The efficacy and safety of epidural morphine/hydromorphone in the treatment of intractable postherpetic neuralgia: A single-center, double-blinded, randomized controlled, prospective, and non-inferiority study.

Objective: Postherpetic neuralgia (PHN) is a clinical puzzle, especially in patients who still suffered from moderate and severe pain after standard treatment. This single-center, double-blinded, randomized controlled, prospective, and non-inferiority study observed the safety and effectiveness of the epidural application of morphine or hydromorphone, trying to provide an alternative method for those patients with refractory PHN. Methods: Eighty PHN patients with a visual analogue scale (VAS) still greater than 50 mm after routine management were randomly divided into two groups according to 1:1, respectively. One group received epidural morphine (EMO group), and the other group received epidural hydromorphone (EHM group). VAS, the number of breakthrough pain, quality of life (QOL), and anxiety/depression assessment (GAD-7 and PHQ-9 scores) were also observed before treatment, at 1, 3, 7, 14, 21, 28, 60, and 90 days after treatment, as well as side effects. Opioid withdrawal symptoms (OWSs) were also measured from 3 to 28 days after treatment. Results: The EHM group was non-inferior to the EMO group in terms of the VAS decrease relative to baseline (VDRB) after 1-week treatment. The VAS of the two groups on all days after treatment was significantly lower than the corresponding baseline findings (p < 0.05). The breakthrough pain (BTP) decreased significantly after treatment and lasted until 14 days after treatment (p < 0.05). There was no significant difference in BTP between the two groups at each time point (p > 0.05). In terms of the QOL, GAD-7, and PHQ-9 outcomes, those were significantly improved after treatment (p < 0.05), and there was no difference between the two groups (p > 0.05). No significant AE difference across the two groups was observed in this study. Few reports of OWS were found in this trial, and there were no significant differences between the two groups (p > 0.05). Conclusion: EHM was non-inferior to EMO in terms of the VDRB after 1-week treatment. For patients with VAS still greater than 50 mm after standard treatment, short-term application of EMO or EHM can ameliorate intractable pain, improve the quality of life, and have no obvious side effects. Short-term epidural opioid application will not lead to the appearance of OWS.

REGEN-COV for the Treatment of Hospitalized Patients with Covid-19

BackgroundHospitalized patients with COVID-19 experience high mortality rates, ranging from 10% to 30%. Combined casirivimab and imdevimab (CAS+IMD) is authorized for use in outpatients with COVID-19 and in post-exposure prophylaxis. The UK-based platform RECOVERY study reported improved survival in hospitalized seronegative patients treated with CAS+IMD; however, in most of the world, anti-spike monoclonal antibody therapy is currently not approved for hospitalized patients. MethodsIn this phase I/II/III double-blind placebo-controlled trial, patients hospitalized with COVID-19 were randomized (1:1:1) to 2.4 g or 8.0 g of CAS+IMD or placebo, and characterized at baseline for viral load and SARS-CoV-2 endogenous immune response. Results1336 patients on low-flow or no supplemental oxygen were treated. The primary endpoint was met: in seronegative patients, the least squares mean difference (CAS+IMD vs placebo) for time-weighted average change from baseline viral load was -0.28 log10 copies/mL (95% confidence interval [CI] -0.51 to -0.05; P = .0172). The primary clinical analysis of death or mechanical ventilation from day 6 to 29 in patients with high viral load had a strong positive trend but did not reach significance. CAS+IMD numerically reduced all-cause mortality in seronegative patients through day 29 (relative risk reduction, 55.6%; 95% CI 24.2-74.0; nominal P = .0032). No safety concerns were noted. ConclusionsIn hospitalized patients with COVID-19 on low-flow or no oxygen, CAS+IMD treatment reduced viral load and the risk of death or mechanical ventilation as well as all-cause mortality in the overall population, with the benefit driven by seronegative patients and no harm observed in seropositive patients.

Influence of tea pigment on cardiac activity in exsomatized toads of myocardial ischemia / 重庆医学

Objective To observe the influence of tea pigment on myocardial contractility,electrocardiogram(ECG) and heart rate in exsomatized toads under the condition of myocardialischemia.Methods Sixty toads were divided into the normal exsomatized toad heart group(A) and myocardial ischemia toad heart(B).Then the group A was re-divided into the Ringer's solution group (A1),tea pigment low dose(200 mg/L) group(A2) and the high dose(400 mg/L) group(A3);the group B was re-divided into the pituitrin model group(B1),pituitrin + tea pigment low dose(200 mg/L) group(B2) and high dose(400 mg/L) group(B3).The BL-420S biological function experiment system was used to record the myocardial contractile force and ECG change curve of exsomatized toad.Results Compared with the group A1,the myocardial contractility in the group A3 was obviously increased(P＜0.05),the difference in the group A2 had no statistical significance(P＞0.05);the QRS peak value of ECG and heart rate had no statistically significant difference(P＞0.05);compared with the group A1,the myocardial contractility,ECG QRS peak value and heart rate in the group B1 were significantly decreased(P＜0.05);compared with the group B1,the myocardial contractility,ECG QRS peak value and heart rate in the group B2 and B3 were significantly increased(P＜0.05).Conclusion Tea pigment can obviously improve the decrease of the exsomatized toad cardiac activity caused by myocardial ischemia.

Effects of social isolation on the cognition and expression of 5-HT2C receptor and ADAR1 in BALB/c mice / 中华行为医学与脑科学杂志

ObjectiveTo explore the effects of social isolation on the cognition and expression of 5-HT2C receptor(5-HT2CR) and adenosine deaminase that act on RNA 1(ADAR1) in BALB/c mice.MethodsThe healthy BALB/c mice were isolated for 2,4,and 8 weeks individually since postnatal 21 days respectively to set up isolation mice model,the same age mice without isolation were regarded as control group.The new object location and the new object recognition tests were used to measure the spatial and non-spatial cognitive function,and western blot was used to measure the protein expression of 5-HT2CR and ADAR1.ResultsThe new object location test showed that the spatial discrimination index (DI) of BALB/c mice isolated for 2 weeks was decreased significantly compared with the control group(control group was (0.075±0.340),isolation group was (-0.653±0.308),P<0.05),and no obvious difference was found for the group isolated for 4 and 8 weeks.The new object recognition test showed that the non-spatial DI of BALB/c mice isolated for 2 and 4 weeks were decreased significantly compared with the control group(control 2 weeks group was (0.088±0.210),isolation 2 weeks group was (-0.945±0.194),P<0.05;control 4 weeks group was (0.105±0.267),isolation 4 weeks group was (-0.506±0.215),P<0.05),and no obvious difference was found for the group isolated for 8 weeks.Compared with the control group the expression of 5-HT2CR and ADAR1 in the hippocampus were decreased significantly for the group isolated for 2 weeks.(5-HT2CR:control group was (1.025±0.144),isolation group was (0.891±0.026),P<0.05.ADAR1: control group was (0.839±0.120),isolation group was (0.629±0.094),P<0.05).ConclusionsTwo week social isolation results in the decrease of spatial and non-spatial cognitive function in BALB/c mice,in the meanwhile,social isolation stress results in the obvious decrease of 5-HT2C receptor and ADAR1 protein expression in the hippocampus of BALB/c mice.

Establishment and Phenotype Analysis of SHBG Knockout Mouse Model / 中国生物工程杂志

Objective:To generate sex hormone binding globulin(SHBG) conditional knockout mice model.In order to investigate the physiological function of SHBG in vivo and to provide experimental means for the study of the relationship between SHBG and gestational diabetes mellitus.Methods:The mouse genomic DNA sequence of SHBG was verified through bioinformatic analysis.According to the SHBG genomic DNA sequence,the gene targeting and knockout vector were constructed.Transfection of the vectors to ES cells by electroporation was performed according to common protocol.Positive ES cells were screened and identified by PCR.Therefore,the dual selected ES cells were microinjected into blastula,then blastula transplantations into the host mice.The chimeric mice were mated with C57BL/6J mice,and the Flox mice were obtained after screening.The Flox mice were hybridized with EIIA-Cre transgenic mice,and the progeny of the SHBG gene knockout (SHBG-/-) mice were obtained by autocopuation for several times.Results:Several Flox homozygous mice and SHBG gene knockout mice were successfully obtained.Compared with control mice,homozygous mice of SHBG gene knockout were well developed and had reproductive ability.The growth and development of SHBG knockout mice were not significantly different from that of wild type mice.Conclusion:Homozygous mice model of SHBG gene knockout was successfully established,which laid the foundation for further study of the role of SHBG in the gestational diabetes.The SHBG gene knockout mouse model was successfully established and the preliminary phenotypic analysis was performed,which laid the foundation for further study on the role of SHBG in gestational diabetes mellitus.SHBG gene knockout mice were normal in appearance.Due to the limited number of samples and many unknown biological characteristics of gene knockout mice,it needs further study.

Study on Inhibitory Effects of Sinomenine-loaded PLGA-TPGS Nanoparticles on the Proliferation of HCa-F Cells in Lymph Tubes and Ectopic Transplantation Tumors in Mice / 中国药房

OBJECTIVE:To study the inhibitory effects of sinomenine(SIN)-loaded polylactic-co-glycolic acid-D-α-tocopherol polyethylene glycol 1000 succinate(PLGA-TPGS)nanoparticles(SPTN)on the proliferation of HCa-F cells in lymph tubes and ec-topic transplantation tumors in mice. METHODS:HCa-F cell suspension were incubated with normal saline,5-fluorouracil(FS), sinomenine solutions (SS),sinomenine PLGA nanoparticles (SPN) and SPTN,with concentration of 80 μg/ml. The cells were marked with CFSE,and then were injected with suspension 50 μl via one footpad of mice. Inhibitory effect of above suspensions on the proliferation of HCa-F in lymph tubes of mice was observed by fluorescence inverted microscope at 3,6,9,12,24 h(n=15). Mice were divided into normal control group,blank PLGA-TPGS nanoparticles (EPTN) group,normal saline group,SPTN group,SPN group,SS group and FS group with 10 mice in each group. The latter 5 groups were injected with relevant medicine 15 mg/kg,once a day,via tail vein for consecutive 10 days after the model of HCa-F cells-bearing ectopic transplantation tumor mice was established. The serum content of ALT,AST,γ-glutamyltransferase(γ-GT),ALB and T-BIL were determined;solid tu-mors were taken,measured and weighed,and the inhibitory rate of tumor was also calculated. RESULTS:The inhibitory effect of above solution on the proliferation of HCa-F cells in descending order was as follows:SPTN>SPN>FS>SS>normal saline. Com-pared with normal saline group,the serum levels of ALT,AST,γ-GT and TBIL of SPTN group,SPN group,SS group and FS group decreased,while ALB level increased(P<0.05);the amount of tumor volume increase and tumor weight in SPTN group, SPN group and FS group decreased significantly (P<0.05). The inhibitory rate of tumor in 3 groups were 49.62%,40.53% and 33.90%. CONCLUSIONS:SPTN can inhibit the proliferation of HCa-F cells in lymph tubes of mice,and can improve HCa-F cells-bearing ectopic transplantation tumor in mice. It is better than SPN and FS.

The effects of social isolation on the exploring behavior and working memory in mice / 中华行为医学与脑科学杂志

Objective To study the effect of social isolation( SI) on the exploratory behavior and working memory in mice. Methods The Kunming mice of postnatal 21 days were divided into the control group,SI 2 weeks group,SI 2 weeks gregarious group,SI 4 weeks group and SI 8 weeks group,according to randomized design with ten animals each. All isolated mice were isolated for 2, 4 and 8 weeks respectively, the gregarious group were housed under normal grouped housing enviroment after isolation until adult, the mice with the relative same age were control groups. All animals were measured for exploratory behavior and working memory by performing open field and T?maze after the treatment. Results In the open field,compared to the relative control group,the central area of the total time in the SI 4 weeks group(0.07±0.04) was less than the control (0.10±0.04) obviously. The central area percentage of total time in SI 8 weeks group (0.64±0.12) were more than the control (0.43±0.08). In the T?maze,the alteration times in SI 2 weeks group (first day (5.92±0.79),second day (6.67±1.3),third day (7.42±1.08),fourth day (8.17±1.27)) were less than the control (first day (6.80±1.14); second day (7.60± 0.84);third day (8.30±0.95);forth day (9.20±1.32)). However,the alteration times of gregarious group showed no obvious change. Both the alteration times of SI 4 weeks (8.18±1.99) in the second day and that of SI 8 weeks (8.29±3.04) in the forth day were more than the control (6.60±2.11) and (7.80±2.53) respectively.Conclu?sions Working memory of SI 2 weeks rats decrease,which can be improved by the resocialization.SI 4 weeks and 8 weeks rats show the decreasing exploring ability and increasing anxiety and work memory.

Analysis of pre-hospital treatment characteristics of patients with cerebrovascular disorders / 中华全科医师杂志

The medical records of stroke patients at Zhenjiang Emergency Medical Center from January 1 to December 31,2011 were analyzed.A total of 797 stroke patients were managed,accounting for 10.42 percent of the emergency number over the same period.The average ages of males and females were (67 ± 14)and (72± 14)years old respectively (P ＜ 0.01).The incidence rate increased with age (P ＜0.05).The highest incidence occurred from 9:00 to 10:00 (n =61,7.7％),while the lowest incidence at 4:00 to 5:00 (n =9,1.1％).A total of 552 (69.3％) cases were sent to class 3A hospitals; the number of patients who independently option hospital were 626 cases (78.5％).Emergency response time (from call to arrival) was an average of 13.49 minutes.A total of 318 cases (39.9％) took no more than 10 minutes and first aid an average of 38.11 minutes.

The effects of social isolation on the spatial and nonspatial cognitive ability in mice / 中华行为医学与脑科学杂志

Objective To study the effects of social isolation (SI)on the spatial and nonspatial cognitive ability in mice.Methods The postnatal 21 day kunming mice were divided into control group,SI 2 weeks group,SI 4 weeks group,SI 8 weeks group and SI 2 weeks gregarious group according to randomized block design,with ten animals each.SI 2 weeks group,SI 4 weeks group and SI 8 weeks group were isolated for 2,4 and 8 weeks respectively,SI 2 weeks gregarious group would be housed under normal grouped housing condition after 2 weeks isolation until adult,the relative control groups were the same age as the relative SI and SI gregarious group.All animals were measured the spatial and nonspatial cognitive ability by carrying the object recognition test(ORT) and object location test (OLT) after the treatment.Results In the ORT,compared to the relative control group,the discrimination index in the SI 2 weeks group,SI 4 weeks group and SI 8 weeks group ( ( - 0.03 ± 0.003 ),( - 0.11 ±0.02) and( - 0.21 ± 0.02 ) respectively) were strikingly lower than the relative control group ( ( 0.29 ± 0.03 ),(0.13±0.07) and (0.09 ±0.03) respectively) (P＜0.05).In the OLT,compared to the relative control group,the discrimination index in the SI 2 weeks group,SI 4 weeks group and SI 8 weeks group( ( -0.15 ±0.02),( -0.30± 0.02),( - 0.32 ± 0.02 ) respectively ) were strikingly lower than the relative control group ( (0.33 ± 0.02 ),(0.41 ± 0.03 ),(0.27 ± 0.04)respectively)(P＜ 0.05 ),while the SI 2 weeks gregarious group with the resocialization to the normal housing condition showed no change.Conclusions 2 weeks,4 weeks and 8 weeks isolation on mice lead to the spatial and nonspatial cognition deficits,while the resocialization to the normal housing condition could recover the damage.

Effects of dehydroepiandrosterone on in vitro cultured osteoblasts and osteoprotegerin in rats / 中国组织工程研究

BACKGROUND: Dehydroepiandrosterone (DHEA) derived from adrenal cortex has an indirect bioeffect through differentiating into androgen or estrogen in the related peripheral tissues. OBJECTIVE: To verify the effects and mechanisms of DHEA on promoting osteoblasts (OBs) proliferation. DESIGN, TIME AND SETTING: The grouping controlled experiment was accomplished in Shanghai Sixth People's Hospital affiliated to Shanghai Jiao Tong University and Institute of Radiation Medicine, Fudan University from January 2006 to February 2007. MATERIALS: Ten SD rats were recruited, 1 day old, regardless of gender. DHEA was the product of American Sigma Company. METHODS: Rat OBs were separated and cultured in vitro. First generation of OBs cultured in a varied concentrations of DHEA (1?10-5, 1?10-7 and 1?10-9 mmol/L) for 72 hours were set up as the experiment group, while those exposed to 1?10-8 mmol/L of estradiol culture were regarded as positive controls and blank control group was set up as well. MAIN OUTCOME MEASURES: The OBs were identified by cell morphology and alkaline phosphatase (ALP) dyeing. Light microscope and methyl thiazolyl tetrazolium assay were used to detect the growth and proliferation of OBs. The formation of mineralized nodus was examined by alizarin bordeaux stain. The concentrations of osteoprotegerin in DHEA culture solution were also measured by double antibody sandwich ABC-ELISA simultaneously. RESULTS: ①Identification of primarily cultured OBs showed ALP dyeing was positive.②Proliferation rate of OBs was increased in experiment groups compared with that of the blank control group, and the most significant increase occurred in the concentration of 1?10-7 mmol/L DHEA culture (P 0.05).③ALP activity in experiment groups was higher, especially in the group with the concentration of 1?10-7 mmol/L DHEA (P 0.05).④ALP activity of unitary cell population was higher in 1?10-9 mmol/L DHEA culture group than that in blank control group (P

Efficacy of dehydroepiandrosterone sulfate in the treatment of osteoporosis in 120 elderly males / 中国组织工程研究

AIM:Although there are many evidences showing positive effects of dehydroepiandrosterone sulfate(DHEA-S) in bone metabolism,the reasonable and thorough experiments are still needed to clear the mechanism of DHEA-S on bone metabolism by excluding the biological effect of its derivative hormone.This experiment is to study the efficacy and safety of DHEA-S in treatment of osteoporosis in elderly males.METHODS:①From October 2005 to October 2006,120 out-and in-patients with primary osteoporosis who were admitted in Shanghai 6th People's Hospital were selected.The diagnosis of primary osteoporosis referred to the new standard from WHO:without the application of sexual hormone,and over 2.5 standard deviation value of bone mineral density lower than the peak value of the same gender subject.All the cases were randomly divided into treatment group and control group(60 cases in every group).② DHEA-S 100 mg and Caltrate-D 600 mg were orally given to the treatment group;Caltrate-D 600 mg was orally given to the control group.③After 6 months,the bone density,serum biochemical markers,markers of bone resorption and formation as well as side effects were measured.RESULTS:120 osteoporosis patients entered into analysis.①Compared to the pretreatment and control group,the bone mineral density in lumbar spine 1,lumbar spine 2-4,femoral neck,and upper part of femoral bone were increased significantly in the treatment group(P 0.05).CONCLUSION:Treatment of osteoporosis in elderly males with DHEA-S is safe and effective without obvious side effects.

Cooperation and innovation on teaching in functional comprehensive experiments of 7-year program / 中华医学教育探索杂志

Training the ability of cooperation and innovation for seven-year students become more and more necessary and urgent,so we should reinforce the corresponding training during lessons and arrange designing experiments to test these abilities.

Effect of L-arginine or L-nitroarginine on kainic acid induced seizure and expression of iNOS mRNA in the rats' hippocampus / 中国药理学通报

AIM To observe the expression of inducible nitric ox ide synthase (iNOS) in the rats' hippocampus of kainic acid (KA) induced-seizur es and the effect of L-arginine(L-Arg) or L-nitroarginine(L- NNA) chronic intervention before KA. METHODS The expression of iN OS mRNA by RT-PCR and behaviour were observed after administration of convulsan t dose of KA (10 mg?kg -1 ) and pretreatment with NO predecessor (L-Ar g, 40 mg?kg -1 ) or a inhibitor of NOS(L-NNA, 50 mg?kg -1 ) befo re KA. RESULTS The time-dependent seizures were induced on rats after giving KA, and were improved and serious in the animals with L-NNA pr etreatment, but they were alleviated by L-Arg pretreatment before KA. Compa red with control, iNOS mRNA expression was feebly at KA 3 h, continuative improv ement accompanying KA time prolonged, and it was markedly enhanced at KA 24 h. I t couldn't be examined at KA 2 d or 3 d, and was obviously improved at KA 7 d a gain. iNOS mRNA appeared weak in the rats hippocampus with L-Arg pretreatme nt after KA 1 h, whereas it wasn't found in L-NNA pretreatment animals. CONCLUSION iNOS mRNA expression appeared in the hippocampus of seizu re rats at a few time after KA, and L-Arg chronic intervention before KA ha s a little effect on it.

Treatment of osteoporosis in men using dehydroepiandrosterone sulfate / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To study the effect of dehydroepiandrosterone sulfate (DHEAS) treatment of osteoporosis in men with T(BMD) > or = 2.5SD.</p><p><b>METHODS</b>Eighty-six patients were randomly divided into two groups: treatment group (n = 44) and control group (n = 42). DHEAS (100 mg q.d.) was given to the treatment group for 6 months. Bone mineral density, (BMD), biochemical markers of bone absorption and formation and other serum biochemical markers were measured before and after DHEAS treatment. Drug side effects were also evaluated.</p><p><b>RESULTS</b>After oral administration of DHEAS (100 mg q.d.) for 6 months, the serum concentrations of DHEAS and IGF-I in the treatment group were 93.75% +/- 16.1% and 17.71% +/- 4.2% higher respectively than those in the control group (P < 0.01). The BMD of L2, L3, L4, L2 - 4 and Neck sections increased in the treatment group by 2.65% +/- 0.65%, 2.70% +/- 0.48%, 3.10% +/- 0.41%, 2.82% +/- 0.37% and 2.32% +/- 0.31%, respectively, as compared with that the control group (P < 0.05 or 0.01). No significant changes were observed in serum FT, E(2) and PSA concentrations in the treatment group as compared with the control group.</p><p><b>CONCLUSION</b>The treatment of osteoporosis in men with DHEAS is safe and effective.</p>

The Association between Obstructive Sleep Apnea Hypopnea Syndrome and Carotid Atherosclerosis In Ischemic stroke Patient / 中国实用内科杂志

Objective To study the relationship between obstructive sleep apnea hypopnea syndrome(OSAHS)and carotid atherosclerosis in ischemic stroke patients.Methods 43 subjects with ischemic stroke were enrolled and divided into carotid atherosclerosis group and carotid normal group according to the intima-media thickness(IMT)and plaque of carotid arteries,which determined with high-resolution ultrasound.Polysomnography(PSG)was performed for all the patients and record the apnea-hypopnea index(AHI),oxygen desaturation index,deep duration with SaO2

Relationship Between the Level of Serum Bilirubin, Uric Acid and the Severity of Coronary Lesion in Elder People / 中国医师杂志

Objective To explore the relationship between the severity of coronary artery lesion and the level of serum bilirubin, uric acid in elder people. Methods 192 elder patients underwent coronary angiography were divided into 5 groups according to the severity of coronary lesion: normal(group A), vessel stenosis

Expression of IL-6 in kainic acid-induced seizure and regulation roles of nitric oxide pathway / 中国药理学通报

AIM To explore the role of nitric oxide (NO) mediators in seizure behavior and the related expression of interlukin 6(IL 6). METHODS The IL 6 immunoreactivity (IL 6 ir) and behaviour were observed in kainic acid (KA) induced seizure following pretreatment with L nitroarginine( L NNA), a inhibitor of nitric oxide synthase(NOS), or the same number of moles of L arginine( L Arg). RESULTS The results showed that time dependent seizures were induced on animals after administration of KA (10 mg?kg -1 ), accompanied by the immediate enhancement of IL 6 ir in hippocampal structure, piriform area and cortex. The behaviors of rats were not markedly altered by chronic pretreatment with L NNA (50 mg?kg -1 ) or L Arg (40 mg?kg -1 ). However, after the administration of KA, the seizure behaviors were obviously different in the group of L NNA and L Arg respectively. Seizure was agrevated in the animals with L NNA pretreatment and many rats died at KA 3 hours, whereas seizure was alleviated after KA in the group of L Arg. IL 6 expression was apparently up regulated in some brain areas such as hippocampus in the group of KA pretreated with L NNA, but opposite effects appeared in the group pretreated with L Arg before KA injection. CONCLUSION These results indicate that endogenous NO mediators may alleviate the seizure behaviors and may down regulated the early expression of IL 6 in KA challenged seizure, but it the mechanism of the early expression of IL 6 with the homeostasis of endogenous NO mediator merits further study.nismoftheearlyexpressionofIL 6withthehome