Objective:To observe the efficacy of pentoxifylline+thioctic acid in the treatment of patients with painful diabetic peripheral neuropathy(PDPN).Methods:70 patients with PDPN admitted from October 2019 to October 2022...Objective:To observe the efficacy of pentoxifylline+thioctic acid in the treatment of patients with painful diabetic peripheral neuropathy(PDPN).Methods:70 patients with PDPN admitted from October 2019 to October 2022 were selected and randomly grouped,with pentoxifylline+thioctic acid treatment in Group A and thioctic acid treatment in Group B,and the treatment efficacy was compared.Results:The treatment efficacy in Group A was higher than that of Group B,P<0.05;the points of each symptom of PDPN in Group A were lower than that of Group B,P<0.05;the C-reactive protein and electromyography indexes of PDPN patients in Group A were better than that of Group B,P<0.05.Conclusion:PDPN patients treated with pentoxifylline+thioctic acid can optimize nerve function,inhibit inflammation progression,and reduce PDPN symptoms,which is an efficient and feasible treatment option.展开更多
Objective:This study aims to evaluate the reliability and validity of neuropathic pain assessment tools among Chinese patients with painful diabetic peripheral neuropathy(PDPN).Methods:One hundred patients with PDPN a...Objective:This study aims to evaluate the reliability and validity of neuropathic pain assessment tools among Chinese patients with painful diabetic peripheral neuropathy(PDPN).Methods:One hundred patients with PDPN and 70 patients with non-neuropathic pain were recruited from five grade III general hospitals in Guangzhou.Pain was assessed using the Leeds Assessment of Neuropathic Symptoms and Signs(LANSS),Douleur Neuropathique 4 questionnaire(DN4),and Brief Pain Inventory for Painful Diabetic Peripheral Neuropathy(BPI-DPN).Reliability was evaluated by internal consistency of the Cronbach's a coefficient and Guttman split-half.Construct validity was analyzed by factor analysis and Spearman correlation coefficients.Sensitivity and specificity were also assessed.Results:The Cronbach's a coefficients of the LANSS,DN4,and BPI-DPN were 0.735,0.750,and 0.898,respectively.The Guttman split-half coefficients of the LANSS,DN4,and BPIDPN were 0.660,0.726,and 0.849,respectively.The cumulative contributions of the LANSS,DN4,and BPI-DPN to the total variance were 61.945%,57.010%,and 66.056%,respectively.The items of the LANSS,DN4,and BPI-DPN presented high factorial loads,ranging from 0.387 to 0.841,0.137 to 0.948,and 0.487 to 0.953,respectively.The LANSS and DN4 exhibited sensitivities of 58.0%and 82.7%,respectively,and specificity of 97.1%.Conclusions:The LANSS or DN4 can be used to detect neuropathic pain in Chinese patients with PDPN.The BPI-DPN can be employed to monitor the effectiveness of pain intervention.展开更多
Studies have shown that myelin-associated glycoprotein(MAG)can inhibit axon regeneration after nerve injury.However,the effects of MAG on neuroma formation after peripheral nerve injury remain poorly understood.In thi...Studies have shown that myelin-associated glycoprotein(MAG)can inhibit axon regeneration after nerve injury.However,the effects of MAG on neuroma formation after peripheral nerve injury remain poorly understood.In this study,local injection of MAG combined with nerve cap made of chitin conduit was used to intervene with the formation of painful neuroma after sciatic nerve transfection in rats.After 8 weeks of combined treatment,the autotomy behaviors were reduced in rats subjected to sciatic nerve transfection,the mRNA expression of nerve growth factor,a pain marker,in the proximal nerve stump was decreased,the density of regenerated axons was decreased,the thickness of the myelin sheath was increased,and the ratio of unmyelinated to myelinated axons was reduced.Moereover,the percentage of collagen fiber area and the percentage of fibrosis marker alpha-smooth muscle actin positive staining area in the proximal nerve stump were decreased.The combined treatment exhibited superior effects in these measures to chitin conduit treatment alone.These findings suggest that MAG combined with chitin conduit synergistically inhibits the formation of painful neuroma after sciatic nerve transection and alleviates neuropathic pain.This study was approved by the Animal Ethics Committee of Peking University People’s Hospital(approval No.2019PHE027)on December 5,2019.展开更多
Introduction: Erectile episodes occurring in the night time are considered normal and are usually related to the REM sleep. Spontaneous painful erections are unusual but they can have a great impact in the patient’s ...Introduction: Erectile episodes occurring in the night time are considered normal and are usually related to the REM sleep. Spontaneous painful erections are unusual but they can have a great impact in the patient’s quality of sleep and, for consequence, quality of life. Report: We present a patient who has been presenting painful erections which wake him up almost every night. We discuss the workup and treatment offered to the patient, as well as the short-time response and two months follow-up. Discussion: Although studies still do not explain this relationship, nocturnal erections occur only during rapid eye movement (REM) sleep, which can be confirmed by polysomnography accompanied by Nocturnal Penile Tumescence testing or RigiScan test. However, diagnosis can be established based exclusively on clinical aspects. Based on all literature reviewed, the initial treatment should safely consist in improvement in sleep architecture and pelvis muscles relaxation. Conclusion: After the first suspicion, polysomnography with rigidity measurements of nocturnal erections should be considered although clinical diagnosis and therapeutic test may be acceptable. The management we suggest is usually effective, well tolerated and sustained.展开更多
We present the case of a 28 year old man from Mali who came to consultation for " lower limb edema and painful gait".The diagnosis of dracunculiasis was established by the suggestive symptomatology and the n...We present the case of a 28 year old man from Mali who came to consultation for " lower limb edema and painful gait".The diagnosis of dracunculiasis was established by the suggestive symptomatology and the notion of a trip back to his native country a year earlier.It was confirmed by the outing of the worm.展开更多
Neuropathic pain originates from damages to the somatosensory nervous system（IASP-International Association for the Study of Pain-taxonomy）.Lesions（traumas,compression,iatrogenic and pharmacological causes）or dise...Neuropathic pain originates from damages to the somatosensory nervous system（IASP-International Association for the Study of Pain-taxonomy）.Lesions（traumas,compression,iatrogenic and pharmacological causes）or diseases（infections,diabetes,ischemia,cancer）lead to the establishment of hypersensitivity.展开更多
Background: Thermal Microcautery (TMC) is a form of peripheral nerve field stimulation and is a technique used in Traditional Indian Medicine (Agnikarma) to manage chronic pain. The aim was to asses TMC in painful kne...Background: Thermal Microcautery (TMC) is a form of peripheral nerve field stimulation and is a technique used in Traditional Indian Medicine (Agnikarma) to manage chronic pain. The aim was to asses TMC in painful knee osteoarthritis (PKO). Methods: A non-randomized controlled trial was employed. All PKO patients on a waiting list for knee replacement were offered PNFS-TMC. Patients in the intervention group received 4 sessions (2 weeks apart) of PNFS-TMC by a pin-point tip of a metal rod. The rod was heated over a flame for 5 minutes before being used to induce a single 1 mm second-degree burn over points of tenderness. The control group was selected from the same waiting list. The primary outcome was assessed by Visual Analogue Scale (VAS) scores. The secondary outcomes were changes in levels of physical day to day activity, sleep and analgesics. Results: 16 PNFS-TMC intervention group patients and 15 control group patients were subject to analysis. Baseline VAS score was higher in PNFS-TMC group [9 ± 1.23 (95% CI 8.38 - 9.61) versus 5.93 ± 2.11 (95% CI 4.81 - 7.06) in the control, P Conclusions: PNFS-TMC could offer a simple, safe, cheap and effective method of pain management in chronic PKO patients.展开更多
Introduction: Hyperbaric oxygen therapy (HBO) is emerging as an alternative technique for treating refractory interstitial cystitis (IC). The theory is that the increased dissolved oxygen in the blood raises the level...Introduction: Hyperbaric oxygen therapy (HBO) is emerging as an alternative technique for treating refractory interstitial cystitis (IC). The theory is that the increased dissolved oxygen in the blood raises the levels of oxygen in the tissues and improves tissue healing. Other urological disorders such as radiation cystitis, Fournier’s gangrene and cyclophosphamide cystitis have also shown a good response to HBO therapy. Method: A literature search with the terms “interstitial cystitis”, “painful bladder syndrome” and “hyperbaric oxygen therapy” found four papers that have trialed HBO therapy in IC patients;three case series and one randomized control trial. Results: A total of 31 patients have been treated with HBO therapy. All four studies show a symptomatic improvement in pain, urgency, bladder capacity and O’Leary-Sant interstitial cystitis index. Urinary frequency only improved in three out of four of the trials. The percentage of patients considered as responders to treatment varied at 25%, 66.7%, 82% and 100%. Conclusion: Preliminary trials of HBO therapy seem to have a good patient response with effective symptomatic relief. The patient response rates varied greatly between the trials. This is due to each trial’s different definition of a “patient responder”. Further work in urology departments at HBO centers is required to further assess the benefits of HBO treatment in IC.展开更多
Background: Vestibulodynia (VBD) and painful bladder syndrome (PBS) are two common and often concomitant conditions. Objective: To assess the effectiveness of an enzymatic combination of papain, bromelain, trypsin, ch...Background: Vestibulodynia (VBD) and painful bladder syndrome (PBS) are two common and often concomitant conditions. Objective: To assess the effectiveness of an enzymatic combination of papain, bromelain, trypsin, chymotrypsin and quercetin in the supportive treatment of VBD/PBS, patients underwent TENS + amitriptyline and pregabalin therapy as a multimodal treatment strategy. Method: 40 patients were randomly assigned to receive a systemic therapy: amitriptyline + pregabalin (Group A) versus amitriptyline + Pregabalin plus a systemic enzyme preparation (Group B). All patients received a transcutaneous electric nerve stimulation (TENS) therapy in a self-administered domiciliary protocol. Results: The VAS and the dyspareunia score after the treatment showed a significant difference in the two groups (VAS: Group A difference of 4.3, Group B difference of 3.1, p = 0.005;dyspareunia: Group A and Group B 1.8 vs. 0.8, p = 0.005). Conclusion: The positive results of our study prove the utility effectiveness of an enzyme combination to decrease and normalize the biomarkers of inflammation in VBD and PBS patients in a multimodal approach.展开更多
Painful diabetic peripheral neuropathy is one of the common chronic complications of diabetes."Pain"is the most typical symptom in patients,which seriously affects their quality of life.Traditional Chinese m...Painful diabetic peripheral neuropathy is one of the common chronic complications of diabetes."Pain"is the most typical symptom in patients,which seriously affects their quality of life.Traditional Chinese medicine(TCM)treatment of the disease includes oral administration of Chinese medicine,TCM fumigation and acupuncture,etc.,which can significantly reduce the pain of patients and reduce the frequency of disease.Chinese decoctions regulate the imbalance of yin and yang in the human body through syndrome differentiation,so as to achieve the balance of yin and yang,which will then eliminate the disease.Chinese medicine fumigation make the medicine seep into the body from the skin to exert the medical effects,and nourish and dredge the meridians.There is no pain if the meridians are smooth flowing,there will be pain if the meridians are blocked,fumigation can be used alone or assisted by other treatment methods to enhance the efficacy.The characteristics of acupuncture are rapid painrelief,economic and convenient,and can quickly relieve pain for patients with low tolerance.展开更多
IN recent years, the bank accounts of India, Brazil and South Africa have been on a path of constant deterioration. These countries rely on shorbterm foreign capital to hold their current account deficits. And with gr...IN recent years, the bank accounts of India, Brazil and South Africa have been on a path of constant deterioration. These countries rely on shorbterm foreign capital to hold their current account deficits. And with grow- ing expectation of a U.S, liquidity contrac- tion, the direction of global capital flow has reversed. The three countries＇ currencies are depreciating on a large scale, Since May, the Indian Rupee＇s exchange rate against the dollar hit a series of record lows. exhibiting a trend of currency crises with a depreciation scale over 20 percent.展开更多
OBJECTIVE:To assess efficacy of Shutangluo fang on painful diabetic peripheral neuropathy(PDPN).METHODS:Adopting stratified randomized and controlled design,82 patients with PDPN were assigned to two groups.Both group...OBJECTIVE:To assess efficacy of Shutangluo fang on painful diabetic peripheral neuropathy(PDPN).METHODS:Adopting stratified randomized and controlled design,82 patients with PDPN were assigned to two groups.Both groups continued conventional therapy.Epalrestat was administered to patients in both groups,and Shutangluo fang was given to patients in the treatment group.The treatment course lasted for 3 months.The changes before and after treatment of symptoms and signs,electrophysiological assessments were observed.RESULTS:The efficacy of the treatment group was better than the control group.The sensory nerve conduction velocity was significantly improved in the treatment group than the control group.CONCLUSIONS:Shutangluo fang is effective on PDPN.展开更多
AS South Africans celebrated the arrival of a new year, the good wishes andresolutions for self-improvement were completely overshadowed by an unprecedented backlash on social media over racist comments uttered by a s...AS South Africans celebrated the arrival of a new year, the good wishes andresolutions for self-improvement were completely overshadowed by an unprecedented backlash on social media over racist comments uttered by a string of both ordinary citizens and those well known in the country.展开更多
Varioocelectomny is a management option for patients with painful varicocele. In this study, we assessed the effectiveness of varicocelectomy for painful varicocele and examined the factors that might be predictive of...Varioocelectomny is a management option for patients with painful varicocele. In this study, we assessed the effectiveness of varicocelectomy for painful varicocele and examined the factors that might be predictive of outcome. All patients who underwent a varicocelectomy for pain between February 2007 and July 2009 were includecL A review of patient medical records was conducted; patient age,body mass index （BMI）, uede, iocatien of the vericocele, tasticular volume, duration and quality of the pain （dull, draaing, throbbing or sharp） and surgical technique （ingulnal versus subinguinal） were documented. All parameters were compared with the rasolution of pain （complete, partial or failure）. We followed up on 53 of 104 patients （51.0%）. Complete postopanntive resolution of pain was reported by 28 patients （52.8%）, whereas 22 （41.5%） reported partial resolution, Only three patients （5.7%） mpaded failure. No relationship was observed between postoperative pain resolution and age, BMI, grade of varicoceio, location of varicocele, ipsilateral testicular, quality of pain or surgical technique. The duration of pain before surllery was the only factor that correlated with postopaative pain resolution （univariate, P=-0.004; multivariate, P=0.002）. Our rasults indicatethat varicocelectomy isan effective treatmentfar painful varicocele in properly selected patients, and that duration of pain before surgery may be predictive of outcome.展开更多
AIM: To evaluate the pain relieving effect of intervention with "Lamaze method of colonoscopy" in the process of colonoscopy.METHODS: Five hundred and eighty-five patients underwent colonoscopy were randomly...AIM: To evaluate the pain relieving effect of intervention with "Lamaze method of colonoscopy" in the process of colonoscopy.METHODS: Five hundred and eighty-five patients underwent colonoscopy were randomly divided into three groups, Lamaze group, anesthetic group and control group. Two hundred and twenty-four patients of Lamaze group, the "Lamaze method of colonoscopy" were practiced in the process of colonoscopy. The Lamaze method of colonoscopy is modified from the Lamaze method of childbirth, which helped patients to relieve pain through effective breathing control. One hundred and seventy-eight patients in anesthetic group accepted sedation colonoscopy. For 183 patients in control group, colonoscopy was performed without any intervention. The satisfactory of colon cleaning, intestinal lesions, intubation time, success ratio, pain grading and complications were recorded. All data were statistically analyzed.RESULTS: There were no significant differences at base line of the three groups(P > 0.05). Anesthetic group shows advantage in intubation time than the other two groups(P < 0.05). Lamaze group shows no advantagein intubation time than that in control group(P > 0.05). The anesthetic group showed an apparent advantage in relieving pain(P < 0.01). Therefore, the "Lamaze method of colonoscopy" performed in colonoscopy could relieve pain effectively comparing with control group(P < 0.05). The patients in anesthetic group had the highest incidence of complications(P < 0.05).CONCLUSION: The performance of the "Lamaze method of colonoscopy" in the process of colonoscopy could relieve patients' pain, minimize the incidence of complications, and is worthy promotion in clinical practice.展开更多
Objective:To evaluate the effects of the standardized extract of fenugreek(Trigonella foenumgraecum L.Family:Leguminasae) seed(IND01) in animal models of peripheral neuropathy. Methods:IND01 was prepared from fenugree...Objective:To evaluate the effects of the standardized extract of fenugreek(Trigonella foenumgraecum L.Family:Leguminasae) seed(IND01) in animal models of peripheral neuropathy. Methods:IND01 was prepared from fenugreek seeds and standardized by high performance liquid chromatography to a marker compound,trigonelline.The effects of daily oral administration of IND01(50,100 and 200 mg/kg) were studied in rats after partial sciatic nerve ligation(PSNL) and sciatic nerve crush injury(SNCI) during 30-days period.The measurements on thermal hyperalgesia(TH),motor function test(MFT) score and motor nerve conduction velocity (MNCV) were recorded.Results:IND01 offered sustained protection against TH and deranged MFT scores in both models from 7-day onwards.Fifteen days of daily oral administration of IND01 restored MNCV reduction in rats with SNCI but not with PSNL.Conclusions:IND01 was found to be effective in rat models of painful peripheral neuropathy.展开更多
BACKGROUND Extracorporeal shock wave therapy (ESWT) can be applied to variousmusculoskeletal conditions including calcific tendinitis. Muscle injuries can leadto hematomas, and unabsorbed hematomas sometimes cause pai...BACKGROUND Extracorporeal shock wave therapy (ESWT) can be applied to variousmusculoskeletal conditions including calcific tendinitis. Muscle injuries can leadto hematomas, and unabsorbed hematomas sometimes cause pain. We report acase of painful hematoma successfully treated with ESWT. To our knowledge, thisis the first reported case of painful intramuscular hematoma treated with ESWT.CASE SUMMARY A 65-year-old man visited the outpatient department for left calf pain withswelling that had persisted since he slipped two weeks prior. The calf pain hadpersisted and was rated visual analog scale 7. On physical examination, there wasa localized, stiff, ovoid mass on his left upper posterior calf. The pain wasaggravated by dorsiflexion of the left ankle or weight-bearing on the left foot.Initial diagnostic ultrasonography showed a hematoma in the left gastrocnemiusmuscle;its texture was firm with low heterogeneity. We applied ESWT to thehematoma. His pain decreased immediately to a visual analog scale 3, and themass was softened. The texture of the hematoma became more heterogeneous onultrasonography. Due to planned overseas travel, he returned three months afterthe initial visit to report that the pain and swelling were dramatically relievedafter ESWT.CONCLUSION We propose that painful hematomas could be a new indication for ESWT. Furtherinvestigation on the effects of ESWT for hematomas is needed.展开更多
The field of neuroimmunology has expanded in recent years providing new insights and therapies into pathologies like stroke, autism, and depression. However, few works explore the relationship between inflammatory sti...The field of neuroimmunology has expanded in recent years providing new insights and therapies into pathologies like stroke, autism, and depression. However, few works explore the relationship between inflammatory stimuli and motivation. Thus, the aim of this study was to determine how non-painful inflammatory stimuli affect reward. To test reward-response, we used the morphine and the nicotine induced conditioned place-preference and place-aversion model in rats with non-painful inflammation. The following inflammatory models were used: non-painful infectious inflammation: 24 hrs prior to conditioning sessions, an injection with Calmette-Guerin bacillus (CGB) 1 × 107 cfu, ip, was administered. Non-painful non-infectious inflammation: 24 hrs prior to conditioning sessions, rats’ sciatic nerve was blocked and cut, followed by the injection of carrageenan (750 μl) in the paw. We then measured the cytokine concentration to determine the inflammatory profile of each of our models. Finally, we administered ibuprofen to determine if it could prevent the effect of inflammation over conditioned place-preference. We show that carrageenan significantly reduced the morphine-induced reward. Non-painful inflammatory stimulus, CGB and denervation + carrageenan, inhibit the conditioned place-preference to morphine and nicotine, CGB also block conditioned place-aversion to nicotine;carrageenan has no effect on CPA. The administration of ibuprofen reinstates conditioned place-preference to morphine and nicotine in the carrageenan model, but has no effect in the CGB model;finally ibuprofen has no effect on CPA. Our data suggest that non-painful-inflammatory stimuli inhibit the reward system, independent of cytokine concentration. Furthermore, the administration of a PGE 2 inhibitor can importantly modulate this phenomenon.展开更多
BACKGROUND Development of infrapatellar saphenous neuroma(ISN)is a well-recognized reason for knee pain following total knee arthroplasty(TKA).So far,very few studies have addressed the development of painful ISN afte...BACKGROUND Development of infrapatellar saphenous neuroma(ISN)is a well-recognized reason for knee pain following total knee arthroplasty(TKA).So far,very few studies have addressed the development of painful ISN after TKA and its impact on functional outcome and patient satisfaction.AIM To present the results of surgical treatment for ISN after primary TKA,the level of pain relief,and the improvement of knee motion and function.METHODS Fifteen patients(13 women,2 men)with persistent medial pain for more than six months after primary TKA,due to osteoarthritis,underwent surgical excision of ISN.ISN diagnosis was confirmed with the presence of Tinel’s sign along the course of the infrapatellar branch of the saphenous nerve and with pain relief after selective nerve block using local anesthetic.Component loosening,malalignment,instability and infection were excluded systematically in all patients as a source of pain.Pain relief in terms of visual analog scale(VAS),active knee range of motion(ROM),and the Knee Society Score(KSS)for pain and function were evaluated preoperatively and at least six months postoperatively.RESULTS The mean patients’age was 71.3±5.4 years old.The mean interval between TKA and neuroma excision was 10 mo(range,6 to 14 mo),while the mean follow-up was 8 mo(range:6 to 11 mo).All 15 patients experienced almost complete immediate pain relief and resolution of allodynia and hyperesthesia after surgery.Pain on the VAS scale improved from 8.6±1.3 preoperatively to 0.8±0.9 at the final follow-up(P=0.001).KSS pain and function scores were improved from 49.3±5.9 and 62.7±12.8 before surgery to 91.8±4.2 and 75.3±11.3 after surgery,respectively(P=0.001 and P=0.015).Active knee ROM was also increased postoperatively from 96±4 to 105±6 degrees(P=0.001).There were no complications and no further operations required.CONCLUSION ISN should be considered a potential cause of persistent pain following TKA.Neuroma excision not only provides immediate pain relief and resolution of symptoms but may also improve the knee range of motion.展开更多
文摘Objective:To observe the efficacy of pentoxifylline+thioctic acid in the treatment of patients with painful diabetic peripheral neuropathy(PDPN).Methods:70 patients with PDPN admitted from October 2019 to October 2022 were selected and randomly grouped,with pentoxifylline+thioctic acid treatment in Group A and thioctic acid treatment in Group B,and the treatment efficacy was compared.Results:The treatment efficacy in Group A was higher than that of Group B,P<0.05;the points of each symptom of PDPN in Group A were lower than that of Group B,P<0.05;the C-reactive protein and electromyography indexes of PDPN patients in Group A were better than that of Group B,P<0.05.Conclusion:PDPN patients treated with pentoxifylline+thioctic acid can optimize nerve function,inhibit inflammation progression,and reduce PDPN symptoms,which is an efficient and feasible treatment option.
文摘Objective:This study aims to evaluate the reliability and validity of neuropathic pain assessment tools among Chinese patients with painful diabetic peripheral neuropathy(PDPN).Methods:One hundred patients with PDPN and 70 patients with non-neuropathic pain were recruited from five grade III general hospitals in Guangzhou.Pain was assessed using the Leeds Assessment of Neuropathic Symptoms and Signs(LANSS),Douleur Neuropathique 4 questionnaire(DN4),and Brief Pain Inventory for Painful Diabetic Peripheral Neuropathy(BPI-DPN).Reliability was evaluated by internal consistency of the Cronbach's a coefficient and Guttman split-half.Construct validity was analyzed by factor analysis and Spearman correlation coefficients.Sensitivity and specificity were also assessed.Results:The Cronbach's a coefficients of the LANSS,DN4,and BPI-DPN were 0.735,0.750,and 0.898,respectively.The Guttman split-half coefficients of the LANSS,DN4,and BPIDPN were 0.660,0.726,and 0.849,respectively.The cumulative contributions of the LANSS,DN4,and BPI-DPN to the total variance were 61.945%,57.010%,and 66.056%,respectively.The items of the LANSS,DN4,and BPI-DPN presented high factorial loads,ranging from 0.387 to 0.841,0.137 to 0.948,and 0.487 to 0.953,respectively.The LANSS and DN4 exhibited sensitivities of 58.0%and 82.7%,respectively,and specificity of 97.1%.Conclusions:The LANSS or DN4 can be used to detect neuropathic pain in Chinese patients with PDPN.The BPI-DPN can be employed to monitor the effectiveness of pain intervention.
基金the National Natural Science Foundation of China,No.31771322Major R&D Program of National Ministry of Science and Technology of China,No.2018YFB1105504+1 种基金Beijing Natural Science Foundation of China,No.7212121and Shenzhen Science and Technology Plan Project of China,No.JCYJ20190806162205278(all to PXZ).
文摘Studies have shown that myelin-associated glycoprotein(MAG)can inhibit axon regeneration after nerve injury.However,the effects of MAG on neuroma formation after peripheral nerve injury remain poorly understood.In this study,local injection of MAG combined with nerve cap made of chitin conduit was used to intervene with the formation of painful neuroma after sciatic nerve transfection in rats.After 8 weeks of combined treatment,the autotomy behaviors were reduced in rats subjected to sciatic nerve transfection,the mRNA expression of nerve growth factor,a pain marker,in the proximal nerve stump was decreased,the density of regenerated axons was decreased,the thickness of the myelin sheath was increased,and the ratio of unmyelinated to myelinated axons was reduced.Moereover,the percentage of collagen fiber area and the percentage of fibrosis marker alpha-smooth muscle actin positive staining area in the proximal nerve stump were decreased.The combined treatment exhibited superior effects in these measures to chitin conduit treatment alone.These findings suggest that MAG combined with chitin conduit synergistically inhibits the formation of painful neuroma after sciatic nerve transection and alleviates neuropathic pain.This study was approved by the Animal Ethics Committee of Peking University People’s Hospital(approval No.2019PHE027)on December 5,2019.
文摘Introduction: Erectile episodes occurring in the night time are considered normal and are usually related to the REM sleep. Spontaneous painful erections are unusual but they can have a great impact in the patient’s quality of sleep and, for consequence, quality of life. Report: We present a patient who has been presenting painful erections which wake him up almost every night. We discuss the workup and treatment offered to the patient, as well as the short-time response and two months follow-up. Discussion: Although studies still do not explain this relationship, nocturnal erections occur only during rapid eye movement (REM) sleep, which can be confirmed by polysomnography accompanied by Nocturnal Penile Tumescence testing or RigiScan test. However, diagnosis can be established based exclusively on clinical aspects. Based on all literature reviewed, the initial treatment should safely consist in improvement in sleep architecture and pelvis muscles relaxation. Conclusion: After the first suspicion, polysomnography with rigidity measurements of nocturnal erections should be considered although clinical diagnosis and therapeutic test may be acceptable. The management we suggest is usually effective, well tolerated and sustained.
文摘We present the case of a 28 year old man from Mali who came to consultation for " lower limb edema and painful gait".The diagnosis of dracunculiasis was established by the suggestive symptomatology and the notion of a trip back to his native country a year earlier.It was confirmed by the outing of the worm.
文摘Neuropathic pain originates from damages to the somatosensory nervous system（IASP-International Association for the Study of Pain-taxonomy）.Lesions（traumas,compression,iatrogenic and pharmacological causes）or diseases（infections,diabetes,ischemia,cancer）lead to the establishment of hypersensitivity.
文摘Background: Thermal Microcautery (TMC) is a form of peripheral nerve field stimulation and is a technique used in Traditional Indian Medicine (Agnikarma) to manage chronic pain. The aim was to asses TMC in painful knee osteoarthritis (PKO). Methods: A non-randomized controlled trial was employed. All PKO patients on a waiting list for knee replacement were offered PNFS-TMC. Patients in the intervention group received 4 sessions (2 weeks apart) of PNFS-TMC by a pin-point tip of a metal rod. The rod was heated over a flame for 5 minutes before being used to induce a single 1 mm second-degree burn over points of tenderness. The control group was selected from the same waiting list. The primary outcome was assessed by Visual Analogue Scale (VAS) scores. The secondary outcomes were changes in levels of physical day to day activity, sleep and analgesics. Results: 16 PNFS-TMC intervention group patients and 15 control group patients were subject to analysis. Baseline VAS score was higher in PNFS-TMC group [9 ± 1.23 (95% CI 8.38 - 9.61) versus 5.93 ± 2.11 (95% CI 4.81 - 7.06) in the control, P Conclusions: PNFS-TMC could offer a simple, safe, cheap and effective method of pain management in chronic PKO patients.
文摘Introduction: Hyperbaric oxygen therapy (HBO) is emerging as an alternative technique for treating refractory interstitial cystitis (IC). The theory is that the increased dissolved oxygen in the blood raises the levels of oxygen in the tissues and improves tissue healing. Other urological disorders such as radiation cystitis, Fournier’s gangrene and cyclophosphamide cystitis have also shown a good response to HBO therapy. Method: A literature search with the terms “interstitial cystitis”, “painful bladder syndrome” and “hyperbaric oxygen therapy” found four papers that have trialed HBO therapy in IC patients;three case series and one randomized control trial. Results: A total of 31 patients have been treated with HBO therapy. All four studies show a symptomatic improvement in pain, urgency, bladder capacity and O’Leary-Sant interstitial cystitis index. Urinary frequency only improved in three out of four of the trials. The percentage of patients considered as responders to treatment varied at 25%, 66.7%, 82% and 100%. Conclusion: Preliminary trials of HBO therapy seem to have a good patient response with effective symptomatic relief. The patient response rates varied greatly between the trials. This is due to each trial’s different definition of a “patient responder”. Further work in urology departments at HBO centers is required to further assess the benefits of HBO treatment in IC.
文摘Background: Vestibulodynia (VBD) and painful bladder syndrome (PBS) are two common and often concomitant conditions. Objective: To assess the effectiveness of an enzymatic combination of papain, bromelain, trypsin, chymotrypsin and quercetin in the supportive treatment of VBD/PBS, patients underwent TENS + amitriptyline and pregabalin therapy as a multimodal treatment strategy. Method: 40 patients were randomly assigned to receive a systemic therapy: amitriptyline + pregabalin (Group A) versus amitriptyline + Pregabalin plus a systemic enzyme preparation (Group B). All patients received a transcutaneous electric nerve stimulation (TENS) therapy in a self-administered domiciliary protocol. Results: The VAS and the dyspareunia score after the treatment showed a significant difference in the two groups (VAS: Group A difference of 4.3, Group B difference of 3.1, p = 0.005;dyspareunia: Group A and Group B 1.8 vs. 0.8, p = 0.005). Conclusion: The positive results of our study prove the utility effectiveness of an enzyme combination to decrease and normalize the biomarkers of inflammation in VBD and PBS patients in a multimodal approach.
基金Shaanxi Province 2020 Key Research and Development Program Project(2020SF-276)Xi'an Health Bureau Science and Technology Project(J201902018)。
文摘Painful diabetic peripheral neuropathy is one of the common chronic complications of diabetes."Pain"is the most typical symptom in patients,which seriously affects their quality of life.Traditional Chinese medicine(TCM)treatment of the disease includes oral administration of Chinese medicine,TCM fumigation and acupuncture,etc.,which can significantly reduce the pain of patients and reduce the frequency of disease.Chinese decoctions regulate the imbalance of yin and yang in the human body through syndrome differentiation,so as to achieve the balance of yin and yang,which will then eliminate the disease.Chinese medicine fumigation make the medicine seep into the body from the skin to exert the medical effects,and nourish and dredge the meridians.There is no pain if the meridians are smooth flowing,there will be pain if the meridians are blocked,fumigation can be used alone or assisted by other treatment methods to enhance the efficacy.The characteristics of acupuncture are rapid painrelief,economic and convenient,and can quickly relieve pain for patients with low tolerance.
文摘IN recent years, the bank accounts of India, Brazil and South Africa have been on a path of constant deterioration. These countries rely on shorbterm foreign capital to hold their current account deficits. And with grow- ing expectation of a U.S, liquidity contrac- tion, the direction of global capital flow has reversed. The three countries＇ currencies are depreciating on a large scale, Since May, the Indian Rupee＇s exchange rate against the dollar hit a series of record lows. exhibiting a trend of currency crises with a depreciation scale over 20 percent.
文摘OBJECTIVE:To assess efficacy of Shutangluo fang on painful diabetic peripheral neuropathy(PDPN).METHODS:Adopting stratified randomized and controlled design,82 patients with PDPN were assigned to two groups.Both groups continued conventional therapy.Epalrestat was administered to patients in both groups,and Shutangluo fang was given to patients in the treatment group.The treatment course lasted for 3 months.The changes before and after treatment of symptoms and signs,electrophysiological assessments were observed.RESULTS:The efficacy of the treatment group was better than the control group.The sensory nerve conduction velocity was significantly improved in the treatment group than the control group.CONCLUSIONS:Shutangluo fang is effective on PDPN.
文摘AS South Africans celebrated the arrival of a new year, the good wishes andresolutions for self-improvement were completely overshadowed by an unprecedented backlash on social media over racist comments uttered by a string of both ordinary citizens and those well known in the country.
文摘Varioocelectomny is a management option for patients with painful varicocele. In this study, we assessed the effectiveness of varicocelectomy for painful varicocele and examined the factors that might be predictive of outcome. All patients who underwent a varicocelectomy for pain between February 2007 and July 2009 were includecL A review of patient medical records was conducted; patient age,body mass index （BMI）, uede, iocatien of the vericocele, tasticular volume, duration and quality of the pain （dull, draaing, throbbing or sharp） and surgical technique （ingulnal versus subinguinal） were documented. All parameters were compared with the rasolution of pain （complete, partial or failure）. We followed up on 53 of 104 patients （51.0%）. Complete postopanntive resolution of pain was reported by 28 patients （52.8%）, whereas 22 （41.5%） reported partial resolution, Only three patients （5.7%） mpaded failure. No relationship was observed between postoperative pain resolution and age, BMI, grade of varicoceio, location of varicocele, ipsilateral testicular, quality of pain or surgical technique. The duration of pain before surllery was the only factor that correlated with postopaative pain resolution （univariate, P=-0.004; multivariate, P=0.002）. Our rasults indicatethat varicocelectomy isan effective treatmentfar painful varicocele in properly selected patients, and that duration of pain before surgery may be predictive of outcome.
基金The Dongguan science and Technology Bureau,No.201350715000809
文摘AIM: To evaluate the pain relieving effect of intervention with "Lamaze method of colonoscopy" in the process of colonoscopy.METHODS: Five hundred and eighty-five patients underwent colonoscopy were randomly divided into three groups, Lamaze group, anesthetic group and control group. Two hundred and twenty-four patients of Lamaze group, the "Lamaze method of colonoscopy" were practiced in the process of colonoscopy. The Lamaze method of colonoscopy is modified from the Lamaze method of childbirth, which helped patients to relieve pain through effective breathing control. One hundred and seventy-eight patients in anesthetic group accepted sedation colonoscopy. For 183 patients in control group, colonoscopy was performed without any intervention. The satisfactory of colon cleaning, intestinal lesions, intubation time, success ratio, pain grading and complications were recorded. All data were statistically analyzed.RESULTS: There were no significant differences at base line of the three groups(P > 0.05). Anesthetic group shows advantage in intubation time than the other two groups(P < 0.05). Lamaze group shows no advantagein intubation time than that in control group(P > 0.05). The anesthetic group showed an apparent advantage in relieving pain(P < 0.01). Therefore, the "Lamaze method of colonoscopy" performed in colonoscopy could relieve pain effectively comparing with control group(P < 0.05). The patients in anesthetic group had the highest incidence of complications(P < 0.05).CONCLUSION: The performance of the "Lamaze method of colonoscopy" in the process of colonoscopy could relieve patients' pain, minimize the incidence of complications, and is worthy promotion in clinical practice.
文摘Objective:To evaluate the effects of the standardized extract of fenugreek(Trigonella foenumgraecum L.Family:Leguminasae) seed(IND01) in animal models of peripheral neuropathy. Methods:IND01 was prepared from fenugreek seeds and standardized by high performance liquid chromatography to a marker compound,trigonelline.The effects of daily oral administration of IND01(50,100 and 200 mg/kg) were studied in rats after partial sciatic nerve ligation(PSNL) and sciatic nerve crush injury(SNCI) during 30-days period.The measurements on thermal hyperalgesia(TH),motor function test(MFT) score and motor nerve conduction velocity (MNCV) were recorded.Results:IND01 offered sustained protection against TH and deranged MFT scores in both models from 7-day onwards.Fifteen days of daily oral administration of IND01 restored MNCV reduction in rats with SNCI but not with PSNL.Conclusions:IND01 was found to be effective in rat models of painful peripheral neuropathy.
文摘BACKGROUND Extracorporeal shock wave therapy (ESWT) can be applied to variousmusculoskeletal conditions including calcific tendinitis. Muscle injuries can leadto hematomas, and unabsorbed hematomas sometimes cause pain. We report acase of painful hematoma successfully treated with ESWT. To our knowledge, thisis the first reported case of painful intramuscular hematoma treated with ESWT.CASE SUMMARY A 65-year-old man visited the outpatient department for left calf pain withswelling that had persisted since he slipped two weeks prior. The calf pain hadpersisted and was rated visual analog scale 7. On physical examination, there wasa localized, stiff, ovoid mass on his left upper posterior calf. The pain wasaggravated by dorsiflexion of the left ankle or weight-bearing on the left foot.Initial diagnostic ultrasonography showed a hematoma in the left gastrocnemiusmuscle;its texture was firm with low heterogeneity. We applied ESWT to thehematoma. His pain decreased immediately to a visual analog scale 3, and themass was softened. The texture of the hematoma became more heterogeneous onultrasonography. Due to planned overseas travel, he returned three months afterthe initial visit to report that the pain and swelling were dramatically relievedafter ESWT.CONCLUSION We propose that painful hematomas could be a new indication for ESWT. Furtherinvestigation on the effects of ESWT for hematomas is needed.
文摘The field of neuroimmunology has expanded in recent years providing new insights and therapies into pathologies like stroke, autism, and depression. However, few works explore the relationship between inflammatory stimuli and motivation. Thus, the aim of this study was to determine how non-painful inflammatory stimuli affect reward. To test reward-response, we used the morphine and the nicotine induced conditioned place-preference and place-aversion model in rats with non-painful inflammation. The following inflammatory models were used: non-painful infectious inflammation: 24 hrs prior to conditioning sessions, an injection with Calmette-Guerin bacillus (CGB) 1 × 107 cfu, ip, was administered. Non-painful non-infectious inflammation: 24 hrs prior to conditioning sessions, rats’ sciatic nerve was blocked and cut, followed by the injection of carrageenan (750 μl) in the paw. We then measured the cytokine concentration to determine the inflammatory profile of each of our models. Finally, we administered ibuprofen to determine if it could prevent the effect of inflammation over conditioned place-preference. We show that carrageenan significantly reduced the morphine-induced reward. Non-painful inflammatory stimulus, CGB and denervation + carrageenan, inhibit the conditioned place-preference to morphine and nicotine, CGB also block conditioned place-aversion to nicotine;carrageenan has no effect on CPA. The administration of ibuprofen reinstates conditioned place-preference to morphine and nicotine in the carrageenan model, but has no effect in the CGB model;finally ibuprofen has no effect on CPA. Our data suggest that non-painful-inflammatory stimuli inhibit the reward system, independent of cytokine concentration. Furthermore, the administration of a PGE 2 inhibitor can importantly modulate this phenomenon.
文摘BACKGROUND Development of infrapatellar saphenous neuroma(ISN)is a well-recognized reason for knee pain following total knee arthroplasty(TKA).So far,very few studies have addressed the development of painful ISN after TKA and its impact on functional outcome and patient satisfaction.AIM To present the results of surgical treatment for ISN after primary TKA,the level of pain relief,and the improvement of knee motion and function.METHODS Fifteen patients(13 women,2 men)with persistent medial pain for more than six months after primary TKA,due to osteoarthritis,underwent surgical excision of ISN.ISN diagnosis was confirmed with the presence of Tinel’s sign along the course of the infrapatellar branch of the saphenous nerve and with pain relief after selective nerve block using local anesthetic.Component loosening,malalignment,instability and infection were excluded systematically in all patients as a source of pain.Pain relief in terms of visual analog scale(VAS),active knee range of motion(ROM),and the Knee Society Score(KSS)for pain and function were evaluated preoperatively and at least six months postoperatively.RESULTS The mean patients’age was 71.3±5.4 years old.The mean interval between TKA and neuroma excision was 10 mo(range,6 to 14 mo),while the mean follow-up was 8 mo(range:6 to 11 mo).All 15 patients experienced almost complete immediate pain relief and resolution of allodynia and hyperesthesia after surgery.Pain on the VAS scale improved from 8.6±1.3 preoperatively to 0.8±0.9 at the final follow-up(P=0.001).KSS pain and function scores were improved from 49.3±5.9 and 62.7±12.8 before surgery to 91.8±4.2 and 75.3±11.3 after surgery,respectively(P=0.001 and P=0.015).Active knee ROM was also increased postoperatively from 96±4 to 105±6 degrees(P=0.001).There were no complications and no further operations required.CONCLUSION ISN should be considered a potential cause of persistent pain following TKA.Neuroma excision not only provides immediate pain relief and resolution of symptoms but may also improve the knee range of motion.
