CT-guided paravertebral injection of doxorubicin for treatment of postherpetic neuralgia: a database-based retrospective stratified study.

Objective: This study explored the impact of different doeses of doxorubicin in CT-guided transvertebral foraminal injections for postherpetic neuralgia (PHN) treatment and the impact of 0.5% doxorubicin treatment on patients with different disease courses and lesion locations. Methods: This retrospective study included 291 patients with PHN who received CT-guided doxorubicin injection at West China Hospital between April 2014 and February 2020. Results: A total of 228 patients received 0.5% doxorubicin treatment and 63 received 0.33% doxorubicin. Both groups showed significantly improvement in visual analogue scale (VAS) and Brief Pain Inventory (BPI) scores. The 0.5% doxorubicin group demonstrated significant lower VAS scores at 6 and 12 months after surgery (all p < 0.001) and a significant lower score on the BPI at 6 and 12 months than the 0.33% doxorubicin group (all p < 0.05). Stratified analysis of 0.5% doxorubicin demonstrated a significant reduction in VAS score at 1 week, 3 months, 6 months, and 12 months after treatment compared to baseline (all p < 0.05) and significant improvements in BPI score after treatment compared to baseline (p < 0.05). The VAS score of the chest group was significant higher than facial, neck and upper limbs and abdomen groupsin groups 1 week after surgery (all p < 0.05). Various aspects of quality of life, including daily life, enjoyment of life, sleep, relationships, work, walking ability, and emotions, significantly decreased after surgery (p < 0.05). Especially in sleep duration, there was an increase in patients reporting intermediate sleep (4-7 h) and a proportion achieving a normal sleep duration of ≥7 h. And no significant differences of BPI were observed among different affected locations. The incidence of adverse events in the 0.5% doxorubicin group and 0.33% doxorubicin group was 8.78 and 6.34%, respectively. Conclusion: CT-guided doxorubicin injection therapy has the potential to alleviate pain and enhance the quality of life in patients with PHN. Notably, the use of a 0.5% doxorubicin concentration yields more pronounced pain relief compared to a 0.33% concentration. While longer durations of PHN and specific affected sites may influence the response to treatment, the overall improvements in quality of life remain consistent.

Identification of the antibacterial mechanism of cryptotanshinone on methicillin-resistant Staphylococcus aureus using bioinformatics analysis.

Cryptotanshinone (CT) is an extract from the traditional Chinese medicine Salvia miltiorrhiza, which inhibits the growth of methicillin-resistant Staphylococcus aureus (MRSA) in vitro. This study aims to determine the antibacterial mechanisms of CT by integrating bioinformatics analysis and microbiology assay. The microarray data of GSE13203 was retrieved from the Gene Expression Omnibus (GEO) database to screen the differentially expressed genes (DEGs) of S. aureus strains that were treated with CT treatment. Gene ontology (GO) and the Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses were used to identify the potential target of CT. Data mining on the microarray dataset indicated that pyruvate kinase (PK) might be involved in the antimicrobial activities of CT. The minimum inhibition concentrations (MICs) of CT or vancomycin against the MRSA strain ATCC43300 and seven other clinical strains were determined using the broth dilution method. The effects of CT on the activity of PK were further measured. In vitro tests verified that CT inhibited the growth of an MRSA reference strain and seven other clinical strains. CT hampered the activity of the PK of ATCC43300 and five clinical MRSA strains. CT might hinder bacterial energy metabolism by inhibiting the activity of PK.

Impaired hepatic regeneration by ischemic preconditioning in a rat model of small-for-size liver transplantation.

OBJECTIVE: Graft size is one of the major risk factors in adult-to-adult living donor liver transplantation and rapid regeneration is an essential post-operative requirement. Ischemic preconditioning (IPC) has been shown to be an effective strategy in the reduction of hepatic ischemia-reperfusion injury and stimulation of liver regeneration. This study was designed to evaluate the effects of IPC on liver regeneration in small-for-size liver grafts. METHODS: We employed a rat orthotopic liver transplantation model using small-for-size (30%) grafts, in the presence or absence (control) of IPC (10 min of ischemia followed by 15 min of reperfusion). Survival rate, graft injury, hepatocellular proliferation, cell cycle progression, Stat3 activation, as well as TNF-alpha and IL-6 expression were assessed. RESULTS: IPC significantly enhanced the extent of graft injury and hindered hepatic regeneration in small-for-size liver grafts. The 7-day survival rate was also reduced by IPC, but failed to reach statistical significance. IPC did not affect TNF-alpha levels, but significantly decreased the elevation of IL-6 after reperfusion. These findings were correlated with down-regulation of cyclin E and cyclin D1, and decreased numbers of PCNA-positive nuclei in IPC grafts. These results were inconsistent with Stat3 activation, as P-Stat3 exhibited a stronger and prolonged pattern of expression in the IPC group, compared to controls. CONCLUSIONS: Ischemic preconditioning may impair liver regeneration in small-for-size liver grafts by decreasing IL-6 and blunting cell cycle progression, through a mechanism at least partially independent of Stat3.