脊髓胶质细胞在小鼠骨癌痛形成中的作用

Objective To evaluate the role of gliocyte in the spinal cord in the development of bone cancer pain (BCP) in mice. Methods Forty male C3H/He mice aged 8-10 weeks weighing 18-22 g were randomly divided into 4 groups ( n = 10 each) : group I sham operation (group S) , group II BCP, group Ⅲ PBS and group IV minocyline (group M) . In group BCP, PBS and M, bone cancer pain was produced by injection of NCTC2472 fibrosarcoma cell suspension (2 x 105 cells) 10 μl into medullary cavity of calcaneus bone, while in group S, PBS solution 10 μl was injected instead of cancer cell suspension. In group PBS and M, PBS 5 μl and minocyline 5 μl (dissolved to 0.2 mmol/L in PBS)_were given IT immediately before cancer cell inoculation once a day for 11 consecutive days respectively. Mechanical pain threshold was measured at 1 d before cancer cell inoculation, and at 0, 3, 5, 7, 9 and 11d after cancer cell inoculation. Cold pain threshold was measured at 3, 7, 9 and 11d after cancer cell inoculation. The animals were killed after measurement of pain threshold and L4-6, segment of spinal cord was removed for determination of GFAP and CD11b expression by Western blot. Results Compared with group S, mechanical pain threshold was significantly increased at 3-11 d after cancer cell inoculation in group BCP and PBS, and at 3 and S d after cancer cell inoculation in group M, and cold pain threshold was significantly increased at 7-11 d after cancer cell inoculation, and expression of CD11b and GFAP was up-regulated in group BCP, PBS and M ( P < 0.05) . Compared with group BCP, mechanical pain threshold was significantly decreased at 3-11 d after cancer cell inoculation, cold pain threshold was significantly decreased at 7-11 d after cancer cell inoculation, and expression of CD11b and GFAP was down-regulated in group M ( P <0.05) . ConclusionThe activiton of gliocyte in the spinal cord is involved in the development of bone cancer pian in mice.     

布托啡诺复合丙泊酚麻醉在无痛内镜下逆行胰胆管造影中的应用

目的观察布托啡诺复合丙泊酚麻醉在内镜下逆行胰胆管造影(ERCP)中的应用效果。方法 36例行ERCP的患者,随机分为2组,Ⅰ组为单纯丙泊酚麻醉组,Ⅱ组为布托啡诺复合丙泊酚麻醉组。观察并比较两组患者术前(T1)、诱导后(T2)、胆管内操作时(T3)的血流动力学变化(MAP、心率)、丙泊酚用量、苏醒时间、术后不良反应。结果Ⅰ组在胆管内操作时心率及血压上升,与Ⅱ组相比有统计学意义;Ⅱ组丙泊酚用量较Ⅰ组明显减少。结论布托啡诺复合丙泊酚麻醉是一种较为理想的无痛ERCP麻醉方法。     

脊髓射频毁损治疗脊髓损伤后慢性疼痛2例并国内文献分析

脊髓损伤后疼痛(spinal cord injury pain,SCIP)的发生率约为34％～94％,常出现于伤后几天到数月内.该疼痛较为顽固,缺乏有效的治疗方法;目前国内多采取药物结合针灸理疗等综合治疗,少数病例行脊髓背根入髓区切开手术等治疗,疗效各不相同.我科2010年行2例脊髓射频毁损治疗脊髓损伤后慢性疼痛,术后疼痛缓解满意;现结合国内文献报告如下.     

密集型银质针导热治疗髌骨软化症引起膝关节疼痛的疗效

目的探讨密集型银质针导热疗法治疗髌骨软化症引起的膝关节疼痛的疗效。方法将髌骨软化症引起的膝关节疼痛患者150例,随机分为银针组和口服药物组。前者采用密集型银质针导热疗法,后者单纯应用口服药物治疗。于治疗前和治疗后的2周、2个月和4个月时,进行视觉模拟评分,并记录疼痛对患者工作和生活的影响程度。结果银针组治疗后不同时点视觉模拟评分及对患者工作和生活的影响程度均小于口服药物组（P〈0．05）。结论密集型银质针导热疗法对髌骨软化症引起膝关节疼痛的治疗效果良好。     

抑制小胶质细胞激活对骨癌痛小鼠疼痛维持的影响

目的研究鞘内注射小胶质细胞特异性抑制剂米诺环素(minocycline,MC)抑制脊髓小胶质细胞的激活对骨癌痛维持的影响。方法采用小鼠跟骨癌痛模型,♂C3H/He小鼠42只,随机分为3组(n=14),sarcoma+PBS(phosphatebuffered saline)组和sarcoma+MC组行小鼠跟骨癌痛模型制作,跟骨内注射肿瘤细胞;sham+PBS组行假手术,跟骨内注射PBS。造模后11天(post-implantation day11,PID11),每组随机取10只小鼠,sham+PBS组和sarcoma+PBS组单次鞘内注射MC溶媒(PBS 5μl),sarcoma+MC组单次鞘内注射MC(1 nmol,5μl)。各组分别在鞘内注射前、注射后0.5、1、2、4、8、24 h测定机械性痛觉超敏、冷痛觉过敏。各组剩余4只小鼠在PID12鞘内注射后1 h行非伤害性触摸右侧足底90min,分析脊髓背角c-fos蛋白的表达。结果骨癌痛导致小鼠机械性痛阈和冷痛阈降低,脊髓背角c-fos蛋白的表达上调;单次鞘内注射MC能暂时提高小鼠疼痛阈值,并抑制脊髓背角c-fos蛋白的表达。结论小胶质细胞的激活对骨癌痛的维持具有重要作用。     

腹腔注射肉毒毒素A抑制CCI模型大鼠机械性触诱发痛和热痛觉过敏的形成

目的 研究肉毒毒素A(Btx-A)对神经病理性疼痛模型大鼠的镇痛作用,并探讨其可能机制.方法 采用大鼠坐骨神经结扎(CCI)模型,雄性SD大鼠50只随机分为5组(n=10):①sham saline组,行假手术,腹腔内注射生理盐水;②sham Btx-A组,行假手术,腹腔内注射Btx-A(30 U/kg);③CCI saline组;④CCI Btx-A(15 U/kg)组;⑤CCI Btx-A(30 U/kg)组;其中③～⑤组制作CCI模型.各组皆于术后即刻腹腔给药,于术前和术后1、3、5、7、14天观察机械缩足反射阈值和热刺激反射潜伏期的变化.结果 神经病理性疼痛模型组大鼠术后第4天形成稳定的机械性触诱发痛和热痛觉过敏,腹腔给予肉毒毒素A大鼠机械缩足反射阈值和热刺激反射潜伏期与sham saline组相比无显著性差异.结论 腹腔给予肉毒毒素A能抑制神经病理性疼痛大鼠机械性触诱发痛和热痛觉过敏的形成.     

肉毒毒素A对慢性坐骨神经结扎大鼠机械痛敏和热痛敏的影响

目的探讨肉毒毒素A(botulinum toxin type A,BoNT-A)后处理对神经病理性疼痛大鼠疼痛行为学的影响。方法建立SD大鼠右侧慢性坐骨神经结扎模型(chronic con-striction injury of sciatic nerve,CCI)。CCI术后d3始,CCI同侧肢体足底注射BoNT-A7.5、15、30U·kg-1或等容积生理盐水,或对侧肢体足底注射BoNT-A15或30U·kg-1。分别于术前、术后1、3、5、7、14d,测定大鼠的机械缩足反射阈值(MWT)和热缩足潜伏期(TWL)。结果CCI手术同侧足底皮下注射BoNT-A可以增加大鼠的MWT和TWL,对侧应用BoNT-A对MWT和TWL无影响。结论BoNT-A可以通过局部作用减轻CCI手术同侧肢体的机械痛敏和热痛敏。     

脊髓胶质细胞在小鼠骨癌痛形成中的作用

Objective To evaluate the role of gliocyte in the spinal cord in the development of bone cancer pain (BCP) in mice. Methods Forty male C3H/He mice aged 8-10 weeks weighing 18-22 g were randomly divided into 4 groups ( n = 10 each) : group I sham operation (group S) , group II BCP, group Ⅲ PBS and group IV minocyline (group M) . In group BCP, PBS and M, bone cancer pain was produced by injection of NCTC2472 fibrosarcoma cell suspension (2 x 105 cells) 10 μl into medullary cavity of calcaneus bone, while in group S, PBS solution 10 μl was injected instead of cancer cell suspension. In group PBS and M, PBS 5 μl and minocyline 5 μl (dissolved to 0.2 mmol/L in PBS)_were given IT immediately before cancer cell inoculation once a day for 11 consecutive days respectively. Mechanical pain threshold was measured at 1 d before cancer cell inoculation, and at 0, 3, 5, 7, 9 and 11d after cancer cell inoculation. Cold pain threshold was measured at 3, 7, 9 and 11d after cancer cell inoculation. The animals were killed after measurement of pain threshold and L4-6, segment of spinal cord was removed for determination of GFAP and CD11b expression by Western blot. Results Compared with group S, mechanical pain threshold was significantly increased at 3-11 d after cancer cell inoculation in group BCP and PBS, and at 3 and S d after cancer cell inoculation in group M, and cold pain threshold was significantly increased at 7-11 d after cancer cell inoculation, and expression of CD11b and GFAP was up-regulated in group BCP, PBS and M ( P < 0.05) . Compared with group BCP, mechanical pain threshold was significantly decreased at 3-11 d after cancer cell inoculation, cold pain threshold was significantly decreased at 7-11 d after cancer cell inoculation, and expression of CD11b and GFAP was down-regulated in group M ( P <0.05) . ConclusionThe activiton of gliocyte in the spinal cord is involved in the development of bone cancer pian in mice.     

布托啡诺复合丙泊酚麻醉在无痛内镜下逆行胰胆管造影中的应用

目的观察布托啡诺复合丙泊酚麻醉在内镜下逆行胰胆管造影（ERCP）中的应用效果。方法36例行ERCP的患者,随机分为2组,Ⅰ组为单纯丙泊酚麻醉组,Ⅱ组为布托啡诺复合丙泊酚麻醉组。观察并比较两组患者术前（T1）、诱导后（T2）、胆管内操作时（T3）的血流动力学变化（MAP、心率）、丙泊酚用量、苏醒时间、术后不良反应。结果Ⅰ组在胆管内操作时心率及血压上升,与Ⅱ组相比有统计学意义;Ⅱ组丙泊酚用量较Ⅰ组明显减少。结论布托啡诺复合丙泊酚麻醉是一种较为理想的无痛ERCP麻醉方法。