Objective To compare endovenous laser therapy (EVLT) with endovenous microwave coagulation (EMC) in the treatment of varicose vein in the lower extremities. Methods Sixty-five (male 30, female 35) patients with 70 lower extremities (35 legs in each treatment group) were pair matched according to age, gender and CEAP classification to receive endovenous laser therapy (EVLT) or endovenous microwave coagulation (EMC). The same surgeon performed all procedures. Patients were monitored on 72 hours, 4 weeks and 6 months after the procedure (by procedural site scored for bruising, skin burn, painful induration or trabes as well as a pain score), the cured extremities were examined via Duplex uhrasonography to evaluate the effects of the procedure. Results All these 65 patients (mean age, 47.52 years) completed treatment and were followed-up. The mean operation time of EMC group was less than that of EVLT (71±25 vs. 59±15, P=0.01). At 72 hour after the procedure, bruising scores and skin buring were significantly different (P<0.05): patients in the EMC group showed less bruising (17.14% vs. 54.29%) but more burn (48.57% vs. 20%) on the procedure site than the patients in the EVLT group. At 4 weeks and 6 months after the procedure, no significant differences were found between patient outcomes, physical conditions, and symptoms and or possible adverse events. In 20/28 patients the pigmentation faded away, Edema were relieved in all the 25 extremities. 4 patients with ankle ulcer were healed. No major complications were found. Conclusions Both EMC and EVLT were effective in treating lower extremities varicose veins, with no major complications.

Objective To investigate the causal association between bronchial asthma and bone mineral density at different sites using a two-sample Mendelian randomization(MR)approach.Meth-ods Summary data for exposure factors and outcome were obtained from different genome-wide associ-ation studies.Single nucleotide polymorphisms strongly associated with bronchial asthma were selected as instrumental variables,and those in linkage disequilibrium were excluded.The inverse-variance weighted(IVW)method was used as the primary method for MR analysis,complemented by weighted median,simple mode,weighted mode,and MR-Egger regression methods.Sensitivity analyses were conducted to assess the stability of the results.Results The random-effects model of IVW analysis showed that heel bone mineral density(OR=0.986;95％CI,0.974 to 0.998;P=0.023)as the outcome dataset had a reverse causal effect with bronchial asthma,while lumbar spine bone mineral density(OR=1.031;95％CI,0.984 to 1.081;P=0.195),femoral neck bone mineral density(OR=1.014;95％CI,0.973 to 1.057;P=0.505),and forearm bone mineral density(OR=1.011;95％CI,0.935 to 1.094;P=0.775)as outcome datasets showed no causal effect with bron-chial asthma.The MR-Egger intercept test results indicated that the P-values for the intercepts of lumbar bone mineral density,femoral neck bone mineral density,forearm bone mineral density,and calcaneal bone mineral density were all over 0.05,suggesting no horizontal pleiotropy and relatively stable results.Conclusion MR analysis reveals a reverse causal effect between bronchial asthma and heel bone mineral density,suggesting that clinicians should strengthen the monitoring of heel bone miner-al density in patients with bronchial asthma to timely detect and intervene osteoporosis.

Objective To study the efficacy and safety of ultrasound-guided pulse radiofrequency(PRF)treatment of the saphenous nerve for knee osteoarthritis(KOA).Methods A total of 289 KOA patients were followed up from March 2021 to October 2023 and divided into PRF group(group A,n=142)and conservative treatment group(group B,n=147)according to different treatment methods.Pain degree(VAS),knee function(OKS),and sleep quality(AIS)of the two groups were recorded before treatment and at 1 week,1 month,3 months and 6 months after treatment;the occurrence of complications was recorded for comparison between the two groups.Results After treatment,VAS,OKS and AIS scores in both groups decreased compared with those before treatment(P＜0.001).In addition,the scores of group A showed a gradual downward trend 6 months after surgery,while the scores of group B showed an overall upward trend 6 months after surgery.The scores of VAS and OKS were significantly lower in group A than in group B from 1 week to 6 months after surgery(P＜0.001).The AIS score of group A was much lower than that of group B from 1 month to 6 months after surgery(P＜0.001).There was no significant difference in the incidence of complications between the two groups(P=0.236).Conclusion Ultrasound-guided PRF treatment of the saphenous nerve is better than conservative treatment because it can better reduce pain and improve knee joint mobility and sleep in patients with KOA.

Objective To investigate the causal association between bronchial asthma and bone mineral density at different sites using a two-sample Mendelian randomization(MR)approach.Meth-ods Summary data for exposure factors and outcome were obtained from different genome-wide associ-ation studies.Single nucleotide polymorphisms strongly associated with bronchial asthma were selected as instrumental variables,and those in linkage disequilibrium were excluded.The inverse-variance weighted(IVW)method was used as the primary method for MR analysis,complemented by weighted median,simple mode,weighted mode,and MR-Egger regression methods.Sensitivity analyses were conducted to assess the stability of the results.Results The random-effects model of IVW analysis showed that heel bone mineral density(OR=0.986;95％CI,0.974 to 0.998;P=0.023)as the outcome dataset had a reverse causal effect with bronchial asthma,while lumbar spine bone mineral density(OR=1.031;95％CI,0.984 to 1.081;P=0.195),femoral neck bone mineral density(OR=1.014;95％CI,0.973 to 1.057;P=0.505),and forearm bone mineral density(OR=1.011;95％CI,0.935 to 1.094;P=0.775)as outcome datasets showed no causal effect with bron-chial asthma.The MR-Egger intercept test results indicated that the P-values for the intercepts of lumbar bone mineral density,femoral neck bone mineral density,forearm bone mineral density,and calcaneal bone mineral density were all over 0.05,suggesting no horizontal pleiotropy and relatively stable results.Conclusion MR analysis reveals a reverse causal effect between bronchial asthma and heel bone mineral density,suggesting that clinicians should strengthen the monitoring of heel bone miner-al density in patients with bronchial asthma to timely detect and intervene osteoporosis.

Objective:To comprehensively evaluate the clinical efficacy and safety of pulse radiofrequency therapy for knee osteoarthritis (KOA) with cardiovascular disease (CVD).Methods:A total of 132 patients with knee osteoarthritis (KOA) and cardiovascular disease (CVD) admitted to the First Affiliated Hospital of Xi′an Jiaotong University from March 2022 to February 2024 were randomly divided into two groups using a random number table method. Group A (65 cases) received ultrasound-guided pulse radiofrequency treatment of the hidden nerve, while group B (67 cases) received oral etoposide tablets and intra-articular injection of sodium hyaluronate. Basic data such as age, gender, height, weight, body mass index (BMI), knee joint function grading (K-L grading), and distribution of cardiovascular disease types were recorded between the two groups. The degree of knee joint pain [Visual Analog Scale (VAS) score] and Knee Joint Function Score (OKS), Athens Insomnia Scale (AIS) scores and incidence of complications. were compared between the two groups at 1 week, 1 month, 3 months, and 6 months after treatment.Results:The VAS score of group A showed a slow decreasing trend from 1 week to 6 months after treatment. The VAS score of group B decreased to the lowest level one week after treatment and gradually increased within 6 months after treatment. The VAS scores of both groups improved after 1 week of treatment and at 1, 3, and 6 months of treatment compared to preoperative levels ( F=703.955, P<0.001), and the degree of postoperative pain improvement in the group A was better than that in the group B ( F=106.575, P<0.001). The OKS of both groups decreased significantly after 1 week of treatment and at 1, 3, and 6 months of treatment, and the time effect was statistically significant ( F=2 233.447, P<0.001). The OKS of the group A was lower than that of group B after 1 week of treatment and at 1, 3, and 6 months of treatment, and the difference was statistically significant ( F=141.214, P<0.001). The AIS scores improved significantly after 6 months of treatment compared to preoperative levels ( F=1 044.424, P<0.001), and the group A had better AIS scores than the group B at 1, 3, and 6 months of treatment, with statistically significant differences ( F=124.864, P<0.001). There was no statistically significant difference in postoperative complications between the two groups ( P>0.05). Conclusions:Ultrasound guided pulsed radiofrequency treatment of KOA with CVD can significantly alleviate postoperative pain, improve joint mobility and sleep quality, and is more effective than traditional conservative treatment of oral etoposide tablets combined with intra-articular injection of sodium hyaluronate.

【Objective】 To investigate the effects of neuropathic pain induced by selective nerve injury (SNI) on intestinal microflora diversity in C57 mice. 【Methods】 36 C57 mice were randomly divided into SNI model group (n=18), sham-operation group (n=8), and control group (n=10). At day 0,1, 3, 7, and 14 after modeling, mechanical pain threshold and thermal pain sensitivity tests were carried out. At day 14 after modeling, colon content (fresh feces) from all the mice were collected for intestinal microflora diversity analysis. 【Results】 One day after modeling, the mechanical pain threshold in SNI group decreased significantly (more than 70%) due to nerve injury, and the thermal pain threshold decreased by 40%, while sham group and control group had no significant decrease. SNI group showed foot hyperalgesia, and the difference was statistically significant compared with sham group and control group (P<0.001). Compared with control group, sham-operation group had a transient decrease in thermal pain threshold on the first day after modeling (P=0.006), but there was no difference in pain threshold between the two groups on the third day after modeling. The α-diversity analysis showed that the abundance of Observed, Chao1, ACE and Simpson in SNI group was significantly lower than that in control group (P<0.05). That is, SNI group had flora disorder due to pain stimulation. Observed, Chao1, ACE, and Simpson were less abundant in sham group than in control group (P<0.05) and the change was between SNI group and control group. 【Conclusion】 Neuropathic pain induced by SNI model resulted in the decrease of mechanical pain threshold and thermal pain threshold, which leads to the reduction of intestinal flora diversity in C57 mice.

【Objective】 To compare the efficacy of radiofrequency thermocoagulation and pulsed radiofrequency for the ganglion impar in treating primary perineal pain. 【Methods】 We analyzed 79 patients with primary perineal pain who underwent radiofrequency thermocoagulation (group A) and pulsed radiofrequency (group B) in the ganglion impar from January 2020 to March 2022. VAS, excellent and good rates, sleep quality, postoperative medication usage, complications, and recurrence were evaluated before and 24 h, 1 W, 1 M, 3 M and 6 M after operation. The differences between the two groups were compared. 【Results】 The VAS score of group A gradually decreased at each level after operation, and the VAS score of group B gradually increased after 24 hours of operation. The differences between the two groups began to appear 1 week after operation, and the differences further increased with the extension of time (P<0.001). In six months after follow-up, the excellent and good rates of group A (86%) was significantly higher than that of group B (22%). In addition to postoperative perineal skin numbness, group A was superior to group B in improving sleep, postoperative oral medication (pregabalin and opioids), and disease recurrence (P<0.05). 【Conclusion】 Radiofrequency thermocoagulation for the ganglion impar can improve the quality of life by reducing pain, improving the excellent and good rates, improving sleep, and reducing recurrence a medication. The effect is better than that of pulsed radiofrequency.

[Objective] To compare the clinical efficacy of pulsed radiofrequency (PRF) in patients with acute herpes zoster neuralgia (AHN) and postherpetic neuralgia (PHN). [Methods] A retrospective analysis was made on 287 patients with thoracic herpes zoster related pain. The patients were divided into acute herpes zoster neuralgia group (group AHN, within 3 months) and PHN group (group PHN, over 3 months) according to the onset time of herpes zoster. Pain degree (VAS), sleep quality (AIS), anxiety and depression (GAD-7 and PHQ-9) at 1 week, 1 month, 3 months, 6 months and 12 months after the procedure were analyzed and compared between the two groups. [Results] The scores of VAS, AIS, GAD-7 and PHQ-9 significantly decreased in both groups after surgery (P<0.001). The four scores decreased more in AHN group than in PHN group from 1 to 12 months after surgery (P<0.001). After 12 months of follow-up, there were fewer cases of taking oral pregabalin and opioids in the former group than in the latter group (P=0.001). [Conclusion] PRF has a good therapeutic effect on herpes zoster related pain and is better than PHN in relieving pain, improving sleep and anxiety and depression in AHN, or can prevent PHN.