UWMC麻醉科和疼痛医学

手术前的方法：问卷调查 ，MTS 和 DNIC 第1部分：人口，社会心理与疼痛相关的人格问卷<ol><li>首先，人口管理调查问卷，以收集有关妇女的病历资料，包括疼痛怀孕前和最近的历史，在怀孕期间及其运载工具。 </li><li>心理问卷前DNIC程序，并在两个休息5分钟内DNIC程序管理。 Spielberger的状态 - 特质焦虑量表前程序管理，害怕疼痛问卷三是在第5分钟的休息时间和疼痛量表问卷Catastrophizing管理是管理在第二个5分钟的休息时间。 Spielberger的状态 - 特质焦虑量表的国家情感的条件和评估第一的状态焦虑水平，然后评估的特质焦虑水平。问卷III疼痛的恐惧中包含的剧烈疼痛，轻微的疼痛，和医疗疼痛的描述。疼痛Catastrophizing量表包括的项目，代表疼痛catastrophizing的三个组成部分：沉思，放大倍率，和无助。 </li><li>最后，短期McGill疼痛问卷2可能会在任何方便的时间点进行管理术前量化程度，神经性和非神经性疼痛主题的经验。 </li></ol>第2部分：机械时间总和（MTS）的评估<ol><li>在女人的前臂，研究人员采用了一个180克冯弗雷灯丝一次或两次，熟悉针刺感。然后，它应用1厘米直径的圆内的11倍。一触式后，女方要求对口头上一个0-100的数字疼痛量表针刺疼痛。然后，连续十触及应用在随机位置与刺激间隔1秒的主体是要求率第十应用程序的痛苦。 </li></ol>第3部分：弥漫有毒抑制控制（DNIC）评估<ol><li>在一个私人的考场，孕妇坐在一个舒服的姿势与放置在她的腿上的枕头。妇女被告知，小型讲座和对话会不会在测试过程中为了获得一致的结果。妇女被要求竭尽所能地专注于他们所描述的指令。研究员如下脚本来管理指令。首先，11点的口头数字疼痛量表解释和测试，然后简要解释。 </li><li>热热电极是经过精心放在女子的优势前臂掌侧内的一部分，并与魔术贴带的担保。该女子问到她的手臂放松，同时保持在同一位置上的热电极。 </li><li>测试的第一部分涉及到两个不同的热感觉熟悉的女人，并根据要求她使用评级的痛苦感觉。热电极的增加和减少在8 ° C /秒，从32 ° C至43 ° C，然后再从32 ° C至44 ° C。每个目标温度，第43 ° C和44 ° C，仍然为7秒。刺激间隔设置为2秒。增加/减少率和刺激间隔设置仍保持在8 ° C /秒和2秒，整个过程中，分别的。热电极由未激活时，在基准温度为32 ° C题目是问率11点的口头数字疼痛量表，6秒后，热电极达到目标温度的痛苦。 </li><li>下一部分的测试涉及将连续三个温度来确定温度的女人疼痛强度为6报告0-10规模。这是第一暖气的热电极45，46和47˚C的随机顺序。三个温度范围内对每个温度的女人反应不同，将增加或减少由1˚C。热电极是不能够达到以上48˚C的温度</li><li>疼痛- 6温度，然后确认。 </li><li>现在，热电极是从女人的前臂，至少5分钟。这是一个完成的问卷调查和文书的好时机。 </li><li>至少5分钟后，热电极放置在同一位置上的女人的前臂。 </li><li>下一部分的测试涉及的热电极加热到30秒的疼痛- 6温度。该女子要求率在测试过程中的刺激疼痛为0，10，20和30秒。这30秒的热刺激是在第一次测试的刺激。 </li><li>再次，热电极是从女人的前臂至少5分钟，在这段时间内完成更多的问卷调查和文书可能。 </li><li>热电极是至少5分钟后，再次放置在sAME女人的前臂上的位置。 </li><li>对于测试的最后一部分，DNIC途径将测试用的热水澡调理刺激。在水浴的水是保持在一个恒定的46.5˚C。女人淹没，直到她的整只手（非主导）在手腕上的水，足足有一分钟，一分钟的热电极加热到同样的痛苦- 6温度在过去30秒。对于前30秒，女子要求率每10秒在水浴的手所产生的痛苦感。然后，最后30秒，她问率热电极（40，50和60秒的时间点）所造成的痛苦的感觉。 </li></ol>第4部分：计算DNIC和MTS <ol><li>机械时间总和计算减去疼痛评级后的第一触摸后的第十触摸疼痛评级。 </li><li>要计算一个DNIC得分，过去三年痛苦的评级或无条件测试刺激的最后疼痛评级的平均减去从过去三年痛苦的评级或空调测试刺激的最后疼痛评级的平均，分别为。 </li></ol> 围产后数据 第5部分：配送信息交货，劳动和分娩或剖宫产，产科和新生儿人口统计标准化椎管内麻醉镇痛模式被记录下来。 第6部分：临床疼痛评分和止痛药收集过程中的阵痛和分娩，12，24和48小时手术后的时间在11点的数值疼痛量表疼痛评级。对于预定的剖宫产的妇女，疼痛评分记录的切口，在婴儿出生时，放置时间皮肤的订书钉或缝线。手术后，切口周围疼痛的评分记录，休息时，坐在和一般从她的子宫痉挛。 记录的时间点，任何阿片类药物，对乙酰氨基酚和非甾体抗炎消耗了产后0至48小时的手术后疼痛的药物剂量。硬膜外麻醉效果的持续时间有关的信息被记录下来。 第7部分：血液样本 DNA提取外周血（EDTA真空采血管，3毫升）。 剖宫产分娩后 第8部分：48小时伤口的痛觉过敏<ol><li>动态和静态的痛觉过敏是剖宫产后48小时内评估。 </li><li>首先，根据Stubhaug等描述的方法，动态的手术切口周围点状的机械刺激痛觉过敏的面积测量周围的疤痕。 （1997年）。简言之，一个180克冯弗雷长丝的刺激开始，以外的hyperalgesic地方没有疼痛的感觉是有经验的和移动向切口，直到女人报告一个明显的变化感知。第一点是一个痛苦，疼痛，或尖锐的感觉似乎是显着，切口的距离来衡量。如果没有感觉的变化出现，刺激停止在0.5厘米的切口。继发性痛觉过敏的面积是由沿径向线测试相隔2.5厘米左右的切口。翻译到方格纸上的意见，表面上是痛觉点除以厘米长的切口厘米的切口距离的总和计算。 </li><li>接下来，机械的静态的点状刺激的痛阈值，使用电子冯弗雷设备进行评估。简单地说，妇女被指示在操作过程中关闭自己的眼睛。一个电子冯弗雷长丝适用于皮肤上的指定点（1厘米以上腹部切口）和应用程序是由至少30秒分开。触觉痛阈值被定义为最小的力量（2克/毫米），是痛苦的感知。三次测定每个评估和计算，平均。 </li></ol>长期跟进方法：2，6和12个月的疼痛问卷第9部分：通过电话访问2，6及产后12个月的后续疼痛问卷最后，研究人员呼吁科目2，6和12个月后，她的剖宫产管理短期McGill疼痛问卷2和一个定制的问卷调查，评估手术后的疼痛经验。此接受电话采访时通常不超过5分钟。 第10部分：代表结果迄今为止，我们在75名妇女进行术前MTS和DNIC（在巴西和N，N = 38 = 37 UWMC西雅图）。图1显示了公关的图形表示E -剖宫产DNIC得分。 <img src="/files/ftp_upload/1671/1671fig2.jpg" alt="图1" /> 图1。DNIC比分定在巴西和北美的妇女选修剖宫产分娩。高效内源性镇痛代表积极DNIC评分（0至+5）。缺乏内源性镇痛代表负DNIC评分（0至-5）。 <img src="/files/ftp_upload/1671/1671fig3.jpg" alt="图2" /> 图2：手术前DNIC得分/ MTS和48h伤口的痛觉过敏之间的相关性。

<ol>
	<li>Eisenach, J. C., Pan, P. H., Smiley, R., Lavand'homme, P., Landau, R., Houle, T. T. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Severity+of+acute+pain+after+childbirth,+but+not+type+of+delivery,+predicts+persistent+pain+and+postpartum.">Severity of acute pain after childbirth, but not type of delivery, predicts persistent pain and postpartum.</a> Pain. 140, 87-94 (2008).</li><li>Kehlet, H., Jensen, T. S., Woolf, C. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Persistent+postsurgical+pain:+risk+factors+and+prevention.">Persistent postsurgical pain: risk factors and prevention.</a> Lancet. 367, 1618-1625 (2006).</li><li>Ecker, J. L., Frigoletto, F. D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Cesarean+delivery+and+the+risk-benefit+calculus.">Cesarean delivery and the risk-benefit calculus.</a> N Engl J Med. 356, 885-888 (2007).</li><li>Carvalho, B., Cohen, S. E., Lipman, S. S., Fuller, A., Mathusamy, A. D., Macario, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Patient+preferences+for+anesthesia+outcomes+associated+with+cesarean+delivery.">Patient preferences for anesthesia outcomes associated with cesarean delivery.</a> Anesth Analg. 101, 1182-1187 (2005).</li><li>Yarnitsky, D., Crispel, Y., Eisenberg, E., Granovsky, Y., Ben-Nun, A., Sprecher, E., Best, L. A., Granot, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Prediction+of+chronic+post-operative+pain:+pre-operative+DNIC+testing+identifies+patients+at+risk.">Prediction of chronic post-operative pain: pre-operative DNIC testing identifies patients at risk.</a> Pain. 138, 22-28 (2008).</li></ol>

初步数据显示，MTS和DNIC可能具有更大的剖宫产后痛觉过敏相关。如果手术前的MTS，DNIC，基因检测和心理问卷可以预测个体易感性，发展严重的手术后的疼痛和持续性疼痛，患者可分层不同的高危人群。作为回报，可能有不同的治疗方法，包括先发制人多式联运镇痛每个患者不同的结果。 <img src="/files/ftp_upload/1671/1671fig1.jpg" alt="图3" /> 图3。手术后的疼痛（PPOP项目）的预测。

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an experimental paradigm for the prediction of post-operative pain (ppop)

许多妇女接受剖腹产没有问题，但是一些经验剖宫产术后疼痛明显。疼痛是与对母亲的短期和长期的负面效果。此前接受手术的妇女，我们可以预测谁是风险发展显着的术后疼痛，并可能防止或尽量减少其消极后果？这些的，一队来自华盛顿大学，斯坦福大学，天主教大学在布鲁塞尔，比利时，巴西圣保罗圣诞老人Joana妇女的医院，和Rambam医疗中心在以色列是目前一个国际科研合作，评估的基本问题。该项目的最终目标是提供期间和之后，剖宫产手术后出现更多的“易感”疼痛的妇女提供个性化的麻醉护理的最佳缓解疼痛。 相当数量的妇女经验中度或重度急性疼痛产后阴道和剖宫产分娩后1此外，剖宫产术后10-15％的妇女患有慢性迁延性疼痛。随着剖宫产率的不断增加， 在美国3和2在巴西率已经很高，这势必造成一个重大的公共卫生问题。当讯问期间和之后，妇女的恐惧和剖宫产节，痛苦的期望，是他们最关心的。4阴道或手术交付后的疼痛程度的个体变异是由包括对疼痛的敏感性，心理因素，年龄，和遗传学多种因素的影响。独特的生产经验，导致止痛药不可预知的要求，从“根本没有”到“甚高”的止痛药剂量。剖宫产术后疼痛是一个很好的模型来研究手术后的疼痛，因为它是在其他年轻和健康的的妇女进行的。因此，建议削弱在急性期的疼痛，因为这可能会导致慢性疼痛疾病。发展的持续性疼痛的影响是巨大的，因为它可能会损害不仅是妇女的能力照顾自己的孩子在产后立即期间，还自己一个相当长的时间时期。 在一系列项目中，一个国际研究网络目前正在调查妊娠对痛觉调制和方法来预测他们将遭受急性剧烈疼痛和潜在的慢性疼痛，通过使用简单的疼痛与遗传分析测试和问卷结合的效果。一个相对较新的方法，调查痛觉调制是通过心理物理测量弥漫有毒抑制控制（DNIC）。这种疼痛调节过程是众所周知的现象“痛抑制疼痛从身体的偏远地区的神经生理学基础。 DNIC范式最近已经演变成一个临床工具和简单的测试，并已被证明是由于怀孕的预测手术后的疼痛。疼痛的敏感性下降和/或增强痛觉调制过程相关联，使用测试，调查疼痛调制应该提供一个更好地了解和参与的途径与怀孕引起的镇痛，可能有助于预测劳动和分娩时的痛苦结局。对于那些提供剖宫产的妇女，DNIC测试与心理问卷调查和遗传测试之前进行手术，应使一个确定妇女容易患上严重，剖宫产后的疼痛和持续性疼痛。这些临床试验应该让麻醉医师不仅提供个性化的医药妇女的承诺，改善福利和满意度，同时也减少围手术期及长期护理由于疼痛和痛苦的整体成本。在规模较大，这些试验探索痛觉调制的可能成为床头的筛选试验，以预测手术后疼痛疾病的发展。

Watch this Scientific Journal Video about An Experimental Paradigm for the Prediction of Post-Operative Pain PPOP at JoVE.com

An Experimental Paradigm for the Prediction of Post-Operative Pain PPOP

弥漫有毒抑制控制，时间总和和伤口的痛觉过敏测试，证明在产科病人。这些测试评估的抑制和兴奋的疼痛处理机制，并在这里利用不同的时间点，在怀孕期间和围产期的期间，以帮助揭示个人为持续性疼痛的风险评估内源性镇痛。

用于预测手术后的疼痛的实验范式（PPOP）

Many women undergo cesarean delivery without problems, however some experience significant pain after cesarean section. Pain is associated with negative ...

an-experimental-paradigm-for-prediction-post-operative-pain

Research

JoVE Journal

Medicine

An Experimental Paradigm for the Prediction of Post-Operative Pain (PPOP)

21.2K 次观看.  University of Washington School of Medicine. 弥漫有毒抑制控制，时间总和和伤口的痛觉过敏测试，证明在产科病人。这些测试评估的抑制和兴奋的疼痛处理机制，并在这里利用不同的时间点，在怀孕期间和围产期的期间，以帮助揭示个人为持续性疼痛的风险评估内源性镇痛。

视频: An Experimental Paradigm for the Prediction of Post-Operative Pain PPOP

Intraoperative Detection of Subtle Endometriosis: A Novel Paradigm for Detection and Treatment of Pelvic Pain Associated with the Loss of Peritoneal Integrity

Endometriosis is a common disease affecting 40 to 70% of reproductive-aged women with chronic pelvic pain (CPP) and/or infertility. The purpose of this study was to demonstrate the use of a blue dye (methylene blue) to stain peritoneal surfaces during laparoscopy (L/S) to detect the loss of peritoneal integrity in patients with pelvic pain and suspected endometriosis. Forty women with CPP and 5 women without pain were evaluated in this pilot study. During L/S, concentrated dye was sprayed onto peritoneal surfaces, then aspirated and rinsed with Lactated Ringers solution. Areas of localized dye uptake were evaluated for the presence of visible endometriotic lesions. Areas of intense peritoneal staining were resected and some fixed in 2.5% buffered gluteraldehyde and examined by scanning (SEM) electron microscopy. Blue dye uptake was more common in women with endometriosis and chronic pelvic pain than controls (85% vs. 40%). Resection of the blue stained areas revealed endometriosis by SEM and loss of peritoneal cell-cell contact compared to normal, non-staining peritoneum. Affected peritoneum was associated with visible endometriotic implants in most but not all patients. Subjective pain relief was reported in 80% of subjects. Based on scanning electron microscopy, we conclude that endometrial cells extend well beyond visible implants of endometriosis and appear to disrupt the underlying mesothelium. Subtle lesions of endometriosis could therefore cause pelvic pain by disruption of peritoneal integrity, allowing menstrual or ovulatory blood and associated pain factors access to underlying sensory nerves. Complete resection of affected peritoneum may provide a better long-term treatment for endometriosis and CPP. This simple technique appears to improve detection of subtle or near invisible endometriosis in women with CPP and minimal visual findings at L/S and may serve to elevate diagnostic accuracy for endometriosis at laparoscopy.

Loss of peritoneal integrity provides a new paradigm to understand and treat chronic pelvic pain in women with mild forms of endometriosis and can be easily detected using intraoperative instillation of dye at the time of laparoscopy.

术中的微妙的子宫内膜异位症的检测：A新型范式为相关联的与的的腹膜的完整性之亏损盆腔疼痛的的的的检测和治疗的

Endometriosis is a  common disease affecting 40 to 70% of reproductive-aged women with chronic  pelvic pain (CPP) and/or infertility. The purpose of this ...

科研

医学

An Ex vivo Model to Study Hormone Action in the Human Breast

The study of hormone action in the human breast has been hampered by lack of adequate model systems. Upon in vitro culture, primary mammary epithelial cells tend to lose hormone receptor expression. Widely used hormone receptor positive breast cancer cell lines are of limited relevance to the in vivo situation. Here, we describe an ex vivo model to study hormone action in the human breast. Fresh human breast tissue specimens from surgical discard material such as reduction mammoplasties or mammectomies are mechanically and enzymatically digested to obtain tissue fragments containing ducts and lobules and multiple stromal cell types. These tissue microstructures kept in basal medium without growth factors preserve their intercellular contacts, the tissue architecture, and remain hormone responsive for several days. They are readily processed for RNA and protein extraction, histological analysis or stored in freezing medium. Fluorescence activated cell sorting (FACS) can be used to enrich for specific cell populations. This protocol provides a straightforward, standard approach for translational studies with highly complex, varied human specimens.

An Ex vivo Model to Study Hormone Action in the Human Breast

We have developed a novel ex vivo model to study hormone action in the human breast. It is based on tissue microstructures isolated from surgical breast tissue specimens which preserve tissue architecture, intercellular interactions, and paracrine signaling.

一个<em&gt;体外</em&gt;模型在乳腺癌研究激素的作用

The study of hormone action in the human breast has been hampered by lack of adequate model systems. Upon in vitro culture, primary mammary epithelial ...

The Monoiodoacetate Model of Osteoarthritis Pain in the Mouse

A major symptom of patients with osteoarthritis (OA) is pain that&#160;is triggered by peripheral as well as central changes within the pain pathways. The current treatments for OA pain such as NSAIDS or opiates are neither sufficiently effective nor devoid of detrimental side effects. Animal models of OA are being developed to improve our understanding of OA-related pain mechanisms and define novel pharmacological targets for therapy. Currently available models of OA in rodents include surgical and chemical interventions into one knee joint. The monoiodoacetate (MIA) model has become a standard for modelling joint disruption in OA in both rats and mice. The model, which is easier to perform in the rat, involves injection of MIA into a knee joint that induces rapid pain-like responses in the ipsilateral limb, the level of which can be controlled by injection of different doses. Intra-articular injection of MIA disrupts chondrocyte glycolysis by inhibiting glyceraldehyde-3-phosphatase dehydrogenase and results in chondrocyte death, neovascularization, subchondral bone necrosis and collapse, as well as inflammation. The morphological changes of the articular cartilage and bone disruption are reflective of some aspects of patient pathology. Along with joint damage, MIA injection induces referred mechanical sensitivity in the ipsilateral hind paw and weight bearing deficits that are measurable and quantifiable. These behavioral changes resemble some of the symptoms reported by the patient population, thereby validating the MIA injection in the knee as a useful and relevant pre-clinical model of OA pain.
The aim of this article is to describe the methodology of intra-articular injections of MIA and the behavioral recordings of the associated development of hypersensitivity with a mind to highlight the necessary steps to give consistent and reliable recordings.

Osteoarthritis (OA), or degenerative joint disease, is a debilitating condition associated with pain that remains only partially controlled by available analgesics. Animal models are being developed to improve our understanding of OA-related pain mechanisms. Here we describe the methodology for the monoiodoacetate model of OA pain in the mouse.

骨关节炎疼痛的鼠标Monoiodoacetate模式

A major symptom of patients with osteoarthritis (OA) is pain that&#160;is triggered by peripheral as well as central changes within the pain pathways. The ...

An Improved Method for Rapid Intubation of the Trachea in Mice

Despite some anatomical and physiological differences, mouse models continue to be an essential tool for studying human lung disease. Bleomycin toxicity is a commonly used model to study both acute lung injury and fibrosis, and multiple methods have been developed for administering bleomycin (and other toxic agents) into the lungs. However, many of these approaches, such as transtracheal instillation, have inherent drawbacks, including the need for strong anesthetics and survival surgery. This paper reports a quick, reproducible method of intratracheal intubation that involves mild inhaled anesthesia, visualization of the trachea, and the use of a surrogate spirometer to confirm exposure. As a proof of concept, 8-12 week old C57BL/6 mice were administered either 2.0 U/kg of bleomycin or an equivalent volume of PBS, and both damage and fibrotic endpoints were measured post-exposure. This procedure allows researchers to treat a large cohort of mice in a relatively short period with little expense and minimal post-procedure care.

This article presents a rapid and simple method for administering bleomycin directly into the mouse trachea via intubation. Key advantages of this method are that it is highly reproducible, easy to master, and does not require specialized equipment or lengthy recovery times.

在小鼠气管插管快速的改进方法

Despite some anatomical and physiological differences, mouse models continue to be an essential tool for studying human lung disease. Bleomycin toxicity ...

Analyzing Beneficial Effects of Nutritional Supplements on Intestinal Epithelial Barrier Functions During Experimental Colitis

Inflammatory bowel diseases (IBD), including Crohn&#39;s disease and ulcerative colitis, are chronic relapsing disorders of the intestines. They cause severe problems, such as abdominal cramping, bloody diarrhea, and weight loss, in affected individuals. Unfortunately, there is no cure yet, and treatments only aim to alleviate symptoms. Current treatments include anti-inflammatory and immunosuppressive drugs that may cause severe side effects. This warrants the search for alternative treatment options, such as nutritional supplements, that do not cause side effects. Before their application in clinical studies, such compounds must be rigorously tested for effectiveness and security in animal models. A reliable experimental model is the dextran sulfate sodium (DSS) colitis model in mice, which reproduces many of the clinical signs of ulcerative colitis in humans. We recently applied this model to test the beneficial effects of a nutritional supplement containing vitamins C and E, L-arginine, and &#969;3-polyunsaturated fatty acids (PUFA). We analyzed various disease parameters and found that this supplement was able to ameliorate edema formation, tissue damage, leukocyte infiltration, oxidative stress, and the production of pro-inflammatory cytokines, leading to an overall improvement in the disease activity index. In this article, we explain in detail the correct application of nutritional supplements using the DSS colitis model in C57Bl/6 mice, as well as how disease parameters such as histology, oxidative stress, and inflammation are assessed. Analyzing the beneficial effects of different diet supplements may then eventually open new avenues for the development of alternative treatment strategies that alleviate IBD symptoms and/or that prolong the phases of remission without causing severe side effects.

Current treatments of inflammatory bowel diseases (IBD) aim at alleviating disease symptoms but may cause severe side effects. Thus, alternative strategies are being investigated in animal colitis models. Here, we explain how the beneficial effects of diet supplements on clinical IBD signs are analyzed in such a colitis model.

分析营养补充剂的有益作用于肠上皮屏障功能在实验性结肠炎

Inflammatory bowel diseases (IBD), including Crohn&#39;s disease and ulcerative colitis, are chronic relapsing disorders of the intestines. They cause ...

A Quantitative Sensory Testing Paradigm to Obtain Measures of Pain Processing in Patients Undergoing Breast Cancer Surgery

Chronic pain following surgery, persistent postsurgical pain, is an important highly prevalent condition contributing to significant symptom burden and lower quality of life. Persistent postsurgical pain is relatively refractory to treatment hence generating a high need for preventive strategies and treatments. Therefore, the identification of patients at risk of developing persistent pain is an area of active ongoing research. Recently it was demonstrated that peri-operative disruptions in central pain processing may be able to predict persistent postsurgical pain at long term follow-up in breast cancer patients. The aim of the current report is to present a short protocol to obtain pain thresholds to different stimuli at multiple sites and a measure of endogenous analgesia in breast cancer patients. We have used this method successfully in a clinical context and detail some representative results from a clinical study.

Persistent postsurgical pain may be related to changes in pain processing. By assessing pain in response to standardized stimuli, changes in pain processing can be elucidated. We present methods to obtain pain thresholds to different stimuli and a measure of endogenous analgesia in patients undergoing breast cancer surgery.

一种定量感官检测方法在乳腺癌手术患者疼痛处理中的研究

Chronic pain following surgery, persistent postsurgical pain, is an important highly prevalent condition contributing to significant symptom burden and ...

Assessment of Static Graviceptive Perception in the Roll-Plane using the Subjective Visual Vertical Paradigm

Vestibular disorders are among the most common syndromes in medicine. In recent years, new vestibular diagnostic systems have been introduced that allow the examination of all semicircular canals in the clinical setting. Assessment methods of the otolithic system, which is responsible for the perception of linear acceleration and perception of gravity, are far less in clinical use. There are several experimental approaches for measuring the perception of gravity. The most frequently used method is the determination of the subjective visual vertical. This is usually measured with the head in an upright position. We present here an assessment method for testing otolith function in the roll plane. The subjective visual vertical is measured in the head upright position as well as with head inclination of &#177; 15&#176; and &#177; 30&#176; in the roll plane. This extended functional paradigm is an easy-to-perform clinical test of otolith function and ensures increased information content for the detection of impaired graviceptive perception.

The perception of gravity is commonly determined by the subjective visual vertical in the head upright position. The additional assessment at head tilts of &#177; 15&#176; and &#177; 30&#176; in the roll plane ensures increased information content for the detection of impaired graviceptive perception.

使用主观视觉垂直范式对卷平面中的静态视觉感知的评估

Vestibular disorders are among the most common syndromes in medicine. In recent years, new vestibular diagnostic systems have been introduced that allow ...

Network Pharmacology Prediction and Experimental Validation of Trichosanthes-Fritillaria thunbergii Action Mechanism Against Lung Adenocarcinoma

We aimed to study the mechanism of Trichosanthes-Fritillaria thunbergii in treating lung adenocarcinoma (LUAD) based on network pharmacology and experimental verification. The effective components and potential targets of Trichosanthis and Fritillaria thunbergii were collected by high-throughput experiment and reference-guided (HERB) database of traditional Chinese medicine and a similarity ensemble approach (SEA) database, and the LUAD-related targets were queried by the GeneCards and Online Mendelian Inheritance in Man (OMIM) databases. A drug-component-disease-target network was constructed by Cytoscape software. Protein-protein interaction (PPI) network, gene ontology (GO) function, and Kyoto encyclopedia of genes and genomes (KEGG) pathway enrichment analyses were conducted to obtain core targets and key pathways. An aqueous extract of Trichosanthes-Fritillaria thunbergii and A549 cells were used for the subsequent experimental validation. Through the HERB database and literature search, 31 effective compounds and 157 potential target genes of Trichosanthes-Fritillaria thunbergii were screened, of which 144 were regulatory targets of Trichosanthes-Fritillaria thunbergii in the treatment of lung adenocarcinoma. The GO functional enrichment analysis showed that the mechanism of action of Trichosanthes-Fritillaria thunbergii against lung adenocarcinoma is mainly protein phosphorylation. The KEGG pathway enrichment analysis suggested that the treatment of lung adenocarcinoma by Trichosanthes-Fritillaria thunbergii mainly involves the PI3K/AKT signaling pathway. The experimental validation showed that an aqueous extract of Trichosanthes-Fritillaria thunbergii could inhibit the proliferation of A549 cells and the phosphorylation of AKT. Through network pharmacology and experimental validation, it was verified that the PI3K/AKT signaling pathway plays a vital role in the action of Trichosanthes-Fritillaria thunbergii in treating lung adenocarcinoma.

Network Pharmacology Prediction and Experimental Validation of Trichosanthes-Fritillaria thunbergii Action Mechanism Against Lung Adenocarcinoma

This study reveals the mechanism of Trichosanthes-Fritillaria thunbergii in treating lung adenocarcinoma based on network pharmacology and experimental verification. The study also demonstrates that the PI3K/AKT signaling pathway plays a vital role in the action of Trichosanthes-Fritillaria thunbergii in treating lung adenocarcinoma.

毛滴虫对肺腺癌作用机制的网络药理学预测及实验验证

We aimed to study the mechanism of Trichosanthes-Fritillaria thunbergii in treating lung adenocarcinoma (LUAD) based on network pharmacology and ...

肝脏硬度分布的定量分析

A Three-Dimensional Digital Model for Early Diagnosis of Hepatic Fibrosis Based on Magnetic Resonance Elastography

Hepatic fibrosis is an early stage of liver cirrhosis, and there are no better non-invasive and convenient methods for the detection and evaluation of the disease. Despite the good progress made with the liver stiffness map (LSM) based on magnetic resonance elastography (MRE), there are still some limitations that need to be overcome, including manual focus determination, manual selection of regions of interest (ROIs), and discontinuous LSM data without structural information, which makes it impossible to evaluate the liver as a whole. In this study, we propose a novel three-dimensional (3D) digital model for the early diagnosis of hepatic fibrosis based on MRE.
MRE is a non-invasive imaging technique that employs magnetic resonance imaging (MRI) to measure the liver stiffness at the scanning site through human-computer interaction. Studies have indicated a significant positive correlation between the LSM obtained through MRE and the degree of hepatic fibrosis. However, for clinical purposes, a comprehensive and precise quantification of the degree of hepatic fibrosis is necessary. To address this, the concept of Liver Stiffness Distribution (LSD) was proposed in this study, which refers to the 3D stiffness volume of each liver voxel obtained by the alignment of 3D liver tissue images and MRE indicators. This provides a more effective clinical tool for the diagnosis and treatment of hepatic fibrosis.

作者聚焦：使用磁共振弹性成像和 AI 推进肝纤维化诊断 

The objective of this study was to develop a novel three-dimensional digital model for the early diagnosis of hepatic fibrosis, which includes the stiffness of each voxel in the patient's liver and can thus, be used to calculate the distribution ratio of the patient's liver at different fibrosis stages.

基于磁共振弹性成像的肝纤维化早期诊断三维数字模型

Hepatic fibrosis is an early stage of liver cirrhosis, and there are no better non-invasive and convenient methods for the detection and evaluation of the ...