[Objectives]This study aimed to investigate the effects of ropivacaine-sufentanil epidural analgesia on labor and maternal and neonatal outcomes.[Methods]A total of 180 primiparas in full-term pregnancy were selected....[Objectives]This study aimed to investigate the effects of ropivacaine-sufentanil epidural analgesia on labor and maternal and neonatal outcomes.[Methods]A total of 180 primiparas in full-term pregnancy were selected.They were randomly divided into treatment group(n=90)and control group(n=90).The primiparas in the treatment group were injected epidurally with ropivacaine and sufentanil for analgesia,and the primiparas in the control group were subjected to vaginal delivery.The VAS scores at 5,10,30 and 60 min of analgesia were observed.The vaginal bleeding amount,total labor duration,neonatal Apgar score and vaginal delivery rate of the two groups were compared.[Results]Compared with the control group,the VAS score in the treatment group differed insignificantly after 5 min of analgesia(P>0.05),and decreased significantly after 10,30 and 60 min of analgesia(P<0.05).The vaginal bleeding amount of the treatment group was significantly smaller than that of the control group(P<0.05).There was no significant difference in the neonatal Apgar score between the two groups(P>0.05).In the treatment group,the vaginal delivery rate increased(P<0.05),the second stage of labor was prolonged(P<0.05),and the first and third stages of labor did not change significantly(P>0.05).[Conclusions]Epidural analgesia with ropivacaine and sufentanil has a good analgesic effect and good safety,and is worthy of clinical promotion.展开更多
BACKGROUND Knee diseases are more common in middle-aged and elderly people,so artificial knee replacement is also more used in middle-aged and elderly people.Although the patient’s pain can be reduced through surgery...BACKGROUND Knee diseases are more common in middle-aged and elderly people,so artificial knee replacement is also more used in middle-aged and elderly people.Although the patient’s pain can be reduced through surgery,often accompanied by moderate pain after surgery and neutralization,which not only increases the psychological burden of the patient,but also greatly reduces the postoperative recovery effect,and may also lead to the occurrence of postoperative adverse events in severe cases.AIM To investigate the analgesic effect of artificial intelligence(AI)and ultrasoundguided nerve block in total knee arthroplasty(TKA).METHODS A total of 92 patients with TKA admitted to our hospital from January 2021 to January 2022 were opted and divided into two groups according to the treatment regimen.The control group received combined spinal-epidural anesthesia.The research group received AI technique combined with ultrasound-guided nerve block anesthesia.The sensory block time,motor block time,visual analogue scale(VAS)at different time points and complications were contrasted between the two groups.RESULTS The time of sensory block onset and sensory block perfection in the research group was shorter than those in the control group,but the results had no significant difference(P>0.05).Duration of sensory block in the research group was significantly longer than those in the control group(P<0.05).The time of motor block onset and motor block perfection in the research group was shorter than those in the control group,but the results had no significant difference(P>0.05).Duration of motor block in the research group was significantly longer than those in the control group.The VAS scales of the research group were significantly lower than that of the control group at different time points(P<0.05).The postoperative hip flexion and abduction range of motion in the research group were significantly better than those in the control group at different time points(P<0.05).The incidence of complications was significantly lower in the research group than in the control group(P=0.049).CONCLUSION In TKA,the combination of AI technology and ultrasound-guided nerve block has a significantly effect,with fewer postoperative complications and significantly analgesic effect,which is worthy of application.展开更多
AIM:To investigate the pharmacological effect of JCM-16021,a Chinese herbal formula,and its underlying mechanisms.METHODS:JCM-16021 is composed of seven herbal plant materials.All raw materials of the formula were exa...AIM:To investigate the pharmacological effect of JCM-16021,a Chinese herbal formula,and its underlying mechanisms.METHODS:JCM-16021 is composed of seven herbal plant materials.All raw materials of the formula were examined according to the quality control criteria listed in the Chinese Pharmacopeia(2005).In a neonatal maternal separation(NMS)model,male SpragueDawley rats were submitted to daily maternal separation from postnatal day 2 to day 14,or no specific handling(NH).Starting from postnatal day 60,rats were administered JCM-16021(2,4,8 g/kg per day)orally twice a day for 28 d.Pain threshold pressure and electromyographic activities of external oblique muscles in response to colorectal distention recorded with a Power Lab System(AD Instruments International),were tested as pain indices.Changes in serotonin(5-HT)and 5-hydroxyindoleacetic acid(5-HIAA)concentrations in the colon of rats were analyzed;the enterochromaffin cell numbers and serotonin transporter in the colon of rats were also evaluated with an immunohistochemistry method.RESULTS:NMS treatment significantly reduced pain threshold pressure(37.4±1.4 mmHg),as compared to that of NH rats(57.7±1.9 mmHg,P<0.05).After JCM-16021 treatment,the pain threshold pressure significantly increased when compared to that before treatment(34.2±0.9 mmHg vs 52.8±2.3 mmHg in the high dose group,40.2±1.6 mmHg vs 46.5±1.3 mmHg in the middle dose group,and 39.3±0.7 mmHg vs 46.5±1.6 mmHg in the low dose group,P<0.05).Also JCM-16021 significantly and dose-dependently decreased electromyographic activity to the graded colorectal distension(CRD),(the meanΔAUC values were:0.17±0.03,0.53±0.15,1.06±0.18,1.22±0.24 in the high dose group;0.23±0.04,0.68±0.17,1.27 ±0.26,1.8±0.3 in the middle dose group;and 0.29 ±0.06,0.8±0.16,1.53±0.24,2.1±0.21 in the low dose group for the pressures 20,40,60,80 mmHg),as compared to the NMS vehicle group.The meanΔAUC values were:0.57±0.12,1.33±0.18,2.57±0.37,3.08±0.37 for the pressures 20,40,60,80 mmHg(P <0.05).JCM-16021 treatment significantly reduced the 5-HT concentrations(from high,middle and low dosage groups:60.25±5.98 ng/100 mg,60.32±4.22 ng/100 mg,73.31±7.65 ng/100 mg),as compared to the NMS vehicle groups(93.11±9.85 ng/100 mg,P<0.05);and increased the 5-HIAA concentrations(after treatment,from high,middle and low dosage groups:54.24±3.27 ng/100 mg,50.34±1.26 ng/100 mg,51.37±2.13 ng/100 mg)when compared to that in the NMS vehicle group(51.75±1.98 ng/100 mg,P <0.05);but did not change the enterochromaffin cell numbers in the colon of rats.In addition,NMS rats had higher SERT expression(n=10)than NH rats(n=8,P<0.05).JCM-16021 treatment significantly decreased SERT expression when compared to the NMS group(P <0.01-0.001).CONCLUSION:JCM-16021 can attenuate visceral hypersensitivity,and this analgesic effect may be mediated through the serotonin signaling pathway in the colon of rats.展开更多
Objective To and connexin 43. Methods investigate the possible relationship between the analgesic effect of acupuncture Connexin 43 gene knock-out mice were randomly divided into 4 groups： a wide type （WT） control ...Objective To and connexin 43. Methods investigate the possible relationship between the analgesic effect of acupuncture Connexin 43 gene knock-out mice were randomly divided into 4 groups： a wide type （WT） control group, a WT acupuncture group, a heterozygous （HT） control group and HT acupuncture group. Hot-plate test and writhing response induced by acetic acid were used for investigating the different analgesic effect of acupuncture on HT and WT mice. Results There was no significant difference in the basic pain threshold value between HT and WT mice （P 〉0.05）. Acupuncture could significantly increase the pain threshold value, prolong the latency period of writhing body and decrease the number of writhing body as compared with pre-acupuncture in WT and HT mice （P 〈 0.01 or P 〈 0.05）. The pain threshold, latency period of writhing and number of writhing body in HT mice were less than WT mice post-acupuncture （P〈0.05）. Conclusion Connexin 43 gene knock-out might partially inhibit the analgesic effect of acupuncture, suggesting that connexin 43 is possibly related with meridians and the effect of acupuncture.展开更多
In the present study, we examined the analgesic effect of repeated electroacupuncture at bilateral Zusanfi （ST36） and Yanglingquan （GB34） once a day for 14 consecutive days in a rat model of chronic sciatic nerve ...In the present study, we examined the analgesic effect of repeated electroacupuncture at bilateral Zusanfi （ST36） and Yanglingquan （GB34） once a day for 14 consecutive days in a rat model of chronic sciatic nerve constriction injury-induced neuropathic pain. In addition, concomitant changes in calcium/calmodulin-dependent protein kinase II expression and synaptic ultrastructure of neurons in the hippocampal CA3 region were examined. The thermal pain threshold （paw withdrawal latency） was increased significantly in both groups at 2 weeks after electroacupuncture intervention compared with 2 days of electroacupuncture. In ovariectomized rats with chronic constriction injury, the analgesic effect was significantly reduced. Electroacupuncture for 2 weeks significantly diminished the injury-induced increase in synaptJc cleft width and thinning of the postsynaptJc density, and it significantly suppressed the down-regulation of intracellular calcium/ calmodulin-dependent protein kinase II expression in the hippocampal CA3 region. Repeated electroacupuncture intervention had a cumulative analgesic effect on injury-induced neuropathic pain reactions, and it led to synaptic remodeling of hippocampal neurons and upregulated calcium/calmodulin-dependent protein kJnase II expression in the hippocampal CA3 region.展开更多
In the present study, a rat model of chronic neuropathic pain was established by ligation of the sciatic nerve and a model of learning and memory impairment was established by ovariectomy to investigate the analgesic ...In the present study, a rat model of chronic neuropathic pain was established by ligation of the sciatic nerve and a model of learning and memory impairment was established by ovariectomy to investigate the analgesic effect of repeated electroacupuncture stimulation at bilateral Zusanfi （ST36） and Yanglingquan （GB34）. In addition, associated synaptic changes in neurons in the paraventricular nucleus of the hypothalamus were examined. Results indicate that the thermal pain threshold （paw withdrawal latency） was significantly increased in rats subjected to 2-week electroacupuncture intervention compared with 2-day electroacupuncture, but the analgesic effect was weakened remarkably in ovariectomized rats with chronic constrictive injury. 2-week electroacupuncture intervention substantially reversed the chronic constrictive injury-induced increase in the synaptic cleft width and thinning of the postsynaptic density. These findings indicate that repeated electroacupuncture at bilateral Zusanfi and Yanglingquan has a cumulative analgesic effect and can effectively relieve chronic neuropathic pain by remodeling the synaptic structure of the hypothalamic paraventricular nucleus.展开更多
The present study observed the effects of repeated electroacupuncture of Zusanli （ST36） and Yanglingquan （GB34） on expression of hippocampal acetylcholinesterase, vesicular acetylcholine transporter, and muscarini...The present study observed the effects of repeated electroacupuncture of Zusanli （ST36） and Yanglingquan （GB34） on expression of hippocampal acetylcholinesterase, vesicular acetylcholine transporter, and muscarinic M1 receptor mRNA in chronic constrictive injury （neuropathic pain） and/or ovariotomy rats. Results demonstrated increased expression of hippocampal acetylcholinesterase, vesicular acetylcholine transporter, and muscarinic M1 receptor mRNA, as well as decreased pain threshold, in a rat model of chronic neuropathic pain after electroacupuncture. The effects of electroacupuncture increased with prolonged time, but the above-mentioned effects decreased in memory-deficient animals. Results indicated that repeated electroacupuncture has a cumulative analgesic effect, which is closely associated with upregulation of acetylcholinesterase and vesicular acetylcholine transporter activity, as well as M1 receptor mRNA expression and memory.展开更多
AIM To identify unique clusters of patients based on their concerns in using analgesia for cancer pain and predictors of the cluster membership.METHODS This was a 3-mo prospective observational study(n = 207).Patients...AIM To identify unique clusters of patients based on their concerns in using analgesia for cancer pain and predictors of the cluster membership.METHODS This was a 3-mo prospective observational study(n = 207).Patients were included if they were adults(≥ 18 years), diagnosed with solid tumors or multiple myelomas, and had at least one prescription of around the clock pain medication for cancer or cancer-treatment-related pain.Patients were recruited from two outpatient medical oncology clinics within a large health system in Philadelphia.A choice-based conjoint(CBC) analysis experiment was used to elicit analgesic treatment preferences(utilities).Patients employed trade-offs based on five analgesic attributes(percent relief from analgesics, type of analgesic, type of sideeffects, severity of side-effects, out of pocket cost).Patients were clustered based on CBC utilities using novel adaptive statistical methods.Multiple logistic regression was used to identify predictors of cluster membership.RESULTS The analyses found 4 unique clusters: Most patients made trade-offs based on the expectation of pain relief(cluster 1, 41%).For a subset, the main underlying concern was type of analgesic prescribed, i.e., opioid vs non-opioid(cluster 2, 11%) and type of analgesic side effects(cluster 4, 21%), respectively.About one in four made trade-offs based on multiple concerns simultaneously including pain relief, type of side effects, and severity of side effects(cluster 3, 27.5%).In multivariable analysis, to identify predictors of cluster membership, clinical and socioeconomic factors(education, health literacy, income, social support) rather than analgesic attitudes and beliefs were found important; only the belief, i.e., pain medications can mask changes in health or keep you from knowing what is going on in your body was found significant in predicting two of the four clusters [cluster 1(-); cluster 4(+)].CONCLUSION Most patients appear to be driven by a single salient concern in using analgesia for cancer pain.Addressing these concerns, perhaps through real time clinical assessments, may improve patients' analgesic adherence patterns and cancer pain outcomes.展开更多
To compare the analgesic and side effects of post-operative analgesia between epidural administration ofneostigmine (NEO) and morphine (MOR) or their combination in patients undergoing abdominal surgery. Methods: One ...To compare the analgesic and side effects of post-operative analgesia between epidural administration ofneostigmine (NEO) and morphine (MOR) or their combination in patients undergoing abdominal surgery. Methods: One hundredand two selective patients undergoing surgery were randomly divided into five groups at the end of the surgical procedure. GroupN1 (n=11) and Group N2(n =15) were administered epidurally with NEO 1 mg and 2 mg respectively, Group M1 (n=18)and Group M2 (n=55) were administered epidurally with MOR 1 mg and 2 mg respectively, Group M1 + N1 (n=17) was administered epidurally with the combination of MOR 1 mg and NEO 1 mg. Results: Single dose epidural administration of NEO (1mg and 2 mg) or MOR (1 mg and 2 mg) showed dose-dependent analgesic effects. The analgesic duration in Group N1 (4.7 ± 2.7 h) was significantly shorter than other four groups (P<0. 01). Group M1, M2 and M1 + N1 showed better analgesic effectsthan group N1 and N2 (16.1±8.7h) , with similar analgesic durations in Group M1, M2 and M1 + N1. me percentages of excellent, good and poor effects were 0%, 54.5 % and 45.5 % respectively in Group N1. The percentages of excellent and good effects were 100% in Group M2 and M1 + N1, but 83.3% in Group N2. The time to first use analgesic medication was similar inGroup M1, M2 and M1 + N1, but longer compared with Croup N1 and N2. The incidences of nausea and vomiting closelyresem-bled one another in Croup N1, N2 and M1 + N1, which were less than those in Group M1 and M2. The incidence of urinary retention was 51.2%, 25.0% and 31.3% in Group M2, M1 and M1 + N1, respectively, but 0% in Group N1 and N2. In GroupN2 two patients opened the bowel movement and one patient developed bradycardia (58 beats/min) at 45 min after receiving NEO.Conclusion: Epidural administration of NEO produces dose-dependent prolonged analgesic effects (similar to MOR) and the combination of MOR and NEO could produce analgesia with fewer side effects than administration of equivalent analgesic doses of eachdrug separately. me epidural administration of NEO 2 mg could provide satisfactory postoperative analgesia.展开更多
文摘[Objectives]This study aimed to investigate the effects of ropivacaine-sufentanil epidural analgesia on labor and maternal and neonatal outcomes.[Methods]A total of 180 primiparas in full-term pregnancy were selected.They were randomly divided into treatment group(n=90)and control group(n=90).The primiparas in the treatment group were injected epidurally with ropivacaine and sufentanil for analgesia,and the primiparas in the control group were subjected to vaginal delivery.The VAS scores at 5,10,30 and 60 min of analgesia were observed.The vaginal bleeding amount,total labor duration,neonatal Apgar score and vaginal delivery rate of the two groups were compared.[Results]Compared with the control group,the VAS score in the treatment group differed insignificantly after 5 min of analgesia(P>0.05),and decreased significantly after 10,30 and 60 min of analgesia(P<0.05).The vaginal bleeding amount of the treatment group was significantly smaller than that of the control group(P<0.05).There was no significant difference in the neonatal Apgar score between the two groups(P>0.05).In the treatment group,the vaginal delivery rate increased(P<0.05),the second stage of labor was prolonged(P<0.05),and the first and third stages of labor did not change significantly(P>0.05).[Conclusions]Epidural analgesia with ropivacaine and sufentanil has a good analgesic effect and good safety,and is worthy of clinical promotion.
文摘BACKGROUND Knee diseases are more common in middle-aged and elderly people,so artificial knee replacement is also more used in middle-aged and elderly people.Although the patient’s pain can be reduced through surgery,often accompanied by moderate pain after surgery and neutralization,which not only increases the psychological burden of the patient,but also greatly reduces the postoperative recovery effect,and may also lead to the occurrence of postoperative adverse events in severe cases.AIM To investigate the analgesic effect of artificial intelligence(AI)and ultrasoundguided nerve block in total knee arthroplasty(TKA).METHODS A total of 92 patients with TKA admitted to our hospital from January 2021 to January 2022 were opted and divided into two groups according to the treatment regimen.The control group received combined spinal-epidural anesthesia.The research group received AI technique combined with ultrasound-guided nerve block anesthesia.The sensory block time,motor block time,visual analogue scale(VAS)at different time points and complications were contrasted between the two groups.RESULTS The time of sensory block onset and sensory block perfection in the research group was shorter than those in the control group,but the results had no significant difference(P>0.05).Duration of sensory block in the research group was significantly longer than those in the control group(P<0.05).The time of motor block onset and motor block perfection in the research group was shorter than those in the control group,but the results had no significant difference(P>0.05).Duration of motor block in the research group was significantly longer than those in the control group.The VAS scales of the research group were significantly lower than that of the control group at different time points(P<0.05).The postoperative hip flexion and abduction range of motion in the research group were significantly better than those in the control group at different time points(P<0.05).The incidence of complications was significantly lower in the research group than in the control group(P=0.049).CONCLUSION In TKA,the combination of AI technology and ultrasound-guided nerve block has a significantly effect,with fewer postoperative complications and significantly analgesic effect,which is worthy of application.
基金Supported by Hong Kong Jockey Club Charities Trust(JCICM16-02)
文摘AIM:To investigate the pharmacological effect of JCM-16021,a Chinese herbal formula,and its underlying mechanisms.METHODS:JCM-16021 is composed of seven herbal plant materials.All raw materials of the formula were examined according to the quality control criteria listed in the Chinese Pharmacopeia(2005).In a neonatal maternal separation(NMS)model,male SpragueDawley rats were submitted to daily maternal separation from postnatal day 2 to day 14,or no specific handling(NH).Starting from postnatal day 60,rats were administered JCM-16021(2,4,8 g/kg per day)orally twice a day for 28 d.Pain threshold pressure and electromyographic activities of external oblique muscles in response to colorectal distention recorded with a Power Lab System(AD Instruments International),were tested as pain indices.Changes in serotonin(5-HT)and 5-hydroxyindoleacetic acid(5-HIAA)concentrations in the colon of rats were analyzed;the enterochromaffin cell numbers and serotonin transporter in the colon of rats were also evaluated with an immunohistochemistry method.RESULTS:NMS treatment significantly reduced pain threshold pressure(37.4±1.4 mmHg),as compared to that of NH rats(57.7±1.9 mmHg,P<0.05).After JCM-16021 treatment,the pain threshold pressure significantly increased when compared to that before treatment(34.2±0.9 mmHg vs 52.8±2.3 mmHg in the high dose group,40.2±1.6 mmHg vs 46.5±1.3 mmHg in the middle dose group,and 39.3±0.7 mmHg vs 46.5±1.6 mmHg in the low dose group,P<0.05).Also JCM-16021 significantly and dose-dependently decreased electromyographic activity to the graded colorectal distension(CRD),(the meanΔAUC values were:0.17±0.03,0.53±0.15,1.06±0.18,1.22±0.24 in the high dose group;0.23±0.04,0.68±0.17,1.27 ±0.26,1.8±0.3 in the middle dose group;and 0.29 ±0.06,0.8±0.16,1.53±0.24,2.1±0.21 in the low dose group for the pressures 20,40,60,80 mmHg),as compared to the NMS vehicle group.The meanΔAUC values were:0.57±0.12,1.33±0.18,2.57±0.37,3.08±0.37 for the pressures 20,40,60,80 mmHg(P <0.05).JCM-16021 treatment significantly reduced the 5-HT concentrations(from high,middle and low dosage groups:60.25±5.98 ng/100 mg,60.32±4.22 ng/100 mg,73.31±7.65 ng/100 mg),as compared to the NMS vehicle groups(93.11±9.85 ng/100 mg,P<0.05);and increased the 5-HIAA concentrations(after treatment,from high,middle and low dosage groups:54.24±3.27 ng/100 mg,50.34±1.26 ng/100 mg,51.37±2.13 ng/100 mg)when compared to that in the NMS vehicle group(51.75±1.98 ng/100 mg,P <0.05);but did not change the enterochromaffin cell numbers in the colon of rats.In addition,NMS rats had higher SERT expression(n=10)than NH rats(n=8,P<0.05).JCM-16021 treatment significantly decreased SERT expression when compared to the NMS group(P <0.01-0.001).CONCLUSION:JCM-16021 can attenuate visceral hypersensitivity,and this analgesic effect may be mediated through the serotonin signaling pathway in the colon of rats.
文摘Objective To and connexin 43. Methods investigate the possible relationship between the analgesic effect of acupuncture Connexin 43 gene knock-out mice were randomly divided into 4 groups： a wide type （WT） control group, a WT acupuncture group, a heterozygous （HT） control group and HT acupuncture group. Hot-plate test and writhing response induced by acetic acid were used for investigating the different analgesic effect of acupuncture on HT and WT mice. Results There was no significant difference in the basic pain threshold value between HT and WT mice （P 〉0.05）. Acupuncture could significantly increase the pain threshold value, prolong the latency period of writhing body and decrease the number of writhing body as compared with pre-acupuncture in WT and HT mice （P 〈 0.01 or P 〈 0.05）. The pain threshold, latency period of writhing and number of writhing body in HT mice were less than WT mice post-acupuncture （P〈0.05）. Conclusion Connexin 43 gene knock-out might partially inhibit the analgesic effect of acupuncture, suggesting that connexin 43 is possibly related with meridians and the effect of acupuncture.
基金supported by the National Natural Science Foundation of China,No.30472241,90709031 and 30973796the Ministry of Science and Technology of China("973"Project),No.2007CB512505+1 种基金provided by the Foundation of Hainan Province,No.310054the Health Department of Hainan Province,Qiong-Wei-45
文摘In the present study, we examined the analgesic effect of repeated electroacupuncture at bilateral Zusanfi （ST36） and Yanglingquan （GB34） once a day for 14 consecutive days in a rat model of chronic sciatic nerve constriction injury-induced neuropathic pain. In addition, concomitant changes in calcium/calmodulin-dependent protein kinase II expression and synaptic ultrastructure of neurons in the hippocampal CA3 region were examined. The thermal pain threshold （paw withdrawal latency） was increased significantly in both groups at 2 weeks after electroacupuncture intervention compared with 2 days of electroacupuncture. In ovariectomized rats with chronic constriction injury, the analgesic effect was significantly reduced. Electroacupuncture for 2 weeks significantly diminished the injury-induced increase in synaptJc cleft width and thinning of the postsynaptJc density, and it significantly suppressed the down-regulation of intracellular calcium/ calmodulin-dependent protein kinase II expression in the hippocampal CA3 region. Repeated electroacupuncture intervention had a cumulative analgesic effect on injury-induced neuropathic pain reactions, and it led to synaptic remodeling of hippocampal neurons and upregulated calcium/calmodulin-dependent protein kJnase II expression in the hippocampal CA3 region.
基金supported by the National Natural Science Foundation of China,No.30472241,90709031 and 30973796the National Basic Research Program of China for Traditional Chinese Medicine Theory("973" Program),No.2007CB512505+1 种基金the Natural Foundation of Hainan Province(No.310054)a grant from the Health Department of Hainan Province(QiongWei 2010-45)
文摘In the present study, a rat model of chronic neuropathic pain was established by ligation of the sciatic nerve and a model of learning and memory impairment was established by ovariectomy to investigate the analgesic effect of repeated electroacupuncture stimulation at bilateral Zusanfi （ST36） and Yanglingquan （GB34）. In addition, associated synaptic changes in neurons in the paraventricular nucleus of the hypothalamus were examined. Results indicate that the thermal pain threshold （paw withdrawal latency） was significantly increased in rats subjected to 2-week electroacupuncture intervention compared with 2-day electroacupuncture, but the analgesic effect was weakened remarkably in ovariectomized rats with chronic constrictive injury. 2-week electroacupuncture intervention substantially reversed the chronic constrictive injury-induced increase in the synaptic cleft width and thinning of the postsynaptic density. These findings indicate that repeated electroacupuncture at bilateral Zusanfi and Yanglingquan has a cumulative analgesic effect and can effectively relieve chronic neuropathic pain by remodeling the synaptic structure of the hypothalamic paraventricular nucleus.
基金supported by the National Natural Science Foundation of China, No. 30472241, key project: 90709031the Ministry of Science and Technology of China ("973" Project), No. 2007CB512505
文摘The present study observed the effects of repeated electroacupuncture of Zusanli （ST36） and Yanglingquan （GB34） on expression of hippocampal acetylcholinesterase, vesicular acetylcholine transporter, and muscarinic M1 receptor mRNA in chronic constrictive injury （neuropathic pain） and/or ovariotomy rats. Results demonstrated increased expression of hippocampal acetylcholinesterase, vesicular acetylcholine transporter, and muscarinic M1 receptor mRNA, as well as decreased pain threshold, in a rat model of chronic neuropathic pain after electroacupuncture. The effects of electroacupuncture increased with prolonged time, but the above-mentioned effects decreased in memory-deficient animals. Results indicated that repeated electroacupuncture has a cumulative analgesic effect, which is closely associated with upregulation of acetylcholinesterase and vesicular acetylcholine transporter activity, as well as M1 receptor mRNA expression and memory.
基金National Institutes of Health/National Institute of Nursing Research,No.NIH/NINR RC1-NR011591
文摘AIM To identify unique clusters of patients based on their concerns in using analgesia for cancer pain and predictors of the cluster membership.METHODS This was a 3-mo prospective observational study(n = 207).Patients were included if they were adults(≥ 18 years), diagnosed with solid tumors or multiple myelomas, and had at least one prescription of around the clock pain medication for cancer or cancer-treatment-related pain.Patients were recruited from two outpatient medical oncology clinics within a large health system in Philadelphia.A choice-based conjoint(CBC) analysis experiment was used to elicit analgesic treatment preferences(utilities).Patients employed trade-offs based on five analgesic attributes(percent relief from analgesics, type of analgesic, type of sideeffects, severity of side-effects, out of pocket cost).Patients were clustered based on CBC utilities using novel adaptive statistical methods.Multiple logistic regression was used to identify predictors of cluster membership.RESULTS The analyses found 4 unique clusters: Most patients made trade-offs based on the expectation of pain relief(cluster 1, 41%).For a subset, the main underlying concern was type of analgesic prescribed, i.e., opioid vs non-opioid(cluster 2, 11%) and type of analgesic side effects(cluster 4, 21%), respectively.About one in four made trade-offs based on multiple concerns simultaneously including pain relief, type of side effects, and severity of side effects(cluster 3, 27.5%).In multivariable analysis, to identify predictors of cluster membership, clinical and socioeconomic factors(education, health literacy, income, social support) rather than analgesic attitudes and beliefs were found important; only the belief, i.e., pain medications can mask changes in health or keep you from knowing what is going on in your body was found significant in predicting two of the four clusters [cluster 1(-); cluster 4(+)].CONCLUSION Most patients appear to be driven by a single salient concern in using analgesia for cancer pain.Addressing these concerns, perhaps through real time clinical assessments, may improve patients' analgesic adherence patterns and cancer pain outcomes.
文摘To compare the analgesic and side effects of post-operative analgesia between epidural administration ofneostigmine (NEO) and morphine (MOR) or their combination in patients undergoing abdominal surgery. Methods: One hundredand two selective patients undergoing surgery were randomly divided into five groups at the end of the surgical procedure. GroupN1 (n=11) and Group N2(n =15) were administered epidurally with NEO 1 mg and 2 mg respectively, Group M1 (n=18)and Group M2 (n=55) were administered epidurally with MOR 1 mg and 2 mg respectively, Group M1 + N1 (n=17) was administered epidurally with the combination of MOR 1 mg and NEO 1 mg. Results: Single dose epidural administration of NEO (1mg and 2 mg) or MOR (1 mg and 2 mg) showed dose-dependent analgesic effects. The analgesic duration in Group N1 (4.7 ± 2.7 h) was significantly shorter than other four groups (P<0. 01). Group M1, M2 and M1 + N1 showed better analgesic effectsthan group N1 and N2 (16.1±8.7h) , with similar analgesic durations in Group M1, M2 and M1 + N1. me percentages of excellent, good and poor effects were 0%, 54.5 % and 45.5 % respectively in Group N1. The percentages of excellent and good effects were 100% in Group M2 and M1 + N1, but 83.3% in Group N2. The time to first use analgesic medication was similar inGroup M1, M2 and M1 + N1, but longer compared with Croup N1 and N2. The incidences of nausea and vomiting closelyresem-bled one another in Croup N1, N2 and M1 + N1, which were less than those in Group M1 and M2. The incidence of urinary retention was 51.2%, 25.0% and 31.3% in Group M2, M1 and M1 + N1, respectively, but 0% in Group N1 and N2. In GroupN2 two patients opened the bowel movement and one patient developed bradycardia (58 beats/min) at 45 min after receiving NEO.Conclusion: Epidural administration of NEO produces dose-dependent prolonged analgesic effects (similar to MOR) and the combination of MOR and NEO could produce analgesia with fewer side effects than administration of equivalent analgesic doses of eachdrug separately. me epidural administration of NEO 2 mg could provide satisfactory postoperative analgesia.
