RESUMO Antecedentes: A acupuntura é um tratamento para a dor neuropática, mas seu mecanismo permanece obscuro. Estudos anteriores mostraram que a analgesia foi induzida em ratos com dor neuropática quando o conteúdo de adenosina da medula espinhal aumentou após a eletroacupuntura (EA); no entanto, o mecanismo por trás desse aumento induzido por eletroacupuntura não foi esclarecido. Objetivo: Este estudo teve como objetivo determinar o papel que a ecto-5'-nucleotidase desempenha na analgesia induzida por EA para dor neuropática. Métodos: Realizamos eletroacupuntura no ponto de acupuntura de Zusanli no sétimo dia após estabelecer um modelo de rato de dor neuropática induzida por lesão de constrição crônica. Observamos o limiar de retirada mecânica e o limiar de dor térmica, e detectamos a expressão de ecto-5'-nucleotidase na medula espinhal usando Western blot. Modelos de ratos com lesão de constrição crônica foram injetados intraperitonealmente com α, β-metilenadenosina 5'-difosfato, um inibidor de ecto-5'-nucleotidase, 30 min antes da eletroacupuntura. O conteúdo de adenosina da medula espinhal foi detectado por meio de cromatografia líquida de alta eficiência. Por último, o agonista do receptor de adenosina A1 N6-ciclopentiladenosina foi injetado por via intratecal no edema lombar dos ratos, e a retirada mecânica e os limiares de dor térmica foram reavaliados. Resultados: Analgesia e aumento da expressão de ecto-5'-nucleotidase e conteúdo de adenosina na medula espinhal foram observados 1 h após a eletroacupuntura. α, β-metilenadenosina 5'-difosfato foi capaz de inibir a sobrerregulação do conteúdo de adenosina e analgesia induzida por eletroacupuntura. Após administração de N6-ciclopentiladenosina, a analgesia induzida por eletroacupuntura foi restaurada. Conclusões: Nossos resultados sugerem que a eletroacupuntura em Zusanli pode produzir analgesia em modelos de ratos com lesão de constrição crônica, possivelmente por meio do aumento da expressão de ecto-5'-nucleotidase induzida por eletroacupuntura, levando ao aumento da expressão de adenosina na medula espinhal.

ABSTRACT Background: Acupuncture is a treatment for neuropathic pain, but its mechanism remains unclear. Previous studies showed that analgesia was induced in rats with neuropathic pain when their spinal cord adenosine content increased after electroacupuncture (EA); however, the mechanism behind this electroacupuncture-induced increase has not been clarified. Objective: This study aimed to determine the role that ecto-5’-nucleotidase plays in EA-induced analgesia for neuropathic pain. Methods: We performed electroacupuncture at the Zusanli acupoint on the seventh day after establishing a rat model of neuropathic pain induced through chronic constriction injuries. We observed the mechanical withdrawal threshold and thermal pain threshold and detected the expression of ecto-5’-nucleotidase in the spinal cord using Western blot. Chronic constriction injury rat models were intraperitoneally injected with α,β-methyleneadenosine 5'-diphosphate, an ecto-5’-nucleotidase inhibitor, 30 min before electroacupuncture. The adenosine content of the spinal cord was detected using high-performance liquid chromatography. Lastly, the adenosine A1 receptor agonist N6-cyclopentyladenosine was intrathecally injected into the lumbar swelling of the rats, and the mechanical withdrawal and thermal pain thresholds were reevaluated. Results: Analgesia and increased ecto-5’-nucleotidase expression and adenosine content in the spinal cord were observed 1 h after electroacupuncture. α,β-methyleneadenosine 5'-diphosphate was able to inhibit upregulation of adenosine content and electroacupuncture-induced analgesia. After administration of N6-cyclopentyladenosine, electroacupuncture-induced analgesia was restored. Conclusions: Our results suggest that electroacupuncture at Zusanli can produce analgesia in chronic constriction injury rat models, possibly via the increased ecto-5’-nucleotidase expression induced through electroacupuncture, thus leading to increased adenosine expression in the spinal cord.

Abstract A number of complications have been ascribed to shoulder arthroscopy, but pulmonary edema is rarely reported. A 64-year-old female underwent right shoulder arthroscopic repair for supraspinatus and subscapular tears under intermuscular sulcus brachial plexus block (ISBPB) and general anesthesia. Finishing suture of torn tendon, and acromion and distal clavicle plasty, the patient represented the symptoms of dyspnea, and oxygen saturation quickly dropped to 80% without oxygen supply. After inhaled oxygen, the oxygen saturation quickly returned to 95%, while dyspnea didn’t improve. Noticing swelling in neck and chest, left movement of the trachea, low breath sounds and wet rales during auscultation, ultrasound examination was performed and found the obvious pleural slip, and a large number of b-lines in the lung, indicating pulmonary edema. After injection of furosemide and dexamethasone (i.v.), the outcome of patient was satisfactory. This is the first report of pulmonary edema as a complication of shoulder arthroscopy, which also reviews the relevant factors of fluid extravasation, and highlights the good use of the equipment at hand to quickly judge the patient's condition.

Abstract To observe the influence of thalidomide on tumor necrosis factor-a (TNF-α) of spontaneous type-2 diabetes rat (kk-Ay rat) model, and to explore the clinical value of TNF-a mediated inflammation approach to improve the injury on epithelial cell of kidney tubules. There are 30 kk-Ay rates being chosen to establish the Diabetic Nephropathy model and divided into thalidomide group and the model control group, 15 pieces for each group respectively. The levels of TNF-α, IL-1β, interleukin -6 (IL-6) and interleukin -18 (IL-18) of kk-Ay in the thalidomide group and the model control group were both at a higher level before treatment, but the difference was not statistically significant (P >0.05); The levels of TNF-α, IL-1β, interleukin -6 (IL-6) and interleukin -18 (IL-18) in kk-Ay rats 8/10/12 weeks after the treatment in the thalidomide group were significantly decreased, with statistically significant differences compared with the model control group (P < 0.05). The histopathological changes of kidney tubules epithelial cell injury on rats were observed through dissection. Thalidomide will effectively lower TNF-α and IL-1β expression levels in kk-Ay rat models, reduce inflammatory response, and thus improve damage on kidney tubules epithelial cell, which is worthy of further exploration and application.

ABSTRACT A closed-form analytical solution to rheological phenomena is obtained based on Hoek-Brown (HB) yield criterion and the generalized Bingham model. Once the circular tunnel is excavated, an initial plastic region is formed. When the total stresses fulfil the yield condition, the initial plastic region steps into the viscoplastic region, in which the displacement develops with time. The one-dimensional constitutive equation of the generalized Bingham model is transformed into a three-dimensional expression in polar coordinates by combining the plane strain condition. With the help of equilibrium differential equation, geometric equation and boundary condition, the stress and displacement in the initial plastic region can be expressed. At the moment of t, the stresses and displacements are described similar to the solutions of the elasto-plastic state. The stresses, strains and displacements after transformation can be expressed in the viscoplastic region. The proposed solution was verified by the closed-form solution of circular tunnels in elastic-brittle-plastic rock mass.