Modern diagnostic methods for early assessment of the abdominal involvement in Schönlein-Henoch disease.

INTRODUCTION: Schönlein-Henoch disease is a small vessel vasculitis resulting from IgA-mediated inflammation. It is the most common acute systemic vasculitis in childhood, mainly affecting the skin, gastrointestinal tract, joints, and kidneys. Although the prognosis of Schönlein-Henoch is generally good, gastrointestinal tract involvement is a potential complication, presenting as massive gastrointestinal bleeding, bowel infarction, perforation, as well as intussusception and peritonitis.

Effects of HeNe laser combined with ultrashort wave therapy on pain factors and anti-inflammatory and pro-inflammatory factors in patients with chronic knee osteoarthritis / 中国医师进修杂志

Objective:To investigate the effects of HeNe laser combined with ultrashort wave therapy on pain factors, anti-inflammatory and pro-inflammatory factors in patients with chronic knee osteoarthritis (KOA).Methods:Using prospective research methods, 108 patients with chronic KOA in Xicheng District Xichang′an Street Community Health Service Center from January 2018 to December 2019 were selected as the research objects, and randomly divided into control group and observation group, with 54 cases in each group. The control group was given shortwave treatment, while the observation group was given HeNe laser combined with ultra-short wave treatment. The clinical efficacy, levels of pain factors, anti-inflammatory and pro-inflammatory factors and knee function were compared between the two groups, and the pain factors including prostaglandin E 2 (PGE 2), substance P (SP), dopamine (DA); the anti-inflammatory and pro-inflammatory factors including transforming growth factor β1 protein (TGF-β1), tumor necrosis factor-stimulating gene (TSG-6), interleukin-10 (IL-10), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), interleukin-1β (IL-1β). Results:The total effective rate of observation group was significantly higher than that of control group: 92.59% (50/54) vs. 75.93% (41/54), P<0.05. After treatment, the levels of PGE 2, SP, DA, TGF-β1, TSG-6, IL-10, TNF-α, IL-6 and IL-1β in the observation group were significantly lower than those in the control group: (2.50 ± 0.29) ng/L vs. (2.85 ± 0.32) ng/L, (1.55 ± 0.35) ng/L vs. (1.73 ± 0.36) ng/L, (12.46 ± 1.82) g/L vs. (15.25±2.20) g/L, (12.46 ± 2.06) μg/L vs. (15.58 ± 2.89) μg/L, (6.02 ± 0.89) ng/L vs. (6.84 ± 0.92) ng/L, (13.64 ± 2.92) ng/L vs. (16.50 ± 3.15) ng/L, (38.82 ± 7.15) ng/L vs. (47.05 ± 8.53) ng/L, (21.92 ± 4.19) ng/L vs. (25.41 ± 5.08) ng/L, (26.49 ± 6.74) ng/L vs. (31.53 ± 7.95) ng/L, P<0.05. After treatment, the levels of PGE2, SP, DA, TGF-β1, TSG-6, IL-10, TNF-α, IL-6 and IL-1β in the observation group were significantly lower than those in the control group ( P<0.05). The excellent rate of knee function in the observation group was significantly higher than that in the control group: 87.04% (47/54) vs. 64.81% (35/54), P<0.05. Conclusions:For patients with chronic KOA, HeNe laser combined with ultrashort wave therapy has better clinical efficacy, which can relieve pain, regulate the imbalance of body factors and improve the function of knee joint.

The effect of modified Miccoli surgery in the treatment of patients with benign thyroid diseases and its influence on the postoperative aesthetic degree of scar score and the expression of pain factors / 中国医师进修杂志

Objective:To investigate the effect of modified Miccoli surgery in the treatment of patients with benign thyroid disease and its intervention on the postoperative aesthetic degree of scar score and the expression of pain factors.Methods:The clinical data of 114 patients with benign thyroid diseases in Hankou Hospital from February 2018 to February 2020 were collected, 57 cases with traditional open thyroid surgery were enrolled in the open group, and 57 cases with modified Miccoli surgery were enrolled in the modified group. The surgery related indicators, postoperative recovery indicators, complications and preoperative, postoperative 1, 3 d serum pain factors substance P (SP), β-endorphin (β-EP), dynorphin ( DYN), immune function indexes CD 3+, CD 4+, CD 8+, parathyroid function related indexes parathyrotropic hormone(PTH), blood calcium, 3 months and 6 months after surgery of observer scar evaluation scale (OSAS), Vancouver scar scale (VSS) scores were compared between the two groups. Results:The length of incision, recovery time of neck movement, and hospital stay and the intraoperative blood loss were lower than those in the open group: (2.2 ± 0.4) cm vs. (6.5 ± 0.7) cm, (19.6 ± 4.8) h vs. (28.2 ± 7.8) h, (4.8 ± 1.4) d vs. (7.1 ± 1.8) d, (21.9 ± 5.1) ml vs. (39.5 ± 7.0) ml, the differences were statistically significant ( P<0.05). The levels of serum SP, β-EP and DYN in the modified group were lower than those in the open group at 1 and 3 d after operation: 1 d after surgery:(87.40 ± 12.25) ng/L vs. (114.96 ± 15.79) ng/L, (149.34 ± 21.49) ng/L vs.(192.15 ± 26.43) ng/L, (1.14 ± 0.21) mg/L vs. (1.59 ± 0.30) mg/L; 3 d after surgery: (80.18 ± 10.79) ng/L vs.(96.24 ± 12.36) ng/L, (137.46 ± 18.57) ng/L vs. (168.24 ± 21.50) ng/L, (0.94 ± 0.16) mg/L vs. (1.27 ± 0.25) mg/L, the differences were statistically significant ( P<0.05). The levels of CD 3+ and CD 4+ in the modified group were higher than those in the open group at 1 and 3 d after the operation, and the CD8+ level was lower than that of the open group: 1 d after surgery: 0.597 ± 0.053 vs. 0.542 ± 0.049, 0.382 ± 0.041 vs. 0.362 ± 0.036, 0.308 ± 0.048 vs. 0.332 ± 0.060; 3 d after surgery: 0.615 ± 0.060 vs. 0.580 ± 0.055, 0.408 ± 0.051 vs. 0.385 ± 0.046, 0.290 ± 0.038 vs. 0.317 ± 0.045, and the differences were statistically significant ( P<0.05). The levels of serum PTH and blood calcium in the modified group were higher than those in the open group at 1 and 3 d after operation: 1 d after surgery: (29.12 ± 6.58) ng/L vs. (20.67 ± 5.14) ng/L, (1.86 ± 0.22) mmol/L vs. (1.59 ± 0.10) mmol/L; 3 d after surgery: (36.39 ± 7.65) ng/L vs. (24.08 ± 5.97) ng/L, (2.03 ± 0.18) mmol/L vs. (1.72 ± 0.14) mmol/L, the differences were statistically significant ( P<0.05). The OSAS and VSS scores of the modified group were lower than those of the open group at 3 and 6 months after surgery: 3 months after surgery: (15.9 ± 3.3) scores vs. (24.7 ± 6.9) scores, (4.4 ± 1.5) scores vs. (8.1 ± 3.2) scores; 6 months after surgery: (10.3 ± 2.7) scores vs. (17.1 ± 5.4) scores, (3.3 ± 1.2) scores vs. (6.9 ± 2.4) scores, the differences were statistically significant ( P<0.05). The incidence of postoperative complications in the modified group was lower than that in the open group: 3.51%(2/57) vs. 15.79%(9/57), the difference was statistically significant ( P<0.05). Conclusions:The application of modified Miccoli surgery in patients with benign thyroid diseases can reduce the length of the incision, reduce the impact on postoperative pain stress, immune function, and parathyroid function, speed up the process of postoperative recovery, improve the appearance of postoperative aesthetic degree of scar, and reduce the risk of complications.

Effects of dezocine and ropivacaine infiltration anesthesia on cellular immune function indicators, anesthesia recovery time and pain factors in patients with open liver resection.

The current experiment was carried out to explore the effects of dezocine combined with ropivacaine infiltration anesthesia on the anesthesia recovery time and pain factors of patients with open hepatectomy. A prospective randomized controlled method was used to select 92 patients with open liver cancer resection in our hospital from August 2017 to November 2019. The patients were divided into a study group (n=46) and a control group (n=46) using a computer-generated random number table. Both groups underwent general anesthesia, based on this, the study group was treated with ropivacaine infiltration anesthesia 10 minutes before skin incision, and dezocine was given intravenously 0.5 h before surgery, the control group was anesthetized with ropivacaine 10 minutes before the incision, and was given a saline injection 0.5 h before the operation. Compared the recovery of anesthesia (recovery time of spontaneous breathing, time to open eyes, time to extubation), the incidence of adverse reactions, and cellular immune function indicators (peripheral blood CD4+, CD4+/CD8+, NK cell levels), stress response indicators [serum blood glucose (Glu), norepinephrine (NE), adrenaline (E)], pain factors [serum dopamine (DA), neuropeptide Y (NPY), substance P (SP)] before induction of anesthesia (T0), completion of surgery (T1), 12 hours after surgery (T2), and 24 hours after surgery (T3) between the two groups, and the degree of pain (VAS score) at T2 and T3 were compared between the two groups. The levels of CD4+, CD4+/CD8+, and NK cells in peripheral blood at T1, T2, and T3 in the study group were higher than those in the control group (P<0.05); serum Glu, NE, and E levels in the study group at T1, T2, and T3 were lower than those in the control group (P<0.05); serum DA, NPY, and SP levels in the study group at T1, T2, and T3 were lower than those in the control group (P<0.05); the VAS scores of the study group at T2 and T3 were lower than those of the control group (P<0.05); the time of spontaneous breathing recovery, eyes opening and extubation in the study group were shorter than those in the control group (P<0.05); the incidence of restlessness (4.35%), transient hypertension (6.52%), and cough (2.17%) in the study group were lower than those in the control group (P<0.05). Dezocine and ropivacaine infiltration anesthesia can significantly shorten the recovery time of anesthesia and inhibit pain factor secretion in patients with open hepatectomy and can reduce the body's stress response after surgery, reduce immune function fluctuations, and can reduce the incidence of adverse reactions to anesthesia, and help promote patients' postoperative recovery.

Clinical Efficacy of Modified Guizhi Jia Gegen Tang on Qi Stagnation and Blood Stasis Syndrome of Cervical Spondylotic Radiculopathy and Function of Neck and Upper Limb / 中国实验方剂学杂志

<b>Objective::To investigate the clinical efficacy of modified Guizhi Jia Gegen Tang on cervical spondylotic radiculopathy (CSR) with Qi stagnation and blood stasis syndrome and its effect on cervical vertebral mobility, isometric muscle strength and pain-related factors. <b>Method::Totally 162 CSR patients with Qi stagnation and blood stasis syndrome were randomly divided into observation group (81 cases) and control group (81 cases). The observation group was given modified Guizhi Jia Gegen Tang orally, 150 mL/time, twice a day, while the control group was given Jingshu granule orally for 6 g/time, twice a day. Both groups were treated for 8 weeks. The changes of median nerve F wave conduction velocity, cervical vertebral mobility, isometric muscle strength, CSR 20 subscale score and visual analogue score (VAS) were recorded before and after treatment. The total effective rate and the cure rate were counted after treatment. The levels of serum pain-related factors (5-HT), nerve growth factor (NGF) and prostaglandin E₂ (PGE₂) were measured before and after treatment. <b>Result::The total effective rate of the observation group was 98.77%, and the cure rate was 40.74%, which were better than 83.95%and 7.41%of the control group (<italic>P</italic><0.01). Compared with before treatment, the conduction velocity of median nerve F wave, cervical vertebral mobility, isometric muscle strength and CSR 20 score increased, whereas VAS score, pain related factors 5-HT, NGF and PGE₂ content decreased in both groups (<italic>P</italic><0.01). Compared with control group, median nerve F wave conduction velocity, cervical vertebral mobility, isometric muscle strength and CSR 20 subscale scores increased, while VAS score decreased, pain related factors 5-HT, NGF and PGE₂ contents decreased in the observation group (<italic>P</italic><0.01). <b>Conclusion::Modified Guizhi Jia Gegen Tang is effective in treating CSR with Qi stagnation and blood stasis syndrome, and can significantly improve the neck and hand functions and relieve pain.

Clinical Efficacy of Duhuo Xuduan Tang in Treatment of Lumbar Disc Herniation / 中国实验方剂学杂志

Objective: To investigate clinical efficacy of Duhuo Xuduan Tang in treatment of lumbar disc herniation with different syndrome types and its effect on serum pain factors, bone morphogenetic protein-7 (BMP-7) and Aggrecan. Method: A total of 121 patients with non-emergency lumbar disc herniation admitted to the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine from January 2017 to June 2018 were randomly divided into observation group (62 cases) and control group (59 cases). The two groups of patients were treated by repositioning maneuver before absolute bed rest. observation group was given Duhuo Xuduan Tang, 150 mL·time-1, 3 times·d-1 orally, while control group was orally given ibuprofen, 300 mg·time-1, vitamin B1, 10 mg·time-1, 2 times·d-1, drugs were taken for 5 days a week, and then stopped for 2 days. Both groups were treated continuously for 4 weeks. changes in visual analogue score (VAS), modified Oswestry dysfunction index (MODI), serum substance P (SP), dopamine (DA), serotonin (5-HT), BMP-7 and Aggrecan were observed before and after treatment with enzyme-linked immunosandwich assay (ELISA). Result: Compared with before treatment, VAS and modified Oswestry dysfunction index scores were lower in both groups (PPPPPConclusion: Duhuo Xuduan Tang has a certain efficacy on different types of lumbar disc herniation, with best efficacy for patients with liver and kidney yin deficiency.