Chronic post-operative pain is a recognized adverse consequence of surgery;managing and preventing it are always a better choice. Proper choice of Anesthetic technique, use of combined anesthesia and pre-emptive analg...Chronic post-operative pain is a recognized adverse consequence of surgery;managing and preventing it are always a better choice. Proper choice of Anesthetic technique, use of combined anesthesia and pre-emptive analgesia may prevent and decrease the incidence of chronic post-operative pain. Transverse abdominis plane block (TAP Block) is a regional anesthesia technique following abdominal surgeries which involve injection of a large amount of local anesthetics in TAP, an anatomical space between the internal oblique and transverse abdominis muscle. The aim of this review is to show the effect and uses of TAP block as a combined anesthesia and multimodal analgesia in preventing chronic post-operative pain.展开更多
BACKGROUND Knee osteoarthritis(KOA),a common disabling pathology characterized by knee joint pain,swelling,and functional impairment,primarily affects middle-aged and older adults.In addition to physical limitations,c...BACKGROUND Knee osteoarthritis(KOA),a common disabling pathology characterized by knee joint pain,swelling,and functional impairment,primarily affects middle-aged and older adults.In addition to physical limitations,chronic pain often leads to psychological problems,including anxiety and depression,which further impact patients’quality of life.AIM To examine the efficacy and safety of celecoxib plus duloxetine in managing chronic pain,anxiety,and depression in patients with KOA.METHODS A retrospective analysis was conducted on 123 patients with KOA treated at our center between February 2020 and February 2023.Of these,66 received celecoxib plus duloxetine,and 57 received celecoxib alone.Outcomes were assessed using the Visual Analog Scale(VAS),the Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC),and the Self-Rating Anxiety Scales(SAS)/Self-Rating Depression Scales(SDS).Safety was evaluated by monitoring changes in liver function enzymes(alanine aminotransferase,aspartate aminotransferase),creatinine,and blood urea nitrogen.RESULTS Patients receiving celecoxib plus duloxetine showed significantly greater reductions in VAS and WOMAC and greater improvements in SAS and SDS scores compared with those receiving celecoxib alone.Hepatorenal function did not differ significantly between the treatment groups.Logistic regression analysis identified patient age,educational background,and treatment regimen as independent predictors of inadequate improvement in negative emotional symptoms.CONCLUSION In patients with KOA,celecoxib plus duloxetine effectively mitigates chronic pain and improves anxiety and depressive symptoms without increasing adverse hepatic or renal effects.These findings support its use as a safe and effective treatment option.展开更多
BACKGROUND Tourniquets are commonly used in elective extremity orthopaedic surgery to reduce blood loss,improve visualization in the surgical field,and to potentially reduce surgical time.There is a lack of consensus ...BACKGROUND Tourniquets are commonly used in elective extremity orthopaedic surgery to reduce blood loss,improve visualization in the surgical field,and to potentially reduce surgical time.There is a lack of consensus in existing guidelines regarding the optimal tourniquet pressure,placement site,and duration of use.There is a paucity of data on the relationship between the site of a tourniquet and postoperative pain in foot and ankle surgery.AIM To explore the relationship between tourniquet site and intensity of post-operative pain scores in patients undergoing elective foot and ankle surgery.METHODS Retrospective analysis of prospectively collected data on 201 patients who underwent foot and ankle surgery in a single institution was undertaken.Intraoperative tourniquet duration,tourniquet pressure and site,and postoperative pain scores using Visual Analogue Score were collected in immediate recovery,at six hours and at 24 h post-op.Scatter plots were used to analyse the data and to assess for the statistical correlation between tourniquet pressure,duration,site,and pain scores using Pearson correlation coefficient.RESULTS All patients who underwent foot and ankle surgery had tourniquet pressure of 250 mmHg for ankle tourniquet and 300 mmHg for thigh.There was no correlation between the site of the tourniquet and pain scores in recovery,at six hours and after 24 h.There was a weak correlation between tourniquet time and Visual Analogue Score immediately post-op(r=0.14,P=0.04)but not at six or 24 h post-operatively.CONCLUSION This study shows that there was no statistically significant correlation between tourniquet pressure,site and postop pain in patients undergoing foot and ankle surgery.The choice of using a tourniquet is based on the surgeon's preference,with the goal of minimizing the duration of its application at the operative site.展开更多
Background: Chronic low back pain is a leading cause of morbidity and disability globally. Low and Middle-Income Countries (LMICs) tend to be more affected, with chronic low back pain (CLBP) being among the leading pr...Background: Chronic low back pain is a leading cause of morbidity and disability globally. Low and Middle-Income Countries (LMICs) tend to be more affected, with chronic low back pain (CLBP) being among the leading presenting complaints at specialist consultation. The exact burden of this disease is sparingly known in our setting. Objective: To evaluate the burden of chronic low back pain at the Yaounde Central Hospital. Methods: This was a descriptive cross-sectional study for a period of 3 months, from March 2022 to May 2022. After obtaining ethical clearance and research authorisations, data was collected using structured questionnaires from patients with chronic low back pain presenting at the Yaounde Central Hospital during the aforementioned time frame. This data was then tabulated with the Statistical Package for Social Sciences (SPSS 23.0), and disability was assessed using the modified Roland Morris Disability Questionnaire and the Oswestry Disability Index. Data analysis was done using the International Business Machines Statistical Package for Social Sciences (IBM-SPSS) VERSION 23.0. Results: 115 cases of CLBP were included. The mean age was 52.62 years, and the sex ratio was 0.3. The average monthly income was less than 50,000 frs CFA, in 37.4% of cases. In 57.9%, patients had a job that involved physical labour. The patients had a secondary level of education in 40.9%, and alcohol consumption was observed in 36%. The average number of days of a work stoppage due to LBP was 12.75 days (±12SD), and the median duration of CLBP was 7.15 (7.5SD) years. The median pain intensity was 7 (±2SD), with leg pain and sensory neuropathy observed in 67.8% and 63.5% respectively. Lumbar X-ray was done in 45.2% and revealed lumbar osteoarthrosis in 62.4%. Hypertension as a comorbidity was observed in 26.1%. Medical treatment was used at least once in 98.3% of cases. The average cost of management per month was assessed, and the median was 52,000 FCFA (±20,876 SD). Using the Oswestry Disability Questionnaire, 46 patients, that is 40% of the study population, were classified as severely disabled with a median ODI score of 40%. The factors which were independently associated with disability were level of education, alcohol consumption, treatment modality, pain intensity, body mass index (BMI), psychological wellbeing and number of sick leave days. Conclusion: Chronic low back pain is common in our setting. There is a female predominance with the mean age of the study population situated in the 5th decade. Low-income earners and patients with a job involving physical labour were the most affected. Medical treatment was the main therapeutic modality, with the average cost of management per month being above the average monthly income of the greater majority of the patients. Several factors influenced disability, some of which were independently associated with it, such as level of education, alcohol consumption and treatment modality.展开更多
In a recent study published in Science Translational Medicine,Jiang et al.uncovered a novel contribution of sensory neuron-derived follistatin(FST)to neuropathic pain by which FST,generated from A-fiber neurons,promot...In a recent study published in Science Translational Medicine,Jiang et al.uncovered a novel contribution of sensory neuron-derived follistatin(FST)to neuropathic pain by which FST,generated from A-fiber neurons,promotes Nav 1.7-mediated noceptive neuronal excitability via binding to the insulin-like growth factor 1 receptor(IGF1R),making it a potential therapeutic target for neuropathic pain(Fig.1A,B)[1].展开更多
Chronic pain after spine surgery(CPSS)is a complex disorder characterized by multifactorial pathogenesis that occurs in 8%–40%of patients undergoing lumbar spine surgery.We aimed to develop a rat model that mimics cl...Chronic pain after spine surgery(CPSS)is a complex disorder characterized by multifactorial pathogenesis that occurs in 8%–40%of patients undergoing lumbar spine surgery.We aimed to develop a rat model that mimics clinical CPSS conditions by taking two sequential surgical procedures.Step 1:A plastic rod was inserted into the left L5 intervertebral foramen to produce a steady compression on the dorsal root ganglion(DRG)and the spinal nerve,a common cause of low back pain(LBP).Step 2:The rod was removed after 7 days when rats exhibited mechanical and heat hypersensitivity in the ipsilateral hindpaw,followed by a full L5 laminectomy to mimic spine decompression surgery in LBP patients.The retention of the rod induced a prolonged LBP-like behavior but was quickly resolved after rod removal without laminectomy.However,rats that received laminectomy after rod removal developed heightened mechanical and heat sensitivity in the hindpaw,impaired gait,and reduced spontaneous exploration activity,indicating CPSS.Patch clamp recording revealed a significant augmentation in the intrinsic excitability of smalldiameter DRG neurons in CPSS rats.Administration of Dermorphin[D-Arg2,Lys4](1–4)amide(DALDA,5mg/kg,i.p.),a peripherally acting mu-opioid receptor(MOR)-preferred agonist,attenuated pain hypersensitivity,capsaicin-induced[Ca^(2+)]i rising and the increased intrinsic excitability of DRG neurons from CPSS rats.Our findings suggest that this new model,which mirrors the nature of CPSS developed in patients,may be useful for future studies of the underlying mechanisms.展开更多
Objective:To explore the relationship between pain degree and pain catastrophe and medical coping mode in patients with chronic pain.Methods:A visual analogue score scale,medical coping style questionnaire and pain ca...Objective:To explore the relationship between pain degree and pain catastrophe and medical coping mode in patients with chronic pain.Methods:A visual analogue score scale,medical coping style questionnaire and pain catastrophe scale were used to survey 200 patients in the pain department.Results:The average scores of pain degree of patients with chronic pain were(5.97±2.29),the average score of the total score of the Pain Catastrophe Scale was(21.21±11.56),and the average scores of facing,avoidance and surrender in the Medical Response Style Questionnaire were(17.93±3.4),(16.82±2.4),and(8.87±2.83),respectively.Pain degree was positively correlated with the yield dimension in pain catastrophe and medical coping(p<0.05).The yield dimension of medical coping was positively correlated with pain catastrophe(p<0.05).Medical coping methods played a partial mediating role between pain degree and pain catastrophe,and the mediating effect accounted for 21.59%of the total effect.Conclusion:The pain level of chronic pain patients can affect the level of pain catastrophe through medical coping,and clinical medical staff should guide patients to adopt positive coping methods to promote their healthy recovery.展开更多
Objective To determine the prevalence,distribution,and associated clinical factors of chronic neuropathic cancer pain(CNCP)among outpatients with chronic cancer pain(CCP)and to inform improved recognition and manageme...Objective To determine the prevalence,distribution,and associated clinical factors of chronic neuropathic cancer pain(CNCP)among outpatients with chronic cancer pain(CCP)and to inform improved recognition and management.Methods In this cross-sectional study,consecutive outpatients with CCP diagnosed according to the International Association for the Study of Pain(IASP)criteria were recruited from the pain clinic at Peking Union Medical College Hospital between June and October 2025.CNCP was diagnosed based on the Neuropathic Pain Special Interest Group(NeuPSIG)criteria.Patients were classified into the CNCP group if they met at least one of the four NeuPSIG criteria,regardless of coexisting visceral or bone pain.Demographic,oncologic,and pain-related data were collected through standardized interviews.Between-group differences in baseline characteristics were assessed using absolute standardized differences and Chi-square or t-tests.Logistic regression analyses were conducted to identify clinical factors associated with CNCP.Results Of 138 eligible patients with CCP,85(61.6%)were classified into the CNCP group and 53(38.4%)into the non-CNCP group.Multivariable logistic regression analysis revealed that bone metastasis(adjusted OR=2.316,95%CI:1.074-5.178,P=0.032),radiotherapy(adjusted OR=2.489,95%CI:1.119-5.803,P=0.025),and voiding dysfunction(adjusted OR=5.470,95%CI:2.150-16.396,P<0.001)were independently associated with CNCP.Pancreatic cancer was inversely associated with CNCP(OR=0.371,P=0.031).Only 5(3.6%)patients in the CNCP group received neuropathic pain-specific interventions,indicating a predominant reliance on single-modality pain management.Conclusions CNCP was present in nearly two-thirds of outpatients with CCP.The identified associations with bone metastasis,radiotherapy,and voiding dysfunction may aid in the early recognition of neuropathic pain components and support the adoption of mechanism-based multimodal pain management strategies.展开更多
Chronic postsurgical pain (CPSP) following gastrointestinal (GI) surgery is acommon issue that poses significant challenges to patients’ recovery and qualityof life. Given the importance of vitamin D in inflammation ...Chronic postsurgical pain (CPSP) following gastrointestinal (GI) surgery is acommon issue that poses significant challenges to patients’ recovery and qualityof life. Given the importance of vitamin D in inflammation reduction, nerverepair, bone health, and immune regulation, its potential role in pain managementhas gained increasing attention. Preliminary evidence suggests that many patientswho undergo GI surgery have lower perioperative vitamin D levels. Patients withvitamin D deficiency have increased opioid use and heightened pain sensitivityafter colorectal cancer surgery. Patients with lower vitamin D levels experiencegreater pain three months after arthroscopic rotator cuff repair or video-assistedthoracoscopic surgery. However, research on the relationship between vitamin Dand CPSP after GI surgery is limited. Larger, well-designed clinical trials areneeded to determine the causal relationship between low vitamin D levels andCPSP, determine the optimal perioperative vitamin D levels, and provide morereliable evidence for clinical application. Moreover, vitamin D has positive effectson various systemic diseases and postoperative recovery, including immuneregulation, infection prevention, wound healing, tissue regeneration, nutritionalstatus, and metabolic health. These findings indicate that vitamin D has broadclinical application potential. We hope to provide a new insight into postoperativerecovery and pain management strategies for GI surgeries.展开更多
BACKGROUND Eosinophilic gastrointestinal(GI)disease(EGID)beyond eosinophilic esophagitis is not commonly reported in the developing world.AIM To estimate the prevalence of EGID in a selected group of pediatric patient...BACKGROUND Eosinophilic gastrointestinal(GI)disease(EGID)beyond eosinophilic esophagitis is not commonly reported in the developing world.AIM To estimate the prevalence of EGID in a selected group of pediatric patients suffering from non-functional chronic abdominal pain(CAP).METHODS A retrospective analysis was conducted on case records of children with CAP.Those exhibiting clinical or laboratory alarming features underwent endoscopic evaluation.Histopathology reports from upper GI endoscopy and ileo-colonoscopy determined the diagnosis of EGID.Subsequent analyses included clinical presentations,presence of atopy in the children or family,hemoglobin,albumin,serum immunoglobulin E(IgE),fecal calprotectin levels,endoscopic appearances,treatment methods,and outcomes.RESULTS A total of 368 children with organic CAP were subjected to endoscopic evaluation.Among them,19(5.2%)patients with CAP were diagnosed with EGID.The median age of the children was 11.1 years(interquartile range=8.4-14.4).The estimated prevalence of EGID in children with organic CAP was 520/10000 children over 5 years.Periumbilical pain was the most common site(63%).Family history of atopy,peripheral blood eosinophilia,and elevated serum IgE were the three parameters significantly associated with EGID.Clinical remission was obtained in all children at 6 months.The 47%had microscopic remission and maintained remission until a 1-year follow-up.The 53%had a fluctuating clinical course after 6 months.CONCLUSION EGID beyond the esophagus is not an uncommon entity among the children of India.It can contribute significantly to the etiology of pediatric CAP.展开更多
Chronic pain is a leading cause of disability and affects over 30%of military veterans and active duty personnel[1].Pharmacological approaches to long-term chronic pain management increase the risk of negative effects...Chronic pain is a leading cause of disability and affects over 30%of military veterans and active duty personnel[1].Pharmacological approaches to long-term chronic pain management increase the risk of negative effects such as addiction,cardiovascular complications,and immunosuppression[2].In contrast,non-drug treatments like audio analgesia have demonstrated efficacy in pain relief without these side effects.Given the prevalence of chronic pain in the military population,it is essential to explore new treatments that effectively target its underlying mechanisms.One promising option is the Pannexin 1(Panx1)channel-forming protein.Panx1 is a large-pore ion channel in the plasma membrane of dorsal root ganglion(DRG)neurons that allows for the release of Adenosine triphosphate(ATP).Th is commentary elaborates on the fi ndings of Xing et al.[3],who investigated the role of Panx1 in peripheral pain sensitization following infl ammatory stimuli.We examine the role of Panx1 in chronic pain,critique Xing et al.’s[3]adjuvant selection and power analysis,and discuss the challenges of translating fi ndings from animal models to human conditions.展开更多
Chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS)is a complex disease that is often accompanied by mental health disorders.However,the potential mechanisms underlying the heterogeneous clinical presentation of...Chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS)is a complex disease that is often accompanied by mental health disorders.However,the potential mechanisms underlying the heterogeneous clinical presentation of CP/CPPS remain uncertain.This study analyzed widely targeted metabolomic data of expressed prostatic secretions(EPS)and plasma to reveal the underlying pathological mechanisms of CP/CPPS.A total of 24 CP/CPPS patients from The Second Nanning People’s Hospital(Nanning,China),and 35 asymptomatic control individuals from First Affiliated Hospital of Guangxi Medical University(Nanning,China)were enrolled.The indicators related to CP/CPPS and psychiatric symptoms were recorded.Differential analysis,coexpression network analysis,and correlation analysis were performed to identify metabolites that were specifically altered in patients and associated with various phenotypes of CP/CPPS.The crucial links between EPS and plasma were further investigated.The metabolomic data of EPS from CP/CPPS patients were significantly different from those from control individuals.Pathway analysis revealed dysregulation of amino acid metabolism,lipid metabolism,and the citrate cycle in EPS.The tryptophan metabolic pathway was found to be the most significantly altered pathway associated with distinct CP/CPPS phenotypes.Moreover,the dysregulation of tryptophan and tyrosine metabolism and elevation of oxidative stress-related metabolites in plasma were found to effectively elucidate the development of depression in CP/CPPS.Overall,metabolomic alterations in the EPS and plasma of patients were primarily associated with oxidative damage,energy metabolism abnormalities,neurological impairment,and immune dysregulation.These alterations may be associated with chronic pain,voiding symptoms,reduced fertility,and depression in CP/CPPS.This study provides a local-global perspective for understanding the pathological mechanisms of CP/CPPS and offers potential diagnostic and therapeutic targets.展开更多
BACKGROUND The occurrence of chronic pain and disability after acute orthopedic trauma is significantly correlated with psychological factors,particularly depression and anxiety.As such,assessment of these factors is ...BACKGROUND The occurrence of chronic pain and disability after acute orthopedic trauma is significantly correlated with psychological factors,particularly depression and anxiety.As such,assessment of these factors is crucial for postoperative rehabilitation.AIM To investigate the correlation between chronic pain,disability,and psychological factors(depression and anxiety)after acute orthopedic trauma surgery.METHODS Data from 120 patients,who underwent surgery for acute orthopedic trauma at Xi’an Traditional Chinese Medicine Hospital(Shaanxi Province,China)between June 2022 and June 2024,were retrospectively analyzed.Basic information and postoperative pain metrics[visual analog scale(VAS)],disability rating index(DRI),Hamilton anxiety rating scale(HAMA)and Hamilton depression rating scale(HAMD)were collected from electronic medical records.Pearson’s correlation analysis was used to examine associations between chronic pain VAS,DRI,HAMD,and HAMA scores.RESULTS Among the 120 patients[79(65.8%)males and 41(34.2%)females],postoperative VAS scores were significantly associated with HAMD and HAMA scores,with correlation coefficients of 0.625(P=0.027)and 0.568(P<0.001),respectively.Postoperative DRI scores were also significantly associated with HAMD and HAMA scores,with correlation coefficients of 0.683 and 0.557,respectively(both P<0.001).CONCLUSION Chronic pain and disability after surgery for acute orthopedic trauma are significantly correlated with psychological factors(depression and anxiety).Multidisciplinary teams should integrate mental health services to improve patient outcomes.展开更多
BACKGROUND Endometriosis affects approximately 10%of reproductive-age women and is frequently associated with chronic pelvic pain.Patients with endometriosis often experience comorbid depression and anxiety,but the un...BACKGROUND Endometriosis affects approximately 10%of reproductive-age women and is frequently associated with chronic pelvic pain.Patients with endometriosis often experience comorbid depression and anxiety,but the underlying mechanisms connecting these conditions are unclear.AIM To assess the prevalence of depression and anxiety in endometriosis patients and explore neuroimmune mechanisms mediated via inflammatory biomarkers.METHODS A retrospective cohort study was conducted with 200 patients with endometriosis-associated chronic pain from June 2020 to December 2024.Depression and anxiety were assessed using validated psychological instruments.Inflammation biomarkers interleukin(ILs)(IL-6,IL-1β),tumor necrosis factor-alpha,C-reactive protein,and brain-derived neurotrophic factor were measured in serum.Pain severity was assessed using visual analog scales.Correlation and regression analyses were performed to examine relationships between inflammatory markers,pain severity,and psychological outcomes.RESULTS Among the 200 patients,42.5%exhibited clinically significant depression and 51.0%showed anxiety symptoms.Serum levels of IL-6,IL-1β,tumor necrosis factor-alpha,and C-reactive protein were significantly higher in patients with comorbid depression and anxiety compared with those without psychological symptoms(P<0.001).Brainderived neurotrophic factor levels were lower in the depression group.Pain severity positively correlated with inflammatory marker levels and with depression and anxiety scores.CONCLUSION Overall,the findings suggest that inflammatory factors mediate a neuroimmune mechanism linking endometriosisassociated chronic pain with depression and anxiety.Therapeutic targets for managing psychological comorbidities in patients with endometriosis through anti-inflammatory interventions should be explored,and an integrated treatment approach addressing both physical and psychological symptoms is emphasized.展开更多
BACKGROUND Acute abdominal pain is often easy to be diagnosed because of acute abdomen,and can be treated reasonably and effectively.It is more difficult to establish the cause of chronic abdominal pain,and some patie...BACKGROUND Acute abdominal pain is often easy to be diagnosed because of acute abdomen,and can be treated reasonably and effectively.It is more difficult to establish the cause of chronic abdominal pain,and some patients repeatedly visit several hos-pitals and still cannot be diagnosed.Chronic abdominal pain caused by chronic appendicitis is such a case.If the degree of abdominal pain is mild and there is no sign of peritonitis,chronic appendicitis is not performed unless the patient re-quests it.CASE SUMMARY We report an extremely rare case of chronic appendicitis caused by a foreign body in the appendix in a 35-year-old woman.The patient had a long-term abdominal pain of unclear cause,and she was repeatedly treated in several hospitals.After antibiotic treatment,the abdominal pain was gradually relieved,but abdominal pain often recurs.We conducted abdominal computed tomography examination,and upon the advice of radiologists,we considered the possibility of foreign bodies in the appendix,and excluded other causes of abdominal pain.The patient requested and consented to laparoscopic appendectomy,and a chicken bone was found in the appendiceal cavity by postoperative incision of the appendiceal spe-cimen.Histopathological examination confirmed chronic appendicitis with fo-reign body giant cell reaction.The patient recovered and was discharged from the hospital.After 2 months of follow-up,abdominal pain did not recur,and the patient had a complete recovery.Core Tip:We report an extremely rare case of chronic appendicitis caused by a chicken bone in the appendix.The patient was 35-year-old woman,and had a long-term abdominal pain of unknown cause.Abdominal computed tomography examination suggested foreign bodies in the appendix,and laparoscopic appendectomy was performed.The postoperative specimen revealed chicken bones in the appendix cavity,and histopathological examination confirmed chronic appendicitis with giant cell reaction of foreign bodies.The patient recovered and was followed up for two months without abdominal pain.Citation:Huang T,Li SK,Wang W,Zhang R.Chronic abdominal pain caused by foreign bodies in the appendix:A case report.World INTRODUCTION Appendicitis is one of the common diseases that cause abdominal pain[1].Appendicitis can be diagnosed and treated effectively when patients with acute abdominal pain are admitted to hospital because of factors such as blockage and infection of appendicitis[2,3].However,the diagnosis of chronic appendicitis is difficult.Acute appendicitis caused by foreign bodies in the appendix is easy to diagnose because of the final surgical treatment[4-6],while chronic appendicitis caused by foreign bodies in the appendix is more difficult to diagnose because of the mild degree of abdominal pain.We here report an extremely rare case of chronic appendicitis caused by foreign bodies in the appendix.The patient had a long-term abdominal pain of unclear cause,and she was repeatedly treated in several hospitals.Abdominal color ultrasound examination indicated a coprolith in the appendiceal cavity and the appendix was normal,so the patient could not be treated with surgery.We conducted abdominal computed tomography(CT)examination,and upon the advice of radiologists,we considered the possibility of foreign bodies in the appendix,and excluded other causes of abdominal pain.The patient requested and consented to laparoscopic appendectomy,and a chicken bone was found in the appendiceal cavity by postoperative incision of the appendiceal specimen.The patient recovered and was discharged from hospital.After 2 months of follow-up,abdominal pain did not recur and the patient had a full recovery.展开更多
Objective:To investigate the relationship between the composition of traditional Chinese medicine(TCM)and depression/anxiety/sleep disturbances(D/A/S)in patients with chronic pain.Methods:This cross-sectional study wa...Objective:To investigate the relationship between the composition of traditional Chinese medicine(TCM)and depression/anxiety/sleep disturbances(D/A/S)in patients with chronic pain.Methods:This cross-sectional study was conducted at 13 tertiary hospitals across China,enrolling patients who experienced chronic pain between November 2023 and May 2024.The Patient Health Questionnaire-9,Generalized Anxiety Disorder-7,Pittsburgh Sleep Quality Index,and TCM constitution categories were used to assess the patients.The association between the TCM constitution and the D/A/S ratio was analyzed using multivariable logistic regression.Results:A total of 1107 patients(63.2%women)were analyzed.Compared with those with a balanced constitution,patients who had qi-deficiency and yin-deficiency were at a higher risk of depression.Qideficiency and yin-deficiency were associated with anxiety.Sleep disturbances were common in patients with qi-deficiency constitution(odds ratio[OR]:2.32,95%confidence interval[CI]:1.42-3.81),yangdeficiency constitution(OR:1.94,95%CI:1.26-2.98),yin-deficiency constitution(OR:2.03,95%CI:1.24 -3.32),blood stasis constitution(OR:2.07,95%CI:1.01-4.22),and qi-stagnation constitution(OR:2.66,95%CI:1.35-5.25).Conclusion:In patients with chronic pain,specific TCM constitutions may be associated with D/A/S.Further longitudinal studies are needed to clarify the potential causal relationships between TCM constitution types and these conditions.展开更多
Background:Chronic pain is defined as pain that lasts for three months or even more.Over 25%of the global population suffers from chronic pain.Tong-luo Qu-tong(TLQT)Plaster is clinically used to treat arthritis.Howeve...Background:Chronic pain is defined as pain that lasts for three months or even more.Over 25%of the global population suffers from chronic pain.Tong-luo Qu-tong(TLQT)Plaster is clinically used to treat arthritis.However,its ability to treat chronic pain remains largely unknown.Methods:In this study,we explored the molecular mechanism of TLQT plaster in relieving chronic muscle pain by combining network pharmacology and RNA-seq analysis.We also applied the Elisa and the RT-qPCR.Results:We found 447 targets in TLQT and 13,599 targets related to chronic pain disease.And 419 intersecting targets were obtained,which mainly enrich the IL-17 signaling pathway,TNF signaling pathway,and Th17 cell differentiation pathway.Further,we constructed the SD rat model of chronic pain.The results of Von Frey Hair Test showed that the relief of muscle pain TLQT treated group was twice as much as that in the model group.The hot plate test results showed that the time of lifting the foot was 1.3 times as much as that of the model group.Moreover,TLQT effectively reduced the inflammation in rat muscle.With RNA-seq analysis,230 differentially expressed genes were collected.The RT-qPCR results indicated that the mRNA expression level of NCF1,CXCL10,and ICAM1 all promoted in the model group,and then decreased significantly in the TLQT treated group.The ELISA results performed that the level of IL-1βand IL-6 in TLQT group high dose group was reduced by about 1.6-fold,and for TNF-α,it was reduced by about 2.6-fold compared with the model group.Immunohistochemistry assay showed that the expression level of CXCL10 and ICAM1 was both up-regulated in the model group and down-regulated in the TLQT group.Conclusion:TLQT plaster reduces chronic muscle pain by inhibiting the expression of NCF1,CXCL10,and ICAM1 and reducing the level of muscle tissue inflammation.展开更多
BACKGROUND Chronic pain and depression often coexist,severely affecting quality of life.Traditional treatments address these conditions separately,but comprehensive psychological cognitive nursing offers a holistic ap...BACKGROUND Chronic pain and depression often coexist,severely affecting quality of life.Traditional treatments address these conditions separately,but comprehensive psychological cognitive nursing offers a holistic approach.By combining cognitive-behavioral strategies and psychological support,it helps improve coping mechanisms,reduce distress,and enhance overall well-being in affected patients.AIM To investigate the impact of comprehensive psychological cognitive nursing on the patients with chronic pain and depression.METHODS From October 2022 to October 2024,171 patients with chronic pain and depression admitted to our hospital were randomly divided into two groups,with 85 patients in the control group and 86 patients in the observation group.The general data from both groups were compared.The control group received standard treatment.The observation group provided full psychological cognitive care in the same way as the control group did.The two groups of patients'psychological states,pain levels,quality of life,sleep quality,and nurse satisfaction were compared before to and during the intervention.RESULTS Compared with the control group,the self-rating anxiety scale(SAS)score,selfrating depression scale(SDS)score,visual analog scale(VAS)score,and Pittsburgh Sleep Quality Index(PSQI)score of the observation group significantly decreased after intervention,while the short-form 36(SF-36)score significantly increased(P<0.05).The SAS score decreased by 17.36%;SDS score decreased by 26.21%.The VAS scores decreased by 57.14%,63.43%,and 69.86%at 12 hours,24 hours and 48 hours,respectively.The SF-36 score indicators increased by 13.29%,13.24%,20.77%,and 19.41%,respectively;The PSQI score decreased by 54.66%.The observation group reported higher nurse satisfaction.CONCLUSION Comprehensive psychological cognitive nursing interventions can significantly reduce patients'pain and depression symptoms while boosting their confidence in managing the illness.展开更多
Objective:Investigating the Mediating Role of Pain in the Relationship Between Sleep Quality and Health-Related Quality of Life Among Elderly Patients with Chronic Diseases.Methods:Using data from the 2018 China Healt...Objective:Investigating the Mediating Role of Pain in the Relationship Between Sleep Quality and Health-Related Quality of Life Among Elderly Patients with Chronic Diseases.Methods:Using data from the 2018 China Health and Retirement Longitudinal Study(CHARLS),this study included 3,284 participants aged 60 years or older with chronic diseases.The sleep quality,pain status,health-related quality of life,and demographic-related data of these elderly patients were obtained.Pearson correlation analysis was conducted to assess the bivariate relationships among the variables.The mediating role of pain in the sleep quality-HRQoL relationship was tested using linear regression models,complemented by bootstrap sampling to verify the indirect effect.Results:Sleep quality was positively associated with health-related quality of life(r=0.218,p<0.001).Conversely,pain demonstrated significant negative correlations with both sleep quality(r=-0.496,p<0.001)and health-related quality of life(r=-0.067,p<0.001).The mediating effect results showed that pain played a partial mediating role between sleep quality and health-related quality of life in elderly patients with chronic diseases(effect value=0.049),and the mediating effect accounted for 23.33%.Conclusion:Pain is a mediating variable between sleep quality and health-related quality of life in elderly patients with chronic diseases.This suggests that clinical practice should incorporate pain assessment into standard clinical care of elderly patients with sleep disorders and chronic diseases.By alleviating pain,sleep quality can be improved,and subsequently,their health-related quality of life can be enhanced.展开更多
Low back pain(LPB)is a common and impactful health concern globally,affecting individuals across various demographics and imposing a significant burden on the health care system.Nonspecific chronic LBP(NCLBP),charac-t...Low back pain(LPB)is a common and impactful health concern globally,affecting individuals across various demographics and imposing a significant burden on the health care system.Nonspecific chronic LBP(NCLBP),charac-terized as pain lasting over 12 weeks without an identifiable cause,leads to notable functional limitations and reduced quality of life.Traditional rehabil-itation programs,often focusing on dynamic exercises for lumbar strengthening,typically do not target the deep stabilizing muscles crucial for lumbar support and effective recovery.Multi-angular isometric lumbar exercise(MAILE)offers a low-impact method for strengthening lumbar stabilizers through multi-angular isometric contractions,reducing risks from dynamic movements.This article examines MAILE’s potential in addressing motor control dysfunctions in NCLBP,highlighting studies on lumbar muscle activation,core stability,and isometric exercises.The article explores the prevalence and socioeconomic impact of NCLBP in the Middle East,highlighting the need for affordable treatment options in areas like Qatar and Saudi Arabia.This article aims to validate the efficacy of MAILE in reducing pain,enhancing mobility,and improving lumbar stability,offering a valuable option for NCLBP management.Future research should focus on large-scale clinical trials to substantiate these findings and guide clinical practice.展开更多
文摘Chronic post-operative pain is a recognized adverse consequence of surgery;managing and preventing it are always a better choice. Proper choice of Anesthetic technique, use of combined anesthesia and pre-emptive analgesia may prevent and decrease the incidence of chronic post-operative pain. Transverse abdominis plane block (TAP Block) is a regional anesthesia technique following abdominal surgeries which involve injection of a large amount of local anesthetics in TAP, an anatomical space between the internal oblique and transverse abdominis muscle. The aim of this review is to show the effect and uses of TAP block as a combined anesthesia and multimodal analgesia in preventing chronic post-operative pain.
文摘BACKGROUND Knee osteoarthritis(KOA),a common disabling pathology characterized by knee joint pain,swelling,and functional impairment,primarily affects middle-aged and older adults.In addition to physical limitations,chronic pain often leads to psychological problems,including anxiety and depression,which further impact patients’quality of life.AIM To examine the efficacy and safety of celecoxib plus duloxetine in managing chronic pain,anxiety,and depression in patients with KOA.METHODS A retrospective analysis was conducted on 123 patients with KOA treated at our center between February 2020 and February 2023.Of these,66 received celecoxib plus duloxetine,and 57 received celecoxib alone.Outcomes were assessed using the Visual Analog Scale(VAS),the Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC),and the Self-Rating Anxiety Scales(SAS)/Self-Rating Depression Scales(SDS).Safety was evaluated by monitoring changes in liver function enzymes(alanine aminotransferase,aspartate aminotransferase),creatinine,and blood urea nitrogen.RESULTS Patients receiving celecoxib plus duloxetine showed significantly greater reductions in VAS and WOMAC and greater improvements in SAS and SDS scores compared with those receiving celecoxib alone.Hepatorenal function did not differ significantly between the treatment groups.Logistic regression analysis identified patient age,educational background,and treatment regimen as independent predictors of inadequate improvement in negative emotional symptoms.CONCLUSION In patients with KOA,celecoxib plus duloxetine effectively mitigates chronic pain and improves anxiety and depressive symptoms without increasing adverse hepatic or renal effects.These findings support its use as a safe and effective treatment option.
文摘BACKGROUND Tourniquets are commonly used in elective extremity orthopaedic surgery to reduce blood loss,improve visualization in the surgical field,and to potentially reduce surgical time.There is a lack of consensus in existing guidelines regarding the optimal tourniquet pressure,placement site,and duration of use.There is a paucity of data on the relationship between the site of a tourniquet and postoperative pain in foot and ankle surgery.AIM To explore the relationship between tourniquet site and intensity of post-operative pain scores in patients undergoing elective foot and ankle surgery.METHODS Retrospective analysis of prospectively collected data on 201 patients who underwent foot and ankle surgery in a single institution was undertaken.Intraoperative tourniquet duration,tourniquet pressure and site,and postoperative pain scores using Visual Analogue Score were collected in immediate recovery,at six hours and at 24 h post-op.Scatter plots were used to analyse the data and to assess for the statistical correlation between tourniquet pressure,duration,site,and pain scores using Pearson correlation coefficient.RESULTS All patients who underwent foot and ankle surgery had tourniquet pressure of 250 mmHg for ankle tourniquet and 300 mmHg for thigh.There was no correlation between the site of the tourniquet and pain scores in recovery,at six hours and after 24 h.There was a weak correlation between tourniquet time and Visual Analogue Score immediately post-op(r=0.14,P=0.04)but not at six or 24 h post-operatively.CONCLUSION This study shows that there was no statistically significant correlation between tourniquet pressure,site and postop pain in patients undergoing foot and ankle surgery.The choice of using a tourniquet is based on the surgeon's preference,with the goal of minimizing the duration of its application at the operative site.
文摘Background: Chronic low back pain is a leading cause of morbidity and disability globally. Low and Middle-Income Countries (LMICs) tend to be more affected, with chronic low back pain (CLBP) being among the leading presenting complaints at specialist consultation. The exact burden of this disease is sparingly known in our setting. Objective: To evaluate the burden of chronic low back pain at the Yaounde Central Hospital. Methods: This was a descriptive cross-sectional study for a period of 3 months, from March 2022 to May 2022. After obtaining ethical clearance and research authorisations, data was collected using structured questionnaires from patients with chronic low back pain presenting at the Yaounde Central Hospital during the aforementioned time frame. This data was then tabulated with the Statistical Package for Social Sciences (SPSS 23.0), and disability was assessed using the modified Roland Morris Disability Questionnaire and the Oswestry Disability Index. Data analysis was done using the International Business Machines Statistical Package for Social Sciences (IBM-SPSS) VERSION 23.0. Results: 115 cases of CLBP were included. The mean age was 52.62 years, and the sex ratio was 0.3. The average monthly income was less than 50,000 frs CFA, in 37.4% of cases. In 57.9%, patients had a job that involved physical labour. The patients had a secondary level of education in 40.9%, and alcohol consumption was observed in 36%. The average number of days of a work stoppage due to LBP was 12.75 days (±12SD), and the median duration of CLBP was 7.15 (7.5SD) years. The median pain intensity was 7 (±2SD), with leg pain and sensory neuropathy observed in 67.8% and 63.5% respectively. Lumbar X-ray was done in 45.2% and revealed lumbar osteoarthrosis in 62.4%. Hypertension as a comorbidity was observed in 26.1%. Medical treatment was used at least once in 98.3% of cases. The average cost of management per month was assessed, and the median was 52,000 FCFA (±20,876 SD). Using the Oswestry Disability Questionnaire, 46 patients, that is 40% of the study population, were classified as severely disabled with a median ODI score of 40%. The factors which were independently associated with disability were level of education, alcohol consumption, treatment modality, pain intensity, body mass index (BMI), psychological wellbeing and number of sick leave days. Conclusion: Chronic low back pain is common in our setting. There is a female predominance with the mean age of the study population situated in the 5th decade. Low-income earners and patients with a job involving physical labour were the most affected. Medical treatment was the main therapeutic modality, with the average cost of management per month being above the average monthly income of the greater majority of the patients. Several factors influenced disability, some of which were independently associated with it, such as level of education, alcohol consumption and treatment modality.
基金supported by the National Natural Science Foundation of China(82474625)Zhejiang Provincial Natural Science Funds(LZ23H270001).
文摘In a recent study published in Science Translational Medicine,Jiang et al.uncovered a novel contribution of sensory neuron-derived follistatin(FST)to neuropathic pain by which FST,generated from A-fiber neurons,promotes Nav 1.7-mediated noceptive neuronal excitability via binding to the insulin-like growth factor 1 receptor(IGF1R),making it a potential therapeutic target for neuropathic pain(Fig.1A,B)[1].
基金supported by the Neurosurgery Pain Research Institute at Johns Hopkins University and by the Lehner Family Foundation.
文摘Chronic pain after spine surgery(CPSS)is a complex disorder characterized by multifactorial pathogenesis that occurs in 8%–40%of patients undergoing lumbar spine surgery.We aimed to develop a rat model that mimics clinical CPSS conditions by taking two sequential surgical procedures.Step 1:A plastic rod was inserted into the left L5 intervertebral foramen to produce a steady compression on the dorsal root ganglion(DRG)and the spinal nerve,a common cause of low back pain(LBP).Step 2:The rod was removed after 7 days when rats exhibited mechanical and heat hypersensitivity in the ipsilateral hindpaw,followed by a full L5 laminectomy to mimic spine decompression surgery in LBP patients.The retention of the rod induced a prolonged LBP-like behavior but was quickly resolved after rod removal without laminectomy.However,rats that received laminectomy after rod removal developed heightened mechanical and heat sensitivity in the hindpaw,impaired gait,and reduced spontaneous exploration activity,indicating CPSS.Patch clamp recording revealed a significant augmentation in the intrinsic excitability of smalldiameter DRG neurons in CPSS rats.Administration of Dermorphin[D-Arg2,Lys4](1–4)amide(DALDA,5mg/kg,i.p.),a peripherally acting mu-opioid receptor(MOR)-preferred agonist,attenuated pain hypersensitivity,capsaicin-induced[Ca^(2+)]i rising and the increased intrinsic excitability of DRG neurons from CPSS rats.Our findings suggest that this new model,which mirrors the nature of CPSS developed in patients,may be useful for future studies of the underlying mechanisms.
文摘Objective:To explore the relationship between pain degree and pain catastrophe and medical coping mode in patients with chronic pain.Methods:A visual analogue score scale,medical coping style questionnaire and pain catastrophe scale were used to survey 200 patients in the pain department.Results:The average scores of pain degree of patients with chronic pain were(5.97±2.29),the average score of the total score of the Pain Catastrophe Scale was(21.21±11.56),and the average scores of facing,avoidance and surrender in the Medical Response Style Questionnaire were(17.93±3.4),(16.82±2.4),and(8.87±2.83),respectively.Pain degree was positively correlated with the yield dimension in pain catastrophe and medical coping(p<0.05).The yield dimension of medical coping was positively correlated with pain catastrophe(p<0.05).Medical coping methods played a partial mediating role between pain degree and pain catastrophe,and the mediating effect accounted for 21.59%of the total effect.Conclusion:The pain level of chronic pain patients can affect the level of pain catastrophe through medical coping,and clinical medical staff should guide patients to adopt positive coping methods to promote their healthy recovery.
文摘Objective To determine the prevalence,distribution,and associated clinical factors of chronic neuropathic cancer pain(CNCP)among outpatients with chronic cancer pain(CCP)and to inform improved recognition and management.Methods In this cross-sectional study,consecutive outpatients with CCP diagnosed according to the International Association for the Study of Pain(IASP)criteria were recruited from the pain clinic at Peking Union Medical College Hospital between June and October 2025.CNCP was diagnosed based on the Neuropathic Pain Special Interest Group(NeuPSIG)criteria.Patients were classified into the CNCP group if they met at least one of the four NeuPSIG criteria,regardless of coexisting visceral or bone pain.Demographic,oncologic,and pain-related data were collected through standardized interviews.Between-group differences in baseline characteristics were assessed using absolute standardized differences and Chi-square or t-tests.Logistic regression analyses were conducted to identify clinical factors associated with CNCP.Results Of 138 eligible patients with CCP,85(61.6%)were classified into the CNCP group and 53(38.4%)into the non-CNCP group.Multivariable logistic regression analysis revealed that bone metastasis(adjusted OR=2.316,95%CI:1.074-5.178,P=0.032),radiotherapy(adjusted OR=2.489,95%CI:1.119-5.803,P=0.025),and voiding dysfunction(adjusted OR=5.470,95%CI:2.150-16.396,P<0.001)were independently associated with CNCP.Pancreatic cancer was inversely associated with CNCP(OR=0.371,P=0.031).Only 5(3.6%)patients in the CNCP group received neuropathic pain-specific interventions,indicating a predominant reliance on single-modality pain management.Conclusions CNCP was present in nearly two-thirds of outpatients with CCP.The identified associations with bone metastasis,radiotherapy,and voiding dysfunction may aid in the early recognition of neuropathic pain components and support the adoption of mechanism-based multimodal pain management strategies.
文摘Chronic postsurgical pain (CPSP) following gastrointestinal (GI) surgery is acommon issue that poses significant challenges to patients’ recovery and qualityof life. Given the importance of vitamin D in inflammation reduction, nerverepair, bone health, and immune regulation, its potential role in pain managementhas gained increasing attention. Preliminary evidence suggests that many patientswho undergo GI surgery have lower perioperative vitamin D levels. Patients withvitamin D deficiency have increased opioid use and heightened pain sensitivityafter colorectal cancer surgery. Patients with lower vitamin D levels experiencegreater pain three months after arthroscopic rotator cuff repair or video-assistedthoracoscopic surgery. However, research on the relationship between vitamin Dand CPSP after GI surgery is limited. Larger, well-designed clinical trials areneeded to determine the causal relationship between low vitamin D levels andCPSP, determine the optimal perioperative vitamin D levels, and provide morereliable evidence for clinical application. Moreover, vitamin D has positive effectson various systemic diseases and postoperative recovery, including immuneregulation, infection prevention, wound healing, tissue regeneration, nutritionalstatus, and metabolic health. These findings indicate that vitamin D has broadclinical application potential. We hope to provide a new insight into postoperativerecovery and pain management strategies for GI surgeries.
文摘BACKGROUND Eosinophilic gastrointestinal(GI)disease(EGID)beyond eosinophilic esophagitis is not commonly reported in the developing world.AIM To estimate the prevalence of EGID in a selected group of pediatric patients suffering from non-functional chronic abdominal pain(CAP).METHODS A retrospective analysis was conducted on case records of children with CAP.Those exhibiting clinical or laboratory alarming features underwent endoscopic evaluation.Histopathology reports from upper GI endoscopy and ileo-colonoscopy determined the diagnosis of EGID.Subsequent analyses included clinical presentations,presence of atopy in the children or family,hemoglobin,albumin,serum immunoglobulin E(IgE),fecal calprotectin levels,endoscopic appearances,treatment methods,and outcomes.RESULTS A total of 368 children with organic CAP were subjected to endoscopic evaluation.Among them,19(5.2%)patients with CAP were diagnosed with EGID.The median age of the children was 11.1 years(interquartile range=8.4-14.4).The estimated prevalence of EGID in children with organic CAP was 520/10000 children over 5 years.Periumbilical pain was the most common site(63%).Family history of atopy,peripheral blood eosinophilia,and elevated serum IgE were the three parameters significantly associated with EGID.Clinical remission was obtained in all children at 6 months.The 47%had microscopic remission and maintained remission until a 1-year follow-up.The 53%had a fluctuating clinical course after 6 months.CONCLUSION EGID beyond the esophagus is not an uncommon entity among the children of India.It can contribute significantly to the etiology of pediatric CAP.
基金supported by the Office of Naval Research Grant(N00014-22-1-2184).
文摘Chronic pain is a leading cause of disability and affects over 30%of military veterans and active duty personnel[1].Pharmacological approaches to long-term chronic pain management increase the risk of negative effects such as addiction,cardiovascular complications,and immunosuppression[2].In contrast,non-drug treatments like audio analgesia have demonstrated efficacy in pain relief without these side effects.Given the prevalence of chronic pain in the military population,it is essential to explore new treatments that effectively target its underlying mechanisms.One promising option is the Pannexin 1(Panx1)channel-forming protein.Panx1 is a large-pore ion channel in the plasma membrane of dorsal root ganglion(DRG)neurons that allows for the release of Adenosine triphosphate(ATP).Th is commentary elaborates on the fi ndings of Xing et al.[3],who investigated the role of Panx1 in peripheral pain sensitization following infl ammatory stimuli.We examine the role of Panx1 in chronic pain,critique Xing et al.’s[3]adjuvant selection and power analysis,and discuss the challenges of translating fi ndings from animal models to human conditions.
基金supported by the National Natural Science Foundation of China(No.81770759 and No.82270806)Innovation Project of Guangxi Graduate Education(No.YCBZ2022094).
文摘Chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS)is a complex disease that is often accompanied by mental health disorders.However,the potential mechanisms underlying the heterogeneous clinical presentation of CP/CPPS remain uncertain.This study analyzed widely targeted metabolomic data of expressed prostatic secretions(EPS)and plasma to reveal the underlying pathological mechanisms of CP/CPPS.A total of 24 CP/CPPS patients from The Second Nanning People’s Hospital(Nanning,China),and 35 asymptomatic control individuals from First Affiliated Hospital of Guangxi Medical University(Nanning,China)were enrolled.The indicators related to CP/CPPS and psychiatric symptoms were recorded.Differential analysis,coexpression network analysis,and correlation analysis were performed to identify metabolites that were specifically altered in patients and associated with various phenotypes of CP/CPPS.The crucial links between EPS and plasma were further investigated.The metabolomic data of EPS from CP/CPPS patients were significantly different from those from control individuals.Pathway analysis revealed dysregulation of amino acid metabolism,lipid metabolism,and the citrate cycle in EPS.The tryptophan metabolic pathway was found to be the most significantly altered pathway associated with distinct CP/CPPS phenotypes.Moreover,the dysregulation of tryptophan and tyrosine metabolism and elevation of oxidative stress-related metabolites in plasma were found to effectively elucidate the development of depression in CP/CPPS.Overall,metabolomic alterations in the EPS and plasma of patients were primarily associated with oxidative damage,energy metabolism abnormalities,neurological impairment,and immune dysregulation.These alterations may be associated with chronic pain,voiding symptoms,reduced fertility,and depression in CP/CPPS.This study provides a local-global perspective for understanding the pathological mechanisms of CP/CPPS and offers potential diagnostic and therapeutic targets.
文摘BACKGROUND The occurrence of chronic pain and disability after acute orthopedic trauma is significantly correlated with psychological factors,particularly depression and anxiety.As such,assessment of these factors is crucial for postoperative rehabilitation.AIM To investigate the correlation between chronic pain,disability,and psychological factors(depression and anxiety)after acute orthopedic trauma surgery.METHODS Data from 120 patients,who underwent surgery for acute orthopedic trauma at Xi’an Traditional Chinese Medicine Hospital(Shaanxi Province,China)between June 2022 and June 2024,were retrospectively analyzed.Basic information and postoperative pain metrics[visual analog scale(VAS)],disability rating index(DRI),Hamilton anxiety rating scale(HAMA)and Hamilton depression rating scale(HAMD)were collected from electronic medical records.Pearson’s correlation analysis was used to examine associations between chronic pain VAS,DRI,HAMD,and HAMA scores.RESULTS Among the 120 patients[79(65.8%)males and 41(34.2%)females],postoperative VAS scores were significantly associated with HAMD and HAMA scores,with correlation coefficients of 0.625(P=0.027)and 0.568(P<0.001),respectively.Postoperative DRI scores were also significantly associated with HAMD and HAMA scores,with correlation coefficients of 0.683 and 0.557,respectively(both P<0.001).CONCLUSION Chronic pain and disability after surgery for acute orthopedic trauma are significantly correlated with psychological factors(depression and anxiety).Multidisciplinary teams should integrate mental health services to improve patient outcomes.
文摘BACKGROUND Endometriosis affects approximately 10%of reproductive-age women and is frequently associated with chronic pelvic pain.Patients with endometriosis often experience comorbid depression and anxiety,but the underlying mechanisms connecting these conditions are unclear.AIM To assess the prevalence of depression and anxiety in endometriosis patients and explore neuroimmune mechanisms mediated via inflammatory biomarkers.METHODS A retrospective cohort study was conducted with 200 patients with endometriosis-associated chronic pain from June 2020 to December 2024.Depression and anxiety were assessed using validated psychological instruments.Inflammation biomarkers interleukin(ILs)(IL-6,IL-1β),tumor necrosis factor-alpha,C-reactive protein,and brain-derived neurotrophic factor were measured in serum.Pain severity was assessed using visual analog scales.Correlation and regression analyses were performed to examine relationships between inflammatory markers,pain severity,and psychological outcomes.RESULTS Among the 200 patients,42.5%exhibited clinically significant depression and 51.0%showed anxiety symptoms.Serum levels of IL-6,IL-1β,tumor necrosis factor-alpha,and C-reactive protein were significantly higher in patients with comorbid depression and anxiety compared with those without psychological symptoms(P<0.001).Brainderived neurotrophic factor levels were lower in the depression group.Pain severity positively correlated with inflammatory marker levels and with depression and anxiety scores.CONCLUSION Overall,the findings suggest that inflammatory factors mediate a neuroimmune mechanism linking endometriosisassociated chronic pain with depression and anxiety.Therapeutic targets for managing psychological comorbidities in patients with endometriosis through anti-inflammatory interventions should be explored,and an integrated treatment approach addressing both physical and psychological symptoms is emphasized.
文摘BACKGROUND Acute abdominal pain is often easy to be diagnosed because of acute abdomen,and can be treated reasonably and effectively.It is more difficult to establish the cause of chronic abdominal pain,and some patients repeatedly visit several hos-pitals and still cannot be diagnosed.Chronic abdominal pain caused by chronic appendicitis is such a case.If the degree of abdominal pain is mild and there is no sign of peritonitis,chronic appendicitis is not performed unless the patient re-quests it.CASE SUMMARY We report an extremely rare case of chronic appendicitis caused by a foreign body in the appendix in a 35-year-old woman.The patient had a long-term abdominal pain of unclear cause,and she was repeatedly treated in several hospitals.After antibiotic treatment,the abdominal pain was gradually relieved,but abdominal pain often recurs.We conducted abdominal computed tomography examination,and upon the advice of radiologists,we considered the possibility of foreign bodies in the appendix,and excluded other causes of abdominal pain.The patient requested and consented to laparoscopic appendectomy,and a chicken bone was found in the appendiceal cavity by postoperative incision of the appendiceal spe-cimen.Histopathological examination confirmed chronic appendicitis with fo-reign body giant cell reaction.The patient recovered and was discharged from the hospital.After 2 months of follow-up,abdominal pain did not recur,and the patient had a complete recovery.Core Tip:We report an extremely rare case of chronic appendicitis caused by a chicken bone in the appendix.The patient was 35-year-old woman,and had a long-term abdominal pain of unknown cause.Abdominal computed tomography examination suggested foreign bodies in the appendix,and laparoscopic appendectomy was performed.The postoperative specimen revealed chicken bones in the appendix cavity,and histopathological examination confirmed chronic appendicitis with giant cell reaction of foreign bodies.The patient recovered and was followed up for two months without abdominal pain.Citation:Huang T,Li SK,Wang W,Zhang R.Chronic abdominal pain caused by foreign bodies in the appendix:A case report.World INTRODUCTION Appendicitis is one of the common diseases that cause abdominal pain[1].Appendicitis can be diagnosed and treated effectively when patients with acute abdominal pain are admitted to hospital because of factors such as blockage and infection of appendicitis[2,3].However,the diagnosis of chronic appendicitis is difficult.Acute appendicitis caused by foreign bodies in the appendix is easy to diagnose because of the final surgical treatment[4-6],while chronic appendicitis caused by foreign bodies in the appendix is more difficult to diagnose because of the mild degree of abdominal pain.We here report an extremely rare case of chronic appendicitis caused by foreign bodies in the appendix.The patient had a long-term abdominal pain of unclear cause,and she was repeatedly treated in several hospitals.Abdominal color ultrasound examination indicated a coprolith in the appendiceal cavity and the appendix was normal,so the patient could not be treated with surgery.We conducted abdominal computed tomography(CT)examination,and upon the advice of radiologists,we considered the possibility of foreign bodies in the appendix,and excluded other causes of abdominal pain.The patient requested and consented to laparoscopic appendectomy,and a chicken bone was found in the appendiceal cavity by postoperative incision of the appendiceal specimen.The patient recovered and was discharged from hospital.After 2 months of follow-up,abdominal pain did not recur and the patient had a full recovery.
基金supported by the Fundamental Research Funds for the Central Universities(2022-JYB-JBZR-035,2023-JYB-KYPT-11)Qihuang Scholars Grant Project 2021.
文摘Objective:To investigate the relationship between the composition of traditional Chinese medicine(TCM)and depression/anxiety/sleep disturbances(D/A/S)in patients with chronic pain.Methods:This cross-sectional study was conducted at 13 tertiary hospitals across China,enrolling patients who experienced chronic pain between November 2023 and May 2024.The Patient Health Questionnaire-9,Generalized Anxiety Disorder-7,Pittsburgh Sleep Quality Index,and TCM constitution categories were used to assess the patients.The association between the TCM constitution and the D/A/S ratio was analyzed using multivariable logistic regression.Results:A total of 1107 patients(63.2%women)were analyzed.Compared with those with a balanced constitution,patients who had qi-deficiency and yin-deficiency were at a higher risk of depression.Qideficiency and yin-deficiency were associated with anxiety.Sleep disturbances were common in patients with qi-deficiency constitution(odds ratio[OR]:2.32,95%confidence interval[CI]:1.42-3.81),yangdeficiency constitution(OR:1.94,95%CI:1.26-2.98),yin-deficiency constitution(OR:2.03,95%CI:1.24 -3.32),blood stasis constitution(OR:2.07,95%CI:1.01-4.22),and qi-stagnation constitution(OR:2.66,95%CI:1.35-5.25).Conclusion:In patients with chronic pain,specific TCM constitutions may be associated with D/A/S.Further longitudinal studies are needed to clarify the potential causal relationships between TCM constitution types and these conditions.
文摘Background:Chronic pain is defined as pain that lasts for three months or even more.Over 25%of the global population suffers from chronic pain.Tong-luo Qu-tong(TLQT)Plaster is clinically used to treat arthritis.However,its ability to treat chronic pain remains largely unknown.Methods:In this study,we explored the molecular mechanism of TLQT plaster in relieving chronic muscle pain by combining network pharmacology and RNA-seq analysis.We also applied the Elisa and the RT-qPCR.Results:We found 447 targets in TLQT and 13,599 targets related to chronic pain disease.And 419 intersecting targets were obtained,which mainly enrich the IL-17 signaling pathway,TNF signaling pathway,and Th17 cell differentiation pathway.Further,we constructed the SD rat model of chronic pain.The results of Von Frey Hair Test showed that the relief of muscle pain TLQT treated group was twice as much as that in the model group.The hot plate test results showed that the time of lifting the foot was 1.3 times as much as that of the model group.Moreover,TLQT effectively reduced the inflammation in rat muscle.With RNA-seq analysis,230 differentially expressed genes were collected.The RT-qPCR results indicated that the mRNA expression level of NCF1,CXCL10,and ICAM1 all promoted in the model group,and then decreased significantly in the TLQT treated group.The ELISA results performed that the level of IL-1βand IL-6 in TLQT group high dose group was reduced by about 1.6-fold,and for TNF-α,it was reduced by about 2.6-fold compared with the model group.Immunohistochemistry assay showed that the expression level of CXCL10 and ICAM1 was both up-regulated in the model group and down-regulated in the TLQT group.Conclusion:TLQT plaster reduces chronic muscle pain by inhibiting the expression of NCF1,CXCL10,and ICAM1 and reducing the level of muscle tissue inflammation.
文摘BACKGROUND Chronic pain and depression often coexist,severely affecting quality of life.Traditional treatments address these conditions separately,but comprehensive psychological cognitive nursing offers a holistic approach.By combining cognitive-behavioral strategies and psychological support,it helps improve coping mechanisms,reduce distress,and enhance overall well-being in affected patients.AIM To investigate the impact of comprehensive psychological cognitive nursing on the patients with chronic pain and depression.METHODS From October 2022 to October 2024,171 patients with chronic pain and depression admitted to our hospital were randomly divided into two groups,with 85 patients in the control group and 86 patients in the observation group.The general data from both groups were compared.The control group received standard treatment.The observation group provided full psychological cognitive care in the same way as the control group did.The two groups of patients'psychological states,pain levels,quality of life,sleep quality,and nurse satisfaction were compared before to and during the intervention.RESULTS Compared with the control group,the self-rating anxiety scale(SAS)score,selfrating depression scale(SDS)score,visual analog scale(VAS)score,and Pittsburgh Sleep Quality Index(PSQI)score of the observation group significantly decreased after intervention,while the short-form 36(SF-36)score significantly increased(P<0.05).The SAS score decreased by 17.36%;SDS score decreased by 26.21%.The VAS scores decreased by 57.14%,63.43%,and 69.86%at 12 hours,24 hours and 48 hours,respectively.The SF-36 score indicators increased by 13.29%,13.24%,20.77%,and 19.41%,respectively;The PSQI score decreased by 54.66%.The observation group reported higher nurse satisfaction.CONCLUSION Comprehensive psychological cognitive nursing interventions can significantly reduce patients'pain and depression symptoms while boosting their confidence in managing the illness.
基金Henan Provincial Government-funded Excellent Clinical Medicine Talent Training Project(Project No.:ZF2024006)Hebei Province Medical Science Research Project Plan(Project No.:20240083)。
文摘Objective:Investigating the Mediating Role of Pain in the Relationship Between Sleep Quality and Health-Related Quality of Life Among Elderly Patients with Chronic Diseases.Methods:Using data from the 2018 China Health and Retirement Longitudinal Study(CHARLS),this study included 3,284 participants aged 60 years or older with chronic diseases.The sleep quality,pain status,health-related quality of life,and demographic-related data of these elderly patients were obtained.Pearson correlation analysis was conducted to assess the bivariate relationships among the variables.The mediating role of pain in the sleep quality-HRQoL relationship was tested using linear regression models,complemented by bootstrap sampling to verify the indirect effect.Results:Sleep quality was positively associated with health-related quality of life(r=0.218,p<0.001).Conversely,pain demonstrated significant negative correlations with both sleep quality(r=-0.496,p<0.001)and health-related quality of life(r=-0.067,p<0.001).The mediating effect results showed that pain played a partial mediating role between sleep quality and health-related quality of life in elderly patients with chronic diseases(effect value=0.049),and the mediating effect accounted for 23.33%.Conclusion:Pain is a mediating variable between sleep quality and health-related quality of life in elderly patients with chronic diseases.This suggests that clinical practice should incorporate pain assessment into standard clinical care of elderly patients with sleep disorders and chronic diseases.By alleviating pain,sleep quality can be improved,and subsequently,their health-related quality of life can be enhanced.
文摘Low back pain(LPB)is a common and impactful health concern globally,affecting individuals across various demographics and imposing a significant burden on the health care system.Nonspecific chronic LBP(NCLBP),charac-terized as pain lasting over 12 weeks without an identifiable cause,leads to notable functional limitations and reduced quality of life.Traditional rehabil-itation programs,often focusing on dynamic exercises for lumbar strengthening,typically do not target the deep stabilizing muscles crucial for lumbar support and effective recovery.Multi-angular isometric lumbar exercise(MAILE)offers a low-impact method for strengthening lumbar stabilizers through multi-angular isometric contractions,reducing risks from dynamic movements.This article examines MAILE’s potential in addressing motor control dysfunctions in NCLBP,highlighting studies on lumbar muscle activation,core stability,and isometric exercises.The article explores the prevalence and socioeconomic impact of NCLBP in the Middle East,highlighting the need for affordable treatment options in areas like Qatar and Saudi Arabia.This article aims to validate the efficacy of MAILE in reducing pain,enhancing mobility,and improving lumbar stability,offering a valuable option for NCLBP management.Future research should focus on large-scale clinical trials to substantiate these findings and guide clinical practice.
