Microdialysis/Acupuncture Needle to Assess Local Tissue

这项研究的目的是探索使用一种由研究人员设计、制造和测试的新型微透析/针灸针灸，以确定该设备和技术是否可以成功地对软组织的化学环境进行采样。具体地说，它将被用来测量和比较三组受试者的小物质(电解质、肌肉代谢物、炎症介质、神经递质、细胞因子和花生四烯酸衍生物)的数量，使用上斜方肌的标准化解剖位置(触发点1)，该区域被认为是该肌肉中最常见的肌筋膜触发点(MTrps)位置。这些物质被认为在软组织疼痛的生化和病理生理学中起着关键作用。受试者将从不同的年龄和性别中挑选。特别选择触发点1来标准化三个精心选择的组中采样点的位置： 1)没有颈部疼痛的健康受试者，通过触发点1的双侧触诊确定没有MTrp(无病理过程，无症状)-正常 2)没有颈部疼痛的健康受试者，通过触诊上斜方肌(病理过程，无症状)之一的触发点1发现潜伏性MTP 3)健康受试者主诉持续不到3个月的颈部疼痛，通过触诊上斜方肌(病理)之一的触发点1发现活动的MTrp 有症状的进程)-活动 这不是一项治疗研究。相反，这项研究的主要目标是了解这种设备和技术是否能成功地在健康受试者中采样化学环境，这些受试者1)有疼痛，2)有MTP和那些没有，3)有活跃的MTP和那些有潜在MTP的人。 协议进度说明： 到目前为止，我们已经招募了24名受试者(14名女性和10名男性)，年龄从23岁到66岁不等。使用我们的微量分析采样技术，我们成功地在上方斜方肌触发点1处收集了每个受试者的样本，没有任何不良事件。我们已经成功地测量了9名受试者(每组3名)21个分析物中的8个。结果： 总体而言，活动组的SP、CGRP、缓激肽、5-羟色胺、去甲肾上腺素、肿瘤坏死因子-α和IL-1β的含量显著高于其他两组(p&lt；0.01)。总体而言，活动组的pH值显著低于其他两组(p&lt；.03)。在活动组，采样结束时(抽搐后)SP和CGRP的含量显著低于基线(p&lt；0.02)。结论：我们的新型微量分析技术能够直接从软组织中连续、实时地采样极少量的非常微小的物质，且系统干扰最小。PH、SP、CGRP、缓激肽、5-羟色胺、去甲肾上腺素、肿瘤坏死因子-α、IL-1β三组间差异有统计学意义。当地的生化环境似乎确实随着LTR的变化而改变。MTrp和正常肌肉生化图谱的探讨

The purpose of this study is to explore the use of a novel 'microdialysis/acupuncture' needle, designed, fabricated, and tested by the investigators, to determine if this device and technique can successfully sample the chemical milieu of the soft tissue. Specifically, it will be used to measure and compare the quantity of small substances (electrolytes, muscle metabolites, inflammatory mediators, neurotransmitters, cytokines, and arachidonic acid derivatives) in three groups of subjects using a standardized anatomical location (trigger point 1) of the upper trapezius muscle, an area that is recognized as the most common location of myofascial trigger points (MTrPs) in that muscle. These substances are believed to play a critical role in the biochemistry and pathophysiology of soft tissue pain. Subjects will be drawn from a range of ages and both sexes. Trigger point 1is selected specifically to standardize the location of a sampling point in three carefully selected groups: 1) healthy subjects without neck pain who have no MTrPs identified by palpation bilaterally in triggr point 1(no pathological process, no symptoms)- Normal 2) healthy subjects without neck pain in whom latent MTrPs are identified by palpation in trigger point 1 in one of the upper trapezius muscles (pathological process, no symptoms)- Latent 3) healthy subjects complaining of neck pain of less than 3 months duration with active MTrPs identified by palpation in trigger point 1 in one of the upper trapezius muscles (pathological process with symptoms)- Active This is not a treatment study. Rather, the primary goal of this study is to learn whether this device and technique can successfully sample the chemical milieu in healthy subjects who 1) have pain and those who don't 2) have MTrPs and those who don?t and 3) have active MTrPs versus those who have latent MTrPs. Description of protocol progress: We have thus far recruited 24 subjects (14 women and 10 men), ranging in age from 23 to 66 years old. With our microanalytical sampling technique, we have successfully collected samples at trigger point 1 in the upper trapezius muscle from each subject without any untoward events. We have successfully measured 8 of the 21 analytes in 9 (with 3 in each group) subjects. Results: Overall, the amounts of SP, CGRP, bradykinin, serotonin, norepinephrine, TNF-alpha and IL-1beta were significantly higher in the Active group than either of the other two groups (p<.01). Overall, pH was significantly lower in the Active group than the other two groups (p<.03). In the Active group, the amounts of SP and CGRP were significantly lower at the end of sampling (post twitch) than at baseline (p<.02). Conclusions: Our novel microanalytical technique enables continuous, real-time sampling of extremely small quantities of very small substances directly from soft tissue, with minimal system perturbation. There are significant differences in pH, SP, CGRP, bradykinin, serotonin, norepinephrine, TNF-alpha and IL-1beta among the three groups. The local biochemical milieu does appear to change with a LTR. Exploration of the biochemical profile of MTrPs and normal muscle may