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1Osteoarticular manifestations of human brucellosis:A review显示文摘Brucellosis is a common global zoonotic disease, which is responsible for a range of clinical manifestations. Fever, sweating and musculoskeletal pains are observed in most patients. The most frequent complication of brucellosis is osteoarticular involvement, with 10% to 85% of patients affected. The sacroiliac(up to 80%) and spinal joints(up to 54%) are the most common affected sites.Spondylitis and spondylodiscitis are the most frequent complications of brucellar spinal involvement. Peripheral arthritis, osteomyelitis, discitis, bursitis and tenosynovitis are other osteoarticular manifestations, but with a lower prevalence. Spinal brucellosis has two forms: focal and diffuse. Epidural abscess is a rare complication of spinal brucellosis but can lead to permanent neurological deficits or even death if not treated promptly. Spondylodiscitis is the most severe form of osteoarticular involvement by brucellosis, and can have single-or multifocal involvement. Early and appropriate diagnosis and treatment of the disease is important in order to have a successful management of the patients with osteoarticular brucellosis. Brucellosis should be considered as a differential diagnosis for sciatic and back pain, especially in endemic regions. Patients with septic arthritis living in endemic areas also need to be evaluated in terms of brucellosis. Physical examination, laboratory tests and imaging techniques are needed to diagnose the disease. Radiography, computed tomography, magnetic resonance imaging(MRI) and bone scintigraphy are imaging techniques for the diagnosis of osteoarticular brucellosis. MRI is helpful to differentiate between pyogenic spondylitis and brucellar spondylitis. Drug medications(antibiotics)and surgery are the only two options for the treatment and cure of osteoarticular brucellosis.Seyed Mokhtar Esmaeilnejad-Ganji Seyed Mohammad Reza Esmaeilnejad-Ganji 2019World Journal of Orthopedics2019,10,2:52
2三个中文版神经病理性疼痛诊断量表的制定与多中心验证显示文摘目的:制定并验证三个中文版神经病理性疼痛诊断量表LANSS(LeedsAssessment ofNeuro-pathic Symptoms and Signs,LANSS)、NPQ(Neuropathic Pain Questionnaire,NPQ)和ID pain。方法:1.制定中文版LANSS、NPQ和ID pain:两名中文为母语、英文流畅的翻译人员,各自将LANSS、NPQ和ID pain翻译成中文。将这两份翻译版本综合成第一个中文版本。另两名英文为母语、中文流畅的翻译人员,各自将第一个中文版本再翻译回英文。然后比较原版LANSS、NPQ和ID pain和翻译成英文的LANSS、NPQ和ID pain。每一个不一致的地方都要认真分析,有必要的话修改中文版本得到第二个中文版本。经预实验和专家讨论后得出最终中文版本。2.验证中文版LANSS、NPQ和ID pain:共十家中心参与研究,每个中心神经病理性疼痛患者7例,伤害感受性疼痛患者7例。入选的患者自行填写NPQ和ID pain量表,必要时由调查者为患者解释量表中的问题。LANSS量表由调查者询问患者并进行填写。3.分析量表的信度(使用Cronbach'sAlpha系数和Guttman分半系数分析组内一致性)和效度(表面效度、ROC曲线下面积、敏感度、特异度、阳性预测值和阴性预测值)。结果:经10个研究中心的专家评价,3个量表的表面效度好。中文版LANSS、NPQ和ID pain的信度好。中文版LANSS和ID pain的效度好。结论:中文为母语的患者可以使用本研究制定并验证的中文版LANSS和ID pain量表作为神经病理性疼痛的诊断工具。李君 冯艺 韩济生 樊碧发 王家双 魏星 刘慧 银燕 吴大胜 刘娜 宫小文 金毅 刘红军 张达颖 章勇 林建 槐洪波 傅志俭 赵序利 杜冬萍 徐永明 阎龙涛 毛鹏 2011中国疼痛医学杂志2011,17,9:39
3Pathophysiology, diagnosis, and treatment of discogenic low back pain显示文摘Discogenic low back pain is a serious medical and social problem, and accounts for 26%-42% of the patients with chronic low back pain. Recent studies found that the pathologic features of discs obtained from the patients with discogenic low back pain were the formation of the zones of vascularized granulation tissue, with extensive innervation in fissures extending from the outer part of the annulus into the nucleus pulposus. Studies suggested that the degeneration of the painful disc might originate from the injury and subsequent repair of annulus fibrosus. Growth factors such as basic fibroblast growth factor, transforming growth factor β1, and connective tissue growth factor, macrophages and mast cells might play a key role in the repair of the injured annulus fibrosus and subsequent disc degeneration. Although there exist controversies about the role of discography as a diagnostic test, provocation discography still is the only available means by which to identify a painful disc. A recent study has classified discogenic low back pain into two types that were annular disruption-induced low back pain and internal endplate disruption-induced low back pain, which have been fully supported by clinical and theoretical bases. Current treatment options for discogenic back pain range from medicinal anti-inflammation strategy to invasive procedures including spine fusion and recently spinal arthroplasty. However, these treatments are limited to relieving symptoms, with no attempt to restore the disc's structure. Recently, there has been a growing interest in developing strategies that aim to repair or regenerate the degenerated disc biologically.Bao-Gan Peng 2013World Journal of Orthopedics2013,4,2:40
4Diabetic neuropathic pain:Physiopathology and treatment显示文摘Diabetic neuropathy is a common complication of both type 1 and type 2 diabetes,which affects over 90% of the diabetic patients.Although pain is one of the main symptoms of diabetic neuropathy,its pathophysiological mechanisms are not yet fully known.It is widely accepted that the toxic effects of hyperglycemia play an important role in the development of this complication,but several other hypotheses have been postulated.The management of diabetic neuropathic pain consists basically in excluding other causes of painful peripheral neuropathy,improving glycemic control as a prophylactic therapy and using medications to alleviate pain.First line drugs for pain relief include anticonvulsants,such as pregabalin and gabapentin and antidepressants,especial y those that act to inhibit the reuptake of serotonin and noradrenaline.In addition,there is experimental and clinical evidence that opioids can be helpful in pain control,mainly if associated with first line drugs.Other agents,including for topical application,such as capsaicin cream and lidocaine patches,have also been proposed to be useful as adjuvants in the control of diabetic neuropathic pain,but the clinical evidence is insufficient to support their use.In conclusion,a better understanding of the mechanisms underlying diabetic neuropathic pain will contribute to the search of new therapies,but also to the improvement of the guidelines to optimize pain control with the drugs currently available.Anne K Schreiber Carina FM Nones Renata C Reis Juliana G Chichorro Joice M Cunha 2015World Journal of Diabetes2015,6,3:34
5Effect of local wound infiltration with ropivacaine on postoperative pain relief and stress response reduction after open hepatectomy显示文摘AIM To prospectively evaluate the effect of local wound infiltration with ropivacaine on postoperative pain relief and stress response reduction after open hepatectomy.METHODS A total of 56 patients undergoing open hepatectomy were randomly divided into two groups:a ropivacaine group(wound infiltration with ropivacaine solution)and a control group(infiltration with isotonic saline solution).A visual analog scale(VAS)at rest and on movement was used to measure postoperative pain for the first 48 h after surgery.Mean arterial pressure(MAP),heart rate(HR),time to bowel recovery,length of hospitalization after surgery,cumulative sufentanil consumption,and incidence of nausea and vomiting were compared between the two groups.Surgical stress hormones(epinephrine,norepinephrine,and cortisol)were detected using enzyme-linked immunosorbent assay,and the results were compared. RESULTS VAS scores both at rest and on movement at 24 h and48 h were similar between the two groups.Significantly lower VAS scores were detected at 0,6,and 12 h in the ropivacaine group compared with the control group(P<0.05 for all).MAP was significantly lower at 6,12,and 24 h(P<0.05 for all);HR was significantly lower at 0,6,12,and 24 h(P<0.05 for all);time to bowel recovery and length of hospitalization after surgery(P<0.05 for both)were significantly shortened;and cumulative sufentanil consumption was significantly lower at 6,12,24,and 36 h(P<0.05 for all)in the ropivacaine group than in the control group,although the incidence of nausea and vomiting showed no significant difference between the two groups.The levels of epinephrine,norepinephrine,and cortisol were significantly lower in the ropivacaine group than in the control group at 24 and 48 h(P<0.01 for all). CONCLUSION Local wound infiltration with ropivacaine after open hepatectomy can improve postoperative pain relief,reduce surgical stress response,and accelerate postoperative recovery.Jing-Xian Sun Ke-Yun Bai Yan-Feng Liu Gang Du Zhi-Hao Fu Hao Zhang Jin-Huan Yang Ben Wang Xiu-Yu Wang Bin Jin 2017World Journal of Gastroenterology2017,23,36:25
6Subchondral bone microenvironment in osteoarthritis and pain显示文摘Osteoarthritis comprises several joint disorders characterized by articular cartilage degeneration and persistent pain,causing disability and economic burden.The incidence of osteoarthritis is rapidly increasing worldwide due to aging and obesity trends.Basic and clinical research on osteoarthritis has been carried out for decades,but many questions remain unanswered.The exact role of subchondral bone during the initiation and progression osteoarthritis remains unclear.Accumulating evidence shows that subchondral bone lesions,including bone marrow edema and angiogenesis,develop earlier than cartilage degeneration.Clinical interventions targeting subchondral bone have shown therapeutic potential,while others targeting cartilage have yielded disappointing results.Abnormal subchondral bone remodeling,angiogenesis and sensory nerve innervation contribute directly or indirectly to cartilage destruction and pain.This review is about bone-cartilage crosstalk,the subchondral microenvironment and the critical role of both in osteoarthritis progression.It also provides an update on the pathogenesis of and interventions for osteoarthritis and future research targeting subchondral bone.Yan Hu Xiao Chen Sicheng Wang Yingying Jing Jiacan Su 2021Bone Research2021,9,3:24
7Rubber band ligation of hemorrhoids: A guide for complications显示文摘Rubber band ligation is one of the most important, costeffective and commonly used treatments for internal hemorrhoids. Different technical approaches were developed mainly to improve efficacy and safety. The technique can be employed using an endoscope with forward-view or retroflexion or without an endoscope, using a suction elastic band ligator or a forceps ligator. Single or multiple ligations can be performed in a single session. Local anaesthetic after ligation can also be used to reduce the post-procedure pain. Mild bleeding, pain, vasovagal symptoms, slippage of bands, priapism, difficulty in urination, anal fissure, and chronic longitudinal ulcers are normally considered minor complications, more frequently encountered. Massive bleeding, thrombosed hemorrhoids, severe pain, urinary retention needing catheterization, pelvic sepsis and death are uncommon major complications. Mild pain after rubber band ligation is the most common complication with a high frequency in some studies. Secondary bleeding normally occurs 10 to 14 d after banding and patients taking anti-platelet and/or anti-coagulant medication have a higher risk, with some reports of massive life-threatening haemorrhage. Several infectious complications have also been reported including pelvic sepsis, Fournier's gangrene, liver abscesses, tetanus and bacterial endocarditis. To date, seven deaths due to these infectious complications were described. Early recognition and immediate treatment of complications are fundamental for a favourable prognosis.Andreia Albuquerque 2016World Journal of Gastrointestinal Surgery2016,8,9:22
8Data mining in Xu Runsan’s Traditional Chinese Medicine practice:treatment of chronic pelvic pain caused by pelvic inflammatory disease显示文摘OBJECTIVE:To research the Traditional Chinese Medicine(TCM)practice of Professor Xu Runsan for treatment of chronic pelvic pain(CPP)caused by sequelae of pelvic inflammatory disease(SPID)by data mining.METHODS:The medical records of inpatients at China-Japan Friendship Hospital confirmed to have CPP caused by SPID were collected(274 visits in total).The data extracted from the medical records were analyzed by frequency statistics,correlation analyses,cluster analyses,and complex network analyses.RESULTS:The most frequently used medicines were warm medicines,bitter medicines,and medicines distributed to the liver meridian.The most common medicinal combinations were Chishao(Radix Paeoniae Rubra)plus Huangqi(Radix Astragali Mongolici)plus Sanqi(Radix Notoginseng)and Ezhu(Rhizoma Curcumae Phaeocoulis);Guizhi(Ramulus Cinnamomi)plus Fuling(Poria)and Chishao(Radix Poeoniae Rubra);and Chaihu(Radix Bupleuri Chinensis)plus Zhishi(Fructus Aurantii Immaturus)and Gancao(Radix Glycyrrhizae).The most frequently used medicines were divided into four groups according to their efficacy;i.e.,medicines that could(a)warm meridians and free collateral vessels,(b)regulate Qi and free collateral vessels,(c)fortify the spleen and nourish blood and Qi,and(d)tonify Qi and activate blood.The most commonly used formulations were Guizhi FulingPill and Sini Powder.The core medicines extracted based on complex network analyses were Chishao(Radix Poeoniae Rubra),Sanqi(Radix Notoginseng),Hua ngqi(Radix Astragali Mongolica),Danshen(Radix Salviae Miltiorrhizae),Ezhu(Rhizoma Curcumae Phaeocaulis), Gancao(Radix Glycyrrhizae),Chaihu(Radix Bupleuri Chinensis),Guizhi(Romulus Cinnomomi),Shuizhi(Hirudo), Fuling(Poria),and Zhishi(Fructus Aurantii Immaturus).CONCLUSION:According to the TCM practice of Professor Xui,treatment of CPP caused by SPID should focus on dissolving stasis and obstructions using medicines that can activate blood,resolve stasis,regulate Qi,and dissipate adhesions.His prescriptions are often based on Guizhi Fuling Pill and Sini Powder.More blood-activating,stasis-resolving,or tonifying medicines could be used according to the accompanying symptoms or symptom patterns identified.Liu Liuqing Yang Fang Xin Ling Jing Yan 2019Journal of Traditional Chinese Medicine2019,39,3:20
9Perioperative pain control after total knee arthroplasty: An evidence based review of the role of peripheral nerve blocks显示文摘Over the last decades,the number of total knee arthroplasty procedures performed in the United States has been increasing dramatically.This very successful intervention,however,is associated with significant postoperative pain,and adequate postoperative analgesia is mandatory in order to allow for successful rehabilitation and recovery.The use of regional anesthesia and peripheral nerve blocks has facilitated and improved this goal.Many different approaches and techniques for peripheral nerve blockades,either landmark or,more recently,ultrasound guided have been described over the last decades.This includes but is not restricted to techniques discussed in this review.The introduction of ultrasound has improved many approaches to peripheral nerves either in success rate and/or time to block.Moreover,ultrasound has enhanced the safety of peripheral nerve blocks due to immediate needle visualization and as consequence needle guidance during the block.In contrast to patient controlled analgesia using opioids,patients with a regional anesthetic technique suffer from fewer adverse events and show higher patient satisfaction;this is important as hospital rank-ings and advertisement have become more common worldwide and many patients use these factors in order to choose a certain institution for a specific procedure.This review provides a short overview of currently used regional anesthetic and analgesic techniques focusing on related implications,considerations and outcomes.Thomas Danninger Mathias Opperer Stavros G Memtsoudis 2014World Journal of Orthopedics2014,5,3:20
10Mechanism of electroacupuncture on inflammatory pain: neural-immune-endocrine interactions显示文摘Nociceptive signals are transmitted by peripheral afferents to the central nervous system under pain condition, a process that involves various neurotransmitters and pathways. Electroacupuncture (EA) has been widely used as a pain management technique in clinical practice. Emerging studies have shown that EA can inhibit the induction and transmission of pain signals and, consequently, mediate anti-nociceptive and anti-inflammatory effects by rebalancing the neural-immune-endocrine interactions. This review summarizes the neural-immune- endocrine circuit including peripheral afferent and central efferent, contributing to EA-induced neuroimmune and neuroendocrine modulation in inflammatory pain models. The peripheral afferent circuit includes crosstalk among immune cells, inflammatory cytokines, peripheral nociceptors. In central efferent primarily involves the neuroinflammatory interactions between spinal nociceptive neurons and glial cells. Furthermore, the hypothalamic- pituitary-adrenal axis, sympathetic and vagal nervous may serve as an essential pathway involved in the mechanism of acupuncture-mediated analgesia within the interactions of the central, immune and endocrine systems. Overall, this review focuses on the interactions of neural-immune-endocrine in inflammatory pain, which may be underlying the mechanism of EA-induced anti-inflammatory and antinociceptive effect.Li Yuan Yang Mingxiao Wu Fan Cheng Ke Chen Haiyong Shen Xueyong Lao Lixing 2019Journal of Traditional Chinese Medicine2019,39,5:20
11Early phase of acute pancreatitis: Assessment and management显示文摘Acute pancreatitis(AP) is a potentially life-threatening disease with a wide spectrum of severity. The overall mortality of AP is approximately 5%. According to the revised Atlanta classification system, AP can be classified as mild, moderate, or severe. Severe AP often takes a clinical course with two phases, an early and a late phase, which should both be considered separately. In this review article, we first discuss general aspects of AP, including incidence, pathophysiology, etiology, and grading of severity, then focus on the assessment of patients with suspected AP, including diagnosis and risk stratification, followed by the management of AP during the early phase, with special emphasis on fluid therapy, pain management, nutrition, and antibiotic prophylaxis.Veit Phillip Jrg M Steiner Hana Algül 2014World Journal of Gastrointestinal Pathophysiology2014,5,3:19
12Novel multimodal analgesia regimen improves post-TACE pain in patients with hepatocellular carcinoma显示文摘Backgroud: Transarterial chemoembolization(TACE) is the primary palliative treatment for patients with unresectable hepatocellular carcinoma(HCC). However, it is often accompanied by postoperative pain which hinder patient recovery. This study was to examine whether preemptive parecoxib and sufentanilbased patient controlled analgesia(PCA) could improve the pain management in patients receiving TACE for inoperable HCC. Methods: From June to December 2016, 84 HCC patients undergoing TACE procedure were enrolled. Because of the willingness of the individuals, it is difficult to randomize the patients to different groups. We matched the patients' age, gender and pain scores, and divided the patients into the multimodal group( n = 42) and control group( n = 42). Patients in the multimodal group received 40 mg of parecoxib, 30 min before TACE, followed by 48 h of sufentanil-based PCA. Patients in the control group received a routine analgesic regimen, i.e., 5 mg of dezocine during operation, and 100 mg of tramadol or equivalent intravenous opioid according to patient's complaints and pain intensity. Postoperative pain intensity, percentage of patients as per the pain category, adverse reaction, duration of hospital stay, cost-effectiveness, and patient's satisfaction were all taken into consideration when evaluated. Results: Compared to the control group, the visual analogue scale scores for pain intensity was significantly lower at 2, 4, 6, and 12 h(all P < 0.05) in the multimodal group and a noticeably lower prevalence of post-operative nausea and vomiting in the multimodal group(31.0% vs. 59.5%). Patient's satisfaction in the multimodal group was also significantly higher than that in the control group(95.2% vs. 69.0%). No significant difference was observed in the duration of hospital stay between the two groups. Conclusion: Preemptive parecoxib and sufentanil-based multimodal analgesia regime is a safe, efficient and cost-effective regimen for postoperative pain control in HCC patients undergoing TACE.Jian-Guo Guo Lu-Ping Zhao Yue-Feng Rao Yin-Ping Gao Xue-Jiao Guo Tan-Yang Zhou Zhi-Ying Feng Jun-Hui Sun Xiao-Yang Lu 2018Hepatobiliary & Pancreatic Diseases International2018,17,6:18
13Anterior knee pain following primary total knee arthroplasty显示文摘Despite improvements in technique and technology for total knee arthroplasty(TKA),anterior knee pain impacts patient outcomes and satisfaction.Addressing the prosthetic and surgical technique related causes of pain after TKA,specifically as it relates to anterior knee pain,can aid surgeons in addressing these issues with their patients.Design features of the femoral and patellar components which have been reported as pain generators include: Improper femoral as well as patellar component sizing or designs that result in patellofemoral stuffing; a shortened trochlear groove distance from the flange to the intercondylar box; and then surgical technique related issues resulting in: Lateral patellar facet syndrome; overstuffed patella/flange combination; asymmetric patellar resurfacing,improper transverse plane component rotation resulting in patellar subluxation/tilt.Any design consideration that allows impingement of extensor mechanism anatomical elements has the possibility of impacting outcome by becoming a pain generator.As the number of TKA procedures continues to increase,it is increasingly critical to develop improved,evidence based prostheses that maximize function and patient satisfaction while minimizing pain and other complications.David Shervin Katelyn Pratt Travis Healey Samantha Nguyen William M Mihalko Mouhanad M El-Othmani Khaled J Saleh 2015World Journal of Orthopedics2015,6,10:15
14Effectiveness and safety of continuous wound infiltrationfor postoperative pain management after open gastrectomy显示文摘AIM: To prospectively evaluate the effectiveness and safety of continuous wound infiltration(CWI) for pain management after open gastrectomy. METHODS: Seventy-five adult patients with American Society of Anesthesiologists(ASA) Physical Status Classification System(ASA) grade 1-3 undergoing open gastrectomy were randomized to three groups. Group 1 patients received CWI with 0.3% ropivacaine(group CWI). Group 2 patients received 0.5 mg/m L morphine intravenously by a patient-controlled analgesia pump(PCIA)(group PCIA). Group 3 patients received epidural analgesia(EA) with 0.12% ropivacaine and 20 μg/m L morphine with an infusion at 6-8 m L/h for 48 h(group EA). A standard general anesthetic technique was used for all three groups. Rescue analgesia(2 mg bolus of morphine, intravenous) was given when the visual analogue scale(VAS) score was ≥ 4. The outcomes measured over 48 h after the operation were VAS scores both at rest and during mobilization, total morphine consumption, relative side effects, and basic vital signs. Further results including time to extubation, recovery of bowel function, surgical wound healing,mean length of hospitalization after surgery, and the patient's satisfaction were also recorded.RESULTS: All three groups had similar VAS scores during the first 48 h after surgery. Group CWI and group EA, compared with group PCIA, had lower morphine consumption(P < 0.001), less postoperative nausea and vomiting(1.20 ± 0.41 vs 1.96 ± 0.67, 1.32 ± 0.56 vs 1.96 ± 0.67, respectively, P < 0.001), earlier extubation(16.56 ± 5.24 min vs 19.76 ± 5.75 min, P < 0.05, 15.48 ± 4.59 min vs 19.76 ± 5.75 min, P < 0.01), and earlier recovery of bowel function(2.96 ± 1.17 d vs 3.60 ± 1.04 d, 2.80 ± 1.38 d vs 3.60 ± 1.04 d, respectively, P < 0.05). The mean length of hospitalization after surgery was reduced in groups CWI(8.20 ± 2.58 d vs 10.08 ± 3.15 d, P < 0.05) and EA(7.96 ± 2.30 d vs 10.08 ± 3.15 d, P < 0.01) compared with group PCIA. All three groups had similar patient satisfaction and wound healing, but group PCIA was prone to higher sedation scores when compared with groups CWI and EA, especially during the first 12 h after surgery. Group EA had a lower mean arterial pressure within the first postoperative 12 h compared with the other two groups.CONCLUSION : CWI with ropivacaine yields a satisfactory analgesic effect within the first 48 h after open gastrectomy, with lower morphine consumption and accelerated recovery.Xing Zheng Xu Feng Xiu-Jun Cai 2016World Journal of Gastroenterology2016,22,5:15
15Irritable bowel syndrome in children:Current knowledge, challenges and opportunities显示文摘Irritable bowel syndrome(IBS) is a common and troublesome disorder in children with an increasing prevalence noted during the past two decades. It has a significant effect on the lives of affected children and their families and poses a significant burden on healthcare systems. Standard symptom-based criteria for diagnosis of pediatric IBS have changed several times during the past two decades and there are some differences in interpreting symptoms between different cultures. This has posed a problem when using them to diagnose IBS in clinical practice. A number of potential patho-physiological mechanisms have been described, but so far the exact underlying etiology of IBS is unclear. A few potential therapeutic modalities have been tested in children and only a small number of them have shown some benefit. In addition, most of the described patho-physiological mechanisms and treatment options are based on adult studies. These have surfaced as challenges when dealing with pediatric IBS and they need to be overcome for effective management of children with IBS. Recently suggested top-down and bottom-up models help integrating reported patho-physiological mechanisms and will provide an opportunity for better understanding of the diseases process. Treatment trials targeting single treatment modalities are unlikely to have clinically meaningful therapeutic effects on IBS with multiple integrating patho-physiologies. Trials focusing on multiple combined pharmacological and non-pharmacological therapies are likely to yield more benefit. In addition to treatment, in the future, attention should be paid for possible prevention strategies for IBS.Niranga Manjuri Devanarayana Shaman Rajindrajith 2018World Journal of Gastroenterology2018,24,21:14
16Effects of Tai Ji Quan training on gait kinematics in older Chinese women with knee osteoarthritis: A randomized controlled trial显示文摘Background: Although Tai Ji Quan has been shown to relieve pain and improve functional mobility in people with knee osteoarthritis(OA), little is known about its potential benefits on gait characteristics among older Chinese women who have a high prevalence of both radiographic and symptomatic knee OA. This study aims to assess the efficacy of a tailored Tai Ji Quan intervention on gait kinematics for older Chinese women with knee OA.Methods: A randomized controlled trial involving 46 older women in Shanghai, China, with clinically diagnosed knee OA. Randomized(1:1)participants received either a 60 min Tai Ji Quan session(n = 23) 3 times weekly or a 60 min bi-weekly educational session(n = 23) for 24 weeks.Primary outcomes were changes in gait kinematic measures from baseline to 24 weeks. Secondary outcomes included changes in scores on the Western Ontario and Mc Master University Osteoarthritis Index(WOMAC) and Short Physical Performance Battery(SPPB).Results: After 24 weeks the Tai Ji Quan group demonstrated better performance in gait velocity(mean difference, 8.40 cm/s, p = 0.01), step length(mean difference, 3.52 cm, p = 0.004), initial contact angle(mean difference, 2.19°, p = 0.01), and maximal angle(mean difference, 2.61°,p = 0.003) of flexed knees during stance phase compared to the control group. In addition, the Tai Ji Quan group showed significant improvement in WOMAC scores(p < 0.01)(mean difference,-4.22 points in pain, p = 0.002;-2.41 points in stiffness, p < 0.001;-11.04 points in physical function, p = 0.006) and SPPB scores(mean difference, 1.22 points, p < 0.001).Conclusion: Among older Chinese women with knee OA, a tailored Tai Ji Quan intervention improved gait outcomes. The intervention also improved overall function as indexed by the WOMAC and SPPB. These results support the use of Tai Ji Quan for older Chinese adults with knee OA to both improve their functional mobility and reduce pain symptomatology.Qingguang Zhu Lingyan Huang Xie Wu Lin Wang Yunya Zhang Min Fang Yu Liu JingXian Li 2016Journal of Sport and Health Science2016,5,3:14
17Platinum-induced neurotoxicity: A review of possible mechanisms显示文摘Patients treated with platinum-based chemotherapy frequently experience neurotoxic symptoms, which may lead to premature discontinuation of therapy. Despitediscontinuation of platinum drugs, these symptoms can persist over a long period of time. Cisplatin and oxaliplatin, among all platinum drugs, have significant neurotoxic potential. A distal dose-dependent symmetrical sensory neuropathy is the most common presentation of platinum neurotoxicity. DNA damage-induced apoptosis of dorsal root ganglion(DRG) neurons seems to be the principal cause of neurological symptoms. However, DRG injury alone cannot explain some unique symptoms such as cold-aggravated burning pain affecting distal extremities that is observed with oxaliplatin administration. In this article, we briefly reviewed potential mechanisms for the development of platinum drugs-associated neurological manifestations.Ozkan Kanat Hulya Ertas Burcu Caner 2017World Journal of Clinical Oncology2017,8,4:14
18Spinal Cord Stimulation for Pain Treatment After Spinal Cord Injury显示文摘In addition to restoration of bladder, bowel, and motor functions, alleviating the accompanying debilitating pain is equally important for improving the quality of life of patients with spinal cord injury(SCI). Currently,however, the treatment of chronic pain after SCI remains a largely unmet need. Electrical spinal cord stimulation(SCS) has been used to manage a variety of chronic pain conditions that are refractory to pharmacotherapy. Yet, its efficacy, benefit profiles, and mechanisms of action in SCI pain remain elusive, due to limited research, methodological weaknesses in previous clinical studies, and a lack of mechanistic exploration of SCS for SCI pain control. We aim to review recent studies and outline the therapeutic potential of different SCS paradigms for traumatic SCI pain. We begin with an overview of its manifestations,classification, potential underlying etiology, and currentchallenges for its treatment. The clinical evidence for using SCS in SCI pain is then reviewed. Finally, future perspectives of pre-clinical research and clinical study of SCS for SCI pain treatment are discussed.Qian Huang Wanru Duan Eellan Sivanesan Shuguang Liu Fei Yang Zhiyong Chen Neil C.Ford Xueming Chen Yun Guan 2019Neuroscience Bulletin2019,35,3:13
19Overlay of a sponge soaked with ropivacaine and multisite infiltration analgesia result in faster recovery after laparoscopic hepatectomy显示文摘BACKGROUND Compared with traditional open surgery,laparoscopic surgery is preferred due to the advantages of less trauma,less pain,and faster recovery.Nevertheless,many patients still suffer from postoperative pain resulting from the surgical incision and associated tissue injury.Many researchers have reported methods to improve postoperative pain control,but there is not a simple and effective method that can be clinically adopted in a widespread manner.We designed this study to prove the hypothesis that application of ropivacaine in the port site and operative site in patients is an effective and convenient method which can decrease postoperative pain and accelerate recovery.AIM To evaluate the effects of ropivacaine on pain control after laparoscopic hepatectomy and its contribution to patient recovery.METHODS From May 2017 to November 2018,146 patients undergoing laparoscopic hepatectomy were randomized to receive infiltration of either 7.5 mg/mL ropivacaine around the trocar insertions,incision,and cutting surface of the liver(with a gelatin sponge soaked with ropivacaine)at the end of surgery(ropivacaine group),or normal saline(5 mL)at the same sites at the end of surgery(control group).The degree of pain,nausea,vomiting,heart rate(HR),and blood pressure were collected.The length of postoperative hospitalization,complications,and the levels of stress hormones were also compared between the two groups.RESULTS Compared with the control group,the ropivacaine group showed reduced postoperative pain at rest within 12 h(P<0.05),and pain on movement was reduced within 48 h.The levels of epinephrine,norepinephrine,and cortisol at 24 and 48 h,HR,blood pressure,and cumulative sufentanil consumption in the ropivacaine group were significantly lower than those in the control group(P<0.05).In the ropivacaine group,hospitalization after operation was shorter,but the difference was not statistically significant.There were no significant differences in postoperative nausea,vomiting,or other complications,including hydrothorax,ascites,peritonitis,flatulence,and venous thrombus(P>0.05),although fewer patients in the ropivacaine group experienced these situations.CONCLUSION Infiltration with ropivacaine in the abdominal wound and covering the cutting surface of the liver with a gelatin sponge soaked with ropivacaine significantly reduce postoperative pain and the consumption of sufentanil.Hao Zhang Gang Du Yan-Feng Liu Jin-Huan Yang Mu-Guo A-Niu Xiang-Yu Zhai Bin Jin 2019World Journal of Gastroenterology2019,25,34:13
20Serotonin transporter and cholecystokinin in diarrhea-predominant irritable bowel syndrome: Associations with abdominal pain, visceral hypersensitivity and psychological performance显示文摘BACKGROUND Visceral hypersensitivity and psychological performance are the main pathophysiological mechanisms of irritable bowel syndrome(IBS).Previous studies have found that cholecystokinin(CCK)can enhance colon movement and that serotonin transporter(SERT)is a transmembrane transport protein with high affinity for 5-hydroxytryptamine,which can rapidly reuptake 5-hydroxytryptamine and then regulate its action time and intensity.We speculate that SERT and CCK might play a role in the pathogenesis of diarrheapredominant IBS(IBS-D)by affecting visceral sensitivity and the brain-gut axis.AIM To determine SERT and CCK levels in IBS-D patients diagnosed using Rome IV criteria and to analyze their associations with abdominal pain,visceral hypersensitivity and psychological performance.METHODS This study collected data from 40 patients with IBS-D at the China-Japan Friendship Hospital from September 2017 to April 2018 and 18 healthy controls.The severity of abdominal pain,visceral sensitivity and psychological performance were evaluated in IBS-D patients and healthy controls,the levels of SERT and CCK in plasma and colonic mucosa were evaluated,and the correlations between them were analyzed.RESULTS There were significant differences in the initial sensation threshold(31.00±8.41 mL vs 52.22±8.09 mL,P<0.001),defecating sensation threshold(51.75±13.57 mL vs 89.44±8.73 mL,P<0.001)and maximum tolerable threshold(97.25±23.64 mL vs 171.11±20.83 mL,P<0.001)between the two groups.IBS-D patients had more severe anxiety(7.78±2.62 vs 2.89±1.02,P<0.001)and depressive(6.38±2.43 vs 2.06±0.73,P<0.001)symptoms than healthy controls.Significant differences were also found in mucosal CCK(2.29±0.30 vs 1.66±0.17,P<0.001)and SERT(1.90±0.51 vs 3.03±0.23,P<0.001)between the two groups.There was a significant positive correlation between pain scores and mucosal CCK(r=0.96,0.93,0.94,P<0.001).Significant negative correlations between anxiety(r=-0.98;P<0.001),depression(r=-0.99;P<0.001),pain evaluation(r=-0.96,-0.93,-0.95,P<0.001)and mucosal SERT were observed.CONCLUSION IBS-D patients had psychosomatic disorders and visceral hypersensitivity.SERT and CCK might be involved in the pathogenesis of IBS-D by regulating the braingut axis and affecting visceral sensitivity.This provides a new potential method for identifying a more specific and effective therapeutic target.Geng Qin Yu Zhang Shu-Kun Yao 2020World Journal of Clinical Cases2020,8,9:13
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