A survey of chronic pain in China.

There is an extensive body of research about chronic pain and treatment in developed countries. In contrast there is a lack of research on this topic in developing countries including China. This study was aimed to estimate the prevalence of chronic pain in different regions of China. Data on pain and its treatment were collected from 9357 participants using questionnaires and telephone-based interviews, from 31 regions of China. Gathered data were then coded into electronic data acquisition system and descriptive and inferential statistical analysis was performed. Out of 9298 participants, the ratio of chronic pain was 31.54% with the proportion of male having chronic pain (33.86%) was higher than that of female (29.53%). The average age of participants with pain (45.02 ± 15.07 years) was higher than free-pain participants (36.19 ± 11.12 years). There were also significant differences between groups in occupation, education levels, and illness history. Proportion of patients with pain duration of 1 year was 12.104%, between 1 and 5 years was 60%, and over 10 years was 10.74%. There were 63.9% of patients with moderate pain and 36.1% with severe pain. About 43.042% of patients thought that pain resulted in sleep disorder, 38.99% thought that it causes anxiety, and about 33% thought depression and irritable bowel was the result of their pain. For the chronic pain, more than half of patients used naprapathy, cupping, and other physical therapies. Up to 2016, the ratio of pain incidence was over 30% in China. The location of pain was focused on back and upper limb. There has been a lack of proper treatment. Patients with pain had obvious economic burden, and their quality of life and psychology were significantly affected.

Effect of acupuncture on vascular permeability in patients undergoing open heart surgery under CPB / 中华麻醉学杂志

Objective To investigate the effect of electro-acupuncture (EA) on vascular permeability in patients undergoing open-heart surgery with CPB. Methods Thirty-two NYHA class Ⅰ or Ⅱ and ASA class Ⅱ or Ⅲ patients with BMI of 19-28 kg/m2 undergoing open heart surgery with CPB were randomly divided into 2 groups ( n = 16 each): Ⅰ control group and Ⅱ acupuncture group . The patients were premedicated with intramuscular phenobarbital 0.1 g, pethidine 50 mg and scopolamine 0.3 mg. Anesthesia was induced with midazolam, propofol, fentanyl and vecuronium and maintained with TCI of propofol and fentanyl in both groups. The patients were acupuncture points (neiguan, lieque, yunmen) were selected for stimulation with stimulator. Acupuncture stimulation was started from 30 min before anesthesia induction and continued until the end of operation. The level of sedation was monitored by BIS and maintained at 40-60 during operation. Urinary microalbumin concentration was used as a parameter of vascular permeability, and was measured before and at the end of operation. Blood samples were taken 24 h before and 24 h after operation for measurement of ALT, AST, total bilirubin, BUN and Cr. Results The two groups were comparable with respect to sex ratio, age, body weight, ASA physical status, and preoperative ejection fraction. There was no significant difference in renal and liver function between the 2 groups.Postoperative urinary microalbumin concentration was significantly lower in acupuncture group than in control group. Conclusion Acupuncture can reduce the effect of open heart surgery performed under CPB on vascular permeability.

Low hematocrit worsens cerebral injury after prolonged hypothermic circulatory arrest in rats.

PURPOSE: This study tests the hypothesis that low hematocrit (Hct) worsens cerebral injury after prolonged hypothermic circulatory arrest (HCA) in rats, and the mechanism involves variable expression of the genes C-Fos, Bcl-2 and Bax. METHODS: A rat HCA model was developed, and 40 animals were randomly assigned to four groups: Sham (sham) group, or Hct groups of Hct 10%, Hct 20% and Hct 30%. After 90 min of HCA at 18 degrees C, physiologic variables were recorded and brain morphological changes were evaluated with light and electron microscopy. Expressions of C-Fos, Bcl-2, Bax in various brain areas were measured by the reverse transcriptase polymerase chain reaction and standard immunohistochemistry techniques. RESULTS: The number of injured neurons in the hippocampus CA1 and parietal cortex in the Hct 10% group (CA1: 11.44 +/- 2.52; cortex: 13.65 +/- 2.31) exceeded the mean number of injured neurons in the Hct 20% group (CA1: 8.29 +/- 1.31; cortex: 10.68 +/- 1.24; P < 0.05) and the Hct 30% group. Mean mitochondrial injury scores were greatest at lower Hct levels, while the expression of C-Fos and Bax were highest in the Hct 10% group and lowest in the Hct30% group (P < 0.05). In contrast, the expression of the Bcl-2 mRNA was greatest in the Hct 30% group (P < 0.05). CONCLUSION: Low Hct worsens cerebral injury after prolonged HCA and CPB in rats, which may relate in part to the variable expression of the genes C-Fos, Bcl-2 and Bax.