ABSTRACT
Objective @#To explore the expression of the μ⁃opioid receptor ( MOR) and the effects of intracellular vesicle transport on the MOR expression during endomorphin 2 ( EM2) analgesia. @*Methods @# Adult male SD rats were randomly divided into 3 groups : control (naive) group , neuropathic pain group and drug group. Spared nerve injury (SNI) induced neuropathic pain rats were employed as the pain model. The drug group rats were the SNI pain ones intrathecally injected with EM2. The methods of immunofluorescence single staining and Western blot were used to detect the expression of MOR total protein , phosphorylated protein and Rab7 protein. Immunofluorescence double staining was used to detect the expression of MOR/Rab7 and MOR/LAMP1 co⁃labeled immunoreactivity.@*Results @#Compared with the control group , the expression of total MOR protein and phosphorylated protein in the dorsal root ganglion (DRG) of the SNI pain rats decreased (P < 0. 05) , and the expression of Rab7 significantly increased (P < 0. 05) . The expression of MOR/Rab7 co⁃labeled immunoreactivity in Rab7 and MOR immunoreactive ( Ⅳir) products and MOR/LAMP1 co⁃labeled immunoreactivity in MOR and LAMP1 ⁃ir products both increased (P < 0. 05) . Multiple intrathecal injection of EM2 significantly increased paw withdrawal threshold in the SNI neuropathic pain rats (P < 0. 01) , the expression of MOR protein and phosphorylated protein in DRG was increased (P < 0. 05) , while the expression of Rab7 decreased (P < 0. 05) . Compared with the control group , the expression of MOR/Rab7 positive products in Rab7 and MOR positive ones decreased , and the expression of MOR/LAMP1 positive products in LAMP1 and MOR positive markers decreased ( P < 0. 05 ) . @*Conclusion @#In the process of analgesia , EM2 inhibits the expression of Rab7 in the DRG of SNI neuropathic pain rats , reduces the transport of MOR to lysosomes , and promotes the re⁃sensitization of MOR.
ABSTRACT
【Objective】 To construct a prediction model of severe obstructive sleep apnea (OSA) risk in the general population by using nomogram in order to explore the independent risk factors of severe OSA and guide the early diagnosis and treatment. 【Methods】 We retrospectively enrolled patients who had been diagnosed by polysomnography and divided them into training and validation sets at the ratio of 7∶3. Patients were divided into severe OSA group and non-severe OSA group according to apnea hypopnea index (AHI)>30. Variables entering the model were identified by least absolute shrinkage and selection operator regression model (Lasso), and logistic regression (LR) method. Then, multivariable logistic regression analysis was used to establish the nomogram, and the area under the receiver operating characteristic curve (AUC) was used to evaluate the discriminative properties of the nomogram model. Finally, we conducted decision curve analysis (DCA) of nomogram model, STOP-Bang questionnaire and Berlin questionnaire to assess clinical utility. 【Results】 Through single factor and multiple factor logistic regression analyses, the independent risk factors for severe OSA were screened out, including moderate and severe sleepiness, family history of hypertension, history of smoking, drinking, snoring, history of suffocation, sedentary lifestyle, male, age, body mass index (BMI), waist and neck circumference. Lasso logistic regression identified smoke, suffocation time, snoring time, waistline, Epworth sleepiness scale (ESS) and BMI as predictive factors for inclusion in the nomogram. The AUC of the model was 0.795 [95% confidence interval (CI): 0.769-0.820] . Hosmer-Lemeshow test indicated that the model was well calibrated (χ2=3.942, P=0.862). The DCA results on the visual basis confirmed that the nomogram had superior overall net benefits within a wide, practical threshold probability range which displayed the nomogram was higher than that of STOP-Bang questionnaire and Berlin questionnaire, which is clinically useful. The Clinical Impact Curve (CIC) analysis showed the clinical effectiveness of the prediction model when the threshold probability was greater than 82% of the predicted score probability value. The prediction model determined that the high-risk population with severe OSA was highly matched with the actual population with severe OSA, which confirmed the high clinical effectiveness of the prediction model. 【Conclusion】 The model performed better than STOP-Bang questionnaire and Berlin questionnaire in predicting severe OSA and can be applied to screening. And it can be helpful to the early diagnosis and treatment of OSA in order to reduce social burden.
ABSTRACT
Objective To analyze the effect of limited internal fixation contrasting micro -external fixator in the treatment of fractures around the hand.Methods Sixty patients with fractures around the hand treated in the First People′s Hospital of Huizhou from May 2015 to May 2017 were selected and randomly divided into the internal fixation group and the external fixation group,and then were treated with effective internal fixation and mini external fixator respectively.The curative effect,operation condition,postoperative recovery and complications of the two groups were compared.Results The treatment effect(excellent and good rate was 96.67%(29/30)),fracture recovery time((6.37 ± 1.25)weeks),hospitalization time((4.32 ±1.23)d)and postoperative complication rate(10.0%(3/30))in the external fixation group were superior to those in the internal fixation group(76.67%(23/30),(8.87 ± 2.12)weeks,(7.29 ± 2.15)d,33.3%(10/30)),the differences were statistically significant(P=0.032;t=15.459,P=0.005;t=17.788,P =0.001;P=0.012).However,there were no significant differences between the external fixation group and internal fixation group in the operation time and the blood loss during operation((28.41±2.87)min vs.(27.67±1.42)min;(16.87 ± 3.71)ml vs.(16.43 ± 2.89)ml)(t=2.459,P=0.423;t=1.788,P =0.619). Conclusion Compared with limited internal fixation,the mini external fixator is reliable and effective,with less complications,and is more conducive to the early activity and functional recovery of the patients with hand fractures.