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BACKGROUND: Because it is traditionally difficult and time-consuming to identify the foramen ovale (FO) with fluoroscopy, we recently developed the H-figure method to acquire fluoroscopic view of FO with shorter procedure time and less radiation. However, the impact of such an H-figure approach on the clinical outcomes of trigeminal ganglion radiofrequency thermocoagulation (RFT) in treating idiopathic trigeminal neuralgia (ITN) remains unclear. METHODS: In a 12-month follow-up retrospective cohort study, patients with ITN had fluoroscopy-guided RFT of trigeminal ganglion via either classic approach (n = 100) or H-figure approach (n = 136) to identify FO. Data of continuous variables were analyzed with a Shapiro-Wilk test for normality and subsequently with a Mann-Whitney test, and the binary data were analyzed with a χ 2 test. The primary outcome was the facial pain measured by a Visual Analog Scale (VAS) 1 year after the treatment. The secondary outcomes included the quality of the fluoroscopic FO views, the threshold voltage to provoke paresthesia, the procedure time, the number of fluoroscopic images, and the facial numbness VAS. RESULTS: Compared with the classic approach group, the H-figure approach group was associated with better long-term pain relief after the procedure, with significantly fewer patients had pain 3 months (6.6% vs 17.0%, P = .012) and 12 months (21.3% vs 38.0%, P = .005) after the procedure, and among patients who had pain after the procedure, patients in the H-figure group had significantly less pain 6 months after the procedure (VAS median [interquartile range (IQR)]: 3 [2-6] vs 6 [4-7], P < .001). Moreover, compared to the classic approach, the H-figure approach provided better fluoroscopic view of FO, lower threshold voltage to elicit paresthesia (median [IQR]: 0.2 [0.2-0.3] vs 0.4 [0.4-0.5] V, P < .0001), with shorter procedure time (median [IQR]: 7.5 [6.0-9.0] vs 14.0 [10.0-18.0] min, P < .0001), and required fewer fluoroscopic images (median [IQR]: 4.0 [3.0-5.0] vs 8.0 [6.0-10.0], P < .0001). CONCLUSIONS: RFT of the trigeminal ganglion using the H-figure approach is associated with superior longer term clinical pain relief than the classic approach in treating ITN.
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Foramen Oval , Neuralgia del Trigémino , Dolor Facial , Fluoroscopía , Humanos , Parestesia , Estudios Retrospectivos , Resultado del Tratamiento , Neuralgia del Trigémino/diagnóstico por imagen , Neuralgia del Trigémino/terapiaRESUMEN
We aimed to comprehensively pool the prevalence of autism spectrum disorder (ASD) diagnosis by birth weight, gestational age, and size for gestational age. PubMed, EMBASE, Web of Science, Ovid PsycINFO, and Cochrane Library were searched up to December 22, 2021. We pooled data using the random-effects model and quantified heterogeneity using the I2 statistic. Of 66 643 records initially identified, 75 studies were included in the meta-analysis. The pooled prevalence estimates of ASD diagnosis are as follows: very-low-birth weight, 3.1% (912 ASD/66,445 individuals); low-birth weight, 2.3% (5672 ASD/593,927 individuals); normal-birth weight, 0.5% (17,361 ASD/2,378,933 individuals); high-birth weight, 0.6% (4505 ASD/430,699 individuals); very preterm, 2.8% (2113 ASD/128,513 individuals); preterm, 2.1% (19 672 ASD/1 725 244 individuals); term, 0.6% (113,261 ASD/15,297,259 individuals); postterm, 0.6% (9419 ASD/1,138,215 individuals); small-for-gestational-age, 1.9% (6314 ASD/796,550 individuals); appropriate-for-gestational-age, 0.7% (21,026 ASD/5,936,704 individuals); and large-for-gestational-age, 0.6% (2607 ASD/635,666 individuals). Compared with the reference prevalence (those in normal-birth weight, term, and appropriate-for-gestational-age individuals), the prevalence estimates of ASD diagnosis in very-low-birth weight, low-birth weight, very preterm, preterm, and small-for-gestational-age individuals increased significantly, while those in high-birth weight, postterm, and large-for-gestational-age individuals did not change significantly. There were geographical differences in the prevalence estimates. This meta-analysis provided reliable estimates of the prevalence of ASD diagnosis by birth weight, gestational age, and size for gestational age, and suggested that low-birth weight (especially very-low-birth weight), preterm (especially very preterm), and small-for-gestational-age births, rather than high-birth weight, postterm, and large-for-gestational-age births, were associated with increased risk of ASD diagnosis. However, in view of marked between-study heterogeneity in most conditions, unknown effects of certain important confounders associated with ASD due to limited information in original articles, and included studies from a relatively small number of countries, the findings of this study should be interpreted with caution.
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Traditional Chinese medicine (TCM) has evolved over several thousands of years, which has been shown to be efficacious in the treatment of ischemic heart disease. Three classical TCM prescriptions, namely Xuefu Zhuyu Decoction, Zhishi Xiebai Guizhi Decoction, and Gualou Xiebai Banxia Decoction, have been extensively used in the treatment of coronary heart disease (CHD). Based on molecular network modeling, we performed a comparative pharmacogenomic analysis to systematically determine the drug-targeting spectrum of the three prescriptions at molecular level. Wide-area target molecules of CHD were covered, which was a common feature of the three decoctions, demonstrating their therapeutic functions. Meanwhile, collective signaling involved metabolic/pro-metabolic pathways, driving and transferring pathways, neuropsychiatric pathways, and exocrine or endocrine pathways. These organized pharmacological disturbance was mainly focused on almost all stages of CHD intervention, such as anti-atherosclerosis, lipid metabolism, inflammation, vascular wall function, foam cells formation, platelets aggregation, thrombosis, arrhythmia, and ischemia-reperfusion injury. In addition, heterogeneity analysis of the global pharmacological molecular spectrum revealed that signaling crosstalk, cascade convergence, and key targets were tendentious among the three decoctions. After all, it is unadvisable to rank the findings on targeting advantages of the three decoctions. Comparative pharmacological evidence may provide an appropriate decoction scheme for individualized intervention of CHD.
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Enfermedad Coronaria/tratamiento farmacológico , Enfermedad Coronaria/genética , Medicamentos Herbarios Chinos/uso terapéutico , Pruebas de Farmacogenómica , Humanos , Medicina Tradicional China , Modelos MolecularesRESUMEN
A Gram-stain negative, ovoid or short rod-shaped, aerobic and non-motile bacterial strain, designated J82T, was isolated from a seawater sample collected from the coast of Yellow Sea in Qingdao, China. The strain grew at salinities of 1.0-6.0% (w/v) NaCl (optimum, 2.5%). Growth occurred at pH 6.0-8.0 (optimum, pH 7.0) and 10-42 °C (optimum, 28-30 °C). The genomic DNA G + C content was determined to be 57.5 mol%. Q-10 was detected as the respiratory quinone. The major fatty acid (>10%) was Summed feature 8 (C18:1 ω7c and/or C18:1 ω6c). The polar lipids consisted of phosphatidylethanolamine, two unidentified aminolipids and two unidentified polar lipids. Phylogenetic analyses based on 16S rRNA gene sequences showed that strain J82T forms a distinct evolutionary lineage within the family Rhodobacteraceae. On the basis of phenotypic, chemotaxonomic and phylogenetic characteristics, the strain merits recognition as representative of a novel genus and species within the family Rhodobacteraceae for which the name Rubricella aquisinus gen. nov., sp. nov. is proposed. The type strain of Rubricella aquisinus is J82T (= DSM 103377T = CCTCC AB 2016170T).
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Rhodobacteraceae/clasificación , Rhodobacteraceae/aislamiento & purificación , Agua de Mar/microbiología , China , ADN Bacteriano/genética , ADN Ribosómico/genética , Ácidos Grasos/análisis , Concentración de Iones de Hidrógeno , Fenotipo , Fosfolípidos/análisis , Filogenia , Quinonas/análisis , ARN Ribosómico 16S/genética , Rhodobacteraceae/genética , Rhodobacteraceae/fisiología , Salinidad , Cloruro de Sodio/análisis , Especificidad de la Especie , Temperatura , Ubiquinona/análisisRESUMEN
BACKGROUND: Patients with thoracic neuropathic pain often do not respond to medication and physical therapy. Coblation technology has been demonstrated to have potential for pain management. METHODS: Fifteen patients underwent computed tomography-guided percutaneous coblation to ablate the thoracic paravertebral nerve for their medication-resistant thoracic neuropathic pain. The pain intensity was assessed by visual analog scale (VAS) 1 day before surgery and 1 week and 1, 3, and 6 months after surgery, and the difference between preoperative and postoperative VAS values was determined to evaluate the pain relief effectiveness. Patients who achieved > 50% pain relief were defined as responders, and the ratio in all patients was calculated. The number of patients who reported mild pain (VAS ≤ 3) was recorded, and the ratio in all responders was calculated. In addition, adverse effects were also recorded to investigate the security of procedure. RESULTS: Twelve (80%) responders achieved > 50% pain relief. The VAS score of responders significantly decreased from 7.42 ± 1.38 before surgery to 2.17 ± 1.11 (P = 0.000), 1.92 ± 1.16 (P = 0.000), 1.75 ± 0.97 (P = 0.000), and 1.58 ± 1.08 (P = 0.000) at 1 week, 1, 3, and 6 months after surgery, respectively. The number of responders with mild pain was 10 (83.3%), 11 (91.7%), 12 (100%), and 12 (100%) at 1 week, 1, 3, and 6 months after surgery, respectively. All responders and 1 nonresponder reported slight numbness after the surgery. CONCLUSION: Percutaneous thoracic paravertebral nerve coblation guided by computed tomography is a potential method for the treatment of thoracic neuropathic pain.
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Ablación por Catéter/métodos , Neuralgia/diagnóstico por imagen , Neuralgia/cirugía , Nervios Torácicos/diagnóstico por imagen , Nervios Torácicos/cirugía , Tomografía Computarizada por Rayos X/métodos , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Manejo del Dolor/métodos , Dimensión del Dolor/métodos , Proyectos Piloto , Estudios RetrospectivosRESUMEN
A Gram-stain-negative, rod-shaped, non-motile and aerobic bacterial strain, designated CHL1T, was isolated from a sludge sample collected from a sewage treatment tank of an agricultural chemical factory. The strain grew at salinities of 0.5-5 % (w/v) NaCl (optimum 2.5 %). Growth occurred at pH 6.0-8.0 (optimum pH 7.0) and 5-40 °C (optimum 28-30 °C). The genomic DNA G+C content was determined to be 70.4 mol%. Q-10 was detected as the respiratory quinone. The major fatty acids (>10 %) were C18 : 1ω7c and/or C18 : 1ω6c and C16 : 0. The polar lipids consisted of diphosphatidylglycerol, phosphatidylethanolamine, phosphatidylcholine, two unidentified phospholipids and two unidentified aminophospholipids. Phylogenetic analyses based on 16S rRNA gene sequences showed that strain CHL1T formed a distinct clade with Albibacter methylovorans DSM 22840T and Methylopila helvetica DM9T within the family Methylocystaceae. On the basis of phenotypic, chemotaxonomic and phylogenetic characteristics, the strain merits recognition as a representative of a novel species of a new genus within the family Methylocystaceae, for which the name Chenggangzhangella methanolivorans gen. nov., sp. nov. is proposed. The type strain of the type species is CHL1T (=KCTC 42661T=CCTCC AB 2015175T). In addition, the species Methylopila helveticaDoronina et al. (2000) is proposed to be transferred to the genus Albibacter as Albibacterhelveticus comb. nov. (type strain DM9T=CIP 106788=VKM B-2189) on the basis of the phylogenetic analysis. An emended description of the genus Albibacter is also provided.
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Methylocystaceae/clasificación , Filogenia , Aguas del Alcantarillado/microbiología , Técnicas de Tipificación Bacteriana , Composición de Base , ADN Bacteriano/genética , Ácidos Grasos/química , Methylocystaceae/genética , Methylocystaceae/aislamiento & purificación , Fosfolípidos/química , ARN Ribosómico 16S/genética , Análisis de Secuencia de ADN , Ubiquinona/análogos & derivados , Ubiquinona/análisisRESUMEN
OBJECTIVES: Postherpetic neuralgia (PHN) is one of the most intractable pain disorders, especially in elderly patients. There is evidence that repetitive transcranial magnetic stimulation (rTMS) reduces neuropathic pain; however, its effectiveness for PHN is unknown. This study investigated the efficacy of high-frequency rTMS in patients with PHN. DESIGN: A total of 40 patients were randomly assigned to receive 10 sessions of real or sham rTMS of the primary motor cortex. Each stimulation session consisted of a series of 300 five-second pulses with a frequency of 10 Hz and an interval of 3 seconds between each train, giving a total of 1500 pulses per session. The primary outcome was pain intensity measured before stimulation from first intervention (T0) to the final stimulation (T10), and 1 and 3 months after final stimulation (T11 and T12). Other outcomes measured included scores on the short form McGill pain questionnaire, self-rating depression scale, quality of life (QOL), sleep quality, the patient global impression of change, medication regulation, and reported adverse events. RESULTS: The real rTMS group demonstrated greater reduction of visual analogue scale (VAS) than the sham group at each time point except for T0 (P = 0.399) and T1 (P = 0.091). Mean VAS reduction in the real rTMS group was 16.89% for duration of disease longer than 6 months. These analgesic effects were associated with long-term improvement in rating-scale items related to QOL. CONCLUSION: The results suggest that rTMS is an effective and safe therapy in patients with PHN.
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Corteza Motora/fisiopatología , Neuralgia Posherpética/terapia , Neuralgia/terapia , Estimulación Magnética Transcraneal , Adulto , Anciano , Anciano de 80 o más Años , Humanos , Masculino , Persona de Mediana Edad , Neuralgia Posherpética/diagnóstico , Dimensión del Dolor , Calidad de Vida , Estimulación Magnética Transcraneal/métodos , Resultado del TratamientoRESUMEN
BACKGROUND: The incidence of myopericarditis after mRNA COVID-19 vaccination among adolescents aged 12-17 years remains unknown. Therefore, we conducted a study to pool the incidence of myopericarditis following COVID-19 vaccination in this age group. METHODS: We did a meta-analysis by searching 4 electronic databases until February 6, 2023. The following main keywords were used: "COVID-19", "vaccines", "myocarditis", "pericarditis", and "myopericarditis". Observational studies reporting on adolescents aged 12-17 years who had myopericarditis in temporal relation to receiving mRNA COVID-19 vaccines were included. The pooled incidence of myopericarditis and 95 % confidence interval (CI) were calculated using a single-group meta-analysis. RESULTS: Fifteen studies were included. The pooled incidences of myopericarditis after mRNA COVID-19 vaccination among adolescents aged 12-17 years were 43.5 (95 % CI, 30.8-61.6) cases per million vaccine doses for both BNT162b2 and mRNA-1273 (39 628 242 doses; 14 studies), and 41.8 (29.4-59.4) cases for BNT162b2 alone (38 756 553 doses; 13 studies). Myopericarditis was more common among males (66.0 [40.5-107.7] cases) than females (10.1 [6.0-17.0] cases) and among those receiving the second dose (60.4 [37.6-96.9] cases) than those receiving the first dose (16.6 [8.7-31.9] cases). The incidences of myopericarditis did not differ significantly when grouped by age, type of myopericarditis, country, and World Health Organization region. None of the incidences of myopericarditis pooled in the current study were higher than those after smallpox vaccinations and non-COVID-19 vaccinations, and all of them were significantly lower than those in adolescents aged 12-17 years after COVID-19 infection. CONCLUSIONS: The incidences of myopericarditis after mRNA COVID-19 vaccination among adolescents aged 12-17 years were very rare; they were not higher than other important reference incidences. These findings provide an important context for health policy makers and parents with vaccination hesitancy to weight the risks and benefits of mRNA COVID-19 vaccination among adolescents aged 12-17 years.
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Vacunas contra la COVID-19 , COVID-19 , Miocarditis , Adolescente , Adulto , Femenino , Humanos , Masculino , Adulto Joven , Vacuna BNT162 , COVID-19/epidemiología , COVID-19/prevención & control , Vacunas contra la COVID-19/efectos adversos , Incidencia , Miocarditis/epidemiología , Miocarditis/etiología , ARN Mensajero , Vacunación/efectos adversosRESUMEN
OBJECTIVE: The objective of this study was to assess outcomes and safety of consecutive neurolytic celiac plexus block (NCPB) technique. DESIGN: Retrospective clinical data analysis. SETTING: The study was conducted in three pain departments and academic medical center. PATIENTS: The subject of this study was 12 patients with terminal visceral (mostly pancreatic) cancer who failed conservative measures. INTERVENTIONS: Twelve celiac plexus alcohol neurolytic procedures were performed for pain control after a positive diagnostic block. MATERIALS AND METHODS: Twelve patients with terminal visceral (mostly pancreatic) cancer who failed conservative measures were managed by consecutive NCPB guided by computed tomography at the pain department of Beijing Xuanwu Hospital between January 2005 and June 2010. The present study evaluated the efficacy of consecutive NCPB technique with regard to pain relief, as well as its adverse effects and complications. RESULTS: The efficacy of consecutive NCPB technique with regard to pain relief was observed by a marked decrease in the visual analog score and in opioid consumption, with preprocedural mean values dropping from (8.7±1.0) and (155±56)mg/day of morphine to (1.8±1.1) and (0)mg/day at the first postprocedural visit, respectively. These results persisted during the 6-month follow-up period or until death. Minor adverse effects (moderate diarrhea and mild hypotension) were frequent (N=3, and N=4, respectively), and severe complications occurred in one patient with a transient paraparesis (N=1). No procedure-related mortality was observed. CONCLUSIONS: The consecutive NCPB technique can provide analgesia and the alleviation of the secondary undesirable effects of analgesic drugs resulting from the decrease of morphine consumption in patients with upper abdominal malignancies. In the subject group, the reliability of its analgesic effect is high, with lower rate of severe complications.
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Plexo Celíaco/efectos de los fármacos , Etanol/uso terapéutico , Bloqueo Nervioso/métodos , Neurotoxinas/uso terapéutico , Dolor Intratable/terapia , Neoplasias Pancreáticas/complicaciones , Anciano , Anestésicos Locales/administración & dosificación , Plexo Celíaco/fisiopatología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neurotoxinas/administración & dosificación , Dolor Intratable/etiología , Dolor Intratable/fisiopatología , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
The molecular conformation of the title compound, C(10)H(16)N(2)O(4), is determined by an intra-molecular N-Hâ¯O hydrogen bond involving the morpholine NH group and the amide O atom. In the crystal, mol-ecules are linked by N-Hâ¯O hydrogen bonds into chains along the a-axis direction.
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INTRODUCTION: Indoleamine 2,3-dioxygenase 1 (IDO1) is highly related to the immune evasion of a wide range of malignancies due to its role in the immune suppression caused by the depletion of tryptophan (Trp) and the accumulation of kynurenine (Kyn). The combination of IDO1 inhibitors with other treatments represents a promising strategy in immunotherapy, although considerable challenges lie ahead. AREAS COVERED: This review focuses on patent publications searched from Espacenet and Google Scholar, and related to IDO1 inhibitors with potential anti-cancer utilization during the period 2018-2022. EXPERT OPINION: Despite the clinical trial failure of the first-in-class IDO1 inhibitor epacadostat in combination with pembrolizumab, numerous studies have been carried on to pursue more efficient IDO1-based immune-modulating therapeutic solutions. A large number of IDO1 inhibitors with new structures and design concepts have been produced with the impetus of crystallographic studies, and have shown great research potential. The elaboration on the combination of IDO1 inhibitors with other targeting agents, the more precise selection of patients, the identification of more reliable biomarkers for evaluating the IDO1 treatment, and the investigation of possible toxicity, are critical factors to promote IDO1-based immunotherapies from bench to bedside.
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Neoplasias , Patentes como Asunto , Humanos , Neoplasias/tratamiento farmacológicoRESUMEN
OBJECTIVE: Little is known about the therapeutic relationship between coblation discoplasty and cervicogenic dizziness (CGD). CGD can be caused by abnormal proprioceptive inputs from compressed nerve roots, intradiscal mechanoreceptors and nociceptors to the vestibulospinal nucleus in the degenerative cervical disc. The aim was to analyze the efficacy of coblation discoplasty in CGD through intradiscal nerve ablation and disc decompression in a 12-month follow-up retrospective study. METHODS: From 2015 to 2019, 42 CGD patients who received coblation discolplasty were recruited as the surgery group, and 22 CGD patients who rejected surgery were recruited as the conservative group. Using intent-to-treat (ITT) analysis, we retrospectively analyzed the CGD visual analogue scale (VAS), neck pain VAS, CGD frequency score, and the CGD alleviation rating throughout a 12-month follow-up period. RESULTS: Compared with conservative intervention, coblation discoplasty revealed a better recovery trend with effect sizes of 1.76, 2.15, 0.92, 0.78 and 0.81 in CGD VAS, and effect sizes of 1.32, 1.54, 0.93, 0.86 and 0.76in neck pain VAS at post-operative 1 week, and 1, 3, 6, 12 months, respectively. The lower CGD frequency score indicated fewer attacks of dizziness until postoperative 3 months (p < 0.01). At post-operative 12 months, the coblation procedure showed increased satisfactory outcomes of CGD alleviation rating (p < .001, -1.00 of effect size). CONCLUSIONS: Coblation discoplasty significantly improves the severity and frequency of CGD, which is important inbridging unresponsive conservative intervention and open surgery.Key messagesThere is a correlation between the degenerative cervical disc and cervicogenic dizziness (CGD).CGD can be caused by abnormal proprioceptive inputs from a compressed nerve root and intradiscal mechanoreceptors and nociceptors to the vestibulospinal nucleus in the degenerative cervical disc.Cervical coblation discoplasty can alleviate CGD through ablating intradiscal nerve endings and decompressing the nerve root.
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Técnicas de Ablación/métodos , Cervicoplastia/métodos , Descompresión Quirúrgica/métodos , Mareo/cirugía , Cuello/cirugía , Mareo/complicaciones , Femenino , Estudios de Seguimiento , Humanos , Análisis de Intención de Tratar , Masculino , Persona de Mediana Edad , Cuello/inervación , Dolor de Cuello/etiología , Dolor de Cuello/cirugía , Dimensión del Dolor , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
The skewed T helper (Th) 2 response plays a critical role in the pathogenesis of allergic asthma. Regulatory T (Treg) cells and the regulatory cytokines are required in maintaining the homeostasis in the body. This study aims to determine the effects of a poly(lactic-co-glycolic) acid (PLGA)-ovalbumin (OVA)+A20 (a ubiquitin E3 ligase) nanovaccine on inhibiting allergic asthma in a murine model. In this study, A20 and OVA (a model antigen) were encapsulated into PLGA to be a nanovaccine (PLGA-OVA+A20). An allergic asthma murine model was developed with OVA as the specific antigen to test the role of PLGA-OVA+A20 nanovaccine in maintaining the immune homeostasis in the airway tissues. The results showed that PLGA-OVA+A20 nanovaccine inhibited the asthma responses in mice by suppressing Th2 inflammatory responses, promoting the generation of Treg cells in the airway tissues. We conclude that the PLGA-OVA+A20 nanovaccine has a marked inhibitory effect on the airway allergic response in sensitized mice by significantly promoting the generation of Treg cell and IL-10. The data suggest that PLGA-OVA+A20 has translational potential in the treatment of allergic asthma.
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Asma/prevención & control , Modelos Animales de Enfermedad , Nanopartículas/administración & dosificación , Ovalbúmina/administración & dosificación , Copolímero de Ácido Poliláctico-Ácido Poliglicólico/administración & dosificación , Proteína 3 Inducida por el Factor de Necrosis Tumoral alfa/administración & dosificación , Animales , Asma/inmunología , Asma/metabolismo , Relación Dosis-Respuesta a Droga , Femenino , Ratones , Ratones Endogámicos BALB C , Linfocitos T Reguladores/efectos de los fármacos , Linfocitos T Reguladores/inmunología , Linfocitos T Reguladores/metabolismoRESUMEN
BACKGROUND: Postherpetic neuralgia (PHN) is one of the most intractable pain disorders and often does not respond to medication, physical, and interventional procedures. Coblation technology has been demonstrated to have potential for neuralgia, but there are rare reports of the efficacy and security of coblation for PHN. The thoracic segment is the most common predilection part of PHN, so we conducted this long-term study to investigate the results of coblation for the treatment of thoracic PHN. OBJECTIVES: The aim of this study was to determine the efficacy and security of computed tomography (CT)-guided coblation of the thoracic nerve root for treatment of PHN. STUDY DESIGN: Self before-after controlled clinical assessment. SETTING: Department of Pain Management, Xuanwu Hospital, Capital Medical University. METHODS: Seventy-seven patients with thoracic PHN sustained for at least 6 months and refractory to conservative therapy were identified. Patients underwent CT-guided percutaneous coblation to ablate the thoracic nerve root for thoracic PHN. The therapeutic effects were evaluated using a Visual Analog Scale (VAS), medication doses, and pain-related quality of life (QoL) scale before coblation, and at 1 week, and at 1, 3, and 6 months after the procedure. Patients who achieved more than 50% pain relief were defined as responders. In addition, adverse effects were also recorded to investigate the security of this procedure. RESULTS: The VAS score significantly decreased from 7.22 ± 1.15 before the coblation to 3.51 ± 1.12 (P = 0.01), 3.02 ± 1.21 (P = 0.006), 3.11 ± 2.15 (P = 0.014), and 2.98 ± 2.35 (P = 0.008) at 1 week, and at 1, 3, and 6 months after the procedure, respectively. The number of responders were 56 (77.78%), 54 (75%), 55 (76.39%), and 54 (75%) at 1 week, and at 1, 3, and 6 months after the procedure, respectively. The doses of anticonvulsants and analgesics were decreased significantly at all time points after the procedure compared with before treatment (P < 0.05). Patient responses on the Brief Pain Inventory Short Form indicated mean scores that were significantly lower than baseline across all domains of pain interference with QoL at all evaluations (P = 0.001). Most of the patients had mild numbness and it did not affect the daily activities after the procedure. No other severe adverse events occurred during or after the procedure. LIMITATIONS: A single-center study, relatively small number of patients, short duration of review of medical record, and the retrospective study. CONCLUSIONS: CT-guided percutaneous thoracic nerve root coblation is an effective and safe method for the treatment of thoracic PHN, and the procedure can also significantly improve the QoL in patients with PHN.
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Neuralgia Posherpética/terapia , Manejo del Dolor/métodos , Ablación por Radiofrecuencia/métodos , Cirugía Asistida por Computador/métodos , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Raíces Nerviosas Espinales , Nervios Torácicos , Tomografía Computarizada por Rayos X/métodos , Resultado del TratamientoRESUMEN
Partially sintered 3 mol % yttria-stabilized tetragonal zirconium dioxide (ZrO(2), zirconia) polycrystal (3Y-TZP) ceramics are used in dental posterior restorations with computer-aided design-computer-aided manufacturing (CAD/CAM) techniques. High strength is acquired after sintering, but shape distortion of preshaped compacts during their sintering is inevitable. The aim of this study is to fabricate new machinable ceramic composites with strong mechanical properties that are fit for all-ceramic dental restorations. Aluminum oxide (Al(2)O(3))-coated 3Y-TZP powders were first prepared by the heterogeneous precipitation method starting with 3Y-TZP, Al(NO(3))(3) . 9H(2)O, and ammonia, then amorphous boron nitride (BN) was produced and the as-received composite powders were coated via in situ reaction with boric acid and urea. Transmission electron microscopy (TEM) and X-ray diffraction (XRD) were used to analyze the status of Al(2)O(3)-BN on the surface of the 3Y-TZP particles. TEM micrographs show an abundance of Al(2)O(3) particles and amorphous BN appearing uniformly on the surface of the 3Y-TZP particles after the coating process. The size of the Al(2)O(3) particles is about 20 nm. The XRD pattern shows clearly the peak of amorphous BN among the peaks of ZrO(2).
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Óxido de Aluminio/química , Compuestos de Boro/química , Cerámica/química , Diseño Asistido por Computadora , Implantes Dentales , Nanopartículas del Metal/química , Itrio/química , Circonio/química , Materiales Biocompatibles/química , Microscopía Electrónica de Transmisión , Polvos , Difracción de Rayos XRESUMEN
BACKGROUND: Trigeminal neuralgia (TN) is a severe type of neuropathic pain which is often inadequately managed using conventional therapies. In this report, we present the first case of TN treated with gasserian ganglion nerve coblation (NC). CASE SUMMARY: A 58-year-old man presented with right facial pain, mostly localized in the right zygomatic zone, alveolar region, and jaws. Similar to acupuncture and shock pain, the pain lasted about five seconds after each attack before resolving unaided. A diagnosis of TN was made, after which treatment with acupuncture therapy and oral carbamazepine was given. However, the pain was not satisfactorily controlled. Subsequently, gasserian ganglion NC of the right trigeminal nerve guided by computed tomography (CT) was performed on the patient. Following this procedure, the right zygomatic, alveolar, submandibular, and cheek pain disappeared completely. The right zygomatic and alveolar areas experienced mild numbness (level II). At 1-, 2-, 3-, and 6-mo follow-ups after surgery, the patient was painless and the numbness score was level I. CONCLUSION: CT-guided gasserian ganglion (NC) is an effective treatment for TN and is associated with less or no postoperative numbness or hypoesthesia in comparison with current standard-of-care approaches.
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Objective: This study examined the effect of Xiaoyaosan and its anti-stress mechanism in rats subjected to chronic immobilization stress at the whole genome level. Methods: Rat whole genome expression chips (Illumina) were used to detect differences in hippocampal gene expression in rats from the control group (CN group), model group (M group) and Xiaoyaosan group (XYS group) that were subjected to chronic immobilization stress. The Gene Ontology terms and signaling pathways that were altered in the hippocampus gene expression profile were analyzed. The network regulating the transcription of the differentially expressed genes was also established. To verify the results from the gene chips, real-time quantitative polymerase chain reaction was used to determine the expression of the GABRA1, FADD, CRHR2, and CDK6 genes in hippocampal tissues. In situ hybridization (ISH) and immunohistochemistry were used to determine the expression of the GABRA1 and CRHR2 genes and proteins, respectively. Results: Compared with the CN group, 566 differentially expressed genes were identified in the M group. Compared with the M group, 544 differentially expressed genes were identified in the XYS group. In the M and XYS groups, multiple significantly upregulated or downregulated genes functioned in various biological processes. The cytokine receptor interaction pathway was significantly inhibited in the hippocampus of the model group. The actin cytoskeleton regulation pathway was significantly increased in the hippocampus of the XYS group. The inhibition of hippocampal cell growth was the core molecular event of network regulating the transcription of the differentially expressed genes in the model group. Promotion of the regeneration of hippocampal neurons was the core molecular event of the transcriptional regulatory network in the XYS group. The levels of the GABRA1, FADD, CRHR2 and CDK6 mRNAs, and proteins were basically consistent with the results obtained from the gene chip. Conclusion: XYS may have the ability of resistance to stress, enhancement immunity and promotion nerve cell regeneration by regulating the expression of multiple genes in numerous pathways and repaired the stress-induced impairments in hippocampal structure and function by inducing cytoskeletal reorganization. These results may provide the possible target spots in the treatment of stress in rats with XYS.
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To reflect the extent of thermolesion of ganglion by testing the change of trigeminal somatosensory-evoked potential (TSEP) before and after ganglion radiofrequency thermocoagulation surgery (GRT), and evaluate long-term clinic effect by follow-up visiting of 1 year.Patients with idiopathic trigeminal neuralgia (TN) in the second division were enrolled between October 2014 and October 2015. They were treated with computed tomography-guided GRT and a follow-up visiting of 1 year. Bilateral TSEP measurements were performed 1 day before and 2 days after the GRT surgery. The latency and peak-to-peak amplitude of W2 and W3 were recorded.Immediate postprocedure pain relief (grades I-III) was 100% and 92.5% 1 year later. Facial numbness rate of grades III and IV was 70%, 40%, and 12.5%, respectively, at immediate, 2 days, and 1 year after GRT. No sever complications happened. The latency of W2 and W3 of patients who had no pain no numbness after 1 year of GRT was 1.74â±â0.24 and 3.84â±â0.66 ms, respectively, of TN side, and 1.71â±â0.39 and 3.63â±â0.85 ms of the healthy side before GRT. The amplitude of W2 and W3 was 1.13â±â0.50 and 1.99â±â1.09 uv, respectively, of TN side and 1.24â±â0.40 and 1.89â±â0.81 uv of the healthy side before GRT. There was no statistical difference of the latency and amplitude between 2 sides of W2 and W3 before surgery (Pâ>â0.05). The latency of W2 and W3 delayed and the amplitude reduced especially in TN side after surgery comparing before (Pâ<â0.001). And, comparisons of the latency and amplitude of W2 and W3 between TN side and the healthy side after surgery showed the latency of W2 and W3 delayed (W2: Pâ=â0.02; W3: Pâ=â0.01) and the amplitude of W2 reduced (Pâ=â0.003), but the amplitude of W3 had no statistical difference (Pâ=â0.22). The mean delayed latency and 95% confident interval of W2 and W3 were 0.22â±â0.35 (0.1-0.34) ms and 0.35â±â0.64 (0.14-0.57) ms, respectively. The mean decreased amplitude and 95% confident interval of W2 and W3 were 22â±â24 (14-30)% and 23â±â32 (12-34)%, respectively.GRT can make the latency delay and the amplitude decrease of TSEP. And the latency and amplitude of W2 and W3 can be considered reliable and safe reference for monitoring the extent of thermolesion.
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Técnicas de Ablación , Potenciales Evocados Somatosensoriales , Nervio Trigémino/fisiología , Neuralgia del Trigémino/terapia , Anciano , Estudios de Casos y Controles , Femenino , Humanos , Masculino , Persona de Mediana Edad , Evaluación de Resultado en la Atención de Salud/métodosRESUMEN
The temporal dynamics of neuronal autophagy and apoptosis in the ischemic penumbra following stroke remains unclear. Therefore, in this study, we investigated the dynamic changes in autophagy and apoptosis in the penumbra to provide insight into potential therapeutic targets for stroke. An adult Sprague-Dawley rat model of permanent ischemic stroke was prepared by middle cerebral artery occlusion. Neuronal autophagy and apoptosis in the penumbra post-ischemia were evaluated by western blot assay and immunofluorescence staining with antibodies against LC3-II and cleaved caspase-3, respectively. Levels of both LC3-II and cleaved caspase-3 in the penumbra gradually increased within 5 hours post-ischemia. Thereafter, levels of both proteins declined, especially LC3-II. The cerebral infarct volume increased slowly 1-4 hours after ischemia, but subsequently increased rapidly until 5 hours after ischemia. The severity of the neurological deficit was positively correlated with infarct volume. LC3-II and cleaved caspase-3 levels were high in the penumbra within 5 hours after ischemia, and after that, levels of these proteins decreased at different rates. LC3-II levels were reduced to a very low level, but cleaved caspase-3 levels remained high 72 hours after ischemia. These results indicate that there are temporal differences in the activation status of the autophagic and apoptotic pathways. This suggests that therapeutic targeting of these pathways should take into consideration their unique temporal dynamics.
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OBJECTIVE: Our previous study evaluated the effectiveness and safety of radiofrequency thermocoagulation (RFT) of trigeminal gasserian ganglion for idiopathic trigeminal neuralgia (ITN). The aim of this study was to evaluate the optimal radiofrequency temperature of computed tomography (CT)-guided RFT for treatment of ITN. METHODS: A retrospective study of patients with ITN treated with a single CT-guided RFT procedure between January 2002 and December 2013. Patients were divided into ≤75â°C, 75â°C, and ≥80â°C groups according to the highest radiofrequency temperature used. Pain relief was graded from poor to excellent, and facial numbness/dysesthesia from I (absent) to IV (most severe). RESULTS: A total of 1161 RFT procedures were undertaken in the 1137 patients. The mean follow-up time was 46â±â31 months. There were no significant differences in the rate of excellent pain relief according to the radiofrequency temperature used. However, more patients experienced with no facial numbness or facial numbness gradually resolved and those patients treated at 75â°C had a lower rate of grade IV facial numbness/dysesthesia than other groups. CONCLUSIONS: The optimal radiofrequency temperature to maximize pain relief and minimize facial numbness or dysesthesia may be 75â°C, but this requires confirmation.