ABSTRACT
OBJECTIVE@#To explore effect of nerve growth factor (NGF) antibody on knee osteoarthritis (KOA) pain model was evaluated by in vitro model.@*METHODS@#Thirty male SPF rats aged 28-week-old were divided into blank group (10 rats with anesthesia only). The other 20 rats were with monoiodoacetate (MIA) on the right knee joint to establish pain model of OA, and were randomly divided into control group (injected intraperitoneal injection of normal saline) and treatment group (injected anti-NGF) intraperitoneal after successful modeling, and 10 rats in each group. All rats were received retrograde injection of fluorogold (FG) into the right knee joint. Gait was assessed using catwalk gait analysis system before treatment, 1 and 2 weeks after treatment. Three weeks after treatment, right dorsal root ganglia (DRG) were excised on L4-L6 level, immunostained for calcitonin gene-related peptide (CGRP), and the number of DRGS was counted.@*RESULTS@#In terms of gait analysis using cat track system, duty cycle, swing speed and print area ratio in control and treatment group were significantly reduced compared with blank group (P<0.05). Compared with control group, duty cycle and swing speed of treatment group were significantly improved (P<0.05), and there was no significant difference in print area ratio between treatment group and blank group (P>0.05). The number of FG-labeled DRG neurons in control group was significantly higher than that in treatment group and blank group (P<0.05). The expression of CGRP in control group was up-regulated, and differences were statistically significant compared with treatment group (P<0.05).@*CONCLUSION@#Intraperitoneal injection of anti-NGF antibody inhibited gait injury and upregulation of CGRP in DRG neurons. The results suggest that anti-nerve growth factor therapy may be of value in treating knee pain. NGF may be an important target for the treatment of knee OA pain.
Subject(s)
Aged , Animals , Male , Rats , Calcitonin Gene-Related Peptide/metabolism , Disease Models, Animal , Ganglia, Spinal/metabolism , Knee Joint , Nerve Growth Factor/therapeutic use , Osteoarthritis, Knee/drug therapy , Pain/metabolism , Rats, Sprague-Dawley , Antibodies/therapeutic useABSTRACT
BACKGROUND: In recent years, extensive studies on the pain management after total knee arthroplasty (TKA) have identified different ways of analgesia. Among which, femoral nerve block (FNB) is the standard antalgic method post-TKA for its effective analgesia, but it may reduce the muscle strength of the quadriceps after TKA and cause serious consequences. Adductor canal block (ACB) is a novel antalgic method that provides fast functional recovery and good ability of pain control after TKA. OBJECTIVE: To compare the functional recovery and ability of pain control of ACB and FNB after TKA through a meta-analysis. METHODS: Databases of WanFang, CNKI, PubMed, Web of Science, and Embase were searched for the literature concerning the analgesia and functional recovery after TKA published before March 2017. The articles were evaluated according to the Cochrane system and a meta-analysis was conducted on Revman 5.1. RESULTS AND CONCLUSION: (1) Twelve articles were included involving 802 patients with 872 knees. (2) Meta-analysis results showed that compared with FNB, ACB significantly reduced the Visual Analogue Scale scores at rest at 8 hours postoperatively (P < 0.001) and significantly improved the muscle strength of quadriceps femoris (P < 0.001) and motor capacity (Timed Up and Go test) (P < 0.05); but the scores at rest at 24 and 48 hours postoperatively, and the scores in activity at postoperative different time points, usage of opioids, and hospitalization time did not differ significantly between two groups. (3) ACB can achieve better analgesia at the early period (8 hours) after TKA, better motor capacity and stronger muscle strength of the quadriceps femoris; thereafter, it is a substitute for FNB after TKA.
ABSTRACT
<p><b>BACKGROUND</b>Early enteral feeding (EF) may result in fever, elevated white blood cell count, increased serum levels of liver enzymes, and diarrhea. We name the complications "enteral refeeding syndrome", as a subtype of refeeding syndrome, because they are likely to result from long-term lack of lumen nutrition. The aim of this study was to investigate the characteristics of enteral refeeding syndrome after long-term total parenteral nutrition (TPN), and the solution for the disease.</p><p><b>METHODS</b>We collected the clinical data of 100 patients with gastrointestinal fistula, who were cured from Apirl 2001 to July 2002. Their fasting time, daily stool frequency, body temperature, heart rate, respiratory rate, levels of transaminases, alkaline phosphatase (AKP), and gamma-glutamylcyclotransferase (gamma-GT), white blood cell count, and systemic inflammatory reaction syndrome (SIRS) score were recorded before and 1, 3, 5, 10, and 15 days after EF. Student's t test and analysis of variance were used to analyze the data.</p><p><b>RESULTS</b>Of the 100 patients, 56 were cured after selective resection of intestinal fistula, 15 were cured by emergency operation, and 29 recovered spontaneously. The levels of AKP and gamma-GT increased significantly on the 3rd day after EF [On the 3rd day after EF, (243.0 +/- 121.6) U/L and (177.2 +/- 109.9) U/L vs. before EF (181.5 +/- 127.5) U/L and (118.4 +/- 94.2) U/L, P < 0.05], and decreased gradually afterwards. The SIRS scores on the 1st day (1.05 +/- 1.08) and 3rd day (0.96 +/- 1.11) after EF were significantly higher than that before EF (0.72 +/- 0.84), then decreased to 0.83 +/- 0.91, 0.49 +/- 0.73 and 0.32 +/- 0.60 on the 5th, 10th and 15th days after EF. The number of patients with diarrhea at 1, 3, 5, 10 and 15 days post-EF were 31, 26, 12, 13, and 7, respectively.</p><p><b>CONCLUSIONS</b>The longer the TPN lasts, the more severe the enteral refeeding syndrome becomes. Continuous EF is effective for the syndrome. Early enteral nutrition is useful in preventing it.</p>