Objective To investigate the effects of paravertebral injection of different concentrations of adriamycin on motor conduction function in rats. Methods Eighty healthy male Wistar rats weighing 250-300 gwere randomly divided into 4 groups (n = 20 each): 3 adriamycin groups receiving paravertebral injection of 0.3%, 0.5% and 1.0% adriamycin 10 μl respectively (group A1, A2, A3) and control group (group C)receiving equal volume of normal saline (NS) instead of adriamycin. The animals were anesthetized with intraperitoneal 3% pentobarbital 40 mg/kg. A right paramedian incision was made in the back from L3 to S1.L4,5,5,6 intervertebral foramina were exposed. 0.3%, 0.5% and 1.0% adriamycin and NS 10 pl were injected into the intervertebral foramina in group A1, A2, A3 and C respectively. Spinal motor evoked pontential (SMEP)was measured at 1, 2, 4 and 8 weeks (T1-4)after paravertebral injection. Results The latent period of SMEP was significantly prolonged and the amplitude decreased at T1-4 in group A3 as compared with group A1, A2 and C.Conclusion Paravertebral injection of 1.0% adriamycin can significantly depress motor conduction function.

Objective To systematically review the efficacy of pregabalin in patients with post-herpetic neuralgia.Methods A comprehensive search was undertaken to identify all randomized placebo-controlled trials of pregabalin in patients with post-herpetic neuralgia.Medline,Web of Science,Cochrane Library,Wanfang Database and CNKI were searched from January 1966 up to December 2008.The modified Jadad scale was used for quality assessment.Numerical rating scale ( NRS),effective analgesia rate and the incidence of adverse effects were taken as main outcomes.Meta-analysis was conducted using the Cochrane Collaboration Review Manager 4.2 software.Results A total of four studies involving 1024 patients were included in this meta-analysis.The modified Jadad scale scores for the 4 studies were ≥ 4.The NRS scores were significantly lower,while effective analgesia rate was higher in groups 150,300,600 mg/d than placebo-controlled group (P ＜ 0.05).There were no significant differences in NRS scores and effective analgesia rate between 150 mg/d and 300 mg/d groups.The NRS scores were significantly lower in 600 mg/d group than in 300 mg/d group,but there were no significant differences in effective analgesia rate between 600 mg/d and 300 mg/d groups.The most frequent adverse effects were dizziness,somnolence,peripheral edema,and headache.Most of the adverse effects were mild or moderate in intensity.The occurrence of adverse effects appeared to be dose-related.Conclusion Pregabalin is effective and safe in patients with post-herpetic neuralgia,but the efficacy of reducing pain is not a dose-dependent manner.

Objective To investigate the efficacy of adriamycin injection around trigeminal ganglion via foramen ovale for treatment of trigeminal neuralgia under the guidance of X-ray and neurostimulator.Methods 0.5% adriamycin 0.5 ml was injected into foramen ovale under the guidance of X-ray and neurostimulator in 78 patients with primary trigeminal neuralgia.Correct location of needle tip wax confirmed by lidocaine injection.THe patients were followed up for 24 months after adriamycin injection.The rate of effectiveness,excellent/good rate,compile remission rate and recurence rate were calculated.The complications were observed.Results On the day of treatment,and at 7 days and 1,6,12,24 months after treatment,the complete remission rate was 21%,18%,51%,45%,43%,and 39%respectively,the excellent/good rate 42%,41%,68%,65%,62%,and 54%respectively,and the rate of effectiveness 76%,82%,92%,91%,78%,and 70%respectivdy.The recurrence rate was 3%,20%and 35%at 6,12 and 24 months after treatment respectively.Facial numbness developed in 17 patients and disappeared after 8-12 months.No severe complication occurred.Conclusion Adriamycin injection around trigeminal ganglion via foramen ovale under the guidance of X-ray and neuronstimulator for treatment of trigeminal neuralgia is effective and safe.

Objective To evaluate the histologic changes of dorsal root ganglion (DRG) and pain threshold following implantation of iodine-125(125I) seeds in the lumbar intervertebral foramina in rats.Methods Thirtysix adult male SD rats aged 6 months weighing 220-250 g were randomly assigned into 3 groups (n =12 each):group sham operation (group A) and groups low and high radioactive 125I seeds (groups B and C).125I seeds of 0.4 and 0.8 mCi were implanted in L4,5 and L5,6 intervertebral foramina in groups B and C respectively.Paw withdrawal threshold to von Frey filament stimulation (MWT) and paw withdrawal latency to thermal nociceptive stimuli (TWL) were measured 2 days before (T1,baseline) and at 2,7,14,30 and 60 days after implantation (T2-6) in 6 animals in each group.The remaining 6 animals in each group were sacrificed at 14 and 60 days after 125I seeds implantation for microscopic examination of L5 DRG.Results MWT and TWL were significantly decreased after 125I seeds implantation at T4 compared with the baseline values at T1 in both groups,and returned to the baseline in group B and were significantly increased in group C at T6.The neurons were severely injured in DRG in groups B and C in a time-and dose-dependent manner.Conclusion Implantation of 125I seeds in intervertebral foramen can induce radiation resection of DRG.

Objective To evaluate the efficacy of destruction of dorsal root ganglia with local doxorubicin injection guided by CT for postherpetic neuralgia involving thoracic back region. Methods One hundred and fifty patients suffering from postherpetic neuralgia in thoracic back region were randomly divided into 3 groups ( n = 50 each): group A oral medicine; B and C groups undergoing local injection under the guidance of C-arm and CT respectively + oral medicine. Three spinal segments severely affected by herpes virus were chosen for paravertebral puncture. 1% lidocaine 1 ml was injected at each segment as test dose. Fifteen minutes later doxorubicin 3.3 mg and betamethasone compound 4.7 mg were injected at each segment if no side-effect occurred. All 3 groups were given oral medicine according to the intensity of pain after local injection. The number of patients who exited from the study because of the side effects of oral medicine was recorded. VAS, sleep interference score (SIS) and a short form of McGill pain questionnaire (SF-MPQ) were used to evaluate the efficacy of the treatment the day before (baseline), 24 h, 1 week, 1, 3 and 6 months after local injection. The dosage of oxycodone extended-release tablets and gabapentin was recorded, and also the incidence of pneumothorax within 12 h after local injection. Results The exit rate, VAS, SIS and SF-MPQ scores, dosage of oxycodone extended-release tablet and gabapentin were significantly lower in B and C groups than in group A, but there was no significant difference between the 2 groups. The incidence of pneumothorax was 10% in group B but no pneumothorax developed in group C.Conclusion Destruction of dorsal root ganglia with local doxorubicin injection guided by CT is more effective for the treatment of postherpetic neuralgia.

ObjectiveTo investigate the effects of paravertebral injection of doxorubicin on pain behavior and ultrastructure of dorsal root ganglion ( DRG ) neurons in rats with neuropathic pain.MethodsOne hundred male SD rats,aged 3 months,weighing 200-250 g,were studied.The spared nerve injury (SNI) model was established by ligation and separation of tibial and common fibular nerves.The rats were randomly divided into 5 groups ( n =20 each):SNI group and different concentrations of doxorubicin groups (groups A1,A2,A3,A4 ).The animals were anesthetized with intrapetitaneal 10％ chioral hydrate 0.3 ml/100 g.The L4,6 intervertebral foramina was exposed.Normal saline and 0.25％,0.50％,0.75％ and 1.00％ doxorubicin 5 μl were injected into the intervertebral foramina in groups SNI,A1,A2,A3,and A4 respectively.The paw withdrawal latency to the radiant heat stimulation (PWL) and paw withdrawal duration to acetone (PWD) were measured before administration and on day 1-28 after administration.Three rats were chosen in each group on day 28 after administration and DRG were removed to observe the ultrastructure of large and small neurons with electron microscope.ResultsCompared with group SNI,PWL was significantly prolonged and PWD was significantly shortened in groups A1,A2,A3,A4 in a concentration manner ( P ＜ 0.05).Nucleus condensation,mitochondrial swelling,increased lysosomes,chromatin condensation,fibrosis of intercellular substances,and cell necrosis were observed in small neurons.Mitochondrial swelling and increased fibers wcre observed in large neurons and most of large neurons survived.ConclusionParavertebral injection of doxorubicin can reduce neuropathic pain and result in damage to large and small DRG neurons,and small neurons in the DRG are more susceptible and vulnerable to doxorubicin than large neurons in rats.

Objective To evaluate the efficacy of lumbar discectomy,radiofrequency ablation and annuloplusty performed with Disc-FX system under the guidance of C-arm in treatment of discogenic low back pain.Methods Twenty-eight patients with discogenic low back pain,with VAS score greater than 7,aged 27-73 yr,underwent lumbar discectomy,radiofrequency ablation and annuloplusty performed using Disc-FX system under the guidance of C-arm.The patients were followed up for 2 months after surgery and pain was assessed using VAS score.VAS scores were recorded before surgery,and at 7 and 14 days and 1 and 2 months after surgery.The effective analgesia was recorded according to VAS scores.The therapeutic effect was evaluated according to Macnab standard 2 months after surgery.Results VAS scores were significantly lower at each time point after surgery than before surgery (P ＜ 0.05).The rate of effective analgesia was 93 % at 2 months after surgery.The excellent and good rate of the therapeutic effect evaluated was 93 %.One female patient developed injury to lumbar venous plexus,and no patients developed infection of intervertebral disk,nerve root injury or spinal cord injury.Conclusion The excellent and good rate is 93 % when lumbar discectomy,radiofrequency ablation and annuloplusty performed using Disc-FX system is used for treatment of discogenic low back pain under the guidance of C-arm,with fewer side effects.

Objective To evaluate the effect of pulsed radiofrequency application to dorsal root ganglions (DRGs) on neuronal Navl.8 expression in a rat model of inflammatory pain.Methods Twenty-four adult male Sprague-Dawley rats,aged 6-8 weeks,weighing 200-250 g,were randomly divided into 4 groups (n =6 each) using a random number table:control group (group C),inflammatory pain group (group IP),pulsed radiofrequency group (group PR),and inflammatory pain + pulsed radiofrequency group (group IP+PR).2.5％ formalin 100 μl was injected into the plantar surface of the right hindpaw to induce inflammatory pain.Pulsed radiofrequency was applied on L4,5 DRGs at 42 ℃ for 180 s starting from 4 days after formalin injection.At 1 day before formalin injection (T0),and 1,3,5 and 7 days after formalin injection (T1-4),the mechanical paw withdrawal threshold (MWT) and thermal paw withdrawal latency (TWL) were measured in the right hindpaw.After the last measurement of pain threshold,the rats were sacrificed,and the DRGs of the L4.5 were removed for determination of Navl.8 mRNA expression (by real-time reverse transcriptase-polymerase chain reaction) and Nav1.8 protein expression (by Western blot).Results Compared with group C,the MWT was significantly decreased,and the TWL was shortened at T1-4,and the expression of Navl.8 protein and mRNA was up-regulated in IP and IP+PR groups (P＜0.05).Compared with group IP,the MWT was significantly increased,and the TWL was prolonged at T1.4,and the expression of Navl.8 protein and mRNA was down-regulated in group IP+PR (P＜0.05).Conclusion The mechanism bv which pulsed radiofrequency application to DRGs reduces inflammatory pain is probably related to down-regulation of neuronal Nav1.8 expression in rats.

Objective To evaluate the effect of hydrogen-rich saline on autophagy in the spinal neurons of rats with neuropathic pain.Methods Sixty pathogen-free male Sprague-Dawley rats,aged 8-l0 weeks,weighing 220-250 g,were randomly assigned into 3 groups (n=20 each) using a random number table:sham operation group (S group),neuropathic pain group (NP group),and hydrogen-rich saiine group (H group).Neuropathic pain was produced by chronic constriction injury of the sciatic nerve in the rats anesthetized with chloral hydrate.Hydrogen-rich saline 5 ml/kg was injected intraperitoneally once a day for 7 consecutive days in group H,while the equal volume of normal saline was given instead in S and NP groups.The mechanical paw withdrawal threshold (MWT) and thermal paw withdrawal latency (TWL)were measured at 1 day before operation (T0) and 1,3,5 and 7 days after operation (T1-4).The animals were sacrificed after measurement of pain threshold at day 7 after operation.L4-6 segments of the spinal cord were harvested to detect the expression of autophagy-related proteins microtubule-associated protein 1 light chain 3 Ⅱ (LC3 Ⅱ),Beclin-1 and p62 by Western blot.Results Compared with group S,the MWT was significantly decreased,and the TWL was significantly shortened at T2-4,and the expression of LC3 Ⅱ,Beclin-1 and p62 was significantly up-regulated at T4 in NP and H groups (P＜0.05).Compared with group NP,the MWT was significantly increased,and the TWL was significantly prolonged at T2-4,and the expression of LC3 Ⅱ and Beclin-1 was significantly up-regulated,and the expression of p62 was significantly down-regulated at T4 in group H (P ＜0.05).Conclusion The mechanism by which hydrogen-rich saline reduces neuropathic pain is related to induction of autophagy in the spinal neurons of rats.

Objective To evaluate the efficacy and influencing factors analysis of doxorubicin treatment for herpes zoster neuralgia postherpetic neuralgia (PHN).Methods From January 2010 to January 2014 in the Second Hospital of Tianjin Medical University,209 cases of herpes zoster neural-gia patients (94 males,1 1 5 females,aged 45-86 years)received doxorubicin non-vascular interven-tional treatment,using visual analogue scale (visual analogue scale,VAS score)to evaluate curative effect,then recorded the related factors of patients (gender,age,location,duration,and degree of pain,whether to have hypoimmunity disease,early antiviral treatment,the presence of hyperalgesia, and outbreak pain,drug concentration,guiding method,the recent curative effect).Using single-fac-tor analysis of variance procedure and multiple factors of logistic regression analysis.Results The to-tal effective rate was 82.76% (1 73/209)after one month,the total effective rate was 86.12% (180/209)after twelve months.Single factor analysis showed that age≤65 years,duration of diseases<3 months,severe pain(VAS≥ 7 )or with low immunity disease was significantly associated with the curative effect of treatment of PHN (P <0.05).Multi-factor analysis showed that with low immunity diseases such as malignant tumor (OR =1.418,95%CI 1.347-8.563),the course of the disease more than 3 months (OR = 2.408,95% CI 3.325-18.643 ) were independent prognostic factors of influencing curative effects.Conclusion With low immunity diseases such as malignant tumor and the duration of more than 3 months,curative effect of doxorubicin non-vascular interventional treatment may be poor,patients should be treated as early as possible.