1.What is Raynaud’s disease (sign)? Raynaud’s disease is a group of paroxysmal peripheral arterial spasm diseases caused by vascular nerve dysfunction. Raynaud`s disease was named after the French physician Raynaud, who first reported 25 cases of episodic ischemic disease of the fingers caused by spasm of the finger arteries in 1862. Later, Hutchinson observed that Raynaud`s disease was not an independent disease, but a common symptom that could be caused by a variety of diseases, which led to the concept of “Raynaud`s phenomena”. The current naming of the disease tends to be collectively called “Raynaud`s syndrome”, which includes both primary Raynaud`s disease and Raynaud`s phenomena secondary to other systemic diseases. 2.What are the clinical manifestations of Raynaud’s disease? Raynaud’s syndrome is often triggered by cold stimulation, or emotional excitement, etc. Typical symptoms are paroxysmal “pale – cyanosis – flushing – normal” cyclic changes in the skin color of the extremities, pale, cyanotic, flushing period with The pale, cyanotic and flushed phases are accompanied by severe tingling pain in the extremities, which disappears when the skin color is normal. The symptoms are recurrent and later lead to dystrophic changes in the skin of the fingers (toes), such as ulcers or gangrene formation at the fingertips. It is common in both hands of the upper extremities, and occasionally in the lower extremities, mouth, lips and nipples. The age of onset is mostly between 20 and 30 years old, and it occurs in cold areas and cold seasons. 3.What are the causes and mechanisms of Raynaud’s syndrome? The cause of Raynaud’s syndrome is still not very clear, but it may be related to sympathetic nerve dysfunction, vascular endothelial injury, neurohormonal abnormalities, hematological abnormalities and abnormal gonadal function. Cold stimulation, emotional excitement, mental stress, and endocrine disorders are the main stimulating factors. The pathological mechanism is mainly intense spasm of small muscular and finger (toe) arteries, causing tissue ischemia (pale phase), hypoxia and metabolite accumulation (cyanotic phase), followed by vasodilation, tissue congestion and reperfusion (flushed phase), improvement of hypoxia and metabolite accumulation being taken away (return to normal). Studies have shown that the perivascular autonomic and sensory nerves, vascular endothelial cells, and vascular smooth muscle are involved in the regulation of vasodilation and contraction. The pathological mechanisms of Raynaud’s syndrome are threefold: (1) neurogenic mechanisms; (2) interaction of blood and vessel wall; (3) inflammatory abnormalities and immune response. Studies have shown that patients are often sympathetically hyperactive, and the application of sympathetic blocking agents can relieve the symptoms, so sympathetic hyperexcitation may be the main cause of the syndrome, while the latter two are often related to the secondary Raynaud’s phenomenon. 4.How to treat Raynaud’s syndrome? A.Medication: Nifedipine, reserpine, prostaglandin, warm tonic Chinese medicine. B.Surgical treatment: Patients who are not treated by internal medicine, have severe ischemic symptoms of the fingertips or cannot continue to use drugs due to the adverse effects of the drugs themselves, can be treated by surgical methods. Currently, the commonly used surgical methods include thoracoscopic upper thoracic sympathetic nerve block, chemical thoracic sympathectomy, stellate ganglion block and extra-arterial sympathectomy of sympathetic nerve endings. Surgical treatment can significantly improve the symptoms of ischemia at the end of the patient’s limbs, promote ulcer healing, relieve pain, reduce the incidence of gangrene and amputation of fingers (toes), and improve the quality of life of patients. C. Minimally invasive interventional treatment: For the main pathogenesis of Raynaud’s syndrome is the reactive spasm of small blood vessels caused by the overexcitation of thoracic sympathetic nerve, our pain department adopts the minimally invasive interventional treatment technique of “CT-guided percutaneous thoracic sympathetic nerve block” to release the overexcitation of thoracic sympathetic nerve, which has achieved good results. The advantage of this technique is that it does not require surgery, but only CT-guided fine needle puncture, which is less traumatic (only two fine needles from the back), fast effect (5 min after block injection), quick recovery (the patient can walk after removing the needles), and low cost (less than 1/2 of the cost of thoracoscopic surgery), and is expected to be the best solution for the treatment of Raynaud’s disease. D. For secondary Raynaud’s phenomenon, treat the primary disease at the same time. E. Prevention of Raynaud’s syndrome: The key to preventing Raynaud’s syndrome is to strengthen warmth measures, relieve mental stress in time, and keep a happy mood.