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Lin Y, Zhong S, Huang C, Zhang G, Jiang G. The efficacy of acupuncture therapies in cervical spondylotic radiculopathy: A network meta-analysis. Heliyon 2024; 10:e31793. [PMID: 38912448 PMCID: PMC11190544 DOI: 10.1016/j.heliyon.2024.e31793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 05/20/2024] [Accepted: 05/22/2024] [Indexed: 06/25/2024] Open
Abstract
Objective To evaluate the efficacy of acupuncture-related therapy in the Bayesian setting by means of a network Meta-analysis. Methods Relevant clinical randomized controlled trials(RCTs) of acupuncture-related therapy for Cervical Spondylotic Radiculopathy(CSR) were searched in the Chinese and English databases from the inception to November 13, 2023. Two researchers reviewed the literature, extracted the data, assessed the risk of bias of the included studies independently, and then used Stata14.0 and WinBUGs14 to analyze. Results There are 28 RCTs in total, of which 2593 patients and 14 acupuncture interventions. Network Meta-analysis revealed that, regarding the VAS scores, Acupoint catgut-embedding, Fu's Subcutaneous Needling and Needle Knife are better than Conventional acupuncture, Electro-acupuncture, Sham needle, Western Medicine, and Electrotherapy; Conventional acupuncture is better than Electrotherapy and Sham needle; Qihuang needle is superior to Sham needle and Electrotherapy; besides, Acupoint catgut-embedding is better than Tuina (Message), Chinese Medicine, Warm needle as well. Regarding the NDI scores, Needle Knife, Warm needle, Fire needle, Long round needle, Acupoint catgut-embedding are better than Conventional acupuncture, Electro-acupuncture, and Cervical traction; Conventional acupuncture is superior to Electro-acupuncture, Cervical traction, Needle Knife and Warm needle; whereas we found Qihuang needle is superior to Acupoint catgut-embedding, besides, Need Knife is superior to Qihuang needle, Long round needle and Acupoint catgut-embedding. In terms of improving the Tanaka Yasuhiro 20-point scale scores(TY), Needle Knife and Qihuang needle are superior to Conventional acupuncture, Warm needle and Electro-acupuncture; moreover, Conventional acupuncture is better than Warm needle. Conclusion In general, Acupoint catgut-embedding shows the best effect at relieving neck pain, then followed by Fu's Subcutaneous Needling and Needle Knife. Needle Knife is the best intervention in improving the functionality of the cervical spine. Like improving overall clinical performance, Needle Knife is the best treatment. Furthermore, our conclusion still needs to be confirmed by higher-quality documentation. In order to choose the best treatment for patients, clinicians are expected to take into account different clinical features and practical clinical settings with caution while choosing an acupuncture-related therapy in CSR. Key Message This article aims at selecting the best acupuncture-related treatment for clinicians to help patients in CSR, and the results of this study indicated that Acupoint catgut-embedding shows the best effect in relieving neck pain, Needle Knife shows the best effect in improving the functionality of cervical spine, Needle Knife shows the best effect in treating overall clinical performance.
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Affiliation(s)
- Yingtong Lin
- Clinical Medical College of Acupuncture Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Sha Zhong
- First Clinical Medical School, Guangzhou University of Chinese Medicine, Guangzhou, China
- Department of Breast and Thyroid Surgery, Guangzhou Women and Children's Medical Center, Guangzhou, China
| | - Chaoyuan Huang
- Department of Gastroenterology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Gangyu Zhang
- Department of Biomedical Engineering, University of Basel, Basel, Switzerland
| | - Ganghui Jiang
- Acupuncture Moxibustion and Rehabilitation Center, First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
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Plener J, da Silva-Oolup S, To D, Csiernik B, Hofkirchner C, Cox J, Chow N, Hogg-Johnson S, Ammendolia C. Eligibility Criteria of Participants in Randomized Controlled Trials Assessing Conservative Management of Cervical Radiculopathy: A Systematic Review. Spine (Phila Pa 1976) 2023; 48:E132-E157. [PMID: 36730764 DOI: 10.1097/brs.0000000000004537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 08/13/2022] [Indexed: 02/04/2023]
Abstract
STUDY DESIGN Systematic review. OBJECTIVE The aim of this study was to evaluate the inclusion and exclusion criteria for participants in randomized control trials (RCTs) assessing conservative management for cervical radiculopathy (CR), to determine if any consensus exists within the literature. SUMMARY OF BACKGROUND DATA A 2012 systematic review identified a lack of uniformity for the eligibility criteria of participants in RCTs evaluating conservative interventions for CR. Since then, a large number of RCTs have been published, signaling the need for an updated evaluation of this topic. MATERIALS AND METHODS We electronically searched MEDLINE, CENTRAL, CINAHL, Embase, and PsycINFO from inception to June 15, 2022, to identify RCTs assessing conservative management of CR. Information extracted was analyzed to determine the level of homogeneity and/or heterogeneity of the inclusion and exclusion criteria across studies. RESULTS Seventy-six RCTs met our inclusion criteria with 68 distinct trials identified. The inclusion of arm pain with or without another symptom ( i.e. numbness, paresthesia, or weakness) was required in 69.12% of trials, 50% of trials required participants to exhibit neck symptoms, and 73.53% of studies required some form of clinical examination findings, but inconsistencies existed for the number and type of tests used. Furthermore, 41.18% of trials included imaging, with 33.82% of trials requiring magnetic resonance imaging findings. The most common exclusion criteria included were the presence of red flags and cervical myelopathy in 66.18% and 58.82% of trials, respectively. CONCLUSIONS Overall, there is still a lack of uniformity for the inclusion/exclusion criteria of trials assessing the conservative management of CR, with some improvements noted compared with the 2012 review. Based on the current literature assessing the diagnostic utility of clinical symptoms and confirmatory tests, we proposed inclusion criteria for trials assessing conservative interventions. Future research should aim to develop standardized classification criteria to improve consistency among studies.
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Affiliation(s)
- Joshua Plener
- Division of Graduate Education, Canadian Memorial Chiropractic College, Toronto, ON, Canada
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Sophia da Silva-Oolup
- Division of Graduate Education, Canadian Memorial Chiropractic College, Toronto, ON, Canada
| | - Daphne To
- Department of Clinical Education, Canadian Memorial Chiropractic College, Toronto, ON, Canada
| | - Ben Csiernik
- Department of Undergraduate Education, Canadian Memorial Chiropractic College, Toronto, ON, Canada
| | | | - Jocelyn Cox
- Department of Undergraduate Education, Canadian Memorial Chiropractic College, Toronto, ON, Canada
| | - Ngai Chow
- Private Practice, Toronto, ON, Canada
| | - Sheilah Hogg-Johnson
- Department of Research and Innovation, Canadian Memorial Chiropractic College, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Institute for Disability and Rehabilitation Research, Oshawa, ON, Canada
- Faculty of Health Sciences, Ontario Tech University, Oshawa, ON, Canada
| | - Carlo Ammendolia
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada
- Department of Medicine, Mount Sinai Hospital, Toronto, ON, Canada
- Department of Surgery, University of Toronto, Toronto, ON, Canada
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Plener J, Csiernik B, To D, da Silva-Oolup S, Hofkirchner C, Cox J, Cancelliere C, Chow N, Hogg-Johnson S, Ammendolia C. Conservative Management of Cervical Radiculopathy: A Systematic Review. Clin J Pain 2023; 39:138-146. [PMID: 36599029 DOI: 10.1097/ajp.0000000000001092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 12/13/2022] [Indexed: 01/06/2023]
Abstract
OBJECTIVE The purpose of this systematic review was to assess the effectiveness and safety of conservative interventions compared with other interventions, placebo/sham interventions, or no intervention on disability, pain, function, quality of life, and psychological impact in adults with cervical radiculopathy (CR). METHODS We searched MEDLINE, CENTRAL, CINAHL, Embase, and PsycINFO from inception to June 15, 2022 to identify studies that were randomized controlled trials, had at least one conservative treatment arm, and diagnosed participants with CR through confirmatory clinical examination and/or diagnostic tests. Studies were appraised using the Cochrane Risk of Bias 2 tool and the quality of the evidence was rated using the Grades of Recommendations, Assessment, Development, and Evaluation approach. RESULTS Of the 2561 records identified, 59 trials met our inclusion criteria (n = 4108 participants). Due to clinical and statistical heterogeneity, the findings were synthesized narratively. There is very-low certainty evidence supporting the use of acupuncture, prednisolone, cervical manipulation, and low-level laser therapy for pain and disability in the immediate to short-term, and thoracic manipulation and low-level laser therapy for improvements in cervical range of motion in the immediate term. There is low to very-low certainty evidence for multimodal interventions, providing inconclusive evidence for pain, disability, and range of motion. There is inconclusive evidence for pain reduction after conservative management compared with surgery, rated as very-low certainty. DISCUSSION There is a lack of high-quality evidence, limiting our ability to make any meaningful conclusions. As the number of people with CR is expected to increase, there is an urgent need for future research to help address these gaps.
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Affiliation(s)
- Joshua Plener
- Division of Graduate Education
- Institute of Health Policy, Management and Evaluation
| | | | | | | | | | | | - Carol Cancelliere
- Institute for Disability and Rehabilitation Research
- Faculty of Health Sciences, Ontario Tech University, Oshawa, Canada
| | | | - Sheilah Hogg-Johnson
- Department of Research and Innovation, Canadian Memorial Chiropractic College
- Institute of Health Policy, Management and Evaluation
- Dalla Lana School of Public Health
- Institute for Disability and Rehabilitation Research
- Faculty of Health Sciences, Ontario Tech University, Oshawa, Canada
| | - Carlo Ammendolia
- Institute of Health Policy, Management and Evaluation
- Department of Surgery, University of Toronto
- Department of Medicine, Mount Sinai Hospital, Toronto
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Fu JL, Perloff MD. Pharmacotherapy for Spine-Related Pain in Older Adults. Drugs Aging 2022; 39:523-550. [PMID: 35754070 DOI: 10.1007/s40266-022-00946-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2022] [Indexed: 12/12/2022]
Abstract
As the population ages, spine-related pain is increasingly common in older adults. While medications play an important role in pain management, their use has limitations in geriatric patients due to reduced liver and renal function, comorbid medical problems, and polypharmacy. This review will assess the evidence basis for medications used for spine-related pain in older adults, with a focus on drug metabolism and adverse drug reactions. A PubMed/OVID search crossing common spine, neck, and back pain terms with key words for older adults and geriatrics was combined with common drug classes and common drug names and limited to clinical trials and age over 65 years. The results were then reviewed with identification of commonly used drugs and drug categories: nonsteroidal anti-inflammatories (NSAIDs), acetaminophen, corticosteroids, gabapentin and pregabalin, antispastic and antispasmodic muscle relaxants, tricyclic antidepressants (TCAs), serotonin-norepinephrine reuptake inhibitors (SNRIs), tramadol, and opioids. Collectively, 138 double-blind, placebo-controlled trials were the focus of the review. The review found a variable contribution of high-quality studies examining the efficacy of medications for spine pain primarily in the geriatric population. There was strong evidence for NSAID use with adjustments for gastrointestinal and renal risk factors. Gabapentin and pregabalin had mixed evidence for neuropathic pain. SNRIs had good evidence for neuropathic pain and a more favorable safety profile than TCAs. Tramadol had some evidence in older patients, but more so in persons aged < 65 years. Rational therapeutic choices based on geriatric spine pain diagnosis are helpful, such as NSAIDs and acetaminophen for arthritic and myofascial-based pain, gabapentinoids or duloxetine for neuropathic and radicular pain, antispastic agents for myofascial-based pain, and combination therapy for mixed etiologies. Tramadol can be well tolerated in older patients, but has risks of cognitive and classic opioid side effects. Otherwise, opioids are typically avoided in the treatment of spine-related pain in older adults due to their morbidity and mortality risk and are reserved for refractory severe pain. Whenever possible, beneficial geriatric spine pain pharmacotherapy should employ the lowest therapeutic doses with consideration of polypharmacy, potentially decreased renal and hepatic metabolism, and co-morbid medical disorders.
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Affiliation(s)
- Jonathan L Fu
- Department of Neurology, Boston University School of Medicine, Boston Medical Center, 85 E. Concord St, 1122, Boston, MA, 02118, USA
| | - Michael D Perloff
- Department of Neurology, Boston University School of Medicine, Boston Medical Center, 85 E. Concord St, 1122, Boston, MA, 02118, USA.
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Zhang YM, Han XJ, Wang YC, Jia HL, Yuan XF, Meng XL, Li ZY, Zhou GF. Yunmen (LU 2) combined with neck-seven-acupoint acupuncture for arm numbness caused by cervical spondylotic radiculopathy: A case report. Medicine (Baltimore) 2021; 100:e26151. [PMID: 34087870 PMCID: PMC8183703 DOI: 10.1097/md.0000000000026151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 05/11/2021] [Indexed: 01/04/2023] Open
Abstract
RATIONALE Cervical spondylotic radiculopathy (CSR) is a common sensory, motor, and reflex disorder. Numbness, a common subjective symptom of CSR, lacks objective quantitative indicators and recognized effective treatments, but is also difficult to recover from. We present a case report describing a traditional acupuncture treatment for CSR, utilizing a special acupuncture method and point, namely the Yunmen point. PATIENT CONCERNS A 40-year-old woman presented with unilateral arm numbness caused by CSR. DIAGNOSES A diagnosis of CSR was made in the orthopedic department of a local hospital. INTERVENTIONS We attempted acupuncture at the Yunmen (LU 2) acupoint combined with neck-seven-acupoint under computed tomographic guidance. OUTCOMES After 10 times treatment sessions, the patient no longer experienced weakness, coldness, or numbness in the affected upper limb. In addition, the stiffness in the neck and shoulders was reduced. On physical examination, the patient's left brachial plexus traction test was negative; reassessment of the CSR-20-point score scale showed a perfect score, and the visual analog scale score was 0. LESSONS Our report indicates that acupuncture at the LU 2 acupoint combined with neck-seven-acupoint is effective in treating numbness and coldness of the arm, and other neurological symptoms caused by cervical spondylosis. Moreover, with the appropriate acupuncture technique, the risk of acupuncture at the LU 2 acupoint can be minimized.
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Affiliation(s)
| | - Xing-Jun Han
- Department of Prevention and Health Centres, Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine
| | - Yong-Cheng Wang
- Department of Cardiovascular, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan
- Departments of First Clinical Medical, Shandong University of Traditional Chinese Medicine, Jinan, China
| | | | - Xiao-Fen Yuan
- Department of Prevention and Health Centres, Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine
| | - Xian-Liang Meng
- Department of Cardiovascular, Taian Traditional Chinese Medicine Hospital, Taian
| | - Zhao-Yu Li
- Departments of First Clinical Medical, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Guo-Feng Zhou
- Departments of First Clinical Medical, Shandong University of Traditional Chinese Medicine, Jinan, China
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Marcolina A, Vu K, Annaswamy TM. Lumbar Spinal Stenosis and Potential Management With Prostaglandin E1 Analogs. Am J Phys Med Rehabil 2021; 100:297-302. [PMID: 33065578 DOI: 10.1097/phm.0000000000001620] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
ABSTRACT Lumbar spinal stenosis is one of the most commonly diagnosed spinal disorders worldwide and remains a major cause for surgery in older adults. Lumbar spinal stenosis is clinically defined as a progressive degenerative disorder with low back pain and associated neurogenic intermittent claudication. Conservative and surgical management of lumbar spinal stenosis has been shown to be minimally effective on its symptoms. A treatment option that has not been investigated in the United States is the utilization of prostaglandin E1 analogs, which have been used primarily in Japan for the treatment of lumbar spinal stenosis since the 1980s. The vasodilatory and antiplatelet aggregation effects of prostaglandin E1 presumably improve symptoms of lumbar spinal stenosis by increasing blood flow to the spinal nerve roots. This brief report examines the potential vascular pathology of lumbar spinal stenosis, reviews evidence on the use of prostaglandin E1 analog limaprost in Japan for lumbar spinal stenosis, and briefly discusses misoprostol as a possible alternative in the United States. The studies summarized in this report suggest that prostaglandin E1 analogs may provide benefit as a conservative treatment option for patients with lumbar spinal stenosis. However, higher-quality studies conducted in the United States and comparison with other currently used conservative treatments are required before it can be recommended for routine clinical use.
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Affiliation(s)
- Austin Marcolina
- From the Department of Physical Medicine & Rehabilitation (PM&R), UT Southwestern Medical Center, Dallas, Texas (AM, TMA); UT Southwestern Medical Center, Dallas, Texas (KV); and VA North Texas Health Care System, Dallas VA Medical Center, Dallas, Texas (TMA)
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7
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Huang Y, Zhang J, Xiong B, Huang R, Zhao W, Zhou M, Chen Q, Xu D, Chen X. Thunder-fire moxibustion for cervical spondylotic radiculopathy: Study protocol for a randomized controlled trial. Trials 2020; 21:143. [PMID: 32029008 PMCID: PMC7006377 DOI: 10.1186/s13063-019-4012-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Accepted: 12/19/2019] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Thunder-fire moxibustion originated in China and contains traditional Chinese medicine. It can produce strong firepower, infrared thermal radiation, and medicinal effects when burning on the acupoints. Thunder-fire moxibustion is commonly used in patients with neck pain, but its efficacy has rarely been systematically demonstrated. We designed a randomized trial of thunder-fire moxibustion on cervical spondylotic radiculopathy (CSR) to investigate whether it is more effective than ibuprofen sustained-release capsules. METHODS One hundred patients will be recruited and randomly divided into thunder-fire moxibustion and ibuprofen groups. The intervention consists of ten treatments and will last for 2 weeks. The Yasuhisa Tanaka 20 Score Scale is used as the primary outcome measure. It contains a combination of the self-conscious symptom in patients, objective clinical evaluation from doctors, and social evaluation (the ability to work and live). The objective and comprehensive evaluation of CSR patients before and after treatment is particularly needed. The Short-Form McGill Pain Questionnaire-2 (SF-MPQ-2), Neck Disability Index score scale (NDI), and the Quality of Life Assessment (SF-36) are applied as secondary outcome measures. The assessment will take place at the baseline and the first and second weekends of treatment. If an adverse event (AEs) occurs, it will be reported. DISCUSSION The aim of this trial is to determine whether thunder-fire moxibustion is more effective than ibuprofen in the treatment of patients with CSR. TRIAL REGISTRATION Chinese Clinical Trial Registry (http://www.chictr.org.cn), ChiCTR1800018820. Registered on 11 October 2018.
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Affiliation(s)
- Yunxuan Huang
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, No.12 Ji Chang Road, Baiyun District, Guangzhou, 510405, China
| | - Jiabi Zhang
- Guangzhou University of Chinese Medicine, No.12 Ji Chang Road, Baiyun District, Guangzhou, 510405, China
| | - Buhui Xiong
- Guangzhou University of Chinese Medicine, No.12 Ji Chang Road, Baiyun District, Guangzhou, 510405, China
| | - Ruina Huang
- The Eighth Affiliated Hospital of Sun Yat-sen University, No. 3025 Shennan Middle Road, Futian District, Shenzhen, 518033, China
| | - Wenjing Zhao
- Shenzhen Pingle Orthopaedic Hospital, No.252 Hangzi Section, Pingshan Avenue, Pingshan District, Shenzhen, 518118, China
| | - Mengxue Zhou
- Kyoto Prefectural University of Medicine, Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Qi Chen
- Guangzhou University of Chinese Medicine, No.12 Ji Chang Road, Baiyun District, Guangzhou, 510405, China
| | - Danghan Xu
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, No.12 Ji Chang Road, Baiyun District, Guangzhou, 510405, China.
| | - Xinghua Chen
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, No.12 Ji Chang Road, Baiyun District, Guangzhou, 510405, China.
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Shen WS, Li CF, Zhou ZS, Zhai NN, Pan LP. MicroRNA-204 silencing relieves pain of cervical spondylotic radiculopathy by targeting GDNF. Gene Ther 2019; 27:254-265. [PMID: 31819204 DOI: 10.1038/s41434-019-0114-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 11/04/2019] [Accepted: 11/19/2019] [Indexed: 12/14/2022]
Abstract
Cervical spondylosis may cause chronic neck pain, radiculopathy and/or myelopathy, and consequently results in severe brain damage. Glial cell line-derived neurotrophic factor (GDNF) is a potent neurotrophic factor for motoneurons. Accumulating microRNAs (miRNAs) have highlighted as critical regulators of GDNF signaling in the mediation of neuroinflammation and neuropathic pain. Hence, we performed this study to investigate the potential role of miR-204 in the neuropathic pain of cervical spondylotic radiculopathy (CSR) by targeting GDNF. A rat model of spinal cord compression (SCC) was established to stimulate a pathologic lesion. RT-qPCR and western blot assays characterized the downregulation of GDNF and the upregulation of miR-204 in spinal cord tissues of rats under the conditions of SCC. Moreover, miR-204 could directly target GDNF, as evidenced by dual-luciferase reporter gene assay. In order to elucidate the roles of miR-204 and GDNF in SCC-induced neuropathic pain, miR-204 sponge, GDNF, or shRNA against GDNF was introduced to the rats, followed by measurements for SCC-induced neuroinflammation and neuropathic pain. GDNF upregulation or miR-204 silencing was identified to reduce the spontaneous pain score, gait scores and cell apoptosis. Furthermore, GDNF upregulation or miR-204 silencing resulted in elevated amplitude of sensory-evoked potentials (SEPs), number of motoneurons, release of pro-inflammatory factors, TNF-α, and IL-1β in addition to an increase in the anti-inflammatory factor BDNF. Taken together, upregulation of GDNF induced by miR-204 silencing confers protection against SCC-induced pain in rat models, suggesting a potential therapeutic target for CSR treatment.
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Affiliation(s)
- Wen-Sheng Shen
- Department of Anesthesiology, Shaoxing Paojiang Hospital, Shaoxing, 312000, PR China.
| | - Cun-Feng Li
- Department of Anesthesiology, Shaoxing Hospital of Traditional Chinese Medicine, Shaoxing, 312000, PR China
| | - Zhi-Shui Zhou
- Department of Anesthesiology, Shaoxing Hospital of Traditional Chinese Medicine, Shaoxing, 312000, PR China
| | - Nan-Nan Zhai
- Department of Anesthesiology, Shaoxing Hospital of Traditional Chinese Medicine, Shaoxing, 312000, PR China
| | - Lu-Ping Pan
- Department of Anesthesiology, Shaoxing Hospital of Traditional Chinese Medicine, Shaoxing, 312000, PR China
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