Is Lidocaine Patch Beneficial for Postoperative Pain?: A Meta-analysis of Randomized Clinical Trials.

OBJECTIVES: The aim of this meta-analysis was to evaluate whether a lidocaine patch is beneficial for postoperative pain as an option for multimodal analgesia. METHODS: Information was obtained from PubMed, Embase, and the Cochrane Central Register of Controlled Trials for clinical randomized controlled trials of lidocaine patches for postoperative pain (as of March 2022). Two researchers independently completed study screening, risk bias assessment, and data extraction. Review Manager (version 5.4, Cochrane Collaboration) was used to conduct the meta-analysis. The evaluation metrics were postoperative pain scores, opioid consumption, and patient satisfaction. RESULTS: Sixteen randomized controlled trials were included, and data from 918 patients were available. Pain scores differed between the 2 groups at 12, 24, and 48 hours postoperatively, and the pain scores of the lidocaine patch group were significantly lower (mean difference [MD]=-1.32 [95% CI, -1.96 to -0.68], P <0.0001; I2 =92%) at 12 hours after the operation; (MD=-1.23 [95% CI, -1.72 to -0.75], P <0.00001; I2 =92%) at 24 hours after the operation; and (MD=-0.25 [95% CI,-0.29 to -0.21], P <0.00001; I2 =98%) at 48 hours after the operation. In addition, the lidocaine patch group had decreased opioid requirements (MD=-3.57 [95% CI, -5.06 to -2.09], P <0.00001; I2 =96%). The lidocaine patch group seemed to be more satisfied, but there was no statistically significant difference (risk ratio, 1.50 [95% CI, 0.74 to 3.05], P =0.26) between the groups. DISCUSSION: Lidocaine patches are beneficial for postoperative pain and can be used in multimodal analgesia to reduce opioid use, but there is no significant increase in patient satisfaction with pain control. More data are needed to support this conclusion due to the large heterogeneity in the present study.

Circular RNAs in and out of Cells: Therapeutic Usages of Circular RNAs.

RNAs are versatile molecules that are primarily involved in gene regulation and can thus be widely used to advance the fields of therapeutics and diagnostics. In particular, circular RNAs which are highly stable, have emerged as strong candidates for use on next-generation therapeutic platforms. Endogenous circular RNAs control gene regulatory networks by interacting with other biomolecules or through translation into polypeptides. Circular RNAs exhibit cell-type specific expression patterns, which can be altered in tissues and body fluids depending on pathophysiological conditions. Circular RNAs that are aberrantly expressed in diseases can function as biomarkers or therapeutic targets. Moreover, exogenous circular RNAs synthesized in vitro can be introduced into cells as therapeutic molecules to modulate gene expression networks in vivo. Depending on the purpose, synthetic circular RNA sequences can either be identical to endogenous circular RNA sequences or artificially designed. In this review, we introduce the life cycle and known functions of intracellular circular RNAs. The current stage of endogenous circular RNAs as biomarkers and therapeutic targets is also described. Finally, approaches and considerations that are important for applying the available knowledge on endogenous circular RNAs to design exogenous circular RNAs for therapeutic purposes are presented.

Clinopodium gracile inhibits mast cell-mediated allergic inflammation: involvement of calcium and nuclear factor-kappaB.

Mast cell-mediated allergic disease is involved in many diseases such as anaphylaxis, rhinitis, asthma and atopic dermatitis. The discovery of drugs for the treatment of allergic disease is an important subject in human health. In this study, we investigated the effect of the water extract of Clinopodium gracile Matsum var. multicaule (WECG) on the mast cell-mediated allergic inflammation and studied the possible mechanism of action. WECG inhibited compound 48/80-induced systemic anaphylaxis and immunoglobulin E-mediated cutaneous anaphylaxis in a dose-dependent manner. WECG dose-dependently reduced histamine release from rat peritoneal mast cells and human mast cells. The inhibitory effect of WECG on histamine release was mediated by the modulation of intracellular calcium. In addition, WECG attenuated the phorbol 12-myristate 13-acetate and calcium ionophore A23187-stimulated gene expression and secretion of proinflammatory cytokines such as tumor necrosis factor-alpha and interleukin-6 in human mast cells. The inhibitory effect of WECG on these proinflammatory cytokines was nuclear factor-kappaB (NF-kappaB) dependent. Our findings provide evidence that WECG inhibits mast cell-derived allergic inflammation and involvement of calcium and NF-kappaB in these effects.