Objective:This paper conducts a bibliometric analysis of the literature on neck pain research from 2000 to 2025,aiming to comprehensively and systematically understand the research landscape,hotspots,and frontier tren...Objective:This paper conducts a bibliometric analysis of the literature on neck pain research from 2000 to 2025,aiming to comprehensively and systematically understand the research landscape,hotspots,and frontier trends in this field,providing a reference for future research directions.Methods:Data were sourced from the Web of Science Core Collection,with the search term TI=“neck pain,”covering the time span from 2000 to 2025,resulting in 2746 articles.Software such as CiteSpace V6.3.R1 and VOSviewer 1.6.20 was used to analyze publication volume,countries,authors,institutions,keywords,and co-citation networks.Results:The number of publications in neck pain research has been increasing year by year,indicating a rising level of research activity.Authors like Falla,D,Jull,G,and institutions such as Univ Queensland and Univ Toronto have significant influence in this field.Co-occurrence analysis of keywords shows that“neck pain,”“low back pain,”and“disability index”are high-frequency keywords,reflecting research hotspots such as the characteristics and treatment of neck pain and its interrelation with pain in other regions.Timeline analysis and keyword emergence analysis reveal the frontiers and development trends in this field,such as the growing attention on emerging therapeutic methods like“exercise therapy”and“dry needling,”while keywords like“intensity,”“individuals,”and“quality”indicate an increasing emphasis on personalization,precision,and quality control in the treatment process.Conclusion:The field of neck pain research is continuously expanding and deepening.Future research should further investigate the pathogenesis of neck pain,its associations with other conditions,the refinement of assessment methods,and the development of innovative rehabilitation strategies.Emphasis should also be placed on interdisciplinary collaboration to provide more robust theoretical foundations and practical guidance for the clinical treatment and rehabilitation management of neck pain.展开更多
Objective:To utilize the VigiAccess database for data mining to analyze the characteristics of adverse reactions induced by mirogabalin,providing critical information for clinical medication use.Method:This study anal...Objective:To utilize the VigiAccess database for data mining to analyze the characteristics of adverse reactions induced by mirogabalin,providing critical information for clinical medication use.Method:This study analyzed data from the VigiAccess database,filtering out adverse reaction reports where mirogabalin was identified as the Primary Suspect Drug(PS).Reporting Odds Ratio(ROR),Proportional Reporting Ratio(PRR),Bayesian Confidence Propagation Neural Network(BCPNN),and Empirical Bayes Geometric Mean(EBGM)methods were employed as data mining algorithms for pharmacovigilance and adverse event monitoring.These methods identify potential drug-adverse event association signals by analyzing the relationship between drug use and adverse event reporting.ROR and PRR focus on calculating reporting ratios,while BCPNN and EBGM use neural networks and empirical Bayes models,respectively,to enhance the accuracy and reliability of signal detection.Results:A total of 734 adverse reaction reports associated with mirogabalin were obtained.The results showed that females reported the highest number of adverse reactions,accounting for 59.67%,while males accounted for 38.83%.In terms of age distribution,the highest number of reports came from individuals over 75 years old,accounting for 33.79%.Adverse reactions mainly involved the nervous system(33.45%),general diseases and reactions at the site of administration(11.62%),and gastrointestinal disorders(10.74%).The most common adverse reactions included dizziness(11.62%),somnolence(8.27%),renal dysfunction(2.90%),and edema(2.82%).Signal intensity analysis revealed that certain adverse reactions(such as renal dysfunction,rhabdomyolysis,and drug-induced liver injury)had significant signal strength,suggesting a strong association with mirogabalin.Conclusion:This study,through signal mining of the VigiAccess database,reveals the characteristics of mirogabalin’s adverse reactions in the real world,particularly in the nervous system and renal function.These findings provide important reference information for clinicians,aiding in the optimization of the safe use of mirogabalin.Future research should further validate the causal relationships of these signals and explore individualized treatment strategies to reduce the incidence of adverse reactions and improve patient outcomes.展开更多
Objective:To investigate the effects of“Three Methods and Three Acupoints”(TMTP)Tuina therapy on spinal microcirculation in sciatic nerve injury(SNI).Methods:Thirty-six SpragueeDawley rats were randomly assigned to ...Objective:To investigate the effects of“Three Methods and Three Acupoints”(TMTP)Tuina therapy on spinal microcirculation in sciatic nerve injury(SNI).Methods:Thirty-six SpragueeDawley rats were randomly assigned to four groups:normal,sham operation,model,and TMTP Tuina.Successful model induction was confirmed by observable hind limb lameness.After 20 sessions,hind limb grip strength and motor nerve conduction velocity(MNCV)were measured at baseline and following the 10th and 20th intervention.CD31 and a-SMA in the ventral horn of SNI model rats were detected using immunofluorescence.Motor neurons in the ventral horn were detected by Nissl staining.PTEN levels in the ventral horn were measured by ELISA,and PI3K,Akt,BDNF,VEGF,and HIF-1a expression was determined by RT-PCR.Spinal cord microcirculation was evaluated by western blotting analysis of the levels of Akt,p-Akt,BDNF,and VEGF.Results:Hind limb grip strength and MNCV significantly improved in the TMTP Tuina group compared to the model group(both P<.001).Morphology of ventral horn motor neurons in the TMTP Tuina group improved compared to the model group,with increased expressions of a-SMA(P=.002)and CD31(P=.006).Western blot analysis indicated increased expression of VEGF(P=.005),p-Akt(P<.001),and BDNF(P=.008)in the ventral horn following Tuina treatment.RT-PCR analysis revealed increased expression of PI3K,Akt,BDNF,VEGF and HIF-1a(all P<.05).In contrast,expression of PTEN decreased compared to the model group(P<.001).Conclusion:TMTP Tuina therapy may restore motor function in rats,enhance ventral horn motor neuron morphology,and promote angiogenesis and vascular smooth muscle proliferation.The mechanism may involve the activation of the PI3K/Akt signaling pathway.展开更多
Understanding and characterization of pain and other sensory symptoms are among the most important issues in the diagnosis and assessment of patient with gastrointestinal disorders. Methods to evoke and assess experim...Understanding and characterization of pain and other sensory symptoms are among the most important issues in the diagnosis and assessment of patient with gastrointestinal disorders. Methods to evoke and assess experimental pain have recently developed into a new area with the possibility for multimodal stimulation （e.g., electrical, mechanical, thermal and chemical stimulation） of different nerves and pain pathways in the human gut. Such methods mimic to a high degree the pain experienced in the clinic. Multimodal pain methods have increased our basic understanding of different peripheral receptors in the gut in health and disease. Together with advanced muscle analysis, the methods have increased our understanding of receptors sensitive to mechanical, chemical and temperature stimuli in diseases, such as systemic sclerosis and diabetes. The methods can also be used to unravel central pain mechanisms, such as those involved in allodynia, hyperalgesia and referred pain. Abnormalities in central pain mechanisms are often seen in patients with chronic gut pain and hence methods relying on multimodal pain stimulation may help to understand the symptoms in these patients. Sex differences have been observed in several diseases of the gut, and differences in central pain processing between males and females have been hypothesized using multimodal pain stimulations. Finally, multimodal methods have recently been used to gain more insight into the effect of drugs against pain in the GI tract. Hence, the multimodal methods undoubtedly represents a major step forward in the future characterization and treatment of patients with various diseases of the gut.展开更多
Methods related to experimental human pain research aim at activating different nociceptors, evoke pain from different organs and activate specific pathways and mechanisms. The different possibilities for using mechan...Methods related to experimental human pain research aim at activating different nociceptors, evoke pain from different organs and activate specific pathways and mechanisms. The different possibilities for using mechanical, electrical, thermal and chemical methods in visceral pain research are discussed with emphasis of combinations (e.g., the multimodal approach). The methods have been used widely in assessment of pain mechanisms in the esophagus and have contributed to our understanding of the symptoms reported in these patients. Hence abnormal activation and plastic changes of central pain pathways seem to play a major role in the symptoms in some patients with gastro-esophageal reflux disease and in patients with functional chest pain of esophageal origin. These findings may lead to an alternative approach for treatment in patients that does not respond to conventional medical or surgical therapy.展开更多
<strong><em>Background. </em></strong>The active ingredient curcumin of traditional Chinese medicine was selected as the research object to investigate the possible mechanism of breast cancer m...<strong><em>Background. </em></strong>The active ingredient curcumin of traditional Chinese medicine was selected as the research object to investigate the possible mechanism of breast cancer metastatic bone pain in mouse walker 256 cells and the effect of curcumin on the NF-κB/TNF-α pathway in order to provide a new idea for clinical treatment of breast cancer metastatic bone pain. <strong><em>Methods.</em></strong> By establishing an animal model of breast cancer bone metastasis in walker 256 cells, the biological behavior of nude mice was observed on the 8th day after successful modeling. Meanwhile, the low dose group, middle dose group and high dose group of mice were given 15 mg/kg, 25 mg/kg, 50 mg/kg of curcumin solution intraperitoneally in 21 days, and the right cavity bone and spinal cord distended in mice (L4-L6) tissues were used to detect related factors, Immunohistochemical method was used to detect c-fos in spinal cord. Expression levels of RANK, NF-κB and TNF-α were detected by RT-PCR and Western blot. Meanwhile, serum levels of Cox2, il-6, leukotriene and PGE2 were detected.<strong><em> Results. </em></strong>Observing the biological behavior index of nude mice, we found that the mechanical pain and thermal pain threshold decreased (p < 0.05), and the cold pain and spontaneous pain scores increased significantly (p < 0.05). After group study, the expression of c-fos in the cancer pain model group was significantly higher than that in the normal control group (p < 0.05), and with the increase of curcumin dose, the expression of c-fos in the high dose group was significantly lower than that in the solvent model group (p < 0.05). The expression of RANK, NF-κB, TNF-α was higher than that of the normal control group and decreased gradually with the increase of curcumin dose, among which the expression of high dose group was significantly lower than that of solvent group (p < 0.05). RANK, NF-κB, TNF-α protein expression was higher than that of normal control group and gradually decreased with the increase of curcumin dose. The levels of Cox2, IL-6, leukotriene and PGE2 in serum decreased with the increase of curcumin dose, and the high dose group decreased significantly (p < 0.05). <em><strong>Conclusions. </strong></em>On the 8th day after the success of the animal model of breast cancer bone metastasis in Walker 256 cells, abnormal biological behaviors such as heat pain, cold pain sensation and spontaneous hyperalgesia were observed. Further studies have found that the increased expression of rank on osteoclasts induced up-regulated expression of NF-κB and c-fos, induced expression of TNF-α gene, and could induce synthesis and release of leukotriene, PGE2 through direct activation of cyclooxygenase, inflammatory media IL-6 cascade reaction, resulting in pathological pain and hypersensitivity. Traditional Chinese medicine active ingredient curcumin could reduce RANK expression of osteoclast, inhibit cell NF-κB and spinal cord c-fos activity, reduce TNF-α expression, inhibit Cox2 activity, and reduce the synthesis and release of inflammatory factors leukotriene and PGE2, thus exerting its analgesic effect, which provides new ideas and methods for clinical treatment of metastatic bone pain in breast cancer.展开更多
Introduction: Complex regional pain syndrome (CRPS) is a disorder characterized by pain as well as a myriad of sensory, autonomic, and motor disturbances. We are reporting a case of child diagnosed with CRPS and succe...Introduction: Complex regional pain syndrome (CRPS) is a disorder characterized by pain as well as a myriad of sensory, autonomic, and motor disturbances. We are reporting a case of child diagnosed with CRPS and successfully treated with supraclavicular brachial plexus catheter infusion of local anesthetic. Case Report: An eight-year-old male underwent a left thoracotomy, repair of esophageal vascular ring, and translocation of the left subclavian to the left carotid artery. Post-operative course was relevant for severe intractable left shoulder and left arm pain associated with allodynia and hyperalgesia. A supraclavicular catheter was inserted, and an infusion of ropivacaine 0.2% was started. The child was sent for physical therapy as he gradually regained all functions of his left arm and resumed his regular activities. Conclusion: Continuous supraclavicular brachial plexus catheter infusion of local anesthetic is a valuable method of reducing pain in severe cases of upper extremity pediatric CRPS and may be safer and more effective than other invasive measures such as sympathetic blocks and epidural catheterization. Further research surrounding the diagnosis and treatment of pediatric CRPS is needed to allow early diagnosis and treatment and to improve outcome.展开更多
Objective: The aim of this study is to determine the role of preoperative low dose intravenous MgSO4 when given adjuvant to ultrasound guided transversus abdominis plane (TAP) block in augmenting postcesarean analgesi...Objective: The aim of this study is to determine the role of preoperative low dose intravenous MgSO4 when given adjuvant to ultrasound guided transversus abdominis plane (TAP) block in augmenting postcesarean analgesic effects and reducing opioid requirements during the first 24 hours. Subjects and Methods: In this prospective, randomized double blind study, a total of sixty full term pregnant women were recruited for the study underwent caesarean section. Thirty patients were assigned to MgSO4 group (A) and another thirty to placebo group (B). Participants in group (A) received 50 mg/kg MgSO4 in 100 ml isotonic saline intravenous (IV) over 20 minutes prior to induction of general anesthesia by 30 minutes while participants in group (B) received 100 ml isotonic saline (placebo) by the same route and over the same duration as control. Results: Visual Analogue Scale (VAS) was analysed within 24 hours postoperatively. The mean pain score at 6 and 12 hours postoperatively was significantly lower in MgSO4 group compared to control group (40.4 ± 5.12 vs 53.6 ± 4.92;26.1 ± 3.01 vs 35.5 ± 3.98 respectively, p = 0.012, 0.005). Comparing both groups regarding the mean time interval of first rescue analgesia (morphine sulphate) requested by the patients, it was longer in MgSO4 group compared to control group. The total dose of rescue analgesia consumed during 24 hours was analysed and it was significantly higher in control group compared to MgSO4 group (10.1 ± 0.95 vs 6.2 ± 0.87, p = 0.001). Conclusion: We concluded that preoperative low doses (50 mg/Kg) of MgSO4 with general anesthesia combined with ultrasound guided TAP block offer longer postoperative pain free periods thus reducing total opioid consumption. In addition to the safety of the drug to the mother and fetus so we recommend IV MgSO4 as an adjuvant therapy with TAP block.展开更多
Objective： This investigation was designed to stratify patients with acute chest pain based on their symptoms, electrocardiogram （ECG）, cardiac injury markers and the number of accompanying traditional risk factors...Objective： This investigation was designed to stratify patients with acute chest pain based on their symptoms, electrocardiogram （ECG）, cardiac injury markers and the number of accompanying traditional risk factors（smoking, obesity, hyperlipemia, hypertension, diabetes）, and to assess the effect of the above factors to obtain a risk stratification for patients with chest pain. Methods： We identified 139 patients with acute chest pain, including 45 myocardiac infarction patients, 65 unstable angina patients and 29 chest pain patients without identified acute coronary syndrome（ACS） admitted to our Coronary Heart Center during December 2004 to February 2005. All patients accepted coronary angiography. All data was collected using questionnaires. Based on reported symptom, electrocardiogram （ECG）, cardiac injury markers and the number of the accompanying traditional risk factors, we stratified all patients into four groups： Group 1, patients with acute chest pain, ECG changes and abnormal cardiac injury biomarkers. Group 2, patients with acute chest pain and ECG changes（without abnormal cardiac injury biomarkers）. Group 3, patients with acute chest pain, normal ECG, normal cardiac injury biomarkers and 〉2 traditional risk factors. Group 4, patients with acute chest pain, normal ECG and normal cardiac injury biomarkers, but only ≤ 2 traditional risk factors. From this data we examined the difference of ACS incidence in the four groups. Results：After stratification the ACS incidence of the grouped patients in turn was 100%, 84%, 69.6% and 53.3%. The combination of early phase ECG and cardiac injury markers identified 70.9% patients with ACS（the specificity being 90.7%）. The mortality of group 3 was higher compared with group 4（69.6% vs 53.3%）, however the P value was more than 0.05 and didn＇ t show significant statistical difference. The correlation analysis found the number of the traditional risk factors had a significant positive correlation （r= 0.202, P = 0.044） with the number of stenosis being more than 50% of the artery diameter. Multiple linear regression showed the hypertension had a significant correlation with the number of the diseased regions（P= 0.014）. Conclusions：The risk stratification based on the symptom, ECG, cardiac injury markers and accompanying traditional risk factors is both important and available in practice. It is unsuitable for patients with a normal ECG and cardiac injury markers to differentiate ACS from non-cardiac chest pain relying only on the number of the accompanying traditional risk factors. However we found the number of the risk factors can indicate the disease severity.展开更多
Background: Transcranial direct current stimulation (tDCS) across cortical brain areas appears to improve various forms of pain, yet evidence of tDCS efficiency and ideal stimulation target is lacking. This study aime...Background: Transcranial direct current stimulation (tDCS) across cortical brain areas appears to improve various forms of pain, yet evidence of tDCS efficiency and ideal stimulation target is lacking. This study aimed to compare the add-on analgesic efficacy of concentric electrode transcranial direct current stimulation (CE-tDCS) stimulation over the primary motor cortex versus the insular cortex on the management of chronic postmastectomy pain. Method: Prospective randomized double-blind sham-controlled study enrolled eighty patients with chronic postmastectomy pain that were randomly assigned to four groups: active motor (AM), sham motor (SM), active insula (AI) and sham insula (SI) group, each received 5 sessions for 20-minute duration with 2 mA tDCS over the targeted area of the contralateral side of pain. Our primary outcome was VAS score, the secondary outcomes were VDS score, LANSS score and depression symptoms by HAM-D scores, assessment was done at 4 time points (prestimulation, after 5<sup>th</sup> session, 15<sup>th</sup> day and one month after the last session). Results: Both active tDCS groups (motor and insula) showed reduction of VAS (P Conclusion: Active tDCS stimulation either targeting the primary motor cortex or the insula cortex has add-on analgesic effect for controlling neuropathic chronic post mastectomy pain and the maximum effect was at 15 days after the last session.展开更多
Background and Aims: The treatment of patients with advanced cancer pain is mainly concentrated in the outpatient department, and most of the time in their family, these patients are easy to be ignored, To study the q...Background and Aims: The treatment of patients with advanced cancer pain is mainly concentrated in the outpatient department, and most of the time in their family, these patients are easy to be ignored, To study the quality of life and its influencing factors of cancer pain patients at home is of great significance to improve the quality of life of patients. Meanwhile, it provides theoretical and practical basis for medical personnel to develop and implement individualized comprehensive intervention programs. Patients and Methods: According to the inclusion and exclusion criteria, 200 patients with cancer pain at home are selected to treat, and their quality of life conditions are observed before treatment, 1 week after treatment and 1 month after treatment, and their influencing factors are analyzed. Results: The patients’ scores of body function, emotional function, cognitive function and social function exist significant difference before and after treatment (p scores of role function and the overall evaluation scores before and after treatment, two stages after treatment exist significant difference (p < 0.01), the symptoms scores of fatigue, pain, diarrhea, nausea and vomiting are significant differences before and after treatment (p appetite loss score before a month and a week after treatment and treatment exists significant difference (p the scores of constipation symptom before treatment and a month after treatment exist significant difference (p < 0.01), only gender on cognitive function before treatment has significant difference (p . One week after treatment, tumor staging and metastasis have impact on overall health evaluation, role function, cognitive function and emotional function (p The location of metastasis and the type of pain affect the role function and emotional function respectively (p . One month after treatment, age, metastasis, metastasis site and pain type have influence on cognitive function, emotional function, overall health evaluation and role function respectively (p The overall health status, body function, role function, emotional function, cognitive function and social function of the patients are lower than those of the Norwegian norm (p < 0.001). The symptoms of pain, appetite, constipation, nausea and vomiting are higher than those of the Norwegian norm before and after treatment (p There was a significant positive correlation between quality of life and total score of social support (p < 0.01). Objective support and subjective support were positively correlated with quality of life (p Conclusion: Cognitive interventions should be individualized. The effectiveness of cancer treatment and the control of cancer recurrence and metastasis have influence on the quality of life of patients with cancer pain at home. Although the patients’ function indexes have been improved after treatment, there exist differences in the improvement after treatment. The symptoms of nausea, vomiting, pain and appetite should be intervened promptly. The management of symptoms such as dyspnea, fatigue, constipation should be focused persistently. Objective support and subjective support were the influencing factors of patients’ quality of life, the construction of social support system should be strengthened, we should help them to overcome negative emotions, return to normal family and social roles, seek help in a positive manner and use support to improve the quality of life.展开更多
Phantom Limb Pain (PLP) is a phenomenon commonly observed in orthopedic rehabilitation units that can have detrimental effects on patients’ functioning. Psychological aspects of PLP have been widely investigated show...Phantom Limb Pain (PLP) is a phenomenon commonly observed in orthopedic rehabilitation units that can have detrimental effects on patients’ functioning. Psychological aspects of PLP have been widely investigated showing that some coping mechanisms are advantageous at certain points but not at others. However, the mechanisms related to positive adjustment to PLP during the course of rehabilitation have not been adequately examined. The aim of the study was to investigate the relationship between PLP and coping mechanism at two points during the rehabilitation process. Thirty one orthopedic inpatients, who had undergone lower-limb amputation following diabetic complications, rated their pain levels and mental coping strategies. The Ways of Coping Checklist, Life Orientation Test, and the McGill Pain Questionnaire, 1-15 days post-surgery and six months post-surgery were used for evaluation. Denial was found to be negatively correlated with PLP shortly after amputation. In contrast, optimism was found to be negatively correlated with PLP six months after the surgery. Emotion-focused coping mechanisms were found to be positively correlated with PLP. It is concluded that denial during the early stages of recuperation and optimism at later stages of rehabilitation is associated with reduced PLP. Awareness of these mental processes by both medical staff and family members may enable acceptance of these processes and thus facilitate patients’ rehabilitation.展开更多
Objective:This research utilizes the FAERS for data mining to identify heart-related side effects caused by opioids,ensuring the safe use of these medications.Methods:Data from 79 quarters(Q12004 to Q32023)involving a...Objective:This research utilizes the FAERS for data mining to identify heart-related side effects caused by opioids,ensuring the safe use of these medications.Methods:Data from 79 quarters(Q12004 to Q32023)involving adverse event(AE)reports for opioids like morphine and oxycodone was reviewed.We applied the MedDRA system to categorize events and used statistical tools,ROR and BCPNN,for signal detection.These findings were cross-checked with drug labels and SIDER 4.1 for accuracy.Identified risks were then categorized by severity using DME and IME classifications.Results:Analysis of adverse events(AEs)for the five examined drugs(35359,14367,144441,10592,and 28848)identified 33,6,12,37,and 34 cardiovascular AEs,and 16,5,7,25,and 21 instances of important medical events(IMEs)respectively.Each drug was linked to cases of cardiac and cardiopulmonary arrest.The cardiovascular AEs varied widely in occurrence and severity,with methadone notably presenting diverse and potent risks,including sudden cardiac death as a distinct medical event(DME).A comparison with SIDER 4.1 showed 11 opioid-related cardiovascular AEs in line with our findings.Standardized MedDRA Queries(SMQs)confirmed these results,indicating stronger signals for methadone and tramadol,while morphine,hydromorphone,and oxycodone exhibited fewer and weaker signals.Conclusion:The study revealed numerous heart-related adverse effects(AEs)not listed on drug labels and identified new AE patterns.Recognizing these differences in AE profiles and risks across different opioids is crucial for safer prescription practices to minimize cardiac complications.展开更多
Otogenic vertigo is a common disorder that affects the vestibular system,which often results in considerable discomfort and impaired daily functioning.Traditional Chinese medicine(TCM),including acupuncture and moxibu...Otogenic vertigo is a common disorder that affects the vestibular system,which often results in considerable discomfort and impaired daily functioning.Traditional Chinese medicine(TCM),including acupuncture and moxibustion,has been historically utilized to manage the symptoms of vertigo.However,the effectiveness and methodology of these treatments have rarely been investigated in the medical literature.This study reviews the existing literature on the point selection,method,and therapeutic effect of acupuncture and moxibustion to provide a reference for the TCM treatment of otogenic vertigo.A literature search was performed using the PubMed search engine.The terms used included otogenic vertigo,acupuncture treatment,and acupuncture point selection.A total of 34 relevant articles were retrieved from PubMed.These suggest that the clinical treatment of otogenic vertigo should consider the functions of zang-fu organs and meridians and select different acupuncture treatment methods according to syndrome differentiation based on the difference between deficiency and excess.Acupuncture and moxibustion therapy should be based on acupoint selection,considering the syndrome differentiation,supplemented with experience.The treatment of otogenic vertigo with acupuncture and moxibustion refers to the selection of appropriate acupuncture methods under the guidance of TCM theory and following the principles of syndrome,disease,and meridian differentiation.Common acupuncture methods include body acupuncture,auricular acupuncture,scalp acupuncture,acupoint injection,electroacupuncture,and moxibustion.There are many acupuncture and moxibustion acupoints selected for the treatment of otogenic vertigo.Individualized treatment according to the patient’s specific condition is effective and safe,which can help to improve the patient’s vertigo symptoms and cerebral blood perfusion.展开更多
OBJECTIVE:To observe the clinical efficacy of acupuncture along fascia,meridians,and nerves combined with ultrasound-guided nerve blockage in the treatment of postherpetic neuralgia.METHODS:A total of 61 outpatients w...OBJECTIVE:To observe the clinical efficacy of acupuncture along fascia,meridians,and nerves combined with ultrasound-guided nerve blockage in the treatment of postherpetic neuralgia.METHODS:A total of 61 outpatients with post-chest and back herpes zoster neuralgia were recruited in the Department of Pain at the Xiyuan Hospital,China Academy of Chinese Medical Sciences from May 2019 to June 2021.They were randomly divided into two groups.Thirty-one patients in the control group were treated with ultrasound-guided thoracic paravertebral nerve block(PVB)alone,one patient declined to continue during treatment(n=30),and thirty patients in the observation group received the acupuncture along the fascia,meridians,and nerves combined with ultrasound-guided PVB treatment(n=30).Both control and observation group received treatment weekly for 4 weeks.The medical history data such as age,sex,presence or absence of comorbidities and disease course were analyzed.The visual analog scale(VAS)score was used to assess the pain degree of two groups at T0(before treatment),T1(1-time treatment ended),T2(2 times treatment ended),T3(3 times treatment ended),and T4(4 times treatment ended).The sleep state was examined by Pittsburgh Sleep Quality Index(PSQI)before and after the study.RESULTS:There was no significant difference in general conditions between the control group and the observation group(P>0.05).The VAS score in both control and observation group was decreased in a time-dependent manner after 1-4 weeks of treatment.There were no significant differences in VAS scores between the two groups after 1 or 2 weeks of treatment(P>0.05).After 3 and 4 weeks of treatment,the VAS score was significantly decreased in the observation group compared with that in the control group(P<0.001).In addition,the reduction in VAS score(after treatment-before treatment)between the two groups was statistically significant[D value:-1.53,95%CI(-2.32,0.74),P<0.001].Furthermore,the sleep state of patients in both groups markedly improved and much obvious in the observation group than that in the control group(P<0.05).CONCLUSION:These results suggest that a combination of acupuncture along fascia,meridians,and nerves with ultrasound-guided PVB treatment is more effective than ultrasound-guided PVB treatment alone.展开更多
AIM: Sensitization most likely plays an important role in chronic pain disorders, and such sensitization can be mimicked by experimental acid perfusion of the esophagus.The current study systematically investigated th...AIM: Sensitization most likely plays an important role in chronic pain disorders, and such sensitization can be mimicked by experimental acid perfusion of the esophagus.The current study systematically investigated the sensory and motor responses of the esophagus to controlled mechanical stimuli before and after sensitization.METHODS: Thirty healthy subjects were included.Distension of the distal esophagus with a balloon was performed before and after perfusion with 0.1 mol/L hydrochloric acid for 30 min. An impedance planimetry system was used to measure cross-sectional area,volume, pressure, and tension during the distensions. A new model allowed evaluation of the phasic contractions by the tension during contractions as a function of the initial muscle length before the contraction (comparable to the Frank-Starling law for the heart). Length-tension diagrams were used to evaluate the muscle tone before and after relaxation of the smooth muscle with butylscopolamine.RESULTS: The sensitization resulted in allodynia and hyperalgesia to the distension volumes, and the degree of sensitization was related to the infused volume of acid. Furthermore, a nearly 50% increase in the evoked referred pain was seen after sensitization. The mechanical analysis demonstrated hyper-reactivity of the esophagus following acid perfusion, with an increased number and force of the phasic contractions, but the muscle tone did not change.CONCLUSION: Acid perfusion of the esophagus sensitizes the sensory pathways and facilitates secondary contractions.The new model can be used to study abnormal sensorymotor mechanisms in visceral organs.展开更多
OBJECTIVE: The quality and quantity of published research papers are important in both scientific and technology fields. Although there are several bibliometric studies based on citation analysis, very few have focuse...OBJECTIVE: The quality and quantity of published research papers are important in both scientific and technology fields. Although there are several bibliometric studies based on citation analysis, very few have focused on research related to Traditional Chinese Medicine in China. METHODS: The bibliometric method used in this study included the following focuses: publication outputs for each year, paper type, language of publication, distribution of internationally collaborative countries, sources of funding, authorization number, distribution of institutes regarding collaborative publications, research fields, distribution of out-puts in journals, citation data, and h-index. RESULTS: A total of 3809 papers published from 1995 to 2012 were extracted from the science citation index(SCI). The cumulative number of papers from all six universities is constantly increasing. The United States attained the dominant position regarding complementary and alternative medicine research. The Chinese Academy of Sciences was the greatest participator in collaborative efforts. Research field analysis showed that the research mainly focused on pharmacology pharmacy, chemistry, integrative complementary medicine, plant sciences, and biochemistry molecular biology. The Shanghai University of Chinese Medicine had the most citations. CONCLUSION: In recent years, in terms of SCI papers, the six Traditional Chinese Medicine universities studied here have made great advances in scientific research.展开更多
The aim of this paper was to describe functional biliary syndromes and methods for evaluation of the biliary tract in these patients. Functional biliary symptoms can be defined as biliary symptoms without demonstrable...The aim of this paper was to describe functional biliary syndromes and methods for evaluation of the biliary tract in these patients. Functional biliary symptoms can be defined as biliary symptoms without demonstrable organic substrate. Two main syndromes exist： Gallbladder dysfunction and sphincter of Oddi dysfunction. The most important investigative tools are cholescintigraphy and endoscopic sphincter of Oddi manometry. In gallbladder dysfunction a scintigraphic gallbladder ejection fraction below 35% can select patients who will benefit from cholecystectomy. Endoscopic sphincter of Oddi manometry is considered the gold standard in sphincter of Oddi dysfunction but recent development in scintigraphic methods is about to change this. Thus, calculation of hilum-to-duodenum transit time and duodenal appearance time on cholescintigraphy have proven useful in these patients. In conclusion, ambient methods can diagnose functional biliary syndromes. However, there are still a number of issues where further knowledge is needed. Probably the next step forward will be in the area of sensory testing and impedance planimetric methods.展开更多
OBJECTIVE: To evaluate the effects of moxa-burning heat stimulating acupoints Zusanli(ST36) and Shenshu(BL23) on macrophage migration inhibitory factor(MIF) and its related molecules which can provide scientific exper...OBJECTIVE: To evaluate the effects of moxa-burning heat stimulating acupoints Zusanli(ST36) and Shenshu(BL23) on macrophage migration inhibitory factor(MIF) and its related molecules which can provide scientific experimental basis for the clinical application of moxibustion treatment of rheumatoid arthritis(RA). METHODS: Thirty rabbits were randomly assigned to control group, RA model(established by injecting Freund’s Complete Adjuvant) group(RA group) and RA model with moxibustion group [Moxa group, Zusanli(ST36) and Shenshu(BL23), 5 moxa pillars/day, 6 d × 3]. The expressions of MIF m RNA were evaluated with reverse transcription polymerase chain reaction;the apoptosis rates of macrophages were detected by erminal deoxynucleotidyl transferase-mediated d TUP nick end labeling;the expressions of related signal molecules were detected with immunohistochemical S-P method and the levels of IL-2 were detected with enzymelinked immunosorbent assay. RESULTS: The expressions of MIF m RNA, extracellular regulated protein kinases 2, p38 mitogen-activated protein kinase and nuclear factor-κ-gene binding p65 in synovial tissue of RA group were significantly increased when compared with control group, which were lower remarkably in moxa group than those in RA group. The apoptosis rates of macrophages in RA group were significantly down-regulated as compared with the control group, which were up-regulated in moxa group compared with the RA group. The levels of IL-2 in synovial fluid from the RA group were elevated significantly as compared with that from control group, but those of the moxa group were reduced when compared with those from RA group. CONCLUSIONS: Moxibustion may simultaneously regulate the expressions of MIF and its related signaling pathways molecules, the apoptosis rate of macrophages in synovial tissue, as well as the level of inflammatory factors in synovial fluid. The results suggest that the antiinflammatory effect of moxibustion on RA may be related to inhibit the expression of MIF in synovial tissue, the molecules of some related signaling pathways and promote the apoptosis of macrophage.展开更多
Objective:The aim of this article was to discuss the theory of doctor-patient co-operated evidence-based medical record and set up the preliminary frame of the doctor-patient co-operated evidence-based medical record ...Objective:The aim of this article was to discuss the theory of doctor-patient co-operated evidence-based medical record and set up the preliminary frame of the doctor-patient co-operated evidence-based medical record following the concept of narrative evidence-based medicine.Methods:The information was searched from Pubmed,Embase,CBMdisc,CNKI.A preliminary agreement was reached by referring to the principles of narrative medicine and advises given by experts of digestive system and evidence-based medicine in both Traditional Chinese Medicine and Western Medicine.Result:This research is a useful attempt to discuss the establishment of doctor-patient co-operated evidence-based medical record guided by the direction of narrative evidence-based medicine.Reflection and outlook:Doctor-patient co-operated medical record can be a key factor of the curative effect evaluation methodology system of integrated therapy of Tradition Chinese Medicine and Western Medicine on spleen and stomach diseases.展开更多
基金Hubei Provincial Natural Science Foundation Innovation and Development Joint Fund Project(Project No.:2025AFD278)Three Gorges University Scientific Fund Project(Project No.:2022kj008)Three Gorges University Special Scientific Fund Project(Project No.:2023kjzx001)。
文摘Objective:This paper conducts a bibliometric analysis of the literature on neck pain research from 2000 to 2025,aiming to comprehensively and systematically understand the research landscape,hotspots,and frontier trends in this field,providing a reference for future research directions.Methods:Data were sourced from the Web of Science Core Collection,with the search term TI=“neck pain,”covering the time span from 2000 to 2025,resulting in 2746 articles.Software such as CiteSpace V6.3.R1 and VOSviewer 1.6.20 was used to analyze publication volume,countries,authors,institutions,keywords,and co-citation networks.Results:The number of publications in neck pain research has been increasing year by year,indicating a rising level of research activity.Authors like Falla,D,Jull,G,and institutions such as Univ Queensland and Univ Toronto have significant influence in this field.Co-occurrence analysis of keywords shows that“neck pain,”“low back pain,”and“disability index”are high-frequency keywords,reflecting research hotspots such as the characteristics and treatment of neck pain and its interrelation with pain in other regions.Timeline analysis and keyword emergence analysis reveal the frontiers and development trends in this field,such as the growing attention on emerging therapeutic methods like“exercise therapy”and“dry needling,”while keywords like“intensity,”“individuals,”and“quality”indicate an increasing emphasis on personalization,precision,and quality control in the treatment process.Conclusion:The field of neck pain research is continuously expanding and deepening.Future research should further investigate the pathogenesis of neck pain,its associations with other conditions,the refinement of assessment methods,and the development of innovative rehabilitation strategies.Emphasis should also be placed on interdisciplinary collaboration to provide more robust theoretical foundations and practical guidance for the clinical treatment and rehabilitation management of neck pain.
基金Hubei Provincial Natural Science Foundation Innovation and Development Joint Fund Project(2025AFD278)Three Gorges University Scientific Fund Project(2022kj008)Three Gorges University Special Scientific Fund Project(2023kjzx001)。
文摘Objective:To utilize the VigiAccess database for data mining to analyze the characteristics of adverse reactions induced by mirogabalin,providing critical information for clinical medication use.Method:This study analyzed data from the VigiAccess database,filtering out adverse reaction reports where mirogabalin was identified as the Primary Suspect Drug(PS).Reporting Odds Ratio(ROR),Proportional Reporting Ratio(PRR),Bayesian Confidence Propagation Neural Network(BCPNN),and Empirical Bayes Geometric Mean(EBGM)methods were employed as data mining algorithms for pharmacovigilance and adverse event monitoring.These methods identify potential drug-adverse event association signals by analyzing the relationship between drug use and adverse event reporting.ROR and PRR focus on calculating reporting ratios,while BCPNN and EBGM use neural networks and empirical Bayes models,respectively,to enhance the accuracy and reliability of signal detection.Results:A total of 734 adverse reaction reports associated with mirogabalin were obtained.The results showed that females reported the highest number of adverse reactions,accounting for 59.67%,while males accounted for 38.83%.In terms of age distribution,the highest number of reports came from individuals over 75 years old,accounting for 33.79%.Adverse reactions mainly involved the nervous system(33.45%),general diseases and reactions at the site of administration(11.62%),and gastrointestinal disorders(10.74%).The most common adverse reactions included dizziness(11.62%),somnolence(8.27%),renal dysfunction(2.90%),and edema(2.82%).Signal intensity analysis revealed that certain adverse reactions(such as renal dysfunction,rhabdomyolysis,and drug-induced liver injury)had significant signal strength,suggesting a strong association with mirogabalin.Conclusion:This study,through signal mining of the VigiAccess database,reveals the characteristics of mirogabalin’s adverse reactions in the real world,particularly in the nervous system and renal function.These findings provide important reference information for clinicians,aiding in the optimization of the safe use of mirogabalin.Future research should further validate the causal relationships of these signals and explore individualized treatment strategies to reduce the incidence of adverse reactions and improve patient outcomes.
基金supported by the National Natural Science Foundation of China(82274675&82074573)the Beijing Natural Science Foundation(7232278).
文摘Objective:To investigate the effects of“Three Methods and Three Acupoints”(TMTP)Tuina therapy on spinal microcirculation in sciatic nerve injury(SNI).Methods:Thirty-six SpragueeDawley rats were randomly assigned to four groups:normal,sham operation,model,and TMTP Tuina.Successful model induction was confirmed by observable hind limb lameness.After 20 sessions,hind limb grip strength and motor nerve conduction velocity(MNCV)were measured at baseline and following the 10th and 20th intervention.CD31 and a-SMA in the ventral horn of SNI model rats were detected using immunofluorescence.Motor neurons in the ventral horn were detected by Nissl staining.PTEN levels in the ventral horn were measured by ELISA,and PI3K,Akt,BDNF,VEGF,and HIF-1a expression was determined by RT-PCR.Spinal cord microcirculation was evaluated by western blotting analysis of the levels of Akt,p-Akt,BDNF,and VEGF.Results:Hind limb grip strength and MNCV significantly improved in the TMTP Tuina group compared to the model group(both P<.001).Morphology of ventral horn motor neurons in the TMTP Tuina group improved compared to the model group,with increased expressions of a-SMA(P=.002)and CD31(P=.006).Western blot analysis indicated increased expression of VEGF(P=.005),p-Akt(P<.001),and BDNF(P=.008)in the ventral horn following Tuina treatment.RT-PCR analysis revealed increased expression of PI3K,Akt,BDNF,VEGF and HIF-1a(all P<.05).In contrast,expression of PTEN decreased compared to the model group(P<.001).Conclusion:TMTP Tuina therapy may restore motor function in rats,enhance ventral horn motor neuron morphology,and promote angiogenesis and vascular smooth muscle proliferation.The mechanism may involve the activation of the PI3K/Akt signaling pathway.
基金Supported by "Det Obelske Familiefond" & "Spar Nord Fonden"
文摘Understanding and characterization of pain and other sensory symptoms are among the most important issues in the diagnosis and assessment of patient with gastrointestinal disorders. Methods to evoke and assess experimental pain have recently developed into a new area with the possibility for multimodal stimulation （e.g., electrical, mechanical, thermal and chemical stimulation） of different nerves and pain pathways in the human gut. Such methods mimic to a high degree the pain experienced in the clinic. Multimodal pain methods have increased our basic understanding of different peripheral receptors in the gut in health and disease. Together with advanced muscle analysis, the methods have increased our understanding of receptors sensitive to mechanical, chemical and temperature stimuli in diseases, such as systemic sclerosis and diabetes. The methods can also be used to unravel central pain mechanisms, such as those involved in allodynia, hyperalgesia and referred pain. Abnormalities in central pain mechanisms are often seen in patients with chronic gut pain and hence methods relying on multimodal pain stimulation may help to understand the symptoms in these patients. Sex differences have been observed in several diseases of the gut, and differences in central pain processing between males and females have been hypothesized using multimodal pain stimulations. Finally, multimodal methods have recently been used to gain more insight into the effect of drugs against pain in the GI tract. Hence, the multimodal methods undoubtedly represents a major step forward in the future characterization and treatment of patients with various diseases of the gut.
基金Supported by Det Obelske Familiefond and Spar Nord Fonden
文摘Methods related to experimental human pain research aim at activating different nociceptors, evoke pain from different organs and activate specific pathways and mechanisms. The different possibilities for using mechanical, electrical, thermal and chemical methods in visceral pain research are discussed with emphasis of combinations (e.g., the multimodal approach). The methods have been used widely in assessment of pain mechanisms in the esophagus and have contributed to our understanding of the symptoms reported in these patients. Hence abnormal activation and plastic changes of central pain pathways seem to play a major role in the symptoms in some patients with gastro-esophageal reflux disease and in patients with functional chest pain of esophageal origin. These findings may lead to an alternative approach for treatment in patients that does not respond to conventional medical or surgical therapy.
文摘<strong><em>Background. </em></strong>The active ingredient curcumin of traditional Chinese medicine was selected as the research object to investigate the possible mechanism of breast cancer metastatic bone pain in mouse walker 256 cells and the effect of curcumin on the NF-κB/TNF-α pathway in order to provide a new idea for clinical treatment of breast cancer metastatic bone pain. <strong><em>Methods.</em></strong> By establishing an animal model of breast cancer bone metastasis in walker 256 cells, the biological behavior of nude mice was observed on the 8th day after successful modeling. Meanwhile, the low dose group, middle dose group and high dose group of mice were given 15 mg/kg, 25 mg/kg, 50 mg/kg of curcumin solution intraperitoneally in 21 days, and the right cavity bone and spinal cord distended in mice (L4-L6) tissues were used to detect related factors, Immunohistochemical method was used to detect c-fos in spinal cord. Expression levels of RANK, NF-κB and TNF-α were detected by RT-PCR and Western blot. Meanwhile, serum levels of Cox2, il-6, leukotriene and PGE2 were detected.<strong><em> Results. </em></strong>Observing the biological behavior index of nude mice, we found that the mechanical pain and thermal pain threshold decreased (p < 0.05), and the cold pain and spontaneous pain scores increased significantly (p < 0.05). After group study, the expression of c-fos in the cancer pain model group was significantly higher than that in the normal control group (p < 0.05), and with the increase of curcumin dose, the expression of c-fos in the high dose group was significantly lower than that in the solvent model group (p < 0.05). The expression of RANK, NF-κB, TNF-α was higher than that of the normal control group and decreased gradually with the increase of curcumin dose, among which the expression of high dose group was significantly lower than that of solvent group (p < 0.05). RANK, NF-κB, TNF-α protein expression was higher than that of normal control group and gradually decreased with the increase of curcumin dose. The levels of Cox2, IL-6, leukotriene and PGE2 in serum decreased with the increase of curcumin dose, and the high dose group decreased significantly (p < 0.05). <em><strong>Conclusions. </strong></em>On the 8th day after the success of the animal model of breast cancer bone metastasis in Walker 256 cells, abnormal biological behaviors such as heat pain, cold pain sensation and spontaneous hyperalgesia were observed. Further studies have found that the increased expression of rank on osteoclasts induced up-regulated expression of NF-κB and c-fos, induced expression of TNF-α gene, and could induce synthesis and release of leukotriene, PGE2 through direct activation of cyclooxygenase, inflammatory media IL-6 cascade reaction, resulting in pathological pain and hypersensitivity. Traditional Chinese medicine active ingredient curcumin could reduce RANK expression of osteoclast, inhibit cell NF-κB and spinal cord c-fos activity, reduce TNF-α expression, inhibit Cox2 activity, and reduce the synthesis and release of inflammatory factors leukotriene and PGE2, thus exerting its analgesic effect, which provides new ideas and methods for clinical treatment of metastatic bone pain in breast cancer.
文摘Introduction: Complex regional pain syndrome (CRPS) is a disorder characterized by pain as well as a myriad of sensory, autonomic, and motor disturbances. We are reporting a case of child diagnosed with CRPS and successfully treated with supraclavicular brachial plexus catheter infusion of local anesthetic. Case Report: An eight-year-old male underwent a left thoracotomy, repair of esophageal vascular ring, and translocation of the left subclavian to the left carotid artery. Post-operative course was relevant for severe intractable left shoulder and left arm pain associated with allodynia and hyperalgesia. A supraclavicular catheter was inserted, and an infusion of ropivacaine 0.2% was started. The child was sent for physical therapy as he gradually regained all functions of his left arm and resumed his regular activities. Conclusion: Continuous supraclavicular brachial plexus catheter infusion of local anesthetic is a valuable method of reducing pain in severe cases of upper extremity pediatric CRPS and may be safer and more effective than other invasive measures such as sympathetic blocks and epidural catheterization. Further research surrounding the diagnosis and treatment of pediatric CRPS is needed to allow early diagnosis and treatment and to improve outcome.
文摘Objective: The aim of this study is to determine the role of preoperative low dose intravenous MgSO4 when given adjuvant to ultrasound guided transversus abdominis plane (TAP) block in augmenting postcesarean analgesic effects and reducing opioid requirements during the first 24 hours. Subjects and Methods: In this prospective, randomized double blind study, a total of sixty full term pregnant women were recruited for the study underwent caesarean section. Thirty patients were assigned to MgSO4 group (A) and another thirty to placebo group (B). Participants in group (A) received 50 mg/kg MgSO4 in 100 ml isotonic saline intravenous (IV) over 20 minutes prior to induction of general anesthesia by 30 minutes while participants in group (B) received 100 ml isotonic saline (placebo) by the same route and over the same duration as control. Results: Visual Analogue Scale (VAS) was analysed within 24 hours postoperatively. The mean pain score at 6 and 12 hours postoperatively was significantly lower in MgSO4 group compared to control group (40.4 ± 5.12 vs 53.6 ± 4.92;26.1 ± 3.01 vs 35.5 ± 3.98 respectively, p = 0.012, 0.005). Comparing both groups regarding the mean time interval of first rescue analgesia (morphine sulphate) requested by the patients, it was longer in MgSO4 group compared to control group. The total dose of rescue analgesia consumed during 24 hours was analysed and it was significantly higher in control group compared to MgSO4 group (10.1 ± 0.95 vs 6.2 ± 0.87, p = 0.001). Conclusion: We concluded that preoperative low doses (50 mg/Kg) of MgSO4 with general anesthesia combined with ultrasound guided TAP block offer longer postoperative pain free periods thus reducing total opioid consumption. In addition to the safety of the drug to the mother and fetus so we recommend IV MgSO4 as an adjuvant therapy with TAP block.
基金This study was supported by the Province Natural Science Foundation of the Department of Education of Jiangsu(01 KJB320003)Innovation Fund of Nanjing Medical University(CX 2003001)
文摘Objective： This investigation was designed to stratify patients with acute chest pain based on their symptoms, electrocardiogram （ECG）, cardiac injury markers and the number of accompanying traditional risk factors（smoking, obesity, hyperlipemia, hypertension, diabetes）, and to assess the effect of the above factors to obtain a risk stratification for patients with chest pain. Methods： We identified 139 patients with acute chest pain, including 45 myocardiac infarction patients, 65 unstable angina patients and 29 chest pain patients without identified acute coronary syndrome（ACS） admitted to our Coronary Heart Center during December 2004 to February 2005. All patients accepted coronary angiography. All data was collected using questionnaires. Based on reported symptom, electrocardiogram （ECG）, cardiac injury markers and the number of the accompanying traditional risk factors, we stratified all patients into four groups： Group 1, patients with acute chest pain, ECG changes and abnormal cardiac injury biomarkers. Group 2, patients with acute chest pain and ECG changes（without abnormal cardiac injury biomarkers）. Group 3, patients with acute chest pain, normal ECG, normal cardiac injury biomarkers and 〉2 traditional risk factors. Group 4, patients with acute chest pain, normal ECG and normal cardiac injury biomarkers, but only ≤ 2 traditional risk factors. From this data we examined the difference of ACS incidence in the four groups. Results：After stratification the ACS incidence of the grouped patients in turn was 100%, 84%, 69.6% and 53.3%. The combination of early phase ECG and cardiac injury markers identified 70.9% patients with ACS（the specificity being 90.7%）. The mortality of group 3 was higher compared with group 4（69.6% vs 53.3%）, however the P value was more than 0.05 and didn＇ t show significant statistical difference. The correlation analysis found the number of the traditional risk factors had a significant positive correlation （r= 0.202, P = 0.044） with the number of stenosis being more than 50% of the artery diameter. Multiple linear regression showed the hypertension had a significant correlation with the number of the diseased regions（P= 0.014）. Conclusions：The risk stratification based on the symptom, ECG, cardiac injury markers and accompanying traditional risk factors is both important and available in practice. It is unsuitable for patients with a normal ECG and cardiac injury markers to differentiate ACS from non-cardiac chest pain relying only on the number of the accompanying traditional risk factors. However we found the number of the risk factors can indicate the disease severity.
文摘Background: Transcranial direct current stimulation (tDCS) across cortical brain areas appears to improve various forms of pain, yet evidence of tDCS efficiency and ideal stimulation target is lacking. This study aimed to compare the add-on analgesic efficacy of concentric electrode transcranial direct current stimulation (CE-tDCS) stimulation over the primary motor cortex versus the insular cortex on the management of chronic postmastectomy pain. Method: Prospective randomized double-blind sham-controlled study enrolled eighty patients with chronic postmastectomy pain that were randomly assigned to four groups: active motor (AM), sham motor (SM), active insula (AI) and sham insula (SI) group, each received 5 sessions for 20-minute duration with 2 mA tDCS over the targeted area of the contralateral side of pain. Our primary outcome was VAS score, the secondary outcomes were VDS score, LANSS score and depression symptoms by HAM-D scores, assessment was done at 4 time points (prestimulation, after 5<sup>th</sup> session, 15<sup>th</sup> day and one month after the last session). Results: Both active tDCS groups (motor and insula) showed reduction of VAS (P Conclusion: Active tDCS stimulation either targeting the primary motor cortex or the insula cortex has add-on analgesic effect for controlling neuropathic chronic post mastectomy pain and the maximum effect was at 15 days after the last session.
文摘Background and Aims: The treatment of patients with advanced cancer pain is mainly concentrated in the outpatient department, and most of the time in their family, these patients are easy to be ignored, To study the quality of life and its influencing factors of cancer pain patients at home is of great significance to improve the quality of life of patients. Meanwhile, it provides theoretical and practical basis for medical personnel to develop and implement individualized comprehensive intervention programs. Patients and Methods: According to the inclusion and exclusion criteria, 200 patients with cancer pain at home are selected to treat, and their quality of life conditions are observed before treatment, 1 week after treatment and 1 month after treatment, and their influencing factors are analyzed. Results: The patients’ scores of body function, emotional function, cognitive function and social function exist significant difference before and after treatment (p scores of role function and the overall evaluation scores before and after treatment, two stages after treatment exist significant difference (p < 0.01), the symptoms scores of fatigue, pain, diarrhea, nausea and vomiting are significant differences before and after treatment (p appetite loss score before a month and a week after treatment and treatment exists significant difference (p the scores of constipation symptom before treatment and a month after treatment exist significant difference (p < 0.01), only gender on cognitive function before treatment has significant difference (p . One week after treatment, tumor staging and metastasis have impact on overall health evaluation, role function, cognitive function and emotional function (p The location of metastasis and the type of pain affect the role function and emotional function respectively (p . One month after treatment, age, metastasis, metastasis site and pain type have influence on cognitive function, emotional function, overall health evaluation and role function respectively (p The overall health status, body function, role function, emotional function, cognitive function and social function of the patients are lower than those of the Norwegian norm (p < 0.001). The symptoms of pain, appetite, constipation, nausea and vomiting are higher than those of the Norwegian norm before and after treatment (p There was a significant positive correlation between quality of life and total score of social support (p < 0.01). Objective support and subjective support were positively correlated with quality of life (p Conclusion: Cognitive interventions should be individualized. The effectiveness of cancer treatment and the control of cancer recurrence and metastasis have influence on the quality of life of patients with cancer pain at home. Although the patients’ function indexes have been improved after treatment, there exist differences in the improvement after treatment. The symptoms of nausea, vomiting, pain and appetite should be intervened promptly. The management of symptoms such as dyspnea, fatigue, constipation should be focused persistently. Objective support and subjective support were the influencing factors of patients’ quality of life, the construction of social support system should be strengthened, we should help them to overcome negative emotions, return to normal family and social roles, seek help in a positive manner and use support to improve the quality of life.
文摘Phantom Limb Pain (PLP) is a phenomenon commonly observed in orthopedic rehabilitation units that can have detrimental effects on patients’ functioning. Psychological aspects of PLP have been widely investigated showing that some coping mechanisms are advantageous at certain points but not at others. However, the mechanisms related to positive adjustment to PLP during the course of rehabilitation have not been adequately examined. The aim of the study was to investigate the relationship between PLP and coping mechanism at two points during the rehabilitation process. Thirty one orthopedic inpatients, who had undergone lower-limb amputation following diabetic complications, rated their pain levels and mental coping strategies. The Ways of Coping Checklist, Life Orientation Test, and the McGill Pain Questionnaire, 1-15 days post-surgery and six months post-surgery were used for evaluation. Denial was found to be negatively correlated with PLP shortly after amputation. In contrast, optimism was found to be negatively correlated with PLP six months after the surgery. Emotion-focused coping mechanisms were found to be positively correlated with PLP. It is concluded that denial during the early stages of recuperation and optimism at later stages of rehabilitation is associated with reduced PLP. Awareness of these mental processes by both medical staff and family members may enable acceptance of these processes and thus facilitate patients’ rehabilitation.
文摘Objective:This research utilizes the FAERS for data mining to identify heart-related side effects caused by opioids,ensuring the safe use of these medications.Methods:Data from 79 quarters(Q12004 to Q32023)involving adverse event(AE)reports for opioids like morphine and oxycodone was reviewed.We applied the MedDRA system to categorize events and used statistical tools,ROR and BCPNN,for signal detection.These findings were cross-checked with drug labels and SIDER 4.1 for accuracy.Identified risks were then categorized by severity using DME and IME classifications.Results:Analysis of adverse events(AEs)for the five examined drugs(35359,14367,144441,10592,and 28848)identified 33,6,12,37,and 34 cardiovascular AEs,and 16,5,7,25,and 21 instances of important medical events(IMEs)respectively.Each drug was linked to cases of cardiac and cardiopulmonary arrest.The cardiovascular AEs varied widely in occurrence and severity,with methadone notably presenting diverse and potent risks,including sudden cardiac death as a distinct medical event(DME).A comparison with SIDER 4.1 showed 11 opioid-related cardiovascular AEs in line with our findings.Standardized MedDRA Queries(SMQs)confirmed these results,indicating stronger signals for methadone and tramadol,while morphine,hydromorphone,and oxycodone exhibited fewer and weaker signals.Conclusion:The study revealed numerous heart-related adverse effects(AEs)not listed on drug labels and identified new AE patterns.Recognizing these differences in AE profiles and risks across different opioids is crucial for safer prescription practices to minimize cardiac complications.
基金Special scientific research project of the Affiliated Hospital of Zhejiang University of Traditional Chinese Medicine,No.2022FSYYZY13.
文摘Otogenic vertigo is a common disorder that affects the vestibular system,which often results in considerable discomfort and impaired daily functioning.Traditional Chinese medicine(TCM),including acupuncture and moxibustion,has been historically utilized to manage the symptoms of vertigo.However,the effectiveness and methodology of these treatments have rarely been investigated in the medical literature.This study reviews the existing literature on the point selection,method,and therapeutic effect of acupuncture and moxibustion to provide a reference for the TCM treatment of otogenic vertigo.A literature search was performed using the PubMed search engine.The terms used included otogenic vertigo,acupuncture treatment,and acupuncture point selection.A total of 34 relevant articles were retrieved from PubMed.These suggest that the clinical treatment of otogenic vertigo should consider the functions of zang-fu organs and meridians and select different acupuncture treatment methods according to syndrome differentiation based on the difference between deficiency and excess.Acupuncture and moxibustion therapy should be based on acupoint selection,considering the syndrome differentiation,supplemented with experience.The treatment of otogenic vertigo with acupuncture and moxibustion refers to the selection of appropriate acupuncture methods under the guidance of TCM theory and following the principles of syndrome,disease,and meridian differentiation.Common acupuncture methods include body acupuncture,auricular acupuncture,scalp acupuncture,acupoint injection,electroacupuncture,and moxibustion.There are many acupuncture and moxibustion acupoints selected for the treatment of otogenic vertigo.Individualized treatment according to the patient’s specific condition is effective and safe,which can help to improve the patient’s vertigo symptoms and cerebral blood perfusion.
文摘OBJECTIVE:To observe the clinical efficacy of acupuncture along fascia,meridians,and nerves combined with ultrasound-guided nerve blockage in the treatment of postherpetic neuralgia.METHODS:A total of 61 outpatients with post-chest and back herpes zoster neuralgia were recruited in the Department of Pain at the Xiyuan Hospital,China Academy of Chinese Medical Sciences from May 2019 to June 2021.They were randomly divided into two groups.Thirty-one patients in the control group were treated with ultrasound-guided thoracic paravertebral nerve block(PVB)alone,one patient declined to continue during treatment(n=30),and thirty patients in the observation group received the acupuncture along the fascia,meridians,and nerves combined with ultrasound-guided PVB treatment(n=30).Both control and observation group received treatment weekly for 4 weeks.The medical history data such as age,sex,presence or absence of comorbidities and disease course were analyzed.The visual analog scale(VAS)score was used to assess the pain degree of two groups at T0(before treatment),T1(1-time treatment ended),T2(2 times treatment ended),T3(3 times treatment ended),and T4(4 times treatment ended).The sleep state was examined by Pittsburgh Sleep Quality Index(PSQI)before and after the study.RESULTS:There was no significant difference in general conditions between the control group and the observation group(P>0.05).The VAS score in both control and observation group was decreased in a time-dependent manner after 1-4 weeks of treatment.There were no significant differences in VAS scores between the two groups after 1 or 2 weeks of treatment(P>0.05).After 3 and 4 weeks of treatment,the VAS score was significantly decreased in the observation group compared with that in the control group(P<0.001).In addition,the reduction in VAS score(after treatment-before treatment)between the two groups was statistically significant[D value:-1.53,95%CI(-2.32,0.74),P<0.001].Furthermore,the sleep state of patients in both groups markedly improved and much obvious in the observation group than that in the control group(P<0.05).CONCLUSION:These results suggest that a combination of acupuncture along fascia,meridians,and nerves with ultrasound-guided PVB treatment is more effective than ultrasound-guided PVB treatment alone.
基金Supported by the "Det Obelske Familifond", "Spar Nord Fonden"and the Danish Technical Research Council
文摘AIM: Sensitization most likely plays an important role in chronic pain disorders, and such sensitization can be mimicked by experimental acid perfusion of the esophagus.The current study systematically investigated the sensory and motor responses of the esophagus to controlled mechanical stimuli before and after sensitization.METHODS: Thirty healthy subjects were included.Distension of the distal esophagus with a balloon was performed before and after perfusion with 0.1 mol/L hydrochloric acid for 30 min. An impedance planimetry system was used to measure cross-sectional area,volume, pressure, and tension during the distensions. A new model allowed evaluation of the phasic contractions by the tension during contractions as a function of the initial muscle length before the contraction (comparable to the Frank-Starling law for the heart). Length-tension diagrams were used to evaluate the muscle tone before and after relaxation of the smooth muscle with butylscopolamine.RESULTS: The sensitization resulted in allodynia and hyperalgesia to the distension volumes, and the degree of sensitization was related to the infused volume of acid. Furthermore, a nearly 50% increase in the evoked referred pain was seen after sensitization. The mechanical analysis demonstrated hyper-reactivity of the esophagus following acid perfusion, with an increased number and force of the phasic contractions, but the muscle tone did not change.CONCLUSION: Acid perfusion of the esophagus sensitizes the sensory pathways and facilitates secondary contractions.The new model can be used to study abnormal sensorymotor mechanisms in visceral organs.
基金Supported by Foundation of Beijing University of Chinese Medicine(Hold by Shengyun Ding)Beijing Nova Program(No.xx2013032)New Century Excellent Talents(Hold by Jianxin Chen)
文摘OBJECTIVE: The quality and quantity of published research papers are important in both scientific and technology fields. Although there are several bibliometric studies based on citation analysis, very few have focused on research related to Traditional Chinese Medicine in China. METHODS: The bibliometric method used in this study included the following focuses: publication outputs for each year, paper type, language of publication, distribution of internationally collaborative countries, sources of funding, authorization number, distribution of institutes regarding collaborative publications, research fields, distribution of out-puts in journals, citation data, and h-index. RESULTS: A total of 3809 papers published from 1995 to 2012 were extracted from the science citation index(SCI). The cumulative number of papers from all six universities is constantly increasing. The United States attained the dominant position regarding complementary and alternative medicine research. The Chinese Academy of Sciences was the greatest participator in collaborative efforts. Research field analysis showed that the research mainly focused on pharmacology pharmacy, chemistry, integrative complementary medicine, plant sciences, and biochemistry molecular biology. The Shanghai University of Chinese Medicine had the most citations. CONCLUSION: In recent years, in terms of SCI papers, the six Traditional Chinese Medicine universities studied here have made great advances in scientific research.
文摘The aim of this paper was to describe functional biliary syndromes and methods for evaluation of the biliary tract in these patients. Functional biliary symptoms can be defined as biliary symptoms without demonstrable organic substrate. Two main syndromes exist： Gallbladder dysfunction and sphincter of Oddi dysfunction. The most important investigative tools are cholescintigraphy and endoscopic sphincter of Oddi manometry. In gallbladder dysfunction a scintigraphic gallbladder ejection fraction below 35% can select patients who will benefit from cholecystectomy. Endoscopic sphincter of Oddi manometry is considered the gold standard in sphincter of Oddi dysfunction but recent development in scintigraphic methods is about to change this. Thus, calculation of hilum-to-duodenum transit time and duodenal appearance time on cholescintigraphy have proven useful in these patients. In conclusion, ambient methods can diagnose functional biliary syndromes. However, there are still a number of issues where further knowledge is needed. Probably the next step forward will be in the area of sensory testing and impedance planimetric methods.
基金Supported by National Natural Science Foundation of China:Study on the Immune Mechanisms of Macrophage M1/M2 Polarization in the Treatment of Rheumatoid Arthritis by Moxibustion “Strengthening Body Resistance and Eliminating Evil”(No. 81973959)National Natural Science Foundation of China:Research on “ImmuneInflammation” Molecular Signal Regulation of NLRP3 Inflammasomes in RA with Moxibustion Treatment (No. 81774435)+2 种基金National Key R&D Program of China:Research on the Functional Characterics of “Special Effect” and “Common Effect” of Acupoints (No. 2019YFC1709001)Foundation of Sichuan Provincial Administration of Traditional Chinese Medicine:Research on MIF-GC Rhythm Regulation Mechanism of Moxibustion in the Treatment of Rheumatoid Arthritis (No. 2018JC007)Foundation of Chengdu University of Traditional Chinese Medicine:Research on the Mechanism of “MIF-target Protein-GC-inflammation” of Antiinflammatory Effect of Moxibustion on Rheumatoid Arthritis (No. QNXZ2018034)。
文摘OBJECTIVE: To evaluate the effects of moxa-burning heat stimulating acupoints Zusanli(ST36) and Shenshu(BL23) on macrophage migration inhibitory factor(MIF) and its related molecules which can provide scientific experimental basis for the clinical application of moxibustion treatment of rheumatoid arthritis(RA). METHODS: Thirty rabbits were randomly assigned to control group, RA model(established by injecting Freund’s Complete Adjuvant) group(RA group) and RA model with moxibustion group [Moxa group, Zusanli(ST36) and Shenshu(BL23), 5 moxa pillars/day, 6 d × 3]. The expressions of MIF m RNA were evaluated with reverse transcription polymerase chain reaction;the apoptosis rates of macrophages were detected by erminal deoxynucleotidyl transferase-mediated d TUP nick end labeling;the expressions of related signal molecules were detected with immunohistochemical S-P method and the levels of IL-2 were detected with enzymelinked immunosorbent assay. RESULTS: The expressions of MIF m RNA, extracellular regulated protein kinases 2, p38 mitogen-activated protein kinase and nuclear factor-κ-gene binding p65 in synovial tissue of RA group were significantly increased when compared with control group, which were lower remarkably in moxa group than those in RA group. The apoptosis rates of macrophages in RA group were significantly down-regulated as compared with the control group, which were up-regulated in moxa group compared with the RA group. The levels of IL-2 in synovial fluid from the RA group were elevated significantly as compared with that from control group, but those of the moxa group were reduced when compared with those from RA group. CONCLUSIONS: Moxibustion may simultaneously regulate the expressions of MIF and its related signaling pathways molecules, the apoptosis rate of macrophages in synovial tissue, as well as the level of inflammatory factors in synovial fluid. The results suggest that the antiinflammatory effect of moxibustion on RA may be related to inhibit the expression of MIF in synovial tissue, the molecules of some related signaling pathways and promote the apoptosis of macrophage.
文摘Objective:The aim of this article was to discuss the theory of doctor-patient co-operated evidence-based medical record and set up the preliminary frame of the doctor-patient co-operated evidence-based medical record following the concept of narrative evidence-based medicine.Methods:The information was searched from Pubmed,Embase,CBMdisc,CNKI.A preliminary agreement was reached by referring to the principles of narrative medicine and advises given by experts of digestive system and evidence-based medicine in both Traditional Chinese Medicine and Western Medicine.Result:This research is a useful attempt to discuss the establishment of doctor-patient co-operated evidence-based medical record guided by the direction of narrative evidence-based medicine.Reflection and outlook:Doctor-patient co-operated medical record can be a key factor of the curative effect evaluation methodology system of integrated therapy of Tradition Chinese Medicine and Western Medicine on spleen and stomach diseases.
