Objective:To discuss the effect of cold exposure on nociception in the rats and its regulatory mechanism on transient receptor potential(TRP)ion channels in the sensory neurons,and to provide the basis for clarifying the biological mechanism of cold-sensitive pain.Methods:Sixteen female SD rats were divided into control group(n=8)and cold group(n=8).The rats in control group were exposed to the environment of(24±2)℃,and the rats in cold group were exposed to low temperature(4 ℃±1 ℃)in an artificial intelligence climate chamber for 4 h daily,for one week.Von Frey filaments were used to detect the mechanical withdrawal threshold(MWT)of the rats in two groups;immunofluorescence staining was used to observe the expression levels of TRPA1,TRPM8,TRPV1,and TRPV4 in dorsal root ganglion(DRG)tissue of the rats in two groups,the expression levels of calcitonin gene-related peptide(CGRP)and substance P(SP)in DRG tissue of the rats in two groups,and the expression levels of TRPA1,TRPM8,TRPV1,and TRPV4 in synovial tissue of the rats in two groups.Results:Compared with control group,the MWT of the rats in cold group was significantly decreased(P＜0.05),the expression levels of TRPA1 and TRPM8 in DRG tissue were significantly increased(P＜0.05),the expression level of TRPV1 was significantly decreased(P＜0.05),there was no significant difference in the expression level of TRPV4(P＞0.05),and the expression levels of CGRP and SP were significantly increased(P＜0.05).Compared with control group,the expression level of TRPA1 in synovial tissue of the rats in cold group was significantly increased(P＜0.05),while the expression levels of TRPM8,TRPV1,and TRPV4 were significantly decreased(P＜0.05).Conclusion:Short-term cold exposure can induce the hyperalgesia of the rats,and its mechanism may be associated with the changes in the expression of TRP ion channels in DRG and synovial tissues.TRPA1 sensory neurons play an important role in local joint cold pain.

Objective: To explore the role of mobile phone addiction and anxiety symptoms in the relationship between childhood psychological abuse and depressive symptoms among college students, in order to provide a basis for mental health promotion. Methods: From February to May 2023, a stratified random sampling method was used to select 1 799 freshmen to juniors from a university in Wuhu City, Anhui Province. The questionnaire survey was conducted using the 2-item Patient Health Questionnaire (PHQ-2), Child Psychological Maltreatment Scale (CPMS), Mobile Phone Addiction Tendency Scale (MPATS), 2-item General Anxiety Disorder (GAD-2). Correlations among each variable were analyzed, and the chain mediating effect of mobile phone addiction and anxiety symptoms was explored. Results: The detection rate of depressive symptoms among college students was 9.7%, and the positive detection rate of childhood psychological abuse was 28.6%. Depressive symptoms were positively correlated with childhood psychological abuse, mobile phone addiction and anxiety symptoms ( r =0.28, 0.32, 0.27, P <0.01). Childhood psychological abuse was positively correlated with mobile phone addiction and anxiety symptoms ( r =0.29, 0.71, P <0.01). Mobile phone addiction and anxiety symptoms were positively correlated ( r =0.30, P <0.01). Childhood psychological abuse could effectively predict depressiove symptoms, mobile phone addiction and anxiety symptoms ( β =0.08, 0.06, 0.66, P <0.01). Mobile phone addiction and anxiety symptoms had a chain mediating effect between childhood psychological abuse and depression symptoms, with a total indirect mediating effect (effect=25.27%, P <0.05), accounting for 72.44% of the total effect. Conclusions Mobile phone addiction and anxiety symptoms play a chain mediating role between childhood psychological abuse and depressive symptoms. Focusing on childhood psychological abuse, mobile phone addiction and anxiety among college students are beneficial for depression symptoms prevention.

Objective:To evaluate the diagnostic value of multiparametric cardiac magnetic resonance(CMR)or detecting the occurrence of acute rejection(AR)after heart transplantation(HT).Methods:From 2019 to 2021, 44 HT recipients are prospectively recruited from Guangdong Provincial People's Hospital.Another 51 healthy volunteers are recruited from a local community as healthy controls.CMR studies are performed for obtaining baseline parameters.According to the clinicopathological diagnostic criteria of AR by the consensus of International Society for Heart and Lung Transplantation, 81 CMR studies of 44 HT recipients are further divided into two groups of AR (18 cases)and non-AR(71 cases). CMR parameters includ global ventricular structure/function, T2, T1, extracellular volume(ECV)and late gadolinium enhancement(LGE). A combined model is established by binary Logistic regression and receiver operator characteristic curve(ROC)constructed.Results:The age range is(41.8±16.8)years in 44 HT recipients and(41.8±9.7)years in 51 healthy controls.T1 mapping indicated that myocardial global ECV of left ventricle is significantly higher in AR patients than non-AR controls(32.4%±6.0% vs 28.5%±2.4%; P<0.001 9). Global native T1 is higher in AR group than that in non-AR group(49.8±3.1 vs 47.5±2.8 ms, P=0.009)and the difference is statistically significant.The cutoff value of global ECV is 30.62% with a sensitivity of 61% and a specificity of 86% for detecting AR.And T2 mapping reveale that T2 value of global left ventricle is significantly higher in AR group than that in non-AR group(49.8±3.1 vs 47.5±2.8 ms, P=0.009). LGE extent is significantly higher in AR group than those in non-AR group( P=0.004). Through including global native T1 and ECV into a logistic regression model, multiparametric CMR can yield an area under curve(AUC)of 0.794.It hints at the potential of CMR for detecting AR. Conclusions:Multiparametric cardiac magnetic resonance offers an excellent predictive capacity for a noninvasive detection of AR.

AIM: To investigate the effect of low-dose aspirin on primary prevention of non-fatal myocardial and cerebral infarction in patients with type 2 diabetes mellitus. METHODS: From January 2015 to December 2016,40-90 years old patients with type 2 diabetes were treated in the Department of Endocrinology of Yijishan Hospital of Wannan Medical College for more than 2 times (the interval of hospitalization was more than 3 months) , we use the hospital's his system to search out-patient and in-patient files, patients were divided into aspirin group and non-aspirin group according to the use of low-dose aspirin within 1 year after the first visit, the basic data of the first visit were collected: name, sex, age, course of diabetes, systolic and diastolic blood pressure, patients were recorded for laboratory markers including fasting blood glucose, glycated hemoglobin, triglyceride, total cholesterol, Low-density lipoprotein, high-density lipoprotein, creatinine, and platelets, complications such as hypertension, coronary heart disease, atrial fibrillation, hyperlipidemia, diabetic nephropathy and arteriosclerosis were recorded. A Chi square test and a Cox proportional hazard model were used to compare baseline data and cerebrovascular disease after the first use of aspirin. RESULTS: Of the 4 176 patients, 2 137 were type 2 diabetes, 417 were eligible for admission, including 198 males, 219 females, 224 aspirin users and 193 non-users. There was no significant difference in the incidence of cerebral infarction between the aspirin group and the non-aspirin group (χ2=0.820, P=0.365). The incidence of non-fatal myocardial infarction was lower than that of the aspirin non-aspirin group (χ2=10.099, P=0.01) , the incidence of massive hemorrhage was significantly higher than that of aspirin-free group χ2=5.425, P=0.020) . In a subgroup analysis of aspirin use, patients younger than 60 years of age had a lower incidence of ischemic stroke (cerebral infarction) and a risk ratio of 0.428 (95%CI: 0.255-0.719, P=0.001) compared with patients older than 60 years of age, the incidence of cerebral infarction was higher in female patients with a risk ratio of 1.574 (95%CI: 1.018-2.434, P=0.041). CONCLUSION: In this study of patients with type 2 diabetes, low-dose aspirin reduced the incidence of nonfatal myocardial infarction but had no significant effect on the incidence of nonfatal ischemic stroke, and significantly increase the incidence of major bleeding events, we should reconsider the use of low-dose aspirin as a potential benefit of nonfatal cerebral infarction in patients with type 2 diabetes.

Objective:To evaluate the clinical efficacy and safety of ultrasound negative pressure suction with percutaneous nephroscope in the treatment of perirenal abscess.Methods:The clinical data of 11 patients with perirenal abscess admitted to Zhejiang Provincial People's Hospital from January 2013 to February 2021 were retrospectively analyzed. There were 4 males and 7 females. The average age was 59(51-76) years. The abscess was located on the left side in 4 cases and on the right side in 7 cases. The average diameter of abscess was 11.2(8.1-19.2) cm. All patients had fever, low back pain and abdominal mass, accompanied by bladder irritation in 6 cases, gross hematuria in 5 cases, abdominal distension, nausea and anorexia in 3 cases. There were 7 cases with type 2 diabetes, 2 cases with rheumatoid arthritis and 6 cases with ipsilateral kidney and ureter stone. Among the 11 patients, 6 had a history of urinary tract infection, 1 had a history of upper respiratory tract infection, 1 had secondary infection of perirenal hematoma after traumatic renal rupture, and 3 had secondary infection of perirenal hematoma after percutaneous nephroscopy. All patients were treated with ultrasound negative pressure suction with percutaneous nephroscope under local anesthesia by single operator. The operation time, intraoperative blood loss, drainage volume, drainage tube indwelling time, postoperative body temperature returned to normal time, postoperative hospital stay, therapeutic effect and complications were analyzed.Results:All operation procedures of 11 patients were successfully completed, including 8 cases of single channel, 2 cases of double channels and 1 case of three channels. The average operation time was 44(20-74)min, the average amount of blood loss was 15(10-20)ml, the average amount of pus was 325(200-500)ml, the average indwelling time of drainage tube was 8(6-12)d, the average time of body temperature returned to normal was 0.9(0.5-2.0)d, and the average hospitalization time was 9.6(7.0-14.0)d. Before discharge, CT reexamination showed that the perirenal abscess disappeared. There were no serious complications during and after operation. The average follow-up time was 4.4(3-8) months. There was no recurrence in all patients.Conclusions:Ultrasound negative pressure suction with percutaneous nephroscope is one of the safe and effective surgical methods for the treatment of perirenal abscess. It has the advantages of small trauma, quick recovery, complete drainage, exact effect and fewer complications.

OBJECTIVE:To study the protective effects and the mechanism of Rabdosia serra water extract(RWE)on hepatic fibrosis(HF)induced by carbon tetrachloride(CCl4)in rats. METHODS:Sixty male SD rats were randomly divided into normal group,model group,colchicine group(0.12 mg/kg),and RWE low-dose,medium-dose and high-dose groups(4,8,16 g/kg,by crude drug),with 10 rats in each group. Except for intraperitoneal injection of olive oil for normal group,other groups were given 40% CCl4olive oil solution intraperitoneally to induce HF model. Since the first day of modeling,each treatment group was given relevant medicine (10 mL/kg) intragastrically, while normal group and model group were given constant volume of water intragastrically,once a day,for consecutive 6 weeks. After medication,biochemical process or ELISA were used to determine the contents of ALT,AST,HA,LN,PCⅢ and Ⅳ-C in serum,the activities or contents of SOD,GSH-Px,MDA,TNF-α,IL-6 and IL-1β in liver tissue. Pathological changes of liver tissue in rats were observed by HE staining. The expression of α-SMA and TGF-β1 in liver tissue were detected by Western blot. RESULTS:Compared with normal group,the contents of ALT,AST,LN,HA,PCⅢ and Ⅳ-C in serum,the contents of MDA,TNF-α,IL-6 and IL-1β in liver tissue were all increased significantly in model group (P＜0.01);the activities of SOD and GSH-Px in liver tissue were decreased significantly(P＜0.01). Liver fibrosis was obvious, and the relative expression of α-SMA and TGF-β 1were increased significantly (P＜0.01). Compared with model group,the contents of ALT,AST,HA,LN,PCⅢ and Ⅳ-C in serum as well as the contents of MDA,TNF-α and IL-6 in liver tissue in colchicines group and RWE groups,the contents of IL-1 β in liver tissue of rats in colchicines group,RWE medium-dose and high-dose groups were all decreased significantly (P＜0.05 or P＜0.01). The activities of SOD and GSH-Px in liver tissue of rats were increased significantly in colchicines group and RWE groups(P＜0.05 or P＜0.01). The fibrosis degree of liver tissue was significantly reduced, while the relative expression of α-SMA and TGF-β 1decreased significantly (P＜0.01). CONCLUSIONS:RWE can protect CCl4-induced HF model rats,the mechanism of which may be associated with regulating lipid metabolism,relieving liver lipid peroxidation injury and anti-oxidative stress response,inhibiting the release of inflammatory factors and the expression of TGF-β1.

Objective To observe the effects of percutaneous endoscopic gastrostomy (PEG)on mortality and complications in patients with persistent dysphagia after stroke using a points scoring system for selecting PEG indication.Methods A total of 75 patients were divided into low score group without PEG,high score group without PEG and low score group with PEG (n=25 each).The follow-up period was 18 months,and the differences in complications,mortalities and survival periods among groups were compared.Results The number of times of aspiration pneumonia was (1.36± 1.44) in low score group,(1.96±2.28) in high score group,(0.36±0.64) in low score group with PEG,with statistically significant differences among three groups (H=7.148,P=0.028).No difference in the morbidity of aspiration pneumonia was found between low score group and high score group (P=0.189).The number of times of aspiration pneumonia was decreased in low score groups after PEG versus in low score group without PEG (P=0.030) and in high score group (P＜0.01).The numberof times of gastrointestinal hemorrhage was (0.48± 0.77)in low score group,(0.64± 0.91) in high score group,(0.12±0.33) in low score group with PEG,with statistically significant differences among three groups (H=5.532,P =0.063).No statistically significant difference in gastrointestinal hemorrhage was found between low score groups and low score group after PEG (P=0.430),as well as between low score group and low score group with PEG (P=0.079).The morbidity of gastrointestinal hemorrhage was lower in low score group than in high score group (P=0.012).The survival rate at the observation end was 88.0％ (22/25),52.0％ (13/25) and 92.0％ (23/25) in low score group,high score group and low score group with PEG,respectively,with statistically significant difference among the three groups (x2 =7.906,P =0.001).Kaplan-Meier survival curve showed that the survival period were longer in the low score group with or without PEG than in high score group (P＜0.01),but no statistically significant difference was found between low score groups with or without PEG (P=0.626).Conclusions The reasonable evaluation using a points-scoring system before PEG might predict the prognosis of such patients:the higher score would indicate higher mortality.PEG operation for low score group with better condition could decrease the aspiration pneumonia and decrease gastrointestinal hemorrhage significantly,but could not prolong general survival time and decrease general mortality.

Objective To evaluate the clinical efficacy and safety of dual shockwave lithotripter in treating urinary calculi.Methods Data of 371 cases treated with Direx-Magna dual shockwave lithotripter was retrospectively collected from July 2016 to June 2017,including 263 male and 108 female.Their age ranged from 15 to 66 years old (mean 36.5 ± 11.0).There was 117 patients with kidney stone,183 patients with upper ureteral and 71 patients with middle or lower stone.The average diameter of stones was (11.3 ± 1.5)mm (ranging 6.9-16.3 mm).The lithotripter was set at 60 times/min/head.Comparative analysis was made between 106 cases in dual mode and 265 cases in single mode.Comparative items included shock frequency,treating time,treating energy,pain scale,stone clear successive rate and complication.Patients were followed by KUB or NCCT at 1 and 2 weeks after the procedure.Stone clear successfully was defined as stone free or with fragment ＜4 mm.Results The overall success rate was 87.3％ (324/371).Among the patients who failed in first session,21 cases were successful with a second session,7 cases were treated with retrograde intrarenal surgery.There were 19 cases lost.Clavien grade Ⅲ complication rate was 0.8％ and no server grade complications.The average treating time was (25.2 ± 8.4) minutes and the average shock was (1419 ±440)times.The dual shockwave subgroup achieved higher success rate [93.4％ (99/106) vs.84.9％ (225/265),P ＜ 0.05] with less treating time [(15.7 ± 3.8) min vs.(29.0 ± 6.5) min],lower energy [(8.9 ± 2.0) kV vs.(10.7 ± 2.8) kV] and fewer shocks (833 ± 149 vs.1 654 ± 261),compared with that of the single shockwave subgroup (P ＜ 0.01).Also,pain scales and other complications were less than those of single shockwave subgroup (P ＜ 0.01).Conclusions Our study shows the new dual shockwave lithotripsy is safe and effective in both dual and single shock wave mode.Dual mode has higher success rate and fewer complications.

Objective To assess the value of endoscopic ultrasonography (EUS) and abdominal CT scan on preoperative T and N staging of advanced gastric cancer.Methods A total of 188 patients with advanced gastric cancer received EUS and CT scan to evaluate the T and N staging and lymphatic metastasis before surgical operation.The postoperative pathologic results acted as gold standard for comparison of the two methods.The results consistent with pathologic results were considered as correct otherwise were incorrect.The accuracy of EUS and CT and the each consistency of two methods with pathology were analyzed.Results For T staging, the accuracy of EUS and CT was 87.2%(164/188), 76.6%(144/188), respectively, and Kappa value of EUS and CT was 0.726 and 0.509, respectively.There was a statistical difference between the two methods(χ2=7.181,P=0.007).For lymph node metastasis, the accuracy of EUS and CT was 72.9%(137/188) and 79.8%(150/188), respectively, and Kappa value of EUS and CT was 0.397 and 0.487, respectively.No statistical difference was found between them(χ2=0.963,P=0.326).The consistency test between the two methods for T and N staging and lymph node metastasis revealed that the Kappa value was 0.507 and 0.649, respectively.The accuracy of EUS on T staging was 93.0%, 93.3%, 96.8% and 91.5% in cardiac cancer, gastric fundus cancer, gastric corpus cancer, and gastric antrum cancer, respectively.Corresponding Kappa value in the 4 different positions were 0.843,0.881,0.940 and 0.710, respectively according to consistency tests.The accuracy of gastric antrum cancer with pylorus invasion was 63.2% and the consistency test Kappa value was 0.340.Conclusion EUS is an accurate method for T staging and lymphatic metastasis of advanced gastric cancer, but there is a lower accuracy for T staging of gastric antrum cancer with pylorus invasion.