Traditional Chinese medicine for foot pain in a patient with complex regional pain syndrome: A case report

BACKGROUND Complex regional pain syndrome(CRPS)is characterized by pain as well as sensory,motor,and sudomotor disorders.Generally,it is classified into two types CRPS-I and CRPS-II.There is no single diagnostic test or treatment approach for CRPS,and a multidisciplinary approach is gaining attention to improve patients’symptoms and their quality of life.CASE SUMMARY A 35-year-old woman with an unremarkable medical history sought treatment for CRPS at a hospital of Korean medicine.During her first visit,she was wheelchairbound due to severe pain in her left lower extremity.She had edema and discoloration of the left foot.She was treated with a combination of traditional Chinese medicine(TCM)approaches,including acupuncture,moxibustion,pharmacopuncture,and herbal decoction,for approximately 20 sessions.The foot and ankle outcome score(FAOS)and visual analog scale(VAS)score for pain were evaluated,along with general signs and functions.Her symptoms,signs,FAOS,and VAS scores improved after treatment,with a significant 7-degree decrease in the VAS score and a 62-point increase in the FAOS score.Additionally,the foot swelling and discoloration gradually resolved.During the phone follow-up,5 mo after the last visit,additional improvements in outcomes were observed.CONCLUSION Combined TCM treatment may be a reasonable and safe option for alleviating symptoms and improving function in patients with CRPS.

Impact of adolescent complex regional pain syndrome on the psychopathology of young men ahead of military service: A retrospective cohort analysis of Korean conscription data

Background: The relationship between physical and psychopathological features in complex regional pain syndrome(CRPS) has been a subject of constant interest, but no data are available in adolescents. Therefore, we aimed to identify the factors associated with psychopathology in adolescents with CRPS ahead of military service.Methods: We retrospectively reviewed all conscription examinees who had completed a Military Personality Inventory(MPI) during a period between February 2013 and December 2016. A total of 63 persons with a history of CRPS(19-years of age for all) were enrolled. Basic demographic and pain-related data were analyzed to examine their association with MPI results. The mean FGR score as well as the 8 subdomain scores were compared between those with pain duration at <15 months(n=30) vs. ≥15 months(n=33). Binary MPI results(normal-abnormal) were also compared between the two groups.Results: In multivariate analysis, abnormal MPI was associated with pain duration, with an odds ratio(OR) at 1.05 for every 1-month increase [95% confidence interval(CI) 1.02–1.08;P=0.002]. Subjects with pain duration at ≥15 months have lower faking good response score(P<0.001 vs. those with pain duration at <15 months), and higher abnormal MPI result rate, faking bad response, inconsistency, anxiety, depression, somatization, paranoid, personality disorder cluster A, and personality disorder cluster B scores(P<0.05). Pain duration was significantly associated with the MPI variables.Conclusions: Pain duration is associated with psychopathology in adolescents with CRPS. Psychopathologic features increased as the disease duration increased. A comprehensive understanding of time-dependent psychopathological factors could support the planning of multimodal approaches for managing adolescent CRPS.

Pediatric Continuous Brachial Plexus Catheter for a Case of Complex Regional Pain Syndrome (CRPS)

Introduction: Complex regional pain syndrome (CRPS) is a disorder characterized by pain as well as a myriad of sensory, autonomic, and motor disturbances. We are reporting a case of child diagnosed with CRPS and successfully treated with supraclavicular brachial plexus catheter infusion of local anesthetic. Case Report: An eight-year-old male underwent a left thoracotomy, repair of esophageal vascular ring, and translocation of the left subclavian to the left carotid artery. Post-operative course was relevant for severe intractable left shoulder and left arm pain associated with allodynia and hyperalgesia. A supraclavicular catheter was inserted, and an infusion of ropivacaine 0.2% was started. The child was sent for physical therapy as he gradually regained all functions of his left arm and resumed his regular activities. Conclusion: Continuous supraclavicular brachial plexus catheter infusion of local anesthetic is a valuable method of reducing pain in severe cases of upper extremity pediatric CRPS and may be safer and more effective than other invasive measures such as sympathetic blocks and epidural catheterization. Further research surrounding the diagnosis and treatment of pediatric CRPS is needed to allow early diagnosis and treatment and to improve outcome.

Resolution of Crohn's disease and complex regional pain syndrome following treatment of paratuberculosis

A cohort of family members with various chronic diseases including Crohn's disease, asthma, complex regional pain syndrome, hypothyroidism, type 1 diabetes mellitus, and lymphangiomatosis and/or evidence of infection by Mycobacterium avium subsp. paratuberculosis(MAP) are described in this series of case reports. MAP was cultured from the blood of three members affected by the first five diseases and there was accompanying elevated anti-MAP Ig G in two members. The patient affected by the sixth disease has a markedly elevated anti-MAP titer. The two patients affected by the first four diseases have been treated with a combination of anti-MAP antibiotics and ultraviolet blood irradiation therapy with resolution of the disease symptomatology and inability to culture MAP in post treatment blood samples. These case reports of patients with MAP infections provide supportive evidence of a pathogenic role of MAP in humans.

Failure to fire after an electrical injury——A complex syndrome in a soldier: complex regional pain syndrome(CRPS)

Complex regional pain syndrome(CRPS) is a disorder characterized by an intractable, disabling pain of the affected limb. It is triggered by various injuries and is often resistant to standard therapy. We report a young soldier with CRPS of the right hand sustained from an electrical injury, who had improvement in resting pain with Zoledronic acid. In this report, we discuss the therapeutic options and the role of bisphosphonates in CRPS.

Frequency and Risk Factors of Complex Regional Pain Syndrome in Cotonou (Benin)

Aim: To determine the frequency and the risk factors of Complex Regional Pain syndrome (CRPS) in Cotonou (Benin). Patients and Méthod: This has been a transversal study carried out over 22 years on files of CRPS infected patients and submitted to rheumatologic consultation in the National Hospital University of Cotonou. Results: 73 out of 17,342 patients examined (0.42%) were suffering from CRPS. Those 73 patients (40 women, 54.8% and 33 men, 45.2%) were in average 54.66 years old and enjoyed an average duration of evolution of 5.79 months. The trauma (41 cases, 56.1%), the stroke (19 cases, 25%), the diabetes (8 cases, 11.3), were the main risk factors that were observed. CRPS was preferably located at the shoulder-hand (34.2%), shoulder (28.8%), wrist-hand (16.4%) and knee (11%). Inflammatory pain was observed in 55 cases. The treatment was dominated by griseofulvina (41 cases, 56.1%), antiinflammatory drugs (38 cases, 52%), analgesic (20 cases, 27, 3%), joint injection by betamethasone (17 cases, 27%). Conclusion: CRPS is not rare in our country. The first risk factor remains the trauma in rheumatologic consultation in Cotonou.

Septic Arthritis of the Hand during Treatment of Complex Regional Pain Syndrome

Complex regional pain syndrome (CRPS) complicated with septic arthritis of the hand has not previously been described. We treated a patient in whom swelling of the wrist recurred during treatment of CRPS and septic arthritis of the hand was induced by group G hemolytic streptococcus. There are case reports of tuberculous arthritis of the hand during treatment of CRPS;however, the causal relationship of wrist joint inflammation with CRPS is unclear. Careful follow-up is necessary for wrist joint inflammation if a patient with CRPS relapses with swelling of the wrist.

Beliefs and Clinical Practice for Complex Regional Pain Syndrome (CRPS) Managed by Physiotherapists on the South Island of New Zealand

On the South Island of New Zealand, Anaesthetists and other Medical Professionals, frequently refer their patients with Complex Regional Pain Syndrome (CRPS) for physiotherapy management. Beliefs about what is important for the management of patients with CRPS are lacking across all medical and allied health disciplines. Difficulties are no gold standard for diagnosis and evidence for intervention methods is moderate or can be conflicting. This paper explores what Physiotherapists believe to be important in a clinical setting for their management of CRPS, as well as documenting and evaluating their interventional methods used in everyday clinical practice across the region of the South Island of New Zealand. This has not been recorded before. Eighty-one Physiotherapists replied to questions on their usual treatment interventions for the management of CRPS, their frequency of use of these treatment interventions, and what they believed to be important in the management of pain and improvement of function. The results demonstrated that CRPS is not a common condition seen regularly by Physiotherapists;that there is a high level of variation between the physiotherapy interventions used and that Physiotherapists’ beliefs regarding interventions used for pain management and functional restoration differ. Education was reported as the most frequently used intervention method. Those physiotherapists seeing CRPS patients more frequently are more likely to use evidence based intervention methods like graded motor imagery or sensory motor training.

Loss of Surround Inhibition and After Sensation as Diagnostic Parameters of Complex Regional Pain Syndrome

Complex Regional Pain Syndrome (CRPS) is a severe chronic pain condition. Patients with CRPS experience allodynia, hyperalgesia, autonomic dysfunction, movement difficulties and dystrophic changes. However other characteristics that may be unique to the pain in CRPS require further study. This study evaluated pain parameters in ninety five subjects composed of three groups: healthy pain free controls, patients with radiculopathy and CRPS patients. Healthy subjects were tested in all four extremities, whereas radiculopathy and CRPS patients were tested only on the most affected extremity. All subjects were tested for the following pain parameters: thermal allodynia, mechanical static and dynamic allodynia, windup, and a hyperalgesic mechanical stimulus. All subjects were also evaluated for autonomic dysfunction, movement disorder and dystrophic skin changes. Statistically significant differences were found between both pain groups and the healthy control subjects as well as between the two pain groups. The finding that statistically differentiated CRPS from radiculopathy and normal controls was pain spread following an algesic mechanical and cold stimulus as well as after sensations to these stimuli. The study demonstrated a simple bedside test that discriminated between CRPS, radiculopathy and healthy control subjects.

Two Cases of Double Crush Syndrome Progressing to Complex Regional Pain Syndrome

The double crush syndrome is described as an increased risk of distal nerve injury after a more proximal injury. This was a case series of two patients who developed Complex Regional Pain Syndrome under circumstances when a double crush phenomenon could have occurred. Both initially had spinal stenosis and subsequent spinal surgery. Both later had crush injuries to a unilateral lower extremity, which progressed to CRPS. There is no documented correlation between double crush syndrome and CRPS;however, these cases raise awareness about a heightened propensity for CRPS in such patients, which will lead to earlier, accurate diagnosis and treatment.

Systemic Complications of Complex Regional Pain Syndrome

Complex Regional Pain Syndrome (CRPS) is a neuropathic pain disorder that is characterized by: 1) Severe pain beyond the area of injury;2) Autonomic dysregulation;3) Neuropathic edema;4) A movement disorder, atrophy and dystrophy. It is most often caused by a fracture, soft-tissue injury or surgical procedure and is divided into Type I, in which no nerve lesion is identified (classic reflex sympathetic dystrophy), and Type II where a specific nerve has been damaged (causalgia). In addition to the peripheral manifestations, there are many internal medical complications whose etiology is often not appreciated. This article will examine how CRPS affects the systems of: cognition;constitutional, cardiac, and respiratory complications;systemic autonomic dysregulation;neurogenic edema;musculoskeletal, endocrine and dermatological manifestations;as well as urological and gastrointestinal function.

Complex regional pain syndrome: From diagnosis to rehabilitation

Complex regional pain syndrome(CRPS) is a debilitating pathology characterised by intense chronic pain associated with vasomotor, sensory and motor dysfunction of the affected limb. Although the pathophysiology of CRPS is not fully understood, it is recognised that inflammatory processes and autonomic dysfunction are involved. These processes are associated with peripheral and central sensitisation as well as changes in brain structure and function, and are reflected in the clinical presentation of CRPS. CRPS management requires an interdisciplinary team and requires the therapeutic approach to be individualised. With regard to pharmacological treatment, bisphosphonates, corticosteroids, ketamine and anticonvulsants have been demonstrated to be effective for CRPS management. Psychotherapy, including cognitive-behavioural therapy, has produced promising results but more studies are needed to confirm its efficacy. Among rehabilitation interventions, there is evidence of the efficacy of physiotherapy and occupational therapy in diminishing CRPS symptoms and achieving a higher level of functioning. In this regard, the rehabilitation modality that seems the most promising according to the actual literature is graded motor imagery, which can help to reverse the maladaptive neuroplasticity occurring in CRPS.

Origin of Particle Spins, Bosons and Fermions, Compounds of Zero Spin Particles, in Complex Spin Region

This paper shows： Bosons and Fermions maybe the compounds П of two zero spin particles which are spin-conjugates each other in complex region. There are two kinds of spin-conjugates of zero spin particle： real spin-conjugate （πReal,π） and imaginary spin-conjugate （πImaginary,π）. Using （πReal, π）, Bosons and Fermions of Antimatter ПR could be formed, and using （πImaginary,π）, Bosons and Fermions of Matter П1 could be formed.

Beneficial effects of hirudotherapy in a chronic case of complex regional pain syndrome

We report about hirudotherapy in a patient with chronic complex regional pain syndrome(CRPS) in the right hand. CRPS is a multifactorial disease associated with disabling pain as well as sensory and motor deficits. The optimal therapeutic management is based on personalized multimodal treatment approaches;however, hirudotherapy has not been described in the available literature. To date, we have completed five medicinal leech treatments. Altogether, hirudotherapy led to rapid and substantial relief of symptoms, especially with respect to pain intensity ratings and skin temperature asymmetries. In addition, the patient’s active and passive agility of the affected limb improved obviously.

Characterization and evolutionary dynamics of complex regions in eukaryotic genomes

Complex regions in eukaryotic genomes are typically characterized by duplications of chromosomal stretches that often include one or more genes repeated in a tandem array or in relatively close proximity. Nevertheless, the repetitive nature of these regions,together with the often high sequence identity among repeats, have made complex regions particularly recalcitrant to proper molecular characterization, often being misassembled or completely absent in genome assemblies. This limitation has prevented accurate functional and evolutionary analyses of these regions. This is becoming increasingly relevant as evidence continues to support a central role for complex genomic regions in explaining human disease, developmental innovations, and ecological adaptations across phyla. With the advent of long-read sequencing technologies and suitable assemblers, the development of algorithms that can accommodate sample heterozygosity, and the adoption of a pangenomic-like view of these regions, accurate reconstructions of complex regions are now within reach. These reconstructions will finally allow for accurate functional and evolutionary studies of complex genomic regions, underlying the generation of genotype-phenotype maps of unprecedented resolution.

Pinning-controlled synchronization of complex networks with bounded or unbounded synchronized regions

This paper studies pinning-controlled synchronization of complex networks with bounded or unbounded synchronized regions. To study a state-feedback pinning-controlled network with N nodes, it first converts the controlled network to an extended network of N＋1 nodes without controls. It is shown that the controlled synchronizability of the given network is determined by the real part of the smallest nonzero eigenvalue of the coupling matrix of its extended network when the synchronized region is unbounded; but it is determined by the ratio of the real parts of the largest and the smallest nonzero eigenvalues of the coupling matrix when the synchronized region is bounded. Both theoretical analysis and numerical simulation show that the portion of controlled nodes has no critical values when the synchronized region is unbounded, but it has a critical value when the synchronized region is bounded. In the former case, therefore, it is possible to control the network to achieve synchronization by pinning only one node. In the latter case, the network can achieve controlled synchronization only when the portion of controlled nodes is larger than the critical value.

State Support of Russian Agro-industrial Complex at the Federal and Regional Levels on Entering the Global Market

The main subject of the report consists in showing positive course of Russian agriculture over the last years-entering the global market. That＇s why it is essential to make following steps to support manufactures aiming them more actively at export： to develop export operations; to develop actively agro-industrial complex perspectives for entering the WTO; to ensure the food safety of agro-industrial complex while exporting the products; in the context of globalization Russian regions are entering more actively the global market as the relatively independent subjects of international economical relationships. The food safety of Russia-such condition of the state economy, when food independence of the country is provided, provision; physical and economic utility of food products is guaranteed by the state and corresponds to requirements of the legislation of the Russian Federation in safety and quality. Participation in the WTO gives to the country set of advantages in the decision food independence. In the world, the country and in region management of efficiency agriculture with a view of advancement to food safety, should be coordinated necessarily with food independence. State support of the Russian agro-industrial complex on the federal and regional levels when entering into the world market-is a factor of the formation of a new geopolitical status of Russia in the world arena, it is the new selection mechanism of the development of globalization processes in favor of the active participation of the agro-industrial complex of Russia in the world economy.

Chronology and Sources of Mesozoic Intrusive Complexes in the Xuzhou-Huainan Region, Central China: Constraints from SHRIMP Zircon U-Pb Dating

SHRIMP zircon U-Pb dating in the Liguo and Jiagou intrusives indicates that they were formed at -130 Ma in the Early Cretaceous. Most inherited zircons in the Liguo intrusive were formed at 2509±43 Ma. Most inherited and detrital zircons in the Jiagou intrusive were formed at -2500 Ma, -2000 Ma and -1800 Ma. The SHRIMP zircon U-Pb dating in two gneiss xenoliths from the Jiagou intrusive yields the ages of 2461±22 Ma and 2508±15 Ma, respectively. The dating results from inherited and detrital zircons in the intrusives and the gneiss xenoliths imply that the magmas could be derived from the partial melting of the basement of the North China Block (NCB). The magmatism is strong and extensive in the periods from 115 to 132 Ma, which is of typical bimodal characteristics. It is suggested that the lithospheric thinning in the eastern North China Block reached its peak in 115-132 Ma.

The complexity feature of crust-mantle boundary in Zhangbei seismic region and its tectonic implication

The ProP waveform data obtained from a deep seismic sounding profile, which ran through Zhangbei seismic region, were processed by means of both seismic wave complexity coefficient and frequency spectrum analysis methods, and the complexity characteristics of crest-mantle boundary beneath the studied area and its adjacent region were determined. The results show that the place below epicenter can be taken as boundary, the northern side of which is Inner Mongolia axis with small complexity coefficient and the southern side of which is Huai＇an basin with large complexity coefficient. The different spectrum patterns at the two sides of the epicenter were inferred from spectrum analysis. In the epicentral area, there have been multi-period magmatic eruptions since Meso-Cenozoic and craters exist at the surface. From the velocity imaging of middle and upper crust in Zhangbei seismic region it can be found that there are crustal low velocity bodies around the craters and also there are low velocity zones, which went into deep crust. It is suggested that the distinct zones of crust-mantle boundary complexity may be the margin, where the magma had intruded due to magma activity in Meso-Cenozoic. The southern side with large complexity coefficient is deep magmatic activity area and the northern side with small complexity coefficient is stable crust-mantle tectonics. The difference of crust-mantle complexity provides deep background for the development of strong earthquake.

基于自适应速度趋势函数的约束层速度反演方法

论文研究了复杂构造区初始层速度约束反演问题。首先得出初始层速度模型的精度对偏移速度建模的质量和迭代稳定尤为重要,常规方法在构造复杂区使初始速度模型产生的误差易导致最终偏移速度模型地质意义失真、真实构造特征掩盖等问题。提升初始速度模型与地下地质特征的匹配和精度成为关键。基于此,论文提出了基于自适应速度趋势函数的约束层速度反演方法。在常规方法的基础上,利用复相关法在时间域剖面上获得地质构造的连续性与变化,并将其作为构造响应算子形成针对性的影响域和权重融入速度趋势函数中,使该函数自适应地质构造特征,提升初始速度模型的精度。再通过对基准速度和速度趋势对深度的梯度进行样条拟合,构建趋势函数的全局高频异常约束,有效预防在构造突变区产生异常高频,进一步增强算法的稳健和可靠性。理论模型和实际数据的测试,验证了本文方法的有效性,反演得到的层速度模型更符合地质规律,并能更好地解决构造复杂区层速度模型的连续性问题,有利于提高复杂构造叠前深度偏移成像精度。