Objective To evalvate the efficacy of patient-controlled epidural analgesia (PCEA) combined with ganciclovir for treatment of postherpetic neuralgia in patients.Methods A total of 60 patients with PHN,aged 51-86 yr,of ASA physical status Ⅰ-Ⅲ,were randomly assigned into 2 groups (n =30 each) using a random number table:ganciclovir group (F group) and PCEA combined with ganciclovir group (FB group).In FB and F groups,ganciclovir 0.25 g was infused intravenously twice a day for 7 consecutive days.In addition,continuous PCEA was performed simultaneously in group FB and the PCEA solution contained ropivacaine 300 mg,prednisolone 20 mg and dezocine 10 mg in 250 ml of normal saline.At 1 day before treatment (T0) and 7 days,1 month,and 6 months after treatment (T1-3),pain was assessed with visual analogue scale (VAS),and the quality of life (QOL) score and pair relief rate were recorded.Results VAS and QOL scores were significantly lower at T1-3 than at T0 in the two groups.Compared with F group,VAS scores were significantly decreased,and QOL score and pain relief rate were increased at T1-3 in FB group.Conclusion PCEA combined with ganciclovir can effectively alleviate postherpetic neuralgia in the patients.

ObjectiveTo observe the characteristic of pulmonary function of children with spastic diplegia and the effects of hydrotherapy on it. Methods30 children with spastic diplegia were divided into hydrotherapy group and control group, who received hydrotherapy and routine rehabilitation or routine rehabilitation only. All patients were tested their pulmonary function and the maximum phonation time before and 2 months after treatment. The longest breath holding time in water of the hydrotherapy group were recorded. ResultsThe vital capacity (VC), expiratory reserve volume (ERV), inspiratory capacity (IC), forced vital capacity (FVC), forced expiratory volume in one second (FEV1), maximum ventilatory volume (MVV), peak expiratory flow (PEF) in all the children decreased significantly compared with the predicted value (P=0.000), but a second rate (FEV1/FVC) didn't （P=0.141）. After treatment, the VC, FVC, FEV1, FEV1/FVC, MVV, PEF values and their percentage of predicted value improved （P＜0.05）, as well as the maximum phonation time （P＜0.05）. ERV, IC values and their percentage of predicted value improved a little from pre-treatment in the control group （P＞0.05）, but significantly in the hydrotherapy group （P<0.05）. The percentage of predicted value of VC, ERV, IC, FVC, FEV1, FEV1/FVC, MVV, and PEF, and the maximum phonation time improved more in the hydrotherapy group than in the control （P＜0.05）. The longest breath holding time in water improved in the hydrotherapy group after treatment （P=0.000）. ConclusionThe pulmonary function impaired in spastic diplegic children, and can be improved with the rehabilitation, especially with the hydrotherapy in addition.

Purpose: Invasive ductal carcinoma (IDC) accounts for 90% of triple-negative breast cancer (TNBC). IDC is mainly derived from the breast ductal epithelium which is innervated by the 4th to 6th thoracic sympathetic nerves. However, little is known about the contribution of the interactions between sympathetic nerves and breast cancer cells to the malignant progression of TNBC. Methods: The expression levels of the β2 -adrenergic receptor (β2 -AR, encoded by ADRB2 gene), nerve growth factor (NGF), and tropomyosin receptor kinase A (TrkA) were determined using immunohistochemistry (IHC). NGF expression levels in the serum were compared by enzyme-linked immunosorbent assay (ELISA). Cell proliferation was assessed using the Cell Counting Kit-8 assay. The β2 -AR, NGF, p-ERK, and p-CERB expression levels were determined using western blotting. TNBC cells and neuronal cells of the dorsal root ganglion (DRG) in 2-day-old Sprague Dawley rats were co-cultured. Using norepinephrine (NE), NGF, and β2 -AR, NGF/TrkA blocker pretreatments, the axon growth of each group of DRG neuron cells was detected by immunofluorescence analysis. Results: The sympathetic adrenergic neurotransmitter NE activated the ERK signaling pathway in TNBC cells. NE/β2 -AR signaling promotes NGF secretion. NGF further facilitates the malignant progression of TNBC by increasing sympathetic neurogenesis. In the coculture assay, the sympathetic adrenergic NE/β2 -AR signal pathway also enhanced NGF secretion. NGF binds TrkA in DRG neurons and promotes axonal growth. Conclusion These results suggest that NE/β2 -AR pathway promotes cell proliferation and NGF production in triple-negative breast cancer.

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