Volume 96  ·  Issue 41  ·  2016

One third of a person's life is spent in sleep. There is a close connection between the brain and sleep in neurological diseases. All types of sleep disorders can occur in Parkinson's disease (PD), Alzheimer's disease (AD), cerebrovascular disease, etc., including sleep breathing disorder, daytime drowsiness, insomnia, restless leg syndrome (RLS) /periodic leg movements (PMLS), rapid eye movement sleep behavior disorder (RBD), etc. Some are risk factors and precursors of these diseases, and a variety of sleep problems can occur after the disease, and affect the patient's short-term and long-term prognosis. In recent years, domestic clinicians have also noticed this problem, and there are special reports on sleep disorders at the annual academic meetings of Chinese Medical Association, Chinese Medical Doctors Association and other societies. This article takes cerebrovascular disease as an example to talk about the necessity of paying attention to sleep disorders.

To investigate the relation between cognition and serum calcium in the patients with Parkinson's disease (PD), analyze the related factors of cognition, and evaluate the correlation of serum calcium with specific cognitive domains.

A total of 77 patients with Parkinson's disease who was hospitalized in the Second Affiliated Hospital of Soochow University, from Dce 2013 to May 2015 were subjected to the cognitive, motor and depression function assessment, and the fasting blood calcium samples were collected from the PD patients and 75 normal control subjects. According to cognitive function, PD patients were divided into dementia group and without dementia group. Then the serum calcium levels of three groups and the related factors of the cognitive were analyzed by multiple linear regression.

(1) The level of serum calcium in PD group with dementia (2.21±0.09) mmol/L was significantly lower than the normal control group (2.30±0.09)mmol/L (P<0.001), and there was no difference between the level of serum calcium in PD group without dementia (2.27±0.13 mmol/L) and normal control group (P=0.144). The level of serum calcium in PD group with dementia was lower than PD group without dementia, and there was marked statistical significance (P=0.023). (2) In PD patients, the cognitive scores correlated with serum calcium levels, education, H-Y stages and Unified Parkinson's Disease Rating Scale (UPDRS) Ⅲ scores (P<0.05), but didn't with gender, age, disease duration, depression levels, Body Mass Index (BMI) and total equivalent levodopa doses (P>0.05). (3) In PD patients, serum calcium level correlated with the visuospatial and executive capability, calculation ability, language ability (P1=0.004; P2=0.027; P3=0.021).

(1) There is correlation between the serum calcium and the cognitive impairment. Lower serum calcium level predicts worse cognitive scores. (2) In PD patients, the change of the cognitive function is affected by their education, H-Y stages and UPDRSⅢ scores. (3) The serum calcium level of PD patients closely relates to the cognitive domain of the visuospatial and executive capability, calculation ability, and language ability.

To investigate the electrophysiological features of tremor intensity, frequency and frequency dispersion of Parkinsonian (PT group) and essential (ET group) tremors using accelerometry.

The amplitude, frequency and frequency dispersion of rest tremor, postural tremor and the influence of weight on tremor of 35 PT patients and 40 ET patients in Department of Neurology, the Second Affiliated Hospital Zhejiang University School of Medicine from May 2015 to April 2016 were retrospectively analyzed and compared. Data of the more and less trembling hands were statistically elaborated.

In resting, postural and loading states, PT amplitudes of the less affected hand were smaller than the more affected one. The less affected hand were (147±32), (142±36), (157±40)μV, the more affected hand were (185±41), (164±29), (190±33)μV, respectively; ET amplitudes of the less affected hand were also smaller than the more affected one, and the less affected hand were (149±33), (157±33), (169±43)μV, the more affected hand were (176±39), (189±39), (213±36)μV, respectively; PT frequencies of the less affected hand were faster than the more affected one, with the less affected hand (6.1±1.1), (6.4±1.7), (6.5±2.0)Hz, the more affected hand (5.4±1.3), (5.5±1.1), (5.7±1.1)Hz, respectively, but ET frequencies of the less affected hand were similar to the more affected one, with the less affected hand (6.5±1.3), (7.0±1.2), (7.2±1.5)Hz, the more affected hand (7.0±1.0), (7.3±1.0), (7.6±1.1)Hz, respectively; in resting and postural states, PT frequency dispersions of the less affected hand were broader than the more affected one, the less affected hand were (2.1±0.6), (2.4±1.1)Hz, respectively; the more affected hand were (1.6±0.8), (1.7±0.9)Hz, respectively. But in loading state, PT frequency dispersions were similar in both sides (2.3±1.2, 2.2±1.1)Hz; In resting, postural and loading states, ET frequency dispersions were also similar in both two sides, the less affected hand were (2.0±1.1), (2.2±0.9), (1.9±1.0)Hz, the more affected hand were (1.8±0.6), (1.9±0.8), (2.1±0.7)Hz.

Tremor intensity is significantly asymmetric both in PT and ET, while frequency and frequency dispersion are symmetric in ET but asymmetric in PT. Bilateral assessment of frequency related tremor parameters may be useful for differentiating ET from PT.

To evaluate the reliability and validity of Parkinson's disease sleep scale-Chinese version (CPDSS) through a study of a large PD population in southwest China, and to explore the prevalence and characteristics of sleep disorders in Parkinson's disease (PD) patients from southwest China.

A total of 544 PD patients and 220 control subjects were enrolled in our study. Demographic data, CPDSS, ESS, PDQ39, HAMD and H-Y stage were assessed in all subjects. Statistical description, Cronbach's alpha coefficient, intra-class correlation coefficient (ICC), Spearman rank correlation coefficient and Mann-Whitney U test were used for statistical analyses.

The Cronbach's alpha coefficient for CPDSS was 0.79, ICC of the total scale was 0.94 and ICC of each item ranged from 0.73 to 0.97. The factor analysis yielded a five-factor solution, which explained 63.4% of the total variance. Total and each item scores of CPDSS in PD patients were lower than those in healthy controls. 69.3% of PD patients had sleep disorder, while prevalence in the control group was only 29.6%. Negative correlation was found between CPDSS and ESS. Daytime sleepiness was the most common factor (35.9%) leading to sleep disorders. The sleep disorders of PD patients in Southwest China were significantly related with the course of disease, the severity of disease, the quality of life, depression, cognitive level and motor symptoms.

CPDSS has good feasibility, reliability and validity in PD population from southwest China. CPDSS is considered as an effective tool for the assessment of sleep disorder in PD patients.

To investigate the clinical characteristics and adverse pregnancy outcomes in pregnant women with new onset systemic lupus erythematosus (SLE) during pregnancy.

The clinical data of 263 pregnancies with SLE in the First Affiliated Hospital of Zhongshan University from 2001 to 2015 were collected and analyzed retrospectively.

Of all the 263 pregnancies, 188 were diagnosed before pregnancy and 75 were newly diagnosed during pregnancy. Among the 75 new onset SLE, 27, 31, 14 and 3 cases were diagnosed during first trimester, second trimester, third trimester and puerperium, respectively. Active lupus was noted in 81.3% of the patients with new onset SLE. The main clinical manifestations of new onset SLE were lupus nephritis (57.3%) and thrombocytopenia (38.7%). SLEPDAI scores as well as the prevalence of lupus nephritis, and thrombocytopenia in patients with new onset SLE was higher than those in the previously diagnosed ones (P<0.05). Among the 75 new onset SLE pregnancies, adverse pregnancy outcomesoccurred in 53 patients, including 34 with pregnancy loss, 15with premature, 8with intrauterine growth restriction, 5with fetal distress and5 with neonatal lupus. Compared with patients withnon-newonset SLE, patients with newonset SLEhad a higher prevalence of adverse pregnancy outcomes (56.4% vs 70.7%,P<0.05), and pregnancy loss (21.8% vs 45.3%,P<0.01) but less live birth (78.2% vs 54.7%,P<0.05).

Most of the patients with new onset SLE occurred during the first and second trimester. The most common clinical features of new onset SLE were lupus nephritis and thrombocytopenia. Patients with new onset SLE were more prone to active lupus, lupus nephritis and thrombocytopenia, as well as more adverse pregnancy outcomes and pregnancy loss.

To explore the changes of brain activity in traffic accident survivors with acute stress response within a week by using functional connectivity density (FCD) method.

A total of 20 traffic accidents survivors with acute stress disorders (acute stress disorder interview >3) and twenty healthy controls from Nanjing Jinling Hospital underwent the 3.0 T resting-state functional magnetic resonance imaging scan from January 2013 to February 2016. Functional connectivity density mapping was used to compare the brain functional connective networks between acute stress response survivors and controls. In additional, Pearson correlation was performed between abnormal short, long-range FCD values and clinical indices.

(1) Compared with controls, patients with acute stress response showed decreased short-range FCD in left ventromedial prefrontal cortex (-0.815±0.264 vs-0.468±0.615, t=-2.198, P<0.05), left hippocampal and parahippocampal gyri (-1.212±0.135 vs-0.887±0.234),t=-5.070, all P<0.05), and increased short-range FCD in right precentral gyrus(0.428±0.256 vs 0.016±0.298,t=4.456, P<0.05), left inferior parietal and superior parietal lobes (0.623±0.290 vs 0.143±0.300,t=4.878, allP<0.05); (2)compared with normal controls, ASR patients showed increased long-range FCD in left precuneus (0.502±0.400 vs-0.042±0.253,t=4.879, P<0.05); (3)the HAMA score of patients positively correlated with short-range FCD value of the left vmPFC (r=0.50, P<0.05).

The long-and short-range functional connectivity in frontal-limbic system is widely changed in survivors with acute stress response, especially the short-range FCD change more significantly, and partly correlated with the severity of their stress symptoms.

To explore the value of power Doppler ultrasonography (PDUS) in the early diagnosis of tibialis posterior tendon injury induced by rheumatoid arthritis (RA).

From January 2014 to December 2015, a total of 48 cases (60 feet) of RA tendinopathy group were selected as the research subjects from Guanghua Hospital; 12 cases(20 feet) of non-RA tendinopathy group and 10 cases (20 feet) of healthy volunteers were selected as control group.The blood flow signals of pannus were observed by PDUS to determine whether the tendon was injured or the degree of the injury. The following indexes were compared and analyzed by Chi-square testing: (1)positive rate of blood flow signal; (2)grade of blood flow signal; (3)spatial distribution of blood flow signal: diffusibility or local.

Of 70 cases(100 feet) in the study, the positive blood flow signals were only in the RA(88.3%) and non-RA group(40.0%) .Grade Ⅲ in RA was 20.0%, while this was not observed in non-RA . Grade Ⅱ in RA and non-RA was 36.7% and 10.0% , respectively. There were significant differences in the positive rate and grades between RA and non-RA group (P<0.01). The spatial distribution of blood flow signal in RA was significantly different from that in non-RA. In RA, they can be detected in the whole tendon.However, they were mainly distributed around the scaphoid in non-RA. In this study, three patients with grade Ⅲwere treated with surgery. The intraoperative findings were consistent with the preoperative ultrasound results.

PDUS can be used to detect the neovascular formation of tendon synovitis. It can detect the early tendon injury before the appearance of foot deformity induced by RA, which can guide clinical early intervention treatment and prevent the occurrence of deformity and other serious consequences.

To investigate the predictive value of dynamic enhanced MR synovial wash in rate (WASHIN) in progression to rheumatoid arthritis (RA) in patients with undifferentiated arthritis (UA).

The data of dynamic enhanced MR synovial WASHIN and C- reactive protein (CRP) of 33 patients with UA were analyzed between October 2014 and January 2016 from Tianjin First Center Hospital, so as to evaluate the correlation between the two indicators. According to the value of CRP, the patients were divided into two groups, the CRP>8 mg/L for CRP positive group (18 cases), CRP≤8 mg/L for CRP negative group (15 cases). Ranked sum test was used to compare the difference of WASHIN between two groups. The ROC curve analysis was carried out to test the diagnostic power of WASHIN.

In 33 patients with UA, the correlation between WASHIN and CRP was positive, r=0.767, P<0.01; as for the WASHIN, there was significant difference between CRP positive group(49.51±19.79)/s and CRP negative group(19.90±14.51)/s (P<0.01). 9 cases were clinically diagnosed with RA during follow-up, of which 8 cases for CRP positive group and 1 case for CRP negative group. The biggest area under the ROC curve of synovial WASHIN was 0.944, the biggest Youden index was 0.85, sensitivity was 100.0%, specificity was 87.5%. 2 cases were clinically diagnosed with osteoarthrosis during follow-up, synovial WASHIN respectively of 18.42 and 21.48 /s.

Synovial WASHIN can improve the sensitivity and specificity to predict the prognosis from UA to RA, and can provide certain guiding significance for clinical work.

To analyze the protein expression differences between colonized multidrug-resistant acinetobacter baumannii (MDR-AB) and infectious MDR-AB using comparative proteomics and matrix assisted laser desorption ionization time of flight mass spectrometry (MALDI-TOF MS) and to explore the molecular characteristics of MDR-AB infections.

A total of 59 MDR-AB strains including 23 of bloodstream infections MDR-AB and 36 of nasal, pharyngeal or environmental colonization MDR-AB were collected from Beijing Tongren Hospital between January 2008 and December 2011. MALDI-TOF MS cluster analysis was applied to identify the differences of protein expression between infection strains and colonization strains (including patient colonization and environmental colonization) of MDR-AB. Two-dimensional protein differences electrophoresis and MALDI-TOF-TOF MS were used to analyze the protein expression differences between bloodstream infection strain and nasal colonization strain isolated from the same patient.

ST92 was the main multiple locus sequence typing of 23 bloodstream infections MDR-AB. Cluster analysis showed that there were differences of protein fingerprint of MADLI-TOF MS between colonized and infectious MDR-AB. Proteomic differences were found between colonization strain and infection strain which were isolated from the same patient. And 9 major different protein spots were identified. They were trigger factor (score of identification was 10 218 and coverage rate was 44%), inosine-5'-monophosphate dehydrogenase (score of identification was 1 919 and coverage rate was 60%), phosphoglycerate kinase (score of identification was 947 and coverage rate was 49%), outer membrane protein 38 (score of identification was 572 and coverage rate was 23%) and so on.

There were differences of protein expression between MDR-AB infection strains and colonization strains. And such different proteins could provide experimental evidence for molecular markers research of MDR-AB infections.

To investigate the feature of antimicrobial resistance, homology and other molecular epidemiology of methicillin-resistant staphylococcus aureus(MRSA) in Department of Critical Care Medicine(ICU).

From October 2010 to December 2011, 149 strains of MRSA were collected and identified through sputum culture of patients from 10 ICUs of 10 teaching hospitals distributed in 9 chinese central city of China. Susceptibility testing to 18 kinds of antibiotic was performed, the method of pulsed field gel electrophoresis (PFGE) was used to analyze the homology, and the technique of multilocus sequencing typing (MLST) was used to identify the sequence type (ST).

Antibiotic susceptibility testing implied that vancomycin, daptomycin and linezolid are 100% sensitive to collected 149 strains of MRSA. Cotrimoxazole resistance rate is about 0-11.1%. Rifampicin resistant rate was less than 25% in 2 hospitals; the resistance rate of gentamicin and moxifloxacin were more than 80% besides of 50% to70% in 3 hospitals; beta lactam resistant rate was 100%. In 149 strains of MRSA, the main types of PFGE were J (28.9%), C (19.5%), G (10.7%), F (8%)types. J, C, G types mainly distributed in the North, while the F type only distributed in the Guiyang region. The MLST type: 8 ST types were determined ultimately. In which, was dominated by ST-239(67 strains, 45%), distributed in the South and North; followed by ST-5 (54 strains, 36.2%), mainly in the Northeast region (χ²=26.42, P<0.01).

Vancomycin, daptomycin and linezolid are 100% sensitive drugs to MRSA in ICU; Higher regional homology for MRSA were observed and it is probably that homologic disseminated infection exited in ICU. It is necessary to enhance continuous monitoring and take effective nosocomial infection control action to avoid MRSA homologic outbreak.

To evaluate the efficacy and safety of endovascular strategies for vertebrobasilar dissecting aneurysm (VBDA) and analyze advantages and disadvantages of different endovascular methods for the treatment of VBDA through long-term follow-up.

Retrospectively analyzing was used for the clinical information of 45 cases of vertebrobasilar dissecting aneurysms treated with endovascular methods in our department from January 2007 to December 2015. The treatment modalities were classified into reconstructive surgery and destructive surgery that were based on parent artery preservation. Reconstructive surgery included stent-assisted coil embolization (24 patients) and the placement of single or multiple overlapping stents (8 patients). Destructive surgery was coil embolization combined with proximal coil trapping of the dissected segment of the parent artery (CE+ PT, 13 patients).

The incidence of perioperative complications was 11.4%, and the mortality associated with these complications was 4.4%. In the patients undergoing reconstructive surgery, one patient suffered from aneurysm rerupture and died, one patient had intraoperative thrombi in the parent artery and resulted in a complete patency after thrombolysis was performed with Tirofiban. Both perioperative complications occurred in patients treated with stent-assisted coil embolization. No complications occurred in patients treated with single or multiple overlapping stents placements. Perioperative brainstem ischemia occurred in three patients who were treated with destructive surgery, and caused one death and two severe disabilities. Clinical outcome evaluations were performed using the Modified Rankin Scale and resulted in the following scores: 0-2 for 41 patients, 3-6 for 4 patients. The prognosis of reconstructive group was better than that of destructive group, with statistical differences (P<0.05). The incidence of perioperative complications in reconstructive group was lower than that in destructive group, without significant differences (P>0.05).

Endovascular treatment is effective and safe for VBDAs. The incidence of perioperative complication in reconstructive group is lower and the prognosis is better than that in destructive group.

To investigate the clinical efficacy, safety and promotion value of TB type thermal balloon endometrial ablation in the treatment of abnormal uterine bleeding.

Fourty three patients who had received TB type endometrial ablation system for treatment of abnormal uterine bleeding from January, 2015 to January, 2016 in theDepartment of gynecology, Beijing Chaoyang Hospital were enrolled in this study. The intra-operative and post-operative complications and improvement of abnormal uterine bleeding and dysmenorrhea were observed.

There were nointra-operative complication occurred, such as uterine perforation, massive hemorrhage or surrounding organ damage. At 6 months after operation, 32 patients developed amenorrhea, 6 developed menstrual spotting, 3 developed menstruation with a small volume and 1 had a normal menstruation. No menstruation with an increased volume occurred. The occurrence of amenorrhea was 76.19% and the response rate was 97.62%.At 6 months after operation, 1 case had no response, 2 cases had partial response and 11 cases had complete response among the 14 cases of pre-operative dysmenorrhea; only 3 cases still had anemia among the 23 cases of pre-operative anemia. Compared with before treatment, patients with dysmenorrhea and anemia both significantly reduced with a statistically significant difference(P<0.01).

TB type thermal balloon endometrial ablation has a significant efficacy with high safety for the treatment of abnormal uterine bleeding, which could have clinical promotion practice.

To compare the anesthesia effect between ultrasound-guided lower extremity nerve block and spinal anesthesia in ankle surgery.

Upon the approval of institutional Ethics Committee and informed consent, 80 patients American Society of Anesthesiology (ASA)Ⅰ-Ⅱaged 18-70 yr, undergoing ankle surgery from December 2014 to May 2015 in the Fifth Affiliated Hospital of Wen Zhou Medical College, were randomly divided by random numbers into two groups (n=40): nerve block group (group N) and spinal anesthesia (group S). The group N was combined with ultrasound-guided femoral nerve, obturator nerve, lateral femoral cutaneous nerve and sacral plexus block; group S was selected spinal anesthesia in the gap of L3-L4. Times of anesthesia procedure (T_r), sensory block (T_fb), motor block (T_mb), duration of sensory block (T_fr) and duration of motor block (T_mr) were recorded. The incidence of hypotension within 30 min after anesthesia and 24 hours postoperatively analgesic were also recorded. The effect of anesthesia was evaluated.

The T_r, T_fb, T_mb, T_fr and T_mr in group N and group S were (15.0±1.5), (11.2±1.2), (13.4±1.4), (816.0±112.9), (432.0±138.9)min and (8.7±1.2), (2.3±0.6), (3.8±1.1), (436.7±130.5), (320.0±34.6)min, respectively. T_r, T_fb, T_mb, T_fr and T_mr in group N were significantly longer than that in group S (t=20.742, 41.945, 34.101, 13.901, 4.948, all P<0.05). There was no significant difference in the incidences of hypotension within 30 min after anesthesia (0 vs 7.5%,P>0.05). The incidence of 24 hours postoperatively analgesic in group N were significantly lower than that in group S (45.0% vs 77.5%,P<0.05). Compared with group S, there was no significant difference in the percentage of anesthetic effect reached gradeⅠ(95% vs 100%,P>0.05) in group N.

Ultrasound-guided nerve block could be safe and effective in patients undergoing ankle surgery, and postoperative analgesia time of nerve block is longer than that of spinal anesthesia.

To explore the manual operation skills of operative treatment of ipsilateral Hawkins Ⅲ talus neck and ankle joint fractures via internal and lateral approaches with Herbert screws, and to study the clinical results.

From Jan 2009 to Dec 2014, the clinical data of 13 patients with ipsilateral Hawkins Ⅲ talus neck and ankle joint fractres via internal and lateral approaches with Herbert screws were retrospectively analyzed in our department.There were 10 males and 3 female, ranging in age from 20 to 60 years with an average age of 31.5 years.The fractures occurred on the right side in 9 patients and on the left side in 4 patients.Three cases had the complication of medial malleolar fracture.Ten cases had the complication of medial and lateral malleolar fracture. Totally 11 cases were made calcaneal skeletal traction, and all the were made CT with three-dimensional image reconstruction.Two cases were treated with emergency operation.Eleven cases were treated with selective operation.The operation time was 5 hours-10 days after injury. The functional results were evaluated by American Orthopaedic Foot and Ankle Society (AOFAS).

The average duration of follow-up was 22.6 months (range, 14-65 months). There was skin necrosis in one cases, no incision infection, malunion and nonunion of the fractures and loss of reduction. At final follow-up, AOFAS ankle score was 75.2 (range, 42 to 93), higher than preoperative 39.2 (range, 23 to 60), the difference was statistically significant (P=0.023). The result was excellent in 4 cases, good in 5 cases, fair in 3 cases and 1 cases in poor, and the overall excellent or good rate was 69.2%. Avascular necrosis occurred in 3 cases (23.1%, 3/13). Traumatic arthritis was found in 5 cases (38.5%, 5/13), involved tibial astragaloid joint in 2 cases, involved subtalar joint in 1 case, involved tibial astragaloid joint and subtalar joint in 2 cases.

The effect of surgical treatment for ipsilateral Hawkins Ⅲ talus neck and ankle joint fractures via internal and lateral approaches with Herbert screws is satisfactory.Correct operative approach and pay more attention to protect blood circulation of intraoperative, anatomical precision and strong reduction and fixation are the key to achieve and gain better long-term results for the surgical treatment of ipsilateral Hawkins Ⅲ talus neck and ankle joint fractures.

Parkinson's disease (Parkinson's disease) is a neurodegenerative disease common in middle-aged and elderly people. It is mainly characterized by progressive degeneration of dopaminergic neurons in substantia nigra and pathological changes of Lewy body formation, biochemical changes such as reduction of dopamine transmitters in the striatum area and imbalance of dopamine and acetylcholine transmitters. Clinically, it is characterized by motor symptoms such as quiescent tremor, bradykinesia and myotonia, and non-motor symptoms such as anosmia, constipation, abnormal sleep behavior and depression. The overall prevalence rate of people over 65 years of age in China is 1700/100,000, and it increases with age, which brings a heavy burden to families and society^[1]。 Up to now, levodopa (LD) is still the gold standard drug for the treatment of Parkinson's disease. However, with the development of the disease, long-term levodopa administration will cause motor complications, such as symptom fluctuation, dyskinesia and other non-motor complications. Among them, levodopa-induced dyskinesia (LID) is one of the common long-term motor complications.

mesenchymal stem cells (MSCs) refer to adult stem cells derived from mesoderm. They are widely present in various tissues, and are relatively abundant in bone marrow and cord blood. They can be differentiated into osteoblasts, chondrocytes, adipocytes, cardiomyocytes, etc^[1]。 MSCs have the characteristics of high self-renewal ability, weak immunogenicity, easy isolation, culture, expansion in vitro, and easy introduction of foreign genes. MSCs also have the ability to chemotaxis to the site of inflammatory damage, so MSCs have shown broad application prospects in cell therapy and gene therapy. The microenvironment of solid tumors is very similar to that of damaged tissues, and both contain a large number of inflammatory cells and inflammatory factors, such as tumor necrosis factor (TNF) -α, interferon (IFN) -γ, interleukin (IL) -6, IL-8, macrophages, mast cells, etc^[2,3,4,5,6]。 MSCs can chemotaxis to small tumor foci and proliferate and differentiate into important components of tumor stroma^[7]。 Taking advantage of the characteristics that MSCs can specifically migrate to tumor sites, MSCs can be used as vectors for tumor therapy, and various genes that have inhibitory effect on tumor can be transfected into MSCs through viral vectors to inhibit or even kill tumors.

As a pure opioid receptor antagonist, naloxone can reverse all the effects mediated by opioid M, β and κ receptors. It is often used clinically to rescue acute alcoholism, reverse overdose of opioid receptor agonist or its related adverse reactions, and counter the adverse reactions mediated by endogenous opioid peptide release under stress conditions. Naloxone is mostly used in conventional doses in these aspects, but it is worth noting in clinical practice that when it is used to antagonize opioid-related adverse reactions, the analgesic effect of the latter will also be partially or completely reversed, thus causing hyperalgesia. Especially for patients who have been treating chronic pain with opioid receptor agonists for a long time, due to the phenomenon of opioid tolerance and dependence, they even have opioid withdrawal symptoms (autonomic nervous system hyperactivity and psychomotor anxiety, etc.) when using naloxone to treat opioid adverse reactions. In this case, it is particularly important to seek effective solutions to alleviate the adverse reactions without reducing the analgesic efficacy of opioid receptor agonists.