Rejected

Spinal surgery causes severe postoperative pain. An erector spinae plane (ESP) block can relieve postoperative pain, but the optimal blocking method has not been defined. The aim of this study is to compare the feasibility of a one-level and a two-level lumbar ESP block and their effect on intraoperative and postoperative analgesia in lumbar spinal surgery.

The etiology of patellofemoral (PF) instability is multifactorial. Excessive external tibial torsion has been associated with recurrent patellar subluxation and persistent anterior knee pain. Several surgical techniques have been historically used to correct this, including medial patellofemoral ligament reconstruction, tibial tuberosity transfer (TTT), trochleoplasty, and tibial derotation osteotomy (TDO). The purpose of this systematic review is to investigate the safety and efficacy of TDO for PF instability and pain.

Skullcapflavone II (SFII), a flavonoid derived from , is an anticancer agent. We aimed to validate SFII for atopic dermatitis (AD) therapy by demonstrating the anti-inflammatory effects of SFII in an AD mouse model produced by the topical application of the vitamin D3 analog MC903. We showed that topical treatment with SFII significantly suppressed MC903-induced serum IgE levels compared with topical hydrocortisone (HC) treatment. Topical SFII also prevents MC903-induced pruritus, skin hyperplasia, and inflammatory immune cell infiltration into lesional skin comparable to topical HC. In addition, MC903-induced immune cell chemoattractants and AD-associated cytokine production in skin lesions were effectively suppressed by topical SFII. The production of MC903-induced effector cytokines influencing T helper (Th)2 and Th17 polarization in lesioned skin is significantly inhibited by topical SFII. Furthermore, we showed that SFII can directly inhibit the production of AD-associated cytokines by human primary keratinocytes, mouse bone marrow-derived cells (BMDCs), and mouse CD4 T cells . Lastly, we demonstrated that topical SFII more effectively suppressed serum IgE levels, the production of IL-4 and thymic stromal lymphopoietin (TSLP), and infiltration of CD4 T cells and Gr-1 cells (neutrophils) into lesion skin compared to topical baicalein (a flavonoid derived from ), which has anti-inflammatory effects. Taken together, our findings suggest that SFII may have promising therapeutic potential for this complex disease the regulation of multiple AD-associated targets.

Trigeminal neuralgia (TN) due to compression from the dolichoectatic vertebrobasilar artery (DVBA) is extremely rare and difficult to treat due to its morphological characteristics. We report two cases of good transposition of DVBA and postoperative course obtained using the anterior petrosal approach and a new vasoculopexy method.

Painful diabetic peripheral neuropathy (DPN) is often refractory to conventional medications. Triple-nerve decompression was proposed for painful DPN due to the frequent involvement of multiple nerve entrapments in diabetes. However, the role of decompressive surgery remains controversial. This trial aims to assess the efficacy of triple-nerve decompression for patients with painful DPN suggestive of nerve entrapment using a randomized controlled trial (RCT) design.

Difficulty predicting prognosis is a major barrier to timely palliative care provision for patients with COPD. The ProPal-COPD tool, combining six clinical indicators and the Surprise Question (SQ), aims to predict 1-year mortality as a proxy for palliative care needs. It appeared to be a promising tool for healthcare providers to identify patients with COPD who could benefit from palliative care.

Evaluation of the clinical efficacy of the drug holisal» according to the results of domestic and foreign studies on modern methods for treatment of inflammatory diseases of the oral mucosa mouth and periodontium.

Brucellosis is an endemic systemic infectious disease, the most common complication is bone and joint involvement. Sacroiliac joint infections and spinal joint infections commonly affect adults, but ankle infections are extremely rare. We report a case of recurrent ankle arthritis caused by .

Hydroxyanthracene derivatives are widely distributed in the plant kingdom, mainly in botanicals such as the and genera. For centuries, plants containing hydroxyanthracene derivatives have been used as herbal remedies, mainly as laxatives. The root and underground stem (rhizome) are used to make medicine, primarily for digestive complaints including constipation, diarrhoea, heartburn, stomach pain, gastrointestinal bleeding, and preparation for certain gastrointestinal diagnostic procedures. The use of hydroxyanthracene-containing botanicals has raised the attention of European Food Safety Authority (EFSA) for the potential genotoxicity activity, that in 2018 concluded "". No genotoxic activity has been reported with other constituents such as rhein, physcion and chrysophanol. In the present study, Rhubarb ethanolic extract of ground rhubarb rhizome (hydroxyanthracene total content 1.39 %) was tested in the Ames Assay in and , up to 5000 µg/plate and up to 5000 µg/mL in human lymphocytes Micronucleus Test (OECD 471 and 487 respectively) in vitro mutagenic and genotoxic effects. Under the experimental conditions used, the rhubarb rhizome extract showed no genotoxic activity.

Reactive arthritis (ReA) is uncommon. The present case is a Chinese man who has been treated with adalimumab and leflunomide to control ankylosing spondylitis (AS). During the treatment, the patient developed a range of symptoms, including fever, fatigue, pustular rash, suppurative urethritis, genital ulcers, oral ulcers, bilateral uveitis, heel pain and swelling and pain of the knee and ankle joints. The laboratory studies revealed the presence of HLA-B27, and urethral secretions were positive for . The patient was eventually diagnosed with ReA. The development of ReA may be related to the combination of adalimumab and leflunomide, which reduces immune function and triggers activation of potential . The patient received 3 weeks of antibiotics, corticosteroids and non-steroidal anti-inflammatory drugs (NSAIDs), resulting in a significant improvement. The dose of corticosteroids was gradually reduced, and adalimumab was reintroduced. The patient was followed up for 3 months without recurrence.