Chinese Med J Peking
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Chinese Med J Peking · Nov 2013
Suppressing SNAP-25 and reversing glial glutamate transporters relieves neuropathic pain in rats by ameliorating imbalanced neurotransmission.
Neuropathic pain results from a lesion or disease affecting the somatosensory system at either the peripheral or central level. The transmission of nociception within the central nervous system is subject to modulation by release and reuptake of neurotransmitters, which maintain a dynamic balance through the assembly and disassembly of the SNARE complex as well as a series of neurotransmitter transporters (inhibitory GABA transporters GAT and excitatory glutamate transporters GT). Neuronal hyper-excitability or defected inhibition involved in neuropathic pain is one of the outcomes caused by imbalanced neurotransmission. SNAP-25, which is one of the SNARE complexes, can modulate the release of neurotransmitters. Glia glutamate transporter (GLT) is one of the two glutamate transporters which account for most synaptic glutamate uptake in the CNS. The role of SNAP-25 and GLT as well as GAT is not clearly understood. ⋯ SNAP-25 and GLT play important roles in the development of neuropathic pain, and the mechanism may involve the imbalance of neurotransmission after peripheral nerve injury. Intrathecal administration of BoNT/A reversed the upregulation of SNAP-25 and downregulation of GLT after CCI, but had no significant effect on the expression of GAT-1.
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Chinese Med J Peking · Oct 2013
Meta AnalysisComparison of unipedicular and bipedicular percutaneous kyphoplasty for treating osteoporotic vertebral compression fractures: a meta-analysis.
Percutaneous vertebroplasty (PKP) has proved its effectiveness regarding minimal invasion, rapid pain reduction, safe cement augmentation, restoring vertebral height, and accelerating complete recovery of osteoporotic vertebral compression fractures (OVCFs). Whether unipedicular or bipedicular PKP provides a better outcome is controversial. ⋯ This meta-analysis comparing unipedicular and bipedicular PKP demonstrated no significant differences regarding VAS, ODI, radiographic outcomes, or complications. Considering the longer operation time and radiation exposure with bipedicular PKP, we recommend unipedicular PKP over bipedicular PKP for treating OVCFs.
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Chinese Med J Peking · Oct 2013
Meta AnalysisComparing minimally invasive and open transforaminal lumbar interbody fusion for treatment of degenerative lumbar disease: a meta-analysis.
Transforaminal lumbar interbody fusion (TLIF) through a minimally invasive approach (mTLIF) was introduced to reduce soft tissue injury and speed recovery. Studies with small numbers of patients have been carried out, comparing mTLIF with traditional open TLIF (oTLIF), but inconsistent outcomes were reported. ⋯ Current evidence suggests that, compared with traditional open surgery, mTLIF reduces blood loss and allows early postoperative recovery, while achieving comparable or slightly better long-term outcomes, and with a comparable risk of complications.
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Chinese Med J Peking · Oct 2013
Randomized Controlled TrialEfficacy of multimodal cocktail periarticular injection with or without steroid in total knee arthroplasty.
Multimodal cocktail periarticular injection (MCPI) with a large volume of low concentration local anesthetics, adrenaline, and anti-inflammatory agents such as non-steroidal anti-inflammatory drug or steroids have shown good pain control and improvement in range of motion after surgery. This study compares the efficacy of pain control after total knee arthroplasty, using multimodal cocktail periarticular injection with steroid or without steroid. ⋯ The patients who received the steroid injection had faster rehabilitation and less non-steroidal antiinflammatory drugs consumption.
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Chinese Med J Peking · Oct 2013
Hyperbaric oxygen intervention on expression of hypoxia-inducible factor-1α and vascular endothelial growth factor in spinal cord injury models in rats.
Hyperbaric oxygen (HBO) intervention is a main therapeutic method and the curative effect has been certified for spinal cord injury (SCI), but the mechanisms of the neuroprotective effect of HBO on SCI remain elusive. This study aimed to observe the change in expression of hypoxia-inducible factor-1α (HIF-1α) and vascular endothelial growth factor (VEGF) after SCI at different time points and to investigate the neuroprotective mechanism of HBO on SCI in rats. ⋯ HBO could improve the hind limb functional recovery after SCI in rats. The elevation and duration of the expression of VEGF and the reduction of expression of HIF-1α by HBO intervention may be inversely related in the repair of damaged spinal cord and neuroprotective effect.