Objective To investigate the clinical efficacy of CT-guided pulsed radiofrequency combined with continuous nerve block in the treatment of refractory postherpetic neuralgia(PHN).Methods A total of 208 patients with refractory PHN,who were admitted to the Hengshui Municipal People's Hospital of China between January 2021 and January 2023,were selected as the subjects of study.Using random number table method,the patients were divided into combination group and control group,with 104 patients in each group.The patients of control group received CT-guided pulsed radiofrequency therapy,and the patients of combination group received additional continuous nerve block therapy on the basis of the treatment of control group.The pain degree at different time point,clinical effective rate,number of analgesia remedy times,quality of sleep,and the levels of serum high mobility group box 1(HMGB1),interleukin-1 β(IL-1β)and interleukin-10(IL-10)were compared between the two groups.Results During the follow-up period,4 patients were lost in touch.Finally,103 patients were included in the combination group and 101 patients were included in the control group.The total treatment response rate in the combination group was 89.32％,which was significantly higher than 78.22％in the control group(P＜0.05).There were statistically significant differences in visual analogue scale(V AS)scores and Athens insomnia scale(AIS)scores including the time effect,inter-group effect and time-group interaction effect,between the two groups(P＜0.05).The postoperative one-week,2-week,4-week VAS scores and AIS scores in the combination group were remarkably lower than those in the control group(P＜0.05).The number of analgesia remedy times in the combination group was smaller than that in the control group,and the used dosage of tramadol in the combination group was lower than that in the control group(P＜0.05).Four weeks after treatment,the serum levels of HMGB1,IL-1β and IL-10 in the combination group were lower than those in the control group(P＜0.05).Conclusion For the treatment of refractory PHN,CT-guided pulsed radiofrequency combined with continuous nerve block can effectively alleviate neural inflammatory damage,and improve pain symptoms and sleep quality,besides,its analgesic effect and clinical efficacy are superior to CT-guided pulsed radiofrequency alone.(J Intervent Radiol,2024,33:264-268)

Objective To discuss the curative effect of pulsed radiofrequency combined with nerve block in treating refractory postherpetic neuralgia(PHN).Methods A total of 201 patients with PHN,who were admitted to the hospital to receive treatment between March 2020 and March 2023,were enrolled in this study.Using random number table method,the patients were divided into pulsed radiofrequency group,nerve block group and combination group,with 67 patients in each group.On the basis of routine medication,the patients of pulsed radiofrequency group received nerve pulsed radiofrequency treatment,the patients of nerve block group received nerve block therapy,while the patients of combination group received nerve block followed by nerve root pulsed radiofrequency.At the preoperative(T0),postoperative 7-day(AT7),30-day(AT30)and 90-day(AT90)time point,the short-form of McGill pain questionnaire(SF-MPQ),Pittsburgh Sleep Quality Index(PSQI),levels of pain mediators including β-endorphin,substance P,calcitonin gene-related peptide(CGRP),and levels of inflammatory factors including tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)were determined.The adverse reactions were recorded.Results The postoperative AT7,AT30 and AT90 scores of PRI,VAS,PPI and PSQI,and levels of substance P,CGRP,TNF-α and IL-6 in combination group were lower than those in pulsed radiofrequency group and in nerve block group(all P＜0.05),while level of β-endorphin in combination group was higher than that in the other two groups(P＜0.05).No obvious adverse reactions were observed in all three groups.Conclusion For the treatment of patients with intractable PHN,the combination therapy of pulsed radiofrequency and nerve block is superior to single therapy in improving pain and sleep quality,which may be related to the regulation of the levels of pain mediators and inflammatory factors.

Objective To explore the effect of pulsed radiofrequency combined with nerve block on the score of short-form of McGill pain questionnaire(SF-MPQ)and the levels of serum substance P(SP)and interleukin(IL)-1β in patients with refractory postherpetic neuralgia(PHN).Methods A total of 219 patients with PHN,who were admitted to the Hengshui Municipal People's Hospital of China between April 2021 and April 2022,were collected as the objects of study.Using random number table method,the patients were divided into group A(n=73,receiving pulsed radiofrequency therapy),group B(n=73,receiving nerve block therapy),and group C(n=73,receiving pulsed radiofrequency combined with nerve block therapy).The SF-MPQ score,levels of serum SP and IL-1β,degree of anxiety and depression,and quality of life were compared between each other among the three groups.Results Among the 219 patients with PHN,6 patients were excluded from this study due to losing in touch or due to receiving other therapies,and finally group A had 71 patients,group B had 70 patients,and group C had 72 patients.At 7 d after treatment(AT7),30 d after treatment(AT30)and 90 d after treatment(AT90),in group C the scores of pain rating index(PRI),visual analogue scale(VAS)and present pain intensity(PPI)were obviously lower than those in group A and group B(P＜0.05),the levels of serum SP and IL-1β were strikingly lower than those in group A and group B(P＜0.05),and the scores of patient health questionnaire-9(PHQ9),generalized anxiety disorder 7-item(DAG7)and Generic Quality of Life Inventory 74(GQOL-74)were remarkably lower than those in group A and group B(P＜0.05).Conclusion Pulsed radiofrequency combined with nerve block can effectively reduce the pain degree and the serum SP and IL-1β levels,relieve the degree of anxiety and depression in patients with refractory PHN,which can improve the quality of life.

[Objective]To summarize the research status and hotspots of tripterygium glycosides(TG),to provide reference basis for future in-depth research and clinical promotion of TG.[Methods]Computer retrieval of literature related to TG from January 2000 to June 2023 was conducted using the China National Knowledge Internet(CNKI),Wanfang Data,China Science and Technology Journal Database(VIP),China Biology Medicine disc(CBM).Use NoteExpress software to merge,duplicate check,and clean data,and use Excel software to construct an annual publication volume line chart.Visualize and analyze the author,organization,and keywords using VOSviewer 1.6.13 and CiteSpace 6.2 R2 software,and draw relevant graphs.[Results]A total of 1 752 articles were included.Since 2008,the number of publications has shown a decreasing trend in recent years after a gradual increase.A total of 4 186 authors were involved,including 75 core authors,forming a collaborative team represented by DING Ying,LI Zhenbin,LIN Na,CUI Ruiqin,CHEN Weidong and others.The main publishing institutions were the First Affiliated Hospital of He'nan University of Chinese Medicine and He'nan University of Chinese Medicine,followed by Dongzhimen Hospital of Beijing University of Chinese Medicine.The research institutions were relatively independent and scattered,mostly through cooperation between traditional Chinese medicine universities and their affiliated hospitals,with less cross regional cooperation.A total of six clusters of key words had been formed in the network diagram.The research focuses were mainly summarized as the clinical research on the application of TG combination drugs in kidney diseases such as diabetes nephropathy,purpura nephritis and nephrotic syndrome,rheumatic immune diseases such as rheumatoid arthritis,skin and mucosal diseases,and the experimental research on the toxicity and side effects of TG.In recent years,keywords that had emerged included dermatitis,eczema,mizolastin,inflammatory factors,immune function,tacrolimus,and so on.[Conclusion]The clinical efficacy and safety research of TG in kidney diseases,rheumatic immune diseases and other fields are hot topics.Dermatitis,eczema,and other skin and mucosal diseases,as well as the mechanism of TG action and inflammatory factors,may be the future research trends.There is still a need to strengthen cooperation among teams,strengthen basic research on the mechanism of TG action,and explore effective compatibility and detoxification methods,providing reference basis for the clinical application of TG in the future.

Background Previous studies show that aluminum exposure could increase the expression of miRNA-134-3p, which is involved in the mechanism of aluminum induced learning and memory impairment. However, it has not been investigated whether the expression level of miRNA-134-3p in the peripheral blood of occupational aluminum exposed workers is related to the blood aluminum concentration yet. Objective To evaluate a potential correlation between aluminum concentration in peripheral blood and miR-134-3p expression in occupational aluminum exposed workers. Methods A total of 184 male aluminum workers in the electrolytic aluminum workshop, aluminum oxide workshop, and thermal power workshop of an aluminum plant in Shanxi were selected by cluster sampling. They were divided into four groups (Q₁-Q₄) according to the quartiles of blood aluminum concentration, with 46 workers in each group. The basic information of workers was collected by questionnaire survey, and the cognitive function of workers was evaluated by Montreal Cognitive Assessment (MoCA). The plasma of workers was collected, and the relative expression level of miR-134-3p in plasma was detected by real-time quantitative polymerase chain reaction (RT-PCR). The plasma aluminum concentration was detected by inductively coupled plasma mass spectrometry (ICP-MS). The associations among workers' peripheral blood aluminum concentration, plasma miR-134-3p expression level, and total MoCA score were evaluated by generalized linear models. Results The workers' medians (P₂₅, P₇₅) of blood aluminum concentration, plasma relative expression level of miR-134-3p, and MoCA score were 39.31 (25.30, 57.41) μg·L^-1, 2.93 (2.29, 3.74), and 22.0 (20.0, 26.0), respectively. The results of the generalized linear model showed that after adjusting for age, body mass index, smoking, and alcohol consumption, compared with the Q₁ group, blood aluminum in the Q₂, Q₃, or Q₄ group had an impact on related plasma miR-134-3p expression level and total MoCA score (P<0.05). With increasing blood aluminum concentration, the expression level of miR-134-3p in workers' plasma gradually increased, showing a positive correlation (b>0, P_trend<0.001), while the total score of MoCA gradually decreased, showing a negative correlation (b<0, P_trend<0.001). As the expression level of miR-134-3p in plasma increased, the total score of MoCA gradually decreased, showing a negative correlation (b<0, P_trend<0.001). There was a linear relationship between peripheral blood aluminum concentration and plasma relative expression level of miR-134-3p of the workers in the middle school and below group and the high school group (P_trend<0.05), b (95%CI)=1.796 (1.248, 2.344) and 1.192 (0.874, 1.510), and no correlation was found in the workers in the college and above group (P_trend>0.05). Conclusion Occupational aluminum exposure can lead to an increase in the expression level of miR-134-3p in plasma of workers, which may be related to a decrease in cognitive function of workers.

Background Chemical modification of RNA is a recent hotspot in the field of epigenetics, but the specific mechanism of chemical modification of RNA in aluminum neurotoxicity has not been fully reported. Objective To investigate the alterations of fat mass and obesity-associated protein (FTO), that demethylates N6-methyladenosine (m⁶A), and brain-derived neurotrophic factor (BDNF) in different brain regions of rats and rat adrenal pheochromocytoma differentiated cells (PC12 cells) following aluminum exposure. Methods Animal experiment: Twenty-four healthy male SD rats were randomly divided into a control group (normal saline) and 10, 20, and 40 μmol·kg⁻¹ exposure groups according to body weight, with 6 rats in each group. Maltol aluminum [Al(mal)₃] was injected intraperitoneally every other day for 3 months. Cell experiment: PC12 cells were divided into a control group and 100, 200, and 400 μmol·L⁻¹ exposure groups exposed to Al(mal)₃ for 24 h. After exposure, the learning and memory ability of rats was measured by water maze experiment, and the protein expression levels of FTO and BDNF in rat cortex (n=6) and hippocampus (n=6) samples as well as in PC12 cells (n=5) were determined by Western blotting. Results The results of water maze test showed that the escape latency of the 40 μmol·kg⁻¹Al(mal)₃ group was higher than those of the control group, the 10 μmol·kg⁻¹Al(mal)₃ group, and the 20 μmol·kg⁻¹Al(mal)₃ group on day 3, 4, and 5 of training (P<0.05). The retention time of the target quadrant of the 40 μmol·kg⁻¹Al(mal)₃ group was also reduced compared with that of the control group (P<0.05), indicating that aluminum exposure damaged the learning and memory ability of the rats. The Western blotting results showed that in the cortex, compared with the control group, the protein expression levels of FTO and BDNF in the aluminum treated groups were decreased (P<0.05). In the hippocampus, compared with the control group, the protein expression levels of FTO and BDNF in the 20 μmol·kg⁻¹ and the 40 μmol·kg⁻¹Al(mal)₃ groups were decreased (P<0.05). In PC12 cells, compared with the control group, the protein expression levels of FTO and BDNF in the aluminum treated groups were decreased (P<0.05). Conclusion Aluminum-induced learning and memory impairment is related to a simultaneous reduction of FTO and BDNF protein expressions, suggesting that m⁶A methylation may be involved.

Objective:To observe any curative effect of combining hydraulic dilatation with radial extracorporeal shock waves on scapulohumeral periarthritis.Methods:A total of 132 patients with scapulohumeral periarthritis were randomly divided into a hydraulic dilatation group, a shock wave group and a combination group. The three treatments were applied for 3 weeks, before and after which shoulder range of motion was evaluated. Shoulder function was quantified using the Japanese Orthopaedic Association′s (JOA′s) shoulder function scoring, pain was reported using a visual analogue scale (VAS), and ability in the activities of daily living (ADL) was also quantified. Serum prostaglandin E2 (PGE2), β-endorphin (β-EP), interleukin 6 (IL-6) and tumor necrosis factor α (TNF-α) were assayed.Results:The treatment response rate of the combination group (95%) was significantly higher than those of the hydraulic dilatation group (70%) and the shock wave group (82%). After the treatment, the average shoulder range of motion, JOA and ADL scores, and β-EP level in all 3 groups had improved significantly, while the average VAS score, and the PGE2, IL-6 and TNF-α levels had decreased significantly, but in each case the improvement in the combination group′s average was significantly greater than those of the other 2 groups. During the treatment there were no such adverse events as intra-articular infection, skin redness, numbness or palpitations.Conclusions:Combining hydraulic dilatation with radial extracorporeal shock waves significantly improves the treatment of scapulohumeral periarthritis. It can effectively promote the recovery of shoulder function and improve quality of life. Its greater effectiveness may be related to improving levels of PGE2, β-EP, IL-6 and TNF-α, and relieving pain and inflammation.

Objective To investigate the prevalence of nutritional risk (NRS2002) and malnutrition inhospitalized stroke patient and their nutritional intervention. Methods The stroke patients admitted to three de-partments of vascular neurology ward including cerebral hemorrhage, cerebral infarction and subarachnoid hemor-rhage in Beijing Tiantan Hospital from January 2018 to January 2019 were recruited using cluster sampling. Nutri-tional risk screening 2002 ( NRS 2002) was used to screen the nutritional risk of inpatients Malnutrition was as-sessed by criteria:(1) body mass index (BMI) <18. 5 kg/m2 with poorer general condition from January 2018 to January 2019;(2) Global leadership initiative on malnutrition ( GLIM) criteria were used except whole body muscle mass measurement from October 2018 to January 2019. The nutritional intervention for patients were closely observed during hospitalization. Results A total of 1532 patients were registered and1036 patients were included in the final analysis considering the inclusion and exclusion criteria. The prevalence of nutritional risk was 33. 0％ ( 342/1036) . The prevalence of malnutrition based on BMI and GLIM criteria was 0. 9％( 9/1036) and 2. 5％ (10/393) respectively. Among the 342 patients with nutritional risk, 112 patients received nutritional support therapy by tube feeding, but only 29 patients received nutritional support that met guideline standards. 81 patients received not standard nutritional support, and 2 patients received highly unregulated nutritional sup-port. No patients received sugar and electrolyte infusion, oral nutritional supplements ( ONS) , oral nutritional a-gents and compound nutrition intervention. The other 230 patients took hospital diet. Conclusion The prevalence of nutritional risk in hospitalized patients with cerebral hemorrhage, cerebral infarction or subarachnoid hemorrhage was high, and the prevalence of malnutrition was extremely low. There was a low proportion of nutri-tional support. High quality of large sample cohort studies will be conducted to show whether reasonable applica-tion of nutritional support therapy in patients with nutritional risk can improve patient outcome.

The ultimate goal of the development of parenteral and enteral nutrition is to achieve T3 transfer of translational medicine in this field. This study is an international cooperative, multicenter and observational clinical study conducted by CSPEN-NUSOC cooperative group for 15 years which is aimed to observe the effect of standardized nutritional support on clinical outcome and cost/effect and verify the clinical value parenteral and enteral nutrition through investigating the prevalence of nutritional risk and malnutrition and the application of nutritional support in adult in-patients.

Objective To study and compare the efficacy of surgery and conservative treatments for patients with critical(30 to 50 ml) spontaneous deep supratentorial intracerebral hemorrhage. Methods The clinical data of 420 patients diagnosed as spontaneous deep supratentorial intracerebral hemorrhage in Affiliated Hospital of Yan'an and Central Hospital of Baoji from August 2011 to September 2016 in this study were retrospectively analyzed. All patients were divided into surgery group(210 cases) and conservative group(210 cases) according to the difference of treatment methods. Large trauma craniotomy was used by the operation group, external ventricular drainage as the standby in necessary. The treatment of conservative group mainly included reduction of intracranial pressure, blood pressure management, prevention of complications and other individualized treatment. The primary outcome was neurological functional status of patients at 6 months of discharging, and the secondary outcomes included the mortality at 1 month and 6 months of discharging, and complications. Continuous data were presented as (x)± s and were compared using the t test, while categorical data were presented as number and percentage and were compared using the χ2 test. Results No obvious difference on mRS score and NIHSS score occurred between two groups(All P>0.05). Stratified analysis, patients with midline shift >5 mm and with intraventricular hemorrhage were more likely to have a favorable outcome from surgery compared with conservative group(18.2％ vs.8.1％, X =4.099, P=0.043; 17.3％ vs.5.0％, χ2 =4.836, P=0.028). The mortality at 1 month days and 6 months in surgery group were significantly lower than that in conservative group(19.0％ vs.31.0％, X2 =7.937, P=0.005; 23.8％ vs.36.7％, X2=8.228, P=0.004). Meanwhile, the incidence of pulmonary infection and with long-term pipe in surgery group were significantly higher than those in conservative group(31.9％ vs.15.7％, X2 =15. 173, P=0.000; 28.6％ rs.19.5％ =4.706, P=0.030). Conclusion Surgery can reduce the 1 month and 6 months mortality in patients with spontaneous deep supratentorial hemorrhage and improve the functional outcomes in patients with large midline shift or with intraventricular hemorrhage compared with conservative treatment.