Rejected

Methylene blue (MB) is a cationic thiazine dye, widely used as a biological stain and chemical indicator. Growing evidence have revealed that MB functions to restore abnormal vasodilation and notably it is implicated even in pain relief. Physicians began to inject MB into degenerated disks to relieve pain in patients with chronic discogenic low back pain (CDLBP), and some of them achieved remarkable outcomes. For osteoarthritis and colitis, MB abates inflammation by suppressing nitric oxide production, and ultimately relieves pain. However, despite this clinical efficacy, MB has not attracted much public attention in terms of pain relief. Accordingly, this review focuses on how MB lessens pain, noting three major actions of this dye: anti-inflammation, sodium current reduction, and denervation. Moreover, we showed controversies over the efficacy of MB on CDLBP and raised also toxicity issues to look into the limitation of MB application. This analysis is the first attempt to illustrate its analgesic effects, which may offer a novel insight into MB as a pain-relief dye.

Triple pelvic osteotomy (TPO) is a prophylactic surgical procedure performed on dogs with canine hip dysplasia. The procedure is indicated in skeletally immature dogs without secondary osteoarthritis (OA). It has been suggested that 60° of rotation is excessive and is associated with poor outcome. The objective of the study was to assess the medium term outcome in dogs having undergone triple pelvic osteotomy (TPO) using 60° dedicated plates. Nine TPOs were performed in seven dogs with hip dysplasia. Eight of nine hips had 72-100% osseous union at the time of revisit. The mean time to final radiographic recheck was 200 days (range, 185-229 days). The mean time to follow-up was 11.5 months (range 11-12 months). All 7 dogs had regained full function and did not require supplemental analgesia. Pelvic canal narrowing was noted in the two dogs with bilateral surgeries, but no clinical consequences were noted according to owner's statement.If more than 40 degrees reduction angles at Ortolani test, 60° of rotation of the acetabulum can be used successfully in dogs with hip dysplasia. At the time of mid-term follow-up, all dogs in this case series had full function.

Osteoarthritis is a progressive degenerative joint disease which is high prevalent in dogs. In the late stage of the disease, it determines chronic neuropathic pain which leads to reduced quality-of-life in affected patients. To date it has not yet been identified a specific treatment, but it has been proved that nutraceutical and dietary supplements may play an important role in controlling inflammation and pain. The aim of this study was to evaluate, by the use of force plate gait analysis, the clinical efficacy of Boswellia and Curcuvet® combined with conventional nutraceutical therapy compared with conventional nutraceutical alone in dogs affected by osteoarthritis.

Pain is a common symptom in people with autosomal dominant polycystic kidney disease (ADPKD), but it is assessed and reported inconsistently in research, and the validity of the measures remain uncertain. The aim of this study was to identify the characteristics, content, and psychometric properties of measures for pain used in ADPKD. We conducted a systematic review including all trials and observational studies that reported pain in people with ADPKD. Items from all measures were categorized into content and measurement dimensions of pain. We assessed the general characteristics and psychometric properties of all measures. 118 studies, we identified 26 measures: 12 (46%) measures were developed for a non-ADPKD population, 1 (4%) for chronic kidney disease, 2 (8%) for polycystic liver disease and 11 (42%) specifically for ADPKD. Ten anatomical sites were included, with the lower back the most common (10 measures [39%]), four measurement dimensions (intensity (23 [88%]), frequency (3 [12%]), temporality (2 [8%]), and sensory (21 [81%]), two pain types, nociceptive including visceral (15 [58%]) and somatic (5 [20%]), and neuropathic (2 [8%]), and twelve impact dimensions, where the most frequent was work (5 [31%]). The validation data for the measures were variable and only the ADPKD Impact Scale reported all psychometric domains. The measures for pain in ADPKD varied in terms of content and length, and most had not been validated in ADPKD. A standardized psychometrically robust measure that captures patient-important dimensions of pain is needed to evaluate and manage this debilitating complication of ADPKD.

China has a high cesarean delivery (CD) and low labor epidural analgesia (LEA) rate. This online survey was conducted to explore the reasons behind this phenomenon and potential solutions.

Patients with visual snow syndrome (VSS) suffer from continuous ("TV snow-like") visual disturbance of unknown pathoetiology. In VSS, changes in cortical excitability in the primary visual cortex and the visual association cortex are discussed, with recent imaging studies tending to point to higher-order visual areas. Migraine, especially migraine with aura, is a common comorbidity. In chronic migraine and episodic migraine with aura but not in episodic migraine without aura, a reduced magnetic suppression of perceptual accuracy (MSPA) reflects a probably reduced inhibition of the primary visual cortex. Here we investigated the inhibition of the primary visual cortex using MSPA in patients with VSS, comparing that with MSPA in controls matched for episodic migraine. Seventeen patients with VSS were compared to 17 age- and migraine-matched controls. Visual accuracy was assessed by letter recognition and modulated by transcranial magnetic stimulation delivered to the occipital cortex at different intervals with respect to the letter presentation (40, 100, and 190 ms). Suppression of visual accuracy at the 100-ms interval was present without significant differences between VSS patients and age- and migraine-matched controls (percentage of correctly recognized trigrams, control: 46.4 ± 34.3; VSS: 52.5 ± 25.4, = 0.56). In contrast to migraine with aura, occipital cortex inhibition, as assessed with MSPA, may not be affected in VSS.

Eczema or atopic dermatitis (AD) is a chronically relapsing dermatosis characterized by pruritus and a significant impact on the quality of life.

High metastasis of clear cell renal cell carcinoma (ccRCC) significantly influenced survival rate of ccRCC patients. Here, we intended to investigate the impacts of circular RNA ITCH (circ-ITCH) on the metastasis of ccRCC. The expression of circ-ITCH in ccRCC tissues and cells was evaluated utilizing qRT-PCR. Transwell assay and wound healing were applied to investigate migration and invasion of ccRCC cells. Target gene prediction and screening and luciferase reporter gene assays were utilized to assess downstream target genes of circ-ITCH. Western blot was utilized to detect metastasis-related protein expression. A xenograft tumor model was established to evaluate the role of circ-ITCH in vivo. Results showed that circ-ITCH was low expressed in ccRCC tissues and cells. Downregulation circ-ITCH promoted cell migration, but overexpressing circ-ITCH inhibited cell migration and invasion in OSRC-2 and SW839 cells. Mechanism investigations claimed that circ-ITCH exerted its metastasis-inhibitory activity via sponging miR-106b-5p and regulating the expression of PDCD4. Conclusively, circ-ITCH suppresses ccRCC metastasis by enforcing PDCD4 expression through binding miR-106b-5p. circ-ITCH may function as a novel diagnostic target to suppress ccRCC metastasis.

Effective treatment remains lacking for neuropathic pain (NP), a type of intractable pain. Low-intensity focused ultrasound (LIFU), a noninvasive, cutting-edge neuromodulation technique, can effectively enhance inhibition of the central nervous system (CNS) and reduce neuronal excitability. We investigated the effect of LIFU on NP and on the expression of potassium chloride cotransporter 2 (KCC) in the spinal cords of rats with peripheral nerve injury (PNI) in the lumbar 4-lumbar 5 (L4-L5) section. In this study, rats received PNI surgery on their right lower legs followed by LIFU stimulation of the L4-L5 section of the spinal cord for 4 weeks, starting 3 days after surgery. We used the 50% paw withdraw threshold (PWT) to evaluate mechanical allodynia. Western blotting (WB) and immunofluorescence (IF) were used to calculate the expression of phosphorylated extracellular signal-regulated kinase 1/2 (p-ERK1/2), calcium/calmodulin-dependent protein kinase type IV (CaMKIV), phosphorylated cyclic adenosine monophosphate response element-binding protein (p-CREB), and KCC in the L4-L5 portion of the spinal cord after the last behavioral tests. We found that PWT decreased ( < 0.05) 3 days post-PNI surgery in the LIFU and LIFU groups and increased ( < 0.05) after 4 weeks of LIFU stimulation. The expression of p-CREB and CaMKIV decreased ( < 0.05) and that of KCC increased ( < 0.05) after 4 weeks of LIFU stimulation, but that of p-ERK1/2 ( > 0.05) was unaffected. Our study showed that LIFU could effectively alleviate NP behavior in rats with PNI by increasing the expression of KCC on spinal dorsal corner neurons. A possible explanation is that LIFU could inhibit the activation of the CaMKIV-KCC pathway.

Neurofeedback (NFB) Therapy is a form of biofeedback, using the electroencephalogram (EEG) that has been in use since the 1970s, serving as a non-pharmacological intervention for epilepsy and psychiatric conditions such as anxiety, depression, insomnia, PTSD, post-concussive syndrome, and now, centralized pain. Chronic pain can increase neuronal activity and eventually causes poor modulation of pain messages. With the emergence of Virtual Reality (VR) in acute pain management, and the contraindications of opioids in chronic pain, applying novel biotechnologies seems like the next frontier in multimodal pain management. In this study, the VR and NFB technologies were fused together (VR-NFB) and used as a novel treatment modality for a 55-year-old woman who suffered from chronic pain secondary to spondylolisthesis with cervical, thoracic, and lumbar disc herniations after a motor vehicle accident with comorbid depression, anxiety, sleep deprivation, and difficulty with activities of daily living, and inability to participate in physical therapy. Our case reports on the sustained analgesia achieved for 1 year after a trial of VR-NFB, and the usefulness of neuromodulation in centralized pain syndromes.