K252a通过下调脊髓背角钾氯共转运体-2的表达缓解大鼠术后持续性痛

目的 观察鞘内注射酪氨酸激酶受体B(tyrosine kinase receptor B,TrkB)抑制剂K252a对皮肤/肌肉切口牵拉术(skin/muscle incision and retraction,SMIR)诱发的术后持续性痛大鼠脊髓背角钾氯共转运体-2(K+-Cl-cotransporter 2,KCC2)蛋白表达的影响. 方法 采用随机数字表法将52只成年雄性SD大鼠随机分成假手术组(对照组)、SMIR组、SMIR+二甲基亚砜(dimethyl sulfoxide,DMSO)组和SMIR+K252a组,每组13只.于术前1d及术后3、7、12、22、32 d测定大鼠机械缩足反射阈值(mechanical withdrawal threshold,MWT),Western blot测定术后7d大鼠脊髓背角KCC2蛋白的表达. 结果 与对照组比较,术后7、12、22 d时MWT在SMIR组[(22.5±2.3)、(24.9±1.4)、(29.5±2.4)g]和SMIR+DMSO组[(24.0±1.9)、(24.8±2.3)、(26.7±2.1)g]明显降低(P＜0.05);与SMIR组比较,术后7、12、22 d时MWT在SMIR+K252a组[(31.6±1.7)、(36.1±2.0)、(38.1±2.1)g]明显上调(P＜0.05).与对照组比较,术后7d时SMIR组和SMIR+DMSO组的脊髓背角KCC2表达明显下调(P＜0.05),SMIR+K252a组未检测到明显变化(P＞0.05).与SMIR组比较,SMIR+K252a组的脊髓背角KCC2表达明显上调(P＜0.05).结论 脊髓背角KCC2的表达变化可能参与了大鼠术后持续性痛的形成.     

脊髓胶质细胞在小鼠骨癌痛形成中的作用

Objective To evaluate the role of gliocyte in the spinal cord in the development of bone cancer pain (BCP) in mice. Methods Forty male C3H/He mice aged 8-10 weeks weighing 18-22 g were randomly divided into 4 groups ( n = 10 each) : group I sham operation (group S) , group II BCP, group Ⅲ PBS and group IV minocyline (group M) . In group BCP, PBS and M, bone cancer pain was produced by injection of NCTC2472 fibrosarcoma cell suspension (2 x 105 cells) 10 μl into medullary cavity of calcaneus bone, while in group S, PBS solution 10 μl was injected instead of cancer cell suspension. In group PBS and M, PBS 5 μl and minocyline 5 μl (dissolved to 0.2 mmol/L in PBS)_were given IT immediately before cancer cell inoculation once a day for 11 consecutive days respectively. Mechanical pain threshold was measured at 1 d before cancer cell inoculation, and at 0, 3, 5, 7, 9 and 11d after cancer cell inoculation. Cold pain threshold was measured at 3, 7, 9 and 11d after cancer cell inoculation. The animals were killed after measurement of pain threshold and L4-6, segment of spinal cord was removed for determination of GFAP and CD11b expression by Western blot. Results Compared with group S, mechanical pain threshold was significantly increased at 3-11 d after cancer cell inoculation in group BCP and PBS, and at 3 and S d after cancer cell inoculation in group M, and cold pain threshold was significantly increased at 7-11 d after cancer cell inoculation, and expression of CD11b and GFAP was up-regulated in group BCP, PBS and M ( P < 0.05) . Compared with group BCP, mechanical pain threshold was significantly decreased at 3-11 d after cancer cell inoculation, cold pain threshold was significantly decreased at 7-11 d after cancer cell inoculation, and expression of CD11b and GFAP was down-regulated in group M ( P <0.05) . ConclusionThe activiton of gliocyte in the spinal cord is involved in the development of bone cancer pian in mice.     

脊髓胶质细胞在小鼠骨癌痛形成中的作用

Objective To evaluate the role of gliocyte in the spinal cord in the development of bone cancer pain (BCP) in mice. Methods Forty male C3H/He mice aged 8-10 weeks weighing 18-22 g were randomly divided into 4 groups ( n = 10 each) : group I sham operation (group S) , group II BCP, group Ⅲ PBS and group IV minocyline (group M) . In group BCP, PBS and M, bone cancer pain was produced by injection of NCTC2472 fibrosarcoma cell suspension (2 x 105 cells) 10 μl into medullary cavity of calcaneus bone, while in group S, PBS solution 10 μl was injected instead of cancer cell suspension. In group PBS and M, PBS 5 μl and minocyline 5 μl (dissolved to 0.2 mmol/L in PBS)_were given IT immediately before cancer cell inoculation once a day for 11 consecutive days respectively. Mechanical pain threshold was measured at 1 d before cancer cell inoculation, and at 0, 3, 5, 7, 9 and 11d after cancer cell inoculation. Cold pain threshold was measured at 3, 7, 9 and 11d after cancer cell inoculation. The animals were killed after measurement of pain threshold and L4-6, segment of spinal cord was removed for determination of GFAP and CD11b expression by Western blot. Results Compared with group S, mechanical pain threshold was significantly increased at 3-11 d after cancer cell inoculation in group BCP and PBS, and at 3 and S d after cancer cell inoculation in group M, and cold pain threshold was significantly increased at 7-11 d after cancer cell inoculation, and expression of CD11b and GFAP was up-regulated in group BCP, PBS and M ( P < 0.05) . Compared with group BCP, mechanical pain threshold was significantly decreased at 3-11 d after cancer cell inoculation, cold pain threshold was significantly decreased at 7-11 d after cancer cell inoculation, and expression of CD11b and GFAP was down-regulated in group M ( P <0.05) . ConclusionThe activiton of gliocyte in the spinal cord is involved in the development of bone cancer pian in mice.     

脊髓IL-1β和TNF-α在胶质细胞活化诱发小鼠骨癌痛中的作用

目的 评价脊髓IL-1β和TNF-α在胶质细胞活化诱发小鼠骨癌痛中的作用.方法 雄性C3H/He小鼠360只,8～10周,体重18～22 g,随机分为6组(n=60):对照组(C组)、假手术组(S组)、骨癌痛+5μl人工脑脊液组(BCP组)、骨癌痛+0.5 nmol氟代柠檬酸组(FC组)、骨癌痛+16μg米诺四环素组(MI组)和骨癌痛+0.25 nmol FC+8 μg MI组(FC+MI组).S组左侧跟骨骨髓腔内仅注入10 μl α-MEN;BCP组、FC组、MI组和FC+MI组注入含有2×105个肿瘤细胞的10 μl α-MEN制备小鼠骨癌痛模型,各组于注射肿瘤细胞前即刻及注射后分别每天定时鞘内注射人工脑脊液、氟代柠檬酸、米诺四环素、氟代柠檬酸+米诺四环素1次,连续21 d.分别于注射肿瘤细胞前0.5 h(T0)、注射后3、5、7、10、14、21 d(T1-6)时采用von Frey细丝刺激足底测定机械痛阈,于T0,1,3,5,6时各组随机取12只小鼠处死取脊髓,采用ELISA法检测IL-1β和TNF-α的含量.结果 与T0时和C组比较,BCP组、FC组、MI组和Fc+MI组L1-6时机械痛阈降低,T1,3,5,6时IL-1β、T5,6时,TNF-α含量升高(P<0.05);与BCP组比较,MI组和FC+MI组T1-6时、FC组T4-6时机械痛阈升高,MI组和FC+MI组T1,3,5,6时、FC组T5,6时IL-1β含量降低,FC组、MI组和FC+MI组T5,6时TNF-α含量降低(P<0.05).结论 脊髓IL-lβ和TNF-α参与了胶质细胞活化诱发小鼠骨癌痛的过程.     

鞘内注射氟代柠檬酸和/或米诺四环素对骨癌痛小鼠疼痛及肿瘤的影响

目的 研究鞘内注射星形胶质细胞抑制剂氟代柠檬酸(fluorocitrate,FC)和/或小胶质细胞特异性抑制剂米诺四环素(minocycline,MI)对C3H/He小鼠跟骨癌性疼痛及肿瘤的影响.方法 将雄性C3H/He小鼠按配伍组设计随机法分为6组(n=20),包括:正常组、假手术组、癌痛+人工脑脊液组(artificial cerebrospinal fluid,ACSF)、癌痛+FC组、癌痛+MI组、癌痛+FC+MI组.术后每天给药1次,持续21 d,并于术前当天、术后3、5、7、10、14、21 d采用机械性痛觉过敏行为学及冷痛敏测定小鼠行为学变化,天平秤称量小鼠体重变化及组织切片HE染色观察肿瘤骨的骨质破坏程度.结果 术前当天各组小鼠的疼痛刺激缩足反应差异无统计学意义(P＞0.05);与正常组及基础值相比,术后3 d假手术组小鼠疼痛刺激缩足反应显著变化(P＞0.05);而癌痛组小鼠疼痛刺激缩足反应显著增加(P＜0.05).其中癌痛组内,与ACSF组相比,术后5 d MI组小鼠疼痛刺激缩足反应显著降低(P＜0.05);MI+FC组小鼠刺激性缩足反应也显著降低(P＜0.01);而FC组术后10 d小鼠刺激性缩足反应显著降低(P＜0.05).术前当天各组组间基础体重差异无统计学意义(P＞0.05).与正常组相比,假手术组和癌痛组小鼠的体重在术后3 d虽有所下降,但差异无统计学意义(P＞0.05).与正常组相比,术后21 d癌痛组小鼠体重显著降低(P＜0.05);与ACSF组相比,MI组、FC组及MI+FC组体重降低较少(P<0.05).同时间点内,癌痛各组间组织切片HE染色发现肿瘤的大小及骨的破坏程度差异无统计学意义.结论 鞘内同时注射氟代柠檬酸和/或米诺四环素明显降低癌痛小鼠的缩足反应,抑制其痛觉过敏或痛觉超敏的产生,改善骨癌痛小鼠体重的变化,但对肿瘤本身的生长及组织的破坏程度无影响.     

脊髓胶质细胞在小鼠骨癌痛形成中的作用

Objective To evaluate the role of gliocyte in the spinal cord in the development of bone cancer pain (BCP) in mice. Methods Forty male C3H/He mice aged 8-10 weeks weighing 18-22 g were randomly divided into 4 groups ( n = 10 each) : group I sham operation (group S) , group II BCP, group Ⅲ PBS and group IV minocyline (group M) . In group BCP, PBS and M, bone cancer pain was produced by injection of NCTC2472 fibrosarcoma cell suspension (2 x 105 cells) 10 μl into medullary cavity of calcaneus bone, while in group S, PBS solution 10 μl was injected instead of cancer cell suspension. In group PBS and M, PBS 5 μl and minocyline 5 μl (dissolved to 0.2 mmol/L in PBS)_were given IT immediately before cancer cell inoculation once a day for 11 consecutive days respectively. Mechanical pain threshold was measured at 1 d before cancer cell inoculation, and at 0, 3, 5, 7, 9 and 11d after cancer cell inoculation. Cold pain threshold was measured at 3, 7, 9 and 11d after cancer cell inoculation. The animals were killed after measurement of pain threshold and L4-6, segment of spinal cord was removed for determination of GFAP and CD11b expression by Western blot. Results Compared with group S, mechanical pain threshold was significantly increased at 3-11 d after cancer cell inoculation in group BCP and PBS, and at 3 and S d after cancer cell inoculation in group M, and cold pain threshold was significantly increased at 7-11 d after cancer cell inoculation, and expression of CD11b and GFAP was up-regulated in group BCP, PBS and M ( P < 0.05) . Compared with group BCP, mechanical pain threshold was significantly decreased at 3-11 d after cancer cell inoculation, cold pain threshold was significantly decreased at 7-11 d after cancer cell inoculation, and expression of CD11b and GFAP was down-regulated in group M ( P <0.05) . ConclusionThe activiton of gliocyte in the spinal cord is involved in the development of bone cancer pian in mice.     

脊髓胶质细胞在小鼠骨癌痛形成中的作用

Objective To evaluate the role of gliocyte in the spinal cord in the development of bone cancer pain (BCP) in mice. Methods Forty male C3H/He mice aged 8-10 weeks weighing 18-22 g were randomly divided into 4 groups ( n = 10 each) : group I sham operation (group S) , group II BCP, group Ⅲ PBS and group IV minocyline (group M) . In group BCP, PBS and M, bone cancer pain was produced by injection of NCTC2472 fibrosarcoma cell suspension (2 x 105 cells) 10 μl into medullary cavity of calcaneus bone, while in group S, PBS solution 10 μl was injected instead of cancer cell suspension. In group PBS and M, PBS 5 μl and minocyline 5 μl (dissolved to 0.2 mmol/L in PBS)_were given IT immediately before cancer cell inoculation once a day for 11 consecutive days respectively. Mechanical pain threshold was measured at 1 d before cancer cell inoculation, and at 0, 3, 5, 7, 9 and 11d after cancer cell inoculation. Cold pain threshold was measured at 3, 7, 9 and 11d after cancer cell inoculation. The animals were killed after measurement of pain threshold and L4-6, segment of spinal cord was removed for determination of GFAP and CD11b expression by Western blot. Results Compared with group S, mechanical pain threshold was significantly increased at 3-11 d after cancer cell inoculation in group BCP and PBS, and at 3 and S d after cancer cell inoculation in group M, and cold pain threshold was significantly increased at 7-11 d after cancer cell inoculation, and expression of CD11b and GFAP was up-regulated in group BCP, PBS and M ( P < 0.05) . Compared with group BCP, mechanical pain threshold was significantly decreased at 3-11 d after cancer cell inoculation, cold pain threshold was significantly decreased at 7-11 d after cancer cell inoculation, and expression of CD11b and GFAP was down-regulated in group M ( P <0.05) . ConclusionThe activiton of gliocyte in the spinal cord is involved in the development of bone cancer pian in mice.     

县级医院120例护理不良事件分析及对策

目的:通过分析县级医院护理不良事件的特点,探讨减少县级医院护理不良事件发生的方法及提高护理安全的有效措施。方法:总结2011年1-12月某县级二级甲等综合医院非惩罚性自愿上报的120例护理不良事件,分析发生率居前三位的护理不良事件类型及其发生的特点和原因。结果:在县级医院中,发生率居前三位的护理不良事件分别是给药错误、压疮、管路滑脱;不同班次、不同工作年限、不同职称的护士中,不良事件的发生率不同(P<0.05)。结论:基于县级医院的管理水平、技术能力、医疗设备的自身特点,其护理不良事件也具有相应的特点,护理管理者应根据县级医院的特点,对护理不良事件进行管理,以期达到减少不良事件的发生、提高护理安全的目的。     

单孔和双孔胸腔镜肺结节日间手术对患者术后疼痛和早期预后的影响

目的 回顾日间手术病房行单/双孔电视辅助胸腔镜肺结节手术患者术后数据,探究不同手术方式对患者术后疼痛和早期预后的影响。方法 回顾性分析集中管理模式下日间病房中693例胸腔镜肺结节日间手术患者的临床及随访资料,将患者分为单孔组和双孔组,并采用倾向性匹配平衡基线资料筛选出单孔组和双孔组各203例,分析两组患者术后疼痛和预后的差异。结果 单孔组相对双孔组术中芬太尼消耗量[0.5(0.35,0.50)mg vs. 0.5(0.40,0.50)mg,P=0.034]、瑞芬太尼消耗量[0.48(0.33,0.63)mg vs. 0.53(0.35,0.73)mg,P=0.031]、术中出血量[20(10,50)mL vs. 50(20,50)mL,P=0.001]、患者术后第3天疼痛评分[2(2,4)分vs. 3(2,4)分,P=0.007]降低,差异有统计学意义。两组患者在术后补救镇痛、胸腔引流量、住院时间以及术后第1、5、9、30天疼痛及咳嗽、术后30 d肺部并发症、非计划就诊方面差异无统计学意义（P> 0.05）。结论 与双孔胸腔镜相比,单孔胸腔镜肺结节日间手术是一项安全可行的术式,可...