Objective To evaluate the efficacy of pregabalin combined with nerve block on postherpetic neuralgia (PHN). Methods 60patients were assigned into group A (n=30), who received pregabalin orally, and group B (n=30), who received nerve block (trigeminalnerve, intercostal nerve, lumbar nerve block) in addition. They were assessed with visual analogue scale (VAS) of pain, sleep score fromHamilton Rating Scale for Depression before and 3 d, 1 week, 2 weeks, 3 weeks, 4 weeks, 5 weeks, 6 weeks, 7 weeks, and 8 weeks aftertreatment. The incidence of pain decreased >50% and >30% were compared. Results The scores of VAS and sleep significantly reduced inboth groups 1~8 weeks after treatment (P<0.01), and decreased significantly 3 d after treatment in group B than in group A (P<0.05). The incidenceof pain decreased >50% and >30% were more in group B than in group A (P<0.05). Conclusion Nerve block combined with oralpregabalin is more effective on PHN.

BACKGROUND: Very satisfactory clinical effects have been achieved in treatment of osteoarthritis of knee with intraarticular injection of sodium hyaluronate (SH) allied with steroid hormones for nerve block. How will such allied treatment be used for periarthritis of shoulder?OBJECTIVE: To probe into the improvement of pain and joint function in periarthritis of shoulder treated with integration of intraarticular injection of SH with nerve and pain block with betamethasone.DESIGN: Self-control was designed before and after experiment.SETTING: Beijing Tiantan Hospital, Capital University of Medical Sciences PARTICIPANTS: Twenty patients with periarthritis of shoulder were included, aged from 40 to 65 years from Pain Clinic of Beijing Tiantan Hospital affiliated to Capital University of Medical Sciences from January to October 2004.METHODS: Integration of intraarticular injection of SH with nerve and pain block with betamethasone was applied to treat 20 cases of periarthritis of shoulder and the record was done before treatment and 1in which, "no any pain sensation" was 0 score, "unable to bear pain with imagination" was 10 scores. Pain score was recorded during quiet involved. 4 scores indicated being impossible completely, 3 scores indicate being possible with help, 2 scores indicate being possibled reluctantly and mostly feeling inconvenient, 1 score indicated being possible reluctantly without inconvenience and 0 score indicated being possible as healthy person.of daily life activity.RESULTS: According to practical management and analysis, 20 cases enment compared with that before treatment [(4.34±1.33),(8.27±1.37)scores,compared with that before treatment [(4.73±1.31), (8.49±1.35)scores,ment compared with that before treatment [ ( 1.10 ±0.74), (3.30 ±0.48 )scores, P ＜ 0.01]. CONCLUSION: Integration of intraarticular injection of SH with nerve and pain block with betamethasone treats effectively periarthritis of shoulder, without remarkably harmful reaction and it is worth in popularization in treatment of pain.

Objective To explore the relationship between insulin resistance (IR) and benign prostatic hyperplasia (BPH) in elderly men. Methods All BPH outpatients in Geriatric department of the second Xiang Ya Hospital in Feb 2008 were recruited in this study. Bioche assays including insulin (FINS), prostate specific antigen (PSA), HbAlc, fasting plasma glucose, 2 hours postprandial blood glucose were performed and HOMA-IR were calculated. The blood pressure, body weight, height and waist circumference were measured, and the body mass index (BMI) was calculated. Prostate volume (PV) was measured by abdominal ultrasound, lower urinary tract symptoms (LUTS) was evaluated by International Prostate Symptom Score (IPSS) and inquired about the history of LUTS in detail. Results (1) HOMA-IR＞ 2.8 was diagnosed as insulin resistance (IR). The patients were divided into two groups: insulin sensitivity (IS) group (n=48) and IR group (n=20). The PV level was higher in IR group than in IS group [(61.1-32. 9) ml vs. (40.4±16.5)ml, P＜0. 05], there were no statistical differences in PSA [(3.3±2.3) μg/L vs. (2.91±1.3) μg/L, P＞0.05], the history of LUTS [(13.4±6.6)years vs. (8.7±6.0)years, P＞0.05], IPSS [(16.42±6.67)scores vs. (13. 29±7.09)scores, P＞0. 05] between the two groups. (2)According to BPH progressivity evaluation provided by MTOPS study (age≥62 years, PSA≥1. 6 μg/L, PV≥31 ml), the patients were divided into two groups: low progressive risk group (n= 30) and high progressive risk group (n= 38). The FINS and HOMA-IR levels were significantly higher in highprogressive risk group than in low progressive risk group (all P＜0. 01). (3)The PV was positively correlated with HOMA-IR level and FINS level (r= 0. 431, 0. 492, P＜0. 01). Conclusions IR exists in majority of elderly BPH patients, the degree of IR and relative high level of FINS are related to the enlargement of PV and the development of BPH.

Objective To observe the effect of pulsed radiofrequency (PRF) on refractory infraorbital neuralgia. Methods From January, 2012 to December, 2014, 49 patients who received ineffective conservative therapy including medicine and nerve blockade underwent PRF treatment. Postoperative Numeric Rating Scale (NRS)=0 or 50%diminution of NRS was considered effective. NRS, effective rate, addition-al carbamazepine dosage and side effects were recorded on the first day, the first week, the second week, the first month, the third month, the sixth month, the first year, and the second year after operation. Results The effective rate were 67%, 67%, 65%, 59%and 51%on the first month, the third month, the sixth month, the first year, and the second year after operation, respectively. No serious side effect was observed, except that eight patients felt short-term (within one month) mild numbness. Conclusion PRF technique is safe and effective for refractory infraorbital neuralgia, and may become an alternative therapy.

Objective To observe the effect of radiofrequency thermocoagulation on patients with refractory supraorbital neuralgia Methods From February, 2007 to September, 2014, 36 patients with refractory supraorbital neuralgia following ineffective conservative ther-apy including medicine and nerve blockade underwent radiofrequency thermocoagulation. Numeric Rating Scale (NRS), Patient Satisfaction Scale (PSS), onset time, effective rate, recurrence rate, additional carbamazepine dosage and side effects were recorded before, and one day, one month, three months, six months, one year, two years after treatment. NRS=0 or 50%diminution was considered effectively. Results It worked two days on average (zero to seven) after treatment. The NRS score decreased (P<0.05) and the PSS score increased (P<0.05) com-pared with the data before treatment. The effective rate was 100%within six months. The recurrence rate was 11.1%within two years. Sec-ond radiofrequency thermocoagulation treatment still worked for the recurrent patients. No other side effect was observed, except permanent frontal numbness, short-time palpebral edema and ecchymosis. Conclusion Radiofrequency thermocoagulation is effective on refractory su-praorbital neuralgia, and the side effects are tolerable so it is an alternative choice for patients experiencing invalid conservative therapy.

Objective:To conduct health economic evaluation of Chinese population-based screening and opportunistic testing strategies for the prevention of Helicobacter pylori ( H. pylori)-related diseases. Methods:The Markov models of H.pylori infection caused non-ulcer dyspepsia, peptic ulcer (PU) and gastric cancer were established. The cost and effects of the population-based screening, opportunistic testing, and non-intervention strategies in 100 000 population of our country were simulation calculated. Wilcoxon signed rank test was used for statistic analysis. Single factor sensitivity analysis was performed to analyze the impact of single parameter uncertainty on cost-effectiveness. Probability sensitivity was used to analyze the impact of common uncertainty of all parameters on cost-effectiveness. Results:Compared with opportunistic testing strategy and non-intervention strategy, the total cost of population-based screening strategy was reduced by 0.43 million yuan(-6.63 million yuan to 7.19 million yuan) and 4.45 million yuan(-8.60 million yuan to 27.93 million yuan), quality adjusted life years (QALY), life years and asmptomatic months were prolonged by 888.00 (479.86 to 1 574.10) and 3 032.78 (1 756.04 to 5 007.84), 651.82 (294.73 to 1 211.94) and 1 868.64 (1 045.88 to 3 148.34), 28 381.91 (19 109.54 to 43 736.72)and 102 537.13 (58 649.18 to 176 868.77) respectively, gastric cancer, deaths from gastric cancer, deaths from PU and deaths from various causes were reduced by 115 cases(52 cases to 232 cases) and 464 cases(266 cases to 803 cases), 74 cases(33 cases to 148 cases) and 260 cases(149 cases to 453 cases), 46 cases(25 cases to 72 cases) and 369 cases(210 cases to 710 cases), 80 cases(42 cases to 126 cases) and 501 cases(331 cases to 772 cases) respectively, and the differences were statistically significant ( Z=1.99, 10.54, 27.39, 27.39, 27.37, 27.39, 27.39, 27.39, 27.21, 27.28, 27.22, 27.28, 27.38, 27.39, 27.39 and 27.39, all P<0.05). Compared with the non-intervention strategy, the opportunistic testing strategy reduced the total cost by 3.89 million yuan(-2.79 million yuan to 18.18 million yuan), QALY, life years and asymptomatic months were prolonged by 1 764.77 (888.70 to 3 406.62), 1 044.16 (524.46 to 1 912.75) and 62 568.69 (30 054.07 to 129 892.76) respectively, gastric cancer, deaths from gastric cancer, deaths from PU and deaths from various causes were reduced by 311 cases(164 cases to 563 cases), 164 cases (87 cases to 301 cases), 325 cases(162 cases to 644 cases) and 399 cases(234 cases to 684 cases) respectively, and the differences were statistically significant ( Z=14.20, 27.39, 27.38, 27.39, 27.25, 27.25, 27.39 and 27.39, all P<0.01). The results of singlefactor sensitivity analysis showed that the uncertainty of any parameter did not affect the cost-effectiveness of three strategies. The results of probability sensitivity analysis indicated that the probability of cost-effectiveness advantage of the population-based screening strategy was 100% and the common uncertainty of all parameters had no effect on cost-effectiveness. Conclusions:For preventing H.pylori-related diseases, the population-based screening strategy has the lowest average cost and the best average effect. However, non-intervention strategy has the highest average cost and the worst average effect. Population-based screening strategy is worthy of promotion throughout China, and opportunistic testing strategy has a higher clinical practical value.

Objective To compare the early therapeutic effects of gentamycin combined with ropivacaine and triamcinolone on trigminal neuralgia.Methods Ninety patients with trigeminal neuralgia were randomly divided into the ropivacaine group and triamcinolone group.The received nerve block peripherally was performed with gentamycin combined with ropivacaine(in the ropivacaine group)or triamcinolone(in the triamcinolone group)respectively.The parameters included pain intensity before and 1 d,3 d,1 week,2 weeks,1 month,2 months and 3 months after treatment,pain relief rate and dosage of carbamazepine of two groups were compared.Results The pain intensity in all the groups decreased at each time point.The value of numeric rating scale(NRS)in the ropivacaine group was significantly less than that in the triamcinolone group at 1 d,1 month,2 months and 3 months.Conclusion Gentamycin combined with ropivacaine is more suitable for trigeminal neuralgia than triamcinolone.

Objective To evaluate the diagnostic value of urine Cystatin C(Cys C) for renal function impairment in neonates with hypoxic-ischemic encephalopathy(HIE).Methods The urine Cys C concentration was measured by enzyme linked immunosorbent assay(ELISA) in 47 cases of HIE newborns(25 cases were mild HIE and 22 cases were moderate-severe HIE) within 3 days after their birth.Twenty-three cases without perinatal asphyxia or other factors which could result in renal function impairment were selected as control group.Urine Cys C with urine retinal-bindingprotein(RBP),?2-microglobulin(?2-MG) and fractional sodium excretion(FENa%) were analyzed by kolmogorov-smirno in each group.Results Compared with control group,the concentration of urine Cys C,RBP and the levels of FENa% in HIE newborns were significantly elevated.The levels of urine Cys C in moderate-severe HIE newborns were significantly higher than those in mild HIE newborns(Pa

ObjectiveTo explore the effect of metabolic syndrome (MS) on the occurrence and development of benign prostate hyperplasia (BPH).Methods 101 elderly BPH patients were divided into two groups:BPH (n = 45) and BPH with MS (n= 56)group.The effects of metabolic indexes,including body mass index (BMI),waist,high density lipoprotein cholesterol (HDL-C),fasting blood glucose (FBS) and insuline resistance index (H()MA-IR),on prostate volume(PV),prostate-specific antigen (PSA),international prostate symptom score (IPSS) and lower urinary tract symptoms (LUTS) were surveyed in BPH patients.Results BPH with MS group showed significantly higher values of PV (t = 3.22,P= 0.003)and longer course of LUTS (t= 2.02,P =0.046) than BPH group.The BPH patients with overweight and obesity had significantly higher levels of PV(49.44±26.83 ml and 51.7±22.2 ml,P=0.021 and 0.043) than BPH patients with normal weight (38.10 ± 10.64 ml).Additionally,BPH patients with abdominal obesity had significantly higher levels of PV than BPH patients without abdominal obesity(50.26±26.51 ml vs.38.99± 11.25ml,P=0.005).BPH patients with low HDL-C had significantly higher PV than BPH patients with normal HDL-C[(54.23±28.92)ml vs.(40.40± 14.87) ml,P=0.009].The values of PV,PSA in the BPH patients with elevated FBS were significantly higher than in BPH patients with normal FBS (t=3.17 and 2.4I,P= 0.035 and 0.013).BPH patients with insuline resistance (IR) had higher values of PV and longer courses of LUTS than BPH patients without IR (t= 3.43 and 3.58,P-0.001).The PV was positively correlated with BMI(r= 0.459.P= O.OOO),FINS (r= 0.42,P=O.OOI),HOMA-IR (r= 0.49,P= 0.003) and gatively correlated with HDL-C (r= 0.38,P-0.000)- Multiple linear stepwise regression analysis showed that PV was closely correlated with HOMA-IR.ConclusionsMS has evident effects on the occurrence and development of BPH.

Objective To investigate the assciation between hypertriglyceridemia and insulin resistance in type 2 diabetes (T2DM).Methods One hundred and forty-nine T2DM patients were divided into hypertriglyceridemia (n =88) and normal-triglyceridemia (n =61) groups according to triglyceridemia levels,waist circumference (WC),waist to height ratio (WHtR),fasting blood-glucose (FPG),glycosylated hemoglobin (HbA1 c),uric acid (UA),total cholesterol (TC),fasting insulin (FINS) and homeostatic model assessment for insulin resistance (HOMA-IR) levels were measured and compared between the two groups.Results Compared with the normal-triglyceridemia group,The levels of WC,WHtR,UA,TC,FINS and HOMA-IR of patients in the thypertri-glyceridemia group were significantly higher (Hypertriglyceridemia group:WC(89.51 ±10.31) cm,WHtR 0.55 ±0.06,UA(316.95 ±88.50) μmol/L,TC(5.74 ± 1.72) mmol/L,FINS (8.63 ± 4.91) μU/L,HOMA-IR 4.48 ± 3.14 ; Normal-triglyceridemia group:WC (86.31 ± 7.98) cm,WHtR 0.53 ± 0.05,Uric(275.48 ± 88.36) μmol/L,TC (5.15 ± 1.13) mmol/L,FINS (6.20 ± 3.89) μU/L,HOMA-IR 3.38 ± 2.76; t value were 2.133,2.315,2.815,2.349,2.364,2.221 ; P ＜ 0.05) ; HOMA-IR correlated positively with WC (r =0.233,P ＜ 0.01),WHtR(r =0.268,P ＜ 0.01),BMI (r =0.161,P ＜ 0.05),FPG(r=0.442,P ＜0.01),AST(r=0.169,P ＜0.0S),UA (r =0.907,P ＜0.01),TG(r =0.220,P ＜0.01)and FINS(r =0.907,P ＜0.01).Conclusion T2DM with hypertriglyceridemia increased insulin resistance.