A large number of cancer patients suffer from pain. Growing evidence suggested that pain might be a serious risk factor for cancer patients. The shared modulators and modulation pathways between neural system and tumor cells, such as various neurotransmitters and neurogenic cytokines, provide essential basis for the effect of pain on tumor. In this article, we reviewed some possible mechanism of this process from two aspects: the systematic regulation of central nervous system on endocrine and immunity, and the regional regulation of peripheral nerves on tumor cells. The aim of this review is to provide more innovative knowledge about pain and cancer and to emphasize the importance of anti-pain in the therapy of cancer.
Cancer Pain ; physiopathology ; Central Nervous System ; Humans ; Memory ; Neurotransmitter Agents ; Pain ; Peripheral Nerves

OBJECTIVETo compare the clinical efficacy between acupuncture and intravenous administration of lipoic acid and alprostadil for distal symmetric multiple peripheral neuropathy of diabetes mellitus.

METHODSSixty patients were randomly divided into an acupuncture group (31 cases) and a medication group (29 cases). Patients in the two groups received basic treatment to control blood sugar within a safe range. On this basis, patients in the acupuncture group were treated with acupuncture at Geshu (BL 17), Weiwanxiashu (EX-B 3), Ganshu (BL 18), Pishu (BL 20), Shenshu (BL 23), Zusanli (ST 36), Taixi (KI 3), ashi points, etc. Patients in the medication group were treated with intravenous administration of lipoic acid (0.6 g) and alprostadil (10 mg). The treatment was given once a day, 10 days for a course of treatment; there was an interval of 2 days between courses, and totally 3 courses were given. The score of peripheral neuropathy of diabetes mellitus, the change of nerve conduction: velocity and clinical efficacy before and after treatment in the two groups were observed.

RESULTSAfter treatment, the score of peripheral neuropathy was significantly reduced in the two groups (both P < 0.05), which was more significant in the acupuncture group (P < 0.05). After treatment, the sensory nerve conduction velocity (SNCV) and motor nerve conduction velocity (MNCV) of median nerve and common peroneal nerve were significantly increased in the two groups (all P < 0.05). Compared between two groups, the SNCV and MNCV of common peroneal nerve in the acupuncture group were significantly superior to those in the medication group (both P < 0.05); the MNCV of median nerve in the acupuncture group was significantly superior to that in the medication group (P < 0.05); the SNCV of median nerve in the acupuncture group was not significantly different from that in the medication group (P > 0.05). The total effective rate was 83.9% (26/31) in the acupuncture group, which was significantly superior to 62.1% (18/29) in the medication group (P < 0.05).

CONCLUSIONAcupuncture and conventional medication both have satisfied effects for distal symmetric multiple peripheral neuropathy of diabetes mellitus, and acupuncture is superior to medication on improving clinical signs of sensory disorder, reflection disturbance and muscle weakness, nerve conduction and clinical curative effect.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Diabetes Mellitus, Type 2 ; complications ; Diabetic Neuropathies ; etiology ; physiopathology ; therapy ; Female ; Humans ; Male ; Middle Aged ; Peripheral Nerves ; physiopathology ; Peripheral Nervous System Diseases ; etiology ; physiopathology ; therapy

Animals ; Macaca mulatta ; Nerve Regeneration ; Peripheral Nerve Injuries ; physiopathology ; Peripheral Nerves ; physiology ; Rats

BACKGROUNDPeripheral nerve injury causes a high rate of disability and a huge economic burden, and is currently one of the serious health problems in the world. The use of nerve grafts plays a vital role in repairing nerve defects. Acellular nerve grafts have been widely used in many experimental models as a peripheral nerve substitute. The purpose of this study was to test the biomechanical properties of acellular nerve grafts.

METHODSThirty-four fresh sciatic nerves were obtained from 17 adult male Wistar rats (age of 3 months) and randomly assigned to 3 groups: normal control group, nerve segments underwent no treatment and were put in phosphate buffered saline (pH 7.4) and stored at 4°C until further use; physical method group, nerve segments were frozen at -196°C and then thawed at 37°C; and chemical method group, nerve segments were chemically extracted with the detergents Triton X-200, sulfobetaine-10 (SB-10) and sulfobetaine-16 (SB-16). After the acellularization process was completed, the structural changes of in the sciatic nerves in each group were observed by hematoxylin-eosin staining and field emission scanning electron microscopy, then biomechanical properties were tested using a mechanical apparatus (Endura TEC ELF 3200, Bose, Boston, USA).

RESULTSHematoxylin-eosin staining and field emission scanning electron microscopy demonstrated that the effects of acellularization, demyelination, and integrity of nerve fiber tube of the chemical method were better than that of the physical method. Biomechanical testing showed that peripheral nerve grafts treated with the chemical method resulted in some decreased biomechanical properties (ultimate load, ultimate stress, ultimate strain, and mechanical work to fracture) compared with normal control nerves, but the differences were not statistically significant (P > 0.05).

CONCLUSIONNerve treated with the chemical method may be more appropriate for use in implantation than nerve treated with the physical method.

Animals ; Biomechanical Phenomena ; Male ; Microscopy, Electron, Scanning ; Peripheral Nerve Injuries ; therapy ; Peripheral Nerves ; physiology ; ultrastructure ; Rats ; Rats, Wistar ; Sciatic Nerve ; physiopathology ; ultrastructure ; Tissue Engineering

Acute Disease ; Child, Preschool ; Female ; Hand, Foot and Mouth Disease ; complications ; physiopathology ; Humans ; Infant ; Male ; Paraplegia ; etiology ; Peripheral Nerves ; physiopathology

OBJECTIVE: To study the characteristics of forensic identification cases involved with peripheral nerve injury, and to discuss how to apply the clinical information, forensic examination and neurophysiological testing. METHODS: One hundred and fifty-eight cases which were diagnosed peripheral nerve injury in clinic, were collected. Then the individual characteristics, injuries, identification results, exaggeration or camouflage were analysed. RESULTS: The male, the unemployed, and the young and middle-aged were common in our cases. The main reasons of "peripheral nerve injury" were traffic accidents and sharp injuries. Most wounded parts were in limbs. Also the exaggeration and camouflage accounted for a considerable proportion in our cases. CONCLUSION The forensic identification of "peripheral nerve injury" cases should be evaluated with clinical information, forensic examination and electrophysiological testing comprehensively.
Accidents, Traffic ; Adolescent ; Adult ; Age Distribution ; Disability Evaluation ; Electromyography ; Electrophysiology ; Female ; Forensic Medicine ; Humans ; Male ; Middle Aged ; Neural Conduction/physiology* ; Peripheral Nerve Injuries ; Peripheral Nerves/physiopathology* ; Peripheral Nervous System Diseases/physiopathology* ; Retrospective Studies ; Trauma Severity Indices ; Wounds, Nonpenetrating/physiopathology* ; Young Adult

We report a patient with Lewis-Sumner syndrome (LSS) who showed an improvement only with plasma exchange (PE). The patient, 32-yr old man, had progressive multifocal motor-sensory deficits with persistent, multiple conduction blocks and marked slowing of NCVs. Nerve pathology supported a diagnosis of demyelinating neuropathy by revealing marked loss of myelinated fibers with inter- and intrafascicular variation. Although the patient was refractory to treatment with corticosteroid and intravenous immunoglobulin, PE produced a dramatic improvement. Our experience strongly proposes that PE should be tried for refractory LSS.
Adrenal Cortex Hormones/therapeutic use ; Adult ; Demyelinating Diseases/*diagnosis/pathology/physiopathology/*therapy ; Humans ; Immunoglobulins, Intravenous/therapeutic use ; Male ; Neural Conduction/physiology ; Peripheral Nerves/pathology/physiopathology ; *Plasma Exchange ; Syndrome ; Treatment Outcome

PURPOSE: The purpose of this study was to examine the effects of exercise on muscle weight and Type I and II fiber cross-sectional area of affected and unaffected hindlimb muscles in rats with neuropathic pain induced by unilateral peripheral nerve injury. METHODS: Neuropathic pain was induced by ligation and cutting of the left L5 spinal nerve. Adult male Sprague-Dawley rats were randomly assigned to one of two groups: The Pain+Exercise (PE) group (n=21) and the Sham+Exercise (SE) group (n=20). All rats had 28 sessions of treadmill exercise at grade 10 for 30 minutes, twice/day at 10 m/min for 14 days. Body weight, food intake and activity were measured every day. At 15 days all rats were anesthetized and soleus, plantaris and gastrocnemius muscles were dissected. Muscle weight and Type I, II fiber cross-sectional area of the dissected muscles were measured. RESULTS: The PE group showed significant increases (p<.05), as compared to the SE group for body weight and total diet intake, muscle weight of the unaffected soleus and plantaris, and in Type I and II fiber cross-sectional area of unaffected three muscles and affected plantaris. CONCLUSION: Exercise for 14 days attenuates unaffected soleus, plantaris and gastrocnemius muscle atrophy in neuropathic pain model.
Animals ; Body Weight ; Disease Models, Animal ; Eating ; Hindlimb/*physiology ; Male ; Muscle Fibers, Skeletal/*physiology ; Muscular Atrophy/etiology/physiopathology ; Neuralgia/*etiology ; Peripheral Nerves/*injuries ; *Physical Conditioning, Animal ; Rats ; Rats, Sprague-Dawley

The aim of this study was to investigate the effect of platelet-rich plasma (PRP) on cavernous nerve (CN) regeneration and functional status in a nerve-crush rat model. Twenty-four Sprague-Dawley male rats were randomly divided into three equal groups: eight had a sham operation, eight underwent bilateral nerve crushing with no further intervention and eight underwent bilateral nerve crushing with an immediate application of PRP on the site of injury. Erectile function was assessed by CN electrostimulation at 3 months and nerve regeneration was assessed by toluidine blue staining of CN and nicotinamide adenine dinucleotide phosphate (NADPH)-diaphorase staining of penile tissue. Three months after surgery, in the group that underwent bilateral nerve crushing with no further intervention, the functional evaluation showed a lower mean maximal intracavernous pressure (ICP) and maximal ICP per mean arterial pressure (MAP) with CN stimulation than those in the sham group. In the group with an immediate application of PRP, the mean maximal ICP and maximal ICP/MAP were significantly higher than those in the injured control group. Histologically, the group with the application of PRP had more myelinated axons of CNs and more NADPH-diaphorase-positive nerve fibres than the injured control group but fewer than the sham group. These results show that the application of PRP to the site of CN-crush injury facilitates nerve regeneration and recovery of erectile function. Our research indicates that clinical application of PRP has potential repairing effect on CN and peripheral nerves.
Animals ; Disease Models, Animal ; Electric Stimulation ; Erectile Dysfunction ; pathology ; physiopathology ; therapy ; Male ; NADPH Dehydrogenase ; metabolism ; Nerve Regeneration ; physiology ; Penile Erection ; physiology ; Penis ; innervation ; Peripheral Nerve Injuries ; Peripheral Nerves ; metabolism ; pathology ; Platelet Transfusion ; Platelet-Rich Plasma ; Radiculopathy ; etiology ; pathology ; physiopathology ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo study the combined effect of low temperature and vibration on function of peripheral circulation and nerve.

METHODS64 rabbits were divided into control group, low temperature group, vibration group and combined effect group randomly, 16 each group. The changes of concentration of ET, Ang II, NO in plasma and SCV, amplitude of sensory nerve action potential, latency of sensory nerve action potential, MCV, distal amplitude of motor nerve, and distal latency of motor nerve were measured before and after experiment.

RESULTSAfter experiment, the concentration of ET, Ang II, NO and SCV, amplitude of sensory nerve action potential, latency of sensory nerve action potential, MCV, distal amplitude of motor nerve, and distal latency of motor nerve were (68.84+/-14.81) pg/ml, (544.01+/-70.20) pg/ml, (123.73+/-9.58) nmol/ml, (25.36+/-6.96) m/s, (1.84+/-0.65) microV, (4.05+/-1.04) m/s, (27.40+/-6.05) m/s, (1.60+/-0.52) microV, (3.51+/-1.30) m/s respectively in low temperature group; (70.22+/-15.02) pg/ml, (540.77+/-68.25) pg/ml, (129.46+/-11.99) nmol/ml, (27.69+/-6.16) m/s, (2.19+/-0.53) microV, (3.86+/-0.89) m/s, (30.03+/-5.21) m/s, (1.65+/-0.49) microV, (3.36+/-l.11) m/s respectively in vibration group; (88.47+/-13.20) pg/ml, (687.38+/-101.44) pg/ml, (70.66+/-4.99) nmol/ml, (20.82+/-3.65) m/s, (1.21+/-0.64) microV, (5.05+/-0.94) m/s, (19.97+/-4.37) m/s, (1.09+/-0.49) microV, (4.49+/-1.26) m/s respectively in combined effect group; compared with pre-experiment, the concentration of ET and Ang II in low temperature group, vibration group and combined effect group were increased after experiment, and the NO was decreased (P<0.05); the nerve conduct velocity and amplitude was decreased and the latency was delayed (P<0.05). After experiment, the concentrations of ET and Ang II in combined effect group were higher than low temperature group and vibration group, and the concentration of NO in combined effect group was lower than low temperature group and vibration group (P<0.05). After experiment, the SCV and MCV in combined effect group were slower than low temperature group and vibration group; the amplitude of sensory nerve action potential and distal amplitude of motor nerve were less than low temperature group and vibration group; the latency of sensory nerve action potential and distal latency of motor nerve in combined effect group was longer than low temperature group and vibration group. The factorial analysis results indicated the synergistic effect between low temperature and vibration (P<0.05).

CONCLUSIONVibration-induced peripheral vascular impairment and nerve impairment would be intensified by low temperature.

Animals ; Blood Circulation ; physiology ; Cold Temperature ; adverse effects ; Female ; Male ; Peripheral Nerves ; physiopathology ; Rabbits ; Vibration ; adverse effects