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Determination of vitamin D and analysis of risk factors for osteoporosis in patients with chronic pain

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World Journal of Clinical Cases 2020年第11期8卷 2150-2161页

作者： Bao-Lin Duan Yuan-Rong Mao Li-Qi Xue Qing-Yuan Yu Mei-Yi Liu Department of pain Qinghai Provincial People’s HospitalXining 810000Qinghai ProvinceChina

BACKGROUND Vitamin D deficiency is common in patients with chronic pain and healthy people,but the difference between the two has not been reported;thus,whether there is a relationship between vitamin D deficiency and chronic pain remains to be *** is a common disease in chronic pain *** the relationship between vitamin D and osteoporosis will provide a basis for the rational supplementation of vitamin D to prevent osteoporosis,and to understand the risk factors of bone mass change to provide a new treatment plan for early prevention of *** To determine 25 hydroxy vitamin D(25OHD)level in patients with chronic pain to clarify its clinical *** relationship between vitamin D and bone mineral density(BMD)and the risk factors for bone mass change were also *** In this study,184 patients with chronic pain were included in the study group,and 104 healthy individuals who underwent routine health checkups during the same period were included in the control group.25OHD level was detected in both groups by enzyme-linked immunosorbent *** to the BMD test results,the patients in the study group were further classified into three subgroups:Normal BMD group,reduced BMD group,and osteoporosis ***,sex,ethnicity,living altitude,body mass index,25OHD level,parathyroid hormone(PTH),calcium(Ca)and phosphorus levels were analyzed statistically in both *** The vitamin D level in the study group was lower than that in the control group at 53.8%vs 57.7%,with no significant difference between the two *** proportion of patients with severe vitamin D deficiency in the study group was higher than that in the control *** mean age was greater in the osteoporosis subgroup,and the youngest in the normal BMD *** D level in the osteoporosis subgroup was lower than that in the other two subgroups,and was not specific for the diagnosis of bone mass reduction and osteopo

关键词： chronic pain Vitamin D deficiency Bone mass reduction Osteoporosis Bone mineral density

Astrocytes in chronic pain:Cellular and Molecular Mechanisms

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Neuroscience Bulletin 2023年第3期39卷 425-439页

作者： Huan-Jun Lu Yong-Jing Gao Institute of pain Medicine and Special Environmental Medicine Co-innovation Center of NeuroregenerationNantong UniversityNantong 226019China

chronic pain is challenging to treat due to the limited therapeutic options and adverse side-effects of *** are the most abundant glial cells in the central nervous system and play important roles in different pathological conditions,including chronic *** regulate nociceptive synaptic transmission and network function via neuron–glia and glia–glia interactions to exaggerate pain signals under chronic pain *** is also becoming clear that astrocytes play active roles in brain regions important for the emotional and memory-related aspects of chronic ***,this review presents our current understanding of the roles of astrocytes in chronic pain,how they regulate nociceptive responses,and their cellular and molecular mechanisms of action.

关键词： Astrocyte Microglia Neuron-glia interaction Spinal cord chronic pain

Targeting the nitric oxide/cGMP signaling pathway to treat chronic pain

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Neural Regeneration Research 2023年第5期18卷 996-1003页

作者： Dan-Yang Li Shao-Jie Gao Jia Sun Long-Qing Zhang Jia-Yi Wu Fan-He Song Dai-Qiang Liu Ya-Qun Zhou Wei Mei Department of Anesthesiology and pain Medicine Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubei ProvinceChina

Nitric oxide(NO)/cyclic guanosine 3′,5′-monophosphate(cGMP) signaling has been shown to act as a mediator involved in pain transmission and processing. In this review, we summarize and discuss the mechanisms of the NO/cGMP signaling pathway involved in chronic pain, including neuropathic pain, bone cancer pain, inflammatory pain, and morphine tolerance. The main process in the NO/cGMP signaling pathway in cells involves NO activating soluble guanylate cyclase, which leads to subsequent production of cGMP. cGMP then activates cGMP-dependent protein kinase(PKG), resulting in the activation of multiple targets such as the opening of ATP-sensitive K+ channels. The activation of NO/cGMP signaling in the spinal cord evidently induces upregulation of downstream molecules, as well as reactive astrogliosis and microglial polarization which participate in the process of chronic pain. In dorsal root ganglion neurons, natriuretic peptide binds to particulate guanylyl cyclase, generating and further activating the cGMP/PKG pathway, and it also contributes to the development of chronic pain. Upregulation of multiple receptors is involved in activation of the NO/cGMP signaling pathway in various pain models. Notably the NO/cGMP signaling pathway induces expression of downstream effectors, exerting both algesic and analgesic effects in neuropathic pain and inflammatory pain. These findings suggest that activation of NO/cGMP signaling plays a constituent role in the development of chronic pain, and this signaling pathway with dual effects is an interesting and promising target for chronic pain therapy.

关键词： bone cancer pain chronic pain cyclic GMP dorsal root ganglion inflammatory pain morphine tolerance neuropathic pain nitric oxide protein kinase G spinal cord

ZD 7288,an HCN channel blocker,attenuates chronic visceral pain in irritable bowel syndrome-like rats

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World Journal of Gastroenterology 2014年第8期20卷 2091-2097页

作者： Yu Chen Chun Lin Ying Tang Ai-Qin Chen Cui-Ying Liu Da-Li Lu Laboratory for pain Research Key Laboratory of Brain Aging and Neurodegenerative DiseasesCenter for Neuroscience ResearchDepartment of Physiology and PathophysiologyFujian Medical University

AIM: To investigate the effects of ZD 7288, a hyperpolarization-activated cyclic nucleotide-gated (HCN) channel blocker, on rats with chronic visceral pain.

关键词： Abdominal withdrawal reflex Electromyography Hyperpolarization-activated cyclic nucleotide-gated channel Visceral hypersensitivity ZD 7288 Irritable bowel syndrome

Magnetic resonance imaging for chronic pain:diagnosis,manipulation,and biomarkers

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Science China(Life Sciences) 2021年第6期64卷 879-896页

作者： Yiheng Tu Jin Cao Yanzhi Bi Li Hu CAS Key Laboratory of Mental Health Institute of PsychologyBeijing 100101China Department of Psychology University of Chinese Academy of SciencesBeijing 100101China Department of Psychiatry Massachusetts General Hospital and Harvard Medical SchoolBoston 02129USA Department of pain Management The State Key Clinical Specialty in Pain MedicineThe Second Affiliated Hospital of Guangzhou Medical UniversityGuangzhou 510260China

pain is a multidimensional subjective experience with biological,psychological,and social *** acute pain can be a warning signal for the body to avoid excessive injury,long-term and ongoing pain may be developed as chronic *** are more than 100 million people in China living with chronic pain,which has raised a huge socioeconomic *** the mechanisms of pain and developing effective analgesia approaches are important for basic and clinical ***,with the development of brain imaging and data analytical approaches,the neural mechanisms of chronic pain have been widely *** the first part of this review,we briefly introduced the magnetic resonance imaging and conventional analytical approaches for brain imaging ***,we reviewed brain alterations caused by several chronic pain disorders,including localized and widespread primary pain,primary headaches and orofacial pain,musculoskeletal pain,and neuropathic pain,and present meta-analytical results to show brain regions associated with the pathophysiology of chronic ***,we reviewed brain changes induced by pain interventions,such as pharmacotherapy,neuromodulation,and ***,we reviewed emerging studies that combined advanced machine learning and neuroimaging techniques to identify diagnostic,prognostic,and predictive biomarkers in chronic pain patients.

关键词： chronic pain magnetic resonance imaging biomarkers machine learning

Neuronal changes resulting in up-regulation of alpha-1 adrenoceptors after peripheral nerve injury

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Neural Regeneration Research 2014年第14期9卷 1337-1340页

作者： Peter D.Drummond Centre for Research on chronic pain and Inflammatory Diseases Murdoch University Perth Western Australia Australia

Under normal conditions, the sympathetic neurotransmitter noradrenaline inhibits the production and release of pro-inflammatory cytokines. However, after peripheral nerve and tissue injury, pro-inflammatory cytokines appear to induce the expression of the alphalA-adreno- ceptor subtype on immune cells and perhaps also on other cells in the injured tissue. In turn, noradrenaline may act on up-regulated alphal-adrenoceptors to increase the production of the pro-inflammatory cytokine interleukin-6. In addition, the release of inflammatory mediators and nerve growth factor from keratinocytes and other cells may augment the expression of alphal-adrenoceptors on peripheral nerve fibers. Consequently, nociceptive afferents acquire an abnormal excitability to adrenergic agents, and inflammatory processes build. These mechanisms could contribute to the development of sympathetically maintained pain in conditions such as post-herpetic neuralgia, cutaneous neuromas, amputation stump pain and complex regional pain syndrome.

关键词： alphal-adrenoceptors up-regulation peripheral nerve injury nerve growth factor pro-inflammatory mediators complex regional pain syndrome

Pharmacological pain management in chronic pancreatitis

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World Journal of Gastroenterology 2013年第42期19卷 7292-7301页

作者： Sφren S Olesen Jacob Juel Carina Graversen Yuri Kolesnikov Oliver HG Wilder-Smith Asbjφrn M Drewes MechSense Department of Gastroenterology and HepatologyAalborg University Hospital9000 AalborgDenmark Mech-Sense Department of RadiologyAalborg University Hospital9000 AalborgDenmark Department of Neurorehabilitation Engineering Bernstein Center for Computational NeuroscienceUniversity Medical Center G ttingenGeorg-August UniversityD-37077 GttingenGermany pain Service Department of OncologyEast Tallinn Central Hospital19086 TallinnEstonia pain and Nociception Neuroscience Research Group Department of AnaesthesiologyPain and Palliative CareRadboud University Nijmegen Medical Centre6525 NijmegenThe Netherlands Center for Sensory-Motor Interaction Department of Health Science and TechnologyAalborg University9000 AalborgDenmark

Intense abdominal pain is a prominent feature of chronic pancreatitis and its treatment remains a major clinical *** studies of pancreatic nerves and experimental human pain research have provided evidence that pain processing is abnormal in these patients and in many cases resembles that seen in neuropathic and chronic pain *** important ultimate outcome of such aberrant pain processing is that once the disease has advanced and the pathophysiological processes are firmly established,the generation of pain can become self-perpetuating and independent of the initial peripheral nociceptive ***,the management of pain by traditional methods based on nociceptive deafferentation(e.g.,surgery and visceral nerve blockade)becomes difficult and often *** novel and improved understanding of pain aetiology requires a paradigm shift in pain management of chronic *** mechanism based pain treatments taking into account altered pain processing are likely to increasingly replace invasive therapies targeting the nociceptive source,which should be reserved for special and carefully selected *** this review,we offer an overview of the current available pharmacological options for pain management in chronic *** addition,future options for pain management are discussed with special emphasis on personalized pain medicine and multidisciplinarity.

关键词： chronic pancreatitis pain Treatment Pharmacology Analgesics Adjuvant analgesics

chronic pain——a case for a preventive medicine?

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Chronic pain——a case for a preventive medicine?

Systematic mechanism-orientated approach to chronic pancreatitis pain

中华医学会疼痛学分会第十一届学术年会

作者： Manfred Zimmermann Neuroscience ＆ pain Research Institute

＜正＞Introducing dysregulation *** the basis of the underlying pathophysiology pain usually is classified as nociceptive pain or neuropathic ***,I present an alternative class of pain as judged by the dominant pathological processes:dysregulation pain.A well known case for dysregulation pain is low back pain with minimal or even no structural pathology such as

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World Journal of Gastroenterology 2015年第1期21卷 47-59页

作者： Stefan AW Bouwense Marjan de Vries Luuk TW Schreuder Soren S Olesen Jens B Frokjær Asbjorn M Drewes Harry van Goor Oliver HG Wilder-Smith pain and Nociception Neuroscience Research Group Department of SurgeryRadboud University Medical Center6500HB GelderlandThe Netherlands Department of Gastroenterology and Hepatology and Clinical Medicine Aalborg University Hospital9100 AalborgDenmark Center for Sensory-Motor Interaction Department of Health Science and TechnologyAalborg University9100 AalborgDenmark Department of Anaesthesiology Pain and Palliative MedicineRadboud University Medical Center6500HB GelderlandThe Netherlands

pain in chronic pancreatitis(CP) shows similarities with other visceral pain syndromes(i.e.,inflammatory bowel disease and esophagitis),which should thus be managed in a similar *** causes of CP pain include increased intrapancreatic pressure,pancreatic inflammation and pancreatic/extrapancreatic ***,CP pain continues to be a major clinical *** is recognized that ongoing pain may induce altered central pain processing,e.g.,central sensitization or pro-nociceptive pain *** this is present conventional pain treatment targeting the nociceptive focus,e.g.,opioid analgesia or surgical/endoscopic intervention,often fails even if technically *** central nervous system pain processing is altered,specific treatment targeting these changes should be instituted(e.g.,gabapentinoids,ketamine or tricyclic antidepressants).Suitable tools are now available to make altered central processing visible,including quantitative sensory testing,electroencephalograpy and(functional) magnetic resonance *** techniques are potentially clinically useful diagnostic tools to analyze central pain processing and thus define optimum management approaches for pain in CP and other visceral pain *** present review proposes a systematic mechanism-orientated approach to pain management in CP based on a holistic view of the mechanisms *** research should address the circumstances under which central nervous system pain processing changes in CP,and how this is influenced by ongoing nociceptive input and *** we hope to predict which patients are at risk for developing chronic pain or not responding to therapy,leading to improved treatment of chronic pain in CP and other visceral pain disorders.

关键词： chronic pancreatitis pain pain treatment Central sensitization Quantitative sensory testing Electroencephalograpy Magnetic resonance imaging