Leprosy with multidrug therapy and treatment in the early stages can prevent disability,but it still represents a significant health problem,mainly in vulnerable populations[1].However,if left untreated,leprosy can ca...Leprosy with multidrug therapy and treatment in the early stages can prevent disability,but it still represents a significant health problem,mainly in vulnerable populations[1].However,if left untreated,leprosy can cause progressive and permanent damage to the skin,nerves,limbs,and eyes.With the constant efforts of the National Leprosy Elimination Programme in India,the implementation of multidrug therapy has lowered the prevalence rate to 0.66/10000 in 2016[1].展开更多
Nociception is an important physiological process that detects harmful signals and results in pain perception. In this review, we discuss important experimental evidence involving some TRP ion channels as molecular se...Nociception is an important physiological process that detects harmful signals and results in pain perception. In this review, we discuss important experimental evidence involving some TRP ion channels as molecular sensors of chemical, thermal, and mechanical noxious stimuli to evoke the pain and itch sensations. Among them are the TRPA1 channel, members of the vanilloid subfamily (TRPV1, TRPV3, and TRPV4), and finally members of the melastatin group (TRPM2, TRPM3, and TRPMS). Given that pain and itch are pro-survival, evolutionarily-honed protective mechanisms, care has to be exercised when developing inhibitory/modulatory com- pounds targeting specific pain/itch-TRPs so that physio- logical protective mechanisms are not disabled to a degree that stimulus-mediated injury can occur. Such events have impeded the development of safe and effective TRPV1- modulating compounds and have diverted substantial resources. A beneficial outcome can be readily accom- plished via simple dosing strategies, and also by incorpo- rating medicinal chemistry design features during compound design and synthesis. Beyond clinical use, where compounds that target more than one channel might have a place and possibly have advantageous features, highly specific and high-potency compounds will be helpful in mechanistic discovery at the structure-function level.展开更多
目的比较不同神经阻滞法对锁骨骨折内固定术患者的麻醉效果及神经损伤程度。方法选取2013年1月至2015年1月洪湖市人民医院收治的80例锁骨骨折内固定术患者为研究对象,按照随机数字表法分为观察组与对照组,各40例。对照组患者给予单纯颈...目的比较不同神经阻滞法对锁骨骨折内固定术患者的麻醉效果及神经损伤程度。方法选取2013年1月至2015年1月洪湖市人民医院收治的80例锁骨骨折内固定术患者为研究对象,按照随机数字表法分为观察组与对照组,各40例。对照组患者给予单纯颈丛阻滞麻醉,观察组患者给予颈丛臂丛联合阻滞麻醉,两组均注入15 m L 1%利多卡因+0.25%布比卡因混合液。比较两组患者的麻醉效果及神经损伤情况。结果对照组心率和非侵入性血压(NIBP)切皮时、骨折复位时升高,术后24 h下降至麻醉前水平[心率:(74±5)次/min,(89±5)次/min,(92±6)次/min,(75±5)次/min;NIBP:(122±8)mm Hg(1 mm Hg=0.133 k Pa),(139±9)mm Hg,(141±9)mm Hg,(121±8)mm Hg];观察组心率、NIBP切皮时、骨折复位时降低,术后24 h升高至麻醉前水平[心率:(75±5)次/min,(72±5)次/min,(71±4)次/min,(74±5)次/min;NIBP:(120±8)mm Hg,(113±8)mm Hg,(110±9)mm Hg,(121±8)mm Hg],差异有统计学意义(P<0.05);观察组患者优良率显著高于对照组[92.5%(37/40)比75.0%(30/40)],差异有统计学意义(P<0.05);观察组患者术后1、2、3、4 h的VAS评分均显著低于对照组[观察组:(5.2±1.2)分,(4.2±1.2)分,(3.0±1.0)分,(3.0±1.0)分;对照组:(6.8±1.2)分,(6.2±1.3)分,(5.2±1.2)分,(3.2±1.0)分],差异有统计学意义(P<0.05);观察组总并发症发生率低于对照组[5.0%(2/40)比20.0%(8/40)],差异有统计学意义(P<0.05)。结论锁骨骨折内固定术患者应用颈丛臂丛联合阻滞麻醉可更好地稳定患者的心率和血压,麻醉效果显著,改善患者疼痛、麻木和感觉异常情况,减少喉返神经阻滞和膈神经阻滞等并发症的发生,神经损伤程度较小,麻醉安全有效,值得在临床推广。展开更多
文摘Leprosy with multidrug therapy and treatment in the early stages can prevent disability,but it still represents a significant health problem,mainly in vulnerable populations[1].However,if left untreated,leprosy can cause progressive and permanent damage to the skin,nerves,limbs,and eyes.With the constant efforts of the National Leprosy Elimination Programme in India,the implementation of multidrug therapy has lowered the prevalence rate to 0.66/10000 in 2016[1].
基金supported by the National Institutes of Health,USA(DE018549,UL1TR001117,P30AR066527,and AR48182 to WL,AR48182-S1 to WL as co-investigatorF33DE024668 and K12DE022793 to YC)+1 种基金the US Department of Defense(W81XWH-13-1-0299 to WL)the Harrington Discovery Institute,Cleveland OH(to WL)
文摘Nociception is an important physiological process that detects harmful signals and results in pain perception. In this review, we discuss important experimental evidence involving some TRP ion channels as molecular sensors of chemical, thermal, and mechanical noxious stimuli to evoke the pain and itch sensations. Among them are the TRPA1 channel, members of the vanilloid subfamily (TRPV1, TRPV3, and TRPV4), and finally members of the melastatin group (TRPM2, TRPM3, and TRPMS). Given that pain and itch are pro-survival, evolutionarily-honed protective mechanisms, care has to be exercised when developing inhibitory/modulatory com- pounds targeting specific pain/itch-TRPs so that physio- logical protective mechanisms are not disabled to a degree that stimulus-mediated injury can occur. Such events have impeded the development of safe and effective TRPV1- modulating compounds and have diverted substantial resources. A beneficial outcome can be readily accom- plished via simple dosing strategies, and also by incorpo- rating medicinal chemistry design features during compound design and synthesis. Beyond clinical use, where compounds that target more than one channel might have a place and possibly have advantageous features, highly specific and high-potency compounds will be helpful in mechanistic discovery at the structure-function level.
文摘目的比较不同神经阻滞法对锁骨骨折内固定术患者的麻醉效果及神经损伤程度。方法选取2013年1月至2015年1月洪湖市人民医院收治的80例锁骨骨折内固定术患者为研究对象,按照随机数字表法分为观察组与对照组,各40例。对照组患者给予单纯颈丛阻滞麻醉,观察组患者给予颈丛臂丛联合阻滞麻醉,两组均注入15 m L 1%利多卡因+0.25%布比卡因混合液。比较两组患者的麻醉效果及神经损伤情况。结果对照组心率和非侵入性血压(NIBP)切皮时、骨折复位时升高,术后24 h下降至麻醉前水平[心率:(74±5)次/min,(89±5)次/min,(92±6)次/min,(75±5)次/min;NIBP:(122±8)mm Hg(1 mm Hg=0.133 k Pa),(139±9)mm Hg,(141±9)mm Hg,(121±8)mm Hg];观察组心率、NIBP切皮时、骨折复位时降低,术后24 h升高至麻醉前水平[心率:(75±5)次/min,(72±5)次/min,(71±4)次/min,(74±5)次/min;NIBP:(120±8)mm Hg,(113±8)mm Hg,(110±9)mm Hg,(121±8)mm Hg],差异有统计学意义(P<0.05);观察组患者优良率显著高于对照组[92.5%(37/40)比75.0%(30/40)],差异有统计学意义(P<0.05);观察组患者术后1、2、3、4 h的VAS评分均显著低于对照组[观察组:(5.2±1.2)分,(4.2±1.2)分,(3.0±1.0)分,(3.0±1.0)分;对照组:(6.8±1.2)分,(6.2±1.3)分,(5.2±1.2)分,(3.2±1.0)分],差异有统计学意义(P<0.05);观察组总并发症发生率低于对照组[5.0%(2/40)比20.0%(8/40)],差异有统计学意义(P<0.05)。结论锁骨骨折内固定术患者应用颈丛臂丛联合阻滞麻醉可更好地稳定患者的心率和血压,麻醉效果显著,改善患者疼痛、麻木和感觉异常情况,减少喉返神经阻滞和膈神经阻滞等并发症的发生,神经损伤程度较小,麻醉安全有效,值得在临床推广。