Objective:To evaluate the effects of intrathecal morphine and fentanyl on interferon (IFN)-γ levels in hippocampus and plasma of rats with incisional pain.Methods:Ninety-six healthy male Sprague-Dawley rats in which intrathecal catheters were successfully inserted, weighing 180-220 g, aged 6-8 weeks, were divided into 4 groups ( n=24 each) using a random number table method: normal saline group (group NS), incisional pain group (group P), morphine and fentanyl group (group MF) and morphine and fentanyl with incisional pain group (group MFP). Incisional pain model was established in group P and group MFP.At 20 min before the model was established, a 50 μl mixture of morphine 5 μg/kg and fentanyl 0.25 μg/kg was intrathecally injected in group MF and group MFP, while normal saline 50 μl was injected intrathecally in group NS and group P. At 24 h before establishment of the model (T 0) and at 1, 6, 24, 48 and 72 h after establishment of the model (T 1-5), 6 mice were randomly selected from each group for determination of the mechanical paw withdrawal threshold (MWT) and thermal paw withdrawal latency (TWL). The animals were sacrificed and hippocampal tissues and blood samples from the inferior vena cava were collected for determination of IFN-γ levels in hippocampal tissues and plasma (by enzyme-linked immunosorbent assay). Results:Compared with group NS, MWT was significantly decreased and TWL was shortened at T 1-5, and IFN-γ concentration in plasma was decreased at T 2, 3 and T 5 in group P, MWT was increased and TWL was prolonged at T 1-3 in group MF, MWT was decreased and TWL was shortened at T 1-3 in group MFP, and IFN-γ concentration in plasma was decreased at T 2 in MF and MFP groups ( P<0.05). Compared with group P, MWT was increased, TWL was prolonged at T 1-5, and IFN-γ concentration in plasma was increased at T 2, 3 and T 5 in MF and MFP groups ( P<0.05). Compared with group MF, MWT was decreased and TWL was shortened at T 1-4, and IFN-γ concentration in plasma was increased at T 2 and T 3 in MFP ( P<0.05). There was no significant difference in IFN-γ concentration at each time point among the 4 groups ( P>0.05). Conclusion:Intrathecal morphine and fentanyl can increase plasma IFN-γ concentration, and improve peripheral immunosuppression.

Objective To investigate the occurrence of anxiety before anesthesia and identify the risk factors for anxiety. Methods A total of 500 patients of both sexes, aged 18-80 yr, of American So-ciety of Anesthesiologists physical statusⅠ-Ⅲ, scheduled for elective surgery, were selected. The patients were investigated using the Generalized Anxiety Disorder 7-item scale and anxiety factor questionnaires. It was evaluated whether the patient had anxiety before anesthesia according to the scale score, and then the patients were divided into anxiety group and non-anxiety group. The possible risk factors for anxiety were compared, and the statistically significant variables were further analyzed by Logistic regression to stratify the risk factors. Results The incidence of pre-anesthesia anxiety was 46. 80％. Logistic regression analysis showed that gender, lack of understanding of the next treatment, fear of death, fear of surgical failure, fear of intraoperative and postoperative pain were independent risk factors for anxiety before anesthesia. Conclusion The incidence of pre-anesthesia anxiety is 46. 80％, and gender, lack of understanding of the next treatment, fear of death, fear of surgical failure, fear of intraoperative and postoperative pain are in-dependent risk factors for pre-anesthesia anxiety in the patients undergoing surgery.

Objective To evaluate the effect of application of pulsed radiofrequency to dorsal root ganglia on activation of spinal astrocytes in a rat model of neuropathic pain (NP).Methods Eighty male Sprague-Dawley rats,aged 6-8 weeks,weighing 200-250 g,were divided into 4 groups (n=20 each) using a random number table method:sham operation group (group Sham),group NP,pulsed radiofrequency group (PRF group) and sham pulsed radiofrequency group (group SPRF).NP was induced by chronic constriction injury (CCI).The mechanical paw withdrawal threshold (MWT) and thermal paw withdrawal latency (TWL) were measured at 1 day before CCI and 1,7,14 and 21 days after CCI.Four rats were sacrificed at 1 day before CCI and 14 and 21 days after CCI,and the L4.6 segments of the spinal cord were harvested to detect the expression of glial fibrillary acidic protein (GFAP) and interleukin-1beta (IL-1β) by Western blot.Results Compared with group Sham,the MWT was significantly decreased and the TWL was shortened at each time point after CCI,and the expression of GFAP and IL-1β was up-regulated at 14 and 21 days after CCI in NP,PRF and SPRF groups (P＜0.05).Compared with group NP,the MWT was significantly increased and the TWL was prolonged at 14 and 21 days after CCI (P＜0.05),and the expression of GFAP and IL-1β was down-regulated at 14 and 21 days after CCI in group PRF (P＜0.05),and no significant change was found in the parameters mentioned above in group SPRF (P＞0.05).Conclusion The mechanism by which pulsed radiofrequency reduces NP is probably related to inhibiting spinal astrocyte activation in rats.

Objective To compare the efficacy of adriamycin chemo-ganglionectomy and radiofre-quency thermocoagulation ( RFT ) of semilunar ganglion in treating craniofacial postherpetic neuralgia ( PHN) . Methods A total of 95 patients with PHN in the areas innervated by maxillary and mandibular divisions of trigeminal nerve, aged 55-90 yr, with the course of disease 6 months-3 yr, were divided into 2 groups using a random number table method: adriamycin chemo-ganglionectomy group ( ADM group, n=48) and RFT group ( n=47) . Hartel anterior approach to puncture was performed via the foramen ovale un-der the guidance of CT in two groups. In group ADM, 0. 5％ adriamycin 2. 5 mg ( 0. 5 ml) was injected via the foramen ovale, and RFT of gasserian ganglion was performed in group RFT. Visual Analog Scale (VAS) and the short-form McGill pain questionnaire (SF-MPQ) scores were evaluated before and after treatment. The rate of effective treatment was calculated, and treatment-related complications were recor-ded. Results Compared with group RFT, no significant change was found in VAS or SF-MPQ scores be-fore treatment, VAS and SF-MPQ scores were increased and the rate of effective treatment was decreased at 1 and 7 days after treatment, VAS and SF-MPQ scores were decreased and the rate of effective treatment was increased at 6 and 12 months after treatment, the incidence of facial numbness, hypoesthesia, masti-catory muscle weakness and weakened corneal reflex was decreased in group ADM ( P<0. 05) . Conclusion Compared with semilunar ganglion RFT, the long-term efficacy of adriamycin chemo-ganglionectomy of semilunar ganglion in treating craniofacial PHN is enhanced, and the safety is higher.

Objective To evaluate the clinical value of adriamycin injection via the foramen ovale and around peripheral trigeminal branches under the guidance of X-ray for treatment of primary trigeminal neuralgia by comparison with the three-dimensional computed tomography (CT).Methods A total of 91 patients with primary trigeminal neuralgia of both sexes,aged 33-76 yr,with the course of disease 6 months-24 yr,with visual analogue scale score of 6-9,were divided into 2 groups using a random number table:X-ray group (n =43) and CT group (n =48).Hartel anterior approach was used to puncture the foramen ovale in 2 groups.One point five percent adriamycin 0.2,0.3 and 0.5 ml were injected via the supraorbital foramen,infraorbital foramen and oval foramen.When pain relief was poor (visual analogue scalc scorc≥ 4) within 1 yr after treatment,oxcarbazepine and adjuncts (tramadol,flupentixol and melitracen tablets,etc.) were taken orally.The requirement for oxcarbazepine and adjuncts was recorded during 1 day-1 week,1 week-1 month,1-3 months,3-6 months and 6 months-1 yr after treatment periods.The operation time,the nuinber of puncture,and developinent and recurrence of complications during treatment and within 1 yr after treatment were recorded.Results Compared with CT group,the number of puncture and incidence of facial hematoma during treatment were significantly increased (P ＜ 0.05 or 0.01),and no significant change was found in the operation time,requirement for oxcarbazepine and adjuncts,incidence of dizziness,nausea and vomiting during treatment,or the incidence and recurrence rate of masticatory muscle weakness and facial numbness after treatment in X-ray group (P＞0.05).Conclusion Compared with the three dimensional CT,X-ray provides similar efficacy and safety when used to guide adriamycin injection via the foramen ovale and around peripheral trigeminal branches for treatment of primary trigeminal neuralgia,showing that X-ray guidance has significant clinical value.

Objective To evaluate the efficacy and influencing factors analysis of doxorubicin treatment for herpes zoster neuralgia postherpetic neuralgia (PHN).Methods From January 2010 to January 2014 in the Second Hospital of Tianjin Medical University,209 cases of herpes zoster neural-gia patients (94 males,1 1 5 females,aged 45-86 years)received doxorubicin non-vascular interven-tional treatment,using visual analogue scale (visual analogue scale,VAS score)to evaluate curative effect,then recorded the related factors of patients (gender,age,location,duration,and degree of pain,whether to have hypoimmunity disease,early antiviral treatment,the presence of hyperalgesia, and outbreak pain,drug concentration,guiding method,the recent curative effect).Using single-fac-tor analysis of variance procedure and multiple factors of logistic regression analysis.Results The to-tal effective rate was 82.76% (1 73/209)after one month,the total effective rate was 86.12% (180/209)after twelve months.Single factor analysis showed that age≤65 years,duration of diseases<3 months,severe pain(VAS≥ 7 )or with low immunity disease was significantly associated with the curative effect of treatment of PHN (P <0.05).Multi-factor analysis showed that with low immunity diseases such as malignant tumor (OR =1.418,95%CI 1.347-8.563),the course of the disease more than 3 months (OR = 2.408,95% CI 3.325-18.643 ) were independent prognostic factors of influencing curative effects.Conclusion With low immunity diseases such as malignant tumor and the duration of more than 3 months,curative effect of doxorubicin non-vascular interventional treatment may be poor,patients should be treated as early as possible.

Objective To evaluate the effect of pulsed radiofrequency application to dorsal root ganglions (DRGs) on neuronal Navl.8 expression in a rat model of inflammatory pain.Methods Twenty-four adult male Sprague-Dawley rats,aged 6-8 weeks,weighing 200-250 g,were randomly divided into 4 groups (n =6 each) using a random number table:control group (group C),inflammatory pain group (group IP),pulsed radiofrequency group (group PR),and inflammatory pain + pulsed radiofrequency group (group IP+PR).2.5％ formalin 100 μl was injected into the plantar surface of the right hindpaw to induce inflammatory pain.Pulsed radiofrequency was applied on L4,5 DRGs at 42 ℃ for 180 s starting from 4 days after formalin injection.At 1 day before formalin injection (T0),and 1,3,5 and 7 days after formalin injection (T1-4),the mechanical paw withdrawal threshold (MWT) and thermal paw withdrawal latency (TWL) were measured in the right hindpaw.After the last measurement of pain threshold,the rats were sacrificed,and the DRGs of the L4.5 were removed for determination of Navl.8 mRNA expression (by real-time reverse transcriptase-polymerase chain reaction) and Nav1.8 protein expression (by Western blot).Results Compared with group C,the MWT was significantly decreased,and the TWL was shortened at T1-4,and the expression of Navl.8 protein and mRNA was up-regulated in IP and IP+PR groups (P＜0.05).Compared with group IP,the MWT was significantly increased,and the TWL was prolonged at T1.4,and the expression of Navl.8 protein and mRNA was down-regulated in group IP+PR (P＜0.05).Conclusion The mechanism bv which pulsed radiofrequency application to DRGs reduces inflammatory pain is probably related to down-regulation of neuronal Nav1.8 expression in rats.

Objective To evaluate the effects of intrathecal low-dose naloxone,morphine and fentanyl on the expression of motillin (MTL) in the hippocampus of rats with incisional pain.Methods Seventy-two healthy male Sprague-Dawley rats,weighing 180-220 g,aged 6-8 weeks,in which intrathecal catheters were successfully implanted,were randomly divided into 6 groups (n =12 each) using a random number table:normal saline group (NS group),incisional pain group (P group),morphine + fentanyl + incisional pain group (MFP group),and naloxone (0.2,1.0 and 5.0 ng/kg) + morphine + fentanyl groups (MFPN1,MFPN2 and MFPN3 groups).Incisional pain was induced by an incision made into the plantar surface of the right hindpaw.At 20 min before induction of incisional pain,the mixture of morphine 5 μg/kg and fentanyl 0.25 mg/kg was injected intrathecally in group MFP,and the mixture of naloxone 0.2,1.0 and 5.0 ng/kg,morphine and fentanyl were injected intrathecally in MFPN1,MFPN2 and MF-PN3 groups,respectively.Six rats in each group were selected,and the mechanical paw withdrawal threshold (MWT) and thermal paw withdrawal latency (TWL) were measured at 24 h before intrathecal catheterization (T0,baseline),at 24 h before induction of incisional pain (T1),and at 1,3 and 6 h after operation (T2-4).The left 6 rats in each group were selected and sacrificed at 6 h after operation,and the hippocampi,body of the stomach and duodenum were removed for detection of MTL content by enzyme-linked immunosorbent assay.Results Compared with group NS,the MWT was significantly decreased,and the TWL was shortened at T2-4 in P and MFPN3 groups,the MWT was significantly decreased,and the TWL was shortened at T4 in group MFPN1,and the TWL was prolonged at T2 in group MFPN2,the MTL contents in hippocampus and body of the stomach were significantly decreased in P,MFP,MFPN1 and MF-PN3 groups,the MTL contents in duodenum were increased in P and MFPN3 groups,and the MTL contents in duodenum were decreased in MFP and MFPN1 groups (P＜0.05),and no significant change was found in the parameters mentioned above in group MFPN2 (P＞0.05).Conclusion Intrathecal naloxone 1.0 ng/kg combined with morphine and fentanyl can inhibit up-regulation of the expression of MTL in the hippocampus of rats with incisional pain,and then is involved in the maintenance of stable gastrointestinal motility.

Objective To evaluate the changes in the levels of motilin in the duodenum in a rat model of incisional pain.Methods Eighty-four healthy male Sprague-Dawley rats,aged 6-8 months,weighing 180-220 g,were randomized into 2 groups (n =42 each) using a random number table:control group (group C) and incisional pain group (group P).The animals were anesthetized with sevoflurane.In group P,a 1 cm long incision was made in the plantar surface of right hindpaw.Six rats were chosen from each group and mechanical paw withdrawal threshold (MWT) and thermal paw withdrawal latency (TWL) were measured at 24 h before operation (T0) and 1,6,24,48 and 72 h after operation (T1-5).Six rats were chosen from each group at T0-5 and sacrificed and the duodenal mucosal tissue was prepared for measurement of motilin levels by ELISA.Pearson linear correlate analysis was performed between the motilin level and pain threshold at each time point in group P.Results Compared with group C,MWT was significantly decreased,TWL was shortened,and motilin levels were significantly increased at T1-4,and no significant change was found at T0 and T5 in group P.The motilin levels were negatively correlated with MWT (r =-0.8 910) and TWL (r =-0.8 463) in group P.Conclusion Incisional pain can promote the secretion of motilin in the duodenum.

Objective To investigate effects of intrathecal injection of morphine and fentanyl combined with low-dose naloxone on the pain behavior and the expression of blood motilin (MTL) in the rat model of incisional pain.Meth?ods A total of 72 healthy male Sprague-Dawley rats (weight 180-220 g), successfully intrathecally catheterized, were ran?domly divided into 6 groups (n=12 ):normal saline group (NS group), incisional pain group (P group), morphine (5μg/kg)+fentanyl (0.25μg/kg) group (MFP group), morphine+fentanyl+naloxone (0.2 ng/kg, 1 ng/kg, 5 ng/kg) group (MFPN1, MF?PN2 and MFPN3 groups). All groups except NS group were made the model of incisional pain on the right plantar surface. At 24-hours before intrathecal cathetherization (T0), 24-hours before modelling (T1), 1-hours (T2), 3-hours (T3) , 6-hours (T4), 24-hours (T5) , 48-hours (T6) and 72-hours (T7) after modelling respectively, paw withdrawal mechanical threshold (PWMT) and paw withdrawal thermal latency (PWTL) were detected in right hind paw in 6 rats of each group. The other 6 rats in each group were sacrificed 6-hour after operation. The plasma expression of motilin was detected by ELISA. Re?sults Compared with NS group, the PWMT was not significantly different in all time points in MFPN2 group. The values of PWTL were significantly longer at T2 and T5 in MFPN2 group than those of NS group (P<0.05). The PWMT and the PWTL were significantly decreased at T2, T3 and T4 in P and MFPN3 groups than those of NS group (P<0.05).Compared with P group, the PWMT at T6, and PWTL at T3 and T4 were significantly decreased in MFPN3 group (P<0.05). The MTL at T6 was significantly decreased in P, MFP, MFPN1 and MFPN3 groups compared with that of NS group (P<0.05). There was no significant difference in MTL between MFPN2 group and NS group (P>0.05).Conclusion In the rat model of incision?al pain, intrathecal injection of naloxone at 1 ng/kg can inhibit the down-regulation of blood motillin caused by morphine and fentanyl, and which can up-regulate the PWTL, enhancing the analgesic effects of opioids.