Objective：To investigate the effect of injecting a compound of Bupivacaine and Fentanyl into sacral spinal space to treat chronic pelvic pain syndrome （CPPS）. Methods： A total of 36 men with recalcitrant （TPPS re...Objective：To investigate the effect of injecting a compound of Bupivacaine and Fentanyl into sacral spinal space to treat chronic pelvic pain syndrome （CPPS）. Methods： A total of 36 men with recalcitrant （TPPS refractory to multiple prior therapies were treated with the injection of a compound of Bupivacaine and Fentanyl （10 ml of 0. 125% Bupivacaine, 0.05 mg Fentanyl, 5 mg Dexamethasone, 100 mg Vitamin B1 and 1 mg Vitamin B12） into sacral space once a week for 4 weeks. The National Institute of Heahh Chronic Prostatitis Symptom Index （NIH-CPSI）, maximum and average flow rate were performed al the start and the end of 4 weeks＇ therapy. Results：Mean NIH-CPSI total score was decreased from 26. 5±1.6 to 13.4±2.0 （p〈0.001）. Significant improvement was seen in each subscore domain. A total of 32 patients （89%） had at least 25% improvement on NIH-CPSI and 22 （61%） had at least 50% improvement. Maximal and average flow rate were increased from 19. 5±3. 8 to 23. 6±4. 2 and 10. 9±2.6 to 14.3±2.4 respectively. Conclusion： Injection of this compound of Bupivacaine, Fentanyl and Dexamethasone into sacred spinal space is an effective and safe approach for recalcitrant CPPS. Further study of the mechanisms and prospective placebo controlled trials are warranted.展开更多
While acute nociceptive pain is a crucial warning system that protects us from injury or disease,chronic pain is not protective,but a pathological condition.As such,it is now recognized as a disease in its own right,w...While acute nociceptive pain is a crucial warning system that protects us from injury or disease,chronic pain is not protective,but a pathological condition.As such,it is now recognized as a disease in its own right,which major classes refer to inflammatory,neuropathic,and idiopathic pain.It is frequent,with up to a third of the population that may suffer at one point from chronic pain.It is often associated with other pathologies,including sleep disorders,anxiety,depression,and is still difficult to treat.It thus represents a significant burden in terms of health and societal impact(Tracey et al.,2019).The mechanisms of chronic pain involve multiple diverse pathways in both the peripheral and central nervous systems(CNS),reflecting its multifaceted biology.Indeed,research over the past decades has established that central sensitization(enhancement in the function of neurons and circuits in central nociceptive pathways),in particular within the dorsal horn,the first central relay of nociceptive inputs plays a key role in the chronicity of pain(Latremoliere and Woolf,2009).展开更多
Intractable chronic pain is a great challenge in clinic.Central sensitization based on the positive changes of dendritic spines is the main mechanism of intractable chronic pain.And low-dose radiation has been proved ...Intractable chronic pain is a great challenge in clinic.Central sensitization based on the positive changes of dendritic spines is the main mechanism of intractable chronic pain.And low-dose radiation has been proved to regulate the changes of dendritic spines negatively.Hence,we make a hypothesis that low-dose radiation could relieve cancer and noncancer pain through negatively regulating the shape and reducing the number and density of dendritic spines in the spinal cord.This method is supposed to be a new therapy for intractable chronic pain by expanding indication to non-cancer pain,translocating radiation site from where the tumor exists to special segments of spinal cord and keeping radiation dose at a low level.This therapy would be reliable for relieving non-cancer pain and supply more choices for relieving cancer pain.展开更多
Summary Pain is not pain because people interpret symptoms differently.Neck pain is one of the most common pains and should not be missing from a study on the effects of pain.Depression does not arise solely from pain...Summary Pain is not pain because people interpret symptoms differently.Neck pain is one of the most common pains and should not be missing from a study on the effects of pain.Depression does not arise solely from pain but is multicausal and often caused by this cumulative effect.展开更多
Neuropathic pain is a complex and debilitating condition caused by lesions or dysfunction within the somatosensory nervous system.Affecting an estimated 7%-10%of the global population,it presents with spontaneous pain...Neuropathic pain is a complex and debilitating condition caused by lesions or dysfunction within the somatosensory nervous system.Affecting an estimated 7%-10%of the global population,it presents with spontaneous pain,hyperalgesia,and allodynia,often accompanied by long-term emotional and cognitive consequences,such as depression and anxiety,which result in a reduced quality of life.Despite extensive research efforts,effective treatments remain limited.This limited efficacy likely stems,in part,from the heterogeneous nature of neuropathic pain,which varies widely across individuals in both clinical presentation and treatment responsiveness.展开更多
Nerve trauma commonly results in chronic neuropathic pain. This is by triggering the release of proinflammatory mediators from local and invading cells that induce inflammation and nociceptive neuron hyperexcitability...Nerve trauma commonly results in chronic neuropathic pain. This is by triggering the release of proinflammatory mediators from local and invading cells that induce inflammation and nociceptive neuron hyperexcitability. Even without apparent inflammation, injury sites are associated with increased inflammatory markers. This review focuses on how it might be possible to reduce neuropathic pain by reducing inflammation. Physiologically, pain is resolved by a combination of the out-migration of pro-inflammatory cells from the injury site, the down-regulation of the genes underlying the inflammation, up-regulating genes for anti-inflammatory mediators, and reducing nociceptive neuron hyperexcitability. While various techniques reduce chronic neuropathic pain, the best are effective on < 50% of patients, no technique reliably or permanently eliminates neuropathic pain. This is because most techniques are predominantly aimed at reducing pain, not inflammation. In addition, while single factors reduce pain, increasing evidence indicates significant and longer-lasting pain relief requires multiple factors acting simultaneously. Therefore, it is not surprising that extensive data indicate that the application of platelet-rich plasma provides more significant and longer-lasting pain suppression than other techniques, although its analgesia is neither complete nor permanent. However, several case reports indicate that platelet-rich plasma can induce permanent neuropathic pain elimination when the platelet concentration is significantly increased and is applied to longer nerve lengths. This review examines the primary triggers of the development and maintenance of neuropathic pain and techniques that reduce chronic neuropathic pain. The application of plateletrich plasma holds great promise for providing complete and permanent chronic neuropathic pain elimination.展开更多
Chronic pain following a spinal cord injury refers to pain that persists or recurs after the injury.This pain can manifest as burning,stinging,or sensations similar to electric shocks.Recent studies have shown that sp...Chronic pain following a spinal cord injury refers to pain that persists or recurs after the injury.This pain can manifest as burning,stinging,or sensations similar to electric shocks.Recent studies have shown that spinal cord stimulation is an effective way to treat chronic pain after spinal cord injury.The purpose of this review is to introduce the technique of spinal cord stimulation,the clinical manifestations of spinal cord injury,and the role of spinal cord stimulation in the treatment of spinal cord injury.The mechanism and clinical application of spinal cord stimulation in the treatment of pain after spinal cord injury are discussed.The mechanism of spinal cord stimulation primarily involves three aspects:neuromodulation,neurochemical regulation,and anti-inflammatory effects,along with nerve repair.In terms of neuromodulation,spinal cord stimulation is based on the gate control theory of pain.It activates large-diameter amyloid-βnerve fibers to promote the release of inhibitory neurotransmitters by gamma-aminobutyric acidergic inhibitory interneurons in the spinal cord,thereby blocking the transmission of pain signals from small-diameter C fibers.Neurochemical studies indicate that spinal cord stimulation can regulate the balance of neurotransmitters within the spinal cord,increasing the release of inhibitory neurotransmitters such as gamma-aminobutyric acid,serotonin,and acetylcholine while reducing the levels of excitatory neurotransmitters.Additionally,spinal cord stimulation exhibits significant anti-inflammatory and neuroprotective effects,downregulating pro-inflammatory factor levels,upregulating anti-inflammatory factor expression,alleviating neuroinflammatory responses,and repairing damaged neural circuits by promoting the secretion of neurotrophic factors and axonal regeneration.Spinal cord stimulation have demonstrated remarkable efficacy in the clinical treatment of pain after spinal cord injury,but there are still limitations such as small sample size and high heterogeneity in clinical studies,as well as insufficient long-term efficacy data.Future research should conduct multi-center large-sample randomized controlled trials,and establish long-term follow-up mechanisms to improve evidence-based medical evidence.展开更多
Knee osteoarthritis(KOA)represents one of the most common causes of chronic pain.The high prevalence and disability rates of KOA impose a severe burden on both individuals and society.In contrast to cutaneous pain,KOA...Knee osteoarthritis(KOA)represents one of the most common causes of chronic pain.The high prevalence and disability rates of KOA impose a severe burden on both individuals and society.In contrast to cutaneous pain,KOA-induced joint pain is characterized as a deep tissue pain that potentially involves distinct subgroups of peripheral sensory neurons and central processing mechanisms.Furthermore,KOA pain is closely related to locomotion activity.Impaired sensorimotor integration and pain mutually reinforce each other in KOA,forming a vicious cycle that exacerbates disease progression.In this review,we highlight the key differences between KOA pain and cutaneous pain,and the latter has been extensively studied in the pain field.We hope to offer new insights into the central mechanisms and development of new treatment strategies for KOA based on the interactions between impaired sensorimotor integration and chronic joint pain.展开更多
Cancer pain is one of the most prevalent and debilitating symptoms in patients with advanced malignancies,arising from multifactorial mechanisms involving peripheral,central,and systemic pathways.Conventional analgesi...Cancer pain is one of the most prevalent and debilitating symptoms in patients with advanced malignancies,arising from multifactorial mechanisms involving peripheral,central,and systemic pathways.Conventional analgesics,including opioids and nonsteroidal anti-inflammatory drugs,are often limited by their insufficient efficacy,tolerance,and risk of dependence.Traditional Chinese Medicine(TCM),characterized by its multi-component,multi-target,and systemic regulatory properties,has shown promising potential in cancer pain management.This review provides a comprehensive overview of the clinical classification and underlying mechanisms of cancer pain(including nerve infiltration,dysregulation of inflammatory mediators and ion channels,central sensitization,neuro-immune crosstalk,metabolic reprogramming,and gut-brain axis impairment),as well as the analgesic effects of representative TCM agents in cancer pain management.For example,bioactive components such as tetrahydroberberine,levo-tetrahydropalmatine,and piperine exert analgesic effects,thereby improving the quality of life of patients by inhibiting inflammatory cascades,regulating neurotransmitter systems,and preserving neural integrity.Commonly used preclinical models,including bone cancer pain,pancreatic cancer pain,and chemotherapy-induced peripheral neuropathy models,are summarized for their utility in mechanistic studies and efficacy evaluations.This review also discusses the current limitations of clinical evidence,such as small sample sizes,short follow-up periods,and limited translation from animal models,alongside major challenges in standardization,mechanistic elucidation,and clinical trial design.Future directions should focus on precise pain phenotyping,integrated multi-target interventions,rigorous efficacy safety validation,and innovations in drug delivery to facilitate the standardization and global adoption of TCM in cancer pain management.展开更多
Chronic pain represents a significant global health challenge,and the limitations of conventional analgesics have urged a search for alternative therapeutic strategies.Cannabinoids derived from Cannabis sativa have em...Chronic pain represents a significant global health challenge,and the limitations of conventional analgesics have urged a search for alternative therapeutic strategies.Cannabinoids derived from Cannabis sativa have emerged as prominent candidates.While psychotropic cannabinoids are known for their analgesic effects,their psychoactive properties often limit their clinical utility.Consequently,interest has shifted towards non-psychotropic cannabinoids that offer potential pain relief without inducing cognitive or euphoric effects.This comprehensive review investigates the pain-modulating mechanisms of cannabinoids,encompassing interactions with the endocannabinoid system and other non-traditional pathways,and summarizes the existing preclinical and clinical evidence supporting their use in various pain states.Furthermore,it discusses the therapeutic potential,clinical considerations,significant challenges,and the need for product standardization.This review also aims to evaluate the role and prospects of non-psychotropic cannabinoids as a therapeutic option for pain management.展开更多
[Objectives]To investigate the clinical efficacy of core stability training combined with conventional rehabilitation in the functional recovery of patients suffering from chronic low back pain.[Methods]A randomized c...[Objectives]To investigate the clinical efficacy of core stability training combined with conventional rehabilitation in the functional recovery of patients suffering from chronic low back pain.[Methods]A randomized controlled trial design was employed in this study.Ninety patients with chronic low back pain were recruited and randomly assigned to either a control group(n=45),which received conventional rehabilitation,or an experimental group(n=45),which received conventional rehabilitation combined with core stability training.Both groups underwent treatment for 6 weeks.Assessments were conducted using the visual analogue scale(VAS),Oswestry disability index(ODI),and finger-to-floor test prior to treatment,6 weeks following treatment,and during the follow-up period,respectively.[Results]Prior to treatment,no statistically significant differences were observed between the two patient groups in terms of general information and various baseline measurements(P>0.05).Following 6 weeks of treatment and throughout the follow-up period,both groups demonstrated significant improvements in VAS scores,ODI scores,and lumbar anteflexion range of motion compared to baseline measurements(P<0.05).Notably,the magnitude of improvement in the experimental group exceeded that of the control group,with this inter-group difference reaching statistical significance(P<0.05).No serious adverse reactions were reported during the treatment process.[Conclusions]Core stability training combined with conventional rehabilitation can significantly enhance the alleviation of pain and functional impairments in patients suffering from chronic low back pain.This approach holds valuable implications for the optimization of rehabilitation treatment protocols.展开更多
Current treatments for neuropathic pain are suboptimal,necessitating the search for more effective therapeutics.Our previous study showed that inhibition of neuroinflammation in the spinal cord induced analgesic effec...Current treatments for neuropathic pain are suboptimal,necessitating the search for more effective therapeutics.Our previous study showed that inhibition of neuroinflammation in the spinal cord induced analgesic effects,and focal repetitive trans-spinal magnetic stimulation showed an anti-neuroinflammatory effect in spinal cord injury rat models.Here,we speculated that repetitive trans-spinal magnetic stimulation might induce an anti-inflammatory effect to alleviate neuropathic pain by upregulating calmodulin-dependent protein kinase kinase beta(CaMKKβ)/adenosine 5′-monophosphate-activated protein kinase(AMPK)/suppressor of cytokine signaling-3(SOCS3)signaling in microglia.Experiments have found that non-invasive focal repetitive trans-spinal magnetic stimulation effectively alleviates mechanical allodynia and spinal neuroinflammation in rats with neuropathic pain induced by chronic sciatic nerve ligation.Further research found that repetitive trans-spinal magnetic stimulation upregulated the expression of SOCS3 in spinal microglia,which subsequently inhibited the phosphorylation of p38 mitogen-activated protein kinase and signal transducer and activator of transcription 3 and nuclear factor-kappa B p65 nuclear translocation in rats with neuropathic pain,thereby suppressing neuroinflammation.The upregulation of SOCS3 by repetitive trans-spinal magnetic stimulation may be achieved through the activation of the CaMKKβ/AMPK signaling pathway in microglia.The results suggested that focal repetitive trans-spinal magnetic stimulation inhibits spinal neuroinflammation and alleviates neuropathic pain by activating the CaMKKβ/AMPK/SOCS3 signaling pathway in spinal microglia.This mechanism provides an effective noninvasive treatment for neuropathic pain caused by peripheral nerve injury.展开更多
Persistent postsurgical pain is a major clinical concern,especially in the aging population,who represent a growing proportion of surgical patients.Although age is a known pain risk factor,the mechanisms driving age-r...Persistent postsurgical pain is a major clinical concern,especially in the aging population,who represent a growing proportion of surgical patients.Although age is a known pain risk factor,the mechanisms driving age-related vulnerability to chronic postoperative pain remain poorly understood.This study aims to investigate how aging influences the resolution of postoperative pain and to elucidate the roles of microglial activation and synaptic remodeling in the spinal dorsal horn.A plantar incision model in young(3-month-old)and aged(18-month-old)male and female mice was used to mimic postoperative pain conditions.Mechanical and thermal hypersensitivity at various postoperative intervals were assessed by von Frey and Hargreaves tests.Microglial activation and inhibitory/excitatory synaptic densities in the spinal dorsal horn were evaluated using immunofluorescence and 3D reconstruction with Imaris software.On postoperative day(POD)3,both age groups exhibited reduced pain thresholds on the ipsilateral side,along with microglial activation in the dorsal horn.On POD 7,pain thresholds in young mice had returned to baseline with no significant microglial activation,while aged mice showed sustained reduction in pain thresholds,continuous microglial activation,and significant loss of inhibitory synapses without detectable changes in excitatory synapse density.These findings are consistent across both sexes,with no sex-related differences.Collectively,these results suggest that aging is associated with persistent postoperative pain,which correlates with microglial activation and inhibitory synapse loss.These insights advance our understanding of age-related pain vulnerability and may inform the development of more effective,targeted,and age-specific therapeutic strategies to prevent or alleviate persistent postoperative pain in elderly patients.展开更多
Pseudounipolar neurons in the dorsal root ganglia(DRG),as the central nodes of primary sensory afferents,possess a distinctive T-junction that is not merely a morphological peculiarity but also performs complex roles ...Pseudounipolar neurons in the dorsal root ganglia(DRG),as the central nodes of primary sensory afferents,possess a distinctive T-junction that is not merely a morphological peculiarity but also performs complex roles in rapid,multiplexed shunting and regulation of sensory signals.This specialized geometry enables separation,filtering,and feedback regulation of neuronal signals,thereby coordinating peripheral and central responses at multiple levels.Recent advances,including spatial transcriptomics,single-cell sequencing,super-resolution microscopy,organoid models,and novel electrophysiological methods,have permitted more precise dissection of the T-junction's molecular composition,ion-channel distribution,and electrophysiological properties.Here,we review current knowledge of the T-junction's developmental regulation and multilayered molecular networks,and we detail its functional alterations in both physiological signaling and pathological pain states,with particular emphasis on ion-channel modulation,signal attenuation,and selective transmission mechanisms.Finally,we discuss contemporary pain-intervention approaches and prospects for precision-targeted therapies,aiming to provide a theoretical foundation for future studies in pain physiology and clinical translation.展开更多
BACKGROUND:Acute pain is a sudden experience secondary to injuries and varies in perception among individuals.In trauma patients,it can negatively aff ect respiratory function,immune response,and wound healing,making ...BACKGROUND:Acute pain is a sudden experience secondary to injuries and varies in perception among individuals.In trauma patients,it can negatively aff ect respiratory function,immune response,and wound healing,making it a signifi cant public health concern.This study is to determine the prevalence and factors associated with acute pain among emergency trauma patients.METHODS:A multicenter cross-sectional study was conducted.Data were collected via interviewer-administered questionnaires and patient chart review.The data were analyzed via the statistical package for social science version 25.Bivariable and multivariable logistic regression analyses were used.Variables with a P-value<0.05 were considered statistically signifi cant.RESULTS:A total of 397 patients were included in the study,for a response rate of 96.8%.The prevalence of pain during admission was 91.9%(95%confi dence intervals[95%CIs]:88.8%-94.4%).Blunt trauma(adjusted odds ratio[aOR]=2.82;95%CI:1.23-6.45),analgesia before admission to the emergency department(aOR=2.71;95%CI:1.16-6.36),documentation of pain severity in the chart(aOR=2.71;95%CI:1.16-6.36),analgesia provided within two hours after admission(aOR=7.60;95%CI:2.79-20.68),use of non-pharmacological pain management methods(aOR=3.09;95%CI:1.35-7.08)and availability of analgesia(aOR=3.95;95%CI:1.36-11.43)were associated with acute pain experience.CONCLUSION:The prevalence of acute pain among emergency trauma patients was high in the study area.Analgesia should be administered prior to admission,and non-pharmacological pain management should be implemented.Moreover,training on pain assessment and management should be provided for healthcare providers in the emergency department.展开更多
Objective:To compare the therapeutic efficacy of intravenous pantoprazole and famotidine for the treatment of epigastric pain in patients presenting to the emergency department.Methods:In this triple-blind randomized ...Objective:To compare the therapeutic efficacy of intravenous pantoprazole and famotidine for the treatment of epigastric pain in patients presenting to the emergency department.Methods:In this triple-blind randomized clinical trial,eligible patients presenting with epigastric pain were randomly assigned to receive intravenous pantoprazole or famotidine.Block randomization was used,and patients,treating physicians,and outcome assessors were blinded to treatment allocation.Pain intensity was assessed at baseline and at 30 and 60 minutes after drug administration.Results:Eighty patients were enrolled,with a mean age of 36.6 years(SD,15.0),and 42.5%were male.Mean pain scores decreased significantly over time in both treatment groups.In the pantoprazole group,pain scores declined from 8.02±1.28 at baseline to 4.75±1.31 at 30 minutes and 1.62±1.29 at 60 minutes,whereas in the famotidine group scores decreased from 8.12±1.48 to 5.37±1.23 and 2.35±1.54,respectively.There was no significant difference in baseline pain scores between groups(P=.92).Pantoprazole resulted in greater pain reduction compared with famotidine at both 30 minutes(P=.04)and 60 minutes(P=.05).Conclusions:Both medications were effective in relieving epigastric pain;however,pantoprazole provided greater and more sustained pain reduction,supporting its preferential use in emergency settings.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
Pain,as a common symptom,seriously affects the patient's health.The aim of this work was to study the physiological responses of the brain and identify the features of Electroencephalography(EEG)signals related to...Pain,as a common symptom,seriously affects the patient's health.The aim of this work was to study the physiological responses of the brain and identify the features of Electroencephalography(EEG)signals related to friction pain.The results showed that the primary brain activation evoked by friction pain was located in the Prefrontal Cortex(PFC).The activation area decreased,and the negative activation intensity in the PFC region increased with increasing intensity of pain.The inhibitory interactions between different brain regions,especially between the PFC and primary somatosensory cortex(SI)regions were enhanced,and excitatory-inhibitory connections between the medial and lateral pain pathways were balanced during pain perception.The percentage power spectral density of theαrhythm(Dα),dominant singularity strength(αpeak)and longest vertical line(Vmax)of EEG signals induced by pain significantly decreased,and the percent-age power spectral density of theβrhythm(Dβ)significantly increased.The combination of multiple features of Dα,Dβ,αpeak and Vmax could significantly improve the average recognition accuracy of different pain states.This study elucidated the neural processing mechanisms of friction-induced pain,and EEG features associated with friction pain were extracted and recognized.It was helpful to study the brain feedback mechanisms of pain and control signals of Brain-Computer Interface(BCI)system related to pain.展开更多
Medical history summary:The child has suffered from episodic joint pain in the lower extremities since childhood,with occurrences ranging from 1 to 3 times daily,predominantly during rainy,cold,and humid weather,as we...Medical history summary:The child has suffered from episodic joint pain in the lower extremities since childhood,with occurrences ranging from 1 to 3 times daily,predominantly during rainy,cold,and humid weather,as well as in the afternoons and evenings.Symptoms and signs:The primary manifestation is episodic pain in the distal extremities,predominantly in the lower limbs,knees,and ankles.Occasionally,the pain may ascend to the elbows,wrists,and palms,and may occasionally affect the proximal extremities and waist.Diagnostic methods:Nerve biopsy and related pathological examinations,along with whole exome sequencing,are helpful for diagnosis,particularly the detection of variants in the SCN11A gene.Treatment approaches:(1)Pharmacotherapy:Sodium channel blockers and nonsteroidal anti-inflammatory drugs such as ibuprofen and naproxen can alleviate pain.(2)Neuromodulation techniques:Techniques such as transcranial magnetic stimulation(TMS)and spinal cord stimulation(SCS)can be employed to improve symptoms.(3)Psychotherapy:Cognitive-behavioral therapy(CBT),relaxation training,or psychological counseling can enhance the patient’s coping abilities.Clinical outcome:Pain relief can be achieved with analgesic medication in children,and pain symptoms generally persist until adulthood,gradually diminishing or even disappearing.Patients can reduce the frequency of episodes by staying warm and avoiding cold and damp conditions.展开更多
Objective:To investigate the clinical efficacy of electrophysiological therapy under different parameter modes in chronic pelvic pain syndrome(CPPS).Methods:A total of 95patients with CPPS from the Department of Urolo...Objective:To investigate the clinical efficacy of electrophysiological therapy under different parameter modes in chronic pelvic pain syndrome(CPPS).Methods:A total of 95patients with CPPS from the Department of Urology,First Affiliated Hospital of Jinan University,were selected and treated with electrophysiological therapy.They were randomly divided into three groups:the fixed-parameter AA7 treatment group,the P2+P4 treatment group,and the precision treatment group(individualized parameter treatment).Pain scores of patients in each group were compared before and after treatment,with a pain score of 0 indicating cure.The cure rate of each group was observed.Results:The average ages of the AA7 group,P2+P4 group,and precision treatment group were 34±14.17 years,35.58±12.57 years,and 35.5±11.27 years,respectively.There was no significant difference in age among the three groups(p>0.05).Before treatment,the pain scores of the AA7 group,P2+P4 group,and precision treatment group were 4.14±1.74,4.64±1.72,and 3.50±1.89,respectively,with no significant differences among the groups(p>0.05).After treatment,the pain scores were 0.71±0.99 for the AA7 group(cure rate:57%),0.49±0.79 for the P2+P4 group(cure rate:67%),and 0.50±0.77 for the precision treatment group(cure rate:64%),with no significant differences among the groups(p>0.05).The cure rates for different pain locations were as follows:83%for lower abdominal pain,74%for perineal pain,62%for dysuria,49%for testicular pain,and 75%for inguinal pain.Conclusion:The pathogenesis of CPPS is complex and diverse,with numerous treatment options and uncertain efficacy,posing significant challenges to clinical practice.This study showed that electrophysiological therapy under different parameter modes significantly reduced pain scores before and after treatment,indicating significant therapeutic effects on CPPS.All three modes demonstrated good cure rates.Individualized precision treatment and fixed-mode P2+P4 or AA7 treatment were safe and effective in CPPS treatment and are worth promoting.Fixed-mode P2+P4 and AA7,due to their easier standardization of parameters and patch modes,reduced the learning curve and had better potential for widespread application.展开更多
文摘Objective：To investigate the effect of injecting a compound of Bupivacaine and Fentanyl into sacral spinal space to treat chronic pelvic pain syndrome （CPPS）. Methods： A total of 36 men with recalcitrant （TPPS refractory to multiple prior therapies were treated with the injection of a compound of Bupivacaine and Fentanyl （10 ml of 0. 125% Bupivacaine, 0.05 mg Fentanyl, 5 mg Dexamethasone, 100 mg Vitamin B1 and 1 mg Vitamin B12） into sacral space once a week for 4 weeks. The National Institute of Heahh Chronic Prostatitis Symptom Index （NIH-CPSI）, maximum and average flow rate were performed al the start and the end of 4 weeks＇ therapy. Results：Mean NIH-CPSI total score was decreased from 26. 5±1.6 to 13.4±2.0 （p〈0.001）. Significant improvement was seen in each subscore domain. A total of 32 patients （89%） had at least 25% improvement on NIH-CPSI and 22 （61%） had at least 50% improvement. Maximal and average flow rate were increased from 19. 5±3. 8 to 23. 6±4. 2 and 10. 9±2.6 to 14.3±2.4 respectively. Conclusion： Injection of this compound of Bupivacaine, Fentanyl and Dexamethasone into sacred spinal space is an effective and safe approach for recalcitrant CPPS. Further study of the mechanisms and prospective placebo controlled trials are warranted.
基金Institut National de la Santéet de la Recherche Médicale(Inserm)UniversitéClermont Auvergne(France)+2 种基金CHU Clermont-Ferrand(to RD)the French government IDEX-ISITE initiative 16-IDEX-0001(to RD)The Fondation pour la Recherche Médicale(FRM)(to SM).
文摘While acute nociceptive pain is a crucial warning system that protects us from injury or disease,chronic pain is not protective,but a pathological condition.As such,it is now recognized as a disease in its own right,which major classes refer to inflammatory,neuropathic,and idiopathic pain.It is frequent,with up to a third of the population that may suffer at one point from chronic pain.It is often associated with other pathologies,including sleep disorders,anxiety,depression,and is still difficult to treat.It thus represents a significant burden in terms of health and societal impact(Tracey et al.,2019).The mechanisms of chronic pain involve multiple diverse pathways in both the peripheral and central nervous systems(CNS),reflecting its multifaceted biology.Indeed,research over the past decades has established that central sensitization(enhancement in the function of neurons and circuits in central nociceptive pathways),in particular within the dorsal horn,the first central relay of nociceptive inputs plays a key role in the chronicity of pain(Latremoliere and Woolf,2009).
基金Lianyungang Municipal Science and Technology Bureau Foundation(SH1338,SH1544,SH1402,SH1420)
文摘Intractable chronic pain is a great challenge in clinic.Central sensitization based on the positive changes of dendritic spines is the main mechanism of intractable chronic pain.And low-dose radiation has been proved to regulate the changes of dendritic spines negatively.Hence,we make a hypothesis that low-dose radiation could relieve cancer and noncancer pain through negatively regulating the shape and reducing the number and density of dendritic spines in the spinal cord.This method is supposed to be a new therapy for intractable chronic pain by expanding indication to non-cancer pain,translocating radiation site from where the tumor exists to special segments of spinal cord and keeping radiation dose at a low level.This therapy would be reliable for relieving non-cancer pain and supply more choices for relieving cancer pain.
文摘Summary Pain is not pain because people interpret symptoms differently.Neck pain is one of the most common pains and should not be missing from a study on the effects of pain.Depression does not arise solely from pain but is multicausal and often caused by this cumulative effect.
基金Institute for Basic Science(IBS)Center for Cognition and Sociality(IBS-R001-D2 to BL).
文摘Neuropathic pain is a complex and debilitating condition caused by lesions or dysfunction within the somatosensory nervous system.Affecting an estimated 7%-10%of the global population,it presents with spontaneous pain,hyperalgesia,and allodynia,often accompanied by long-term emotional and cognitive consequences,such as depression and anxiety,which result in a reduced quality of life.Despite extensive research efforts,effective treatments remain limited.This limited efficacy likely stems,in part,from the heterogeneous nature of neuropathic pain,which varies widely across individuals in both clinical presentation and treatment responsiveness.
文摘Nerve trauma commonly results in chronic neuropathic pain. This is by triggering the release of proinflammatory mediators from local and invading cells that induce inflammation and nociceptive neuron hyperexcitability. Even without apparent inflammation, injury sites are associated with increased inflammatory markers. This review focuses on how it might be possible to reduce neuropathic pain by reducing inflammation. Physiologically, pain is resolved by a combination of the out-migration of pro-inflammatory cells from the injury site, the down-regulation of the genes underlying the inflammation, up-regulating genes for anti-inflammatory mediators, and reducing nociceptive neuron hyperexcitability. While various techniques reduce chronic neuropathic pain, the best are effective on < 50% of patients, no technique reliably or permanently eliminates neuropathic pain. This is because most techniques are predominantly aimed at reducing pain, not inflammation. In addition, while single factors reduce pain, increasing evidence indicates significant and longer-lasting pain relief requires multiple factors acting simultaneously. Therefore, it is not surprising that extensive data indicate that the application of platelet-rich plasma provides more significant and longer-lasting pain suppression than other techniques, although its analgesia is neither complete nor permanent. However, several case reports indicate that platelet-rich plasma can induce permanent neuropathic pain elimination when the platelet concentration is significantly increased and is applied to longer nerve lengths. This review examines the primary triggers of the development and maintenance of neuropathic pain and techniques that reduce chronic neuropathic pain. The application of plateletrich plasma holds great promise for providing complete and permanent chronic neuropathic pain elimination.
基金supported by Key Tackling Project of the Education Department of Liaoning Province,No.2024C011the Medical-Industrial Joint Innovation Funding Project of the First Hospital of Dalian Medical University and Dalian Institute of Chemical Physics,No.DMU-1&DICP UN202311(both to ZL).
文摘Chronic pain following a spinal cord injury refers to pain that persists or recurs after the injury.This pain can manifest as burning,stinging,or sensations similar to electric shocks.Recent studies have shown that spinal cord stimulation is an effective way to treat chronic pain after spinal cord injury.The purpose of this review is to introduce the technique of spinal cord stimulation,the clinical manifestations of spinal cord injury,and the role of spinal cord stimulation in the treatment of spinal cord injury.The mechanism and clinical application of spinal cord stimulation in the treatment of pain after spinal cord injury are discussed.The mechanism of spinal cord stimulation primarily involves three aspects:neuromodulation,neurochemical regulation,and anti-inflammatory effects,along with nerve repair.In terms of neuromodulation,spinal cord stimulation is based on the gate control theory of pain.It activates large-diameter amyloid-βnerve fibers to promote the release of inhibitory neurotransmitters by gamma-aminobutyric acidergic inhibitory interneurons in the spinal cord,thereby blocking the transmission of pain signals from small-diameter C fibers.Neurochemical studies indicate that spinal cord stimulation can regulate the balance of neurotransmitters within the spinal cord,increasing the release of inhibitory neurotransmitters such as gamma-aminobutyric acid,serotonin,and acetylcholine while reducing the levels of excitatory neurotransmitters.Additionally,spinal cord stimulation exhibits significant anti-inflammatory and neuroprotective effects,downregulating pro-inflammatory factor levels,upregulating anti-inflammatory factor expression,alleviating neuroinflammatory responses,and repairing damaged neural circuits by promoting the secretion of neurotrophic factors and axonal regeneration.Spinal cord stimulation have demonstrated remarkable efficacy in the clinical treatment of pain after spinal cord injury,but there are still limitations such as small sample size and high heterogeneity in clinical studies,as well as insufficient long-term efficacy data.Future research should conduct multi-center large-sample randomized controlled trials,and establish long-term follow-up mechanisms to improve evidence-based medical evidence.
基金supported by the Natural Science Foundation of Beijing Municipality(No.F252065)the National Natural Science Foundation of China(No.32271190,32571323)the STI 2030 Major Project(No.2021ZD0203202)。
文摘Knee osteoarthritis(KOA)represents one of the most common causes of chronic pain.The high prevalence and disability rates of KOA impose a severe burden on both individuals and society.In contrast to cutaneous pain,KOA-induced joint pain is characterized as a deep tissue pain that potentially involves distinct subgroups of peripheral sensory neurons and central processing mechanisms.Furthermore,KOA pain is closely related to locomotion activity.Impaired sensorimotor integration and pain mutually reinforce each other in KOA,forming a vicious cycle that exacerbates disease progression.In this review,we highlight the key differences between KOA pain and cutaneous pain,and the latter has been extensively studied in the pain field.We hope to offer new insights into the central mechanisms and development of new treatment strategies for KOA based on the interactions between impaired sensorimotor integration and chronic joint pain.
基金supported by the National Natural Science Foundation of China(No.82360238,82071245)。
文摘Cancer pain is one of the most prevalent and debilitating symptoms in patients with advanced malignancies,arising from multifactorial mechanisms involving peripheral,central,and systemic pathways.Conventional analgesics,including opioids and nonsteroidal anti-inflammatory drugs,are often limited by their insufficient efficacy,tolerance,and risk of dependence.Traditional Chinese Medicine(TCM),characterized by its multi-component,multi-target,and systemic regulatory properties,has shown promising potential in cancer pain management.This review provides a comprehensive overview of the clinical classification and underlying mechanisms of cancer pain(including nerve infiltration,dysregulation of inflammatory mediators and ion channels,central sensitization,neuro-immune crosstalk,metabolic reprogramming,and gut-brain axis impairment),as well as the analgesic effects of representative TCM agents in cancer pain management.For example,bioactive components such as tetrahydroberberine,levo-tetrahydropalmatine,and piperine exert analgesic effects,thereby improving the quality of life of patients by inhibiting inflammatory cascades,regulating neurotransmitter systems,and preserving neural integrity.Commonly used preclinical models,including bone cancer pain,pancreatic cancer pain,and chemotherapy-induced peripheral neuropathy models,are summarized for their utility in mechanistic studies and efficacy evaluations.This review also discusses the current limitations of clinical evidence,such as small sample sizes,short follow-up periods,and limited translation from animal models,alongside major challenges in standardization,mechanistic elucidation,and clinical trial design.Future directions should focus on precise pain phenotyping,integrated multi-target interventions,rigorous efficacy safety validation,and innovations in drug delivery to facilitate the standardization and global adoption of TCM in cancer pain management.
文摘Chronic pain represents a significant global health challenge,and the limitations of conventional analgesics have urged a search for alternative therapeutic strategies.Cannabinoids derived from Cannabis sativa have emerged as prominent candidates.While psychotropic cannabinoids are known for their analgesic effects,their psychoactive properties often limit their clinical utility.Consequently,interest has shifted towards non-psychotropic cannabinoids that offer potential pain relief without inducing cognitive or euphoric effects.This comprehensive review investigates the pain-modulating mechanisms of cannabinoids,encompassing interactions with the endocannabinoid system and other non-traditional pathways,and summarizes the existing preclinical and clinical evidence supporting their use in various pain states.Furthermore,it discusses the therapeutic potential,clinical considerations,significant challenges,and the need for product standardization.This review also aims to evaluate the role and prospects of non-psychotropic cannabinoids as a therapeutic option for pain management.
文摘[Objectives]To investigate the clinical efficacy of core stability training combined with conventional rehabilitation in the functional recovery of patients suffering from chronic low back pain.[Methods]A randomized controlled trial design was employed in this study.Ninety patients with chronic low back pain were recruited and randomly assigned to either a control group(n=45),which received conventional rehabilitation,or an experimental group(n=45),which received conventional rehabilitation combined with core stability training.Both groups underwent treatment for 6 weeks.Assessments were conducted using the visual analogue scale(VAS),Oswestry disability index(ODI),and finger-to-floor test prior to treatment,6 weeks following treatment,and during the follow-up period,respectively.[Results]Prior to treatment,no statistically significant differences were observed between the two patient groups in terms of general information and various baseline measurements(P>0.05).Following 6 weeks of treatment and throughout the follow-up period,both groups demonstrated significant improvements in VAS scores,ODI scores,and lumbar anteflexion range of motion compared to baseline measurements(P<0.05).Notably,the magnitude of improvement in the experimental group exceeded that of the control group,with this inter-group difference reaching statistical significance(P<0.05).No serious adverse reactions were reported during the treatment process.[Conclusions]Core stability training combined with conventional rehabilitation can significantly enhance the alleviation of pain and functional impairments in patients suffering from chronic low back pain.This approach holds valuable implications for the optimization of rehabilitation treatment protocols.
基金National Natural Science Foundation of China,Nos.82302877(to QW),82172541(to TW)the Natural Science Foundation of Hunan Province,No.2023JJ30549(to QW)Clinical Medical Technology Innovation Guidance Project of Hunan Provincial Science and Technology Department,No.2021SK51815(to QW).
文摘Current treatments for neuropathic pain are suboptimal,necessitating the search for more effective therapeutics.Our previous study showed that inhibition of neuroinflammation in the spinal cord induced analgesic effects,and focal repetitive trans-spinal magnetic stimulation showed an anti-neuroinflammatory effect in spinal cord injury rat models.Here,we speculated that repetitive trans-spinal magnetic stimulation might induce an anti-inflammatory effect to alleviate neuropathic pain by upregulating calmodulin-dependent protein kinase kinase beta(CaMKKβ)/adenosine 5′-monophosphate-activated protein kinase(AMPK)/suppressor of cytokine signaling-3(SOCS3)signaling in microglia.Experiments have found that non-invasive focal repetitive trans-spinal magnetic stimulation effectively alleviates mechanical allodynia and spinal neuroinflammation in rats with neuropathic pain induced by chronic sciatic nerve ligation.Further research found that repetitive trans-spinal magnetic stimulation upregulated the expression of SOCS3 in spinal microglia,which subsequently inhibited the phosphorylation of p38 mitogen-activated protein kinase and signal transducer and activator of transcription 3 and nuclear factor-kappa B p65 nuclear translocation in rats with neuropathic pain,thereby suppressing neuroinflammation.The upregulation of SOCS3 by repetitive trans-spinal magnetic stimulation may be achieved through the activation of the CaMKKβ/AMPK signaling pathway in microglia.The results suggested that focal repetitive trans-spinal magnetic stimulation inhibits spinal neuroinflammation and alleviates neuropathic pain by activating the CaMKKβ/AMPK/SOCS3 signaling pathway in spinal microglia.This mechanism provides an effective noninvasive treatment for neuropathic pain caused by peripheral nerve injury.
基金supported by the National Natural Science Foundation of China(No.82401445 and 82271249)the China Postdoctoral Science Foundation(No.2024M752251)+3 种基金the Postdoctoral Fellowship Program of CPSF(No.GZC20241141)the Sichuan Science and Technology Program(No.2024NSFSC1636 and 2025ZNSFSC1645)the Postdoctoral Research Fund of West China Hospital of Sichuan University(No.2024HXBH013)1-3-5 Project for Disciplines of Excellence of West China Hospital of Sichuan University(No.ZYYC23002)。
文摘Persistent postsurgical pain is a major clinical concern,especially in the aging population,who represent a growing proportion of surgical patients.Although age is a known pain risk factor,the mechanisms driving age-related vulnerability to chronic postoperative pain remain poorly understood.This study aims to investigate how aging influences the resolution of postoperative pain and to elucidate the roles of microglial activation and synaptic remodeling in the spinal dorsal horn.A plantar incision model in young(3-month-old)and aged(18-month-old)male and female mice was used to mimic postoperative pain conditions.Mechanical and thermal hypersensitivity at various postoperative intervals were assessed by von Frey and Hargreaves tests.Microglial activation and inhibitory/excitatory synaptic densities in the spinal dorsal horn were evaluated using immunofluorescence and 3D reconstruction with Imaris software.On postoperative day(POD)3,both age groups exhibited reduced pain thresholds on the ipsilateral side,along with microglial activation in the dorsal horn.On POD 7,pain thresholds in young mice had returned to baseline with no significant microglial activation,while aged mice showed sustained reduction in pain thresholds,continuous microglial activation,and significant loss of inhibitory synapses without detectable changes in excitatory synapse density.These findings are consistent across both sexes,with no sex-related differences.Collectively,these results suggest that aging is associated with persistent postoperative pain,which correlates with microglial activation and inhibitory synapse loss.These insights advance our understanding of age-related pain vulnerability and may inform the development of more effective,targeted,and age-specific therapeutic strategies to prevent or alleviate persistent postoperative pain in elderly patients.
基金supported by grant from the National Key Technology Support Program of the Ministry of Science and Technology of China(No.2021ZD0203204)。
文摘Pseudounipolar neurons in the dorsal root ganglia(DRG),as the central nodes of primary sensory afferents,possess a distinctive T-junction that is not merely a morphological peculiarity but also performs complex roles in rapid,multiplexed shunting and regulation of sensory signals.This specialized geometry enables separation,filtering,and feedback regulation of neuronal signals,thereby coordinating peripheral and central responses at multiple levels.Recent advances,including spatial transcriptomics,single-cell sequencing,super-resolution microscopy,organoid models,and novel electrophysiological methods,have permitted more precise dissection of the T-junction's molecular composition,ion-channel distribution,and electrophysiological properties.Here,we review current knowledge of the T-junction's developmental regulation and multilayered molecular networks,and we detail its functional alterations in both physiological signaling and pathological pain states,with particular emphasis on ion-channel modulation,signal attenuation,and selective transmission mechanisms.Finally,we discuss contemporary pain-intervention approaches and prospects for precision-targeted therapies,aiming to provide a theoretical foundation for future studies in pain physiology and clinical translation.
文摘BACKGROUND:Acute pain is a sudden experience secondary to injuries and varies in perception among individuals.In trauma patients,it can negatively aff ect respiratory function,immune response,and wound healing,making it a signifi cant public health concern.This study is to determine the prevalence and factors associated with acute pain among emergency trauma patients.METHODS:A multicenter cross-sectional study was conducted.Data were collected via interviewer-administered questionnaires and patient chart review.The data were analyzed via the statistical package for social science version 25.Bivariable and multivariable logistic regression analyses were used.Variables with a P-value<0.05 were considered statistically signifi cant.RESULTS:A total of 397 patients were included in the study,for a response rate of 96.8%.The prevalence of pain during admission was 91.9%(95%confi dence intervals[95%CIs]:88.8%-94.4%).Blunt trauma(adjusted odds ratio[aOR]=2.82;95%CI:1.23-6.45),analgesia before admission to the emergency department(aOR=2.71;95%CI:1.16-6.36),documentation of pain severity in the chart(aOR=2.71;95%CI:1.16-6.36),analgesia provided within two hours after admission(aOR=7.60;95%CI:2.79-20.68),use of non-pharmacological pain management methods(aOR=3.09;95%CI:1.35-7.08)and availability of analgesia(aOR=3.95;95%CI:1.36-11.43)were associated with acute pain experience.CONCLUSION:The prevalence of acute pain among emergency trauma patients was high in the study area.Analgesia should be administered prior to admission,and non-pharmacological pain management should be implemented.Moreover,training on pain assessment and management should be provided for healthcare providers in the emergency department.
文摘Objective:To compare the therapeutic efficacy of intravenous pantoprazole and famotidine for the treatment of epigastric pain in patients presenting to the emergency department.Methods:In this triple-blind randomized clinical trial,eligible patients presenting with epigastric pain were randomly assigned to receive intravenous pantoprazole or famotidine.Block randomization was used,and patients,treating physicians,and outcome assessors were blinded to treatment allocation.Pain intensity was assessed at baseline and at 30 and 60 minutes after drug administration.Results:Eighty patients were enrolled,with a mean age of 36.6 years(SD,15.0),and 42.5%were male.Mean pain scores decreased significantly over time in both treatment groups.In the pantoprazole group,pain scores declined from 8.02±1.28 at baseline to 4.75±1.31 at 30 minutes and 1.62±1.29 at 60 minutes,whereas in the famotidine group scores decreased from 8.12±1.48 to 5.37±1.23 and 2.35±1.54,respectively.There was no significant difference in baseline pain scores between groups(P=.92).Pantoprazole resulted in greater pain reduction compared with famotidine at both 30 minutes(P=.04)and 60 minutes(P=.05).Conclusions:Both medications were effective in relieving epigastric pain;however,pantoprazole provided greater and more sustained pain reduction,supporting its preferential use in emergency settings.
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.
基金National Natural Science Foundation of China(grant number:52375224)Natural Science Foundation of Jiangsu Province(grant number:BK20242086)+2 种基金Priority Academic Program Development of Jiangsu Higher Education Institutions,a project supported by"the Fundamental Research Funds for the Central Universities"(grant number:202410976)Graduate Innovation Program of China University of Mining and Technology(grant number:2024WLKXJ075)Postgraduate Research&Practice Innovation Program of Jiangsu Province(grant number:KYCX24_2719).
文摘Pain,as a common symptom,seriously affects the patient's health.The aim of this work was to study the physiological responses of the brain and identify the features of Electroencephalography(EEG)signals related to friction pain.The results showed that the primary brain activation evoked by friction pain was located in the Prefrontal Cortex(PFC).The activation area decreased,and the negative activation intensity in the PFC region increased with increasing intensity of pain.The inhibitory interactions between different brain regions,especially between the PFC and primary somatosensory cortex(SI)regions were enhanced,and excitatory-inhibitory connections between the medial and lateral pain pathways were balanced during pain perception.The percentage power spectral density of theαrhythm(Dα),dominant singularity strength(αpeak)and longest vertical line(Vmax)of EEG signals induced by pain significantly decreased,and the percent-age power spectral density of theβrhythm(Dβ)significantly increased.The combination of multiple features of Dα,Dβ,αpeak and Vmax could significantly improve the average recognition accuracy of different pain states.This study elucidated the neural processing mechanisms of friction-induced pain,and EEG features associated with friction pain were extracted and recognized.It was helpful to study the brain feedback mechanisms of pain and control signals of Brain-Computer Interface(BCI)system related to pain.
文摘Medical history summary:The child has suffered from episodic joint pain in the lower extremities since childhood,with occurrences ranging from 1 to 3 times daily,predominantly during rainy,cold,and humid weather,as well as in the afternoons and evenings.Symptoms and signs:The primary manifestation is episodic pain in the distal extremities,predominantly in the lower limbs,knees,and ankles.Occasionally,the pain may ascend to the elbows,wrists,and palms,and may occasionally affect the proximal extremities and waist.Diagnostic methods:Nerve biopsy and related pathological examinations,along with whole exome sequencing,are helpful for diagnosis,particularly the detection of variants in the SCN11A gene.Treatment approaches:(1)Pharmacotherapy:Sodium channel blockers and nonsteroidal anti-inflammatory drugs such as ibuprofen and naproxen can alleviate pain.(2)Neuromodulation techniques:Techniques such as transcranial magnetic stimulation(TMS)and spinal cord stimulation(SCS)can be employed to improve symptoms.(3)Psychotherapy:Cognitive-behavioral therapy(CBT),relaxation training,or psychological counseling can enhance the patient’s coping abilities.Clinical outcome:Pain relief can be achieved with analgesic medication in children,and pain symptoms generally persist until adulthood,gradually diminishing or even disappearing.Patients can reduce the frequency of episodes by staying warm and avoiding cold and damp conditions.
文摘Objective:To investigate the clinical efficacy of electrophysiological therapy under different parameter modes in chronic pelvic pain syndrome(CPPS).Methods:A total of 95patients with CPPS from the Department of Urology,First Affiliated Hospital of Jinan University,were selected and treated with electrophysiological therapy.They were randomly divided into three groups:the fixed-parameter AA7 treatment group,the P2+P4 treatment group,and the precision treatment group(individualized parameter treatment).Pain scores of patients in each group were compared before and after treatment,with a pain score of 0 indicating cure.The cure rate of each group was observed.Results:The average ages of the AA7 group,P2+P4 group,and precision treatment group were 34±14.17 years,35.58±12.57 years,and 35.5±11.27 years,respectively.There was no significant difference in age among the three groups(p>0.05).Before treatment,the pain scores of the AA7 group,P2+P4 group,and precision treatment group were 4.14±1.74,4.64±1.72,and 3.50±1.89,respectively,with no significant differences among the groups(p>0.05).After treatment,the pain scores were 0.71±0.99 for the AA7 group(cure rate:57%),0.49±0.79 for the P2+P4 group(cure rate:67%),and 0.50±0.77 for the precision treatment group(cure rate:64%),with no significant differences among the groups(p>0.05).The cure rates for different pain locations were as follows:83%for lower abdominal pain,74%for perineal pain,62%for dysuria,49%for testicular pain,and 75%for inguinal pain.Conclusion:The pathogenesis of CPPS is complex and diverse,with numerous treatment options and uncertain efficacy,posing significant challenges to clinical practice.This study showed that electrophysiological therapy under different parameter modes significantly reduced pain scores before and after treatment,indicating significant therapeutic effects on CPPS.All three modes demonstrated good cure rates.Individualized precision treatment and fixed-mode P2+P4 or AA7 treatment were safe and effective in CPPS treatment and are worth promoting.Fixed-mode P2+P4 and AA7,due to their easier standardization of parameters and patch modes,reduced the learning curve and had better potential for widespread application.
