Rejected

Eccrine porocarcinoma is an extremely rare skin adnexal malignant neoplasia with highly invasive and metastatic potential. We report an additional case of eccrine porocarcinoma with intracranial metastases. This case is characterized by a complete record of the progress of eccrine porocarcinoma, its immunohistochemistry after three operations showed a progressive increase in the level of Ki-67 index.

Continuous popliteal sciatic nerve block (CPSNB) has been performed in outpatient foot and ankle surgery as a regional anesthesia method to relieve postoperative pain. Its efficacy as well as safety is yet to be established. There are two purposes of this study: (1) to validate the efficacy of CPSNB with regards to better pain relief and reduced analgesics consumption; (2) to assess the safety of CPSNB.

Single-shot spinal anaesthesia (SSS) and combined spinal-epidural (CSE) anaesthesia are both commonly used for caesarean section anaesthesia. Spinals offer technical simplicity and rapid onset of nerve blockade which can be associated with hypotension. CSE anaesthesia allows for more gradual onset and also prolongation of the anaesthesia through use of a catheter.

The purpose of this qualitative study was to describe the experiences of pain acceptance in Chinese cancer patients with chronic pain.

BACKGROUND Tick-borne relapsing fever is a disease that is caused by infection with a Borrelia bacterium, and is transmitted by ticks. This infectious disease is characterised by relapsing episodes of high fever, often accompanied by aspecific symptoms. CASE DESCRIPTION We describe the history of a 20-year-old woman who developed recurrent episodes of fever with headache and vomiting after a holiday in Morocco. Additional examination showed pleiocytosis in the cerebrospinal fluid, which was initially suggestive of viral meningitis. However, Borrelia spp. were isolated from a 16S-rRNA-PCR-test which led to the diagnosis 'tick-borne relapsing fever'. The patient was treated with intravenous ceftriaxone for two weeks, after which time her symptoms gradually improved. CONCLUSION Prompt antibiotic treatment of tick-borne relapsing fever can prevent a serious course of the disease. For this reason, in patients with recurrent episodes of fever, it is important to consider this diagnosis if they have recently made a trip to Africa, America or the Middle East.

Diabetic neuropathic pain (DNP) and depression (DP) are the common complications in patients with diabetes. The purpose of our research was to observe whether brain-derived neurotrophic factor (BDNF) levels and tropomyosin receptor kinase B (TrkB) in the nervous system have effects on rats with comorbid DNP and DP, and to determine whether dihydromyricetin (DHM) may influence BDNF/ TrkB pathway to mitigatethe comorbidity. The study showed that DHM treatment could attenuates pain and depressive behavior in DNP and DP combined rats. Compared with the control group, the expression level of BDNF/TrkB in the hippocampus of DNP + DP group were reduced, while the expression levels in the spinal cord and DRG were increased. However, after treatment with DHM, those changes were reversed. Compared with the control group, the level of IL-1β and TNF-α in the hippocampus, spinal cord and DRG in the DNP + DP group was significantly increased, and DHM treatment could reduce the increase. Thus our study indicated that DHM can relief symptoms of DNP and DP by suppressing the BDNF/TrkB pathway and the proinflammatory factor, and BDNF/TrkB pathway may be an effective target for treatment of comorbid DNP and DP.

Herpes zoster (HZ) risk appears to vary by sex and geographic ancestry/ethnicity.

Schistosomiasis caused by Schistosoma mansoni (Sm) is a chronic, debilitating and potentially deadly neglected tropical disease. The licensure of a vaccine to prevent schistosomiasis would represent a major breakthrough in public health.

To analyze the clinical effect of ultrasound-guided erector spinae block combined with pregabalin on post-herpetic neuralgia (PHN) in the elderly. Sixty patients with post-herpetic neuralgia from January 2018 to January 2019 in the Department of Pain, First Affiliated Hospital of Bengbu Medical College were selected. The patients were divided into two groups according to the random number table (30): group C and ultrasound-guided erector spinae block (ESPB) group. Group C was treated with the oral drug pregabalin. ESPB group was treated with ultrasound-guided erector spinae block combined with oral drug pregabalin. The digital rating scale (NRS) score, sleep quality score (QS), total pregabalin dosage, and correlation during treatment were recorded before and after treatment at 1, 2, 3, 4, 6, and 8 weeks after treatment. Four weeks after treatment, the scores of NRS and QS in ESPB group were 2.00(2.00-3.00) and 1.00(1.00-2.00) respectively, which were significantly lower than those in group C 3.00(3.00-4.00) and 2.00(2.00-3.00). The differences were statistically significant (-2.318,-2.533, all 0.05). The dosage of pregabalin in ESBP group was 1.73(1.65-1.99)g, less than that in group C 7.28(7.28-7.28)g, and the difference was statistically significant (-4.916, 0.05). The NRS score and QS score of ESPB group at the 8th week of follow-up were 2.50(2.00-4.00) and 1.00(0.00-2.00), respectively, which were significantly lower than those of group C 4.00(3.00-4.00) and 1.00(1.00-2.00). The difference was statistically significant (-2.426,-2.691, all 0.05). The significant effective rate of ESPB group was 70.0%, which was significantly better than that of group C (36.7%). The difference was statistically significant (χ(2)=6.694, 0.05). Adverse reactions were mild in both groups. Ultrasound-guided erector spinae block can effectively alleviate the pain of elderly patients with PHN in the chest, significantly reduce the dosage of oral drugs, improve the sleep quality of patients, and have higher safety.

To analyze and summarize the clinical-pathological features of dermatosis papulosa nigra of Han Chinese people. We collected 71 cases of dermatosis papulosa nigra in the Third people's Hospital of Hangzhou Affiliated to Zhejiang Chinese Medical University of Department of Dermatology from January 2010 to January 2019 which were confirmed clinically and pathologically. The clinical and histopathological data of all patients were analyzed and summarized, and relevant literature were reviewed. Among the 71 patients, 51 were female and 25 were male, their average age was (44±13) years, the average age of onset was (39±14) years, and the average time of diagnosis was (65±51) months. The lesions were multiple dark brown papules with smooth surface, and mostly distributed in the chest and abdomen, 46 cases (64.8%), followed by the back and neck. The mean diameter of the lesions was (1.76±0.99) mm. Meanwhile, the initial onset of pruritus was observed in 15 patients. The pathological features of all lesions were similar to seborrheic keratosis. According to pathological classification, there were 49 (69.0%) cases of the acanthotic type, 11(15.5%) cases of the hyperkeratotic type, 6 (8.5%) cases of spiroid type, 4 (5.6%) cases of irritated type, and 1 (1.4%) case of clonal type. Epidermal pigmentation and/or dermal papillary pigmented granules were observed in 56 cases (78.9%), of which 46 cases (64.8%) had basal layer pigmentation. In addition, inflammatory cell infiltration was found in the superficial dermis of lesions of 10 patients (14.1%) with symptom of itching. Dermatosis papulosa nigra of Han Chinese people has some unique clinical and pathological features.