Objective To investigate the effect of spinal cord electrical stimulation on diabetic peripheral neuropathy.Methods A total of 120 patients with diabetic peripheral neuropathy were randomly assigned to three groups,with 40 cases in each group.Group A was treated with pregabalin.Group B received radiofrequency therapy of lumbar sympathetic ganglion.Group C was treated with spinal cord electrical stimulation.The treatment course was six months.Pain,EMG parameters,hemorheology indexes,quality of life,sleep quality,and HbA1c were compared among groups.Results Group C had higher therapeutic effective rate than groups A and B(P<0.05)after 6 months of treatment.After 1 week,3 months,6 months and 12 months of treatment,the visual analogue scale(VAS)scores and HbA1c levels of group C were lower than those of groups A and B(P<0.05).After 6 months of treatment,the motor nerve and sensory nerve conduction velocities of the median nerve and peroneal nerve in group C were higher than those in groups A and B(P<0.05).After 6 months of treatment,the whole blood viscosity and capillary plasma viscosity of group C were lower than those of groups A and B(P<0.05).After 6 months of treatment,the 36-item short form health survey(SF-36)score of group C was higher than that of groups A and B,and the Pittsburgh sleep quality Index(PSQI)score of group C was lower than that of groups A and B(P<0.05).The incidence of adverse reactions in group C was lower than that in groups A and B(P<0.05).Conclusion Compared with drugs and lumbar sympathetic ganglion radiofrequency therapy,spinal cord electrical stimulation has a better efficacy in the treatment of diabetic peripheral neuropathy.It can continuously relieve neuropathic pain,increase the velocity of motor and sensory nerve conduction,improve the hemorheology,HbA1c levels,quality of life and sleep quality,and has high safety and significant clinical value.

Objective: To investigate the effects of buccal acupuncture on analgesia, immune indicators, and expression levels of Survivin and Livin proteins in patients with advanced-stage primary liver cancer. Methods: Eighty patients with advanced-stage primary liver cancer were selected and divided into control and treatment groups according to the difference in treatment modalities, with 40 patients in each group. The control group received transcatheter arterial chemoembolization (TACE), and the treatment group received buccal acupuncture in addition to TACE. The recent efficacy, analgesic effect, liver function, serum tumor markers, Survivin and Livin protein expression levels in liver cancer tissue, and immune indexes were analyzed and compared between the two groups. Results: The objective response rate (ORR) and disease control rate (DCR) of the treatment group were 37.5％ and 77.5％, respectively, which were significantly higher than those of the control group (22.5％ and 52.5％), and the recent efficacy of the treatment group was significantly better than that of the control group (P<0.05). The onset of analgesia in the treatment group was significantly faster than that in the control group (P<0.05), the duration of analgesia was significantly longer than that in the control group (P<0.05), and the numeric rating scale (NRS) score of pain after treatment was significantly lower than that in the control group (P<0.05). In the treatment group, the aspartate aminotransferase (AST), alanine aminotransferase (ALT), and albumin/globulin (A/G) were significantly lower than those in the control group (P<0.05), and the serum levels of alpha-fetoprotein (AFP), alpha-L-fucosidase (AFU), and carcinoembryonic antigen (CEA) were significantly lower than those in the control group (P<0.05), and the expression levels of Survivin and Livin in liver cancer tissue were significantly lower than those in the control group (P<0.05); CD4+ and CD4+/CD8+ in the treatment group were significantly higher than those in the control group, and CD8+ was significantly lower than that in the control group after treatment (P<0.05). Conclusion: Buccal acupuncture can reduce the degree of pain and liver function damage in patients with advanced- stage primary liver cancer and lower the serum tumor marker levels, and its mechanism of action may be related to the down-regulation of Survivin and Livin protein expression levels in the liver cancer tissue and the regulation of the immune function.

Objective To evaluate the effects of age factors on the pharmacokinetics of ropivacaine during combined lumbar plexus-sciatic nerve block in patients.Methods Twenty patients of both sexes,aged ≥ 18 yr,weighing 50-75 kg,of American Society of Anesthesiology physical status Ⅰ or Ⅱ,scheduled for elective lower extremity surgery,were divided into 2 groups (n=10 each) according to age:young and middle-aged group (18-59 yr) and elderly group (≥ 60 yr).Combined lumbar plexus-sciatic never block was performed using an ultrasonic instrument and a nerve stimulator.Lumbar plexus block was performed with 0.5％ ropivacaine 30 ml.Sciatic never block was performed with 2％ lidocaine 10 ml plus 0.75％ ropivacaine 10 ml.Before administration and at 5,10,15,20,30,45,60,120,180 and 360 min after administration,blood samples were collected from the radial artery for determination of the blood concentration of ropivacaine by high-performance liquid chromatography.The area under the concentrationtime curve,maximum concentration (Cmax),time to C terminal elimination half-life and clearance were calculated.Results Compared with young and middle-aged group,the blood concentration of ropivacaine was significantly decreased at 5-45 min after administration,the Cmax was significantly decreased,terminal elimination half-life was significantly prolonged (P＜0.05),and no significant change was found in area under the concentration-time curve,the time to C and clearance in elderly group (P＞ 0.05).Conclusion Age factors can affect the pharmacokinetics of ropivacaine during combined lumbar plexus-sciatic nerve block,and both absorption and metabolism of ropivacaine are slower in elderly patients than in young and middle-aged patients.