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【目的】探究幼年大鼠经历外周神经损伤后不发生神经病理性疼痛反应的生理机制。【方法】出生10d或33d大鼠构建坐骨神经分支选择性损伤（SNI）诱导的神经病理性疼痛模型，术后7d检测后肢机械痛阈值并用实时荧光定量PCR检测脊髓白细胞介素-10（IL-10）和β-内啡肽前体阿黑皮素原（POMC）基因表达水平。出生10d幼年大鼠构建SNI模型后7d，连续3d鞘内注射生理盐水或IL-10抗体或β-内啡肽抗体，每次注射后1h检测后肢机械痛阈值。实时荧光定量PCR检测脊髓IL-10和POMC基因表达水平。【结果】与成年大鼠神经损伤后的表现相反，幼年大鼠SNI术后7d不表现疼痛超敏，脊髓IL-10和POMC基因表达升高。鞘内注射IL-10抗体和β-内啡肽抗体能够引发幼年大鼠机械痛超敏；鞘内注射IL-10抗体能拮抗SNI引起的幼年大鼠脊髓POMC基因表达升高，而相反注射β-内啡肽抗体则不影响IL-10基因的表达。【结论】幼年大鼠神经病理性疼痛反应缺失与其脊髓IL-10/β-内啡肽通路激活有关。

： GLP-1受体是B族G-蛋白偶联受体，主要分布于胰岛、肺、胃、小肠、肾脏、心脏和中枢神经系统。GLP-1 受体在外周通过促进血糖依赖式的胰岛素分泌和增加胰岛素敏感性参与血糖调节，在中枢神经系统参与神经保护 和镇痛。本文简述我们实验室最近发现的脊髓小胶质细胞GLP-1受体/IL-10/β-内啡肽通路及其与一些中草药镇 痛作用之间的关系。GLP-1，艾塞那肽和WB4-24激动脊髓GLP-1受体，通过cAMP/PKA/p38β/CREB信号转导通路 合成/表达IL-10，后者通过自分泌方式活化IL-10受体/STAT3通路合成/表达β-内啡肽，从而在多种慢性疼痛模型 产生显著镇痛作用。止痛中草药独一味通过激动脊髓背角小胶质细胞GLP-1受体/β-内啡肽通路产生镇痛作用。 以山栀子苷为代表的环烯醚萜苷包括京尼平苷、马钱子苷、梓醇和莫诺苷，是人和大鼠GLP-1受体正构性激动剂。 这些研究结果提示，脊髓GLP-1受体/IL-10/β-内啡肽通路可能是已被人体证明有效的治疗慢性疼痛新靶点。

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Objective: To investigate the effects of general anesthesia combined with epidural anesthesia on perioperative fibrinolysis function for patient with gastric cancer. Methods: From April 2013 to June 2015 in our hospital, 80 patients with gastric cancer who needed radical surgery were selected and equally divided into treatment group and control group, 40 patients each group. The patients in control group were given general anesthesia, and the patients in treatment group were given general anesthesia combined with epidural anesthesia. Then the indexes of haemodynamics, fibrinolytic function and the incidence of deep vein thrombosis of two groups were observed and compared. Results: All patients were completed the surgery, and the MAP and HR values in the patient after induction were statistically significant differences compared with before induction (P <0.05), but had no significant difference in comparison between the two groups (P>0.05), and the MAP and HR values after surgery were showed no significant difference in comparison within the group and between the two groups (P>0.05). The serum D-dimer and fibrinogen values in the times of induction 5 min and after surgery in the treatment group were significantly lower than that of the control group, and the differences were statistically significant compared with before induction (P<0.05). The incidence of deep vein thrombosis was 5.0%in the treatment group, and 17.5 %in the control group, and it was significantly lower in the treatment group than that of the control group (P<0.05). Conclusions: General anesthesia combined with epidural anesthesia in operative treatment of gastric cancer patients can improve perioperative fibrinolysis, thus reduce patients' hypercoagulable state, has good security and can effectively prevent the formation of deep vein thrombosis. [ABSTRACT FROM AUTHOR]

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