[Application of ultrasound-guided selective nerve branch blockage in lumbar spinal nerve posterior branch syndrome].

OBJECTIVE: To investigate the efficacy and safety of ultrasound-guided selective nerve branch blockage in the treatment of lumbar spinal nerve posterior branch syndrome. METHODS: A total of 40 patients with lumbar spinal nerve posterior branch syndrome treated by Pain Clinic from May 2017 to December 2018 were selected. According to the method used in locating site for nerve blockage, the patients were divided into ultrasound-guided group and anatomical positioning group, with 20 cases in each group. In anatomical positioning group, there were 7 males and 13 females, aged (63.42±7.71) years old, weighted (63.65±10.72) kg, numerical rating scale (NRS) was (6.61±1.52) scores, course of disease was (16.55±4.68) months. Pain sites:4 cases at L2,3, 8 cases at L3,4, 11 cases at L4,5, and 11 cases at L5S1. In ultrasound-guided group, there were 10 males and 10 females, aged (59.58±10.21) years old, weighted (60.61±13.81) kg, NRS was(6.84±2.43) scores, and course of disease was(13.70±5.98) months. Pain sites:6 cases at L2,3, 6 cases at L3,4, 9 cases at L4,5, and 13 cases at L5S1. Ultrasound-guided group used ultrasound-guided selective posteromedial branch and posterolateral branch nerve blockage, and the anatomical positioning group used anatomical localization method to block the posteromedial branch and posterolateral branch of lumbar spinal nerve. Each nerve branch was injected 3 ml of 0.125% ropivacaine. The number of treatment required and prone position time of each treatment were recorded, and the NRS scores of patients at the time points of immediately after the end of the treatment, the first week, the second week, the first month and the third month were evaluated. And adverse events such as local anesthetic allergy and poisoning, local puncture infection, total spinal anesthesia, dizziness, drowsiness, nausea, vomiting and other adverse reactions were observed. RESULTS: There were no statistically significant differences in gender, age, weight, NRS, course of disease and pain segment distribution between two groups (P>0.05). The number of treatment required in anatomical positioning group was significantly higher than that in ultrasound-guided group (P<0.000 1). During each treatment, the time in the prone position of the patients in anatomical positioning group was significantly lower than that in ultrasound guided group (P< 0.000 1). NRS scores immediately after the end of treatment, 1 week, 2 weeks, 1 month and 3 months, anatomical positioning group were 2.98 ±0.25, 3.04 ±0.38, 3.37 ±0.47, 3.42 ±0.85, 3.50 ±0.43, respectively, 2.94 ±0.31, 3.00 ±0.29, 3.21 ±0.68, 3.16 ± 0.94, 3.17±0.53 in ultrasound-guided group, and there was significant difference at 1 month and 3 months between two groups(P< 0.05). There were no adverse events such as local anesthetic allergy and poisoning, local puncture infection, and total spinal anesthesia, and no adverse reactions such as lethargy, nausea, and vomiting occurred in two groups. There were 6 cases of dizziness in anatomical positioning group and 12 cases in ultrasound guided group. The difference between two groups was statistically significant(P<0.05). CONCLUSION: Comparedwith anatomicalpositioning, ultrasound-guided selective nerve branch block for the treatment of posterior branch of the lumbar spinal cord syndrome can reduce the number of treatments and maintain a longer therapeutic effect, but it is also necessary to pay attention to the time of each treatment to avoid dizziness and other adverse reactions.

[Influence of different processed methods on 10 kinds of ginsensides in Panacis Quinquefolii Radix].

The influence on 10 kinds of ginsensides of different processed methods of Panacis Quinquefolii Radix was discussed. White Panacis Quinquefolii Radix (sliced and dried at -80 °C), red Panacis Quinquefolii Radix( steamed, sliced and dried at -80 °C) and commercial Radix Panacis Quinquefolii (dried by electric blast air) processed by different methods. HPLC-PDA-ESI- MS method was established before by our team. Ten kinds of ginsenosides of them were determined. The content of total ginsenosides were as follow: commercial Panacis Quinquefolii Radix > white Panacis Quinquefolii Radix > red Panacis Quinquefolii Radix. Compared with white Panacis Quinquefolii Radix, the content of Re, Rc, Rb3 and Rb2 of Red Radix Panacis Quinquefolii decreased but increased that of Rg,, Rb1. Both Rg2 and Rg, were not found in white Panacis Quinquefolii Radix and commercial Panacis Quinquefolii Radix by PDA detector, and low response in ESI-MS, while red Panacis Quinquefolii Radix was to the high content that of 0. 027% and 0.040 1%. The constituent of RA0 of red Panacis Quinquefolii Radix was higher than the other two. After Panacis Quinquefolii Radix processed, the kind and content of ginsensides were significantly changed. The constituent of some kinds of ginsensides was increased and some decreased. Rf was not found in all Panacis Quinquefolii Radix samples which were consistent with the former documents.

[Research on dynamic accumulation of nine ginsenosides and two pseudo-ginsenosides of Panax quinquefolium root of different growth years and harvest months in Canada].

OBJECTIVE: To research the dynamic accumulation of ginsenosides Rg1, Re, Rb1, Rg2, Rc, Rb2, Rb3, Rd, Rg3 and pseudo-ginsenosides F11,RT5, which was grown from one- to five-year-old and harvested from May to September of Panax quinquefolium root in Canada. METHODS: RP-HPLC-ELSD was adopted. The analysis was performed on a Dimaonsil C18 (250 mm x 4.6 mm, 5 µm) column, the mobile phase was acetonitrile (A)-deionized water (B) in gradient elution mode. The flow rate was 1.0 mL/min and column temperature was set at 30 °C. The carrier gas was nitrogen with flow rate of 2.8 L/min, the drift tube temperature was 100 °C, and the injection volume was 10 µL. The principle component analysis and cluster analysis of SPSS software (version 19.0) were conducted for the data analysis. RESULTS: The RP-HPLC-ELSD method for determining simultaneously nine ginsenosides and two pseudo-ginsenosides was established. The total content of ginsenosides of one- to two-year-old was low and increased from May to September in each year. That of three- to five-year-old declined from June to July and increased from August, and was the highest in September of three- to five-year-old samples. The total content from September of three-year-old samples was similar. The content of nine ginsenosides and two pseudo-ginsenosides was relatively high in all the samples except ginsenoside Rc, which wasn't determined in some samples. The ginsenosides Rd, Rb3 and pseudo-ginsenoside F11 were higher than others. The principle component analysis results showed that ginsenosides Rg1, Re, Rb1, Rc, Rb2, Rb3, Rg3 and pseudo-ginsenosides F11,RT5 could be the characteristic ginsenosides of Panax quinquefolium root in Canada. The cluster analysis indicated that the chemical constituent and dynamic accumulation of ginsenosides of one- to two-year-old was similar except the sample of July of four-year-old and there was no obvious difference of three- to five-year-old. CONCLUSION: With the consideration of the content of ginsenoside, cultivation cost of four- to five-year-old, and risk of waterlogging and plant diseases, it is suggested that Panax quinquefolium root from September of three-year-old can be regarded as the same quality.

Characterization of tibetan medicine zuota by multiple techniques.

Zuota is regarded as the king of Tibetan medicine. However, due to the confidentiality of this precious medicine, the scientific characterization of Zuota is very scarce, which limits the pharmacology and biosafety studies of Zuota. Herein, we collected four different Zuota samples from Tibet, Qinghai, Gansu, and Sichuan and characterized them by multiple techniques. Our results showed that Zuota was mainly an inorganic mixture of HgS, sulfur, and graphite. Morphologically, Zuota samples were composed of nanoparticles, which further aggregated into microsized particles. Chemically, the majorities of Zuota were S and Hg (in the forms of HgS and pure sulfur). All samples contained pure sulfur with orthorhombic crystalline. Zuota from Qinghai province had different HgS crystalline, namely, hexagonal crystalline. The others were all face-centered cubic crystalline. Carbon in Zuota NPs was in the form of graphite. The implication to future studies of Zuota was discussed.