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Objective:To observe the clinical efficacy of combining repeated transcranial magnetic stimulation (rTMS) with radiofrequency ablation (RF) of dorsal root ganglia in treating herpes zoster infection and neuralgia.Methods:Eighty-four individuals with a herpes zoster infection who had suffered from neuralgia for no more than 7 days were divided randomly into a control group, an rTMS group, an RF group, and an observation group, each of 21. All were treated with gabapentin, valciclovir and mecobalamin. The rTMS group received rTMS treatment, 5 days per week, for 2 consecutive weeks. The RF group received RF treatment of the dorsal root ganglia on the 15th day after enrollment, while the observation group received only the medication. Before the experiment as well as after 3, 7, 16, 30 and 60 days, all of the subjects self-assessed their discomfort using a pain visual analog scale (VAS). The Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA), Quality of Life Assessment Scale (QOL-SF36), and Pittsburgh Sleep Quality Index (PSQI) were also administered.Results:The average VAS, HAMA, HAMD, QOL-SF36, and PSQI scores of the observation group improved continuously and significantly during and after the treatment. Beyond 16 days all of those results were significantly better than the control group′s averages, and the observation group′s average VAS, HAMA and HAMD results were also significantly better than those of the rTMS group. The observation group′s average VAS, HAMA, HAMD and PSQI scores had improved significantly more than the RF group′s averages beyond 30 days.Conclusion:Combining rTMS and dorsal root ganglion RF can effectively alleviate the early pain symptoms of herpes zoster infection and neuralgia, relieve anxiety and depression, and significantly improve sleep and life quality. Such therapy is worthy of clinical promotion and application.
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Pulmonary fibrosis is an irreversible interstitial lung disease characterized by lung parenchyma remodeling and collagen deposition. In recent years, the incidence and mortality of pulmonary fibrosis caused by unknown causes have risen. However, its pathogenesis is still unclear. C-X-C motif chemokine ligand 12 (CXCL12)/C-X-C chemokine receptor 4 (CXCR4)/CXCR7 signal axis plays a critical regulatory role in pulmonary fibrosis disease. In addition, the signal axis has been shown to regulate recruitment and migration of circulating fibrocytes, mesenchymal stem cells to the damage lung tissue, the migration of endothelial cells, the proliferation and differentiation of fibroblasts and endothelial cells, which further affects the occurrence and progression of pulmonary fibrosis. In this review, we summarized the pathogenesis and treatment research progress of CXCL12 and its receptor CXCR4/CXCR7 in the occurrence and progression of pulmonary fibrosis.
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Humans , Chemokine CXCL12 , Endothelial Cells/pathology , Ligands , Lung/pathology , Pulmonary Fibrosis/pathology , Receptors, CXCR4ABSTRACT
Three sesquiterpenoids and nine iridoids were isolated from the roots and rhizomes of Valeriana jatamansi by various chromatographic methods. Their structures were identified by physicochemical properties, NMR and MS data. Among them, valeriananoid G (1) was a new patchoulol-type sesquiterpenoid, and compound 3 was isolated from the genus Valeriana for the first time. Compounds 3 and 10 exhibited significant inhibitory effects on nitric oxide production induced by lipopolysaccharide in RAW 264.7 macrophages, with IC50 values of 19.00 and 3.66 μmol·L-1, respectively. In addition, compounds 4, 6 and 12 showed anti-influenza virus activity with IC50 values of 51.75, 51.40 and 102.08 μmol·L-1, respectively.
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Objective:To observe any effect of combining ultrasound-guided stellate ganglion pulsed radiofrequency irradiation with electroacupuncture in treating migraine.Methods:Seventy-two migraine patients were randomly divided into a combined group, an electroacupuncture group and a control group, each of 24. All three groups were treated with etocoxib and zolmitriptan dispersible tablets, while the electroacupuncture group and the combined group were additionally provided with electroacupuncture or ultrasound-guided stellate ganglion pulsed radiofrequency irradiation combined with electroacupuncture. The therapeutic interventions were administered once daily for 7 days. A visual analogue scale (VAS), a migraine-specific quality of life questionnaire (MSQOL), the Hamilton anxiety scale (HAMA), the Hamilton depression scale (HAMD) and a migraine disability scale (MIDAS) were used to evaluate each patient before the experiment and on the 3rd, 7th, 30th and 90th days after completion of the treatment.Results:The average VAS, MSQOL, HAMA and HAMD scores of the combined and acupuncture groups had improved significantly at all time points. Moreover, the average MIDAS scores of the combined and acupuncture groups had improved significantly 30 and 90 days after the treatment. On the 3rd day after the treatment, the average VAS, MSQoL, HAMA and HAMD scores of the combined group were significantly higher than the acupuncture group′s averages, while the average MIDAS score of the former group was significantly lower on the 30th and 90th days after the treatment. The average VAS, HAMA and HAMD scores of the combined group were significantly lower than the control group′s averages 3, 7, 30 and 90 days after the treatment, while their average MSQOL score was significantly higher. The average MIDAS score of the combined group was significantly lower than the control group′s average 30 and 90 days after the treatment.Conclusion:Ultrasound-guided stellate ganglion pulsed radiofrequency irradiation combined with electroacupuncture can significantly relieve the symptoms of migraine and improve the life quality of migraine patients for at least 3 months.
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Teaching rounds is an important part of clinical teaching practice, therefore, we established a demonstration team for teaching ward rounds. By formulating standard operation procedure for teaching rounds and encouraging innovation on teaching models, the team played a demonstration role in the clinical teaching rounds, which not only made up the shortcomings in teaching, but also improved the teaching level of clinical teachers and the quality of clinical training.
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OBJECTIVE@#To investigate the effect of placement of peripherally inserted central catheter (PICC) via the upper versus lower extremity veins in neonates through a Meta analysis.@*METHODS@#CNKI, Wanfang Data, VIP Data, CBMdisc, PubMed, Web of Knowledge, Embase, Medline, Cochrane Library and Google Scholar were searched for control studies on the effect of PICC placement via the upper versus lower extremity veins in neonates. RevMan 5.3 was used to perform a Meta analysis of the studies which met the inclusion criteria.@*RESULTS@#A total of 18 studies were included, among which there were 8 randomized controlled trials and 10 cohort studies, with 4 890 subjects in total. Compared with those undergoing PICC placement via the upper extremity veins, the neonates undergoing PICC placement via the lower extremity veins had significantly lower incidence rates of complications (RR=0.83, 95%CI: 0.75-0.92, P<0.05), catheter-related infections (RR=0.77, 95%CI: 0.60-0.99, P<0.05), catheter malposition (RR=0.28, 95%CI: 0.18-0.42, P<0.05), extravasation of the infusate (RR=0.52, 95%CI: 0.40-0.70, P<0.05), and unplanned extubation (RR=0.82, 95%CI: 0.69-0.98, P<0.05). They also had a significantly higher first-attempt success rate of puncture (RR=1.17, 95%CI: 1.05-1.30, P<0.05) and a significantly shorter PICC indwelling time (MD=-0.93, 95%CI: -1.26-0.60, P<0.05).@*CONCLUSIONS@#The above evidence shows that PICC placement via the lower extremity veins has a better effect than PICC placement via the upper extremity veins in neonates.
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Humans , Infant, Newborn , Catheterization, Central Venous , Catheterization, Peripheral , Cohort Studies , Lower Extremity , Retrospective StudiesABSTRACT
Objective To observe the clinical effect of combining extracorporeal shock waves with pulsed radiofrequency irradiation of the dorsal root ganglia in the treatment of spinal cord-derived abdominal pain. Methods A total of 88 patients were randomly divided into a control group, a shock wave group, a pulsed irradiation group and a combination group, each of 22. All of the patients were given etocoxib and pregabalin medication for 3 weeks. In ad-dition to the drugs, the shock wave group received extracorporeal shock wave therapy, and the irradiation group re-ceived pulsed radio frequency irradiation of the dorsal root ganglia. The combination group received both. A visual an-alogue scale was used to assess perceived pain. The quality of life short form 36 ( QOL-SF36) , Hamilton anxiety scale and Hamilton depression scale were administered to all 4 groups before the treatments and after 1, 4 and 12 weeks of the treatments. The development of diseases, gastrointestinal function, medical treatment and medical expenses of the 4 groups were observed for two years after the treatments. Results After 4 weeks of treatment, the average scores of all four groups in all of the evaluations had improved significantly compared with before the treatment. In combination group′s average results were significantly better than those of the other 3 groups from 4 weeks until 12 weeks after the treatment. During the subsequent two years that group′s gastrointestinal symptoms, hospital visits and medical expen-ses were all significantly lower, on average, than those of the other groups. Conclusion Extracorporeal shock waves combined with pulsed radio frequency irradiation of the dorsal root ganglia has significant clinical efficacy for alleviating spinal cord-derived abdominal pain. It can significantly reduce medical costs and is worthy of clinical pro-motion.
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Teaching rounds is an important part of clinical teaching practice,therefore,we established a demonstration team for teaching ward rounds.By formulating standard operation procedure for teaching rounds and encouraging innovation on teaching models,the team played a demonstration role in the clinical teaching rounds,which not only made up the shortcomings in teaching,but also improved the teaching level of clinical teachers and the quality of clinical training.
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Objective To observe the clinical effect of pulsed radiofrequency electrotherapy combined with acupuncture or electroacupuncture in treating neuralgia after herpes zoster infection.Methods Eighty-eight patients were divided into a control group,an electroacupuncture group,a pulsed electrotherapy group and a combined group using a random number table.The 4 groups were routinely given gabapentin and tramadol,while the electroacupuncture group was additionally treated with electroacupuncture,the pulsed electrotherapy group received radiofrequency irradiation of the dorsal root ganglion,and the combined group was given CT-guided pulsed radiofrequency electrotherapy combined with electroacupuncture or acupuncture.Before the treatment and 15 days and 1 month afterward,everyone was evaluated using a visual analogue scale (VAS) for pain intensity,the Hamilton anxiety (HAMA) and depression (HAMD) scales and the short form 36 (QOL-SF36) quality of life assessment.The area of painful skin was also measured.Results There were no significant differences among the 4 groups at the outset in any of the measurements.Significant improvement was observed in all of the measurements 15 and 30 days after the treatment except in the control group.The combined group was by then significantly better than the other 3 groups.Their dosage of gabapentin and tramadol had decreased significantly compared with the other groups after 3 months of treatment.Conclusion CT-guided pulsed radiofrequency electrotherapy combined with acupuncture or electroacupuncture is safe and effective for treating post-herpes neuralgia.It is worthy of clinical application and promotion.
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Objective To observe the clinical efficacy and safety of non-surgical spinal decompression com-bined with intervertebral foramen injection in the treatment of lumbar intervertebral disc herniation. Methods Nine-ty-six patients were randomly divided into a control group, a decompression group, an injection group and a combined group. All of the subjects were given loxoprofen sodium and chestnut seed extract. The decompression group was trea-ted with non-operative spinal decompression. The injection group received intervertebral foramen injections. The com-bined group received both treatments. Pain perceptions, quality of life perceptions and lumbar dysfunction were ob-served before the treatment, and 2 days, 1 month, 6 months and 12 months afterward. Results There were no sig-nificant differences among the groups in average pain perceptions quantified using a visual analogue scale ( VAS) be-fore the treatment. The average scores on a 36-item short-form health survey, the Oswestry disability index and a Jap-anese Orthopedic Association instrument also were not significantly different. All of those indicators had improved sig-nificantly in the decompression, injection and combined groups at 1, 6 and 12 months after the treatment, but the combined group′s average indicators were all significantly better than the other groups′ averages at the same time points. All of the significant improvements in the combined group′s averages occurred in the first month after the com-bined treatment. Conclusion Non-operative spinal decompression has a synergistic effect with intervertebral fora-men injection in treating patients with lumbar disc herniation. Their combined effect is better than either treatment a-lone. Their combined effect is lasting, safe and has few complication risks. It is worthy of clinical application.
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A new naphthalene derivative and three known compounds were isolated from the petroleum ether extract of the bulbs of Eleutherine americana by using various chromatographic techniques, such as column chromatography over silica gel and semi-preparative HPLC. Their structures were elucidated by spectroscopic date (MS, UV, IR, NMR), which were identified as eleutherol B (1), 4,8-dihydroxy-3-methoxy-1-methylanthraquinone-2-carboxylic acid methyl ester (2), 8-hydroxy-3,4-dimethoxy-1-methylanthraquinone-2-carboxylic acid methyl ester (3), and isoeleutherine (4). Compound 1 is a new compound. The diastolic blood vessels activity of compound 1 and 2 were potent, reaching 82.5% and 85.3% at the concentration of 10 μmol·L⁻¹, which were basically the same as that of the positive drug tanshinone ⅡA.
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Objective To explore the expression of miRNA-181a (miR-181a) in patients with multiple myeloma (MM) and its effect on biological features of MM cells. Methods CD138+cells of bone marrow from 25 MM patients and 10 patients with hematological non-malignancies were purified by using immunomagnetic separation, and the expression of miR-181a in CD138+cells and MM cell lines including RPMI 8226, H929 and U266 were detected by real-time quantitative PCR. The effects of down-regulation and up-regulation of miR-181a expression on the biological characteristics of MM cells were studied with miR-181a antagomir and agomir. Results Compared with patients with hematological non-malignant diseases, the expression of miR-181a in CD138+ cells was upregulated in MM patients. Compared with CD138+ cells in hematological non-malignancies, high expressions of miR-181a were observed in RPMI 8226 and U266 myeloma cell line, while low expressions of miR-181a were observed in H929 cells. Down-regulation of miR-181a with 100 nmol/L miR-181a antagomir could inhibit the proliferation of U266 cells at 24,48 and 72 h [(67.1 ± 3.3) %vs. (50.5 ± 4.1) %, (71.5 ± 3.6) % vs. (52.3 ± 2.2) %, (78.1 ± 5.4) % vs. (69.5 ± 4.3) %, P < 0.05 respectively], whereas up-regulation of miR-181a with 100 nmol/L miR-181a agomir could significantly promote the proliferation of H929 cells at 24 h and 48 h [(21.2 ± 2.4) %vs. (38.5 ± 3.6) %, ( 61.3 ± 5.4) %vs. (82.2 ±6.9)%, P<0.01 respectively]. Cell cycle analysis showed that miR-181a antagomir made U266 cell cycle arrest in the G0/G1 phase. Meanwhile, susceptibility test results indicated that the apoptosis of U266 cells induced by doxorubicin, paclitaxel and 5-fluorouracil was increased when the proliferation of miR-181a expression was down-regulated with miR-181a antagomir. In migration assay, the data showed that down-regulation of miR-181a with miR-181a antagomir could inhibit the migration of U266 cells, and the proportion of migrated cells in the experimental group (62 ± 10) %was lower than that in the control group (89 ± 12) %(P< 0.05), whereas up-regulation of miR-181a with miR-181a agomir could improve the migration of H929 cells, and the proportion of migrated cells in the experimental group (242 ± 9) % was higher than that in the control group (98 ± 8)%(P<0.01). Conclusions The high expression of miR-181a expressed highly by MM cells may promote the proliferation, migration and drug resistance of myeloma cells, indicating that miR-181a could be an important prognostic biomarker candidate, and the application of gene silencing may improve the prognosis of MM.
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Objective To investigate the relation of autophagy and postherpetic neuralgia in elderly patients,and provide new methods for prevention and treatment of postherpetic neuralgia.Methods One hundred thirty-five specimens were obtained from elderly patients with herpes zoster,containing 83 patients with herpes zoster plus neuralgia and 52 cases with non-neuralgia herpes zoster.The level of autophagy was determined by acridine orange-stain.The protein expressions of autophagy marker protein LC3 and autophagy related protein Beclinl were detected by Western blot.Results Flow cytometer detection after acridine orange-stain showed that mean fluorescence intensity (MFI) of herpes zoster plus neuralgia patients was 0.775±0.068 and non-neuralgia herpes zoster patients was 0.342±0.025.The level of autophagy of non-neuralgia herpes zoster patients was significant lower than herpes zoster plus neuralgia patients (P＜0.05).The expressions of autophagy marker protein LC3 and autophagy related protein Beclin1 detected by Western blot also showed the level of autophagy of non-neuralgia herpes zoster patients was decreased compared with herpes zoster plus neuralgia patients.Conclusions High level autophagy is risk factor for postherpetic neuralgia in elderly patients.
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Objective To evaluate the clinical efficacy of compound matrine injection combined with fentanyl transdermal patch in the treatment of elderly patients with advanced gastric cancer.Methods A total of 100 elderly patients with advanced gastric cancer were enrolled in this study.All patients were randomly divided into the observation group (n =50) given compound matrine injection plus Fentanyl transdermal patch and the control group given fentanyl transdermal patch alone(n=50).The analgesic efficacy,quality of life and adverse reaction were evaluated and compared between the two groups.Results The analgesic efficacy was significantly higher in the observation group[76％(38/50)]than in the control group[(44％),(x2=4.46,P＜0.05)].Before treatment,the life quality scores were similar between two groups.After treatment,the life quality score of the two groups was significantly improved as compared with pre-treatment.In addition,life quality score was significantly higher in the observation group than in control group(t=8.61,P＜0.05).After treatment,only mild adverse events were observed in two groups,with no significant difference in adverse events between the two groups(x2 =0.00,P＞0.05).Conclusions Compound matrine injection plus Fentanyl transdermal patch are safe and effective in the treatment of carcinoma pain in elderly patients with advanced gastric cancer.
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Objective· To identify the effect and potential mechanism of gambogic acid (GA) on natural killer/T-cell lymphoma (NK/TCL) cell lines.Methods · SNK-1,SNK-6 and SNT-8 were incubated with various concentrations of GA for 24 h,and cell viability was detected with CCK-8 assay.Cell apoptosis was examined by Annexin V-FITC/PI staining assay.Levels of proteins regulating cell apoptosis and phosphorylation levels of proteins in key signaling pathways were detected by Western blotting.Results · GA showed a potent effect on reduction of cell viability of NK/fCL cell lines in CCK-8 assay.GA increased the percentages of Annexin V positive cells and induced activation of caspase-3 and caspase-9,cleavage of PARP as well as the reduction of Bcl-xl.GA also inhibited the phosphorylation levels of STAT3 in SNK-1 and SNT-8,and ERK1/2 in SNK-1 and SNK-6 significantly.Conclusion· GA induces cell apoptosis in NK/TCL cell lines SNK-1,SNK-6 and SNT-8.Anti-apoptosis protein Bcl-xl and signaling pathway JAKs/STATs and MEK/MAPK might be involved in this process.
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The remodeling and reparative process post myocardial infarction (MI) can be divided into three phases:the inflammatory phase,the proliferative phase and the stable phase.The inflammatory immune response plays an important part in the process of cardiac remodeling.First of all,the initiation of inflammatory response relies on the activation of innate immunity with a group of pro-inflammatory cytokines,chemokines and adhesion molecules.These molecules lead to the infiltration of the infarct area with neutrophils and mononuclear cells,further clearing the wound from dead cardiomyocytes and matrix debris.After resolution of inflammatory response,reparative cells and cytokines infiltrate into the heart and promote the differentiation and growth of myofibroblasts and endothelial cells,contributing to wound contraction as well as producing fiber tissue to form a scar.Moreover,overactive immune responses could accentuate infarct injury and dilative remodeling while deficiency of inflammation leads to insufficient repair,which highlights the dual function of the immune response in myocardial injury and repair post MI.Also the intense immune response along with fibrosis in non-infarct area is also closely associated with adverse remodeling.Thus,targeting specific factors in the inflammatory reaction may hold promise in patients with MI.
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Objective@#To investigate the pathogen spectrum distribution and drug resistance of febrile neutropenic patients with hematological diseases in Shanghai.@*Methods@#A retrospective study was conducted on the clinical isolates from the febrile neutropenic patients hospitalized in the departments of hematology in 12 general hospitals in Shanghai from January 2012 to December 2014. The drug susceptibility test was carried out by Kirby-Bauer method. WHONET 5.6 software was used to analyze pathogenic bacteria and drug susceptibility data.@*Results@#A total of 1 260 clinical isolates were collected from the febrile neutropenic patients. Gram-positive bacteria accounted for 33.3% and Gram-negative bacteria accounted for 66.7%. Klebsiella pneumoniae (12.5%) , Stenotrophomonas maltophilia (9.5%) , Escherichia coli (9.1%) , Pseudomonas aeruginosa (8.7%) , Acinetobacter baumannii (6.6%) , Staphylococcus aureus (5.6%) and Enterococcus faecium (5.0%) were ranked in the first 7 of all pathogens. In the respiratory tract secretions specimens, non-fermented strains accounted for 56.2%. Stenotrophomonas maltophilia accounted for 15.2%. Enterobacteriaceae and coagulase-negative Staphylococci accounted for 42.3% (104/246) and 32.6% (85/246) respectively in blood samples. Enterobacteriaceae and Enterococcus bacteria accounted for 39.4% (76/193) and 28.5% (55/193) respectively in pus specimens. The detection rates of methicillin resistant Staphylococcus aureus (MRSA) and methicillin resistant coagulase negative Staphylococci (MRCNS) were 54.3% and 82.5%, respectively. Staphylococcus bacterial strain was not found to be resistant to linezolid, vancomycin and teicoplanin. The detection rate of Enterococcus vancomycin-resistant strains was 8.9%. Enterococcus was not detected resistance to oxazolidinone strains. Enterobacteriaceae bacteria were highly sensitive to carbapenems. The resistance rate of Pseudomonas aeruginosa to imipenem and meropenem was 34.1% and 15.8%, respectively. Stenotrophomonas maltophilia was more sensitive to minocycline hydrochloride, levofloxacin and sulfamethoxazole. The resistance rate of Acinetobacter baumannii only to cefoperazone-sulbactam was less than 10.0%. The antibiotic resistance rate of Klebsiella pneumoniae, Stenotrophomonas maltophilia, Pseudomonas aeruginosa and Acinetobacter baumanii to most of common antibiotics was lower than that of the CHINET surveillance.@*Conclusions@#The pathogenic strain distribution in common infection sites of febrile neutropenic patients was characterized. Bacterial resistance surveillance was better than the CHINET nationwide large sample surveillance in China.
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Objective@#To investigate the sagittal root position and apical bone height of the maxillary anterior teeth in order to provide anatomical information for immediate implant placement in the esthetic region.@*Methods@#Cone-beam CT (CBCT) data from 300 randomly selected patients who met the inclusion criteria were included in this study. After three-dimensional reconstruction, the sagittal plane (the sagittal plane through the long axis of the tooth) was determined. The positions and angulations of the tooth roots were classified with reference to the alveolar process. By comparing the buccal and palatal bone thickness at the mid-root level, the toot positions with reference to the mid-alveolar line were defined and classified as follows, type B (closer to the buccal alveolar surface), type M (midway between the buccal and palatal alveolar surface) and type P (closer to the palatal alveolar surface). By comparing the angulations of the alveolar process with the long axis of the roots, the angulations were classified as follows, type 1 (root apex angulated toward the palatal side or parallel to the alveolus), type 2 (root apex angulated toward the buccal side with the long axis passing posterior to point A) and type 3 (root apex angulated toward the buccal side with the long axis passing anterior to point A). The frequency of each category was counted and the apical bone height was measured. The subjects were divided into three age groups, 19-30 years, 31-50 years and 51-75 years.@*Results@#The overall mean apical bone height of the healthy maxillary central incisors was (9.2±3.0) mm, the lateral incisors was (10.0±2.9) mm and the canine was (8.1±3.1) mm. There was no significant difference in the height of apical bone between central incisors and lateral incisors (P>0.05). There was no significant difference in the height of apical bone between male and female (P>0.05). The height of apical bone in group 31-50 years and 51-75 years were greater than that in group 19-30 years (P<0.05), respectively. The proportion of the maxillary anterior teeth type B, M, P was 98.5% (1 774/1 800), 0.3% (5/1 800) and 1.2% (21/1 800) respectively. The proportion of type 1, 2, 3 was 2.6% (46/1 800), 58.6% (1 055/1 800) and 38.8% (699/1 800) respectively.@*Conclusions@#There was enough apical bone height in the area of maxillary anterior teeth, but the majority of roots positioned more buccally.
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Based on the scheme and classification system of International Classification of Functioning, Disability and Health-Children and Youth Version (ICF-CY), the motor dysfunction of cerebral palsy children mainly involved body structure and function, including skele-tal development, joint, function of muscle and nerve reflex, and the systemic movement disorder. A hydrotherapy intervene scheme was rec-ommended based on dysfunction under ICF-CY framework.
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Objective To observe the clinical efficacy of combining buprenorphine with joint mobilization in the treatmeut of periarthritis of the shoulder.Methods A total of 103 patients were randomly divided into groups A,B and C.Group A received buprenorphine and joint mobilization;group B was treated with the non-steroidal antiinflammatory drug loxoprofen sodium and joint mobilization;group C received only joint mobilization.One week,3 weeks and three months after the treatment,the subjects used a visual analogue scale (VAS) to rate their level of discomfort,and Constant-Murley scores (CMS) and the degree of shoulder activity were quantified in all 3 groups.Any differences in the intensity of joint mobilization were also observed.Results The VAS ratings,CMS and the degree of activity of the shoulder joint improved significantly in all three groups after the treatment.One week after the treatment,the average VAS score of group A (2.8±1) was significantly lower than that of groups B (3.8±1) and C (4.5± 1.3),but group A's average CMS (60.1±10.7) had increased to significantly more than those of groups B (48.8± 11.0) and C (44.9±9.7).At the same time,the average shoulder joint rear protraction,90° extorsion abduction,internal rotation and external rotation angles of group A were all significantly bigger than those of groups B and C.The differences were maintained until at least three months after the treatment.One week after the treatment,the intensity of the joint mnobilization of group A was significantly higher than in groups B and C,with that discrepancy also continuing until at least 3 months after the treatment.Conclusions Buprenorphine combined with joint mobilization is very effective in the treatment of periarthritis of the shoulder.It is simple,safe and elicits good patient compliance.It is worthy of pronotion among shoulder periarthritis patients.