Objective To observe the effect of buprenorphine transdermal patch combined with gabapentin in patients with diabetic peripheral neuralgia (DPN).Methods Sixty patients were divided randomly into experimental (A) and control (B) groups.Patients in group A were treated with buprenorphine transdermal patch combined gabapentin.Patients in group B were orally administered pregabalin only.The period of treatment was 8 weeks.The analgesic effect [visual analogue scale (VAS) scores] , sleep scores, daily doses of gabapentin, and adverse reactions were evaluated before treatment, and the 2nd weeks, 4th weeks and 8th weeks after treatment.Results The VAS scores of group A were significantly lower than group B at 4th weeks and 8th weeks after treatment [(2.8 ± 1.6) points vs (3.8 ± 1.5) points,(2.6 ± 0.5) points vs (3.5 ± 1.6) points, P ＜ 0.05].The sleep scores of group A were significantly higher than group B (P ＜ 0.01).The daily doses of gabapentin were significantly lower [(853.0 ± 349.8) mg vs (1575.8 ± 351.0) mg, (845.1 ± 342.7) mg vs (1434.2 ± 440.8) mg, (826.9 ± 298.5) mg vs (1389.8 ±356.6)mg, P ＜ 0.05].The incidence of adverse reactions was significantly lower in group A (10.7％ vs 25.9％ , 10.7％ vs 29.6％ , P ＜ 0.05).Conclusions The combination of buprenorphine transdermal patch and gabapentin is effective and safe for the patients with DPN.

Objective To investigate the therapeutic efficacy and safety of stellate ganglion block (SGB) with ropivacaine to treat Renault's disease.Methods Thirty seven patients with Renault's disease were randomly assigned into two groups:the lidocainegroup (L group,18 patients) treated by SGB with 5 ml of 1％ lidocaine,and the Ropivacaine-group (R group,19 patients) treated by SGB with 5 ml of 0.2％ ropivacaine.The efficacy,adverse reactions,and the recurrence after 3 months of two groups were observed and compared.Results The total effective rate of 89.5 ％ in group R was significantly higher that 55.6％ in group L (P ＜ 0.05).There were less times(22 times) presenting no Homers'sign in group R compared to group L (43 times).The incidence of adverse reaction and the recurrence after 3 months in group R were not statistically significantly different form group L (P ＞ 0.05).Conclu-sions SGB with 0.2％ ropivacaine could obtain better efficacy compared to lidocaine,and had a higher security.

Objective To evaluate the clinical effect of computed tomography?guided visceral nerve plexus ethanol neurolysis through post?curs of diaphragm approach in the treatment of patients with pancreatic cancer pain using,and study the safety and life quality improvement of patients . Methods A total of 58 patients suffered from pancreatic cancer pain,who were treated in the department of pain medicine of the First Hospital of China Medical University from October 2013 to December 2014,were recruited for the study. The patients were divided into two groups according to the willing of the patients and their families,group A(32 cases)was treated with Visceral Nerve Plexus ethanol Neurolysis,while group B(26 cas?es)was treated with oral opioid drugs. The analgesic effect,changes in the amount of opioid drugs,changes in the PSQI scores and the improvement of quality of life were evaluated before treatment and 1 day(T1),15 days(T15),30 days(T30),60 days(T60)after treatment. Record the adverse reactions in the course of treatment. Results All the patients of group A successfully received visceral nerve plexus ethanol neurolysis,the VAS scores,Karnofsky scores,and PSQI scores of all the observed time points(after the operation)were statistically different compared to those before treatment and group B. Statistically difference was also observed in quality of life between two groups(P<0.05). The amount of opioid drugs of group B was statistically increased than that of group A(P<0.01).The most common side effects in Group A were postural hypotension(6 cases),diar?rhea(2 cases),and intercostal neuralgia,while nausea(20 cases),constipation(11 cases)and dizziness(8 cases)were seen in the Group B. Con?clusion Visceral nerve plexus ethanol neurolysis through post?curs of diaphragm approach by the guide of CT is effective and safe for the patients with pancreatic cancer pain,and the complications were totally acceptable.

Objective To investigate the value of Q-analysis real-time elasticity in differentiating between benign and malignant thyroid nodules. Methods Eighty-six thyroid nodules in 62 patients with pathologic diagnosis were included in this study and were examined using Q-analysis real-time elasticity. The real-time elasticity features were observed and the quantitative index including the whole elasticity rate and the local elasticity rate were compared between benign and malignant nodules. Results There were 51 benign and 35 malignant nodules according to histopathological examination. The Q-analysis curve of real-time elasticity of benign nodules was smoother and with lower peak, compared with that of malignant nodules. The whole elasticity rate of malignant nodules were significantly higher than that of benign nodules (3.59±0.84 vs 2.32±0.56, P=0.000). And the local elasticity rate of malignant nodules were significantly higher than that of benign nodules (3.96±1.32 vs 2.39±0.58, P=0.000). The cutoff point of whole elasticity rate for the differential diagnosis was 3.25 with sensitivity, specificity and diagnostic accuracy as 71.4%, 96.1% and 86.0% respectively. The cutoff point of local elasticity rate for the differential diagnosis was 3.45 with sensitivity, specificity and diagnostic accuracy as 68.6%, 96.1% and 84.9% respectively. The diagnostic efficiency of whole elasticity rate and local elasticity rate had no significant difference (P=0.591).Conclusions Q-analysis real-time elasticity could provide the real-time elasticity features of thyroid nodules. The whole and local elasticity rate as the quantitative index contributed to the differential diagnosis of benign and malignant thyroid nodules.

Aim To construct a eukaryotic expression vector of human MCHR2 and to analyze the stable expression and signal transduction pathways of MCHR2 in CHO cells. Methods The full-length MCHR2 cDNA fragment was amplified by PCR from the human fetal brain cDNA library and inserted into eukaryotic expres-sion vector pcDNA3.1(+), resulted in the recombinant expression vector pcDNA3.1-MCHR2. The recombinant plasmid was confirmed by the restriction enzymatic digestion and DNA sequencing analysis, and then transfected into CHO cells by lipofectamine. A stably-transfected cell line was obtained by the dominant G418 selection, and the expression of the MCHR2 gene on transcription and translation levels were identified by RT-PCR and Western blot. Signal transduction pathways mediated by MCHR2 were analyzed by measurement of intracellular cAMP and calcium. Results The eukaryotic expression vector pcDNA3.1-MCHR2 was successfully constructed and the MCHR2 gene was stably transfected into CHO cells. A stably-transfected cell line was established and the MCHR2 gene was efficiently transcribed and translated. MCH stimulation had no effect on the production of cAMP, however, it could induce a clear and transient increase of intracellular calcium, suggesting that MCHR2 was only coupled to Gq protein. Conclusion The stable expression of MCHR2 and analysis of its signal transduction pathways in CHO cell line provided a solid experimental foundation for further studies on the function of the MCHR2 gene in vitro.

Objective To investigate the treatment effect of flupirtine maleate on postherpetic trigeminal neuralgia and the subsequent effects on patient quality of life.Methods Forty patients with postherpetic trigeminal neuralgia were selected at our hospital from December 2015 to December 2016,and they were randomized and divided into a control group and an observation group.Patients in the control group were treated with gabapentin and oxycodone-acetaminophen,and the patients in the observation group were treated with flupirtine maleate on the basis of the control group.Visual analogue scale (VAS) scores,quality of life scores (SF-36 scale),and clinical effective rate were compared between the two groups before and after treatment.Results There was a significant decrease (P ＜ 0.05) in the VAS scores of the two groups after treatment when compared to those before treatment.The VAS score of the patients in the observation group was significantly lower than that of the patients in the control group (P ＜ 0.05).The scores for each dimension in the observation group were significantly higher than those in the control group (P ＜ 0.05).Conclusion When combined with the basic conventional treatment,flupirtine maleate can effectively improve the treatment effects in postherpetic trigeminal neuralgia and effectively relieve pain,thereby improving the quality of life.