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Myofascial pain syndrome (MPS) is characterized by myofascial trigger points and fascial constrictions. At present, domestic and foreign scholars have not reached a consensus on the etiology and pathogenesis of MPS. Due to the lack of specific laboratory indicators and imaging evidence, there is no unified diagnostic criteria for MPS, making it easy to confuse with other diseases. The Chinese Association for the Study of Pain organized domestic experts to formulate this Chinese Pain Specialist Consensus on the diagnosis and treatment of MPS. This article reviews relevant domestic and foreign literature on the definition, epidemiology, pathogenesis, clinical manifestation, diagnostic criteria and treatments of MPS. The consensus is intended to normalize the diagnosis and treatment of MPS and be used by first-line doctors, including pain physicians to manage patients with MPS.

Lumbar disc herniation is a common disease in the clinical context and does great harm to either the physical or mental health of patients suffering from this disease. Many guidelines and consensus for the diagnosis and treatment of lumbar disc herniation have been published domestically and internationally. According to the expert consensus, clinicians could adopt tailored and personalized diagnosis and treatment management strategies for lumbar disc herniation patients.

Spinal pain (SP) is a common condition that has a major negative impact on a patient's quality of life. Recent developments in ultrasound-guided injections for the treatment of SP are increasingly being used in clinical practice. This clinical expert consensus describes the purpose, significance, implementation methods, indications, contraindications, and techniques of ultrasound-guided injections. This consensus offers a practical reference point for physicians to implement successfully ultrasound-guided injections in the treatment of chronic SP.

Background Recent advances have indicated a complex interplay between the autonomic nervous system and the innate immune system. Targeting neural networks for the treatment of sepsis is being developed as a therapeutic strategy. Because electroacupuncture at select acupoints can modulate activities of the autonomic nervous system, we tested the hypothesis that electroacupuncture at specific acupoints could modulate systemic inflammatory responses and improve survival via its impact on the autonomic nervous system in a rat model of sepsis. Methods Sprague-Dawley male rats received electroacupuncture for 45 min before and at 1, 2, or 4 h after a lethal dose of intraperitoneal lipopolysaccharide injection (6 mg/kg). Outcomes included survival and systemic cytokine responses. Also, the possible roles of neural circuitry, including the hypothalamic-pituitary-adrenal axis and the autonomic nervous system, were evaluated. Results Electroacupuncture pretreatment at the Hegu acupoints significantly attenuate systemic inflammatory responses and improve survival rate from 20% to 80% in rats with lethal endotoxemia. Such a site-specific effect requires the activation of muscarinic receptors in the central nervous system, but not increasing central sympathetic tone. In the periphery synergistic, rather than independent, action of the sympathetic and parasympathetic systems is also necessary. Conclusions Electroacupuncture pretreatment has a dramatic survival-enhancing effect in rats with lethal endotoxemia, which involves the activation of efferent neural circuits of the autonomic nervous system (e.g., cholinergic antiinflammatory pathway). This approach could be developed as a prophylactic treatment for sepsis or perioperative conditions related to excessive inflammation.

Combine harvester is one of the most complex agricultural machinery during field operation. To obtain maximal capacity and better performance, a controller area network (CAN bus) based monitor system was constructed and tested. The prototype system consists of a series of microcontroller driven nodes to collect on board information. In each node, an embedded controller was utilized to perform the data acquisition and communication task. The developed software could accomplish multiple tasks including data acquisition, information exchange and data storage at a frequency of 1 Hz. The developed system could be further extended for fault diagnosis and control.

Hemodilution is a commonly used technique in cardiopulmonary bypass (CPB) and deep hypothermic circulation arrest (DHCA). Our previous study showed that lower hematocrit aggravated the brain injury after DCHA. Because the excitatory amino acids are critical pathways of ischemic neuronal damage, the purpose of the present study was to investigate the effects of different degrees of hemodilution on the excitatory amino acid content in different brain areas after DHCA Adult Sprague-Dawley rats were randomly divided into four groups: group I hematocrit (Hct) 10% (H1), group II Hct 20% (H2), group III Hct 30% (H3), and control group (C). All animals except those in the control group underwent DHCA at 18°C for 90 minutes. Different degrees of hemodilution were accomplished by changing the composition and volume of the priming solution used in CPB. High-performance liquid chromatography was used to determine the concentration of glutamate (Glu), aspartate (Asp), glycine (Gly), gamma-aminobutyric acid (GABA), and taurine (Tau) in the cerebral cortex, hippocampus, and thalamus. We found that the concentration of these five amino acids in the hippocampus and cortex were all increased after DHCA. Glu, Asp, and Gly in the hippocampus and cortex were significantly lower in the Hct 30% group than in the other two groups (p

Summary Introduction The delta opioid peptide [D-Ala2, D-Leu5]enkephalin (DADLE) plays a key role in neuronal protection against both hypoxic and ischemic conditions. However, the cellular mechanisms of action of DADLE under these conditions remain unclear. Methods Ischemia was simulated with perfusing the brain slices with glucose-free artificial cerebrospinal fluid. Apoptosis was examined using an in situ cell death detection kit and expressed as the percentage of positively labeled neurons relative to total number of neurons. PCR was performed by adding cDNA, 5 pm dNTP, 1 μL Taqase, and primers. PCR products were separated with electrophoresis, stained with ethidium bromide, and visualized under ultraviolet light. Aims To investigate the potential effects of DADLE in an ex vivo model of cerebral ischemia/reperfusion. Results DADLE attenuated lactic dehydrogenase release and neuronal apoptosis in a concentration-dependent manner. The protective effects of DADLE were attenuated by representative selective delta2, but not delta1 opioid antagonists. Treatment with PD98059, a selective inhibitor of ERK kinase (MEK), also blocked the protective effect of DADLE as well as ERK phosphorylation induced by DADLE. Conclusions Endogenous opioid peptides could promote cell survival via delta2 opioid receptors, possibly through the downstream MEK-ERK pathway.

Aim: To investigate the neuroprotective effect of propofol and its intracellular mechanism on neurons in vitro . Methods: Cell viability was determined with 3-(4, 5-dimethylthiazol-2-yl)-2,5-diphenyltetrazoliumbromide reduction. Apoptotic cell death was determined by Hoechst 33258 staining and a fluorescence-activated cell sorter. The caspase-3 activity was measured by fluorometric assay. Mitogen-activated protein (MAP) kinase phosphorylation was detected with Western blotting. Results: The pretreatment of rat pheochromocytoma cell line PC12 with propofol (1-10 mumol/L) resulted in a significant recovery from hydrogen peroxide (H 2 O 2 )-induced cell death and the inhibition of H 2 O 2 induced caspase-3 activation and PC12 cell apoptosis. Propofol inhibited the H 2 O 2 -induced p38 MAP kinase, but not c-Jun N-terminal kinase or extracellular signal-regulated kinase 1 and 2 activations. Conclusion: Propofol might attenuate H 2 O 2 -induced PC 12 cell death through the inhibition of signaling pathways mediated by the p38 MAP kinase.

Introduction The study sought to assess the feasibility and accuracy of measuring mixed venous oxygen saturation (SvO2) through the left main bronchus (SpO2trachea) Methods Twenty hybrid pigs of each sex were studied. After anesthesia, a Robertshaw double-lumen tracheal tube with a single-use pediatric pulse oximeter attached to the left lateral surface was introduced toward the left main bronchus of the pig by means of a fibrobronchoscope. Measurements of SpO2trachea and oxygen saturation from pulmonary artery samples (SvO2blood) were performed with an intracuff pressure of 0 to 60 cmH2O. After equilibration, hemorrhagic shock was induced in these pigs by bleeding to a mean arterial blood pressure of 40 mmHg. With the intracuff pressure maintained at 60 cmH2O, SpO2trachea and SvO2blood were obtained respectively during the pre-shock period, immediately after the onset of shock, 15 and 30 minutes after shock, and 15, 30, and 60 minutes after resuscitation. Results SpO2trachea was the same as SvO2blood at an intracuff pressure of 10, 20, 40, and 60 cmH2O, but was reduced when the intracuff pressure was zero (p < 0.001 compared with SvO2blood) in hemodynamically stable states. Changes of SpO2trachea and SvO2blood corresponded with varieties of cardiac output during the hemorrhagic shock period. There was a significant correlation between the two methods at different time points. Conclusion Measurement of the left main bronchus SpO2 is feasible and provides similar readings to SvO2blood in hemodynamically stable or in low saturation states. Tracheal oximetry readings are not primarily derived from the tracheal mucosa. The technique merits further evaluation.

To investigate the effect of nano-hydroxyapatite/collagen (nHA/collagen) composite as a graft extender and enhancer when combined with recombinant human bone morphogenetic protein-2 (rhBMP-2) on lumbar intertransverse fusion in rabbits.Sixty-four adult female New Zealand white rabbits, aged 1 year and weighing 3.5-4.5 kg, underwent similar posterolateral intertransverse process arthrodesis and were randomly divided into 4 groups based on different grafts: autogenous cancellous bone alone (ACB group), nHA/collagen alone (HAC group), half autogenous cancellous bone and half nHA/collagen (ACB+HAC group) and nHA/collagen combined with rhBMP-2 (HAC+BMP group). The fusion masses were analyzed by manual palpation, radiography, biomechanical testing and histological examination.Fusion was observed in 4 cases in the 6th week and in 5 cases in the 10th week after surgery in ACB group. No case showed fusion in HAC group. In ACB+HAC group, there was fusion in 3 cases in the 6th week and in 4 cases in the 10th week after surgery. In HAC+BMP group, fusion in 1 case was found in the 4th week, in 5 cases in the 6th week and in 6 cases in the 10th week after surgery. It suggested that ACB, ACB+HAC and HAC+BMP groups showed similar fusion ratio and mechanical strength in the 6th and 10th week after surgery. According to the microstructure analysis of the samples, nHA/collagen had no negative effect when implanted together with ilium autograft. In HAC+BMP group, new bone-like tissue was observed in the 2nd week postoperatively, and nearly all of the implanted composites were replaced by mature bone matrix and new bones in 10th week postoperatively.The nHA/collagen, especially combined with rhBMP-2, is a promising bone substitute, for it has quick biodegradation, fine bone-bending ability, and high osteoconductivity on posterolateral spinal fusion in rabbits.

In the title compound, C(14)H(21)N(3)O(3), the oxamide group has a transoid conformation. In the crystal, the mol-ecules are connected by N-H⋯O and O-H⋯N hydrogen bonds into a double chain running along the b axis.

The study sought to assess the feasibility and accuracy of measuring mixed venous oxygen saturation (SvO2) through the left main bronchus (SpO2trachea) Twenty hybrid pigs of each sex were studied. After anesthesia, a Robertshaw double-lumen tracheal tube with a single-use pediatric pulse oximeter attached to the left lateral surface was introduced toward the left main bronchus of the pig by means of a fibrobronchoscope. Measurements of SpO2trachea and oxygen saturation from pulmonary artery samples (SvO2blood) were performed with an intracuff pressure of 0 to 60 cmH2O. After equilibration, hemorrhagic shock was induced in these pigs by bleeding to a mean arterial blood pressure of 40 mmHg. With the intracuff pressure maintained at 60 cmH2O, SpO2trachea and SvO2blood were obtained respectively during the pre-shock period, immediately after the onset of shock, 15 and 30 minutes after shock, and 15, 30, and 60 minutes after resuscitation. SpO2trachea was the same as SvO2blood at an intracuff pressure of 10, 20, 40, and 60 cmH2O, but was reduced when the intracuff pressure was zero (p < 0.001 compared with SvO2blood) in hemodynamically stable states. Changes of SpO2trachea and SvO2blood corresponded with varieties of cardiac output during the hemorrhagic shock period. There was a significant correlation between the two methods at different time points. Measurement of the left main bronchus SpO2 is feasible and provides similar readings to SvO2blood in hemodynamically stable or in low saturation states. Tracheal oximetry readings are not primarily derived from the tracheal mucosa. The technique merits further evaluation.