Objective To investigate the physicochemical characteristics of urinary stone induced by ceftriaxone.Methods Two children cefriaxone-associated urinary stone samples were received for component analysis in our hospital in April 2012,of which one was from a boy whose clinical data was not available,and the other was from a boy who suffered acute lower abdominal pain and vomiting after treatment with ceftriaxone for 5 d in early April.Ultrasound demonstrated a stone in his right upper ureter.Computed tomography showed right upper ureteral stone,which was radiolucent on plain abdominal radiograph.After a conservative treatment for 3 d,the stone in right upper ureter was spontaneously passed,which was confirmed by the ultrasound and intravenous pyelography.The two received stone samples were analyzed by infrared spectroscopy,scanning electron microscopy and energy disperse spectroscopy for component analysis.Results The compositions of two stone samples were free ceftriaxone and calcium ions combined with a molar ratio of 1:1.Conclusions The ceftriaxone could induce urinary stone in children.This special stone has radiolueent imaging,and it is composed of calcium ceftriaxone salt.

Objective:To construct a risk prediction model for chronic pain in elderly patients and verify its predictive value.Methods:From January 2020 to June 2021, 320 elderly patients admitted to the Pain Department of Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School were selected by convenience sampling. The general information of patients was collected, and patients were divided into chronic pain group ( n=185) and non-chronic pain group ( n=135) according to whether they had chronic pain. The patients were investigated with the Numerical Rating Scale (NRS) , Self-Rating Anxiety Scale (SAS) , Self-Rating Depression Scale (SDS) , Pittsburgh Sleep Quality Index (PSQI) , Morse Fall Scale, Constipation Symptom and Efficacy Scale, and bioelectrical impedance method. The binomial Logistic regression analysis was used to explore the risk factors of chronic pain in elderly patients and establish a risk prediction model. The predictive value of the risk prediction model was evaluated by the receiver operating characteristic (ROC) curve. Results:The NRS score of 185 patients with chronic pain was (4.34±1.50) . Lower limbs, lumbosacral region and neck were the most common parts of chronic pain. Osteoarthritis and cervical spondylosis were the main diseases causing chronic pain. Binomial Logistic regression analysis showed that high SDS score, high Morse Fall Scale score, high constipation symptom score, high SAS score and low appendicular skeletal muscle mass index were independent risk factors for chronic pain in elderly patients ( P<0.05) . The area under the ROC curve of the risk prediction model for chronic pain in elderly patients was 0.878, the sensitivity was 92.53%, and the specificity was 67.04%. Conclusions:The risk prediction model based on anxiety, depression, falls, myasthenia and constipation has good clinical value in predicting chronic pain in elderly patients, and can provide support for early identification and intervention of chronic pain in elderly patients.

Background: Postherpetic neuralgia (PHN) is the most common complication of acute herpes zoster. The treatment of PHN remains a challenge for clinical pain management. Despite the effectiveness of anticonvulsants, antidepressants, and lidocaine patches in reducing PHN, many patients still face intractable pain disorders.In this randomized controlled study, we evaluated whether hydromorphone through intravenous patient-controlled analgesia (IV PCA) was effective in relieving PHN. Methods: Patients with PHN were randomly divided into two groups, one group received oral pregabalin with IV normal saline, another group received oral pregabalin with additional IV PCA hydromorphone for two weeks. Efficacy was evaluated at 1, 4, and 12 weeks after the end of the treatments. Results: Two hundred and one patients were followed up for 12 weeks. After treatment, numerical rating scale (NRS) score of patients in the hydromorphone group was significantly lower than that of the control group, and the difference of NRS scores between the two groups was statistically significant at 4 and 12 weeks after treatment. The frequency of breakthrough pain in the hydromorphone group was significantly lower than that in the control group 1 and 4 weeks after treatment.After treatment, the quality of sleep in the hydromorphone group was significantly improved compared with the control group. The most common adverse reactions in the hydromorphone group were dizziness and nausea, with no significant respiratory depression. Conclusions IV PCA hydromorphone combined with oral pregabalin provides superior pain relief in patients with PHN, which is worthy of clinical application and promotion.

Background: Postherpetic neuralgia (PHN) is the most common complication of acute herpes zoster. The treatment of PHN remains a challenge for clinical pain management. Despite the effectiveness of anticonvulsants, antidepressants, and lidocaine patches in reducing PHN, many patients still face intractable pain disorders.In this randomized controlled study, we evaluated whether hydromorphone through intravenous patient-controlled analgesia (IV PCA) was effective in relieving PHN. Methods: Patients with PHN were randomly divided into two groups, one group received oral pregabalin with IV normal saline, another group received oral pregabalin with additional IV PCA hydromorphone for two weeks. Efficacy was evaluated at 1, 4, and 12 weeks after the end of the treatments. Results: Two hundred and one patients were followed up for 12 weeks. After treatment, numerical rating scale (NRS) score of patients in the hydromorphone group was significantly lower than that of the control group, and the difference of NRS scores between the two groups was statistically significant at 4 and 12 weeks after treatment. The frequency of breakthrough pain in the hydromorphone group was significantly lower than that in the control group 1 and 4 weeks after treatment.After treatment, the quality of sleep in the hydromorphone group was significantly improved compared with the control group. The most common adverse reactions in the hydromorphone group were dizziness and nausea, with no significant respiratory depression. Conclusions IV PCA hydromorphone combined with oral pregabalin provides superior pain relief in patients with PHN, which is worthy of clinical application and promotion.