Hyogo University of Health Sciences

To explore if Hewei Jiangni granule (, HWJNG) could regulate esophageal hypersensitivity via stromal interaction molecule 1 (STIM1)/transient receptor potential vanilloid subfamily member 1 (TRPV1) pathway.

Qualitative analysis of HWJNG was analysis by high performance of liquid and gas chromatography. In vivo, animal model of non-erosive reflux disease (NERD) was established by fructose intake and restraint stress. HWJNG and Omeprazole were administered by gavage to the drug intervention group. Reflux and visceral hypersensitivity were analyzed by pathological changes, PH value test, mechanical paw withdrawal threshold, thermal withdrawal latency and mast cells (MCs) degranulation. In vitro, substance P (SP)-induced P815 cells and dorsal root ganglion (DRG) cells were co-cultured. Expression in both mice and cells of STIM1, TRPV1, and esophageal visceral hypersensitivity-related gastrointestinal neurochemicals were validated by enzyme linked immunosorbent assays, quantitative real-time polymerase chain reaction (qRT-PCR) and Western blot. Moreover, overexpression and small interfering RNA against STIM1 were utilized to verify of the role of HWJNG in DRG cells.

HWJNG significantly suppressed intercellular space widening, injury of mitochondrial, MCs degranulation, mechanical allodynia and heat neuropathic sensory and increased pH value of esophageal mucosa in NERD mice. HWJNG inhibited expression of visceral hypersensitivity-related gastrointestinal neurochemicals in esophageal mucosa and activated P815 cells, and expression of the STIM1, TRPV1 and related neurotransmitters in DRG and DRG cells. STIM1 siRNA and HWJNG both reduced P815 cells adhesion to DRGs cells and Ca²⁺ flow into the cytoplasmic space of DRG cells. Furthermore, HWJNG could reversed STIM1 overexpression induced upregulation of TRPV1.

HWJNG suppressed intercellular space widening in NERD mice, stabilized MCs and restored neuronal hyperexcitability by regulating visceral hypersensitivity viaSTIM1/TRPV1 pathway.

This study aimed to determine whether total dietary intake assessed in the acute phase after hip fracture surgery is associated with walking ability.

The retrospective observational study.

A single institution.

Patients with hip fractures aged ≥65 years.

Dietary intake was recorded daily on an 11-point scale using visual plate waste. The primary outcome was walking ability, which was assessed using functional ambulation categories at discharge. We categorised the patients into those with improved walking ability (functional ambulation categories score ≥3) and those without (<3). Cox proportional hazard models were used to estimate hazard ratios and 95% confidence intervals for functional ambulation categories according to total dietary intake during acute hospitalisation.

In total, 182 patients were included with a median age of 85 years; 73.6% were women. The median dietary intake during the first week after surgery, the second postoperative week, and throughout the postoperative period were 24.5, 28.4, and 27.1 kcal, respectively. After adjusting for potential confounders, high total dietary intake (hazard ratio, 1.05; 95% confidence intervals, 1.02–1.09; P = .006) and high dietary intake after the second week (hazard ratio, 1.04; 95% confidence intervals, 1.01–1.08; P = .017) were associated with walking ability.

Total dietary intake was associated with walking ability at discharge during the acute postoperative period after hip fracture. Dietary intake following the second postoperative week may play a significant role in the recovery of walking ability.

Pain after a stroke interferes with daily life and the rehabilitation process. This study aimed to clarify the prognosis of pain in subgroups of patients with pain after a stroke using pain quality data.

The study included 85 patients with pain after stroke undergoing exercise-based rehabilitation. Items of the Neuropathic Pain Symptom Inventory (NPSI) were used, and patients with pain after stroke were clustered according to their scores of NPSI. Other clinical assessments, such as physical and psychological conditions, were assessed by interviews and questionnaires, and then these were compared among subgroups in a cross-sectional analysis. Longitudinal pain intensity in each subgroup was recorded during 12 weeks after the stroke and the patients’ pain prognoses were compared between subgroups.

Four distinct subgroups were clustered: cluster 1 (cold-evoked pain and tingling), cluster 2 (tingling only), cluster 3 (pressure-evoked pain), and cluster 4 (deep muscle pain with a squeezing and pressure sensation). The cross-sectional analysis showed varying clinical symptoms among the subgroups, with differences in the prevalence of joint pain, limited range of motion, somatosensory dysfunction, and allodynia. There were no significant differences in pain intensity at baseline among the subgroups. A longitudinal analysis showed divergent prognoses of pain intensity among the subgroups. The pain intensity in cluster 4 was significantly alleviated, which suggested that musculoskeletal pain could be reduced with conventional exercise-based rehabilitation. However, the pain intensity of patients in clusters 1 and 2 remained over 12 weeks.

The study classified patients into clinically meaningful subgroups using pain quality data and provided insight into their prognosis of pain. The findings could be useful for guiding personalized rehabilitation strategies for pain management.

Assessment of pain quality in patients with pain after stroke leads to personalized rehabilitation for pain management.