters may lead to ineffective medical response. In the present study, Fourier transform infrared spectroscopy (FTIR) and the 2-dimensional infrared (2D-IR) spectroscopy were used to identify different almonds, which were extracted with different solvents including water, methanol, ethanol, chloroform and ethyl acetate, respectively. A new simple FTIR method was developed in the present study. According to the gradient solvent polarity, a new 2D IR method was first developed, and the commodities of almonds in China were analyzed by using the FTIR spectroscopy supported by hierarchical clustering of characteristic peaks. Moreover, 5-hydroxymethyl-2-furfural could be used as a detection index and control target in the quality control of medicinal almonds.
China ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Prunus dulcis ; chemistry ; Quality Control ; Seeds ; chemistry ; Spectroscopy, Fourier Transform Infrared ; methods

BACKGROUND:Unclear pathogenesis of osteoarthritis results in a lack of radical therapy.The current studies mainly focus on pain relief and joint function improvement.Establishing an animal model is helpful to explore the pathogenesis,prevention and treatment of osteoarthritis,and also contributes to develop health food with new functions used for preventing and improving osteoarthritis.OBJECTIVE:To overview the establishment of the osteoarthritic animal model and its application in functional food research,thereby providing scientific basis for reasonable selection of ostecarthritic animal models and screening tests of bioactive substances.METHODS:CNKI and PubMed databases were retrieved for the articles related to animal model establishment published before May,2016,using the keywords of "osteoarthritis,animal model" in Chinese and English,respectively.Totally 157 articles were searched initially after repetitive ones excluded,and then 59 eligible articles were included.RESULTS AND CONCLUSION:Animal models of osteoarthritis are established in a variety of ways,and have their own advantages and disadvantages,with different application scopes.Therefore,we need select and establish appropriate animal models used for studying the pathogenesis of osteoarthritis and screening more specific and effective substances that can prevent and improve osteoarthritis.Additionally,it is of great significance for further developing the corresponding functional health food to alleviate the patients' pain and improve their quality of life.

Objective To determine the content of polyethylene glycol 15000 ( PEG15000 ) , the main degradation product of medical coating system inside the body by using high performance liquid chromatography -evaporative light scattering detector ( HPLC-ELSD ) and to evaluate its degradation rule.Methods The medical coating system was implanted into the back of rats , and these rats were executed by cervical vertebra dislocation zero, one, two, three, four, five, six, seven, eight, nine, ten, twelve weeks (n=6) after operation, respectively and washed with phosphate buffer to collect the rest gel and washing fluid , then HPLC-ELSD was used to determine the content of PEG 15000 in the rest gel and washing fluid .Results Gel in rats was intact until the end of the third week , presented as colorless transparent pieces until the sixth week, and then transformed to liquid state , presented as water until the ninth week and not seen by naked -eye until the twelfth week.The content of PEG15000 in the rest gel was decreased progressively with the extension of experiment weeks .Conclusion The degradation rate of gel inside the body of rates presents the rule of one fast and one slow;which conforms to the requirements in physiological process of dural defects healing.

BACKGROUNDContralateral C7 (cC7) transfer had been widely used in many organizations in the world, but the outcomes were significantly different. So the purpose of the study was to evaluate the outcome of patients treated with cC7 transferring to median nerve and to determine the factors affecting the outcome of this procedure.

METHODSA retrospective review of 51 patients with total root avulsion brachial plexus injuries who underwent cC7 transfer was conducted. All of the surgeries were performed with two surgery stages and median nerve was the recipient nerve. The cC7 nerve was used in three different ways. The entire C7 root was used in 11 patients; the posterior division together with the lateral part of the anterior division was used in 15 patients; the anterior or the posterior division alone was used in 25 patients. The mean follow-up period was 6.9 years.

RESULTSThe efficiency of the surgery in these 51 patients was 49.02% in motor and 62.75% in sensory function. The patients with entire C7 root transfer obtained significantly better recovery in both motor and sensory function than the patients with partial C7 transfer. The best function recovery could be induced if the interval between the two surgery stages was 4-8 months.

CONCLUSIONScC7 transfer is an effective procedure in repairing median nerve. But using the entire C7 root transfer can obtain better recovery; so we emphasize using the entire root as the donor. The optimal interval between two surgery stages is 4-8 months.

Adolescent ; Adult ; Brachial Plexus ; surgery ; Child ; Female ; Humans ; Male ; Median Nerve ; surgery ; Middle Aged ; Nerve Transfer ; methods ; Retrospective Studies ; Young Adult

OBJECTIVETo explore the effective methods for the treatment of complex tibial plateau fractures.

METHODSFrom May 2008 to April 2011, 28 patients with complex tibial plateau fractures were treated indirect reduction techniques, bilateral locking plate fixation combined with autologous bone grafts. There were 21 males and 7 females, with an average age of 43 years ranging from 21 to 65. There were 11 cases in Schatzker type V, 17 in VI. The effect was evaluated by Rasmussen standard on clinical and radiological.

RESULTSAll patients were followed-up for 7 to 36 months (averaged of 21.5 months). Healing time of fracture was from 3 to 8 months (averaged 5.5 months). The results of Rasmussen scores in clinical was 4.50 +/- 1.32 in pain, 4.32 +/- 1.63 in walking ability, 4.07 +/- 1.34 in knee activity, 4.78 +/- 1.27 in stability of the knee, 4.85 +/- 1.12 in stretch knee; the results in radiation was 5.07 +/- 0.92 in articular surface collapse, 5.00 +/- 0.98 in platform widened, 5.14 +/- 0.85 in knee external varus. The effect result was excellent in 8 cases, good in 15, fair in 3 and poor in 2.

CONCLUSIONThe key for the treatment of complex tibial plateau fractures was to fully assess the damage as much as possible to protect the soft tissue, select the appropriate timing of surgery and surgical incision, application of indirect reduction techniques, limited incision and effective internal fixation to restore joint surface smooth and good limb alignment, early exercise, in order to achieve maximum recovery of joint function.

Adult ; Aged ; Bone Plates ; Bone Transplantation ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; instrumentation ; Humans ; Male ; Middle Aged ; Recovery of Function ; Retrospective Studies ; Tibial Fractures ; diagnostic imaging ; physiopathology ; surgery ; Tomography, X-Ray Computed ; Treatment Outcome ; Young Adult

Objective To investigate the effects of connective tissue growth factor (CTGF) on the chronic peripheral nerve compression injury and explore the function of CTGF in peripheral nerve compression injury and repair. Methods From July 2010 to September 2010, fifty aduh male SD rats were randomly divided into group A and B: group A (sham-operated group): only exposed the sciatic nerve; group B (compression group): undergone sciatic nerve entrapment operation on the right hind leg according to the method which Mackinnon adopted when he established the model of chronic sciatic nerve compression.Electron microscopy,immunohistochemistry,RT-PCR and Western-blot were performed to observe the morphological changes of the compressed nerve tissue and to determine the level of CTGF,collagen- Ⅰ,Ⅲ (COL- Ⅰ,Ⅲ),2,4,6,8,10 weeks after the surgery,respectively. Results After sciatic nerve compression,the collagen in nerve increased ; The expression of CTGF and COL- Ⅰ, Ⅲ in sciatic nerve of compressed group increased, which was statistically different compared with the sham-operation group (P ＜ 0.05); In the meanwhile,the contents of CTGF and COL- Ⅰ,Ⅲ were positively correlated in a certain period. Conclusion Peripheral nerve fibrosis can be caused by chronic nerve compression.The expression of COL- Ⅰ,Ⅲ in sciatic nerve increased and CTGF get involved in the pathophysiological process, which suggests that CTGF plays an important role in the process of neural injury and fibrosis.

A multiplex RT-PCR assay based on GeXP system was developed in order to detect simultaneously human enterovirus 71 (EV71) and coxsackievirus A16 (CVA16) and other coxsackieviruses (CVA4, 5, 9 and 10, CVB1, 3 and 5). Enterovirus detection was performed with a mixture of 12 pairs of oligonucleotide primers including one pair of published primers for amplifying all known pan-enterovirus genomes and eleven primer pairs specific for detection of the VP1 genes of EV71, C A16, CVA4, CVA5, CVA9, CVA10, CVB1, CVB3 and CVB5, respectively. The specificity of multiplex RT-PCR system was examined using enterovirus cell cultures and positive strains identified previously from hand-foot-and-mouth disease (HFMD) patients. Serial dilution of titrated EV71 and C A16 cell cultures and in vitro transcripted RNA of enterovirus VP1 regions were used to detect the sensitivity of the multiplex RT-PCR system. The limit of detection for this multiplex RT-PCR system was 10(0.5) TCID50/microL for EV71 and C A16 cell cultures and 1000 copies for in vitro transcripted RNA of nine viruses per assay. This multiplex RT-PCR assay is a rapid, sensitive and specific assay for the diagnosis of common enterovirus infection in cases of HFMD outbreak and is also potentially useful for molecular epidemiological investigation.
DNA Primers ; genetics ; Enterovirus ; classification ; genetics ; isolation & purification ; Hand, Foot and Mouth Disease ; diagnosis ; virology ; Humans ; Reverse Transcriptase Polymerase Chain Reaction ; methods