Neuropathic pain(NP) has similar phenotypes but different sequential neuroinflammatory mechanisms in the pathological process. It is of great significance to inhibit the initiation of neuroinflammation, which has become a new direction of NP treatment and drug development in recent years. Mongolian drug Naru-3 is clinically effective in the treatment of trigeminal neuralgia, sciatica, and other NPs in a short time, but its pharmacodynamic characteristics and mechanism of analgesia are still unclear. In this study, a spinal nerve ligation(SNL) model simulating clinical peripheral nerve injury was established and the efficacy and mechanism of Naru-3 in the treatment of NPs was discussed by means of behavioral detection, side effect evaluation, network analysis, and experimental verification. Pharmacodynamic results showed that Naru-3 increased the basic pain sensitivity threshold(mechanical hyperalgesia and thermal radiation hyperalgesia) in the initiation of SNL in animals and relieved spontaneous pain, however, there was no significant effect on the basic pain sensitivity threshold and motor coordination function of normal animals under physiological and pathological conditions. Meanwhile, the results of primary screening of target tissues showed that Naru-3 inhibited the second phase of injury-induced nociceptive response of formalin test in mice and reduced the expression of inflammatory factors in the spinal cord. Network analysis discovered that Naru-3 had synergy in the treatment of NP, and its mechanism was associated with core targets such as matrix metalloproteinase-9(MMP9) and interleukin-1β(IL-1β). The experiment further took the dorsal root ganglion(DRG) and the stage of patho-logical spinal cord as the research objects, focusing on the core targets of inducing microglial neuroinflammation. By means of Western blot, immunofluorescence, agonists, antagonists, behavior, etc., the mechanism of Naru-3 in exerting NP analgesia may be related to the negative regulation of the MMP9/IL-1β signaling pathway-mediated microglia p38/IL-1β inflammatory loop in the activation phase. The relevant research enriches the biological connotation of Naru-3 in the treatment of NP and provides references for clinical rational drug use.
Rats ; Mice ; Animals ; Matrix Metalloproteinase 9/metabolism* ; Rats, Sprague-Dawley ; Neuroinflammatory Diseases ; Interleukin-1beta/metabolism* ; Spinal Cord/metabolism* ; Signal Transduction ; Hyperalgesia/metabolism* ; Neuralgia/metabolism*

OBJECTIVE: To explore effects of acupotomy on pain, function, gait and serum inflammatory factors in patients with knee osteoarthritis(KOA). METHODS: From December 2017 to June 2019, 110 patients with KOA were collected and divided into acupotomy group(56 cases) and western medicine group(54 cases) by using random number table method. In acupotomy group, there were 16 males and 40 females, aged from 46 to 74 years old with an average of (62.98±6.68) years old, the course of disease ranged from 1 to 240 months with an average of 24.5(15.25, 33.00) months;were treated with acupotomy on the pain points around knee joint once a week for 3 weeks. In western medicine group, there were 18 males and 36 females, aged from 47 to 73 years old with an average of (64.19±5.98 ) years old;the course of disease ranged from 1 to 220 months with an average of 25.00(13.75, 33.00) months;were took celecoxib capsule orally, 200 mg once a day for 3 weeks. Oxford Knee Score(OKS) was performed before treatment, 3 weeks and 3 months after treatment. Gait kinematics analysis and serum levels of tumor necrosis factor-α(TNF-α) and interleukin-1β (IL-1β) were measured before and after treatment for 3 weeks. RESULTS: All patients were followed up from 6 to 24 months with an average of(15.03±4.55) months. OKS between two groups decreased significantly at 3 weeks and 3 months after treatment(P<0.001). Functional scores and overall scores in acupotomology group were significantly decreased at 3 months compared with 3 weeks after treatment(P<0.001). OKS of acupotomy group were significantly lower than those of western medicine group at 3 weeks and 3 months after treatment(P<0.05). Gait speed, frequency and length between two groups were significantly improved at 3 weeks after treatment(P<0.05). At 3 weeks after treatment, gait freguency of acupotomy group was significantly improved compared with western medicine group(P<0.05). TNF-α and IL-1β were significantly lower in both groups at 3 weeks after treatment than before treatment(P<0.05). At 3 weeks after treatment, level of IL-1 β was lower in western medicine group than in acupotomy group(P<0.05), and difference in TNF-α level was not statistically significant(P>0.05). CONCLUSION Acupotomology of pain points could significantly improve pain, function, gait, and decreased serum inflammatory factors at early to mid stage of KOA patients, in particular, it is superior to non-steroidal anti-inflammatory drugs in terms of knee function recovery and cadence improvement.
Acupuncture Therapy ; Aged ; Anti-Inflammatory Agents, Non-Steroidal/therapeutic use* ; Celecoxib/therapeutic use* ; Female ; Gait ; Humans ; Interleukin-1beta ; Male ; Middle Aged ; Osteoarthritis, Knee/drug therapy* ; Pain/drug therapy* ; Tumor Necrosis Factor-alpha

OBJECTIVE：To sepa rate and identify the phenols compounds in Aurantii Fructus Immaturus ，and to provide reference for basic research of its effective substances. METHODS ：The phenols compounds were isolated and separated by silica gel，HW-40F gel column ，ODS reversed column and preparation HPLC. Their physicochemical properties and spectral data were used to identify the structures. RESULTS & CONCLUSIONS ：Totally 12 compounds were isolated from Aurantii Fructus Immaturus，identified as 6′-O-trans- cinnamoyl- 3，5-dihydroxyphenyl β-D-glucopyranoside（compound 1），methyl 3-（2′，4′- dihydroxy phenyl ）propionate（compound 2），phloroglucinol（compound 3），aurantiside A （compound 4），5，7，4′-trihydroxy-8， 3′-dimethoxyflavone-3-O-6″-（3-hydroxyl-3-methylglutaroyl） β-D-glucopyranoside （compound 5）， aromadendrin-7-O-β-D- glucopyranside（compound 6），hesperidin-7-O-β-D-glucoside（compound 7），naringin（compound 8），hesperidin（compound 9）， narirutin （compound 10），neoeriocitrin （compound 11），eriocitrin （compound 12）. Among them ，compound 1 is a new compound，and compounds 2 and 3 are isolated from Critus for the first time.

Purpose To investigate the value of application of D2-40/CD34-CK cocktail antibodies by double immunohistochemical staining for assessment of lymphovascular invasion (LVI) and to determine its prognostic significance in colorectal cancer with insufficient lymph node harvest. Methods Specimens from 133 cases of colorectal cancer with less than 12 lymph nodes were selected. HE staining and double immunohistochemical staining of the cocktail antibodies were performed to compare the difference of the two methods in screening for LVI. The The relationship between LVI confirmed by cocktail antibody immunohistochemical staining and clinicopathological characteristics and overall survival (OS) of patients was analyzed. Results (1) The detection rates of cocktail antibody double immunohistochemical staining and HE staining for LVI were 42.9％ (57/133) and 21.8％ (29/133) with statistically significant difference (P < 0.001). (2) The presence of LVI confirmed by double staining was significantly associated with Dukes staging, depth of invasion, clinical stages, lymph node metastasis and tumor budding (P < 0.05). (3) The presence of LVI, the location and extent of LVI, and the number of tumor cells in thrombus ≥5.5 for cases with LVI ≤2 clusters, were significantly associated with OS (P < 0.05). Conclusion D2-40/CD34-CK cocktail antibodies double staining is superior to routine HE staining in assessing LVI. LVI is intimately associated with tumor stage, lymph nodes metastasis and tumor budding, and it is an independent prognostic factor for CRC patients. It should be a supplementary examination for these patients with insufficient lymph node harvest.

OBJECTIVEEstablishing a rabbit model of vertebral artery type of cervical spondylosis(CSA) and to observe the characteristics of timeliness in improving the blood flow of vertebral artery by massage, and discusse the material basis of this timeliness based on NPY and ET-1.

METHODSFifty New Zealand healthy and white rabbits, 6-month-old, the body mass of (2.0±0.5) kg, with half males and half females, were randomly divided into blank group, model group, three massage groups(including massage for 10 min, 20 min, and 30 min group by random number table), 10 rabbits in each group. In addition to the blank group, CSA rabbit model was made by injection of sclerosing agent in other groups. The rabbits of massage for 10 min, 20 min, and 30 min groups received the massage therapy of corresponding duration, one times a day, continuous 10 days. The blood flow of vertebral artery in each group was detected by PeriFlux5000 laser doppler, and the contents of NPY and ET-1 in serum were detected by ELISA before and after treatment.

RESULTSChanges in blood flow of vertebral artery before and after treatment:there was no significant difference between model group and massage for 10 min group;there was significant difference between model group and massage for 20, 30 min groups(<0.01); there was significant difference between massage for 10 min group and massage for 20, 30 min groups(<0.01); there was no significant difference between massage for 20 min group and massage for 30 min group. Changes of NPY content before and after treatment: there was significant difference between model group and massage for 10 min group(<0.05); there was significant difference between model group and massage for 20, 30 min groups(<0.01); there was significant difference between massage for 10 min group and massage for 20, 30 min groups(<0.01); there was no significant difference between massage for 20 min group and massage for 30 min group. Changes of ET-1 content before and after treatment:there was no significant difference between model group and massage for 10 min group;there was significant difference between model group and massage for 20, 30 min groups(<0.01); there was significant difference between massage for 10 min group and massage for 20 min, 30 groups (<0.01); there was no significant difference between massage for 20 min group and massage for 30 min group.

CONCLUSIONSMassage needed 20 min for rabbits with CSA can only significantly improve the blood flow of vertebral artery. However, prolonging the time of massage has no obvious effect. The material basis of this timeliness characteristic of massage is closely related to the change of NPY and ET-1 levels in serum.

Objective To investigate the infection status of intestinal nematodes and their risk factors in rural residents of Jiangxia District, Wuhan City, so as to provide the reference for the establishment of targeted prevention and control measures. Methods According to the requirements of cross-sectional study of the national human key parasitic diseases, the residents in Shanpo Sub-district, Jiangxia District were randomly selected as the objects for the investigation of the infection status of Ascaris lumbricoides, hookworm and Trichuris trichiura. A questionnaire survey was performed simultaneously. Results Totally 236 residents received the stool tests, and only the hookworm eggs were found, with an infection rate of 7.63% (18 cases). The survey of intestinal parasitic infection status and their risk factors in 600 residents found 397 cases of suspected roundworm infection, 355 cases of suspected hookworm larvae dermatitis, 295 cases of suspected hookworm infection, and 145 cases of suspected whipworm infection, respectively. The Logistic regression analysis found that the risk factors of suspected roundworm infection included not always washing hands after toilet, using manure and fertilizer, and not often wearing shoes when doing farm work; the protective factors included knowing how roundworm infection was gained, and not using fresh dung for fertilization. The risk factors of suspected hookworm infection included using well water and pond water as the source of drinking water, eating food off the ground, using manure and fertilizers, and not washing when there was only one cutting board, and its protective factors included using tap water and well water as drinking water source, knowing how the roundworm infection was gained, and sometimes or not suing fresh feces for fertilization. The risk factors for suspected whipworm infection included eating food off the ground. Conclusions The intestinal parasite prevalence in the residents of the Shanpo Sub-district, Jiangxia District in Wuhan City is relatively high, and some risk factors associated with their infection indeed exist. Therefore, the regional government and health department should strengthen the health education to improve the residents’ knowledge about parasitic diseases and selfprotection awareness. At the same time, the residents should take physical examination regularly and take necessary deworming treatment to effectively control the prevalence and spread of intestinal parasitic diseases.

OBJECTIVE: To study the chemical constituents of ethanol extract from Cirtus aurantium. METHODS: The ethanol extract of C. aurantium was isolated and purified by silica gel column, open ODS column, preparation liquid chromatography, HW-40F gel column and macroporous resin column. The structure of compounds was analyzed and identified according to physicochemical properties and spectral data (mass spectrum, hydrogen spectrum, carbon spectrum). RESULTS: Eight compounds were isolated from ethanol extract of C. aurantium, i. e. Rimboxo (1), Thymidine (2), Uracil (3), Cyclo-(Leu1-Ile2-Ala3-Thr4-Gly5-Thr6-Phe7) (4), Cyclo- (Leu1-Leu2-Pro3-Tyr4-Gly5-Ser6-Pro7) (5), Meranzin hydrate-β-D-glucoside (6), Umbelliferone (7), Linaloyl glucoside (8). CONCLUSIONS: Compound 1, 2, 3, 8 are isolated from Citrus L. for the first time, compound 4, 5, 6 were isolated from C. aurantium for the first time. The study lays the foundation for quality evaluation of C. aurantium.

OBJECTIVETo investigate the impact of cement distribution index on the occurrence of refracture in the adjacent segments after percutaneous vertebroplasty.

METHODSThis retrospective analysis was conducted among 143 patients who received percutaneous vertebroplasty for osteoporotic vertebral compression fracture between April, 2011 and April, 2014. Of the 134 patients with complete follow-up data, 18 had adjacent segment fracture within 1 year following the surgeries (re-fracture group), and 116 patients without new fracture served as the control group. All the patients underwent X-ray examinations after the surgery and according to the position and shape, the cement in the vertebrae were classified into 5 types (I to V), and the volume-cubage index was computed based on the cement volume and vertebral cubage. Age, gender, bone mineral density (BMD), cement distribution index, volume-cubage index, and cement leakage were evaluated in the 2 groups, and the variables with significant differences between the 2 groups were analyzed in Logistic regression analysis.

RESULTSBMD was significantly lower and the rate of cement leakage was significantly higher in the re-fracture group than in the control group (P<0.05). Significant difference was found in cement distribution index between the 2 groups (P<0.05) but not in age, gender, cement volume or volume-cubage index (P>0.05). Logistic regression analysis indicated that BMD, cement leakage and cement distribution index all significantly affected the occurrence of adjacent vertebral fractures following percutaneous vertebroplasty.

CONCLUSIONA low BMD, cement leakage and a low cement distribution index are all risks factor of adjacent vertebral fracture after percutaneous vertebroplasty.

Objective To compare two different methods of pressure sores prevention in the pediatric (0-14 years old) neurosurgery operation which duration more than 6 hours.Methods A total of 193 pediatric brain tumors patients , which were in accordance with the inclusive criteria in October 2014 to December 2015 , were randomly divided into control group (96 cases) and observation group (97 cases).The patients of control group used conventional pressure sores nursing care plus foam dressings and the patients of observation group used conventional pressure sores nursing care plus homemade rubber water sac decompression pad .Instantly after the operation , 4 hours later and 24 hours after the operation , the situation of skin pressure sores was recorded respectively , and the maximum diameter of erythema was measured , and the process was put into phases .The skin pressure sores was compared between the two groups .Results Preoperative pediatric waterlow pressure sore risk rating scale was similar between the two groups , and there was no statistical significance ( P>0.05).In control group, 12 cases appeared different degree of erythema in the head , hip, tail lumbosacral region, heel, and other easy to pressure parts of the body , but no blister and burst .The with incidence of pressure sores 12.5%.In observation group, 4 cases appeared phase I pressure sores .The difference was statistically significant between two groups (P<0.05).Conclusions For pediatric neurosurgery, especially the operation time is more than 6 hours, the rubber decompression homemade water sac mat can reduce the pressure of surgery in children with skin effectively , improve local blood circulation , prevent the occurrence of pressure sores, and also reduce the treatment cost .It eases to use, and is worth of promoting .