Efficacy of ultrasound guided intercostal nerve pulse radiofrequency combined with nerve block in the treatment of post-herpetic neuralgia / 中国基层医药

Objective:To analyze the efficacy and safety of ultrasound-guided intercostal nerve pulse radiofrequency combined with nerve block in the treatment of post-herpetic neuralgia.Methods:The clinical data of 62 patients with post-herpetic neuralgia who received treatment in The Affiliated Hospital of Southwest Medical University from May 2017 to May 2021 were retrospectively analyzed. These patients underwent nerve block (NB group, n = 30) or pulsed radiofrequency plus nerve block (PRF + NB group, n = 32). Before and after treatment, The Numerical Rating Scale (NRS) score and Pittsburgh Sleep Quality Index (PSQI) score were compared between the two groups. After treatment, the occurrence of complications including pneumothorax, infection, and skin numbness was evaluated in each group. Results:Before treatment, there were no significant differences in NRS and PSQI scores between the two groups (all P > 0.05). Immediately, 1 week and 1 month after treatment, there was no significant difference in PSQI score between the two groups (all P > 0.05). At 3 and 6 months after treatment, the NRS score in the NB +PRF group was (1.71 ± 0.35) points and (1.68 ± 0.36) points, which were significantly lower than (2.72 ± 0.68) points and (3.26 ± 0.76) points in the NB group ( t = 54.40, 78.18, both P < 0.05). There were no treatment-related complications such as pneumothorax, infection, nerve numbness, or muscle weakness in the two groups. Conclusion:Ultrasound-guided pulsed radiofrequency combined with nerve block has a definite curative effect on post-herpetic neuralgia and is highly safe. The medium- and long-term efficacy of the combined therapy is superior to that of nerve block alone.

Neuromodulación percutánea utilizando radiofrecuencia pulsada versus crioablación en pacientes con síndrome facetario lumbar / Percutaneous neuromodulation with pulsating radiofrequency vs cryoablation for the treatment of patients with lumbar facet syndrome

Resumen: Introducción: El dolor en columna lumbar afecta a un alto porcentaje de la población y presenta un significativo impacto socioeconómico. El síndrome facetario lumbar tiene una prevalencia entre 15-31% con incidencia a lo largo de la vida de hasta 52% en algunas series. Debido al empleo de distintos tipos de tratamiento y diversos criterios de selección de los pacientes, la tasa de éxito varía en la literatura. Objetivo: Comparar resultados de tratamiento con rizólisis aplicando radiofrecuencia pulsada versus crioablación en pacientes con diagnóstico de síndrome facetario lumbar. Material y métodos: De Enero de 2019 a Noviembre de 2019, ocho pacientes fueron divididos aleatoriamente en dos grupos: el grupo A tratados con radiofrecuencia pulsada y el grupo B tratados con crioablación. Se evaluó el dolor con la escala visual análoga y el índice de discapacidad de dolor lumbar de Oswestry a las cuatro semanas, además de tres y seis meses. Resultados: El seguimiento fue de seis meses. De forma inmediata los ocho pacientes (100%) refirieron mejoría de los síntomas y del dolor. De los cuatro pacientes que se encontraban en limitación funcional intensa, uno pasó a estar sin limitación funcional, dos de ellos pasaron a limitación funcional mínima y uno a limitación funcional moderada al primer mes; se reportaron diferencias estadísticamente significativas. Conclusiones: Ambos tratamientos controlan el dolor en el corto plazo; también hay una mejoría de las capacidades físicas. La morbilidad que acompaña a la neurólisis, ya sea radiofrecuencia o crioablación, es muy baja.

Abstract: Introduction: Lumbar spine pain affects a high percentage of the population and has a significant socioeconomic impact. Lumbar facet syndrome has a prevalence between 15-31% with lifetime incidence of up to 52% in some series. Due to the use of different types of treatment and different patient selection criteria, the success rate varies in the literature. Objective: To compare results of treatment with rhizolysis applying pulsed radiofrequency versus cryoablation in patients diagnosed with lumbar facet syndrome. Material and methods: From January 2019 to November 2019, eight patients were randomly divided into two groups: group A treated with pulsed radiofrequency and group B treated with cryoablation. Pain was assessed with the visual analogue scale and the Oswestry low back pain disability index at four weeks, in addition to three and six months. Results: Follow-up was six months. Immediately the eight patients (100%) reported improvement in symptoms and pain. Of the four patients who were in intense functional limitation, one of them became without functional limitation, and two of them went to minimum functional limitation and one to moderate functional limitation at the first month, statistically significant differences were reported. Conclusions: Both treatments control pain in the short term; there is also an improvement in physical abilities. The morbidity accompanying neurolysis either radiofrequency or cryoablation is very low.

Study on the changes of cellular immune function after endoscopic radiofrequency ablation in extrahepatic cholangiocarcinoma / 肿瘤研究与临床

Objective:To investigate the effect of radiofrequency ablation treatment of extrahepatic cholangiocarcinoma under endoscopic retrograde cholangiopancreatography on the cellular immune function of patients with extrahepatic cholangiocarcinoma.Methods:A prospective cohort study was conducted on 78 patients with inoperable extrahepatic cholangiocarcinoma who visited Shanxi Provincial People's Hospital from October 2019 to January 2022. All of 78 patients underwent endoscopic radiofrequency ablation. Peripheral venous blood was collected from all patients at 1 day before treatment, 1 week after treatment and 1 month after treatment. Lymphocyte subsets were detected by flow cytometry, and levels of cytokines were detected by enzyme-linked immunosorbent assay. Seventy-eight healthy subjects with the same age and gender as the patients were selected as healthy controls, and the same indicators were tested.Results:The patient's peripheral blood total bilirubin was (193±83) μmol/L at 1 day before treatment, and decreased to (55±49) μmol/L at 1 week after treatment ( t = 16.70, P < 0.001); γ-glutamyltransferase was (242±108) U/L at 1 day before treatment, and decreased to (92±70) U/L at 1 week after treatment ( t = 19.12, P < 0.001). The proportion of natural killer (NK) cells, CD3 + T cells, CD4 + T cells, ratio of CD4 + T cells to CD8 + T cells (CD4/CD8) and level of interferon γ (IFN-γ) of patients at 1 day before treatment were lower than those of healthy control group (all P < 0.05), the proportion of CD8 + T cells and regulatory T cells was higher than those of healthy control group (both P < 0.001), and there was no significant difference in the levels of interleukin 4 (IL-4) between the patients at 1 day before treatment and the healthy control group ( P = 0.545). At 1 week and 1 month after treatment, the proportion of NK cells, CD3 + T cells, CD4 + T cells, CD4/CD8 and IFN-γ level in patients increased compared with 1 day before treatment (all P < 0.001), and decreased at 1 month after treatment compared with 1 week after treatment (all P < 0.001). At 1 week and 1 month after treatment, the proportion of CD8 + T cells and IL-4 level in patients decreased compared with 1 day before treatment (both P < 0.001), and increased at 1 month after treatment compared with 1 week after treatment (both P < 0.001). At 1 week and 1 month after treatment, the proportion of regulatory T cells decreased compared with 1 day before treatment (both P < 0.001), and decreased at 1 month after treatment compared with 1 week after treatment ( P < 0.001). Conclusions:Patients with extrahepatic cholangiocarcinoma are at a low level of immunity. Endoscopic radiofrequency ablation treatment can alleviate the patient's immunosuppression, enhance the patient's cellular immunity.

Ultrasound-guided stellate ganglion pulsed radiofrequency irradiation combined with electroacupuncture can relieve migraine / 中华物理医学与康复杂志

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.

Advances in diagnosis and treatment of primary hemifacial spasm / 中华全科医师杂志

Primary hemifacial spasm is a motor disorder of facial muscles related to facial nerve. During the attack, the facial muscles present irregular and involuntary clonus, which can be induced or aggravated by emotional excitement, mental tension and random facial movement, seriously affecting daily work and life. The pathogenesis, diagnosis, differential diagnosis and treatment of the primary hemifacial spasm have been studied extensively in recent years. This article reviews the progress in these aspects.

Comparison of clinical efficacy of microwave thermotherapy versus microneedling in the treatment of axillary bromhidrosis / 中华皮肤科杂志

Objective:To compare clinical efficacy and safety of microwave thermotherapy versus microneedling in the treatment of axillary bromhidrosis.Methods:From May 2018 to March 2019, 116 patients with different degrees of axillary bromhidrosis were collected from Department of Dermatology, Xijing Hospital, The Fourth Military Medical University, including 56 treated with microwave thermotherapy by using a miraDry device, and 60 treated with microneedling by using a BodyTite device. These patients were followed up for 12 months after treatment, and clinical efficacy, complications and recurrence rate were evaluated.Results:After 12 months of follow-up, no significant difference in the response and recurrence rates were observed between the microwave group (94.64%[53 cases], 5.36%[3 cases], respectively) and microneedling group (93.33%[56 cases], 6.67%[4 cases], respectively; both χ2=0.088, P=0.767) . However, the incidence of postoperative complications was significantly lower in the microwave group (0) than in the microneedling group (6.67%, including 2 cases of skin burns and 2 cases of scars; χ2=3.867, P=0.049) . Conclusion:In the treatment of axillary bromhidrosis, microwave thermotherapy showed equivalent clinical efficacy with lower incidence of complications compared with microneedling.

Analysis on the factors that affect the therapeutic effects of endoscopic radiofrequency ablation on gastroesophageal reflux disease / 中国基层医药

Objective:To investigate the factors that affect the therapeutic effects of endoscopic radiofrequency ablation (Stretta procedure) on gastroesophageal reflux disease (GERD).Methods:Seventy patients with gastroesophageal reflux disease who received endoscopic radiofrequency ablation (Stretta procedure) treatment in Jinhua Hospital of Traditional Chinese Medicine from January 2016 to January 2019 were included in this study. They were divided into good prognosis group ( n = 57) and poor prognosis group ( n = 13) according to prognostic effects. The clinical data of all patients were collected, including gender, age, body mass index (BMI), course of disease, complications (hypertension, coronary heart disease, diabetes), smoking, drinking, Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA) scores. Unconditional stepwise logistic regression was performed to analyze the factors that affect the therapeutic effects of Stretta procedure on GERD. Results:Univariate analysis results revealed that the proportion of patients aged ≥ 60 years with BMI ≥ 25 kg/m 2, alcohol abuse, HAMD score ≥ 8, HAMD score ≥ 7 was significantly higher in the poor prognosis group than in the good prognosis group ( χ2 = 9.574, 10.821, 22.575, 8.653, 10.586, 4.070, 8.653, all P < 0.05). Logistic regression analysis confirmed that female gender, age ≥ 60 years, BMI ≥ 25 kg/m 2, course of disease ≥ 5 years, alcohol abuse, HAMD score ≥ 8 and HAMA score ≥ 7 were the risk factors for poor prognosis of gastroesophageal reflux disease ( χ2 = 11.174, 6.023, 8.698, 5.972, 5.821, 7.485, 5.443, all P < 0.05). Consistency analysis revealed that gender, age, BMI, course of disease, alcohol abuse, HAMD score and HAMA score could be used to predict the therapeutic effects of endoscopic radiofrequency ablation (Stretta procedure) on GERD. Combined application of gender, age, BMI, course of disease, alcohol abuse, HAMD score and HAMA score exhibited higher consistency than a single application, 0.827 > 0.577, 0.533, 0.795, 0.547, 0.606, 0.434 and 0.547. Conclusion:There are many factors that affect the therapeutic effects of endoscopic radiofrequency ablation (Stretta procedure) on GERD, including gender, age, BMI, course of disease, alcohol abuse, HAMD score and HAMA score. This is of certain reference value for clinical treatment of GERD, and combined application of these influential factors has a high accuracy in the prediction of the therapeutic effects of Stretta procedure on GERD.

Clinical efficacy of pulsed radiofrequency in the treatment of knee osteoarthritis: a meta-analysis / 国际生物医学工程杂志

Objective:To evaluate the clinical efficacy of pulsed radio-frequency(PRF) for knee osteoarthritis(KOA) using Meta-analysis.Methods:The literature of controlled clinical studies on PRF in the treatment of KOA was retrieved, the retrieval databases included China Biomedical Literature Database, The Cochrane Library, PubMed, Web of Science, Medline, Embase, CNKI, Wanfang Database, VIP Database, CBM, EBSCO and Network database. The retrieval period was the time of inception to February 2021. The retrieved literature was screened, quality evaluated and data extracted by two researchers. Statistical analysis was performed using Review Manager 5.3 software.Results:A total of 8 studies were included, including 411 patients with KOA. The 200 patients in the trial group were underwent PRF treatment and the 211 patients in the control group were underwent conventional treatment. Meta-analysis results showed that the experimental group was superior to the control group in terms of knee VAS score, WOMAC score, Lysholm score and effective rate, and the differences were statistically significant (all P<0.05). Conclusions:PRF is more effective in treating KOA than conventional treatment. The quality of the literature research in this study that met the inclusion criteria was low, and a large number of high-quality studies are needed to evaluate the efficacy and safety of PRF treatment.

Pulsed radiofrequency inhibits expression of P2X3 receptors and alleviates neuropathic pain induced by chronic constriction injury in rats / 中华医学杂志(英文版)

Background@#Pulsed radiofrequency (PRF) is a minimally invasive interventional technique that provides a novel and effective treatment strategy for neuropathic pain (NP). PRF is advantageous because it does not damage nerves and avoids sensory loss after treatment. At present, animal studies have demonstrated that PRF is safe and effective for relieving the NP associated with sciatic nerve damage in rats with chronic constriction injury (CCI). However, the mechanism through which this effect occurs is unknown. An increasing body of evidence shows that the expression of the P2X ligand-gated ion channel 3 (P2X3) receptor is closely related to NP; this study was to investigate whether the expression of this receptor is involved in NP relief due to PRF.@*Methods@#A total of 36 healthy adult male Sprague-Dawley (SD) rats were randomly divided into three groups: Sham group, CCI group, and PRF group. The right sciatic nerve was ligated in CCI group and PRF group to establish a CCI model; the right sciatic nerve was separated but not ligated in Sham group. On day 14 after the operation, PRF was administered to the ligated sciatic nerve in PRF group (42°C, 45 V, 2 min). A non-live electrode was placed at the exposed sciatic nerve for the rats in Sham and CCI groups. The hindpaw withdrawal threshold (HWT) and thermal withdrawal latency (TWL) were measured at the right hindpaw at different time points before and after PRF or sham therapy. On day 28 after treatment, the dorsal root ganglion (DRG) and spinal dorsal horn of the right L4–6 were harvested from each group to determine the mRNA and protein levels of the P2X3 receptor.@*Results@#On day 28 after PRF treatment, the HWT (8.33 ± 0.67 g vs. 3.62 ± 0.48 g) and TWL (25.42 ± 1.90 s vs. 15.10 ± 1.71 s) were significantly higher in PRF group as compared to CCI group (P < 0.05). The mRNA expression of the P2X3 receptor in the DRG in PRF group was 23.7% lower than that in CCI group (P < 0.05), in the spinal dorsal horns in PRF group was 22.7% lower than that in CCI group (P < 0.05). The protein expression of the P2X3 receptor in the DRG in PRF group was 27.8% lower than that in CCI group (P < 0.05), in the spinal dorsal horns in PRF group was 35.6% lower than that in CCI group (P < 0.05).@*Conclusion@#PRF possibly reduces NP in CCI rats by inhibiting the expression of the P2X3 receptor in the L4–6 DRG and spinal dorsal horns.

Efficacy of lumbar sympathetic ganglion pulsed radiofrequency in treatment of diabetic neuropathic pain / 中华麻醉学杂志

Objective To evaluate the efficacy of lumbar sympathetic ganglion pulsed radiofrequency (PRF) in treatment of diabetic neuropathic pain.Methods Forty-eight patients of both sexes with diabetic neuropathic pain,aged 45-75 yr,with the course of disease 4-7 yr,were divided into 2 groups (n =24 each) using a random number table method:control group (C group) and PRF group (P group).Group C was treated with conventional drugs.Bilateral lumbar sympathetic ganglion PRF was performed on the basis of conventional drug therapy in group P.The serum concentrations of tumor necrosis factor-alpha and interleukin-6 were measured by enzyme-linked immunosorbent assay.The visual analogue scale score was recorded before treatment and at 1,2 and 4 weeks of treatment.The degree of efficacy was recorded at 4 weeks of treatment,and the total effective rate was calculated.Results Compared with group C,the visual analogue scale score and serum concentrations of tumor necrosis factor-alpha and interleukin-6 were significantly decreased,and the total effective rate and degree of curative efficacy were increased in group P (P＜0.05).No pulsed radiofrequency-related complications or drugs-related adverse reactions were found in two groups.Conclusion Lumbar sympathetic ganglion PRF can effectively relieve diabetic neuropathic pain in the patients.

Clinical observation on the treatment of cervical spondylotic radiculopathy by the pulsed radiofrequency combined with the fixed-point lateral flexion and rotation realignment cervical manipulation / 国际生物医学工程杂志

Objective To observe the clinical efficacy of pulsed radiofrequency combined with fixed-point lateral flexion and rotation realignment cervical manipulation in the treatment of cervical spondylotic radiculopathy (CSR). Methods Sixty-three patients with CSR were randomly divided into observation group (n=32) and control group (n=31). The observation group was given pulse radiofrequency combined with fixed-point lateral flexion and rotation realignment cervical manipulation, and the control group was given the pulsed radiofrequency treatment. Visual analog scale (VAS) and Japanese Orthopaedic Association (JOA) scores were obtained before the treatment, 7 days and 3 months after the treatment. The temperature differences of bilateral upper limbs infrared thermal imaging were observed before and 3 months after the treatment in the two groups. The clinical efficacy of the two groups was evaluated by using TCM disease and syndrome diagnosis criteria. Results After 7 days and 3 months of the treatment, the VAS scores of the two groups were lower than those before treatments, the VAS scores of the observation group were lower than the control group, and all the differences were statistically significant (all P<0.05). The JOA scores in the two groups were higher than those before treatment, the JOA scores of the observation group were higher than the control group , and the differences were statistically significant (all P<0.05). There was no statistically significant difference in the infrared temperature difference between the upper limbs of the observation group and the control group before treatments [(0.83±0.27) °C vs (0.87±0.29) °C, P>0.05]. Three months after the treatment, the temperature difference of infrared thermography in the upper limbs of the observation group was better than that of the control group (P<0.05), and the cure rate of the observation group was better than that of the control group, and the difference was statistically significant (68.75％vs 22.58％, P<0.05). There was no statistically significant difference in the total effective rate between the two groups (93.75％vs 90.32％, P>0.05). Conclusions The pulsed radiofrequency combined with the fixed-point lateral flexion and rotation realignment cervical manipulation in the treatment of radiculopathic cervical spondylosis was effective in improving pain, function and infrared imaging temperature of upper limbs.

Non-surgical lipolysis techniques / 中华皮肤科杂志

In recent decades,non-invasive techniques have markedly developed.Non-invasive body contouring represents the fastest growing area of modem aesthetic medicine.Patients' fear of surgery has made micro-invasive and non-invasive lipolysis technology a hot topic in recent years.There are currently five leading non-invasive or micro-invasive techniques for reducing localized subcutaneous adipose tissue,including deoxycholic acid injection,cryolipolysis,ultrasonic lipolysis,radiofrequency lipolysis and laser lipolysis.This review mainly summarizes the recent findings regarding the action mechanisms,clinical efficacy of and adverse reactions to non-invasive lipolysis techniques.

The effect of needle tip position on the analgesic efficacy of pulsed radiofrequency treatment in patients with chronic lumbar radicular pain: a retrospective observational study / 대한통증학회지

BACKGROUND: Pulsed radiofrequency (PRF) is a treatment modality that alleviates radicular pain by intermittently applying high-frequency currents adjacent to the dorsal root ganglion. There has been no comparative study on analgesic effect according to the position of the needle tip in PRF treatment. The objective of this study is to evaluate the clinical outcomes of PRF according to the needle tip position. METHODS: Patients were classified into 2 groups (group IP [group inside of pedicle] and group OP [group outside of pedicle]) based on needle tip position in the anteroposterior view of fluoroscopy. In the anteroposterior view, the needle tip was advanced medially further than the lateral aspect of the corresponding pedicle in group IP; however, in group OP, the needle tip was not advanced. The treatment outcomes and pain scores were evaluated at 4, 8, and 12 weeks after applying PRF. RESULTS: At 4, 8, and 12 weeks, there were no significant differences between the successful response rate and numerical rating scale score ratio. CONCLUSIONS: The analgesic efficacy of PRF treatment did not differ with the needle tip position.

Effect of sciatic nerve pulsed radiofrequency glial activation levels in spinal dorsal horn in chronic constriction injury rat models and its analgesia effect / 吉林大学学报(医学版)

Objective:To observe the effect of sciatic nerve pulsed radiofrequency (PRF) on the activation levels of microglia cells and astrocytes in spinal dorsal horn in the chronic constriction injury (CCI) rat models, and to explore the relationships between the analgesic mechanism of sciatic nerve PRF and the activation levels of microglia cells and astrocytes in the spinal dorsal horn.Methods:Forty male SD rats were randomly divided into CCI shamoperation+RPF sham group (SS group) , CCI sham-operation+RPF group (SP group) , CCI+RPF sham group (CS group) , CCI+RPF group (CP group) (n=10) .PRF was applied on the sciatic nerve on the 4th day after CCI operation for 120s, with a maximum temperature of 42℃.The mechanical withdrawal thresholds (MWT) and thermal paw withdrawal latencies (TWL) were measured to evaluate mechanical hyperalgesia and thermal hyperalgesia 1dbefore operation (D0) and 1, 3, 5, 7dafter operation (D1, D3, D5, D7) .Western blotting method was used to detect the protein expression levels of ionized calcium binding adapter molecule 1 (Iba-1) and glial fibrillary acidic protein (GFAP) in the ipsilateral spinal dorsal horn of L3-5after pain behavioral test (D7) .Results:Compared with SS group, the rats in CS group after CCI had the significant behavioral changes, such as hallux valgus, lameness, toe bending, and foot raising during walking;MWT and TWL were decreased significantly (P＜0.01) ;the expression levels of Iba-1and GFAP proteins in the ipsilateral spinal dorsal horn were increased significantly (P＜0.05) .Compared with CS group, the behavioral changes of the rats in CP group (D5, D7) such as hallux valgus, lameness, toe bending, and foot raising during walking were alleviated significantly;MWT and TWL were increased significantly (P＜0.01) ;the Iba-1protein expression level in spinal dorsal horn was downregulated significantly (P＜0.05) and the GFAP protein expression level did not change significantly (P＞0.05) .Conclusion:PRF on sciatic nerve can relieve the neuropathic pain (NP) of the CCI rat models;PRF on sciatic nerve can inhibit activation of the microglia cells in the spinal dorsal horn.The analgesic mechanism of PRF on sciatic nerve may be associated with the inhibition of the activation of microglia cells in the spinal dorsal horn.

Effect of pulsed radiofrequency on phenotypic transformation of lumbar sympathetic ganglion in rats with diabetic neuropathic pain / 中华麻醉学杂志

Objective To evaluate the effect of pulsed radiofrequency (PRF) on the phenotypic transformation of the lumbar sympathetic ganglion (LSG) in the rats with diabetic neuropathic pain (PDN).Methods Twenty-four clean-grade healthy adult male Sprague-Dawley rats,aged 2 months,weighing 180-220 g,were divided into 4 groups (n =6 each) according to the method of random number table:control group (group C),group PDN,group PRF,and PRF control group (group PC).The PDN model was established by intraperitoneal injection of streptozotocin 60 mg/kg in anesthetized rats.Citrate-sodium citrate buffer 6 ml/kg was intraperitoneally injected in group C.Group PC only received radiofrequency needle puncture.PRF was performed on the right L3 LSG in group PRF.The mechanical paw withdrawal threshold (MWT) to yon Frey filament stimulation was measured before intraperitoneal injection (baseline,T0),before PRF and at 1,3,5,7 and 14 days after PRF.The rats were then sacrificed,and ipsilateral L3 LSGs were removed for determination of the expression of tyrosine hydroxylase (TH) and vesicle glutamate transporter2 (VGLUT2) in LSGs (by double immunofluorescent staining) and for examination of pathological changes (with a light microscope).The number of neurons expressing VGLUT2 was counted.Results Compared with group C,the MWT was significantly decreased at T1-6,and the number of neurons expressing VGLUT2 was increased at T6 in PDN,PC and PRF groups (P＜0.05).Compared with PDN and PC groups,the MWT was significantly increased at T2-6,and the number of neurons expressing VGLUT2 was decreased at T6 in group PRF (P＜0.05).TH expression in LSGs was found,and no VGLUT2 expression in LSGs was observed in group C,the expression of TH and VGLUT2 in LSGs was found in the other three groups,especially in PDN and PC groups,and most of the neurons expressing VGLUT2 expressed TH simultaneously.Conclusion The mechanism by which PRF mitigates PDN is related to inhibiting the phenotypic transformation of LSGs in the rats.

Pesquisa de opinião sobre eficácia, custos e cicatrização de procedimentos de resurfacing para rugas estáticas faciais / Expert survey on the efficacy, costs and healing of resurfacing procedures for facial static wrinkles

Foi realizada uma pesquisa de opinião entre especialistas em "resurfacing" cutâneo com a finalidade de compararem-se custos e benefícios entre as técnicas de laser de CO2 totalmente ablativo, lasers fracionados ablativos, lasers fracionados não ablativos, radiofrequência fracionada ablativa, microagulhamento, dermabrasão, peelings médios e peelings de fenol- -óleo de cróton. A opção mais eficaz para tratamento de rugas estáticas faciais foi peeling de fenol-óleo de cróton, ranqueado em primeiro lugar por 71,4% dos experts, seguido de laser de CO2 totalmente ablativo, por 28,6%. Sobre "downtime", os procedimentos elencados com recuperação mais rápida foram microagulhamento e laser fracionado não ablativo, com 42,9% cada um, seguidos por radiofrequência fracionada ablativa, com 14,3%. O período para recuperação completa dos efeitos colaterais e adversos foi percebido como mais curto no microagulhamento por 50% dos experts. Sobre os custos operacionais, o procedimento menos custoso foram peelings médios, de acordo com a opinião de 71,4% dos especialistas. Tais resultados apontam para melhor custo/benefício de procedimentos como peelings químicos e microagulhamento, de acordo com a opinião dos 14 especialistas brasileiros que responderam ao questionário.

A survey on the opinion of specialists regarding skin resurfacing was performed, with the objective of comparing costs and benefits between the techniques: totally ablative CO2 laser, fractional ablative lasers, fractional non-ablative lasers, ablative fractional radiofrequency, microneedling, dermabrasion, medium peels, phenol-croton oil peels. The most effective option for the treatment of static wrinkles was the phenol-croton oil peel, in first place by 71.4% of the experts, followed by totally ablative CO2 laser, by 28.6%. Regarding downtime, procedures ranked as fastest recovery were microneedling and fractional non-ablative lasers, with 42.9% each, followed by ablative fractional radiofrequency, with 14.3%. Complete recovery period for side and adverse effects was perceived as shorter with microneedling by 50% of the experts. Regarding operating costs. The less costly procedure was medium peels, according to the opinion of 71.4% of the experts. Such results point towards a better cost/benefit of procedures such as chemical peels and micro-needling, according to the opinion of 14 Brazilian specialists who answered the questionnaire.

Radiofrecuencia pulsada para tratamiento de neuralgia de nervio pudendo bajo guía ultrasonográfica: a propósito de dos casos / Radiofrequency pulsed for treatment of neuralgia of nervio pudendo under ultrasonographic guide: a purpose of two cases

INTRODUCCIÓN: La neuralgia de nervio pudendo (NNP) se presenta como un dolor neuropático intenso, ardiente y difuso en la zona perineal, acompañado en ocasiones de hipoestesia, alodinia, hiperalgesia, sensibilidad dérmica, parestesia y entumecimiento que empeora el dolor en sedestación. Es un síndrome subdiagnosticado que, en ocasiones, se presenta refractario al tratamiento farmacológico y fisiátrico. OBJETIVOS: Evaluar la eficacia de la radiofrecuencia pulsada (RFP) guiada por ultrasonido para el tratamiento de dolor crónico, realizada a dos pacientes con NNP refractarios a tratamiento conservador. MATERIALES Y MÉTODO: Siendo positivo el bloqueo diagnóstico realizado con 0,5-1 ml de lidocaína al 2 por ciento, se practicó RFP bajo guía ecográfica a 2 pacientes (1 femenina de 36 años y 1 masculino de 54 años) con diagnóstico de NNP (según criterio de Nantes) y se realizó seguimiento a 1 semana y a 1 mes del procedimiento, observando la evolución del dolor mediante la utilización de la escala visual análoga (EVA), calidad de vida según lo informado en consulta y evolución en la ingesta y dosis de medicamentos. RESULTADOS: Luego del procedimiento la reducción del dolor fue significativa en ambos casos, en la paciente 1 (femenina) la EVA pasó de 10/10 (preoperatorio) a 1/10 a una semana del procedimiento y desapareció por completo al mes, retirándose en su totalidad la medicación indicada para la NNP. Asimismo, la paciente manifestó mejora en la calidad de vida, al no tener ya dolor durante el coito. Por su parte, en el paciente 2 (masculino), el dolor se redujo en un 50 por ciento registrándose un EVA que pasó de 8/10 (preoperatorio) a 4/10 a la semana y al mes de realizado el procedimiento. En su caso, al no haber desaparecido por completo el dolor, continuó tomando la medicación indicada (duloxetina 30 mg) y refirió poder sentarse con comodidad, ya sin el dolor intenso que lo aquejaba en esta posición, pudiendo incluso realizar un viaje de larga distancia. DISCUSIÓN: La RFP es un procedimiento efectivo en aquellos pacientes correctamente diagnosticados de neuralgia del nervio pudendo según el criterio de Nantes, refractarios a tratamiento farmacológico y/o fisioterápico, practicada por profesionales con entrenamiento y/o experiencia en la técnica de radiofrecuencia pulsada así como en el manejo de ultrasonido para ubicar sonoanatómicamente el nervio pudendo, en un ámbito seguro para la realización del procedimiento.

INTRODUCTION: The pudendal neuralgia is presented as a neurophatic pain that is intense, burning, difusse in the perineal area, sometimes accompanied by hypoesthesia, allodynia, hyperalgesia, dermal sensitivity, paresthesia and numbness that worsens by sitting. It ́s a syndrome underdiagnosed that can sometimes be refractory to traditional management like pharmacological or physical therapy. OBJECTIVES: Test the effectiveness of pulsed radiofrecuency by ultrasound-guided treatment of cronic pain done to two patients with pudendal neuralgia that were refractory to the conservative treatment. MATERIALS AND METHODS: As the diagnostic block done with 0,5-1 ml with 2 percent of lidocaine gave a positive outcome, we perform a pulsed radiofrecuency by an ultrasound-guide to two patients (36 year old female and a 54 year old male) with pudendal neuralgia diagnosted according to Nantes criteria and a tracing of 1 week and 1 month of the procedure was performed observing the pain evolution through visual analogue scale, quality of life according to the as reported in consultation and evolution in the intake and dose of medications. RESULTS: The reduction of pain was significant in both cases, in patient 1 (female) the VAS went from 10/10 (preoperative) to 1/10 to a week of the procedure and disappeared completely to 1 month, with the medicines completely withdrawn indicated for pudendal neuralgia. The female patient (1) showed improvement in the quality of life by not having pain during intercourse. On the other hand, in patient 2 (male), the pain was reduced by 50 percent, registering an EVA that went from 8/10 (preoperative) to 4/10 to 1 week and 1 month after the procedure was performed. In his case, since the pain had not completely disappeared, he continued to take the indicated medication (duloxetine 30 mg) and referred to be able to sit comfortably, without the intense pain that afflicted him in this position, even being able to travel long distances. DISCUSSION: Pulsed radiofrequency is an effective procedure in those patients correctly diagnosed with pudendal neuralgia according to the Nantes criterion, refractory to pharmacological and / or physiotherapeutic treatment, practiced by professionals with training and / or experience in the pulsed radiofrequency technique as well as in the management of ultrasound to locate the pudendal nerve sonoanatomically, in a safe environment for carrying out the procedure.

Efficacy of Treatment with Coblation Turbinate Reduction in Patients with Allergic Rhinitis Responding to Medication / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The effectiveness of turbinate surgery has been well demonstrated in allergic rhinitis refractory to medication. On the contrary, the efficacy of surgery in allergic rhinitis that responds to medication has not been assessed. The aim of this study was to determine the surgical outcomes in patients with allergic rhinitis responsive to medication. SUBJECTS AND METHOD: Patients with allergic rhinitis responsive to medication and those who had undergone coblation turbinate reduction were enrolled in this study. The visual analog scale was used to assess the allergic symptoms before treatment, during medication treatment as well as postoperatively at 6 and 12 months. In addition, the degree of patient satisfaction regarding the surgery was investigated postoperatively at 12 months. RESULTS: Twenty-four patients (mean age=33.6±14.9 years; men-to-women ratio=1:1) were included in this study. During the pretreatment period, all allergic symptoms significantly improved after treatment with both medication and surgery. At 6 months postoperatively, the degree of patients' allergic symptoms was lower than in those treated with medication. However, when compared at 12 months postoperatively, all the symptoms, excluding nasal obstruction, were not significantly different from those who received medication. Surveyed postoperatively at 12 months 54.2% of patients advocated for surgical treatment. CONCLUSION: Although surgery yielded better outcome than did medication during the early postoperative period, there was little difference in the outcome at 12 months postoperatively. Therefore, we need to be careful when choosing surgical intervention for patients with allergic rhinitis responsive to medication.

Treatment of Lung Cancer-Related Intractable Hiccups Using Pulsed Radiofrequency: Clinical Experience / 한국호스피스완화의료학회지

While most benign hiccups can be controlled with empirical therapy, intractable hiccups lasting longer than one month tend to have significant adverse effects with obscure etiology. Treatment strategies for intractable hiccups have not been established. Only a few sporadic cases of bilateral phrenic nerve blockage have been reported. Here, we report a case of intractable hiccups that lasted five weeks in a 56-year-old male patient with a lung cancer above the right diaphragm. We hypothesized that his intractable hiccups were caused by irritation and mass effect caused by the lung cancer. We performed an ultrasound-guided right unilateral phrenic nerve pulsed radiofrequency treatment, and the patient's intractable hiccups were successfully managed without complication.

Evaluation of efficacy of microneedling radiofrequency for the treatment of facial acne scars / 中华皮肤科杂志

Objective To evaluate the efficacy and safety of microneedling radiofrequency in the treatment of facial acne scars.Methods A retrospective study was conducted.According to the inclusion and exclusion criteria,42 patients with acne scars receiving microneedling radiofrequency treatment (observation group) and 47 patients with acne scars treated with fractional CO2 laser (control group) in Guangzhou Institute of Dermatology were enrolled into this study from June 2016 to June 2017.Single-blind evaluation was conducted according to a four-grade scoring system and ECCA grading scale (échelle d'évaluation clinique des cicatrices d'acné) by two clinically experienced dermatologists to evaluate and compare the clinical efficacy between the 2 groups,based on the clinical photos before and after the treatment.Statistical analysis was done by using chi-square test,t test of two independent samples and paired Wilcoxon signed rank test.Results After treatment,no significant difference in the total response rate was observed between the observation group (92.9％,39 cases) and control group (89.4％,42 cases;x2 =0.042,P ＞ 0.05).Before the treatment,there was no significant difference in the ECCA score between the observation group (46.7 ± 16.3) and control group (45.7 ± 15.8,t =0.271,P ＞ 0.05).After the treatment,the ECCA score in the observation group and control group significantly decreased into 29.5 ± 15.1 and 31.3 ± 14.9 respectively (Z =-5.713,-6.086,respectively,both P ＜ 0.05).Conclusion Microneedling radiofrequency is effective for the treatment of facial acne scars,with high safety and less injuries.